Pharmacy and Therapeutics (P&T) Committee Policies

• The P&T Committee plays a critical role in ensuring safe, effective, and cost-efficient medication use in healthcare settings.

Pharmacy and Therapeutics (P&T) Committee Policies

Key policies include:

1) Formulary Management by P&T Committee

• Purpose: Maintain an approved list of medications for safe, effective, and cost-effective use.

Policies:

• Review new drugs based on clinical evidence, safety, and cost.

• Substitute costly brand drugs with generics if equivalent.

• Periodic reviews to ensure ongoing relevance.

2) Inpatient Prescription Management

• Purpose: Promote safe medication practices for inpatients.

Policies:

• Use standard order sets for common drugs.

• Set safe dose ranges for patient groups (e.g., pediatrics).

• Implement alerts for drug interactions.

3) Outpatient Prescription Management

• Purpose: Address medication needs post-discharge or in outpatient settings.

Policies:

• Limit dispensed quantities to prevent overuse.

• Set guidelines for refills.

• Provide patient counseling on drug usage and safety.

4) Automatic Stop Orders

• Purpose: Prevent unnecessary prolonged medication use.

Policies:

• Apply duration limits on certain drugs (e.g., 5 days for antibiotics).

• Require regular monitoring, with discontinuation if tests are missed.

• Allow provider override if continuation is necessary.

5) Emergency Drug List Management

• Purpose: Ensure essential drugs are available for emergencies.

Policies:

• Compile a list of necessary emergency drugs.

• Maintain adequate stock levels and monitor expiration.

• Train staff on emergency drug use and administration.

• These policies support effective and safe medication practices throughout the institution.

Here's a table summarizing commonly used emergency medications and their usual adult doses:

Drug	Usual Adult Dose	Indication
Adenosine	6 mg rapid IV push; may repeat with 12 mg	Supraventricular tachycardia (SVT)
Amiodarone	150-300 mg IV over 10 minutes	Ventricular fibrillation, VTach
Atropine	0.5 mg IV; may repeat up to 3 mg	Bradycardia
Dopamine	2-20 mcg/kg/min IV infusion	Shock, bradycardia
Epinephrine (1:10,000)	1 mg IV/IO every 3-5 mins	Cardiac arrest
Epinephrine (1:1,000)	0.3-0.5 mg IM or SC	Anaphylaxis
Glucagon	1 mg IM/IV/SC	Severe hypoglycemia when IV glucose isn't feasible
Lidocaine	1-1.5 mg/kg IV bolus	Ventricular arrhythmias
Magnesium Sulfate	1-2 g IV over 5-20 minutes	Torsades de pointes, eclampsia
Naloxone (Narcan)	0.4-2 mg IV/IM/IN; may repeat	Opioid overdose
Sodium Bicarbonate	1 mEq/kg IV bolus	Metabolic acidosis, tricyclic overdose
Vasopressin	40 units IV single dose	Cardiac arrest (alternative to epinephrine)

This table provides general guidelines; specific doses may vary depending on clinical context and patient factors.