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PCIM Pharmacy

Contact Numbers:

  • Elizabeth Moss, PharmD, CDE, Clinical Pharmacy Specialist Pager 214-786-0790
  • Clinic Pharmacy 214-590-5854 (9AM to 6:30PM)

Services Provided:

  • Review medication histories to check for adherence
  • Refill Protocol
  • Pain Management Protocol
  • Refer to PharmD for drug therapy titration of medications for chronic disease states = diabetes, hypertension, dyslipidemia, polypharmacy, and others
  • Non-formulary request evaluation
  • Prior Authorization of medications requested by patients for Medicare

 
Title Filter     Display # 
# Article Title Author
1 Opioid Equivalency Chart PHHS
2 Pain Medication Management Guidelines PCIM
3 Protocol Refill Clinic PCIM
4 Refill Report PCIM

Resources

Calculators

A-a Gradient
Patient age
Barometric pressure
PaO2
PaCO2
FiO2
A-a Gradient
Normal A-a Gradient
Calculated Osmolality
Serum sodium
Serum glucose
Serum BUN
Calculated Osm
Child's Class
Bilirubin
Albumin
INR
Ascites
Encephalopathy
Child-Pugh score
Scoring:
 A: 5-6
B: 7-9
C: 10-15
Cockroft-Gault eGFR
Patient age
Patient sex
Weight
 
Serum creatinine
eGFR
Corrected Calcium
Calcium
Albumin
Corrected calcium
Corrected Sodium

Sodium
Glucose
Corrected sodium

FENa / FEUrea

Serum sodium or BUN
Serum creatinine
Urine sodium or urea
Urine creatinine
Fractional excretion (%)

Free Water Deficit

Serum sodium
Ideal sodium
Weight
 

Free water deficit (L)

Heparin Dosing

For ischemic CVA the heparin dosing is as follows: no bolus, and 600-1000 units/hr drip (not weight-based). For other indications, use the calculator below.
Heparin indication

(For ACS, strongly consider LMWH instead of unfractionated heparin. Also, if using a IIb/IIIa inhibitor with unfractionated heparin, dose the unfractionated heparin as though the patient has a STEMI.)
 
Patient sex
Weight
Height
Heparin dosing weight (kg)
Bolus dose
*
Initial drip rate
*


*Maximum doses:
VTE 9000 bolus, 2000/hr gtt
NSTEMI 5000 bolus, 1000/hr gtt
STEMI 5000 bolus, 1000/hr gtt
Ideal Body Weight / BMI

Patient's sex
Weight
 
Height
Weight (kg)
BMI
Ideal body weight (kg)

MDRD eGFR

Patient sex
Patient age
African-American?
Serum creatinine
eGFR / 1.73 m2

MELD Score
Bilirubin
INR
Creatinine*
*If the patient has been dialyzed at least twice within the last week, enter "4.0" for the serum creatinine.
MELD Score
Three-month mortality risk based on MELD Score:
Score
Mortality
‹10
4%
10-19
27%
20-29
76%
30-39
83%
40+
~100%
Narcotic Converter

First drug
First drug dose (mg)
Second drug
Second drug dose (mg)

Note #1: Opioid analgesics have widely variable half lives, and when you switch from one form to another, you should adjust the scheduling accordingly.

Note #2: Methadone should be dosed by someone with experience using the drug. Consult palliative care or pain management.

QTc

QT (msec)
HR (bpm)
QTc (msec)

Steroid Converter

First steroid
Dose to convert (mg)
Second steroid
Second steroid dose (mg)

TIMI Risk
Age over 65
3 or more CAD risk factors
Prior coronary stenosis (50% or more)
ST segment deviation on initial ECG
2 or more anginal events in previous 24 hours
ASA use in last 7 days
Cardiac enzyme elevation
TIMI Score
TIMI Risk for cardiac event (mortality, new MI, or need for emergent revascularization) in the next 14 days:
 
Score
0-1
4.7%
 
2
8.3%
 
3
13.2%
 
4
19.9%
 
5
26.2%
 
6-7
40.9%
TTKG
Serum potassium
Urine potassium
Serum osmolality
Urine osmolality
TTKG
Framingham Calculator