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Drug Text

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Drug Text Enter EditDosages ...Drug Enter/EditDrug Interaction Management ...Electrolyte File (IV)Lookup into Dispense Drug FileMedication Instruction File Add/EditMedication Route File Enter/EditOrderable Item Management ...Orderable Item ReportFormulary Information ReportDrug Text Enter/EditDrug Text File ReportPharmacy System Parameters EditStandard Schedule EditSynonym Enter/Edit

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Drug Text Entry

• Use SCREEN EDITOR to edit data• Select IHS Kernel Option: TB User's Toolbox• Change my Division• Display User Characteristics• Edit User Characteristics• Electronic Signature code Edit• Menu Templates ...• Spooler Menu ...• Switch UCI• TaskMan User• User Help

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Drug Text/Enter Edit Overview

• Where does drug text enter/edit live?• PDM > DRUG TEXT ENTER/EDIT

• What format can I use?• Can copy from Excel, WORD, or Text files

• What type of information should I enter?• Conversion tables• Dosing tables• Blackbox warnings• Pregnancy guidelines

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Drug Text/Enter Edit Overview Cont…

74 Characters AND 1 line or less… 74 Characters AND 2 lines or more…

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Drug Text/Enter Edit Overview Cont….

• When processing a prescription the pharmacist also has the ability to view the Drug Text within RPMS.

• The pharmacist should answer the question, “Restriction/Guideline(s) exist. Display? : (N/O): No// O”

as YES (O) to see the same information that is also displayed to the provider in EHR.

• Orderable Item Text: CEPHALEXIN 250MG/5ML EVERY 6 HOURS

Weight (Lbs) Weight (Kg) Dose - MG Dose - ML ------------- ------------- ------------ --------------- > 11 > 5 65.5 MG 1.25 ML (1/4 TSP) 12-28 5-12.5 125 MG 2.5 ML (1/2 TSP) >28 >12.5 250 MG 5 ML (1 TSP)

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Excel Dose TableCEPHALEXIN SUSPENSION    

50MG/KG/DAY IN 4 DOSES    

    QID x 10d      

    *   *

    # OF MLS * TOTAL AMT. *

LBS KG PER DOSE * NEEDED *

9 4 1.0 * 40 *

11 5 1.3 * 50 *

13 6 1.5 * 60 *

15 7 1.8 * 70 *

18 8 2.0 * 80 *

20 9 2.3 * 90 *

22 10 2.5 * 100 *

24 11 2.8 * 110 *

26 12 3.0 * 120 *

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Entering Drug TextThis option enables you to edit entries in the DRUG TEXT file.

Select DRUG TEXT NAME: CEPHALEXIN,PEDS Are you adding 'CEPHALEXIN,PEDS' as a new DRUG TEXT (the 41ST)? No// Y (Yes)

There may be entries in your DRUG file and PHARMACY ORDERABLE ITEM file linked to this Drug Text Name. Editing information related to this Drug Text entry will affect the display of information related to these.

Do you want to review the list of drugs and orderable items linked to this DrugText entry? ? YES// NO

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Entering Drug Text (cont.)

Do you want to edit the Drug Text Name? NO//

IMPORTANT!! After editing the Drug Text Name OR Text, review the drugs and orderable items linked to this entry for accuracy.

Do you want to edit the text for this entry? YES//

TEXT: No existing text Edit? NO// YES

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Screen EditorYou are now in the Screen Editor Mode. If this is not what you have on your screen, then you may have the LINE EDITOR mode as your default. If so, you will have to back out to a menu prompt and do ^TBOX, select EDIT USER CHARACTERISTICS, use the ENTER key to move down to the PREFERED EDITOR: type in SCREEN EDITOR. ENTER down to the COMMAND LINE: then ^, and answer YES to the SAVE CHANGES BEFORE LEAVING FORM QUESTION.

This is an example of what the Screen Editor Screen will look like.

==[ WRAP ]==[ INSERT ]====< TEXT >=====[ <PF1>H=Help ]

TEXT INFORMATION IS ENTERED HERE

=<=======T=======T=======T=======T========T>======

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ENTERING DRUG TEXT:

TEXT EDITOR, SUMMARY OF KEY SEQUENCES

Navigation

Incremental movement Arrow keysOne word left and right <Ctrl-J> and <Ctrl-L>Next tab stop to the right <Tab>Jump left and right <PF1><Left> and <PF1><Right>Beginning of line <PF1><PF1><Left>End of line <PF1><PF1><Right> or: <Find> and <Select> or: <Home> and <End>

Screen up or down <PF1><Up> and <PF1><Down> or: <Prev Scr> and <Next Scr> or: <Page Up> and <Page Down>

Top or bottom of document <PF1>T and <PF1>BGo to a specific location <PF1>G

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Exiting/Saving Exit and save text <PF1>E Quit with optional save <PF1>Q or <Ctrl-E> Exit, save, and switch editors <PF1>A Save without exiting <PF1>S Enter minutes for AutoSave <PF1><PF1>S Deleting Character before cursor <Backspace> Character at cursor <PF4> or <Remove> or <Delete> From cursor to end of word <Ctrl-W> From cursor to end of line <PF1><PF2> Entire line <PF1>D

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Tab Setting

• To set the Tabs for your entry:• Count the number of characters in the individual columns

and use these numbers to set the Tab stops. Add 1-2 additional spaces to make the entry easier to read.

