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PHARMACY FORMULARY 2018 (ACCORDING TO THE AMERICAN HOSPITAL FORMULARY SERVICE)

4:00 Antihistamine Drugs4.04 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 Antihistamines4:04441. Loratadine (Claritin) 10 mg tablet

4.92 Other Antihistamines1. 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 vial2. 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 Generation1. Ceftriaxone (Rocephin) Inj. 1 gm/50ml D5W

Fourth Generation

Look Alike/Sound Alike Medication High Risk/High Alert Med Black Box Warning Risk/Evaluation & Mitigation H - Hazardous

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1. Cefepime (Maxipime) Inj 1gm and 2gm vial

8:12.07 Miscellaneous -lactam Antibiotics 8.12.07.08 Carbapenems

1. Merrepenem (Merrem) 1 gm vial

8:12.12 Macrolides8:12.12.92 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 ml2. Ampicillin (Omnipen) INJECTION : 0.5 gm, 1 gm vial3. Amoxicillin/Clavulanate (Augmentin) 500 mg tablet

8:12.16.12 Penicillinase Resistant Penicillins1. 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 Quinolones1. Ciprofloxacin HCL (Cipro) ORAL : 250mg & 500 mg tablet,

INJECTION : 400mg/200ml D5W

2. Levofloxacin (Levaquin) ORAL : 500 mg tablet, INJECTION: 500 mg/D5W 100 ml

8:12.20 Sulfonamides1. Trimethoprim/Sulfamethoxazole 160 mg/800 mg tablet (Bactrim DS,

Septra DS), Trimethoprim/Sulfamethoxazole Suspension (Bactrim)

8:12.24 Tetracyclines1. Doxycycline Hyclate (Vibramycin) 100 mg capsule

8:12.28 Miscellaneous Antibiotics 1. Bacitracin Powder for Injection—50,000 units2. Clindamycin HCL (Cleocin) ORAL: 300 mg capsule, INJECTION:

600 mg/D5W 50 ml , 900 mg/D5W 50 ml 3. Vancomycin HCL (Vancocin) 500mg, 750mg (add-vantage), 1 gm

vial, 1 gm add-vantage vial


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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 Antiprotozoals8 :30.04 Amebicides

1. Metronidazole (Flagyl) 250mg tablet, INJECTION : 500mg/100ml,

8:92 Miscellaneous Anti-infectives1. Metronidazole (Flagyl) ORAL: 250 mg tablet, INJECTION. 500 mg/100 ml

10:00 Antineoplastics—no antineoplastics on formulary

12:00 Autonomic Drugs 12:04 Parasympathomimetic (Cholinergic) agents

1. Neostigmine Methylsulfate (Prostigmin) Injection 1:1000 5ml syringe

12:08.08 Antimuscarinics/Antispasmodics1. Atropine Sulfate Inj 0.4 mg/ml vial, 1 mg/10 ml syringe2. Dicyclomine HCL (Bentyl) 10 mg capsule3. Glycopyrolate (Robinul) Injection 1 mg/5 ml syringe4. Hyoscyamine Sulfate (Levsin) 0.125 mg sublingual tablet5. Ipratropium Bromide (Atrovent) 0.02 % 0.5 mg/2.5 ml Inhalation soln6. Scopolamine (Transderm Scop) 1.5 mg/2.5 cm2 Transdermal System

12:12 Sympathomimetic (Adrenergic) Agents12:12.04 Alpha Adrenergic Agonists

1. Phenylephrine HCl (Neo-Synephrine) Injection: 10 mg/ml vial

12:12.08 Beta Adrenergic Agonists12:12.08.08 Selective Beta 1 Adrenergic Agonists

1. Dopamine 400mg/D5W 250ml

12:12.08.12 Selective Beta 2 Adrenergic Agonists1. 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 solution3. Terbutaline (Brethine) 1mg/ml 1ml vial


