GEORGETOWN HEALTHCARE SYSTEM - FORMULARY
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PHARMACY FORMULARY 2020
(ACCORDING TO THE AMERICAN HOSPITAL FORMULARY SERVICE)
4:00 Antihistamine Drugs
4.04 First Generation Antihistamines
1. Diphenhydramine ORAL: (Benadryl) 25 mg tablet, 12.5 mg/5 ml elixir, INJECTION: 50mg/ml vial,
2. Promethazine (Phenergan) ORAL: 25 mg tablet,
INJECTION: Inj. 25 mg/ml ampul, RECTAL: 12.5 mg & 25mg suppository
4.08 Second Generation Antihistamines4:0444
1. Loratadine (Claritin) 10 mg tablet
92. Other Antihistamines
1. Famotidine (Pepcid) ORAL: 20mg tablet, INJECTION: 20mg/2ml
8:00 Anti-infective Agents
8:08 Anthelmintics (none available)
8:12 Antibacterials
8:12.02 Aminoglycosides
1. Amikacin (Amikin) Inj 500mg/2ml vial
2. Gentamicin (Garamycin) INJECTION : 80mg/2ml vial, 80mg/50ml
120mg/100ml, Ophth Sol 5ml bottle, Ophth Ointment 3.5gm tube,
3. Tobramycin INJECTION: (Nebcin) 80 mg/2 ml vial, OPHTH: 0.3% Drops 5 ml, POWDER: Vial 1.2 grams
8:12.06 Cephalosporins
First Generation
1. Cefazolin (Ancef,Kefzol) Inj. 1gm vial, 1gm/50ml & 2gm/50ml D5W
2. Cephalexin (Keflex) 500mg capsule
Second Generation—none available
Third Generation
1. Ceftriaxone (Rocephin) Inj. 1 gm/50ml D5W, 1 gm vial
Fourth Generation
1. Cefepime (Maxipime) Inj 1gm and 2gm vial
8:12.07 Miscellaneous (-lactam Antibiotics
08. Carbapenems
1. Merrepenem (Merrem) 1 gm vial
8:12.12 Macrolides
8:12.12.92 Other Macrolides
1. Azithromycin (Zithromax) ORAL: 250 mg tablet, 200mg/5ml Suspension, INJECTION: 500 mg vial
8:12.16 Penicillins
8:12.16.04 Natural Penicillins
1. Penicillin G Benzathine (Bicillin LA) Inj. 1.2 million
Units (refrigerate)
.
8 :12.16.08 Aminopenicillins
1. Amoxicillin (Amoxil) 250 mg capsule, 250mg/5ml 100 ml
2. Ampicillin (Omnipen) INJECTION : 0.5 gm, 1 gm vial
3. Amoxicillin/Clavulanate (Augmentin) 500 mg tablet
8:12.16.12 Penicillinase Resistant Penicillins
1. Nafcillin (Unipen) 1 gram vial
8:12.16.16 Extended Spectrum Penicillins
1. Ampicillin/Sulbactam (Unasyn) Inj. 1.5 gm vial, 3 gm vial
2. Piperacillin/Tazobactam (Zosyn) Inj. 3.375 gm vial
8:12.18 Quinolones
1. Ciprofloxacin HCL (Cipro) ORAL : 250mg tablet, INJECTION : 400mg/200ml D5W
2. Levofloxacin (Levaquin) ORAL : 500 mg tablet, INJECTION:
500 mg/D5W 100 ml, 750mg/D5W 150 ml
8:12.20 Sulfonamides
1. Trimethoprim/Sulfamethoxazole 160 mg/800 mg tablet (Bactrim DS,
Septra DS), Trimethoprim/Sulfamethoxazole Suspension (Bactrim)
8:12.24 Tetracyclines
1. Doxycycline Hyclate (Vibramycin) 100 mg capsule
8:12.28 Miscellaneous Antibiotics
1. Bacitracin Powder for Injection—50,000 units
2. Clindamycin HCL (Cleocin) ORAL: 300 mg capsule, INJECTION:
600 mg/D5W 50 ml , 900 mg/D5W 50 ml
3. Vancomycin HCL (Vancocin) 500mg, 750mg, 1 gm vial, 1 gm vial
4. Linezolid (Zyvox) Inj 600mg/300ml bag (Restricted), 600mg tablet
8:14 Antifungals
1. Fluconazole (Diflucan) ORAL: 100 mg tablet, INJECTION: 200 mg/100 ml
8:16 Antimycobacterials
1. Rifampin (Rifadin) ORAL : 300 mg capsule
8:18 Antivirals—
1. Oseltamivir (Tamiflu) 75mg capsule (added February 2018)
8:30 Antiprotozoals
8 :30.04 Amebicides
1. Metronidazole (Flagyl) 250mg tablet, INJECTION : 500mg/100ml,
8:92 Miscellaneous Anti-infectives
1. Metronidazole (Flagyl) ORAL: 250 mg tablet, INJECTION. 500 mg/100 ml
10:00 Antineoplastics—
10:00.00 1. Gemcitabine (Gemzar) 1 gram/50 ml (ordered as needed, 96 hrs ahead)
12:00 Autonomic Drugs
12:04 Parasympathomimetic (Cholinergic) agents
1. Neostigmine Methylsulfate (Prostigmin) Injection 1:1000 5ml syringe
12:08.08 Antimuscarinics/Antispasmodics
1. Atropine Sulfate Inj 0.4 mg/ml vial, 1 mg/10 ml syringe
2. Dicyclomine HCL (Bentyl) 10 mg capsule
3. Glycopyrolate (Robinul) Injection 1 mg/5 ml syringe
4. Hyoscyamine Sulfate (Levsin) 0.125 mg sublingual tablet
5. Ipratropium Bromide (Atrovent) 0.02 % 0.5 mg/2.5 ml Inhalation soln
6. Scopolamine (Transderm Scop) 1.5 mg/2.5 cm2 Transdermal System
12:12 Sympathomimetic (Adrenergic) Agents
12:12.04 Alpha Adrenergic Agonists
1. Phenylephrine HCl (Neo-Synephrine) Injection: 10 mg/ml vial
12:12.08 Beta Adrenergic Agonists
12:12.08.08 Selective Beta 1 Adrenergic Agonists
1. Dobutamine 250mg/250ml Inj (Oct 2019)
2. Dopamine 400mg/D5W 250ml
12:12.08.12 Selective Beta 2 Adrenergic Agonists
1. Albuterol (Ventolin, Proventil) Oral Inhaler (90 mcg of albuterol per actuation), Inh Solution: 2.5mg/3ml
2. Levalbuterol (Xopenex): 0.63 mg/3 ml inh solution
3. Terbutaline (Brethine) 1mg/ml 1ml vial
12:12.12 Alpha and Beta Adrenergic Agonists
1. Ephedrine Sulfate : 50 mg/ml 1ml vial, 50mg/5ml syringe
2. Epinephrine HCL Injection :(Adrenalin) 1 mg/ml (1:1000) 1 ml ampule (preservative-free and sulfite free), 0.1 mg/ml (1:10,000) 10 ml syringe and 1mg/ml 30ml multidose vial
3. Norepinephrine Bitartrate--(Levophed) 4 mg/4 ml
4. Racepinephrine-(S-2 Inhalant) 2.25 % Inhalation Solution 0.5 ml
12:16 Sympatholytic (Adrenergic Blocking) Agents
12:16.04 Alpha Adrenergic Blocking Agents
12:16.04.12 Selective (Alpha Adrenergic Blocking Agents)
1.Tamulosin Hydrochloride (Flomax) 0.4 mg capsule
12:20 Skeletal Muscle Relaxants
12:20.04 Centrally Acting Skeletal Muscle Relaxants
1. Carisoprodol (Soma) 350 mg tablet
2. Cyclobenzaprine HCL (Flexeril) 10 mg tablet
3. Methocarbamol (Robaxin) Inj: 1000mg vial, 500mg & 750mg tab
4. Tizanidine (Zanaflex) 2 mg tablet
12:20.08 Direct Acting Skeletal Muscle Relaxants
1. Dantrolene Sodium (Ryanodex) Injection 250 mg vial
12:20.20 Neuromuscular Blocking Agents
Depolarizing Agents
1. Succinylcholine (Quelicin) 20 mg/ml 5ml syringe
Nondepolarizing Agents
1. Rocuronium (Zemuron) 50 mg/5 ml vial (refrigerate)
2. Ropivacaine (Naropin) 0.2% 2mg/ml 20ml, 0.5% 5mg/ml 20ml
12:92 Miscellaneous Autonomic Drugs
1. Nicotine (NicoDerm ( CQ) Transdermal System-7 mg, 14 mg , 21 mg
and 2mg Gum
16:00 Blood Derivatives--none available
20:00 Blood Formation, Coagulation and Thrombosis
20:04 Antianemia Drugs
20:04.04 Iron Preparations
1. Iron Preparations, Oral
a. Ferrous Sulfate (Feosol) 325 mg (65 mg iron) tablet
20:12 Antithrombotic Agents
20:12.04 Anticoagulants
20:12.04.08 Coumarin Derivatives
1. Warfarin Sodium (Coumadin) 1 mg, 5mg tablet
20:12.04.12 Direct Thrombin Inhibitors
