Step Therapy Criteria 2014 MSOFL_Medica Last Updated: 01/01/2014 ANTIDEPRESSANT THERAPY - UHCMR Products Affected Criteria Step 1: One of the following Tier 1 or Tier 2 or Tier 3 antidepressants: SSRI, SNRI, bupropion, mirtazepine. Step 2: Emsam CAMPTOSAR INJECTION THERAPY - UHCMR Products Affected Criteria Step 1: Irinotecan 20 mg/mL injection (generic). Step 2: C
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Friendshipventures.orgCAMPS OF COURAGE & FRIENDSHIP
PHYSICIAN’S STANDING ORDERS
Tylenol tabs (acetaminophen) 500 mg. 1-2 tabs every 4-6 hr. or acetaminophen liq.10-15mg/kg every 4-6 hr. Ibuprofen 200 mg.1-2 tabs every 4-6 hours or Children’s Ibuprofen Oral Suspension administered per package directions Do not give if history of ulcer or other stomach problems. Discontinue use and see physician if black-colored stools. Aspercreme or topical analgesic equivalent. Apply to affected area per package directions. Orajel. Apply to affected area per package instructions. Cough drop if unable to gargle with warm salt water. Tussin DM cough syrup or equivalent as directed for non-diabetic. Not to be given to anyone under the age of 6 (six). Sudafed PE 30 mg., Sudafed PE liquid or Claritin 10 mg. or equivalent of loratadine. Maalox (liquid antacid) or Tums administered per package directions; do not use for more than 24-48 hours without Clear liquid diet; avoid dairy products X24 hrs. Bland diet first day after symptoms subside. If no response: Imodium(loperamide) or equivalent administered per package directions if no blood in stools and no fever. May hold routine prescribed bowel medication during episodes of loose stools. Day 2 with no BM: 8 oz. prune juice and/or 1 Tbsp Metamucil, at breakfast and supper, encourage fluids Day 3: continue giving prune juice and/or Metamucil; also give 30mL Milk of Magnesia, encourage fluids Day 4 (12-24 hours after MOM): Bisacodyl 10 mg suppository or equivalent (resident camp only)encourage fluids Day 5 (12 hours after suppository): Fleets enema (resident camp only)encourage fluids If bowel sounds are absent or constipation continues after administration of an enema, contact M.D. Itching due to insect bites or rash: Anti- itch lotion or gel or Hydrocortisone 1% cream (with application of cold compress for insect bites) Benadryl tabs (Diphenhydramine) or Liquid Benadryl or Claritin (loratadine) administered per package directions May apply Meat Tenderizer paste for bee sting. EpiPen: Jr. and Adult dose Auto-Injector located in dining hall and health center. Personal supply to be carried with individual at all times. After administration immediately dial 911 for emergency transport. Lotrimin cream or equivalent applied per package directions Artificial Tears or lubricating eye drops instilled per package directions. May administer one dose of loratadine or 13. Probable conjunctivitis: Flush affected eye with Artificial Tears and apply warm compress for 5-10min. Repeat as needed for comfort. If no improvement after 4hrs contact caregiver and advise to see MD. 14. Minor cuts and scrapes: cleanse with soap and water or half-strength Hydrogen Peroxide. Apply Bacitracin or equivalent, topically then apply 15. Chapped lips: Lip Balm or equivalent applied to topically per package directions
16. Mosquito/insect bite prevention: Mosquito Repellent cream/lotion to skin or spray to clothing per package directions
17. Sunburn prevention: Sunscreen SPF 15 or greater applied topically per package directions
18. Sunburn discomfort: Aloe gel applied to skin per package directions.
19. Dry skin: A & D Cream or moisturizing lotion applied topically as needed
20. Head Lice: Lice Free, Lice Sol Kit or equivalent used topically per package directions
21. Hypoglycemia: Glutose 15 grams to responsive client who has symptoms of hypoglycemia or dramatic drop from usual glucose level.
22. Qualified staff may initiate CPR and use of AED when warranted.
23. For medication error to wrong camper or accidental poisoning call Poison Control at 1-800-222-1222 and FOLLOW INSTRUCTIONS.
24. Possible MI: administer 162mg chewable ASA (81mg x2) if over the age of 18, person is able to swallow, and EMS more than 20 min away.
***All tablets, capsules, and liquids given PO unless otherwise stated in camper/staff/volunteer personal profile***
Health screening will occur within 24 hours of staff / individual’s participation in a Friendship Ventures service. The following items will be
A. Individual will be screened for any observable evidence of illness, mental health issue, communicable disease, or injury. B. Any evidence of illness, communicable disease, or injury will be referred to appropriate licensed personnel for evaluation and treatment. Caregiver Signature: ___________________________ Date: ________________ Last updated 4/4/13
1st Quarter 2012 Prescription Drug Use The average percentage of claims that are filled as Higher in Obese People generics is 70 percent. The potential is about 85 percent, however, so further opportunity exists. A new survey from the Centers of Disease Control and Almost 60 percent of employers cover 90-day Prevention (CDC) found that obese adults in the Unites supplies of main