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MOCHA Enhancements

MOCHA Enhancements. Looking Toward the Horizon Presented by Amy K. Colón, R.Ph. Michael J. Martinko, R.Ph. . JUNE 27. 2012. MOCHA 1.0 Enhancements Increment 1 .

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MOCHA Enhancements

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  1. MOCHA Enhancements Looking Toward the Horizon Presented by Amy K. Colón, R.Ph. Michael J. Martinko, R.Ph. JUNE 27. 2012

  2. MOCHA 1.0 Enhancements Increment 1 • Contains enhancements and fixes to issues that were reported through testing Pharmacy Reengineering (PRE) MEDICATION ORDER CHECK HEALTHCARE APPLICATION (MOCHA) 1.0. • Will be released in a set of 5 patches PSJ*5*260, PSJ*5*268, PSO*7*390, PSS*1*164, and PSS*1*169 • Work is being done concurrently with MOCHA V. 2.0 by a separate team of developers and test sites • Release is expected to occur Summer 2012 • No additional hardware is required • Changes affect both the inpatient and outpatient pharmacy packages • Increment 2 is currently in the midst of a 6 month development period

  3. MOCHA 1.0 Enhancements Increment 1 • Displays additional fields to the Drug-Allergy order check warnings • Historical/Observed, Severity, Signs/Symptoms A Drug-Allergy Reaction exists for this medication and/or class! Prospective Drug: AMOXICILLIN 250MG CAP Causative Agent: PENICILLIN Historical/Observed: OBSERVED Severity: SEVERE Signs/Symptoms: ANAPHYLAXIS Drug Class: AM110 PENICILLIN-G RELATED PENICILLINS (LOCAL) Provider Override Reason: NOT READING ORDER CHECKS TODAY

  4. MOCHA 1.0 Enhancements Increment 1 • Stores Drug –Allergy order check details with the applicable order Select Item(s): Next Screen// DA Display Drug Allergies Drug Allergy Occurrence Event for Rx#: 2055124 Causative Agent: ERYTHROMYCIN Historical/Observed: OBSERVED Severity: MODERATE Ingredient: ERYTHROMYCIN Signs/Symptoms: DIARRHEA, NAUSEA AND VOMITING Drug Class: AM200 ERYTHROMYCINS/MACROLIDES Provider Override Reason: OK TO GIVE, DISCUSSED WITH PATIENT

  5. MOCHA 1.0 Enhancements Increment 1 • Adds a field on the patient medication profile header for display of CRCL and BSA, when available Patient Information May 09, 2012@12:03:19 Page: 1 of 1 Name: Ward: PID: Room-Bed: Ht(cm): DOB: Wt(kg): Sex: Admitted: Dx: Heart Ache Last transferred: ******** CrCL: 117.6(est.) (CREAT:1.0mg/dL 2/26/12) BSA (m2): 2.04

  6. MOCHA 1.0 Enhancements Increment 1 • Provides an option on the medication profile to allow a user to check for drug-drug interactions and allergies before the drug is entered for that patient • Help Text: • “The following list of order checks is a comprehensive report of all Outpatient, Non-VA, and Clinic medication orders on this patient's profile. It may include orders that are local, remote, active, pending, recently discontinued, or expired. Please note that the sort order and format displayed in this report differs from the display of MOCHA 1.0 order checks which occurs during order processing.”

  7. MOCHA 1.0 Enhancements Increment 1 • Sample of hidden option “DX Check Interactions” Drug: ERYTHROMYCIN STEARATE 250MG TAB *** DRUG INTERACTION(S) *** ============================================================ ***Critical*** with WARFARIN (COUMADIN) NA 5MG (PEACH) TAB and ERYTHROMYCIN STEARATE 250MG TAB CLINICAL EFFECTS: Concurrent use of a macrolide antibiotic may result in increased effects of the anticoagulant with possible elevated INR and/or bleeding. =============================================================

  8. MOCHA 1.0 Enhancements Increment 1 • Provides an option independent of a patient profile which checks drug interactions on 2 or more meds. The option is placed on each of these menus: • PDM Manager Menu, Outpatient Pharmacy Manager Menu, Pharmacist Menu, Unit Dose Medications Menu, and IV Menu Check Drug Interaction Drug 1: SELEGILINE HCL 5MG Drug 2: FLUOXETINE HCL 20MG CAP Drug 3: Now Processing Enhanced Order Checks! Please wait... *** DRUG INTERACTION(S) *** ***Critical*** with FLUOXETINE HCL 20MG CAP and SELEGILINE HCL 5MG CAP CLINICAL EFFECTS: Concurrent use...

