CLINICAL CORNER

Seratonin Syndrome

by Kimberly D. Griego, PharmD, RPh, CGP Serotonin is a chemical the body produces to enable communication between cells in the brain and throughout the body. New medications have been developed to increase the amount of serotonin available in the brain to help treat multiple conditions including depression. However, too much serotonin can lead to excessive nerve cell stimulation which could cause the potential for a collection of symptoms referred to as Serotonin Syndrome. Serotonin syndrome is an over-load of serotonin[...]
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Drug Recall – Levsin (Hyoscyamine sulfate) 0.125mg

Seven batches of Hyoscyamine 0.125 mg tablets, sublingual, and oral disintegrating tables have been recalled.  This recall is being initiated due to both superpotent and subpotent test results. Contract Pharmacy Services has purchased this product.  A pharmacy representative will directly contact those facilities that have current active orders to ensure the product is removed and returned to the pharmacy. If you receive medications from a source other than CPS please ensure you check your current supply and contact your pharmacy for direction. Taking[...]
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DRUG SHORTAGE – Maxipime (cefepime)

Contract Pharmacy Services is advising customers that we continue to experience a significant shortage of Maxipime (cefepime).  At this time, all wholesalers are out of stock and CPS has a very limited supply.  There is no information available regarding when this shortage may be resolved.  We ask that you consider ordering an alternative product. Cefepime 1 gm and 2 gm vials and Add-vantage are on back order. Cefepime is a 4th generation Cephalosporin. Alternatives to treat healthcare-associated pneumonia include Meropenem OR doripenem PLUS[...]
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RECALL – Liquid Products Produced by PharmaTech, LLC

PharmaTech, LLC is voluntarily recalling all liquid products manufactured from October 20, 2015 through July 15, 2016 as a precautionary measure due to a potential risk of product contamination with Burkholderia cepacia.  PharmaTech produces products that are provided by multiple companies including Bayshore, Centurion, Rugby, Major, Metron and Virtus. CPS has purchased the following products that may be affected by this recall: Rugby – Senexion Liquid 237 ml Rugby – Calcionate (Calcium Glubionate) Syrup 473 mL Rugby – Cerovite Liquid 236 mL Rugby – Vitamin[...]
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Glipizide XL 2.5 mg Tablet UNAVAILABLE

Glipizide XL 2.5 mg Tablet Contract Pharmacy Services has depleted all stock of Glipizide XL 2.5 mg Tablets.   All 4 manufactures are out of stock with no expected resolution date.  CPS does have available supply of all other strengths of Glipizide XL (5 mg and 10 mg) and Glipizide immediate release (5 mg and 10 mg).  The immediate release Glipizide is scored and can be cut if necessary. Please contact Kimberly Griego, PharmD at KGriego@contractpharmacy.com or 267-487-9033 with any questions.  
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RECALL of Diocto Liquid Docusate

PharmaTech LLC, the manufacturer of the branded product Diocto Liquid (docusate sodium solution), is recalling all lots of Diocto due to a risk of product contamination with Burkholderia cepacia.  Contract Pharmacy Services purchased limited supplies of this product in the past.  Those facilities that may have received this product will be contacted directly by CPS so that the product can be removed from active stock. If there is a chance that you have purchased this product from a source other than[...]
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Quarterly Report – Biologics for Rheumatoid Arthritis & Psoriasis

Biologic response modifiers (biologics for short) are medications that are genetically engineered from a living organism, such as a virus, gene or protein, to stimulate the body’s natural response to infection and disease.  They target proteins, cells and pathways responsible for the symptoms and damage of rheumatoid arthritis and other types of inflammatory illnesses.  The proteins targeted include tumor necrosis factor (TNF), interleukin inhibitors (IL) and T-cell activation. Biologic medications are less toxic to the liver, kidneys and bone marrow compared[...]
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Quarterly Drug Information Corner

Vaccine Update Intra Nasal Influenza Vaccine – The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) voted to recommend that the live attenuated influenza vaccine (LAIV; FluMist quadrivalent) should not be used in the United States for the 2016 to 2017 influenza season.   This is an interim recommendation, as there may be additional data obtained prior to the start of this year’s flu season. Data has shown during the last three flu seasons (2013-2014 through[...]
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UPDATE – Liquid Docusate

The Centers for Disease Control (CDC) is continuing the investigation into a multistate outbreak of infections caused by Burkholderia cepacia that may be linked to contaminated liquid docusate (Colace).  At this time, the CDC recommends that clinicians should not recommend the use of any liquid docusate products.  This recommendation has been expanded to all patient populations.  If a stool softener is needed and the patient is unable to swallow pills, an alternative would be to use a docusate 100 mg gelcap. [...]
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SHORTAGES Update

Bicillin L-A Shortage Update CPS currently has a limited supply of Bicillin L-A (penicillin G Benzathine) injection in stock.  All products are currently on backorder due to manufacturing delays.   CPS is in close contact with wholesalers regarding this shortage and it is anticipated the manufacture will be shipping product soon. Bicillin L-A is penicillinase-sensitive penicillin indicated for mild to moderate upper respiratory Streptococcus infections and syphilis.  Bicillin L-A is the recommended treatment for syphilis and is the only option for pregnant women[...]
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