FENTANYL PCA ORDERS

  • PRESCRIPTION FOR GENEVA WOODS INFUSION PHARMACY
    Fentanyl PCA infused intravenously via CADD pump


  • to

  • mcg to
  • .

  • minutes as needed for pain
  • .
  • Prescriptions for patients who are terminally ill or living in a LTCF will be valid for a maximum period of 60 days. Refills are not allowed, but the pharmacy may give the patient partial fills of a prescription written for a 60-day supply of fentanyl.
    Prescriptions for patients who are neither terminally ill nor living in a LTCF will require a new prescription before dispensing each fill. Geneva Woods Infusion Pharmacy will only dispense an appropriate quantity of drug that will fit in one container (bag or CADD cassette) to eliminate the risk involved with supplying the patient with multiple containers of narcotics to be stored in the refrigerator.
    • Sodium Chloride 0.9% flush, Heparin flush, and all ancillary supplies per Geneva Woods Pharmacy protocol
    • Alteplase 2 mg – instill into each occluded lumen of central line PRN and allow to dwell per manufacturer guidelines x 2 refills

  • • If no central intravenous access, Geneva Woods nurse to insert peripheral IV, rotating the site per Geneva Woods Pharmacy protocol
    For all first doses of medications, first dose precautions per Geneva Woods Pharmacy protocol will be followed.
    Geneva Woods nurse to teach patient and/or caregiver the care and use of therapy-related devices as well as educate regarding possible adverse events related to the therapy and IV access device
  • Please fax completed form to Geneva Woods Infusion Pharmacy
    907.334.8587