Pharmacy Things to Know: Difference between revisions

From Guide to YKHC Medical Practices

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'''How to find magic mouthwash''': You can search magic mouthwash under Diphenhyd – you may wish to spell out what he individual compound and the options ie with or without lidocane (villages only have it without lidocaine). Other ways to find it are to search for “FIRST” (the brand name) or “BLM” (the components Benadryl/lidocaine/maalox)
===How to find magic mouthwash===
You can search magic mouthwash under Diphenhyd – you may wish to spell out what he individual compound and the options ie with or without lidocane (villages only have it without lidocaine). Other ways to find it are to search for “FIRST” (the brand name) or “BLM” (the components Benadryl/lidocaine/maalox)


'''Thick it order—How to get more for family''': Send a message to the case manager, who will give you the Certificate of Medical Necessity already filled out. If not available that day, find an experienced pediatrician to locate one for you.
===Thick it order—How to get more for family===
Send a message to the case manager, who will give you the Certificate of Medical Necessity already filled out. If not available that day, find an experienced pediatrician to locate one for you.


'''Loratidine use''': Loratadine is for children under 18 or elders over 65 only. The only indications are allergic rhinitis or chronic urticarial
===As Indicated On Presciptions===
Always order one time medications as "As Indicated" not "Once."  (for example, epipens and Diastat.)  If you order it "once," it is no longer an active medication, it will not show on patient discharge information and future providers will not be able to re-order. Any refills placed on "once" orders are not valid or active, thus will not be seen in pharmacy.  If in the ED, the medication cannot be pulled from PickPoint for discharge meds.


'''Always use 10 days of antibiotics for all peds patients'''. This will keep therapy standardized with less chance of mistakes. It also follows the CHAM protocols.
===Acute vs Maintenance===  
 
Discharge medications default to "Maintenance."  All antibiotics and short term medications should be ordered as "acute."  This will allow "acute" medications to "fall off" of the medication list once the course is complete.
On Presciptions, always order one time medications as "As Indicated" not "Once."  (for example, epipens and Diastat.)  If you order it "once," it is no longer an active medication, it will not show on patient discharge information and future providers will not be able to re-order.  Any refills placed on "once" orders are not valid or active, thus will not be seen in pharmacy.  If in the ED, the medication cannot be pulled from PickPoint for discharge meds.
 
Acute vs Maintenance: Discharge medications default to "Maintenance."  All antibiotics and short term medications should be ordered as "acute."  This will allow "acute" medications to "fall off" of the medication list once the course is complete.


===Retail Pharmacy===
You can click on "Retail Pharmacy" in the the Electronic Health Record side menu to see if any medication refills exist and the last time it was refilled.
You can click on "Retail Pharmacy" in the the Electronic Health Record side menu to see if any medication refills exist and the last time it was refilled.


==="per CHAM"===
Do NOT use "per CHAM" during health aide visits.  Enter the chart and order every medication on the PowerPlan proposed by the Health Aide unless mailing/hand carry from YKHC Main Pharmacy.
Do NOT use "per CHAM" during health aide visits.  Enter the chart and order every medication on the PowerPlan proposed by the Health Aide unless mailing/hand carry from YKHC Main Pharmacy.


===RMT IM medications===
When giving IM medications to children over RMT, verify concentration of the medication they have and give the Health Aide the number of mg and mL you want them to give, especially for morphine and benzos.  When writing instructions in the RMT addendum, put the mg and mL amount first, then in parentheses the mg/kg.  If you put the mg/kg first, the Health Aide may accidentally misinterpret this as the dose (e.g. Dexamethasone vial 10mg/1mL 7mg or 0.7mL (0.6mg/kg) rather than Dexamethasone vial 10mg/1mL 0.6mg/kg (7mg or 0.7mL).  '''ALWAYS VERIFY THE CONCENTRATION!'''
When giving IM medications to children over RMT, verify concentration of the medication they have and give the Health Aide the number of mg and mL you want them to give, especially for morphine and benzos.  When writing instructions in the RMT addendum, put the mg and mL amount first, then in parentheses the mg/kg.  If you put the mg/kg first, the Health Aide may accidentally misinterpret this as the dose (e.g. Dexamethasone vial 10mg/1mL 7mg or 0.7mL (0.6mg/kg) rather than Dexamethasone vial 10mg/1mL 0.6mg/kg (7mg or 0.7mL).  '''ALWAYS VERIFY THE CONCENTRATION!'''


