TOP 50 IV drugs

[feelit83]

Do you guys know where i can find a credible source that lists the top used/selling IV drugs used in the hispital setting.

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[Epic]

Wholesalers or GPOs may have the list.

But I would think Normal Saline and/or D5 1/2 NS with 20meq KCL should be on the list...

 

[pharmacogenomic]

I'm also guessing ms, fentanyl or hydromorphone is on there too.

Either promethazine or prochlorperazine as well.

Can't forget one of the many cephalosporins.....that will depend on the hospital mix.

What possible purpose can this list serve?

 

[njac]

I'm also guessing ms, fentanyl or hydromorphone is on there too.

Either promethazine or prochlorperazine as well.

Can't forget one of the many cephalosporins.....that will depend on the hospital mix.

What possible purpose can this list serve?

this summer I was trying to get a list of the most popular meds in the hospital where I was on rotation from the purchaser so I could research if any of them needed different dosing in obese patients... but the drugs with the largest quantites ordered were basically APAP and NS.

 

[feelit83]

guys, i need the top 50 not just 2 drugs, lol.

I just called Mckesson, and they have to research it too. They should know the top 50 dont you think! They deal with every drug known to mankind!

 

[pharmacogenomic]

guys, i need the top 50 not just 2 drugs, lol.

I just called Mckesson, and they have to research it too. They should know the top 50 dont you think! They deal with every drug known to mankind!

Well.....think about it a bit more. The top 50 "purchased"? If using that parameter, then APAP may or may not be there - its cheap (its also not IV....but....). But, lets take an IV drug which is similar - morphine. Its purchased frequently (in my hospital one strength or another is delivered 6 days out of 7), but it is inexpensive. So, it won't appear on you list if you are looking at expenditures. Likewise, we purchase it in about 10 different IV formulations....so, that skews your list. It is dosed frequently, if you are looking at the numbers of doses given per time frame. However, one hospital may choose to not carry the 4mg MS syringes, but will use 2x2mg for each 4mg dose. The dose is 4mg....but the product size is 2mg.

Now, if you're looking at the top 50 "selling" - as in pt charges? Now...you have real funny numbers. That liter of NS (with or without K) costs the hospital very little since the costs are tied up with the tubing. The contract for that is bundled with the pumps, fluids & tubings. Likewise, most narcotic contracts are bundled as well.

Are you looking at the most frequently "dosed" drugs - it would be more likely heparin lock flushes (or....rather saline flushes since heparin flush has gone out of favor). But, those are very inexpensive drugs.

So - a drug may be in the top 50 because of its cost or its frequency of use or patient charge - they are give you different information.

If your purpose is similar to what njac's was, then you'd want to limit your search to drugs which are distributed in adipose tissue then find how frequently those drugs are ordered (which means each pt who received that drug = 1 order.) If your drug search results in the drug being ordered in only 1 pt per week, month, whatever time frame....then you have a more directed set of numbers.

Let us know what your purpose is - budgetary review, DUR (what njac was doing), just curiousity........then it won't be so difficult. At this point, your search criteria is too broad.

 

[tussionex]

guys, i need the top 50 not just 2 drugs, lol.

I just called Mckesson, and they have to research it too. They should know the top 50 dont you think! They deal with every drug known to mankind!

i agree...you need to narrow your criteria. do you want the top fifty ordered, dispensed, by cost...?

mckesson as in your wholesaler or as in your pharmacy system vendor?

 

[feelit83]

The top 50 Dispensed in hospital is what im looking for.

I really appreciate your help guys.



Ugh this assignment is ******ed. this rotation is such B&**Sh**t

 

[pharmacogenomic]

The top 50 Dispensed in hospital is what im looking for.

I really appreciate your help guys.



Ugh this assignment is ******ed. this rotation is such B&**Sh**t

Again - clarification!

Dispensed doses??? So, if a pt is post op & nauseous & get 3 promethazine doses or has pain & gets 6 hits on the ms pca - is that what you're looking for?

If so - look at analagesics (ms, fentanyl, hydromorphone) or antiemetics (promethazine, prochoperazine).

We have gone to the longer acting antibiotics which are dosed once or twice a day (not the q4h pcn of my day) so those won't appear.

Likewise, pressors or drugs to lower pressure (dopamine, nipride, nit, etc) won't show up because like NS with K - they last a long time (you have to run an IV at a fast clip if you go thru a liter in an hour or two - go see your ER or OR for rescuc. records for that).

But, for run of the mill IV drugs, it will be ns flushes, analgesics & antiemetics. Not much of interest there IMO.

 

[pharmacogenomic]

One last comment - whoever gave this assignment to a pharmacy student is devising a "makework" assignement.

Perhaps Epic can give a different spn to it if he ever gets off the "tables" or the golf course.

But, this is the random nonsense which is spewed out by people who have no idea what really goes on in a hospital, IMO!

 

[tussionex]

One last comment - whoever gave this assignment to a pharmacy student is devising a "makework" assignement.

Perhaps Epic can give a different spn to it if he ever gets off the "tables" or the golf course.

But, this is the random nonsense which is spewed out by people who have no idea what really goes on in a hospital, IMO!

agreed.

however, if dispensed doses are what the OP is looking for...how 'bout asking mckesson to query that out of the dose history/dispense history tables?
still sounds like "busy work", but it can be a good lesson in database structure!