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12:12.12 Alpha and Beta Adrenergic Agonists1. Ephedrine Sulfate : 50 mg/ml 1ml vial, 50mg/5ml syringe2. 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 ml4. Racepinephrine--(S-2 Inhalant) 2.25 % Inhalation Solution 0.5

ml

12:16 Sympatholytic (Adrenergic Blocking) Agents12:16.04 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 Relaxants12:20.04 Centrally Acting Skeletal Muscle Relaxants

1. Carisoprodol (Soma) 350 mg tablet2. Cyclobenzaprine HCL (Flexeril) 10 mg tablet3. Methocarbamol (Robaxin) Inj: 1000mg vial, 500mg & 750mg tab4. Tizanidine (Zanaflex) 2 mg tablet

12:20.08 Direct Acting Skeletal Muscle Relaxants1. Dantrolene Sodium (Ryanodex) Injection 250 mg vial

12:20.20 Neuromuscular Blocking Agents Depolarizing Agents

1. Succinylcholine (Quelicin) 20 mg/ml 5ml syringe

Nondepolarizing Agents1. 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 Drugs1. Nicotine (NicoDerm CQ ) Transdermal System-7 mg, 14 mg , 21 mg and 2mg and 4mg Gum

16:00 Blood Derivatives --none available

20:00 Blood Formation, Coagulation and Thrombosis20:04 Antianemia Drugs

20:04.04 Iron Preparations


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1. Iron Preparations, Orala. Ferrous Sulfate (Feosol) 325 mg (65 mg iron) tablet

20:12 Antithrombotic Agents20:12.04 Anticoagulants

20:12.04.08 Coumarin Derivatives1. Warfarin Sodium (Coumadin) 1 mg, 5mg tablet

20:12.04.14 Direct Factor Xa Inhibitors1. Rivaroxaban (Xarelto) 10mg, 15mg tablet

20:12.04.16 Heparins1. Enoxaparin Sodium (Lovenox ) 30 mg/0.3 ml, 40 mg/0.4 ml, 100 mg/1 ml

2. Heparin Injectiona. Heparin Sod inj (porcine intestinal mucosa)

1000 units/ml 1ml and 5000 units/ml 1mlb. Heparin lock 100 units/ml vial

20:12.16 Hemostatics1. Thrombin, topical (Thrombin-JMI) 5000 U vial

20:12.18 Platelet Aggregation Inhibitors1. Clopidrogrel (Plavix) 75mg tablet (added February 2018)

20:12.20 Thrombolytic Agents1. Alteplase (Cathflo - Activase ) 2 mg vial

20:28.16 Hemostatics1. Tranexamic Acid 100mg/ml 10ml vial

24:00 Cardiovascular Drugs24:04 Cardiac Drugs

24:04.04 Antiarrhythmic Agents24:04.04.04 Class IA Antiarrhythmics

1. Procainamide (Pronestyl) Inj. 100mg/ml 10ml vial

24:04.04.08 Class 1b Antiarrythmics1. 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


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24:04.04.20 Class III Antiarrythmics1. Amiodarone (Cordarone) (Pacerone )

150 mg/3 ml ampule, 200mg tablet

24:04.04.24 Class IV Antiarrythmics1. Adenosine (Adenocard) Inj 6 mg/2ml2. Diltiazem (Cardizem)---see section 24:28.923. Verapamil (Calan)---- see section 24:28.92

24:04.08 Cardiotonic Agents----Cardiac Glycosides1. Digoxin (Lanoxin) 500 mcg/2 ml amp, 0.25mg tablet

24:06 Antilipemic Agents—do not carry

24:08 Hypotensive Agents24:08.16 Central Alpha Agonists

1. Clonidine (Catapres) 0.1 mg/24 hr TTS patches, 0.1 mg tablet, INJ: 100mcg/ml 1ml and 10ml vials

24:08.20 Direct Vasodilators1. Hydralazine HCL (Apresoline) 25 mg tablet, 20 mg/ml vial

24:12 Vasodilating Agents24:12.08 Nitrates and Nitrites

1. Nitroglycerin (Nitro-Bid) 2% ointment 1 gm, (Nitrostat) 0.4 mg SL tablet, inj: 50 mg/D5W 250 ml glass bottle

24:20 Alpha-Adrenergic Blocking Agents1. Labetalol (Normodyne, Trandate)---see in 24:24

24:24 Beta-Adrenergic Blocking Agents1. Atenolol (Tenormin) 25 mg tablet2. Esmolol (Brevibloc)—10mg/ml 10ml vial3. Labetalol HCL (Trandate) INJ: 20mg/4ml syringe, 100 mg/20 ml vial4. Metoprolol Tartrate (Lopressor) 25mg tablet, 5 mg/5 ml ampule5. Metoprolol Succinate (Toprol) 25mg tablet6. Propanolol (Inderal) 1mg/ml 1ml vial

24:28 Calcium-Channel Blocking Agents24:28.08 Dihydropyridines

1. Amlodipine Besylate (Norvasc) 5 mg tablet

24:28.92 Calcium Channel Blocking Agents, Miscellaneous1. Diltiazem HCL (Cardizem) 30mg tablet, INJ: 25 mg/5 ml vial2. Verapamil HCL (Calan) INJ: 5 mg/2 ml vial


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24:32 Renin-Angiotensin-Aldosterone System

24:32.04 Angiotensin-Converting Enzyme Inhibitors1. Enalapril (Vasotec) Inj: 1.25 mg/ml 2ml vial, Oral: 5mg tablet2. Lisinopril (Zestril, Prinivil) 10 mg tablet

24:32.08 Angiotensin II Receptor Antagonists1. Losartan (Cozzar) 50mg tablet

28:00 Central Nervous System Agents28:04 General Anesthetics

28:04.16 Inhalation Anesthetics1. Desflurane (Suprane) 240ml bottle 2. Sevoflurane (Ultane) 250ml bottle

28:04.92 General Anesthetics, Miscellaneous1. Etomidate (Amidate) 20 mg/10 ml ampule2. Ketamine Inj 50mg/ml 10ml vial3. Propofol (Diprivan) Inj: 1% 100mg/10ml, 200 mg/20 ml,

and 1000mg/100ml vial

28:08 Analgesics and Antipyretics28:08.04 Nonsteroidal Anti-inflammatory Agents

28:08.04.08 Cyclooxygenase-2 (COX-2) Inhibitors1. 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 Agents1. Ibuprofen (Advil) (Motrin) 200 , 600 & 800mg

tablet, Suspension: 100mg/5ml unit dose2. Ketorolac Tromethamine (Torado) 10 mg tablet,

Injection:30 mg vial, 60mg/2ml vial

28:08.08 Opiate Agonists1. 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


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b. Hydrocodone Bitartrate/Acetaminophen (Lortab Elixir) 7.5mg/325mg per 15ml cup

c. Hydrocodone Bitartrate/Acetaminophen (Norco 5) 5 mg/325 mg tablet

d. Hydrocodone Bitartrate/Acetaminophen (Norco 7.5) 7.5 mg/325 mg tablet

e. Hydrocodone Bitartrate/Acetaminophen (Norco 10) 10 mg/325 mg tablet

f. 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 bag5.. Meperidine HCL (Demerol) Inj: 25 mg/ml, 50 mg/ml, 50mg

tablet6. Morphine Sulfate

a. PCA: 1mg/ml 100ml bagb. Injection: 2mg/ml, 4mg/ml, 10 mg/ml

Preservative free (Duramorph): 10 mg/10 ml,

7. Oxycodone Productsa. Oxycodone 5mg tablet b. Oxycodone /Acetaminophen (Percocet) 5 mg/325 mg and 10mg/325mg tabletc. 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 Agonists1. Nalbuphine (Nubain) Inj. 10mg/ml 1ml amp

28:08.92 Miscellaneous Analgesics and Antipyretics1. Acetaminophen (Tylenol)

Oral Solution: 160 mg/5 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 Combinationsa. Acetaminophen/Butalbital/Caffeine 325 mg/50 mg/40 mg

tablet (Fioricet )4. Ziconotide Acetate (Prialt) 100mcg/ml 1 ml vial (compounded)


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28:10 Opiate Antagonists1. Naloxone HCL (Narcan) 0.4 mg/ml vial, 2mg syringe

