FORMULARY Revised January 2019

Transcription

1 MEDICATION STRENGTH NOTES ANTIMICROBIALS-ANTIBIOTICS AMOXICILLIN CAPS 500 MG AMOXICILLIN SUSP 125 MG/5 ML 250 MG/5 ML 400 MG/5 ML AMOXICILLIN CHEW 250 MG AMOXICILLIN AND CLAVULANIC ACID CAPS (AUGMENTIN) 250 MG, 875 MG AMOXICILLIN AND CLAVULANIC ACID (AUGMENTIN) SUSP AZITHROMYCIN TABS AZITHROMYCIN SUSP BACTRIM/SEPTRA BACTRIM/SEPTRA DS BACTRIM/SEPTRA SUSP CEPHALEXIN CAPS CEPHALEXIN SUSP CIPROFLOXACIN CLINDAMYCIN CAPS CLINDAMYCIN LIQUID DOXYCYCLINE CAPS OR TABS LEVOFLOXACIN PENICILLIN VK ANTIMICROBIAL-ANTIFUNGALS FORMULARY Revised January MG/5 ML 250 MG/5 ML 600 MG/5 ML 250 MG 200 MG/5 ML 400 MG 800 MG 200 MG SMX/40 MG TMP PER 5 ML 250 MG, 500 MG 125 MG/5 ML 250 MG/5 ML 250 MG, 500 MG 150 MG 25 MG/ML 100 MG 250 MG, 500 MG, 750 MG 250 MG, 500 MG FLUCONAZOLE TABS 150 MG, 200 MG NYSTATIN SUSPENSION 100,000 U/ML NEW FORMULARY ITEM ANTIMICROBIALS-ANTIPARASITIC AND PROTOZOA ALBENDAZOLE CHEW 200 MG SUPPLIED BY CHHF CHLOROQUINE 150 MG CHLOROQUINE LIQUID 50 MG/5 ML MEBENDAZOLE TABS 100 MG ALBENDAZOLE PREFERRED MEBENDAZOLE SUSP 100 MG/5 ML ALBENDAZOLE PREFERRED METRONIDAZOLE TABS 500 MG PRIMAQUINE TABS 5 MG, 10 MG, 15 MG TINIDAZOLE TABS 500 MG

2 ANTIMICROBIALS-ANTIVIRALS ACYCLOVIR TABS OR CAPS ANALGESICS-ANTIINFLAMMATORIES ACETAMINOPHEN TABS ACETAMINOPHEN INFANTS OR CHILDRENS SUSPENSION ACETAMINOPHEN DROPS 200 MG 325 MG, 500 MG 160 MG/ 5 ML NOT AVAILABLE IN THE US. BE CAREFUL WITH DOSING BASED ON STRENGTH ACETAMINOPHEN CHEWABLES 160 MG ACETAMINOPHEN SUPPOSITORIES ANALGESICS-ANTIINFLAMMATORIES-NSAIDS IBUPROFEN 200 MG, 400 MG, 600 MG, 800 MG IBUPROFEN SUSPENSION 100 MG/5 ML NAPROXEN 220 MG, 375 MG, 500 MG NEW FORMULARY ITEM MELOXICAM 15 MG ANALGESICS/ANTIINFLAMMATORIES-STEROIDS PREDNISONE PREDNISOLONE SYRUP ANTICONVULSANTS 5 MG, 10 MG, 20 MG 5 MG/5 ML 15 MG/5 ML CARBAMAZEPINE 100 MG, 200 MG LEVETIRACETAM 500 MG NEW FORMULARY ITEM PHENYTOIN 50 MG, 100 MG ANTIDEPRESSANTS-SSRIs SERTRALINE CARDIOVASCULAR-ACE-I or ARB ENALAPRIL TABS LISINOPRIL TABS LOSARTAN TABS CARDIOVASCULAR-PREVENTION ASA - Aspirin 81 CARDIOVASCULAR-BETA BLOCKERS ATENOLOL TABS METROPROLOL TARTRATE TABS CARDIOVASCULAR-CALCIUM CHANNEL BLOCKERS AMLODIPINE TABS DILTIAZEM CD CARDIOVASCULAR-DIURETICS FUROSEMIDE HYDROCHLOROTHIAZIDE CARDIOVASCULAR-ACUTE CHEST PAIN 50 MG, 100 MG 5 MG, 10 MG 10 MG, 20 MG 50 MG, 100 MG 81 MG 50 MG, 100 MG 50 MG, 100 MG 5 MG, 10 MG 120 MG, 180 MG, 240 MG 20 MG, 40 MG 12.5 MG, 25 MG NITROSTAT TBS 0.04 MG LOCATED IN INJECTABLE CABINET