• From the above Cephalexin EXCEL worksheet, the first Tab would be at 4, the second at 8, third at 19, and fourth at 22.

=<===T===T==========T==T=======================>===== 4 8 19 22LBS / KG / # OF MLS / * / NEEDED(3+1) 3+1) ( 9+2)(1+2)

• Adjust each Drug Text entry based on the number of characters per line and the Tab stops needed.

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Copy to Editor Form

• The next step is to Drag and Copy the work sheet, and paste it into the SCREEN EDITOR form

• Use the Screen Editor to move items or adjust tabs or margins

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ExamplesDRUG TEXT NAME: ACETAMINOPHEN CHEWABLE PEDIATRDRUG TEXT:

ACETAMINOPHEN CHEWABLE DOSING CHART80MG/TABLET 10-15MG/KG/DOSE

LB(S) KG MG #TABS 6-11 LBS 3-5 KG 40MG 1/2 TABLET12-17 LBS 6-8 KG 80MG 1 TABLET18-23 LBS 9-11 KG 120MG 1 & 1/2 TABLETS24-35 LBS 12-16 KG 160MG 2 TABLETS36-47 LBS 17-21 KG 240MG 3 TABLETS48-59 LBS 22-27 KG 320MG 4 TABLETS60-71 LBS 28-32 KG 400MG 5 TABLETS

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ACETAMINOPHEN ELIXIR 160MG/5ML PEDIATRIC DOSING CHART Q46H prn

Wt in LBS Wt in KG Dose in MG Dose in ML(s) ----------------------------------------------------------------------------- 6-11 LBS 3-5 KG 40MG 1.25ML 12-17 LBS 6-8 KG 80MG 2.5ML 18-23 LBS 9-11 KG 120MG 3.75ML 24-35 LBS 12-16 KG 160MG 5ML 36-47 LBS 16-21 KG 240MG .5ML 48-59 LBS 21-27 KG 320MG 10ML 60-71 LBS 27- 32 KG 400MG 12.5ML

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DRUG TEXT NAME: MEVACOR-ZOCOR-LIPITOR DOSING DRUG TEXT: The following chart provides selected HMG CoA reductase inhibitors and the adult dosage range for primary therapeutic indications: GENERIC BRAND DRUG NAME NAME (US) DOSAGE RANGE* (mg) =============== ============ ===================== Atorvastatin Lipitor 10 to 80 mg PO QD Fluvastatin Lescol 20 to 80 mg PO QD Fluvastatin XL Lescol 80 mg PO QD Lovastatin Mevacor 20 to 80 mg PO QD Pravastatin Pravachol 10 to 40 mg PO QD Simvastatin Zocor 10 to 40 mg PO QD ----------------------------------------------------- Key: * = patients receiving cyclosporine, fibrates, or niacin, or patients with

renal insufficiency may require lower doses. PO = orally QD = daily REFERENCES: 1. Hutchison TA & Shahan DR (Eds): DRUGDEX(R) System. MICROMEDEX, Inc. Englewood, Colorado (Edition expires 12/2000).

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OTITIS MEDIA Treatment AMOXICILLIN CLAVULANATE (Augmentin) Usual dose for otitis media/sinusitis: 40 mg/kg/day (amoxicillin component) in divided doses every 8 hours, with meals.

(Dose range: 20-40 mg/kg/day) Example: Augmentin "250" suspension Supplied as: 10 kg (22 lbs.) 1/2 tsp q 8 h 75 ml bottle: 10 days 15 kg (33 lbs.) 3/4 tsp q 8 h 100 ml bottle: 10 days 20 kg (44 lbs.) 1 tsp q 8 h 150 ml bottle: 10 days 40 kg and over adult doses Alternative twice daily dosing: Usual dose: 45 mg/kg/day (amoxicillin component) in divided doses every 12 hours, with meals (Dose range: 25-45 mg/kg/day)

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The Crow Service Unit P&T committee has selected Lovastatin as our first line drug. Patients need to be on a dose for 4-6 weeks to determine effect. After failure with Lovastatin the next drug to try is Simvastatin. Atorvastatin is be used only after treatment failures or documented side effects with Lovastatin and Simvastatin.

The following chart provides selected HMG CoA reductase inhibitors and the adult dosage range for primary therapeutic indications:

GENERIC BRAND DRUG NAME NAME (US) DOSAGE RANGE* (mg) =============== ============ ===================== Atorvastatin Lipitor 10 to 80 mg PO QD Fluvastatin Lescol 20 to 80 mg PO QD Fluvastatin XL Lescol 80 mg PO QD Lovastatin Mevacor 20 to 80 mg PO QD Pravastatin Pravachol 10 to 40 mg PO QD Simvastatin Zocor 10 to 40 mg PO QD STATIN DOSE EQUIVENCY TABLE Potency Rating Expressed in MGs Generic Name Brand Name 1 2 3 4 5 Atorvastatin Lipitor 10 20 40 Fluvastatin Lescol 20 40 80 Lovastatin Mevacor 10 20 40 80 Pravastatin Pravachol 10 20 40 Simvastatin Zocor 5 10 20 40 80

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Questions?