Drugs approved for cystic fibrosis?

[belfry]

I work for a smaller hospice, and we recently admitted our first (and so far only) CF patient. I wondered if anyone out there has a list of commonly approved meds, I didn't have a list when I admitted and went overboard approving, because to me, all the meds he had seemed to be appropriate for hospice payment. I have looked online to no avail.

[leslie :-D]

the most common meds for cf, would be bronchodilators, mucolytics, anti-inflammatories, and abx prn.

they'd be covered.

leslie

[chloecatrn]

Pancreatic enzymes, too. Pancrease, Pancreacarb, etc.

[belfry]

Thanks...I had a Friday pm admit on call, one hour before pharmacyclosed...no meds at home, 6 weeks in pt, MD nor admin available for consult....had a bunch of meds prescribed on dch from

hop....I approved most of them, as I had no formulary and so went with my heart and nursing judgement....so all lung meds, allpain meds, all digestive meds, all pancreas relAted meds..then got busted for over approving. Didn't help that the poor little guy passed 4 days later.

[leslie :-D]

Thanks...I had a Friday pm admit on call, one hour before pharmacyclosed...no meds at home, 6 weeks in pt, MD nor admin available for consult....had a bunch of meds prescribed on dch from

hop....I approved most of them, as I had no formulary and so went with my heart and nursing judgement....so all lung meds, allpain meds, all digestive meds, all pancreas relAted meds..then got busted for over approving. Didn't help that the poor little guy passed 4 days later.

the only ones i would have questioned, were the digestive/pancreatic meds.

i would want to assess how well pt was eating, or if he was eating at all.

considering he died 4 days later, i'm guessing his appetite wasn't at its peak.

leslie

[belfry]

Thanks, everybody. Maybe this will get us a little help for next time we have a CF admission, so nobody makes the same mistake!

Oh, I just realized I need to change my profile....I now have a big FIVE years exp, 4 of those in hospice!

[tewdles, RN]

I think you did fine, your assessment based upon knowledge of the disease in the absence of a formulary.

In the future I would recommend that you let the MD decide what will be covered at time of admission...it is required that you collaborate with a couple of disciplines, one being medical. In most cases that call is a few moments of time for the both of you...sometimes not so much. But hey...if the med list is unusual or complicated I have no problem passing responsibility higher up the pay grade...at the time of admission.

[belfry]

Good idea...but the guy had all scripts so prescribing was not the issue, and our MD never dictates what is covered, it is a nursing call. All good until we run into uncharted (LOL) territory, then the MBAs get their panties in a twist since the dollar signs are so big. because we all want an MBA and her niece the gum smacker in billing who thinks nurses are paid way to much to make those medical decisions.....