3 DIABETES GLIPIZIDE 5 MG, 10 MG METFORMIN 500 MG, 1000 MG INSULIN -LANTUS 100 units / ML INSULIN -LEVEMIR 100 units / ML GASTROINTESTINAL-ANTIHISTAMINES MECLIZINE 12.5 MG, 25 MG PROMETHAZINE 12.5 MG, 25 MG PROMETHAZINE SUPPOSITORIES 12.5 MG, 25 MG GASTROINTESTINAL-CONSTIPATION AND DIARRHEA BISACODYL 10 MG COLACE 100 MG, 200 MG LOPERAMIDE (IMODIUM) 2 MG LOPERAMIDE (IMODIUM) LIQUID 1 MG PER 7.5 ML GASTROINTESTINAL-H2 ANTAGONIST FAMOTIDINE (PEPCID) 20 MG RANITIDINE 150 MG RANITIDINE SYRUP 15 MG/ML GASTROINTESTINAL-OTHER BISMUTH SUBSALICYLATE (PEPTO-BISMOL) 262 MG BISMUTH SUBSALICYLATE SUSP 262 MG/5 ML CALCIUM CARBONATE (TUMS, ANTACID) 500 MG DICYCLOMINE 10 MG PROBIOTICS GASTROINTESTINAL-PPI ESOMEPRAZOLE (NEXIUM) 20 MG, 40 MG OMEPRAZOLE 20 MG, 40 MG PANTOPRAZOLE 40 MG OPHTHALMIC/OTIC CORTISPORIN OTIC SUSP GENTAMICIN OPHTHALMIC DROPS 0.30% LUBRICANT EYE DROPS OFLOXACIN OPHTHALMIC DROPS 0.30% TETRAHYDROZOLINE EYEDROPS (DECONGESTANT) 0.05% RESPIRATORY-ANTIHISTAMINES CETIRIZINE (ZYRTEC) 10 MG CETIRIZINE (ZYRTEC) SYRUP 5 MG/ML CHLORPHENIRAMINE 4 MG DIPHENHYDRAMINE (BENADRYL) 25 MG, 50 MG DIPHENHYDRAMINE SYRUP 12.5 MG / 5 ML FEXOFENADINE (ALLEGRA) 60 MG, 180 MG LORATADINE (CLARITIN) 10 MG TOBRAMYCIN IS SUITABLE ALTERNATIVE; CAN BE USED AS OTIC ALSO OTHER FLUOROQUINOLONE IS SUITABLE ALTERNATIVE; CAN BE USED AS OTIC ALSO SOME ANTIHISTAMINES UNDER GI