1. Bivalirudin (Angiomax) 250mg vial (10/2019)
20:12.04.14 Direct Factor Xa Inhibitors
1. Rivaroxaban (Xarelto) 10mg, 15mg tablet
20:12.04.16 Heparins
1. Enoxaparin Sodium (Lovenox) 30 mg/0.3 ml, 40
mg/0.4 ml, 100 mg/1 ml
2. Heparin Injection
a. Heparin 25,000 units/500ml bag (Oct 2019)
b. Heparin 1000 units/500m bag (Oct 2019)
c. Heparin Sod inj (porcine intestinal mucosa) 1000 units/ml 1ml and 5000 units/ml 1ml
d. Heparin lock 100 units/ml vial
20:12.16 Hemostatics
1. Thrombin, topical (Thrombin-JMI) 5000 U vial
20:12.18 Platelet Aggregation Inhibitors
1. Cangrelor (Kengreal) Inj 50mg/10ml vial (Oct 2019)
2. Clopidrogrel (Plavix) 75mg & 300mg tablet (February 2018, 10/2019)
3. Prasugrel (Effient) 10mg tablet (Oct 2019)
4. Ticargrelor (Brillinta) 90mg tablet (Oct 2019)
20:12.20 Thrombolytic Agents
1. Alteplase (Cathflo - Activase () 2 mg vial
20:28.16 AntiHeparin Agents
1. Protamine Inj 250mg/25ml vial (Oct 2019)
20:28:16 Hemostatics
1. Tranexamic Acid 100mg/ml 10ml vial
24:00 Cardiovascular Drugs
24:04 Cardiac Drugs
24:04.04 Antiarrhythmic Agents
24:04.04.04 Class IA Antiarrhythmics
1. Procainamide (Pronestyl) Inj. 100mg/ml 10ml vial
24:04.04.08 Class 1b Antiarrythmics
1. Lidocaine HCL (Xylocaine) 2% 100 mg/5 ml
syringe, 2 gram/D5W 500 ml pre-mixed bag
24:04.04.16 Class II Antiarrhythmics—see Beta Blockers
24:04.04.20 Class III Antiarrythmics
1. Amiodarone (Cordarone) (Pacerone ()
150 mg/3 ml, 900mg/10ml, 200mg tablet
24:04.04.24 Class IV Antiarrythmics
1. Adenosine (Adenocard) Inj 6 mg/2ml, 90mg/30ml
2. Diltiazem (Cardizem)---see section 24:28.92
3. Verapamil (Calan)---- see section 24:28.92
24:04.08 Cardiotonic Agents----Cardiac Glycosides
1. Digoxin (Lanoxin) 500 mcg/2 ml amp, 0.25mg tablet
24:06 Antilipemic Agents—do not carry
24:08 Hypotensive Agents
24:08.16 Central Alpha Agonists
1. Clonidine (Catapres) 0.1 mg/24 hr TTS patches, 0.1 mg tablet, INJ: 100mcg/ml 10ml vials
24:08.20 Direct Vasodilators
1. Hydralazine HCL (Apresoline) 25 mg tablet, 20 mg/ml vial
24:12 Vasodilating Agents
24:12.08 Nitrates and Nitrites
1. Nitroglycerin (Nitro-Bid) 2% ointment 1 gm, (Nitrostat) 0.4 mg
SL tablet, NTG oral Spray, inj: 100 mg/D5W 250 ml glass bottle
24:20 Alpha-Adrenergic Blocking Agents
1. Labetalol (Normodyne, Trandate)---see in 24:24
24:24 Beta-Adrenergic Blocking Agents
1. Atenolol (Tenormin) 25 mg tablet
2. Esmolol (Brevibloc)—10mg/ml 10ml vial
3. Labetalol HCL (Trandate) INJ: 20mg/4ml syringe, 100 mg/20 ml vial
4. Metoprolol Tartrate (Lopressor) 25mg tablet, 5 mg/5 ml ampule
5. Metoprolol Succinate (Toprol) 25mg tablet
6. Propanolol (Inderal) 1mg/ml 1ml vial
24:28 Calcium-Channel Blocking Agents
24:28.08 Dihydropyridines
1. Amlodipine Besylate (Norvasc) 5 mg tablet
2. Nicardipine (Cardene) 2.5mg/ml 10ml vial (Oct 2019)
24:28.92 Calcium Channel Blocking Agents, Miscellaneous
1. Diltiazem HCL (Cardizem) 30mg tablet, INJ: 25 mg/5 ml vial
2. Verapamil HCL (Calan) INJ: 5 mg/2 ml vial
24:32 Renin-Angiotensin-Aldosterone System
24:32.04 Angiotensin-Converting Enzyme Inhibitors
