Copy of dhs_drug formulary for the hwla initiative_july 2012_2.xls

DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Allergies, Cold and Flu
Guaifenesin/ Dextromethorphan 100mg-10mg/5mL Oral Solution Anticonvulsant
Divalproex delayed release 125mg sprinkle capsule Divalproex ER 250mg tablet
Anticonvulsant
Abott Patient Assistance
Foundation

3 YES
Divalproex ER 500mg tablet
Anticonvulsant
Abott Patient Assistance
Foundation

3 YES
GlaxoSmithKline Bridges to
Lamotrigine 100mg tablet
Anticonvulsant
Access
1 NO
GlaxoSmithKline Bridges to
Lamotrigine 150mg tablet
Anticonvulsant
Access
1 NO
GlaxoSmithKline Bridges to
Lamotrigine 200mg tablet
Anticonvulsant
Access
1 NO
GlaxoSmithKline Bridges to
Lamotrigine 25mg tablet
Anticonvulsant
Access
1 NO
Anti-Infectives
Abacavir/Lamivudine/Zidovudine 300-150-300mg Aminosalycylic Acid 4gm packet powder for suspension Amoxicillin 125mg/5mL powder for suspension Amoxicillin 250mg/5mL powder for suspension Amoxicillin 400mg/5mL powder for suspension                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Anti-Infectives
Efavirenz/Emtricitabine/Tenofovir 600-200-300mg Emtricitabine/Rilpivirine/Tenofovir 200-25-300mg tablet Erythromycin Ethyl Succinate 200mg/5mL suspension                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Anti-Infectives
Lopinavir/Ritonavir 80mg/mL-20mg/mL solution Pegylated Interferon Alfa 2B 120mcg/0.5mL Antineoplastics
                  PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Arthritis & Pain
Acetaminophen/ Hydrocodone 325mg/10mg (Norco) tablet Acetaminophen/ Hydrocodone 325mg/5mg (Norco) tablet Acetaminophen/ Oxycodone 325/5mg (Percocet) Acetaminophen/Codeine 300mg/15mg (Tylenol #2) tablet Acetaminophen/Codeine 300mg/30mg (Tylenol #3) tablet Acetaminophen/Codeine 300mg/60mg (Tylenol #4) tablet Acetaminophen/Hydrocodone 500mg/5mg (Vicodin) tablet Aspirin 325mg (with or w/o enteric coating) Colchicine/ probenecid 0.5mg/500mg tablet Fentanyl Transdermal 100mcg/hr (Duragesic) Fentanyl Transdermal 25mcg/hr (Duragesic) Fentanyl Transdermal 50mcg/hr (Duragesic) Fentanyl Transdermal 75mcg/hr (Duragesic) Morphine Sulfate Extended-Release (MS Contin) 15mg Morphine Sulfate Extended-Release (MS Contin) 30mg Morphine Sulfate Extended-Release (MS Contin) 60mg Morphine Sulfate Immediate-Release 15mg tablet Morphine Sulfate Immediate-Release 30mg tablet Asthma/COPD
Formoterol (Foradil) Aerolizer 12 mcg cap Ipratropium HFA 17mcg inhaler
Asthma/COPD
Boehringer Ingelheim Cares
12.9gm
Foundation, Inc.
1 YES
Mometasone/Formoterol (Dulera) 100mcg/5mcg
Asthma/COPD
Merck Patient Assistance
13gm
Program
2 YES
Mometasone/Formoterol (Dulera) 200mcg/5mcg
Asthma/COPD
Merck Patient Assistance
13gm
Program
2 YES
Montelukast 10mg tablet
Asthma/COPD
Merck Patient Assistance
Program

2 NO
Cholesterol
Ezetimibe 10mg tablet
Cholesterol
Merck Patient Assistance
Program

2 NO
                  PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Cholesterol
Niacin-controlled released (Slo Niacin) 500mg tablet CNS Agents/ Sedative Hypnotic
Acetaminophen/ Butalbital/ Caffeine (Fioricet) Acetaminophen/ Butalbital/ Caffeine (Fioricet) 325/50/40 Amphet ASP/Amphet/ Dextroamphet Salts 5mg tab Amphetamine/ Dextroamphetamine Salts 5mg tab Aripiprazole 10mg tablet
CNS Agents/ Sedative Hypnotic
BMS Patient Assistance
Foundation