  9. MOCHA 1.0 Enhancements Increment 1 • Simplifies the prompts seen in Inpatient Pharmacy, when a therapeutic duplication message allows an existing order to be discontinued This patient is already receiving the following INPATIENT and/or OUTPATIENT order(s) for a drug in the same therapeutic class(es) as FLUOXETINE 20MG CAP: ClomiPRAMINE HCL CAP,ORAL C 05/09 06/08 A Give: 25MG PO QHS (BEDTIME) Class(es) Involved in Therapeutic Duplication(s): Antidepressants ====================================================================== Do you wish to continue with the current order? YES// ClomiPRAMINE HCL CAP,ORAL C 05/09 06/08 A Give: 25MG PO QHS (BEDTIME) Enter DC to discontinue the above order or press <RETURN> to continue:

  10. MOCHA 1.0 Enhancements Increment 1 • Provides order checks against IMO Clinic Orders in the Inpatient pharmacy. This will include recently discontinued and/or expired clinic orders that have a stop date within the last 90 days. Unit Dose Example: ====================================================================== This patient is already receiving the following INPATIENT and/or OUTPATIENT order(s) for a drug in the same therapeutic class(es) as RISPERIDONE 50MG INJ SA 50MG/ML INJ :       Clinic Order: RISPERIDONE 25MG INJ SA(DISCONTINUED)           Schedule: Q30D            Dosage: 25MG         Start Date: JUN 7, 2012@13:00          Stop Date: JUN 15, 2012@15:22:27

  11. MOCHA 1.0 Enhancements Increment 1 • Decouples the automated dispensing machine interface calls from the current Inpatient Medication (IP) package routines. • The beneficiaries of this enhancement will be the IRM departments of sites with interfaces for inpatient automated dispensing machines • These sites will not have to recreate local medications for numerous routines whenever PRE releases new versions of these routines • Adds order checks to the verification process when verification is being done as a separate (re-entry of patient record) function from order acceptance •  Adds new report in the PEPS Services option to list the Vendor Interface unavailable times • Provides the ability to print the ‘Check PEPS Services Setup’ messages

  12. Introduction to MOCHA 2.0 Functionality • MOCHA V. 2.0 uses the same interface to First Databank (FDB) as MOCHA V. 1.0. • MOCHA V. 2.0 implements the first increment of dosage checks • Maximum Single Dose Checks for simple and complex orders are introduced for both Outpatient Pharmacy and Inpatient Medications applications. Text of Single Dose Warning Message: METFORMIN HCL 500MG TAB: Single dose amount of 3000 MILLIGRAMS exceeds the maximum single dose amount of 1000 MILLIGRAMS.

  13. MOCHA 2.0 Functionality • In the pharmacy packages, when a Maximum Single Dose Order Check cannot be performed, then a detailed Order Level Error Messages (with reasons ) is provided Maximum Single Dose Check could not be performed for Drug: LOMUSTINE 100MG CAP Reason: Body surface area required

  14. MOCHA 2.0 Functionality • In CPRS, when a Maximum Single Dose Order Check cannot be performed, then a generic Order Level notice is provided

  15. MOCHA 2.0 Functionality • Creates a new Pharmacy Data Management (PDM) option called Lookup Dosing Check Info for Drug so that a user can view all data that can affect dosing checks for a drug. The screen shot is abbreviated to fit this slide. WARFARIN (COUMADIN) NA 1MG (PINK) TAB  (GCNSEQNO: 014198) ========================================================================== VA PRODUCT NAME: WARFARIN NA 1MG TAB NDF DOSAGE FORM: TAB DEA, SPECIAL HDLG: 6PR   VA DRUG CLASS: BL110 EXCLUDE DOSAGE FORM FROM DOSAGE CHECKS: NO OVERRIDE DOSAGE FORM DOSE CHECK EXCLUSION FOR VA PRODUCT: NO ***DRUG ELIGIBLE FOR DOSAGE CHECKS***

