Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

Appendix F: UWHC Guideline for Medication Route Interchange in Adult PatientsGuideline developed by UWHC Center for Drug PolicyCoordination: Lee Vermeulen, MS, RPh, FCCP, Director, Center for Drug PolicyLast Revised by: Wendy Horton, PharmD, BCPS; Kerry Goldrosen, PharmDApproved by P&T: June 2009Next Scheduled Review Date: June 2011A. BackgroundThis guideline outlines the framework and clinical criteria to support the UWHC MedicationRoute Interchange Protocol.B. CriteriaTo initiate interchanges in the route of medication administration (from parenteral to enteralroute, including administration via various feeding tubes), the pharmacist will assess forappropriateness based on the following criteria:1.0 Parenteral to EnteralTo initiate the parenteral to enteral interchange, which includes medications administeredorally or via feeding tubes, the medication must be listed in Table 1. In addition, patientsmust meet all inclusion criteria and none of the exclusion criteria.1.1 Inclusion Criteria1.1.1 Patient must have a diet order and be tolerating either a clear liquid or moreadvanced diet or must be tolerating enteral tube feedings.1.1.2 Patient must have the ability to adequately absorb medications via theenteral route.1.2 Exclusion Criteria1.2.1 Patient is unable to swallow, is strict NPO, or refuses oral medications.1.2.2 Severe vomiting or diarrhea has been documented within the past 24 hoursor patient has an acute condition that affects gastrointestinal absorption (i.e.gastrointestinal obstruction or bleed, severe diarrhea, ileus, severe vomitingor mucositis).1.2.3 Patient is hemodynamically unstable (sustained heart rate >100beats/minute, respiratory rate >24 breaths/minute, systolic blood pressure100beats/minute, respiratory rate >24 breaths/minute, systolic blood pressure