1. Enalapril (Vasotec) Inj: 1.25 mg/ml 2ml vial, Oral: 5mg tablet
2. Lisinopril (Zestril, Prinivil) 10 mg tablet
24:32.08 Angiotensin II Receptor Antagonists
1. Losartan (Cozzar) 50mg tablet
28:00 Central Nervous System Agents
28:04 General Anesthetics
28:04.16 Inhalation Anesthetics
1. Desflurane (Suprane) 240ml bottle
2. Sevoflurane (Ultane) 250ml bottle
28:04.92 General Anesthetics, Miscellaneous
1. Etomidate (Amidate) 20 mg/10 ml ampule
2. Ketamine Inj 50mg/ml 10ml vial, 10mg/ml 5ml syringes
3. Propofol (Diprivan) Inj: 1% 100mg/10ml, 200 mg/20 ml,
and 1000mg/100ml vial
28:08 Analgesics and Antipyretics
28:08.04 Nonsteroidal Anti-inflammatory Agents
28:08.04.08 Cyclooxygenase-2 (COX-2) Inhibitors
1. Celecoxib (Celebrex) 100 mg capsule
28:08.04.24 Salicylates
1. Aspirin Oral: 81 mg tablet (plain), 81 mg (enteric coated) , 325 mg tablet, 325mg (enteric coated)
28:08.04. Other Non Steroidal Anti-inflammatory Agents
1. Ibuprofen (Advil) (Motrin) 200 , 600 & 800mg tablet, Suspension: 100mg/5ml unit dose
2. Ketorolac Tromethamine (Torado)
Injection:30 mg vial, 60mg/2ml vial
28:08.08 Opiate Agonists
1. Codeine Products
a. Acetaminophen and Codeine Phosphate (Tylenol No.3)
300 mg/30 mg tablet
2. Fentanyl Products
a. (Duragesic) Transdermal 25mcg, 50mcg patches
(Sublimaze) 100 mcg/2 ml vial, 250 mcg/5 ml ampul,
PCA: 10mcg/ml 100ml bag
3. Hydrocodone Bitartrate Combinations
a. Hydrocodone Bitartrate/Acetaminophen (Lortab Elixir)
7.5mg/325mg per 15ml cup
a. Hydrocodone Bitartrate/Acetaminophen (Norco 5)
5 mg/325 mg tablet
b. Hydrocodone Bitartrate/Acetaminophen (Norco 7.5)
7.5 mg/325 mg tablet
c. Hydrocodone Bitartrate/Acetaminophen (Norco 10) 10 mg/325 mg tablet
d. Hydrocodone Bitartrate/Ibuprofen (Vicoprofen) tablet
3. Belladonna/Opium Suppositories (B&O) 16.2mg/30mg
4. Hydromorphone (Dilaudid) 2mg tablet, 2mg/ml inj, PCA:
0.2mg/ml 100ml bag
5.. Meperidine HCL (Demerol) Inj: 25 mg/ml, 50 mg/ml, 50mg tablet
6. Morphine Sulfate
a. PCA: 1mg/ml 100ml bag
b. Injection: 2mg/ml, 4mg/ml, 10 mg/ml Preservative free (Duramorph): 10 mg/10 ml,
7. Oxycodone Products
a. Oxycodone 5mg tablet
b. Oxycodone /Acetaminophen (Percocet) 5 mg/325 mg
and 10mg/325mg tablet
c. Oxycodone Substained Release (Oxycontin) 10mg tablet
8. Sufentanil Inj (Sufenta) 50mg/ml 1ml ampuls
9. Tapentadol (Nucynta) 50mg tablet
10. Tramadol HCL (Ultram) 50 mg tablet
28:08.12 Opiate Partial Agonists—none carried
28:08.92 Miscellaneous Analgesics and Antipyretics
1. Acetaminophen (Tylenol)
Oral Solution: 160 mg/5 ml, 650mg/20.3 ml oral solution. Oral : 325 mg, 500mg tablet, Rectal: 120mg Supp.325mg Supp. INJECTION (Ofirmev) : 1000mg/100ml vial
2. Acetaminophen and Codeine Phosphate-(Tylenol No. 3) 300 mg/30 mg tablet, ELIXIR: 120MG/12MG/5ML
3. Other Acetaminophen Combinations
a. Acetaminophen/Butalbital/Caffeine 325 mg/50 mg/40 mg tablet (Fioricet )
4. Ziconotide Acetate (Prialt) 100mcg/ml 1 ml vial (compounded)
28:10 Opiate Antagonists
1. Naloxone HCL (Narcan) 0.4 mg/ml vial, 2mg syringe
28:12 Anticonvulsants
28:12.04 Barbiturates---none available
28:12.08 Benzodiazepines
1. Clonazepam (Klonopin) 0.5 mg tablet