  16. MOCHA 2.0 Functionality Lookup Dosing Check Info for Drug (Continued) Strength: 1   Unit: MG POSSIBLE DOSAGES:   DISPENSE UNITS PER DOSE: 1               DOSE: 1MG             PACKAGE: IO    BCMA UNITS PER DOSE:   FDB ROUTES: ORAL FDB DOSE UNITS: EA, MG BSA REQUIRED FOR DOSAGE CHECKS: NO WEIGHT REQUIRED FOR DOSAGE CHECKS:   YES for Age in Days: 0-4744 (ORAL)                        30-4744   NO for Age in Days:  23725-40150 (ORAL)                        6570-23724 (ORAL)                        4745-6569 (ORAL)                        6570-23725                        23726-40150

  17. How Dosage Checks are Excluded • No dosing checks will be performed on supply items. • No dosing checks will be performed on items with excluded dosage forms, • unless an individual override is set at the product level • Conversely, dosing checks will be performed on items with dosage forms that • are marked for dosing checks, unless and individual exclusion is set at the • product level

  18. MOCHA 2.0 Specifics • Dosage checks occur after all enhanced order checks (clozapine, allergy, aminoglycosides, dangerous meds for patients >64, metformin lab results, drug level errors, local and remote drug interactions, local and remote duplicate therapy) • If a dosage check cannot be done, then an order level error message occurs after all other enhanced order checks • If a dosage is within range, then no dose message will appear • The most recent values for height and weight found in the VITALS application are used to calculate the BSA in m2 for a patient

  19. Data Required for Dose Checks to be Performed • Patient Parameters: (Age, Weight and Body Surface Area (BSA in m2) • Drug • Single Dose Amount • Dose Unit (FDB Equivalent) • Dose Rate Unit • Dose Route (FDB Equivalent) • Dose Type • Frequency • Duration • Duration Rate

  20. How FDB Interprets Possible Doses DosageSingle DoseDose UnitFDB Dose Unit Ordered Amount ===================================================== 325MG 325 MG MILLIGRAMS 0.5GM 0.5 GM GRAMS 1 TABLET 1 TABLET(S) TABLET(S) 20MEQ 20 MEQ MILLIEQUIVALENTS 10ML 10 ML MILLILITERS

  21. How FDB Interprets Doses for Solutions Marked as Premixes IV Type Volume Infusion Drug Single Dose FDB Dose Rate Unit Amount Unit ======================================================== Piggyback 20 ML 20 MILLILITERS Admixture 125 ML 125 MILLILITERS

  22. How FDB interprets Local Possible Doses for Single Ingredient Products

  23. Further Commentary on FDB Dose Units

  24. How FDB interprets Local Possible Doses for Multi Ingredient Products

  25. How FDB interprets Dosages for Continuous IVs

  26. MOCHA Credits by Lina Bertuzis Portions of the previous MOCHA 2.0 slides were excerpted from documentation prepared by Lina Bertuzis. Lina’s PRE team work is largely done behind the scenes. She is extremely talented at defining pharmacy functionality and has written a requirements document that is greater than 700 pages in length. Many thanks to Lina!

  27. Comparing Enhanced & Dosing Order ChecksEnhanced Order Checks (MOCHA v1.0) • MOCHA v1.0 enhanced order checks consist of duplicate drug, therapeutic duplication, and drug interaction order checks based on FDB data. • Usually occur after a dispense drug or orderable item have been identified. • A message is displayed before the order checks occur: Now Processing Enhanced Order Checks! Please Wait... • Order checks can be triggered by: • New order entry via backdoor pharmacy options • Finishing a pending order • Renewing an order • Copying an order • Editing an order which results in creation of a new order • Reinstating an order

  28. Comparing Enhanced & Dosing Order ChecksDosing Order Checks (MOCHA v2.0) • MOCHA v2.0 dosing order checks will consist of a maximum single dose order check based on the patients demographics (age, weight, body surface area) pertinent to that medication. • Dosing order checks will have some differences from the enhanced order checks. • In CPRS will be displayed along with enhanced order checks. • In backdoor pharmacy will occur AFTER the enhanced order checks, many times after the “accept” prompt. • NO message is displayed before the dosing order checks occur. If no dose warning or error message is displayed (dosage entered is within normal limits), the order check is invisible to the user. • Dosing checks have different triggers than the enhanced order checks.