28:12 Anticonvulsants28:12.04 Barbiturates---none available

28:12.08 Benzodiazepines 1. Clonazepam (Klonopin) 0.5 mg tablet2. Diazepam (Valium) Oral : 5mg tablet, 10mg/2ml

syringe3. 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 capsule2. Magnesium Sulfate 50 % 2 ml vial, 1 gm/100ml

Prefill bag 3. Pregabalin (Lyrica) 25mg, 50mg & 100mg capsule

28:16 Psychotherapeutic Agents28:16.04 Antidepressants –none stocked

28:16.08 Antipsychotic Agents28:16.08.04 Atypical Antipsychotics

1. Risperidone (Risperdal) 0.25mg tablet2. Ziprasidone (Geodon) Inj. 20mg/ml,

28:16.08.08 Butyrophenones1. Haloperidol (Haldol) Inj:5mg/ml

28:20 Anorexigenic Agents and Respiratory and Cerebral Stimulants1. Ammonia inhalant 0.33 ml ampule2. Caffeine Sodiuim Benzoate Inj 2ml amp

28:24 Anxiolytics, Sedatives, and Hypnotics

28:24.04 Barbiturates—none available

28:24.08 Benzodiazepines1. Alprazolam (Xanax) 0.25mg tablet2. Chlordiazepoxide HCL (Librium) 10 mg


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3. Diazepam (Valium) 5 mg tablet4. Lorazepam (Ativan) 1 mg tablet, 2 mg/ml vial

5. Midazolam HCL (Versed) Inj. 2mg/2ml vial, Elixir 2mg/5ml unit dose6. 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 Agents1. Pregabalin (Lyrica) 25 mg & 100 mg capsule

28:92 Miscellaneous Central Nervous System Agents1. Flumazenil (Romazicon) Injection 0.5 mg/5 ml vial

36:00 Diagnostic Agents

36:40 Kidney Function1. Methylene Blue Injection

36:56 Myasthenia Gravis1. Neostigmine (Prostigmin) 1:1000 1mg/ml 5 ml syringe

36:68 Roengenography1. Diatrizoate Meglumine (Cystografin) 30% 100ml bottle2. Gadopentetate Dimeglumine (Magnevist) 15ml vial3. Iohexol (Omnipaque) 240mg/ml 10ml, 300mg/ml 50ml bottle4. Iopamidol (Isovue-300) 61%

36:84 Tuberculosis --Tuberculin PPD (Tubersol ) 1 ml vial


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40:00 Electrolytics, Caloric, and Water Balance40:08 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 Detoxicants1. Lactulose (Chronulac Syrup) 10 g/15 ml u/d

40:12 Replacement Preparations1. 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 syringec. Calcium Gluconate Injection--10% 10 ml vial

2. Potassium Supplementsa. 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 vialb. Sodium Chloride 0.9% 10ml prefilled syringe and 10ml vial

4. Hetastarch Solution (Hespan) 500ml bag

40:18 Ion-Removing Agents40:18.18 Potassium-Removing Agents

1. Sodium Polystyrene Sulfonate (Kayexalate) 15 g per 60 ml Suspension

40:20 Caloric Agents 1. Dextrose

a. Parenteral:(1) D50W 1 ml vial and 50 ml syringe

2. Fat emulsionsa. Fat Emulsion (Intralipid): 20%--500ml bag


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40:28 Diuretics 48:28.08 Loop Diuretics

1. Furosemide (Lasix) 20 mg tablet, Inj: 20 mg/2 ml vial,

48 :28.20 Thiazide Diuretics1. 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-infectives52:04.04 Antibacterials

1. Bacitracin Ointment—Unit dose and 30 gm tube2. Bacitracin Ophthalmic Ointment 3.5 gm3. Ciprofloxaxin 0.3% and Fluocinolone 0.025% (Otovel) Otic

Solution 0.25ml vials4. Neomycin/Polymyxcin B Sulfates/Dexamethasone (Maxitrol)

Ophthalmic Drops5. Neomycin/Polymyxin B Sulfates/Bacitracin (Neosporin)

