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Regional Pharmaceutical Resources

Regional Pharmaceutical Resources. Colleen Terriff, PharmD , BCPS (AQ-ID), MPH (soon) Clinical Associate Professor Washington State University College of Pharmacy Deaconess Hospital and Rockwood Health Systems November 21, 2013. History of Involvement. 1999 hoax anthrax letter

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Regional Pharmaceutical Resources

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  1. Regional Pharmaceutical Resources Colleen Terriff, PharmD, BCPS (AQ-ID), MPH (soon) Clinical Associate Professor Washington State University College of Pharmacy Deaconess Hospital and Rockwood Health Systems November 21, 2013

  2. History of Involvement • 1999 hoax anthrax letter • Y2K preparation for hospitals • Poster at Midyear and AJHP publication • MMRS Spokane City/County Pharmaceutical Coordinator (2000- present) • Sept 11, 2001 • Participation in variety of exercises: • Mass vaccination • Mass dispensing • Mass casualty

  3. Pharmaceutical Coordinator • CDC CHEMPACK med exchanges • Assist with public health • Stockpiling: • Decisions: location, medications, ancillary supplies • Distribution • Dosing and preparation information • Inventory • Destruction

  4. Pharmaceutical Resources • MMRS Stockpiles • CHEMPACKS • SNS Antiviral Cache • VA Cache • HRSA Employee Cache • Hospital Inventory for SRHD • Community Pharmacy Inventory as needed

  5. Bioterrorism Planning

  6. Local BioterrorismPharmaceutical Plan (MMRS) • Agents • Levaquin IV/PO, doxycycline IV/PO, gentamicin IV • Others • dosing syringes, sterile water for injection • Considerations • pediatrics, pregnancy, elderly, immunocompromised • first-responders and healthcare professionals • prophylaxis vs. treatment

  7. Chemical Terrorism Planning

  8. Local Chemical TerrorismPharmaceutical Plan (MMRS) • Nerve agent antidotes: • 2004: • MARK-1 and diazepam autoinjectors with “sprinklings” of 2-PAM vials, diazepam carpujects • ALS transport (AMR and Medstar) and non-transport (fire) • 2009: • Duodotes • Cyanide antidotes (hydroxocobalamin) • fire chief rigs • Expired: AMR

  9. CHEMPACK Program • Nerve agent antidotes • antidotes more readily available • improve local response time • treat thousands of patients (including peds) • Federally owned cache • decrease cost to local areas: initial and replacement • Shelf-Life Extension Program (SLEP)

  10. Shelf-Life Extension Program • Previously- military • SNS in conjunction with the FDA may extend shelf-life of meds (expiration date) • Strict criteria: • storage and security • Meds from CHEMPACK: • regardless of dating on vials/packages…. • ensured potency!! • Just implemented for Tamiflu susp.

  11. CHEMPACK DistributionEastern Washington • Hospital: • Deaconess • Holy Family • Sacred Heart • Valley • EMS: • AMR (x2) • Valley Hospital • Colville • Pullman

  12. Strategic National Stockpile Program • CDC/Federal Government assistance • Stockpile (4 components): • 12 hour push package • antibiotics (IV and PO) and antidotes • fluids, bandages, IV supplies, supportive care meds • Vendor Managed Inventory- drug or equip.-specific • Vaccine and Antitoxin • CHEMPACK program- pilot: NY, SD, WA • Additional resources: personnel, $$

  13. Antivirals Spring 2009 • CDC released 25% of SNS antivirals • DOH received antivirals and then distributed to sites identified by local HD • Local: • Hospitals • Retail/chain with expanded access • Issues: • storage (physical) • short expiration of suspension • different packaging

  14. Antiviral Issues Continued… • Locals now own stockpile • Who is the “gatekeeper” of access? • Need to use up local supply (in pharmacies) first, then can utilize SNS • Ancillary supplies…

  15. VA Stockpile • Large facilities • Small facilities: • Spokane • Mass casualty • Color coded • Includes supportive care meds • 2008 Directive

  16. HRSA Employee Cache • Ciprofloxacin • Doxycycline • For employees and families and hospital-based EMS providers • Maintained by area hospitals

  17. Deaconess Stockpiles • MMRS- ill patients (i.e. IV meds) • ED provider can access • MMRS- POD • SRHD or Spokane EOM- to be sent to POD • CHEMPACK plus expired meds • Antiviral SNS cache • Employee cache • Antibiotics and antivirals • HRSA grants

  18. Hospital Pharmacy Inventory • Deaconess and Shriners • Holy Family and Deer Park • Sacred Heart • Valley • VA • Antibiotics, chemical exposure treatment, antivirals • Estimation • SRHD listed resource

  19. Community Pharmacy Inventory • Enroll help of: • WSU College of Pharmacy Drug Information Center • Spokane Pharmacy Association • Limited meds • Dispensing to community

  20. MOU’s with Pharmacy • State-wide initiative community pharmacies: • Chains • Independents • SRHD with WSU COP: • Mass dispensing • Mass vaccination

  21. Medication Destruction • Partnering with law enforcement (SPD) • Coordinating stockpile destruction with other incineration needs for LE • Mainly MMRS chemical terrorism meds

  22. Moving Forward • MMRS defunct • CHEMPACK program will continue until ? • Local stockpiles expired • Keep expired meds until funding changes

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