  29. Comparing Enhanced & Dosing Order ChecksDosing Order Checks (MOCHA v2.0) • Dosing order checks are generated by all of the actions that trigger the enhanced order checks, PLUS: • Editing the following for a Unit Dose order: • Dosage Ordered • Units per Dose (for Dispense Drug) • Med Route • Schedule • Editing the following for an IV order • Infusion rate (only applies to IV types of ‘Admixture’, ‘Hyperal’, ‘Chemotherapy Admixture’, ‘Continuous Syringe’ or ‘Chemotherapy Continuous Syringe’) • Schedule (only applies to IV types of ‘Piggyback’, ‘Intermittent Syringe’, ‘Chemotherapy Piggyback’, or ‘Chemotherapy Intermittent Syringe’) • Med Route • Volume (does not apply to orders with IV types of ‘Piggyback’, ‘Intermittent Syringe’, ‘Chemotherapy Piggyback’, or ‘Chemotherapy Intermittent Syringe’ with IV Solution not marked as Premix)

  30. Examples of Dosing Order ChecksDosing Order Checks (MOCHA v2.0) • Dosing examples will be created utilizing a 75 year old female test patient with a height of 71 inches (180.3cm) a weight of 206.5 lb (93.7 kg) and a calculated body surface area (BSA) of 2.14 (using the system’s Dubois formula).

  31. Examples of Dosing Order ChecksCPRS Dosing Order Checks (MOCHA v2.0) Example #1 • Entering an inpatient medication order for lisinopril 80mg.

  32. Examples of Dosing Order ChecksCPRS Dosing Order Checks (MOCHA v2.0) Example #1 • A dosing warning message is displayed.

  33. Examples of Dosing Order ChecksCPRS Dosing Order Checks (MOCHA v2.0) Example #2 • Entering an inpatient medication order for lithium carbonate 600mg.

  34. Examples of Dosing Order ChecksCPRS Dosing Order Checks (MOCHA v2.0) Example #2 • A drug interaction warning message and a dosing warning message are displayed.

  35. Examples of Dosing Order ChecksCPRS Dosing Order Checks (MOCHA v2.0) response required

  36. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) XXXXXXXXXXXXXXXXXXXXX Ward: C MEDIC D PID: 999-99-9999 Room-Bed: XXXXX Ht(cm): 180.34 (00/00/00) DOB: 00/00/00 (75) Wt(kg): 93.86 (00/00/00) Sex: MALE Admitted: 00/00/00 Dx: PHLEBITIS/ STABLE Last transferred: ******** - - - - - - - - - - - - - - - - P E N D I N G - - - - - - - - - - - - - - - - 1 LISINOPRIL TAB ? ***** ***** P Give: 80MG PO QD-(EVERY DAY) 2 LITHIUM CARBONATE CAP,ORAL ? ***** ***** P Give: 600MG PO BID-WF Enter ?? for more actions PI Patient Information SO Select Order PU Patient Record Update NO New Order Entry Select Action: Quit//

  37. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) *(1)Orderable Item: LISINOPRIL TAB <DIN> Instructions: 80MG *(2)Dosage Ordered: 80MG Duration: (3)Start: 04/23/12 14:03 *(4) Med Route: ORAL (BY MOUTH) REQUESTED START: 04/24/12 09:00 (5) Stop: 05/23/12 18:00 (6) Schedule Type: CONTINUOUS *(8) Schedule: QD-(EVERY DAY) (9) Admin Times: 09 *(10) Provider: XXXXXXXXXXXX [es] (11) Special Instructions: (12) Dispense Drug U/D Inactive Date LISINOPRIL 40MG TAB 2 + Enter ?? for more actions BY Bypass FL Flag DC Discontinue FN Finish Select Item(s): Next Screen//