Ophthalmic Ointment 6. Ofloxacin Ophth Drops 5ml bottles7. Tobramycin (Tobrex) 0.3 % Ophth Oint 3.5 gm8. Tobramycin/Dexamethasone (TobraDex) Ophthalmic

suspension 2.5ml and 5 ml bottles


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52:04.92 EENT Anti-infectives, Miscellaneous1. Silver Nitrate Applicators

52:08 Anti-inflammatory Agents52:08.08 Corticosteroids for Inhalation

1. Fluticasone (Flonase) Nasal Spray

52:16 Local Anesthetics (EENT)1. Cocaine 4% Topical Solution 4 ml vial2. Lidocaine Viscous (Xylocaine) 2% 20ml u/d

52:24 Mydriatics—none available

52:32 Vasoconstrictors1. Epinephrine HCL 0.1 % (1:1000) 1 ml ampule2. Oxymetazoline HCL (Afrin) 0.05 % Nasal Solution 15 ml3. 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--Miscellaneous1. Artificial Tears Ophthalmic Solution 15 ml2. Balanced Salt Ophthalmic Solution (BSS) 15ml3. Chloraseptic (Phenol) Lozenzes4. Ear Drops (Debrox Earwax Removal) 15ml5. Mineral Oil/White Petrolatum (Refresh) Ophthalmic Ointment 0.4ml6. Sodium Potassium Phosphate (Nasal Flo) packets7. Sodium Chloride Nasal Spray 45ml

56:00 Gastrointestinal Drugs56:04 Antacids and Adsorbents

Antacids 1. Calcium Carbonate 500 mg (Tums) tablet2. Magnesium Hydroxide (Milk of Magnesia ) 30ml suspension) 3. Mag Hydroxide/Al Hydroxide + Simethicone Susp (Maalox Plus) 30ml

Adsorbents1. Activated Charcoal a. Actidose Suspension 25 gm

b. Actidose-Sorbitol Suspension 25 gm

56:08 Antidiarrhea Agents1. Bismuth Salts


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a. Bismuth Subsalicylate (Pepto-Bismol) 15 ml suspension2. Loperamide HCL (Imodium) 2 mg capsule, Solution: 1mg/5ml

56:10 Antiflatulents 1. Simethicone (Mylicon Infant’s Drops) 40 mg/0.6 ml suspension2. 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 suppository3 Poly Ethylene Glycol 3350 (Miralax, Golytely) 17 gm packet4. Psyllium Powder (Konsyl) 3.4 gm packets

5. Saline Laxativesa. Magnesium Citrate Oral Solution 10 fl ozb. Magnesium Hydroxide (Milk of Magnesia) 30ml

6. Stool Softenersa. Docusate Sodium (Colace) 100 mg capsule, 50 mg/5 ml syrup

56:20 Emetics—none available

56:22 Antiemetics56:22.08 Antihistamines

1. Meclizine HCL (Antivert) 25 mg tablet

56:22.20 5HT3 Receptor Antagonists1. 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 Inhibitors1. Pantoprazole (Protonix) 40mg tablet

56:32 Prokinetic Agents1. Metoclopramide HCL (Reglan) 10 mg tablet, Inj : 10mg mg/2 ml vial


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68:00 Hormones and Synthetic Substitutes 68:04 Adrenals

1. Betamethasone Acet/Betamethasone Sod Phos (Celestone) Inj 6mg/ml2. Dexamethasone (Decadron) Inj. 4 mg/ml and 10mgml vial, PO:4mg

tablet 3. Hydrocortisone: (Solu-Cortef) Injection--100 mg vial4. 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 tablet7. Triamcinolone Acetonide (Kenalog) Injection: 40 mg/ml vial

68:16 Estrogens1. Conjugated Estrogens (Premarin) Vaginal Cream 30 gm tube

68:20 Antidiabetic Agents

68:20.08 Insulins1. 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 Agents68 :22.12 Glucagon Inj 1mg (1 unit) vial