1 NO
Aripiprazole 15mg tablet
CNS Agents/ Sedative Hypnotic
BMS Patient Assistance
Foundation

1 NO
Aripiprazole 20mg tablet
CNS Agents/ Sedative Hypnotic
BMS Patient Assistance
Foundation

1 NO
Aripiprazole 30mg tablet
CNS Agents/ Sedative Hypnotic
BMS Patient Assistance
Foundation

1 NO
                  PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
CNS Agents/ Sedative Hypnotic
Merck Patient Assistance
Rizatriptan 10mg tablet
CNS Agents/ Sedative Hypnotic
Program
2 YES
Diabetes
Blood Glucose Meter
Diabetes
PAP/Prior Authorization
Insulin glargine 100units/ml vial
Diabetes
Sanofi-Aventis U.S. Patient
10mL
Assistance Program
1 YES
Insulin NPH/Regular 70/30 100units/ml vial                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Diabetes
Takeda Pharmaceuticals
Pioglitazone 15mg tablet
Diabetes
America Patient Assistance
Program

1 YES
Takeda Pharmaceuticals
Pioglitazone 30mg tablet
Diabetes
America Patient Assistance
Program

1 YES
Takeda Pharmaceuticals
Pioglitazone 45mg tablet
Diabetes
America Patient Assistance
Program

1 YES
Ear Health
Antipyrine/Benzocaine (Auralgan) otic solution (FDA REMOVED) Carbamide Peroxide (Debrox) 6.5% Otic drop Gastrointestinal Health
Belladonna/Phenobarbital (Donnatal) Elixir Bismuth Subsalicylate (Pepto-Bismol) 262mg tablet Bismuth Subsalicylate (Pepto-Bismol) 262mg/15mL Oral suspension Diphenoxylate/Atropine 0.025mg/5mL-2.5mg/5mL solution Diphenoxylate/Atropine 0.025mg-2.5mg tablet Magnesium Hydroxide 400mg/5mL (Milk of Magnesia) oral suspension Magnesium hydroxide/ aluminum hydroxide/ simethacone (Maalox) oral Glaucoma & Eye Care
Brimonidine (Alphagan P) 0.15% eye drops Naphazoline HCl 0.025%/ Pheniramine Maleate 0.3% Ophthalmic Polymyxin Sulfate/TMP (Polytrim) ophthalmic solution                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Glaucoma & Eye Care
Sulfacetamide Sodium 10% ophthalmic solution Tobramycin/ Dexamethasone ophthalmic drop Heart Health & Blood Pressure
Aspirin 81mg (with or w/o enteric coating) Triamterene/HCTZ 37.5/25mg capsule/tablet                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Heart Health & Blood Pressure
Other Medical Conditions
Chlorhexidine Gluconate 0.12% oral solution Hydrocortisone 2.5% Rectal Cream (Proctozone HC) Skin Conditions
Bacitracin, neomycin, polymyxin B ointment/cream (Triple Antibiotic) Betamethasone Dipropionate 0.05% ointment                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Skin Conditions
Nystatin/Triamcinolone cream/ointment (Mycolog II) Thyroid Conditions
Vitamins & Nutritional Health
Calcium Carbonate 500mg + Vitamin D 200 units tablet Calcium Carbonate 600mg +Vitamin D 400 Units tablet Ergocalciferol 50,000 International Units Women's Health
Estrogen conjugated 0.625mg/gm vaginal cream Estrogen conjugated/Medroxyprogesterone 0.3/1.5mg tablet (Prempro) Estrogen conjugated/Medroxyprogesterone 0.625/2.5mg tablet (Prempro) Estrogen conjugated/Medroxyprogesterone 0.625/5mg tablet                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information DHS DRUG FORMULARY FOR THE HWLA INITIATIVE - BY DRUG NAME
July 2012
Bolded and italicized denote Patient Assistance Program (PAP) availability
Medication
Therapeutic Class
Additional Information
$4 Program
PAP Availability
Women's Health
Norethindrone/Eth Estradiol (Ortho-Novum) 1-35-28 tablet                   PAP Legend: 1=Very Accessible, no SSN required 2=Accessible requires SSN  3=Less Accessible, requires SSN and additional information

Source: http://www.dhs.co.la.ca.us/wps/PA_1_QDN2DSD3005DD02DJ6VQC830G3/DhsSite/AmbulatoryCare/pdf/DHS%20Drug%20Formulary%20for%20the%20HWLA%20Initiative.pdf

Toxicite_al

ET DE MÉDECINE D’URGENCE http://www.rarmu.com/ Toxicité des anesthésiques locaux Toxicity by local anesthetic drugs ________________________________________________________________________________________________ Points essentiels à retenir : Actuellement, la prévention du risque toxique par les anesthésiques locaux repose sur: • le respect des posologies, • et la sur

Meine sehr geehrten damen und herren,

eines schönen Morgens brechen wir mit John, dem amerikanischen Arzt, zu einer seiner Inspektionsfahrten auf. John betreut ein Trachoma-Programm der WHO hier in Guatemala. Die Indios aus den Bergdörfern gehen nie zum Arzt. Zum einen gibt es keinen Arzt in diesen Gegenden, zum zweiten käme der Besuch eines Arztes viel zu teuer, in der Tat so teuer, dass ein Indianer sich gar nicht vorstellen kann

Copyright © 2010-2014 Medical Articles