Hospital formulary
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Unlabeled indications for antineoplastic drugs listed in the American Hospital Formulary-Drug Information, United States Pharmacopeia Dispensing Information-Drug Information for the Health Care Professional (Volume 1), and the American Medical Association-Drug Evaluations were evaluated. Specifically, the total number of unlabeled and unique uses (ie, not listed in either of the other two compendia) of 35 antineoplastic drugs were compared. Using a nonparametric analysis of variance to evaluate the results, significant differences in both the average unlabeled indications per drug and unique unlabeled indications per drug were found among the resources checked. The implications of the study results on reimbursement by private insurance carriers of unlabeled antineoplastic drug use is discussed in this article.
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Several factors influence the safety with which neural blockade is performed, and something as simple as proper packaging can make a significant difference. For example, bulk packaging, individual boxes, and labels all should be color coded for easy identification and to alert the prescriber of ingredients requiring particular caution. One must also take care not to confuse single-use with multiple-use products, if the latter cannot be eliminated from formulary. Furthermore, substitutions must be made properly, particularly to avoid complications associated with products that contain preservatives.