UTMB DEPARTMENT OF PHARMACY POLICY AND PROCEDURES Page 1 of 3 Section 07.

00 Medication Use Effective Date: 08/31/00 Policy 07.42 Food/Drug Interaction Last Review/Revision Date: 05/13/03 Next Review Date: 05/13/06 Author: Department of Pharmacy FOOD/DRUG INTERACTION AUDIENCE This document is directed to licensed nurses, Department of Pharmaceutical Services personnel and Food and Nutrition Services personnel. On units with POE, the physician is flagged to select an Appropriate diet based on ordered medications. In addition, Patient education sheets will print on the patient care areas automatically. Nursing Service will educate the patient with the initial dose of a target medication, and will reinforce the education as needed, and prior to discharge. Pharmacy may provide educational support if requested. Food and Nutrition Services personnel may also participate in reinforcing patient education. On units not on computerized order entry (POE), the pharmacy label shall identify the medication as a food/drug interaction medication to help identify the need for a diet change. Process improvement mechanisms shall monitor this process in an ongoing fashion to ensure compliance. GUIDELINES Upon receipt of physician medication orders for UTMB patients, the pharmacist will do the following: Step 1 Action Screen all orders for appropriateness, clarity, and accuracy, with special attention given to food/drug interactions. Identify patients started on any of the following target medications: ! Isoniazid ! Warfarin ! Monoamine Oxidase Inhibitors

POLICY

UTMB DEPARTMENT OF PHARMACY POLICY AND PROCEDURES Page 2 of 3 Section 07.00 Medication Use Effective Date: 08/31/00 Policy 07.42 Food/Drug Interaction Last Review/Revision Date: 05/13/03 Next Review Date: 05/13/06 Author: Department of Pharmacy These medications are flagged on the Pharmakon drug selection list and the Patient's Medication Profile with *FDI* to remind pharmacy personnel of the potential for a significant food/drug interaction. 3 On non-POE units, notify the physician of any significant food/drug interactions by completing a preprinted Pharmacist's Note Label, and placing it in the progress notes of the Patient's Medical Record. On units with POE, the physician will be notified automatically during ordering. Example: Date: S/O: Patient has been prescribed the medication________________. This medication has significant food/drug interaction. The patient's food tray has been adjusted to prevent possible food/drug interaction. Patient counseling information has been provided. Please call if further information is needed. _____________________, R.Ph. beeper #

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A/P:

Food/Drug Interaction

Notifying Food and Nutrition of diet change. On units with POE, the modified diet order is linked to the drug order. The physician can choose not to modify the diet. On non-POE unties, pharmacy will notify the physicians and Food and Nutrition regarding a change of diet if indicated. Once notified, food and nutrition services will modify the next patient food tray.

UTMB DEPARTMENT OF PHARMACY POLICY AND PROCEDURES Section 07.00 Medication Use Page 3 of 3 Effective Date: 08/31/00 Policy 07.42 Food/Drug Interaction Last Review/Revision Date: 05/13/03 Next Review Date: 05/13/06 Author: Department of Pharmacy Patient/ Family Education Nursing shall provide education to the patient utilizing the patient education sheets generated on the nursing unit upon the order of a food/drug interaction target medication. Education will be ongoing and documented on the Patient/Family Teaching Form in the Patient's Medical Record. Food and Nutrition Service personnel may reinforce patient education by providing written information about food/drug interactions and notification of any modifications in the patient's food tray.