Pharmacy formulary – eff

Page 1 of 15
Pharmacy Formulary
340B Pharmaceutical Assistance for Migrant & Seasonal Farmworkers
NC Farmworker Health Program (NCFHP)
Updated 09/15/2013

REMINDERS: Prescribe or dispense the drug form, dosage, and type (generic vs. name
brand) AS IT APPEARS on the formulary. In most cases the generic form is the lowest-
priced version of a medication but there are some exceptions, with the name-brand
having a 340B price lower than generics. If you need to prescribe or dispense a drug or
dosage not listed on the formulary, please NOTIFY your local health outreach staff.

Drug Name
Drug Category
Drug Class
Anti-microbials
Antibiotics
Amoxicillin (tabs/caps, liquid) Augmentin (500 & 875mg tabs & 400/5, 600/5 Susp) Azithromycin (250mg) Ceftin (500mg) Cephalexin (tabs/caps, liquid) Ciprofloxacin (500mg tabs) Clarithromycin (500mg IR dosing only) Clindamycin (caps only) Dicloxacillin (caps only) Doxycycline (tabs only) Erythromycin (tabs/caps, liquid, opth) Gentamicin (opth only) Nitrofurantoin (100mg BID dosing only) Omnicef 125/5ml liquid Penicillin (tabs, liquid) Rocephin (inj) Septra ( DS tabs and liquid) Tetracycline (caps only) Antifungals
Page 2 of 15
Anti-microbials
Antifungals (cont.) Terazol-7 vaginal
Anthelmintics
Antivirals
Acyclovir (caps only) Amantadine Tamiflu (pills/liquid) Cardiovascular
Anti-anginals
Beta Blockers
Atenolol (90 day supply allowed per co-pay) Carvedilol (Coreg) Labetalol (100mg, 200mg) Metoprolol (tabs/caps) Propranolol (tabs/caps) Calcium Channel
Blockers
ACE inhibitors
Antihypertensives/ Clonidine (tabs/caps)
Combination
Products
Hydralazine (tabs/caps) Lisinopril Lisinopril/HCTZ Methyldopa Diuretics
Furosemide (90 day supply) (tabs/caps) HCTZ (90 day supply) Spironolactone (tabs/caps) Triamterene/HCTZ (90 day supply) Antiarrhythmics
Page 3 of 15
hyperlipidemics
Cardiovascular
Drugs (cont.)
hyperlipidemics
Oral anticoagulant Warfarin
CNS Agents
Anticonvulsants
Carbamazepine (tabs/caps) Gabapentin (tabs/caps) Phenobarbital (tabs/caps) Phenytoin (tabs/caps) Valproic Acid (250mg) Benzodiazepines
Clonazepam (0.5mg and 1mg) Diazepam (tabs) Lorazepam (tabs/caps) Tricyclic
antidepressants
antidepressants
Citalopram Fluoxetine Paroxetine Trazodone Zoloft (Sertraline )(50mg and 100mg) Antipsychotic/
Anxiolytics
Chlorpromazine (tabs) Haloperidol (tabs) Lithium (tabs/caps) Sedative/Hypnotics Zolpidem (Ambien) 5mg and 10mg
Stimulants
Adderall 5mg (immediate release only) Methylphenidate (immediate release only) Page 4 of 15
Antiparkinsons
Sinemet (immediate release only) Trihexyphenidyl (tabs) CNS Agents
Narcotic analgesics Acetaminophen w/ codeine
(tabs/caps) Hydrocodone/APAP (5/500) Hydrocodone/APAP ES (7.5/750) Analgesics
Diclofenac Sulindac (150 and 200mg tabs/caps) Toradol (in-clinic injection only) Cold,Cough,
Anaphylaxis
injector/Epipen) Epinephrine 0.15mg (auto-injector/Epipen Jr.) Antitussive/
expectorant
Mucinex-DM Tessalon perles Tussionex (limit 120ml/dispensing) Antihistamines
Cetirizine (10mg tabs) Hydroxyzine (tabs, liquid) Loratadine (tabs/caps, liquid) Meclizine (tabs) Antihistamine/
decongestant
(liquid,syrup,tabs/caps) Triprolidine/pseudoephedrine (liquid, syrup, tabs) Decongestant/
expectorant
Diabetic agents
Lantus (100U/vial) Novolin N Novolin R Novolin 70/30 pre-mix Humalog Oral Diabetic
Glyburide Metformin (500mg/1000mg) Page 5 of 15
Glucose elevating
Dextrose (tabs/ inj – office use only) Diabetic supplies
Strips (Prodigy, TrueTest, or TrueTrack) Antidiarrheals
Loperamide (Imodium) (tabs/caps, liquid) Lomotil Laxatives
Polyethylene Glycol/Miralax (limit 1 bottle/copay) Golytely (1 time use bottles) Lactulose Acid lowering
agents/ulcer
protectants
Prevacid Ranitidine (tabs) Sucralfate (tabs only) Antispasmodic
Bentyl 10mg and 20mg Donnatal (tabs and liquid) Antiemetics
Meclizine (tabs/caps) Metoclopramide (tabs) Promethazine (tabs and supp) Anorectal
Anusol HC cream (2.5%) Anusol HC suppositories Genitourinary
Hormones
Adrenal steroids
Prednisone Prednisolone liquid Solu-medrol (INJ ONLY) Page 6 of 15
Hormones (cont.)
BCPs (cont.)
Menest (60 day supply) Premarin vaginal cream Provera (60 day supply) Cancer tx
Thyroid agents
Musculoskeletal
Ibuprofen (600 and 800mg tabs/caps) Indomethacin (tabs/caps) Meloxicam (Mobic) (tabs) Naproxen (tabs) Sulindac (150 and 200mg tabs) Gout therapy
Allopurinol (60 day supply) Probenecid Indomethacin (tabs/caps) Prednisone Muscle relaxants
Cyclobenzaprine Diazepam (tabs) Methocarbamol (tabs) Page 7 of 15
Opthalmics
Anti-infective
Bacitracin/polymixin B (oint, drops) Ciprofloxacin (drops, sol) Cortisporin opth (susp) Erythromycin (oint) Gentamicin (drops) Ocuflox (drops, sol) Polymyxin/trimethoprim (drops, sol) Sulfacetamide (oint, drops) Respiratory
Respiratory
Asthma (cont.)
QVAR (HFA/inhaler) Albuterol (neb ONLY) Serevent diskus Theophylline (tabs/caps) Nasal steroid
Nicotine
Cessation
Replacement
Benzoyl peroxide 10% gel, 10% cream Clindamycin 1% topical sol Erythromycin 2% topical gel Retin-A cream/gel Antibiotics
Antifungal
Ketoconazole 2% cream and shampoo Miconazole (cream, oint) Nystatin cream and oint Selenium sulfide (cream, oint) Corticosteroids
Clobetasol (Temovate) cream and oint Hydrocortisone 2.5% cream Page 8 of 15
Triamcinolone (0.1% and 0.5% cream) Triamcinolone 0.1% dental paste Pediculocides/
scabicides
Keratolytics
Moisturizers
Combinations
Vitamins/Minerals
Vitamins/Minerals
Infant vitamin drops One a day MVI Prenatal vitamins (limit #100/copay) Page 9 of 15
Alphabetical Listing
Drug Name
Drug Category
Drug Class
Augmentin (500 & 875mg tabs & 400/5, Vitamins/Minerals -
Page 10 of 15
Dextrose (tabs/ inj – office use only) Page 11 of 15
Vitamins/Minerals -
Vitamins/Minerals -
Page 12 of 15
Loperamide (Imodium) (tabs/caps, liquid) Methylphenidate (immediate release only) TrueTrack, TrueTest) Mucinex-D (600mg/60mg) (limit 18/co- Page 13 of 15
Vitamins/Minerals -
Vitamins/Minerals -
Page 14 of 15
Strips (Prodigy, TrueTest, or TrueTrack) Page 15 of 15

Source: http://www.ncfhp.org/Data/Sites/1/ncfhp-pharmacy-formulary_09_15_-13-w-alphbet-list.pdf

anbos.nl

Exameneisen Inleiding Voor u liggen de exameneisen voor de specialisatie Acne. Deze eisen zijn opgesteld door ISEO Consult in samenwerking met het KWC, op basis van het commentaar van drie deskundigen uit het vak, te weten: de dames K. Lubkemann, C. Oosterwijk en C.Prent. De exameneisen zijn ter vaststelling voorgelegd aan het bestuur van ANBOS. De vaststellingsdatum vindt u op het voor

sairaalakl.fi

Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation : A Comparative Study Salvatore Giordano, Hilkka Peltoniemi, Peter Lilius and Asko SalmiThe online version of this article can be found at: can be found at: Aesthetic Surgery Journal Additional services and information for Aesthetic Surgery Journal O

Copyright © 2010-2014 Online pdf catalog