  38. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) CPRS Order Checks: LISINOPRIL 40MG TAB: Single dose amount of 80 MILLIGRAMS exceeds the maximum single dose amount of 40 MILLIGRAMS. Overriding Provider: XXXXXXXXXXX Overriding Reason: these are the provider comments SIGNIFICANT drug-drug interaction: LISINOPRIL 40MG TAB and LITHIUM CARBONATE 300MG CAP [UNRELEASED] - Concurrent use of ACE inhibitors or ARBs may result in elevated lithium levels and lithium toxicity. - Monograph Available Overriding Provider: XXXXXXXXXXXX ORDER NOT VERIFIED Enter ?? for more actions BY Bypass FL Flag DC Discontinue FN Finish Select Item(s): Quit// FN Finish

  39. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) Now Processing Enhanced Order Checks! Please wait... ================================================================================ This patient is receiving the following order(s) that have a SIGNIFICANT Drug Interaction with LISINOPRIL 40MG TAB: LITHIUM CARBONATE CAP,ORAL ? ***** ***** P Give: 600MG PO BID-WF *** REFER TO MONOGRAPH FOR SIGNIFICANT INTERACTION CLINICAL EFFECTS ================================================================================ Display Professional Interaction Monograph(s)? NO//

  40. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) Now Processing Enhanced Order Checks! Please wait... ================================================================================ This patient is receiving the following order(s) that have a SIGNIFICANT Drug Interaction with LISINOPRIL 40MG TAB: LITHIUM CARBONATE CAP,ORAL ? ***** ***** P Give: 600MG PO BID-WF *** REFER TO MONOGRAPH FOR SIGNIFICANT INTERACTION CLINICAL EFFECTS ================================================================================ Display Professional Interaction Monograph(s)? NO// Do you want to Intervene with LISINOPRIL 40MG TAB? NO//

  41. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) Now Processing Enhanced Order Checks! Please wait... ================================================================================ This patient is receiving the following order(s) that have a SIGNIFICANT Drug Interaction with LISINOPRIL 40MG TAB: LITHIUM CARBONATE CAP,ORAL ? ***** ***** P Give: 600MG PO BID-WF *** REFER TO MONOGRAPH FOR SIGNIFICANT INTERACTION CLINICAL EFFECTS ================================================================================ Display Professional Interaction Monograph(s)? NO// Do you want to Intervene with LISINOPRIL 40MG TAB? NO// NO

  42. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) LISINOPRIL 40MG TAB: Single dose amount of 80 MILLIGRAMS exceeds the maximum single dose amount of 40 MILLIGRAMS. Do you want to Continue? NO//

  43. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) LISINOPRIL 40MG TAB: Single dose amount of 80 MILLIGRAMS exceeds the maximum single dose amount of 40 MILLIGRAMS. Do you want to Continue? NO// YES Now creating Pharmacy Intervention For LISINOPRIL 40MG TAB PROVIDER:

  44. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) LISINOPRIL 40MG TAB: Single dose amount of 80 MILLIGRAMS exceeds the maximum single dose amount of 40 MILLIGRAMS. Do you want to Continue? NO// YES Now creating Pharmacy Intervention For LISINOPRIL 40MG TAB PROVIDER: PROVIDER: XXXXXXXXXXXX RECOMMENDATION: 8 NO CHANGE See 'Pharmacy Intervention Menu' if you want to delete this intervention or for more options. Would you like to edit this intervention? N// O

