|
The following are excerpts from the newsletter
July
14,1999
July 28,1999
- Evidence builds: lack of
focus on human factors allows error-prone devices
- Safety Briefs:
- CAUTION! Poorly handwritten orders for AVANDIA
(rosiglitazone), a new drug for type 2 diabetes mellitus,
can look like COUMADIN (warfarin).
Handwritten prescription for Avandia
which was confused with Coumadin
- Vaccine manufacturers, the Public Health Service (PHS),
and the American Academy of Pediatrics (AAP) are working
to eliminate or reduce the amount of thimerosal, a mercurial
used as a preservative, in vaccines. The federal action
is intended to increase public assurance of vaccine
safety. There is no evidence of harm from mercury in
vaccines given to young children, nor is there any need
to test for mercury exposure. While the mercury content
of vaccines given to children under 6 months of age
meets FDA standards for intermittent exposures, it exceeds
EPA standards for prolonged daily exposure (not directly
relevant to vaccines given at wide intervals). PHS and
AAP are reminding clinicians that the known risks of
vaccine-preventable infections are far more serious
than risks from vaccinating children according to the
recommended schedule. But they also note that clinicians
may modify the schedule and give the first dose of hepatitis
B vaccine at 2 to 6 months of age, when the infant is
considerably larger, rather than at birth. This schedule
adjustment should apply only to infants born to HbsAg-negative
mothers; the dose just after birth is still needed by
infants born to HbsAg-positive mothers. ). Merck and
SmithKline report that they will release hepatitis B
vaccines without thimerosal in fall 1999, pending FDA
approval. Thimerosal is included in the following brands
of vaccine:
- DTaP (Acel-Imune, Certiva, Tripedia only),
- DTwP (all),
- DT (all),
- Td (all),
- TT (all),
- DTwP-Hib (Tetramune, TriHIBiT),
- Hib (HibTITER multidose, ProHIBiT only),
- hepatitis B (Engerix-B, Recombivax-HB),
- influenza (all),
- meningococcal (Menomune),
- pneumococcal (Pnu-Imune 23 only),
- rabies (BioPort brand only).
Additional information is available at the CDC website
(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4826a3.htm)
or the AAP website (www.aap.org/new/thimpublic.htm).
For complete listings of vaccine ingredients, see the
current (August 1999) edition of ImmunoFacts: Vaccines
& Immunologic Drugs.
- On July 16, 1999, CDC recommended a temporary pause
in the use of rotavirus vaccine (ROTASHIELD, Wyeth-Ayerst
- Standardizing the way that labels are placed on syringes
can reduce errors with "IV push" medications.
- Pharmacia & Upjohn aggrees to consider labeling and
color changes for DETROL to decrease potential
for error.
- ISMP discourages the use of generic name abbreviations
and use of the first few letters of a generic name as
a trademark.
subscribe now
|
|