 

[Epic]

Do you guys know where i can find a credible source that lists the top used/selling IV drugs used in the hispital setting.

I am going to help you just because the person who gave you this assignment is a mocking foron. But you'll have to wait until I get home..so I can send you a spread sheet list of monthly drug dispense of some of my hospitals. But you'll have to pick out which drugs are IVs...

PM your email addy to me.

 

[pharmacogenomic]

I am going to help you just because the person who gave you this assignment is a mocking foron. But you'll have to wait until I get home..so I can send you a spread sheet list of monthly drug dispense of some of my hospitals. But you'll have to pick out which drugs are IVs...

PM your email addy to me.

Now this is one very, very nice guy! See feelit, there are some really nice pharmacists around. He's got the ability to let loose with the #'s that tuss & I can't.

Now you can get something out of this assignment - look at Epics spreadsheets - what does he see? what can a dop hide if he wants & what can't he hide, no matter how long he talks?

 

[feelit83]

thanks i really appreciate it epic. im seriously struggling with this.

 

[Epic]

Now this is one very, very nice guy! See feelit, there are some really nice pharmacists around. He's got the ability to let loose with the #'s that tuss & I can't.

Now you can get something out of this assignment - look at Epics spreadsheets - what does he see? what can a dop hide if he wants & what can't he hide, no matter how long he talks?

Me..a nice guy? You best stop it....giving me a bad reputation...

 

[Epic]

thanks i really appreciate it epic. im seriously struggling with this.

Aren't you lucky...you struggle will soon end. I sent you a spread sheet. And I'm still in Vegas..

You owe us a report... of how it went.

 

[tussionex]

i say let the OP query it out!

nah....j/k!

but you do owe us a report of how this goes and why some ***** is asking for that information!

 

[Epic]

Interesting... here is an abbreviated list

0.9% NaCl... combined saline flush to 1 liter bag
Ondansetron 4mg/2ml
D5W
Protonix IV
D5/.45% NaCl
Flagyl 500mg
Reglan 10mg
Zosyn 3.375g
Vancomycin 1gram
Solumedrol 40mg

 

[humira49]

Interesting... here is an abbreviated list

0.9% NaCl... combined saline flush to 1 liter bag
Ondansetron 4mg/2ml
D5W
Protonix IV
D5/.45% NaCl
Flagyl 500mg
Reglan 10mg
Zosyn 3.375g
Vancomycin 1gram
Solumedrol 40mg

odd - ondansetron & protonix. No h2 blocker, all proton pump inhibitors? Has this hospital dropped the promethazine/prochlorperazine option ....is it not on a standardized order (ie pca standard order?).

Also, still lots of reglan.....again odd. Is that OR or L&D?

Finally, Flagyl 500mg IV, really? or metronidazole 500mg IV. Do they culture every case of diarrhea & therefore have to treat?

I wouldn't have guessed this list for sure!

 

[rxforlife2004]

Top 50 IV? Heck, i'll show u what i think most common at my hospital
Pain:
Demerol
MOrphine sulfate
Dilaudid
Vistaril
Versed
Antibotics:
Ancef
Flagyl
Clindamycin
Azithromycin
Unasyn
ZOsyn
Primaxin
Vancomycin
Genta/Amikacin/Tobra
Levaquin
Zyvox
Antifungal:
Cancidas
Amphotericin B
Others:
Benadryl
Compazine
Narcan
Phenergan
many more....

 

[Epic]

odd - ondansetron & protonix. No h2 blocker, all proton pump inhibitors? Has this hospital dropped the promethazine/prochlorperazine option ....is it not on a standardized order (ie pca standard order?).

Also, still lots of reglan.....again odd. Is that OR or L&D?

Finally, Flagyl 500mg IV, really? or metronidazole 500mg IV. Do they culture every case of diarrhea & therefore have to treat?

I wouldn't have guessed this list for sure!

c'mon... you know H2 blocker went away when Wyeth dropped the price Protonix inj... and with a recent black box warning for promethazine, the use has plummetted. Not sure why reglan use is high... But I like the idea of high Metronidazole IV... Rarely you will see a new antibiotic with anaerobic coverage run a trial against flagyl....because flagyl in combo with a cephalosporin will be much superior than other drugs..inlcuding penems.

 

[Epic]

Top 50 IV? Heck, i'll show u what i think most common at my hospital
Pain:
Demerol
MOrphine sulfate
Dilaudid
Vistaril
Versed
Antibotics:
Ancef
Flagyl
Clindamycin
Azithromycin
Unasyn
ZOsyn
Primaxin
Vancomycin
Genta/Amikacin/Tobra
Levaquin
Zyvox
Antifungal:
Cancidas
Amphotericin B
Others:
Benadryl
Compazine
Narcan
Phenergan
many more....

Good try... but every one of those IVs will require flushing with saline.. sometimes twice.. so saline will be the most used IV. I hope you're not using that much ampho, cancidas, and zyvox... and Demerol..

 

[psychoandy]

Where are the cephalosporins other than ancef? We tear through way more ceftriaxone/cefepime/ceftazidime compared to say, iv zithromax or zyvox. Plus, by most dispensed, wouldn't ampi be up there as well?

At my hospital almost every floor stocks vanco, zantac, and ancef, so those are easily the fastest movers other than hydration bags. If we're counting lytes, bicarb and mag bags are super popular as well.