2. Diazepam (Valium) Oral : 5mg tablet, 10mg/2ml syringe
3. Lorazepam (Ativan) Oral : 0.5mg & 2mg tablet, Inj. 2mg/ml
28:12.12 Hydantoins
1. Fosphenytoin Sodium (Cerebyx) 500 mg PE/ml 10 ml vial, PE/10 ml vial (PE = phenytoin sodium equivalents)
28:12.92 Miscellaneous Anticonvulsants
1. Gabapentin (Neurontin) 100 mg, 300 mg capsule
2. Magnesium Sulfate 50 % 2 ml vial, 1 gm/100ml Prefill bag
3. Pregabalin (Lyrica) 25mg, 50mg & 100mg capsule
28:16 Psychotherapeutic Agents
28:16.04 Antidepressants –none stocked
28:16.08 Antipsychotic Agents
28:16.08.04 Atypical Antipsychotics
1. Risperidone (Risperdal) 0.25mg tablet
2. Ziprasidone (Geodon) Inj. 20mg/ml,
28:16.08.08 Butyrophenones
1. Haloperidol (Haldol) Inj:5mg/ml
28:20 Anorexigenic Agents and Respiratory and Cerebral Stimulants
1. Ammonia inhalant 0.33 ml ampule
2. Caffeine Sodiuim Benzoate Inj 2ml amp
28:24 Anxiolytics, Sedatives, and Hypnotics
28:24.04 Barbiturates—none available
28:24.08 Benzodiazepines
1. Alprazolam (Xanax) 0.25mg tablet
2. Chlordiazepoxide HCL (Librium) 10 mg
3. Diazepam (Valium) 5 mg tablet
4. Lorazepam (Ativan) 1 mg tablet, 2 mg/ml vial
5. Midazolam HCL (Versed) Inj. 2mg/2ml vial, Elixir
2mg/5ml unit dose
6. Temazepam (Restoril) 15 mg capsule
28:24.92 Miscellaneous Anxiolytics, Sedatives, & Hypnotics
1. Hydroxyzine Hydrochloride (Atarax) 25 mg tablet, Inj :
25mg/ml 1ml vial
2. Promethazine HCL (Phenergan) 25 mg tablet,
Inj: 25 mg/ml, Rectal: 12.5mg and 25 mg suppository,
3. Zolpidem Tartrate (Ambien) 5 mg tablet
28:32 Antimigraine Agents—none available
28:36 Antiparkinsonian Agents—none available
28:40 Fibromyalgia Agents
1. Pregabalin (Lyrica) 25 mg & 100 mg capsule
28:92 Miscellaneous Central Nervous System Agents
1. Flumazenil (Romazicon) Injection 0.5 mg/5 ml vial
36:00 Diagnostic Agents
36:40 Kidney Function
1. Methylene Blue Injection
36:56 Myasthenia Gravis
1. Neostigmine (Prostigmin) 1:1000 1mg/ml 5 ml syringe
36:68 Roengenography
1. Diatrizoate Meglumine (Cystografin) 30% 100ml bottle
2. Gadopentetate Dimeglumine (Magnevist) 15ml vial
3. Iodixanol (Visipaque) 50ml and 150ml vials (Oct 2019)
4. Iohexol (Omnipaque) 240mg/ml 10ml, 300mg/ml 50ml bottle
5. Iopamidol (Isovue-300) 61%
36:84 Tuberculosis--Tuberculin PPD (Tubersol ) 1 ml vial
40:00 Electrolytics, Caloric, and Water Balance
40:08 Alkalinizing Agents
1. Sodium Citrate and Citric Acid (Bicitra ) 30 ml unit dose cup
2. Sodium Bicarbonate 8.4 % (1mEq/ml) 10 ml Syringe , 50 ml Syringe
40:10 Ammonia Detoxicants
1. Lactulose (Chronulac Syrup) 10 g/15 ml u/d
40:12 Replacement Preparations
1. Calcium Salts
a. Calcium Carbonate, Precipitated
(1) Calcium Carbonate + Vitamin D (Oscal) 500 mg/200mg tablet
(2) Calcium Carbonate (Tums () 500 mg chewable tablet
b. Calcium Chloride---Calcium Chloride 10% 10 ml syringe
c. Calcium Gluconate Injection--10% 10 ml vial
2. Potassium Supplements
a. Potassium Chloride Oral
(1) Klor-Con 20 mEq tablet
b. Potassium Chloride Injection
(1) D5W1/2NS + KCL 10mEq/1000ml bag and 20mEq/1000 bag
2) D5WNS + KCl 20mEq 1000ml bag
(3) 0.45% NACl + KCl 20mEq 1000ml bag
