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INTERN MEDICATION GUIDE INTERN MEDICATION GUIDE 2020 Updated by A Given, Pharmacy December 2019 Page 1 INTERN MEDICATION GUIDE Table of Contents: Table of Contents: .......................................................................................................................................... 2 PHARMACY CONTACT NUMBERS ............................................................................................................... 4 MEDICATION MANAGEMENT PLAN ............................................................................................................. 5 ADULT NATIONAL INPATIENT MEDICATION CHART (NIMC) ...................................................................... 6 Background Rationale ............................................................................................................................ 6 Overview ................................................................................................................................................ 6 Patient Identification ............................................................................................................................... 7 Allergies & Adverse drug reactions (ADR) .............................................................................................. 7 Numbering of medication charts ............................................................................................................. 8 Venous Thromboembolism (VTE) prevention .......................................................................................... 8 Regular Medication Orders ..................................................................................................................... 9 Frequency (Guidance Only) .................................................................................................................. 10 Approved Abbreviations ....................................................................................................................... 10 Prescriber identification: ....................................................................................................................... 11 Variable Dose Medications ................................................................................................................... 12 Warfarin dosing .................................................................................................................................... 12 When required (PRN) medication orders .............................................................................................. 13 Stat Dose Orders ................................................................................................................................. 13 Phone Orders ....................................................................................................................................... 13 Ceasing Medication Orders .................................................................................................................. 14 Limited Duration Medication Orders ...................................................................................................... 15 Less than daily administration............................................................................................................... 15 Re-writing Medication Charts ................................................................................................................ 15 HIGH DOSE OPIATES/INSULIN .................................................................................................................. 16 INTRAVENOUS THERAPY ORDER CHART ................................................................................................ 17 OTHER MEDICATION CHARTS .................................................................................................................. 18 DISCHARGE PRESCRIPTIONS ................................................................................................................... 19 What needs to be included: .................................................................................................................. 20 Drugs of Addiction (DA) ........................................................................................................................ 21 PHARMACEUTICAL BENEFITS SCHEME (PBS) ......................................................................................... 21 Authority PBS prescriptions .................................................................................................................. 21 PBS website ......................................................................................................................................... 23 TNH MEDICATION GUIDE ........................................................................................................................... 25 Prescribing Unfamiliar Medications ....................................................................................................... 25 Other documents/forms you may be asked to complete: ....................................................................... 25 ANTIMICROBIAL STEWARDSHIP PROGRAM ............................................................................................ 26 Antibiotic Guidance (iGuidance) ........................................................................................................... 26 The Direct Oral Anticoagulants (DOACs) .............................................................................................. 27 Page 2 INTERN MEDICATION GUIDE ANTIBIOTIC PRESCRIBING GUIDELINES BY CONDITION ........................................................................ 28 Sepsis of unclear focus ........................................................................................................................ 28 Vancomycin dosing .............................................................................................................................. 28 Acute Cystitis ....................................................................................................................................... 29 Catheter-associated UTI ....................................................................................................................... 29 Pyelonephritis ...................................................................................................................................... 29 Prostatitis ............................................................................................................................................. 30 Cellulitis ............................................................................................................................................... 30 Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) ........................................................ 30 Community Acquired Pneumonia.......................................................................................................... 31 Aspiration Pneumonia .......................................................................................................................... 31 Hospital Acquired Pneumonia............................................................................................................... 32 Peritonitis due to perforated viscus ....................................................................................................... 32 Acute cholecystitis ................................................................................................................................ 33 Ascending cholangitis ........................................................................................................................... 33 Acute Appendicitis ................................................................................................................................ 33 Acute diverticulitis................................................................................................................................. 33 Acute pancreatitis ................................................................................................................................. 34 Infected pancreatic necrosis / pancreatic abscess ................................................................................ 34 GENERAL SURGICAL UNIT ANTIBIOTIC PROPHYLAXIS GUIDE ...................................................... 34 HANDY MEDICATION GUIDES ................................................................................................................... 35 Endocrinology ...................................................................................................................................... 35 End of Life Care ................................................................................................................................... 35 Vascular Device Protocols ............................................................................................................................ 36 Fluid Prescribing ........................................................................................................................................... 37 Rule of 1’s – oversimplified but memorable ........................................................................................... 37 The Real Rules: Correct but easy to forget! .......................................................................................... 37 ON-LINE TRAINING ..................................................................................................................................... 38 COMMON MEDICATION CHEAT SHEET………………………………………………………………………….39 This booklet was created by the Pharmacy Department. Available from: Medical Education Unit (MEU), located at Level 2, NH – Education, NCHER - Northern Centre Health Education & Research. Telephone: 8468 0758 Please advise suggestions/amendments to: Pharmacy Department (Team Leader for Education x58664) Page 3 INTERN MEDICATION GUIDE PHARMACY CONTACT NUMBERS Pharmacists are always willing to help all medical staff. All ward pharmacists are also available on MEDTASKER. Ward pharmacist Extension Emergency 52696 Emergency – Admissions (for MMP completion) 0447163874 SSU and CDU 0447141711 Ward 1 – Day Oncology 52094 Ward 2 – Children’s Unit 52205 Ward 3 52350 Ward 4 52472 Ward 5– Cardiology 58447 Ward 6– Observation Unit 52473 Ward 7 – Psychiatry 1 58994 Ward 8 - Psychiatry 2 52885 Ward 9 - DPU 52662 Ward 11/12 – Maternity & Special Care Nursery 52205 Ward 13 52884 Ward 14 52459 Ward 16 52477 Ward 17 - ICU 52532 Ward 18 52474 Speciality pharmacist Oncology 52094 Renal / Dialysis 58387 Antimicrobial stewardship 58452 Hospital in the home (HITH) 52967 Clinical Trials 58571 Palliative Care 0439920501 Dispensary Inpatient 58572 Outpatient 58571 Discharges 52204 Manufacturing 58578 Director of Pharmacy 58560 Deputy Director of Pharmacy 58561 Associate Director of Pharmacy 52663 Team Leader – Medicine 52661 Team Leader – Surgical 52662 Team Leader – Oncology + Women’s and Children’s 52094 Team Leader – Education, Development and Research 52664 Team Leader – Quality Use of Medicines & Safety 52665 Page 4
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