Jersey shore hospital

JERSEY SHORE HOSPITAL
APPROVED LIST OF THERAPEUTIC SUBSTITUTIONS
Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Angiotensin Converting
Enzyme (ACE) Inhibitors
Antacids
Antibiotics
Inhalation therapy
Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Calcium Channel Blockers
Diuretics
Grains/mg conversions
Originally, a grain was defined as the weight of a grain seed from the middle of an ear of barley. Today the inconsistencies are due to two apothecary/troy versus the more modern avoirdupois H-2 Antagonist
Ranitidine (Zantac) is the only H-2 antagonist Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Intravenous to Oral
Substitution List
Insulins
Rapid/Short acting
Intermediate acting
Long Acting ( Basal)
Premixes
Laxatives
Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Lipid Lowering Agents
NSAID Substitution List
Pain Medications
Potassium
Potassium (immediate release The potassium will be substituted on a Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Proton Pump Inhibitors
Topical Steroids/
Low Potency
Flucinolone acetonide (Synalar) 0.01% cr/soln Hydrocortisone (Hytone , Cortaid other): 0.25%, 0.5%, 1%, 2.5% Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Topical Steroids/
Medium Potency
Betamethasone dipropionate (Diprosone) Lotion 0.05%. Hydrocortisone valerate (Westcort) 0.2% cr/oint Mometasone furoate (Elocon) 0.1% cr/oint/lotion Triamcinolone (Aristocort, Kenalog) 0.025%, 0.1%, 0.5% cr,oint, aerosol Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Topical Steroids/
High Potency
Fluocinolone acetonide (Synalar) 0.2% cr Topical Steroids/
Very High Potency
Halobetasol propionate (Ultravate) 0.05% cr, oint Vitamins/Minerals
Non Formulary Drug
Approved Formulary
Comments/Medical Staff Approval
Therapeutic Equivalent
Therapeutic Substitution is the selection of a chemically different drug that is considered to be a therapeutic alternative with a comparable therapeutic effect. All therapeutic substitutions require Medical Staff approval. All Therapeutic Substitutions will be treated as a verbal order. The initiator of the action will write the order change and the physician will countersign it within 24 hours. The Physician has the option to write “do not substitute” if he/she doesn’t feel the therapeutic substitution is appropriate. Reviewed 10/2010, 3/2013

Source: http://0357c88.netsolhost.com/documents/Pharmacy/THERAPEUTIC%20SUBSTITUTION%20LIST%20MARCH%202013.pdf

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