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July o Appropriate timing of medications for treatment of Parkinson’s Disease...p.1 o MAR Reminder...p.1 o New or Updated DAGs...p.2 2015 o Preventing Medication Errors with Barcode Scanning..p.2 o Update: Ordering TPN...p2 Brigham and Women’s Faulkner Med Thread CONNECTING DISCIPLINES THROUGH MEDICATION INFORMATION Appropriate timing of medications for treatment of Parkinson’s Disease About one-third of patients with Parkinson’s disease will visit the Emergency Room or are hospitalized each year. These patients often have complex medication schedules. For example, it is quite normal for carbidopa/levodopa to be taken every 1 to 2 hours. With such complex medication schedules it is important for hospitals to allow these patients to take their medications as they would at home. This can help minimize symptoms of the disease as much as possible during their stay. Parkinsonian symptoms such as tremor, impaired balance/posture, and muscle rigidity all greatly increase the risk of falls. Approximately threequarters of hospitalized patients with Parkinson’s disease do not receive their medications on time hospitalization. Medications such or have doses omitted entirely as haloperidol may be given to a while hospitalized. patient with Parkinson’s disease for the associated dementia and The dosage of medications used agitation. Although thought to be for treatment of Parkinson’s helpful, these medications may disease should not be abruptly cause harm. Haloperidol may reduced because this may have exacerbate the patient’s symptoms the same effect as delaying or instead of relieving them and has omitting doses. Changes to the the additional risk of falls. administration schedule of these medications may make these When patients with Parkinson’s patients uncomfortable and disease are admitted to the potentially put them at an hospital it is important that they increased risk of injury. receive their medications as close to their home schedule as It is important to understand which possible. It is also important to common medications should not avoid contraindicated medications. be prescribed to patients with These steps can reduce the risk of Parkinson’s disease because they exacerbating the patient’s could exacerbate their condition. condition which in turn may lead to One study found that one-third of falls and a longer hospital stay. all Parkinson’s patients had been prescribed at least one - Joe Braasch, MCPHS contraindicated medication during Pharmacy Student 2015 New or Updated DAGs: Check out what’s new in the Faulkner DAG library on Faulkner 411 Adenosine Heparin Preventing Medication Errors with Barcode Scanning Barcode scanning is a useful mechanism to prevent medication errors by ensuring that the correct product is being used for medication administration. Even with this system in place, mistakes can happen if one does not use proper scanning technique. 4. If the manufacturer’s barcode is unavailable, as in the case of products compounded by the BWF pharmacy, the barcode on the EPIC label should be used to document administration. Here are some helpful tips to remember to help prevent unnecessary errors in medication administration: 1. Look at the medication that is being administered. Make sure that it matches the dose and description of the product on the MAR (tablet, capsule, injection). 2. Always scan the barcode at the time of administration. This ensures that the accurate product is administered at the time of documentation. 3. Scan the manufacturer bar code if available for products to be administered. The EPIC labels come with several different barcodes on the label. These are useful for medication tracking and dispensing within the pharmacy, but should not be used during administration. To help prevent accidental scanning of the wrong label, these barcodes will now read “FOR PHARMACY USE ONLY” to serve as a reminder not to use this for scanning during administration. SCAN these barcodes NOT this barcode Using these tips can ensure the right patient receives the right medication and dose. MAR Reminder: Look for Pharmacist Verification As a reminder, medications will appear in the MAR immediately after they have been entered by the prescriber, even if they have not been verified by a pharmacist. A stop sign on the right in the MAR indicates a medication is unverified and should be verified prior to administration. Editor: Alana Gruszecki, PharmD NEXT PHARMACY AND THERAPEUTICS COMMITTEE MEETING: August 13, 2015