MEDICATION USE IN SCHOOLS RESOURCE MANUAL Philip E. Johnson, MS RPh FASHP J. Michael Hayes, PharmD Vera Farkas Reinstein, PharmD Steven M. Simmons, PharmD FASHP Jean Benson, BS RPh Florida Society of Health-System Pharmacists Florida Edition 2003 MEDICATION USE IN SCHOOLS FLORIDA EDITION 2003 RESOURCE MANUAL May, 2003 EDITOR – IN – CHIEF Philip E. Johnson, MS RPh FASHP Director of Pharmacy, H Lee Moffitt Cancer Center, Tampa, FL Past President and Board of Directors, FSHP, Tallahassee, FL Assistant Dean, U. Florida College of Pharmacy, Gainesville, FL Associate Clinical Professor, NOVA Southeastern College of Pharmacy, Davie, FL Associate Clinical Professor, Shenandoah College of Pharmacy, Winchester, VA ASSOCIATE EDITORS J. Michael Hayes, PharmD RPh Drug Information Coordinator, H Lee Moffitt Cancer Center, Tampa, FL Past Board of Directors, FSHP, Tallahassee, FL Clinical Assistant Professor, U. Florida College of Pharmacy, Gainesville, FL Vera Farkas Reinstein, PharmD BCPS Clinical Pharmacist, Ambulatory Care, Bay Pines VA Hospital, Bay Pines, FL Board of Directors, FSHP, Tallahassee, FL Associate Clinical Professor, NOVA Southeastern College of Pharmacy, Davie, FL Steven M. Simmons, PharmD RPh FASHP Regional Medical Scientist, Glaxo SmithKline Inc., Jacksonville, FL Past President and Board of Directors, FSHP, Tallahassee, FL Jean M. Benson, BS RPh Investigational Drug Service Coordinator, H. Lee Moffitt Cancer Center, Tampa, FL Knowing is not enough; we must apply. Willing is not enough; we must do. ...Goethe 3 Florida Edition 2003 The authors gratefully acknowledge advice, content development and editorial support from the following: Lynda Kinard Dr. Sharon Perlman, MD Director, Coordinated School Health Program Nephrology Florida Department of Education Dr. E.Michael Reisman, MD Diane Mennitt, MS RN NCSN Pediatric Urology Consultant, School Nursing Florida Department of Education Dr. Mark Cavitt, MD Child and Adolescent Psychiatry Mary Jo Butler Director of Intervention and Prevention Services Dr. Jeffrey M. Ewid, MD Florida Department of Education Pediatric Pulmonology Sylvia Forehand Byrd, ARNP MPH NCSN Dr. Shiela M. Love, MD Executive Community Health Nursing Director Pediatric Orthopedics Florida Department of Health School Health Services Program Dr. Henry Shapiro, MD Developmental and Behaviorial Pediatrics Trena Webb, MS RN NCSN Director of School Health Dr. Casadanta, MD Escambia County Health Department and Susan Doyle, RN Florida Department of Health Pediatric Neurology Daisy Vickers, RN Dr. Robert Nelson, MD District Nursing Supervisor Allergy and Immunology Hamilton County Schools Dr. Yul Reinstein, MD Karen Thoennes, BSN RN NCSN Pediatric Gastro- Enterology Health Services Coordinator School District of Escambia County Dr. J. Bruce Hess, MD Florida Department of Education Pediatric Urology Kathleen C. Rose, BS RN NCSN Dr. James Hartfield, MD School Nurse Managed Care Lee County Florida Larry Gonzalez, JD Julia C. Pallentino, JD RN FSHP Legislative Advisor and Lobbyist Florida Department of Health Derek Pike and Pam White Dr. David Cimino, MD FSHP Executive Vice President Adolescent Health We thank Health Care Logistics for allowing us to use their artwork. HCL has agreed to waive all shipping charges for school health related purchases. CALL FREE: 1-800-848-1633 • FAX FREE: 1-800-447-2923 (Available 24 hours a day) E-Mail: [email protected] 4 Guide For Readers OBJECTIVES MEDICATION IDENTIFICATION This book was designed to facilitate several school health Several editors requested picture identification charts for responsibilities defined under Florida Statute 381.0056. proprietary medication products. At the time of publication “The Legislature finds that health services conducted as no free service is available. Your options are to contact a poi- a part of the total school health program should be carried son control center, a licensed pharmacy, or purchase a book out to appraise, protect, and promote the health of students. such as the “Physician’s Desk Reference” (PDR). School health services supplement, rather than replace, parental responsibility and are designed to encourage par- ents/guardians to devote attention to child health, to discover DISCLAIMER health problems, and to encourage use of the services of their The authors/editors, reviewers, and publisher of this book physicians, dentists, and community health agencies.” Specific have made extensive efforts to ensure that the content, medica- responsibilities listed in Florida Statute 381.0056 include: tions, and dosage regimens are accurate and conform to the • Meeting emergency health needs in each school; standards accepted at the time of publication. The references used are listed in the General References section. Professional • Maintenance of records on incidents of health problems, judgement was used to determine which information to pro- corrective measures taken, …; vide to make this reference useful to the intended user, without • Provide inservice health training for school personnel; overwhelming one with infrequent or insignificant concerns. However, changes in state laws, constant changes in informa- • Make available adequate physical facilities for tion resulting from continuing research and clinical experience, health services; reasonable differences in opinions among authorities, unique • …inform parents or guardians in writing that their aspects of individual clinical situations, and the possibility of children who are students in the district schools will human error in preparing such an extensive text require that receive specified health services as provided for in the reader exercise individual judgment when making deci- the district health services plan. sions. If necessary consult and compare information from It is hoped that this book will serve school district authorities, other experts or sources, especially if the medication or topic school administrators, and school health staff in the following is unfamiliar or is used infrequently. ways: Several forms have been selected or created by the editors to 1. Provide “best practice” concepts and models for devel- serve as examples for your consideration. These forms are oping medication policies, procedures, and guidelines. not necessarily complete and may not follow district policy. Sample forms are to be used with professional discretion. 2. Serve as a tool for nurses providing training to health aides and other support staff. 3. Provide information on medications and medication COPYRIGHT related topics. Applied for March 1, 2003. All rights reserved under the Universal Copyright Convention. TABLE OF CONTENTS & INDEXING The authors retain ownership and copyright of this book. The authors encourage you to copy it, distribute it, adopt it, The Table of Contents lists all topics and medications in the and/or adapt it to your unique needs, as long as it is not order in which they appear. The Index lists all medications, done for financial gain, and appropriate reference and credit both Generic and Brand Name in alphabetical order. is given. However, we claim no responsibility if the content material or format is modified. CONTACTING FSHP Florida Society of Health-System Pharmacists 2304 Killearn Center Blvd., Suite A Tallahassee, Florida 32308-3524 www.FSHP.org 850-906-9333 5 Dedication This book is dedicated to three people, without whom this book would not have been written, nor would my life be as rich and full. The teacher who inspired me to become a pharmacist; Who challenged me to find ways to improve myself every day; Who encouraged me to help others; Who inspired me by fighting for the rights of students; The teacher who I proudly called “Mom”. The nurse who inspires me with concern for all children; Who helped me identify the issues; Who challenged me and worked with me to “improve the system”; Who gave me ideas, yet kept me grounded in practicality; The nurse I am proud to say is my wife. The student who didn’t let asthma slow him down; Who always finds a way to meet a challenge; Who inspires me with his cheerful persistence; Who tries his hardest and does his best; The student I am proud to call “Son”. I wish to thank my co-authors, Mike, Vera, Jean, and Steve who generously donated their time and enthusiastically supported this project through all stages. They are all recognized leaders in the pharmacy profession and I am proud to be their colleague. Larry Gonzalez is a good friend and colleague who opened many doors and arranged many meetings. Without his contacts, legisla- tive acumen, support, encouragement, and guidance this project would not have been possible. Dianne, Sylvia, Kathy, Trena, Daisy, Karen, and Lynda are recognized leaders in school health who helped identify the issues, current information sources, and focus of the book. We spent many hours planning, discussing policy, and reviewing drafts. I learned much from these dedicated professionals, and remain impressed and inspired by their sense of mission to help improve the health of our children. … Phil 6 1 INTRODUCTION ..............................................................................................................11 The School Setting. .. .. .. .. .. .. .12 . Synergy of Teamwork . 12 Determinants of Health. 12 Reliability of Student Health Information . 13 Summary Comment. 13 Cost of Inadequate Health Services in Schools . 14 OF CONTENTS TABLE 2 TEACHING CHILDREN ABOUT MEDICINE ..................................................................15 Ten Guiding Principles for Teaching