(4) NS + KCL 20mEq 1000ml bag
(5) KCL 10mEq/100ml Sterile Water bag
3. Sodium
a. Bacteriostatic Sodium Chloride Injection 0.9 % 30 ml vial
b. Sodium Chloride 0.9% 10ml prefilled syringe and 10ml vial
4. Hetastarch Solution (Hespan) 500ml bag
40:18 Ion-Removing Agents
40:18.18 Potassium-Removing Agents
1. Sodium Polystyrene Sulfonate (Kayexalate) 15 g per 60 ml Suspension
40:20 Caloric Agents
1. Dextrose
a. Parenteral:
1) D50W 50 ml vial and 50 ml syringe
2. Fat emulsions
a. Fat Emulsion (Intralipid): 20%--500ml bag
40:28 Diuretics
48:28.08 Loop Diuretics
1. Furosemide (Lasix) 20 mg tablet, Inj: 20 mg/2 ml vial,
48 :28.20 Thiazide Diuretics
1. Hydrochlorothiazide (HCTZ): 25 mg tablet
40:36 Irrigating Solutions ---obtain from Material Management
40:40 Uricosuric Agents---None available
44:00 Enzymes-----
1. Hyaluronidase (Hylenex) 150 units/vial
48:00 Antitussives, Expectorants, and Mucolytic Agents
48:08 Antitussives
1. Benzonatate (Tessalon) 100mg capsule
2. Hydrocodone Bitartrate Combinations
a. Hydrocodone Bitartrate/Acetaminophen 7.5 mg/325 mg per 15 ml
b. Hydrocodone Bitartrate/Acetaminophen: 5 mg/325 mg, 7.5 mg/325 mg 10 mg/325mg tablets
48:16 Expectorants --none available
48:24 Mucolytic Agents—none available
52:00 Eye, Ear, Nose, and Throat (EENT) Preparations
52:04 Anti-infectives
52:04.04 Antibacterials
1. Bacitracin Ointment—Unit dose and 30 gm tube
2. Bacitracin-Polymyxin Ophthalmic Ointment 3.5 gm
3. Ciprofloxaxin 0.3% and Fluocinolone 0.025% (Otovel) Otic
Solution 0.25ml vials
4. Neomycin/Polymyxcin B Sulfates/Dexamethasone (Maxitrol)
Ophthalmic Drops
5. Neomycin/Polymyxin B Sulfates/Bacitracin (Neosporin)
Ophthalmic Ointment
6. Ofloxacin Ophth Drops 5ml bottles
7. Tobramycin (Tobrex) 0.3 % Ophth Oint 3.5 gm
8. Tobramycin/Dexamethasone (TobraDex) Ophthalmic
suspension 2.5ml and 5 ml bottles
52:04.92 EENT Anti-infectives, Miscellaneous
1. Silver Nitrate Applicators
52:08 Anti-inflammatory Agents
52:08.08 Corticosteroids for Inhalation
1. Fluticasone (Flonase) Nasal Spray
52:16 Local Anesthetics (EENT)
1. Cocaine 4% Topical Solution 4 ml vial
2. Lidocaine Viscous (Xylocaine) 2% 20ml u/d
52:24 Mydriatics—none available
52:32 Vasoconstrictors
1. Epinephrine HCL 0.1 % (1:1000) 1 ml ampule
2. Oxymetazoline HCL (Afrin) 0.05 % Nasal Solution 15 ml
3. Phenylephrine HCL (Neo-Synephrine) 0.5 % Nasal Soln 15 ml,
4. Phenylephrine Inj. (Neo-Synephrine HCL) 10 mg/ml 1 ml vial
52:40 Anti Glaucoma Agents—none available
52:92 EENT Drugs--Miscellaneous
1. Artificial Tears Ophthalmic Solution 15 ml
2. Balanced Salt Ophthalmic Solution (BSS) 15ml
3. Chloraseptic (Phenol) Lozenzes
4. Ear Drops (Debrox Earwax Removal) 15ml
5. Mineral Oil/White Petrolatum (Refresh) Ophthalmic Ointment 0.4ml
6. Sodium Potassium Phosphate (Nasal Flo) packets
7. Sodium Chloride Nasal Spray 45ml
56:00 Gastrointestinal Drugs
56:04 Antacids and Adsorbents
Antacids
1. Calcium Carbonate 500 mg (Tums) tablet
2. Magnesium Hydroxide (Milk of Magnesia ) 30ml suspension)
3. Mag Hydroxide/Al Hydroxide + Simethicone Susp (Maalox Plus) 30ml
Adsorbents
