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Clinical changes: PCA shortage, NICOTROL, and Cefotaxime, LiquiBand

24 Jan 2016

By: Matt Tanner, pharmacist in charge, Shauna Claudio operating room nurse manager and Joseph Schabel, pharmaceutical care director


PCA shortage worsening
Pharmacy can no longer supply fentanyl PCAs. At our current utilization rate, Pharmacy will run out of morphine PCAs in mid-February and hydromorphone PCAs in mid-March. We do not anticipate this shortage will resolve before mid-April of this year. Your continued use of morphine and hydromorphone PCAs is greatly appreciated. If you have questions, contact Matt Tanner in Pharmacy or at 503-814-2048.

NICOTROl inhaler discontinued
Beginning Feb. 1, NICOTROL inhaler will no longer be available for inpatients. Nicotine gum and patches will continue to be available. The NICOTROL inhaler packages are intended for outpatient use and contain a limited number of mouthpieces. More than 50 percent of the cartridges are wasted at a cost of more than $40,000 annually. NICOTROL inhaler is a prescription product to aid in smoking cessation for the relief of nicotine withdrawal symptoms. NICOTROL inhaler therapy is recommended for use as part of a comprehensive behavioral smoking cessation program. Nicotine gum, lozenges, and patches are available over-the-counter at most pharmacies and supermarkets.

Cefotaxime is in very limited supply both at Salem Health and nationwide. Because neonates and some pediatric patients cannot tolerate ceftriaxone, Pharmacy and Therapeutics restricted the use of cefotaxime to use in NICU and pediatric patients only. For patients with SBP, please use ceftriaxone 2 grams IV q24h (see: Up To Date). If you have questions about this, please e-mail Matt Tanner, or call at 503-814-2048.

LiquiBand OCTYL
LiquiBand OCTYL has been trialed for the past month. Due to the positive response, we will be replacing Dermabond with LiquiBand OCTYL beginning the week of Jan. 25.