ࡱ> $&#1234 bjbjUU i4??3 $PS44C($>U$i$ dCfCfCfCfCfCfC$F1ITCD*##|D*D*CC".".".D* 8kRdC".D*dC".".>S"B Cd,$AhPCC0C BpI-IBB8IBu$&0".O'C(u$u$u$CC".u$u$u$CD*D*D*D*Iu$u$u$u$u$u$u$u$u$ :  24 August 2010 Kyle Reid Tender Analyst PHARMAC PO Box 10-254 Wellington 6143 Kyle.Reid@pharmac.govt.nz Dear Kyle Re: 2010/2011 Multi-product Tender We support the PHARMAC proposal to tender for certain pharmaceuticals as sole supply status to community pharmacies (C)and DHB hospital pharmacies (H). In particular wecomment onthe following proposals: We support theproposal for C and H availability with stated DV limits: Glycerol suppos 3 g or less 1% Ranitidine oral liquid 150mg in 10 ml 1% Amiloride tabs 5 mg 1% Amlodipine tab 2.5 mg 1% Fluconazole oral liquid 10 mg in 1 ml 1% Mebendazole oral liquid 100 mg in 5 ml 1% Nitrofurantoin oral liquid 25 mg in 5 ml 1% Trimethoprim oral liquid 1% Indometha cin caps 25 mg 1% Indomethacin caps 50 mg 1% Indomethacin LA caps75 mg 1% Metoclopramide oral liquid 5 mg / 5 ml 1 % Paracetamol oral liquid 120 mg/ 5 ml 20% Paracetamol oral liquid 250 mg/ 5 ml 20% Tramadol oral liquid 100 mg in 1 ml 1% Cetirizine oral liquid 1 mg in 1 ml 1 % Chlorpheniramine oral liquid 2 mg in 5 ml 1% We support the proposal for H availability with stated DV limits: Amikacin injection 5 mg in 1 ml x 5ml 1% We request an additional H availabilty with DV Limit of 1% for: Hydrochlorothiazide tabs 12.5mg and 25 mg We request consideration for H and C availability for: Glycerol suppos 1g Movicol-Half powder Flecainide oral liquid We note with concern the following proposal: Phenobarbitone oral liquid 15 mg in 5 ml for H & C availability: Our concern is that, for stability and solubility reasons, a proprietary product may contain unacceptable quantities of alcohol and therefore be inappropriate as a medicine for children. A case report in the Bromley News Update 146 1 describes a medication safety issue when an alcohol-containing preparation was dispensed for a child who then suffered an adverse event: Phenobarbitone in children: A child was discharged home for terminal care on Phenobarbitone syrup. The child became unexpectedly drowsy on discharge and it was realised that the community pharmacy had issued Phenobarbitone syrup which contained 38% alcohol. There is an alternative alcohol-free preparation which would need to be specified and is used in specialist hospital pharmacies. The reference text Martindale: The Extra Pharmacopoeia 2 also advises caution when administering phenobarbitone elixir (38% alcohol) to neonates and the potential for alcohol toxicity. Recently our SIG sent PHARMAC a letter recommending a phenobarbitone sodium oral liquid for inclusion in the Pharmaceutical Schedule.3 This formulation with a 28 day expiry requires compounding by a pharmacist. The product does not contain alcohol and is safe for use in children. To avoid confusion for dispensing pharmacists we request that a phenobarbitone oral liquid containing alcohol is not accepted for tender.There is an additional medication safety issue in that two strengths of solution could become available thus increasing the risk of dispensing errors. The concerns stated relating to alcohol as an additive in