1. Activated Charcoal
a. Actidose Suspension 25 gm
b. Actidose-Sorbitol Suspension 25 gm
56:08 Antidiarrhea Agents
1. Bismuth Salts
a. Bismuth Subsalicylate (Pepto-Bismol) 15 ml suspension
2. Loperamide HCL (Imodium) 2 mg capsule, Solution: 1mg/5ml
56:10 Antiflatulents
1. Simethicone (Mylicon) 80 mg chewable tablet
56:12 Cathartics and Laxatives
1. Diphenylmethane Laxatives
a. Bisacodyl (Dulcolax) 5 mg tablet, 10 mg suppository
2. Hyperosmotic Laxatives--
a. Sodium Phosphate Mono Dibasic (Fleets) Enema 4.5 oz
b. Glycerin (Fleet) adult suppository
3 Poly Ethylene Glycol 3350 (Miralax, Golytely) 17 gm packet
4. Psyllium Powder (Konsyl) 3.4 gm packets
5. Saline Laxatives
a. Magnesium Citrate Oral Solution 10 fl oz
b. Magnesium Hydroxide (Milk of Magnesia) 30ml
6. Stool Softeners
a. Docusate Sodium (Colace) 100 mg capsule, 50 mg/5 ml syrup
56:20 Emetics—none available
56:22 Antiemetics
56:22.08 Antihistamines
1. Meclizine HCL (Antivert) 25 mg tablet
56:22.20 5HT3 Receptor Antagonists
1. Ondansetron (Zofran) Injection: 4 mg/2 ml vial
(Zofran ODT) 4 mg orally-disintegrating tablet
56:28 Anti Ulcer Agents and Acid Suppresants
56:28.12 Histamine H2 Antagonists
1. Famotidine (Pepcid) 20 mg tablet, 20 mg/2 ml vial
56:28.28 Prostaglandins—none available
56:28.36 Proton Pump Inhibitors
1. Pantoprazole (Protonix) 40mg tablet, 40mg vial for inj
56:32 Prokinetic Agents
1. Metoclopramide HCL (Reglan) 10 mg tablet, Inj : 10mg mg/2 ml vial
68:00 Hormones and Synthetic Substitutes
68:04 Adrenals
1. Betamethasone Acet/Betamethasone Sod Phos (Celestone) Inj 6mg/ml
2. Dexamethasone (Decadron) Inj. 4 mg/ml, 10mgml vial, PO:4mg tablet
3. Hydrocortisone: (Solu-Cortef) Injection--100 mg vial
4. Methylprednisolone Acetate (Depo Medrol)-40mg/ml and 80mg/ml vial
5. Methylprednisolone Succinate (Solu Medrol) 1 gram, 40mg and 80mg
6. Prednisone (Deltasone () 10mg and 20 mg tablet
7. Triamcinolone Acetonide (Kenalog) Injection: 40 mg/ml vial PF,
40mg/vial with Preservative
68:16 Estrogens
1. Conjugated Estrogens (Premarin) Vaginal Cream 30 gm tube
68:20 Antidiabetic Agents
68:20.08 Insulins
1. Insulin (rapid-acting)
a. Insulin inj R (regular insulin): Humulin R
2. Insulin (intermediate-acting)
a. Isophane insulin susp (NPH): Humulin N
68 :22 Antihypoglycemic Agents
68 :22.12 Glucagon Inj 1mg (1 unit) vial
68 :28 Pituitary
1. Desmopressin (DDADP) Inj 4mcg/ml 1 ml
2. Vasopressin Injection (Pitressin) 20 unit/ml vial (not available in house)
68:36 Thyroid and Antithyroid Agents—
2. Levothyroxine (Synthroid) 50mcg tablet
72:00 Local Anesthetics
1. Bupivacaine HCL (Marcaine HCL) 0.25 %, 0.5 % 10ml, 30ml, 0.75% 10ml
2. Bupivacaine Liposomal (Exparel)—133mg/10ml vial (added 2/2019)
3. Bupivacaine with Epinephrine(Marcaine HCL with Epinephrine) 0.25 % 10 ml and
0.5% with Epi 1:200,000 10ml MPF vial and 30 ml vial
4. Chlorprocaine HCL 2% (Nesacaine) (available upon request)
5. Mepivacaine (Carbocaine) 2% 50ml vial
4. Lidocaine HCL
a. (Xylocaine-MPF) : 0.5% 50ml, 1 % 20ml & 30 ml vial
b. (Xylocaine) 1 % : 5ml ampul, 20 ml vial, 50 ml vial,
c. 2 % 2ml, 10ml, 20 ml vial,
