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Related article: Separate heparin, insulin and other medications measured in units. Purchase products that are well-labeled. Insulin Do not use the abbreviations "u" for "units." Diazepam 5mg Really Weak Next Day Store insulin and heparin separately to avoid mix-ups. Require two independent dose checks on all insulin orders. Magnesium Intravenous Do not use abbreviations for morphine and magnesium. . Employ independent double-checks of all calculations, dose preparations, and pump settings. Narcotics and Opiates Label medications by generic name as well as brand name. Employ independent double checks of drug, dose, pump setting and line placement for PCA and epidural drugs. Use standardized concentrations of I.V. solutions. . All patients receiving opiates should be screened for allergies. Ensure that naloxone or an equivalent is available/accessible in areas where narcotics are administered. Use liquid adapters and disposable syringes to insure dosing accuracy. Concentrated Electrolytes (Potassium. TPN) Injectable potassium and total parenteral nutrition are not available at ECRH. Investigational Drugs Refer to Pharmacy Manual procedure Psychotropics (NGAs & SSRIs) Use dosage within established Maximum Recommended Daily Dosage.(MRDD) Dosages above MRDD must be approved by the Clinical Director. Dispense as unit dose. Lithium Citrate Solution Use dosage within established Maximum Recommended Daily Dosage.(MRDD) Dosages above MRDD must be approved by the Clinical Director. Use liquid adapters and disposable syringes to insure dosing accuracy. Liquid Medications Use liquid adapters and disposable syringes to insure dosing accuracy for liquid medications with non consistent dosing (i.e.3.33ml rather than 5ml or 4ml dosing). Neuromuscular Blocking Agents/ Paralytics (pending beginning of ECT) May only be given by a physician trained in airway management or a certified registered nurse anesthetist. Medication must be clearly labeled as a paralytic agent. Dose must be verified by two practitioners before administration II-17-MEDICATION RECONCILIATION DBHDD Policy No. 03-529 Medication Reconciliation at Admission and Discharge II-18 DISCHARGE AND PASS MEDICATIONS A. Discharge medications: The ECRH Pharmacy provides medications for its patients/clients that are discharged or go on pass. There are specific policies about the amounts and other things as they relate to the type of consumer that is being served. These will be discussed in their specific section. All discharge and pass medications orders must contain complete dispensing instructions, including patients name, drug name, strength, form, quantity, and directions. The physician must sign and date the order. A separate prescription with a DEA number is needed to dispense Schedule II medication to discharged patients. Patients will be offered counseling on their medication and medication information leaflets will be sent along with the medication. Discharge medications at ECRH: Medications must be written on a patients discharge form (MH 5-5-410 in appendix). A maximum of 5 days supply can be dispensed for Augusta Campus patients. To receive schedule II medications a separate prescription including the physicians DEA number, must be written. Liquid psychotropic medications are not dispensed to patients without careful counseling of the patient or caregiver to prevent medication errors. Prior arrangements must Diazepam 5mg Really Weak Next Day be made with the pharmacy for this type of medication to be dispensed. A progress note must be entered into the patients record stating the necessity for dispensing this dosage form.