General Health Topic - Prescription Assistance Plans

Hello Everyone,

I want to share this very important topic with you and I would like to ask you to forward this information to everyone you know that might benefit. Everyone could potentially benefit.

As you know, the cost of many prescription medications keeps rising. If you do not have insurance or a prescription drug plan, the cost of many of these drugs can be unaffordable.

I want to bring to your attention is a fantastic service called the "Partnership for Prescription Assistance"

The Partnership for Prescription Assistance helps qualified patients who lack prescription coverage get the medicines they need through public or private programs. Many patients can get covered medications free or at little cost.

They bring America’s pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups together to provide a single point of access to more than 475 public and private patient assistance programs, including more than 180 programs offered by pharmaceutical companies.

The Partnership for Prescription Assistance mission is to increase awareness of patient assistance programs and boost enrollment of those who are eligible. In order to find out what patient assistance programs you may qualify for, all you have to do is answer a few short eligibility questions. Their web site will help supply you with the information you need to get involved in a program and will allow you to download applications online. You can then follow the instructions on the application to apply.

Here is the important link:

https://www.pparx.org/

The web site has areas for patients, for caregivers and also for prescribers. You can select on your particular state to find a free or discounted drug program. For patients in Texas, it will direct you to http://www.pparxtx.org/ and has items specific for Texans. They also have information in Spanish. On that site you can sign up for an e-mail newsletter as well.

To see a list of participating programs and companies, click on this link:

https://www.pparx.org/ViewCompanies.php

To access the Partnership for Prescription Assistance by phone, you can call toll-free, 1-888-4PPA-NOW (1-888-477-2669).

Please pass this information along to all your family, friends and patients.

Hope you find this information helpful.

Thanks,

Dr. Paul

GENERAL HEALTH INFO - Drugs in the News

Hello Everyone,

There has been an recent unfortunate medication error that has garnered alot of press. It appears that the twin children of the actor, Dennis Quaid were given an inappropriate dose of the anticoagulant drug, HEPARIN. Fortunately, the children are doing well and should make a full recovery.

Heparin is an anticoagulant that prevents the formation of blood clots in the body. It works by inhibiting the coagulation enzymes Thrombin (Factor IIa) Factor Xa and Factor IXa.

Heparin is used for the prevention of blood clots for patients that have had a heart attack, cardiac bypass surgery, prevention of blood clots in the legs and many other conditions where the formation of blood clots need to be prevented. The prevention of these conditions normally use higher doses of heparin. These doses are often called "Therapeutic doses"

Heparin is also used in lower doses for the prevention of blood clots forming in intravenous catheters or at the end of intravenous catheters. (Catheter Flush)

Heparin is not absorbed if taken orally so it must be given as an intravenous or subcutaneous injection.

The major side effect of heparin is unwanted bleeding. Heparin is also know as a "HIGH ALERT DRUG" A High alert drug is one that can cause significant harm to a patient even when used as intended. They cause harm more commonly and the adverse effects tend to be more serious.

I was asked, "How did this mix-up occur?"

Heparin is commercially available in many different strengths, reported as "Units/milliliter" (U/ML) (units/ml)

Because different conditions required different doses of heparin, most hospitals carry all the different strengths in their inventory.

Heparin is available in:

10,000 Units/ml \
5,000 Units/ml THESE ARE COMMON FOR THERAPEUTIC DOSES
1,000 Units/ml /

For Flushing Intravenous catheters the common strengths are:

100 Units/ml for adults
10 Units/ml for pediatric patients

In the incident with the Quaid children, they were supposed to receive a dose of the 10 Unit/ml Heparin but instead received a dose of the 10,000 Unit/ml heparin. That is a 1000 fold error.

See if you can see the potential for error in the following example:

Heparin 100u/ml IV as directed. - With the word "UNIT" not spelled out, the u could be mistaken for another zero. Therefore a dose of 1000 Units could be given instead of 100 units. Imagine if that order were hastily written out and not typed. It would be more difficult to read correctly. It can happen that easily!

There are many strategies out there to try to prevent these errors. The most important strategy is for the Pharmacists and Nurses to be constantly vigilant and aware that the potential for these errors exist. Check and Double check. If I am not sure, I ask. Then double check again!

For more information, please read the following from the Institute for Safe Medication Practices (ISMP)

http://www.ismp.org/Newsletters/acutecare/articles/20071129.asp

For information on High Alert Medications please see this link.

http://www.ihconline.org/ihi/ReduceHarmHighAlertMedications/PreventHarmFromHighAlertMedications.pdf

Thanks for your attention.

Dr. Paul