$TXT Created by CURTIS,RICHARD L at MNTVBB.FO-ALBANY.MED.VA.GOV  (KIDS) on Tuesday, 10/21/03 at 09:18
=============================================================================
Run Date: OCT 22, 2003                     Designation: PSN*4*77
Package : PSN - NATIONAL DRUG FILE            Priority: EMERGENCY
Version : 4        SEQ #71                      Status: Released
                  Compliance Date: OCT 25, 2003
=============================================================================

Associated patches: (v)PSN*4*74    <<= must be installed BEFORE `PSN*4*77'

Subject: CRITICAL DRUG-DRUG INTERACTION NOT ALERTING FOR ONE DOSE

Category: 
  - Routine

Description:
============

 ***********************************************************
 PLEASE NOTE: 
 This patch should only be loaded during NON-PEAK hours.
 Installation time will take possibly 30 minutes or more.
 ***********************************************************
 This patch addresses the problem of providers not being alerted about 
 critical or significant Drug-Drug interactions by order check when 
 one of the drugs is Paroxetine 20MG TAB (Paxil).
  
 ASSOCIATED E3R(s):
 ==================
 N/A
  
 ASSOCIATED NOIS:
 ================
 1.  BAC-0803-41912   Critical Drug-Drug Interaction not alerting for one 
                      dose
  
 PARTICIPATING TEST SITES:
 =========================
  
 Manchester, NH
 Martinsburg, WV
 Clarksburg, WV
  
 NOIS OVERVIEW:
 ==============
 1.  BAC-0803-41912
  
     Problem:
     --------
     When providers order TRAMADOL and PAROXETINE HCL 20MG TAB (PAXIL) 
     they are not being alerted by order check.  These two drugs are
     set Nationally for the Critical Drug-Drug order check which is
     enabled system wide.  When ordering the 10MG, 30MG, 40MG, 50MG and
     60MG dosages of PAROXETIN with the TRAMADOL, the order check Warning
     for Critical Drug-Drug Interaction works, but it does not work when
     ordering the 20MG dose of PAROXETINE.  All the dosages are linked to the
     same orderable item.  This is a Patient Safety issue.
  
     Resolution:
     -----------
     This patch will automatically re-index the "APD" cross reference in
     the Drug Interaction File (56), which is what triggers the order
     check warning.  The 20MG dose of PAROXETINE is missing from this
     cross reference, along with all the drugs it is supposed to be linked
     to for the Critical Drug-Drug order check.  Re-indexing this cross
     reference will properly rebuild the index and resolve this problem.
  
 TECHNICAL:
 ==========
 Routine PSN4P77 has been created to automatically re-index the "APD"
 cross reference in the Drug Interaction File (56) via a Fileman call.
  
 ROUTINE SUMMARY:
 ================
 The following is a list of the routine(s) included in this patch.  The
  second line of each of these routine(s) will look like:
  
      <tab>;;4.0; NATIONAL DRUG FILE;**[patch list]**; 30 OCT 98
  
                             CHECK^XTSUMBLD results
  Routine name      Before Patch          After Patch         Patch List
  ============      ============          ===========         ==========
  PSN4P77                    N/A                26036             77
  
  
 ***WARNING*** This patch should only be loaded during NON-PEAK hours.
               Installation time will take possibly 30 minutes or more.
  
    1.  Use the INSTALL/CHECK MESSAGE option on the PackMan menu.
  
    2.  Review your mapped set.  If the routines are mapped, they should
        be removed from the mapped set at this time.
  
    3.  From the Kernel Installation & Distribution System menu, select
        the Installation menu.
  
    4.  From this menu, you may elect to use the following options
        (when prompted for INSTALL NAME, enter PSN*4.0*77)
        a.  Backup a Transport Global - This option will create a backup
            message of any routines exported with the patch.  It will NOT
            backup any other changes such as DDs or templates.
        b.  Compare Transport Global to Current System - this option will
            allow you to view all changes that will be made when the patch
            is installed.  It compares all components of the patch
            (routines, DDs, templates, etc.).
        c.  Verify Checksums in Transport Global - This option will ensure
            the integrity of the routines that are in the transport global.
  
    5.  Use the Install Package(s) option and select the package PSN*4.0*77.
  
    6.  When prompted "Want KIDS to INHIBIT LOGONs during the install?
        YES//" respond NO.
  
    7.  When prompted "Want to DISABLE Scheduled Options, Menu Options, and
        Protocols? YES//" respond NO.  Enter the Device you want to print
        the Install messages.  You can queue the install by entering a 'Q'
        at the device prompt.  Enter a "^" to abort the install.
  
    8.  If any routines were unmapped as part of step 2, they should be
        returned to the mapped set once the installation has run to
        completion.

Routine Information:
====================

Routine Name:
  - PSN4P77


Routine Checksum:

=============================================================================
User Information:
Entered By  : CURTIS,RICHARD                Date Entered  : OCT 07, 2003
Completed By: PEREZ,CAROL                   Date Completed: OCT 22, 2003
Released By : MUSGROVE,STEVE                Date Released : OCT 22, 2003
=============================================================================


Packman Mail Message:
=====================

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