Page 41 - Christiana Care Focus

Treatment of metastatic cutaneous squamous cell carcinoma (CSCC) or locally advanced CSCC in patients who are not candidates for curative surgery or curative radiation.
Treatment of:
1. Newly diagnosed acute myeloid leukemia (in combination with azacitidine, decitabine, or low-dose cytarabine) in patients ≥75 years of age or in patients with comorbidities that preclude use of intensive induction chemotherapy.
2. Chronic lymphocytic leukemia or small lymphocytic lymphoma in adult patients with or without 17p deletion who have received at least one prior therapy.
3. High-risk myelodysplastic syndrome.
• Approved for labeled indications only.
• Prescribing limited to oncologists.
• Availability for administration limited to Christiana Care- owned ambulatory oncology infusion sites.
• Approved for labeled indications and high-risk myelodysplastic syndrome only.
• Prescribing limited to hematologists and oncologists.
| Pharmacy Services
Formulary Update |
Medication – Generic/Brand Name
Cemiplimab-rwlc injection/Libtayo
Venetoclax/Venclexta
May 2019
Strength/Size
350 mg/7 mL 7-mL vial
10 mg, 50 mg and 100 mg tablets
Use/Indication Comment
Bupivacaine liposome injection/ Exparel®
High-dose insulin standard concentration
High-dose insulin infusion medication level
B E S T P R A C T I C E
Q. What does LASA mean?
The availability of bupivacaine liposome injection has been expanded to include use for interscalene blocks at all Christiana Care sites, as well as joint replacement procedures at Christiana Hospital and Wilmington Hospital.
A second standard concentration of 2,500 units of regular insulin in 250 mL (10 units/mL) of 0.9% sodium chlo- ride (NS) has been approved for treatment of beta blocker or calcium channel blocker toxicity. A concentration of 100 units of regular insulin in 100 mL of NS (1 unit/mL) is the standard concentration for other indications.
An intravenous insulin product containing 2,500 units of regular insulin in 250 mL of NS is a Level 1 medication for the purpose of administration.
R E V I E W : Look-Alike and Sound-Alike Medications . Q. What is TallMan lettering?
A. LASA stands for Look-Alike-Sound-Alike medications.
Q. Why are some drugs designated as Look-Alike- Sound-Alike or LASA?
A. LASA medications have similar drug names, packaging or pronunciation. These similarities create a high potential to cause drug errors.
Q. Why are Look-Alike-Sound-Alike or LASA labels placed on medications?
A. Labeling medications and pharmacy medication bins with LASA labels helps call out the potential for confusion in order to minimize medication errors.
Example: hydroxizine versus hydralazine – this LASA pair gets confused very easily even though they have very different uses.
If you have questions, contact Dean Bennett at 302-733-3039 or 302-733-3584, or call the Safety Hotline, 7233 (SAFE) from within Christiana or Wilmington hospitals. From outside, call 302-623-7233 (SAFE).
A. TallMan lettering is a strategy to prevent LASA errors.
We use a combination of upper-case and lower-case letters to highlight the difference in LASA medication names in our clinical systems, printed order sets, and Pharmacy dispensing labels to draw attention to the potential for a LASA error.
Example: levoFLOXacin versus levothyROXine
Q. What are other strategies to help prevent LASA errors?
A. • Reduce LASA drugs on the formulary, when possible.
• Physically separate two LASA drugs (known as “a problematic pair”) in storage areas or in separate drawers in AcuDose cabinets.
• Use the generic name as the primary name and add brand names in CPOE, PowerChart, AcuDose and labels where possible. 
FOCUS • SUMMER 2019 39
ADDITION
MEDICATION POLICY CHANGES