Department of Pharmacy Policies & Procedures

Number: 5:01.7

Effective Date: May, 1987

Revisions: 3/96; 4/00; 4/02

Reviewed: 10/09

Approval: P&T Committee; Pharmacy Director

Subject: MEDICATIONS IN STANDARD PROCEDURE ORDERS

A. POLICY

Standard procedure orders are orders written for procedures in which the medication administered as an adjunct to the procedure is standard and understood to be ordered with the procedure itself. All medication utilized in this manner must be reviewed by the pharmacy for availability, dosing and usage.

B. STANDARD ORDERS

PROCEDURE MEDICATIONS

1. Barium Enema 1 Bottle Magnesium Citrate

1 BisKit

2. Enteroclysis Prep 4 Bisacodyl Tablets 5mg

3. IVP (Intravenous Pyelogram) 4 Bisacodyl Tablets 5mg & 1 Bisacodyl Supp.

4. SBFT (Small Bowel Follow Thru) 4 Bisacodyl Tablets 5mg & 1 Bisacodyl Supp.

5. UGI with Small Bowel Follow Thru 4 Bisacodyl Tablets 5mg & 1 Bisacodyl Supp.

6. UGI (Upper GI) Nothing

C. CONTENTS OF THE BISKIT

4 Bisacodyl Tablets 5 mg.

4 DOSS Capsules 100 mg.

1 Bisacodyl Supp. 10 mg.