4 RESPIRATORY-ASTHMA ALBUTEROL TABLETS 2 MG, 4 MG INHALER PREFERRED ALBUTEROL SYRUP 2 MG/ 5ML INHALER PREFERRED ALBUTEROL (SALBUTAMOL) INHALER 90 MCG ALBUTEROL NEBULIZATION 2.5 MG ALBUTEROL/IPRATROPIUM NEBULIZATION 2.5 MG/500 MCG NEW FORMULARY ITEM BECLOMETHASONE INHALER 40 MCG, 80 MCG MONTELUKAST (SINGULAIR) 4 MG, 5 MG, 10 MG BUDESONIDE/FORMOTEROL INHALER (SYMBICORT) 80 MCG/4.5 MCG FLUTICASONE/SALMETEROL INHALER (ADVAIR) 250 MCG/ 50 MCG RESPIRATORY-COUGH GUAIFENESIN TABS 400 MG GUAIFENESIN SYRUP 100 MG/ 5 ML RESPIRATORY-TOPICAL NASAL DECONGESTANT NASAL SPRAY (OXYMETAZOLINE) 0.05% FLUTICASONE NASAL SPRAY 50 MCG/DOSE NEW FORMULARY ITEM NORMAL SALINE NASAL SPRAY SCABIES/LICE TREATMENTS LICE SHAMPOO IVERMECTIN TABS 6 MG PERMETHRIN CREAM 5% SCABIES SOLUTION SCABIES SOAP WOMENS AND MENS HEALTH-BPH CAN BE PURCHASED IN HONDURAS TAMSULOSIN 0.4 MG NEW FORMULARY ITEM WOMENS AND MENS HEALTH-CONTRACEPTION CONDOMS ORAL CONTRACEPTIIVE COMBINATION-LOW DOSE TOPICAL CREAMS/OINTMENTS TRIPLE ANTIBIOTIC OINTMENT IS SUITABLE BACITRACIN ALTERNATIVE BUT NEOMYCIN MAY BE SENSITIZING DIPHENYDRAMINE CREAM 2% HC GENERALLY PREFERRED CLOTRIMAZOLE 1% 1% HEMORRHOIDAL CREAM HYDROCORTISONE 1% 1% KETOCONAZOLE (NIZORAL) SILVADENE 1% TRIAMCINOLONE CREAM 0.10% MODERATE STRENGTH STEROID IS SUITABLE ALTERNATIVE TOPICALS-VAGINAL CLOTRIMAZOLE CREAM MICONAZOLE CREAM 2%

5 VITAMINS/MINERALS/ELECTROLYTE SOLUTION ADULT CHILDREN'S CHEWABLE INFANT MULTIVITAMIN DROPS PRENATAL FERROUS SULFATE FERROUS SULFATE ELIXIR FOLIC ACID ORAL REHYDRATION SOLUTION/PEDIALYTE/ELECTROLYTES INJECTABLES 325 MG 220 MG / 5 ML 1 MG CEFAZOLIN (ANCEF) DIPHENHYDRAMINE LIDOCAINE LIDOCAINE WITH EPINEPHRINE METHYLPREDNISOLONE (SOLUMEDROL) FOR INTRAVENOUS OR INTRAMUSCULAR USE TRIAMCINOLONE OTHER DEPOT STEROIDS ACCEPTABLE ALTERNATIVE FOR IM OR INTRAARTICULAR USE CEFTRIAXONE (ROCEPHIN) 250 MG EPINEPHRINE 1 MG/ML PROMETHAZINE 25 MG KETOROLAC 30 MG/ML NALOXONE (NARCAN) 0.4 MG/ML RESTRICTED FORMULARY-LIMITED BY INDICATION CYCLOBENZAPRINE 5 MG FOR ACUTE MUSCLE SPASMS; RECOMMEND LIMITED QUANTITY OF 30 GRISEOFULVIN 125 MG TINEA INFECTION LABETOLOL 100 MG HYPERTENSION DURING PREGNANCY LEVOTHYROXINE 75 MCG LIMIT USE TO PATIENT ON CURRENT THERAPY AND MONITORED ELSEWHERE; 100 MCG IS ACCEPTABLE ALTERNATIVE BASED ON PRICE AND AVAILABILITY OXYTOCIN INJECTION 10 MG/ML POST PARTUM TIMOLOL OPHTHALMIC 0.50% TRANEXAMIC ACID 100 MG/10 ML LIMIT USE TO PATIENT ON CURRENT THERAPY AND MONITORED ELSEWHERE; OTHER BETA BLOCKER OPHTHALMIC IS SUITABLE ALTERNATIVE HEMMORRHAGE FROM TRAUMA OR POST PARTUM

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