Christina - This is one reason that I went with the MIS allergens from FDB -
everything is based on NDC#. If you use FDB and are 5.5 or greater, I would
advise changing. We've run into this problem with Robitussin AC (with
Codeine) and Codeine allergies. If you do not have the correct class under a
drug (48:08 ANTITUSSIVES
48:16 EXPECTORANTS) and have at least one of these classes under
Codeine (we only had (28:08.08 OPIATE AGONISTS), you won't be flagged.
Same thing for duplicate checking. I know that this is absurd, but believe
me, you either have the classes for you generic names correct, or you have
the potential for errors in allergies and duplicate checking and Meditech is
not going to fix this other than the fact that they have if you go to using
MIS allergens. I'm trying to convince them to use the formulary duplicate
checking too, but so far they don't seem to want to do that. Also, the AHFS
classes have changes each year, so each generic name needs to be checked
each time the AHFS book comes out.
Charlie
Charles Downs Pharm.D.
Washington County Hospital
Inpatient Pharmacy
251 E. Antietam Street
Hagerstown, MD, 21740
301-790-8904
----- Original Message -----
From: "Castillo, Cristina" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Friday, March 23, 2007 4:31 PM
Subject: [MEDITECH-L] Allergy Alert
Hello Lr's,
We have a scenario where one of the patient allergies is Morphine HCL.
During order entry, the pharmacist enters an order of Morphine sulfate
but she did not get flagged at all. The allergy was entered as a
Generic. I checked the drug dictionary for MSO4, obviously the
Ingredient is Morphine and on the Ingredient Allergy field, one of them
is Morphine (F05). I called MEDITECH and asked them how come we did not
get the alert. This was their response:
Pellerin,Tracie (MEDITECH) - Mar 22, 2007 - 2004 EDT: The generic
associated as an allergy is not the one associated to the drug MORP0050
that was ordered. If you would like to capture all allergies associated
with Morphine, the allergy should be entered as a class allergy rather
than a generic.
Our Director of Pharmacy does not fully agree with MEDITECH. She
believes that the user should still have gotten the flag as Morphine
(regardless of how the allergy was entered, generic vs class) is clearly
the main Ingredient and is also defined in the Ingred Allergy. If
Pharmacy goes by Class Allergy, it's good in a way that it checks
everything but at the same time they would get unnecessary alerts which
can de-sensitize the user of these flags. Most of our pharmacists select
the generic allergy.
I have emailed MEDITECH again about how our pharmacy feels but hasn't
gotten any response yet. Has this happened to you? How did you resolve
the situation? How do you enter the allergy, generic or class?
We are Magic 5.4 and we have First Data Bank.
Cristina C. Kimball, BSN, RN
Manager, Clinical Informatics
Pacific Alliance Medical Center
531 W. College St.
Los Angeles, Ca 90012
Ph: (213) 437-4214
Fax: (213) 617-9203
Email: [EMAIL PROTECTED]
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