===Multivitamins===
If you are having difficulty finding this, type "Multiple" or "animal" in the prescription search.
===Dosing Calculator===
The dosing calculator is designed to round up.  Pay attention to dosing once you click "apply standard dose," sometimes you will get 6.88mL.  Please, change this to something reasonable.  Medication syringes do not always mark one tenth, so consider rounding to 1/2 mL amounts.
===Prescribing Augmentin and Septra===
When prescribing Augmentin and Septra, EHR is unable to differentiate between the two drugs contained in the medication, thus mLs will not be calculated by EHR or printed on the prescription.  When prescribing these two meds, free text number of mL into the "Special Instructions" box.  Augmentin is dosed by Amoxicillin and Septra is dosed by Trimethoprim
===Dosing Ranges===
EHR is unable to have dosing ranges, therefore YKHC has set order sentences to specific doses (e.g. tylenol dosing in 10-15mg/kg and YKHC sentences are set at 15mg/kg).  This can be changed manually to fall within the range.
===Medication Dosing===
Many resources provide dosing in weight per day (e.g. Amoxicillin 80-100mg/kg/day div BID).  When ordering in EHR, make sure to calculate mg/kg/dose (e.g. Amoxicillin 45mg/kg/dose BID).


===[[How to remove an allergy banner]] on YKHC Electronic Health Record===
===[[How to remove an allergy banner]] on YKHC Electronic Health Record===

Revision as of 23:03, 10 November 2020

How to find magic mouthwash

You can search magic mouthwash under Diphenhyd – you may wish to spell out what he individual compound and the options ie with or without lidocane (villages only have it without lidocaine). Other ways to find it are to search for “FIRST” (the brand name) or “BLM” (the components Benadryl/lidocaine/maalox)

Thick it order—How to get more for family

Send a message to the case manager, who will give you the Certificate of Medical Necessity already filled out. If not available that day, find an experienced pediatrician to locate one for you.

As Indicated On Presciptions

Always order one time medications as "As Indicated" not "Once." (for example, epipens and Diastat.) If you order it "once," it is no longer an active medication, it will not show on patient discharge information and future providers will not be able to re-order. Any refills placed on "once" orders are not valid or active, thus will not be seen in pharmacy. If in the ED, the medication cannot be pulled from PickPoint for discharge meds.

Acute vs Maintenance

Discharge medications default to "Maintenance." All antibiotics and short term medications should be ordered as "acute." This will allow "acute" medications to "fall off" of the medication list once the course is complete.

Retail Pharmacy

You can click on "Retail Pharmacy" in the the Electronic Health Record side menu to see if any medication refills exist and the last time it was refilled.

"per CHAM"

Do NOT use "per CHAM" during health aide visits. Enter the chart and order every medication on the PowerPlan proposed by the Health Aide unless mailing/hand carry from YKHC Main Pharmacy.

RMT IM medications

When giving IM medications to children over RMT, verify concentration of the medication they have and give the Health Aide the number of mg and mL you want them to give, especially for morphine and benzos. When writing instructions in the RMT addendum, put the mg and mL amount first, then in parentheses the mg/kg. If you put the mg/kg first, the Health Aide may accidentally misinterpret this as the dose (e.g. Dexamethasone vial 10mg/1mL 7mg or 0.7mL (0.6mg/kg) rather than Dexamethasone vial 10mg/1mL 0.6mg/kg (7mg or 0.7mL). ALWAYS VERIFY THE CONCENTRATION!

Multivitamins

If you are having difficulty finding this, type "Multiple" or "animal" in the prescription search.

Dosing Calculator

The dosing calculator is designed to round up. Pay attention to dosing once you click "apply standard dose," sometimes you will get 6.88mL. Please, change this to something reasonable. Medication syringes do not always mark one tenth, so consider rounding to 1/2 mL amounts.

Prescribing Augmentin and Septra

When prescribing Augmentin and Septra, EHR is unable to differentiate between the two drugs contained in the medication, thus mLs will not be calculated by EHR or printed on the prescription. When prescribing these two meds, free text number of mL into the "Special Instructions" box. Augmentin is dosed by Amoxicillin and Septra is dosed by Trimethoprim

Dosing Ranges

EHR is unable to have dosing ranges, therefore YKHC has set order sentences to specific doses (e.g. tylenol dosing in 10-15mg/kg and YKHC sentences are set at 15mg/kg). This can be changed manually to fall within the range.

Medication Dosing

Many resources provide dosing in weight per day (e.g. Amoxicillin 80-100mg/kg/day div BID). When ordering in EHR, make sure to calculate mg/kg/dose (e.g. Amoxicillin 45mg/kg/dose BID).

How to remove an allergy banner on YKHC Electronic Health Record

  • Click the allergy on the banner bar.
  • Select the allergy and click Modify.
  • Change the status from “active” to “cancelled.” In the next box, choose a reason like “OK on retrial.”
  • Click Apply and Okay.
  • Done!

category:Pediatrics

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