Unique Plan Description: Tikosyn (dofetilide) (MH FH)
Plan Selection Display: Tikosyn (dofetilide) (MH FH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-02-27 12:56:43
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 12:23:33
Available at all facilities: Yes

Tikosyn (dofetilide) (MH FH)
Vital Signs
	Vital Signs
		T;N, Q15MIN, 4, Dose(s)/Time(s)
			Comment: or until stable then per nursing protocol
Laboratory
	CBC with Diff
		Stat, spec type = Blood
	Comprehensive Metabolic Panel
		Stat, spec type = Blood
	Magnesium Level
		Stat, spec type = Blood
Diagnostic Tests
	ECG
		T;N, Stat
			Comment: notify MD if QT > 500ms
Medications
	Tikosyn
		500 mcg, Capsule, By Mouth, BID
			Comment: Order ECG 2 hours post medication admin
		250 mcg, Capsule, By Mouth, BID
			Comment: Order ECG 2 hours post medication admin
		125 mcg, Capsule, By Mouth, BID
			Comment: Order ECG 2 hours post medication admin
Patient Care
	Notify MD
		T;N, if QT greater than 500ms
	Order ECG
		T;N, 2 hours post medication administration
	Notify MD
		T;N, if patient is taking verapamil, ketoconazole, macrolide, Bactrim, Tagamet, antibiotics, protease inhibitors or SSRIs
	Notify MD of Lab results
		T;N, of abnormal lab.
	Cardiac Telemetry Monitoring
		T;N, Telemetry Indications: ACS/Arrhythmia/QTc
			Comment: Measure QT prior to each dose of Tikosyn and 2 hours after each dose. Notify MD if QT increases by 15% or exceeds 500ms
Consults/Follow-up
	Pharmacy Consult
		Dofetilide (Tikosyn) prescribed; follow policy to evaluate, drug interactions, appropriate dosing, and provide education

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase