Drug Therapy
Committee Meeting Highlights
December 2004
Volume
XV, Issue 1
New Business
Revised PICU Dosing Card
Approved
Discussion
The PICU dosing card was submitted for final approval. The Committee was informed
that the card has been cross-referenced for each medication and approved by
the Pediatric Collaborative Practice Group. Administrative approval of the PICU
dosing card was granted with the recommendation of providing references where
dosing recommendations deviate substantially from standard critical care references.
The Committee approved the Pediatric Intensive Care Unit dosing card.
Cox-II Inhibitors and NSAIDs Update
#2
Discussion
The Committee discussed the recent FDA alerts and recent modifications to package
labeling. One of the alerts stated that the FDA has revised the safety labeling
for valdecoxib (Bextra) to include a boxed warning advising of the risk of serious
skin reactions and a new bolded warning advising of its contraindication after
coronary artery bypass graft (CABG) surgery. The skin reactions which have been
reported include Stevens-Johnson syndrome and Toxic Epidermal Necrolysis. The
Committee also discussed the early data release from the naproxen ADAPT study.
A statement is being prepared for MGPO physicians to guide them with prescribing
options. The letter has been formulated by experts at the MGH and BWH and is housed
on the PCOI website. The Committee concluded that we should be moving away from
the use of valdecoxib and other COX-II inhibitors. Given the current uncertainty
about the COX-2 inhibitors, we will continue to monitor this class closely.