Feel free to contact us with any questions related to medication safety, regulatory compliance or drug acquisition.
This section will relay your questions and answers as they relate to medication management in the ambulatory surgery world.
For example:
E.Q. asks: What should we do if there is a narcotic discrepancy at the “end of day” count?
JDJ: Attempt to resolve the discrepancy by reviewing records with Anesthesia and other staff involved. If unresolved, an incident report must be completed listing all staff present that day. Forward the report to your Administrator or Director of Nursing. The Consultant Pharmacist should also be contacted. As per DEA, any theft or loss of a controlled drug substance must be reported by the facility Administrator. Refer to the DEA website below for additional instructions. Contact JDJ Consulting if you have any further questions.
Question: What is the treatment for bupivicaine toxicity?
Answer: Intralipids 20%
Contact JDJ Consulting for a copy of a protocol for treatment of bupivicaine toxicity.
Research shows that the incidence of errors with injectable medications is higher than with other forms of medications. Studies also suggest that half of all harmful medication errors originate during the drug administration phase; of those errors, about two-thirds involve injectable medications. (click on web site for complete article and contact JDJ Consulting if you have any questions.)
Web site:
http://www.ismp.org/newsletters/acutecare/articles/20071115.asp?ptr=y
Please refer to the website below for information on generic Dantrolene. Contact JDJ Consulting if you have any qustions.
Site:
The FDA has the website below which tracks all drug shortages. Please feel free to contact JDJ Consulting if you have any questions or need assistance with substitutions.
Site:
Question: What drug is used to reverse a narcotic (fentanyl) overdose?
Answer: Naloxone
Bonus Question: What drug is used to reverse a benzodiazepine (versed) overdose?
Answer: Romazicon (flumazenil)
Question: What drug is administered to treat Malignant Hyperthermia?
Answer: Dantrium (dantrolene)
Bonus Question: What is the dose?
Answer: 2.5mg/kg IV push up to a total of 10mg/kg
Federal guidelines for the proper disposal of expired drugs can be found at the web site listed below. Please remember that DEA form 41 must be completed prior to destruction of controlled drug substances. Please contact JDJ Consulting if you have any questions or concerns.
Web Site:
http://www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf