WELFORD CHART NOTES
NEWSLETTER
Volume 25, No. 4 October, 2004
copyright 2004, Welford Medical Computing, Inc. All rights reserved
CROSS-REACTING ALLERGY WARNINGS (User's Manual, pgs. 843-845)
Before version 4.6, Welford Chart Notes already warned you if you were about to place a patient on a drug to which he was allergic, or which contained a component to which he was allergic, or which belonged to the same Class of drugs to which he was allergic. For example, if a patient were allergic to amoxicillin, it would warn if you placed the patient on amoxicillin (same drug), Augmentin (contains amoxicillin), or ampicillin (same class). Similarly, it would check the patient's current medications when you declared a new allergy and would warn if the patient were currently taking that drug, a combination containing that drug, or another drug in that class.Version 4.6 adds another kind of allergy warning, called cross-reacting allergies. Cross-reacting allergies involve three situations:
·
the two drugs belong to different classes, but patients who are allergic to one drug tend to be allergic to the other drug. For example, patients who are allergic to penicillins are more likely to be allergic to cephalosporins.·
the second drug is formulated with the first drug as a vehicle or secondary ingredient, not one of the active ingredients. For example, tetanus toxoid is formulated with thimerosal. It is not an active ingredient, but it is in the product, and patients who are allergic to thimerosal should avoid tetanus toxoid.·
the second drug is manufactured such that traces of the first drug might be in the final product, even though it is not intentional. For example, influenza vaccine is manufactured using eggs; patients who are allergic to eggs are advised to avoid influenza vaccine, because there may be traces of residual egg protein in the vaccine.Version 4.6 now warns about all of these situations whenever you add a medication to the Medication Editor, write a Prescription, add a medication in the Prescription Log, or declare the patient to have a new Allergy. These warnings help you to avoid inadvertently prescribing a medication to which a patient is allergic.
You can select the minimum level of Severity you wish to see. Let's set the level to Moderate and above:
1. Press System\Allergy Options.
2. Under Cross-Reacting Severity, select Moderate or above and press Ok.
When you order a medication for which the patient has a cross-reacting allergy, or declare the patient allergic to a medication which cross-reacts with one of the patient's current medications, a red warning window appears in the center of the screen and a warning bell sounds. The red window explains what drug is cross-reacting with what other drug. If you want to read more about the cross-reacting allergy, press the Info button to read about the reaction.
Let's see this in action:
1. Press Write\Allergies and enter Kelly Erickson.
2. Press Add and enter "eggs" as the drug to which she is allergic, with a reaction of "hives" and a severity of "moderate". Press Ok to store this Allergy, and then Cancel to leave her Allergy Editor.
4. Press Add and enter "flu vaccine" as the Drug.
5. A warning appears on the screen that this cross-reacts with eggs.
6. Press the Info button to read more about this reaction. Note that it tells you the drug the patient is on (FLU VACCINE), the substance to which the patient is allergic (EGG), the reaction to eggs (hives), the severity of the allergic reaction (moderate), the reason for the warning (flu vaccine is manufactured using eggs), and the severity of the cross-reacting allergy warning (Absolute: don't give flu vaccine to patients with true allergy to eggs).
You can also look up which drugs cross-react with any drug and read the cross-reacting allergy information. Let's look up which drugs cross-react with cephalexin:
1. Press Libraries\Cross-Reacting Allergies.
3. You will see the list of PENICILLAMINE and PENICILLINS, the drugs that cross-react with cephalexin.
4. Double-click on PENICILLINS, or highlight it and press Ok, to read the detailed description of the cross-reaction.
Cross-reacting Allergy information is updated quarterly, along with the other data in each quarterly update (such as new drug interactions, dosages, etc.).
OCTOBER QUARTERLY UPDATE RELEASED
This month we are releasing the October, 2004 Quarterly update. The update includes new medications, diagnostic terms, drug interactions, drug dosing information, spelling words, drug-disease Alerts, Web Links, algorithms, medication test reminders, cross-reacting allergies, and dozens of new patient education brochures. This update has over 6000 drug interactions with over 2300 references, over 11,000 Alerts, over 9800 Web Links, and nearly 1300 Brochures, including new or revised Brochures on azacitidine, efalizumab, fosamprenavir, miglustat, olanzapine-fluoxetine, pemetrexed, rifaximin, rosuvastatin, telithromycin, tinidazole, tiotropium, trospium, atrial fibrillation, bipolar disorder, hookworm, rabies, von Willebrand's disease, and many others .HOW DO I GET THIS UPDATE?
To obtain the October Quarterly Update, you must be an active subscriber to the Comprehensive Support Package. If you have let your support package lapse and would like to renew and obtain the latest version, contact MEDCOM Information Systems at 800-424-0258.NEWS ON UPCOMING VERSIONS
We are continuing to add new features to version 4.7, as well as speeding up performance of existing features. We have added lots of new features to allow you to track Referrals and be warned when patients fail to follow through on them.SEND US YOUR TIPS
If you have tips, shortcuts, guestions, or suggestions for future newsletter topics, please send them to us at:Welford Medical Computing, Inc.
3779 Hermitage Trail
Rockford, IL 61114
or
MEDCOM Information Systems, Inc.
2117 Stonington Avenue
Hoffman Estates, IL 60195
http://medcom@emirj.com