Cedars-Sinai Medical Center

medical staff pulse newsletter

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Aug. 15, 2014 | Archived Issues

P and T Approvals, Tramadol Change, Warnings About Promacta and Sporanox

Pharmacy Focus

See highlights of the June 3 meeting of the Pharmacy and Therapeutics Committee. Also, tramadol is now being managed as a controlled substance, and the federal government has released a warning about Promacta and a list of contraindications for Sporanox.

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Meetings and Events


Grand Rounds

Click here to view upcoming grand rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - August 2014 (PDF)


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue. Click here to email us your milestones and comments.

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Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

P and T Approvals, Tramadol Change, Warnings About Promacta and Sporanox

Pharmacy Focus

Highlights of the June 3 meeting of the Pharmacy and Therapeutics Committee are summarized in the PDF link below. Also, tramadol is now being managed as a controlled substance, and the federal government has released a warning about Promacta and a list of contraindications for Sporanox.

P and T Committee Approvals - June 3, 2014 (PDF)

Tramadol Is Now Managed as a Controlled Substance

The U.S. Drug Enforcement Administration has placed tramadol (Ultram) into Schedule IV of the Controlled Substances Act. Tramadol tablets are now managed as a controlled substance throughout the medical center.

Tramadol tablets will be kept locked and secured at all times in the Pyxis medication dispensing system or in locked narcotic drawers, cabinets or boxes. For areas where tramadol tablets are not available in Pyxis, they will be dispensed and tracked on a Controlled Medication Disposition Record (CMDR) form.

For discharge prescriptions, a prescription written on secure paper or called in to a pharmacist is required before the medication can be dispensed.

If you have any questions regarding this change, please contact your pharmacist.

FDA Warns of Promacta Risk in Hepatitis C Patients

The U.S. Food and Drug Administration has warned that in patients with chronic hepatitis C, Promacta (eltrombopag) in combination with interferon and ribavirin may increase the risk of hepatic decompensation. In two controlled clinical trials in patients with chronic hepatitis C and thrombocytopenia, ascites and encephalopathy occurred more frequently on the arm receiving a treatment of Promacta plus antivirals than on the arm that received antivirals plus a placebo.

The FDA recommends discontinuing Promacta if antiviral therapy is discontinued.

For more information, click here.

Contraindications Are Listed for Sporanox

According to the FDA, co-administration of the following drugs is contraindicated with Sporanox (itraconazole) capsules:

  • Methadone
  • Disopyramide
  • Dofetilide
  • Dronedarone
  • Quinidine
  • Ergot alkaloids, such as dihydroergotamine, ergometrine (ergonovine), ergotamine and methylergometrine (methylergonovine)
  • Irinotecan
  • Lurasidone
  • Oral midazolam
  • Pimozide
  • Triazolam
  • Felodipine
  • Nisoldipine
  • Ranolazine
  • Eplerenone
  • Cisapride
  • Lovastatin
  • Simvastatin
  • Colchicine (in subjects with renal or hepatic impairment)

Co-administration with itraconazole can cause elevated plasma concentrations of these drugs and may increase or prolong the pharmacologic effects and adverse reactions to these drugs. For example, increased plasma concentrations of some of these drugs can lead to QT prolongation and ventricular tachyarrhythmias, including occurrences of torsades de pointes, a potentially fatal arrhythmia.

For more information, click here.