THE FORMULARY

1. The Formulary is a listing of drugs, dosage forms, package sizes, and drug strengths stocked by the Hospital and ACC Pharmacies. It is published as a quick reference to assist the physician and nursing staffs.

The Formulary is divided into four general sections: the Introduction, a Therapeutic Index, the Drug Monographs, and a General Reference Section.

2. The Therapeutic Index is a listing by pharmacological or therapeutic category of those drugs which are carried in one or more dosage forms, by the Pharmacy. The listing is alphabetical by generic name under each category. From the Therapeutic Index, the physician can determine if the desired drug is stocked in any form. If it is, she/he will then refer to the Drug Monographs Section for complete information.

3. The Drug Monographs Section is a straight alphabetical listing of both trade names and generic names. The trade name will be cross referenced to the generic name under which the complete information will be found. Each Complete monograph will contain the following information:

1. Official, non-proprietary, or generic name.

2. Trade name: Common trade or proprietary names which refer to the generic drug. The listing of a trade name does not necessarily mean that it is stocked as such by the Pharmacy.

3. Category: The American Hospital Formulary Service Reference System of Therapeutic Classification which relates to the information in the Therapeutic Section of the Formulary.

4. Dosage Form: This lists all the dosage forms which are available in the Pharmacy.

5. Note: Information of special interest or of an unusual nature is indicated here. However, the absence of a cautionary note does not necessarily imply that a particular drug may be used without the necessary precaution or discretion.

4. The General Reference Section contains information and aids that are used in patient care. In it are contained dosing formula conversion tables for weight, measures and temperature, as well as guidelines for use of certain drugs as adopted by the Pharmacy Committee.

5. Drug items are listed generically in The Formulary. Orders for drugs written by University Hospital physicians or written for patients treated at the University Hospital (to include the Ambulatory Care Center) are interpreted and filled using generic names.

6. The heart of the Formulary System is the Pharmacy & Therapeutics Committee. The Committee is established by the Hospital Medical Board. Membership will be comprised of representatives of the professional departments/services, house staff, nursing, pharmacy, administration, College of Pharmacy, and other interested parties.

7. The Committee shall be responsible for the development and surveillance of all drug utilization policies and practices within the hospital in order to assure optimum clinical results and a minimum potential for hazard. The Committee shall assist in the formulation of broad professional policies regarding the evaluation, appraisal, selection, procurement, storage, distribution, use, safety procedures and all other matters relating to drugs in the hospital. It shall perform the following specific functions.

1. Serve as an advisory group to the hospital medical staff and the pharmacy on matters pertaining to the choice of available drugs.

2. Make recommendations concerning drugs to be stocked on the nursing unit floors and by other services.

3. Develop and review the formulary or drug list for use in the hospital.

4. Prevent unnecessary duplication in stocking drugs and drugs in combination having identical amounts of the same therapeutic ingredients.

5. Develop and review procedures to control the use of dangerous and toxic drugs with such procedure to be approved by the medical staff.

6. Develop a procedure for handling and control of drugs brought into the hospital by patients.

7. Evaluate clinical data concerning new drugs or preparations requested for use in the hospital.

8. Establish standards concerning the use and control of drugs.

9. Review of the appropriateness of the empiric and therapeutic use of drugs through the analysis of individual or aggregate patterns of drug practice.

10. Development of policies and procedures relating to the selection, distribution, handling, use and administration of drugs and diagnostic testing materials.

11. Review of all significant adverse drug reactions.

8. Additions to the Formulary are made by submitting a "Physician’s Request for Addition to the Formulary" to the Secretary of the P&T Committee. Blank Forms can be obtained from the Inpatient Pharmacy, extension 686-6220. Forms will be forwarded to the physician only, they will not be given to a Medical Service Representative.

9. Physicians requesting drug additions to the University Hospital Formulary are to review drug usage data on formulary items which are comparable to the agent being requested. Usage data is available from the Pharmacy upon request. The requestor is to assert whether the requested item has a greater therapeutic or economic value than items that are currently available.

10. The Pharmacy Committee meets monthly on the fourth Monday of the month. Requests received within 10 calendar days of the meeting would generally be included on the meeting agenda.

11. Non-formulary Drugs and drug items can be obtained when needed to treat a specific illness or disease. Whenever such an item is needed for a University Hospital patient, a chart order or prescription signed by an attending staff physician on the clinical service treating the patient is required. The drug is obtained as soon as possible from a local wholesaler, community pharmacy, or neighboring hospital.