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[e-drug] Formulary Review (3)

E-DRUG: Formulary Review (3)


i am also editing my hospital formulary.
i think before you drop the drug, it is important to check with the relevant
previous users of the drug.

Though cetirizine may be a better non sedative antihistamine, sometimes the
sedative chlorpheniramine group drug is needed for it's sedative effects eg in 
a patient who
needs bed rest. Safety in pregnancy is also more established with the old
drug. I also know of some prescribers treating short term insomnia with
chlorpheniramine group drugs instead of zolpidem ( off label) while they figure 
out other
causative factors of insomnia.
[The older 'sedating' antihistamines are usually more effective than the newer 
non-sedating antihistamines for pruritis; Moderator]

Though azithromycin seems better and more convenient in certain
indications, sometimes users may need EES for it's prokinetic effects as it
has more studies on that. But if you do not have many bedridden inpatients
in your hospital needing prokinetics, then maybe it's ok to delete it.

I suggest to have a look at what population of patients ( paediatrics?
pregnant? very ill? etc)  normally come to your hospital, or probably have
a chat with the other medical specialties.

In our hospital we have a drugs and therapeutics committee who will review
and decide on these issues, but before the committee decides, we always
call in all heads of departments so they will have a say.

Just my two cents. Thank you
Michelle Tan Hwee Pheng
Drug Information Centre
Pharmacy Department
Universiti Kebangsaan Malaysia Medical Centre
Michelle Tan Hwee Pheng <hptan@ppukm.ukm.edu.my>

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