Re: [MEDITECH-L] Dose Range Checking in MG 5.5

Mon, 16 Oct 2006 02:37:12 -0700 

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Beth - The 5.5 dose range checking was put in place from what I can see to use FDB's and other vendor's dose range checking. I don't see where it is that much of an improvement other than that it looks at the max times a med can be administered in one day. Also, in the customer defined parameters on page 7 you can now set some global parameters, which is some help. You'll just have to play around with the different settings like I did because there is no on-line documentation and Meditech's documentation was basically worthless. Also, on page 6 of the drug dictionary, some extra dose range fields were added, but they are of minimal value.
     As for using FSV dose ranges, you really need to be entering disease state information for it to work. It also doesn't take into account decreased renal function in those medications eliminated renally. I've had to create my own dose range rules for some drugs such as I've copied below:
CAMPRAL 333 mg tablet- NDC# 00456333001
For the treatment of ALCOHOLISM, the recommended oral daily dose for patients
over 60 kilograms is 1998 milligrams and for patients under 60 kilograms, 1333
milligrams/day. The total dose should be given in three divided doses, to be
taken with meals. Acamprosate therapy should be initiated immediately after
alcohol detoxification has taken place and the patient has abstained from
alcohol for 7 days and should not be interrupted if relapses
occur. The recommended duration of therapy is one year (Prod Info Campral(R),
1996a).

VFEND 200 mg tablet NDC# 00049318030
The recommended dose of oral voriconazole is 200 milligrams (mg) every 12 hours
for patients who weigh more than 40 kilogram (kg) and 100 mg every 12 hours for
patients who weigh less than 40 kg for the treatment of INVASIVE ASPERGILLOSIS.
Oral tablets should be taken 1 hour before or 1 hour after a meal (Prod Info
VFEND(R) I.V., VFEND(R) tablets, oral suspension, 2004).
Also, Meditech allows for a loading dose range, but there is no way to denote an order as a loading dose, such as in the following example:
 
Caspofungin (Cancidas) has a loading dose of 70 mg daily and a maintenance dose of 50 mg
daily. However, when I enter the 70 mg loading dose, I get flagged if I have the max dose set at 50 mg.
As you can see, Meditech and the FSV's have a long way to go to get this right. By the way, we are Magic 5.5 SR2.
 
Charlie
Charles Downs Pharm.D.
Washington County Hospital
Inpatient Pharmacy
251 E. Antietam Street
Hagerstown, MD, 21740
301-790-8904
----- Original Message -----
Cc: Ed Chan
Sent: Monday, October 09, 2006 11:38 AM
Subject: [MEDITECH-L] Dose Range Checking in MG 5.5

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We are MG PHA 5.4 using the First DataBank formulary service, and would like to get some feedback from other users who have experience with  MG PHA 5.5 Dose Range Check.  Is it working as designed?   Any comment is greatly appreciated.

 

Thanks!

 

 

Beth Lupien
John Muir / Mt. Diablo Health Systems
Systems Support Analyst
(925) 941-2078 (x 32078)
[EMAIL PROTECTED]

 

 

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