See from Dr. Norwood. Michele
Michele Ziglar, RN, MSN
Trauma Program Manager
Holmes Regional Trauma Center
1350 South Hickory Street
Melbourne, Florida 32901
321-434-1589 (office)
321-609-3087 (beeper)
321-508-0491 (cell)
Michele.Ziglar@health-first.org
>>> Natalie Norwood 04/29/03 02:28PM >>>
your CroFab question was forwarded to me from Michele Ziglar (our
Trauma Coordinator).
i am the Clinical Coordinator for Pharmacy and have worked in trauma /
critical care / ER settings for the past 11+ years. currently, we do
not stock CroFab since our existing supply of the Wyeth antivenin (the
old product) is still adequate. but sometime in the near future, we
will probably have to depend on CroFab.
yes, the products are quite different. unfortunately the dosing needs
seem to be much higher with the CroFab product than with the old Wyeth
product. (and can range between 8-20 vials depending on the size of
envenomation or the pt response) ... and are quite expensive right
now.
unlike the old product, Crofab is administered to initiate control and
then to provide scheduled doses q6h x3 doses (using 2 vials with each of
these doses). initial control may require 2 separate administrations of
up to 6 vials each time.
reconstitution of Crofab is key (and product must be used soon after
mixed) - essentially both are good for up to 4 hours after mixed.
several recent articles are available and may assist in your efforts.
New Eng J of Med. August 1, 2002 (p. 347-356) and
Nov 28, 2002 (p. 1804-5)
Annals of Emerg Med. Feb 2001;37:181-188.
Annals of Emerg Med. June 2002;39:609-15.
this June 2002 issue of the Annals has various articles related to
Crofab (describing multiple concerns with its use - ie, anaphylaxis,
etc). the entire issue is worth looking at.
hope this helps.
Natalie A. Norwood, PharmD
"MMS <health-first.org>" made the following
annotations on 04/29/2003 02:33:44 PM
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