  45. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) XXXXXXXXXXXXXXXXXXXXX Ward: C MEDIC D PID: 999-99-9999 Room-Bed: XXXXX Ht(cm): 180.34 (00/00/00) DOB: 00/00/00 (75) Wt(kg): 93.86 (00/00/00) *(1)Orderable Item: LISINOPRIL TAB <OCI><DIN> Instructions: 80MG *(2)Dosage Ordered: 80MG Duration: (3)Start: 04/23/12 14:03 *(4) Med Route: ORAL (BY MOUTH) REQUESTED START: 04/24/12 09:00 (5) Stop: 05/23/12 18:00 (6) Schedule Type: CONTINUOUS *(8) Schedule: QD-(EVERY DAY) (9) Admin Times: 09 *(10) Provider: XXXXXXXXXXXX [es] (11) Special Instructions: (12) Dispense Drug U/D Inactive Date LISINOPRIL 40MG TAB 2 ED Edit AC ACCEPT Select Item(s): Next Screen//

  46. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) *(1)Orderable Item: LISINOPRIL TAB <OCI><DIN> Instructions: 80MG *(2)Dosage Ordered: 80MG Duration: (3)Start: 04/23/12 14:03 *(4) Med Route: ORAL (BY MOUTH) REQUESTED START: 04/24/12 09:00 (5) Stop: 05/23/12 18:00 (6) Schedule Type: CONTINUOUS *(8) Schedule: QD-(EVERY DAY) (9) Admin Times: 09 *(10) Provider: XXXXXXXXXXXX [es] (11) Special Instructions: (12) Dispense Drug U/D Inactive Date LISINOPRIL 40MG TAB 2 ED Edit AC ACCEPT Select Item(s): Next Screen// 8 Order Check Overrides/Interventions exist for this order. Display? (Y/N)? Y//

  47. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) *(1)Orderable Item: LISINOPRIL TAB <OCI><DIN> Instructions: 80MG *(2)Dosage Ordered: 80MG Duration: (3)Start: 04/23/12 14:03 *(4) Med Route: ORAL (BY MOUTH) REQUESTED START: 04/24/12 09:00 (5) Stop: 05/23/12 18:00 (6) Schedule Type: CONTINUOUS *(8) Schedule: QD-(EVERY DAY) (9) Admin Times: 09 *(10) Provider: XXXXXXXXXXXX [es] (11) Special Instructions: (12) Dispense Drug U/D Inactive Date LISINOPRIL 40MG TAB 2 ED Edit AC ACCEPT Select Item(s): Next Screen// 8 Order Check Overrides/Interventions exist for this order. Display? (Y/N)? Y// NO SCHEDULE: QD-(EVERY DAY)// Q4H 01-05-09-13-17-21 NOTE: This change in schedule also changes the ADMIN TIMES and SCHEDULE TYPE. Enter RETURN to continue or '^' to exit:

  48. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) XXXXXXXXXXXXXXXXXXXXX Ward: C MEDIC D PID: 999-99-9999 Room-Bed: XXXXX Ht(cm): 180.34 (00/00/00) DOB: 00/00/00 (75) Wt(kg): 93.86 (00/00/00) *(1)Orderable Item: LISINOPRIL TAB <OCI><DIN> Instructions: 80MG *(2)Dosage Ordered: 80MG Duration: (3)Start: 04/23/12 14:03 *(4) Med Route: ORAL (BY MOUTH) REQUESTED START: 04/24/12 09:00 (5) Stop: 05/23/12 18:00 (6) Schedule Type: CONTINUOUS *(8) Schedule: Q4H (9) Admin Times: 01-05-09-13-17-21 *(10) Provider: XXXXXXXXXXXX [es] (11) Special Instructions: (12) Dispense Drug U/D Inactive Date LISINOPRIL 40MG TAB 2 + This change will cause a new order to be created. ED Edit AC ACCEPT Select Item(s): Next Screen//

  49. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) LISINOPRIL 40MG TAB: Single dose amount of 80 MILLIGRAMS exceeds the maximum single dose amount of 40 MILLIGRAMS. Do you want to Continue? NO//

  50. Examples of Dosing Order ChecksBackdoor Pharmacy Dosing Order Checks (MOCHA v2.0) LISINOPRIL 40MG TAB: Single dose amount of 80 MILLIGRAMS exceeds the maximum single dose amount of 40 MILLIGRAMS. Do you want to Continue? NO// YES Now creating Pharmacy Intervention For LISINOPRIL 40MG TAB PROVIDER:

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