phenobarbitone oral liquid would equally apply to all oral liquids which may become available for use in children. Appropriate advice should be obtained regarding the suitability of additive ingredients in preparations which may be used as medicines for children. This letter is supported by members of the Pharmacist & Therapeutics Special Interest Group: Dianne Wright, Clinical & Advisory Paediatric Pharmacist,Taranaki Base Hospital. Dr Philip Moore, Paediatrician. Hawkes Bay DHB. Louise McDermott, Paediatric Pharmacist, Christchurch Hospital. Andrew Sutton, Team Leader Womens and Childrens Health, Auckland City Hospital. Caroline De Luca, Senior Paediatric Pharmacist and Formulary Pharmacist, Auckland City Hospital. Barbara Robertshawe, Paediatric Pharmacist, Christchurch Hospital. Libby Martindale, Paediatric Pharmacist, Hawkes Bay Hospital Brenda Hughes, Specialist Paediatric Pharmacist, SIG Convenor. References: 1. EMBED Outlook.FileAttach 2. Sweetman S (ed.), Martindale: The Extra Pharmacopoeia (36th ed.). London: Pharmaceutical Press; 2009. 3.  HYPERLINK "http://www.paediatrics.org.nz/index.asp?pageID=2145864761" PSNZ Submission to PHARMAC re Phenobarbitone sodium oral liquid     THE PAEDIATRIC SOCIETY OF NEW ZEALAND Secretariat: Email:Denise Tringham P O Box 22 234 Wellington 6441 Tel: (04) 938 4827 Fax: (04) 976 4827 psnz@paradise.net.nz  PSNZ Feedback re 2010/2011 Multi-Product Tender 2 Health of our children: Wealth of our nation S\{r ^ a & g <fزؠuucL,heAhY7B*CJH*OJQJ^JaJph#hJzB*CJOJQJ^JaJph,huhY7>*B*CJOJQJ^JaJph&hY7>*B*CJOJQJ^JaJph#hY7B*CJOJQJ^JaJph+hBhY75>*B*CJOJQJ^JphhvvB*CJOJQJ^JphhY7B*CJOJQJ^JphhJzB*CJOJQJ^JphhY7h$G-5CSmoy{p r : ~ + e gdY7gdY7 1 b $ & h >Thf$a$gdY7gdY7fg !"#$*ϽiU@)h$^8hY7B*CJOJQJ^JaJph&hY7B*CJH*OJQJ^JaJph,hQhY7B*CJH*OJQJ^JaJph,hQhY76B*CJOJQJ^JaJph&hY76B*CJOJQJ^JaJph#hY7B*CJOJQJ^JaJph#hQhY76CJOJQJ^JaJhY76CJaJhQhY76CJaJhQhY756CJ\aJhY756CJ\aJ*+.2BK'*'GW;xyԫw–––ww–d%hM+hY7B*CJOJQJ^JphhY7CJOJQJ^JaJ hM+hY7CJOJQJ^JaJ)hM+hY7B*CJOJQJ^JaJph,h'ThY7>*B*CJOJQJ^JaJph#hY7B*CJOJQJ^JaJph)h$^8hY7B*CJOJQJ^JaJph,hhhY7B*CJH*OJQJ^JaJph#()*H<yTUdgdJzgdY7gdY7$a$gdY7')XYʳʥ~iR;,jhY7B*CJOJQJU^JaJph,hg58hY7B*CJH*OJQJ^JaJph)jh!hY7CJOJQJU^JaJ)jP hY7CJOJQJUV^JaJ#jhY7CJOJQJU^JaJhY7CJOJQJ^JaJ,h'ThY7>*B*CJOJQJ^JaJph#hY7B*CJOJQJ^JaJph)h$^8hY7B*CJOJQJ^JaJphhM+hY7CJOJQJ^J2̧̹zqaQqCh$GB*CJOJQJphh$G5B*CJ(OJQJphh$G5B*CJ$OJQJphh$G5OJQJ%jh$G5OJQJUmHnHuh*hRhy0jhy0U hgCCJ#hY7B*CJOJQJ^JaJph$hA1hY70JCJOJQJ^JaJ,jhY7B*CJOJQJU^JaJph8jhA1hY7B*CJOJQJU^JaJph()*+,3CRbv  $If  !Sn#$If !Sn#$If$ x$Ifa$  $Ifd23Ϳմͨբ hgCCJhy0hRCJaJhRhRCJaJjh$GUmHnHuh*hRh$Gh$G5OJQJh$GB*CJOJQJphh$G5B*CJOJQJphv|zxvkvzvx $ !n#a$ !ekd$$If\u+#a  !Sn#$If  $If gdJz $ !a$ !gd = ,&P . 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Submissions

The Paediatric Society believes all children and youth should, by right, attain optimal physical, mental and social health and wellbeing.  By working as a coordinated national network of health professionals the Society dedicates its efforts and resources to making official submissions to both Government and Non-Government organisations on issues that will impact on the health and wellbeing of children and young people.

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