68 :28 Pituitary1. Desmopressin (DDADP) Inj 4mcg/ml 1 ml 2. Vasopressin Injection (Pitressin) 20 unit/ml vial

68:36 Thyroid and Antithyroid Agents—2. Levothyroxine (Synthroid) 50mcg tablet

72:00 Local Anesthetics1. Bupivacaine HCL (Marcaine HCL) 0.25 %, 0.5 % 10ml, 30ml, 0.75% 10ml

2. 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

3. Chlorprocaine HCL 2% (Nesacaine)

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


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c. Lidocaine HCL with Epineprhine 1%: 20ml and 30ml, and 2% 20ml d. Lidocaine (Lidoderm) 5 % patche. Lidocaine (Xylocaine) 2 % topical jelly 30 ml tube

5. Ropivacaine (Naropin) Inj—0.2% 10ml, 100ml bottle, 0.5% 20ml vial

6. RECK (Ropivacaine+Epinephrine+Clonidine+Ketorolac) Solution 50ml

7. Tetracaine 0.5% Ophth Drops 5 ml

76:00 Oxytocics1. Oxytocin (Pitocin) 10 units/ml 1ml vial

80:00 Serums, Toxoids, and Vaccines80:04 Serums

1. Antivenin (Crotalidae) Polyvalent Immune Fab (Crofab) vial—not available

2. Digoxin Immune Fab (DigiBind) 38 mg vial—not available

80:08 Toxoids1. Tetanus and Diphtheria Toxoid

80:12 Vaccines1. Influenza Virus Vaccine (seasonal availability) (refrigerate)

84:00 Skin and Mucous Membrane Agents84:04 Anti-infectives

84:04.04 Antibacterials1. Bacitracin Zinc Ointment 0.9gm u/d, 15 gm tube2. Triple Antibiotic Ointment BacitracinZinc/Neomycin/Polymyxin

B Sulfate (Neosporin) 0.9 g, 14 gm tube3. Mupirocin (Bactroban) 2 % Ointment 22 gm tube

84:04.06 Antivirals—none available

84:04.08 Antifungals1. Clotrimazole

a. (Lotrimin) 1% Top Cream 15gm, Vaginal Cream 45 gm2. Gentian Violet 1% Solution 60ml bottle

84:04.12 Scabicides and Pediculicides—none available

84:04.92 Miscellaneous Local Anti-infectives1 Chlorhexidine (Hibiclens) Topical Solution2 Phenol 89% Solution


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3 Phenol Spray ( Chloraseptic) 6 oz bottle4 Povidone-Iodine 10% Ointment 30 gm tube5 Silver Sulfadiazine (Silvadene) Cream 50 gm tube

84:06 Anti-inflammatory Agents1. Hydrocortisone

a. 1 % Topical Cream 1 oz,

84:08 Antipruritics and Local Anesthetics 1. Lidocaine-Prilocaine 2.5-2.5% (Emla) Cream 30 gm2. Phenazopyridine HCL (Pyridium) 100 mg tablet3. 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

88 :00 Vitamins88 :08 Vitamin B Complex

1. Folic acid 1 mg tablet2. Thiamine HCL100 mg (Vitamin B1) tablet, 100 mg/ml vial

88.16 Vitamin D Products1. Calcitriol (Rocaltrol) 0.5mcg capsule

88:24 Vitamin K1. Phytonadione (AquaMEPHYTON) 10 mg/ml ampule

88 :28 Multivitamin Preparations1. Therapeutic multivitamin with minerals (Hemocyte Plus) tablet

92 :08 5 Alpha Reductase Inhibitors2. Finasteride (Proscar) 5 mg tablet

92:12 Antidotes1. Flumazenil –see 28:922. Glucagon---see 68:22.123. Methylene Blue 1% 10 ml vial


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4. Naloxone (Narcan)—see 28:105. Phytonadione---see 88:24

94 :00 Devices1. Gelatin Sponge Absorbable (Gelfoam) : Size 50, 1002. Hylan G-F 20 (Synvisc-One)-48 mgsyringe

96 :00 Pharmaceutical Aids1. Glycerin Liquid 6 oz bottle


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