d. 4 % 5 ml ampule –topical solution
c. Lidocaine HCL with Epineprhine 1%: 20ml and 30ml, and 2% 20ml
d. Lidocaine (Lidoderm) 5 % patch
e. Lidocaine (Xylocaine) 2 % topical jelly 30 ml tube
5. Ropivacaine (Naropin) Inj—0.2% 10ml, 0.5% 20ml vial
6. RECK (Ropivacaine+Epinephrine+Clonidine+Ketorolac) Solution 50ml syringe
7. Tetracaine 0.5% Ophth Drops 5 ml
76:00 Oxytocics
1. Oxytocin (Pitocin) 10 units/ml 1ml vial
80:00 Serums, Toxoids, and Vaccines
80:04 Serums
1. Antivenin (Crotalidae) Polyvalent Immune Fab (Crofab) vial—not available
2. Digoxin Immune Fab (DigiBind) 38 mg vial—not available
80:08 Toxoids
1. Tetanus and Diphtheria Toxoid
80:12 Vaccines
1. Influenza Virus Vaccine (seasonal availability) (refrigerate)
84:00 Skin and Mucous Membrane Agents
84:04 Anti-infectives
84:04.04 Antibacterials
1. Bacitracin Zinc Ointment 0.9gm u/d, 15 gm tube
2. Triple Antibiotic Ointment BacitracinZinc/Neomycin/Polymyxin
B Sulfate (Neosporin) 0.9 g, 14 gm tube
3. Mupirocin (Bactroban) 2 % Ointment 22 gm tube
84:04.06 Antivirals—none available
84:04.08 Antifungals
1. Clotrimazole
a. (Lotrimin) 1% Top Cream 15gm, Vaginal Cream 45 gm
2. Gentian Violet 1% Solution 60ml bottle
84:04.12 Scabicides and Pediculicides—none available
84:04.92 Miscellaneous Local Anti-infectives
1. Chlorhexidine (Hibiclens) Topical Solution
2. Phenol 89% Solution
3. Phenol Spray ( Chloraseptic) 6 oz bottle
4. Povidone-Iodine 10% Ointment 30 gm tube
5. Silver Sulfadiazine (Silvadene) Cream 50 gm tube
84:06 Anti-inflammatory Agents
1. Hydrocortisone
a. 1 % Topical Cream 1 oz,
84:08 Antipruritics and Local Anesthetics
1. Ethyl Chloride Spray (added 02/19)
2. Lidocaine-Prilocaine 2.5-2.5% (Emla) Cream 30 gm
3. Phenazopyridine HCL (Pyridium) 100 mg tablet
4. Tetracaine/Benzocaine/Butambe (Cetacaine) Spray
84:24 Basic Oils and Other Solvents
1. Mineral Oil Light 10ml vial (topical)
84:28 Keratolytic Agents
1. Silver Nitrate Sticks
86:00 Smooth Muscle Relaxants
86:12 Genitourinary Smooth Muscle Relaxants
1. Oxybutynin Chloride (Ditropan) 5 mg tablet
86 :16 Respiratory Smooth Muscle Relaxants
1. Aminophylline Inj 500mg/20ml vial
88 :00 Vitamins
88 :08 Vitamin B Complex
1. Folic acid 1 mg tablet
2. Thiamine HCL100 mg (Vitamin B1) tablet, 100 mg/ml vial
88.16 Vitamin D Products
1. Calcitriol (Rocaltrol) 0.5mcg capsule
88:24 Vitamin K
1. Phytonadione (AquaMEPHYTON) 10 mg/ml ampule (not in stock)
88 :28 Multivitamin Preparations
1. Therapeutic multivitamin with minerals (Hemocyte Plus) tablet
92 :08 5 Alpha Reductase Inhibitors
1. Finasteride (Proscar) 5 mg tablet
92:12 Antidotes
1. Sugammadex (Bridion)—200mg/2ml vial (added 2/2019)
2. Flumazenil –see 28:92
3. Glucagon---see 68:22.12
4. Methylene Blue 1% 10 ml vial
5. Naloxone (Narcan)—see 28:10
6. Phytonadione---see 88:24
94 :00 Devices
1. Gelatin Sponge Absorbable (Gelfoam) : Size 50, 100
2. Hylan G-F 20 (Synvisc-One)-48 mgsyringe
96 :00 Pharmaceutical Aids
1. Glycerin Liquid 6 oz bottle[pic]
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REMS
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