Microsoft word - 2010 chip formulary updated 080110.doc
2010 Formulary Introduction from the Health Partners Pharmacy
Prescription quantities cannot be altered
Health Partners, Inc. is pleased to provide
department when applicable.
unless approved by the physician, and must
be within the limits of the plan’s days supply.
KidzPartners (Children’s Health Insurance
The Health Partners P&T Committee will
Prescribed medications or regimens that are
non-formulary require prior authorization.
inclusion in the formulary. The evaluation
process includes a literature review, and
therapy in an ambulatory setting. Excluded
professionals. Formal reviews are prepared
If a member presents at a pharmacy with a
manufacturers who have not contracted with
authorization, whether for a non-formulary
immediately, Health Partners will allow the
pharmacy to dispense an interim supply of
approved by the Health Partners Pharmacy
products have been selected to provide the
If the recipient is in immediate need of the
most clinically appropriate and cost-
medication in the professional judgment of
effective medications for KidzPartners
the pharmacist and if the prescription is for a
new medication (one that the recipient has
not taken before or that is taken for an acute
management of a specific patient. In those
condition), Health Partners will allow the
instances, the unlisted medication may be
formulary inclusion an attempt will be made
pharmacy to dispense a 5-day supply of the
to examine the drug relative to similar drugs
currently on formulary. In addition, entire
pharmacy the opportunity to initiate the
reviewed. This review process may result in
The KidzPartners Formulary is organized by
therapeutic class in an effort to continually
promote the most clinically useful and cost-
prescribed for the treatment of an illness or
pharmacologic class or disease state. Each
condition that is chronic in nature in which
section contains a list of drugs selected to
there has not been a break in treatment for
be on this formulary. Prescribing a drug
greater than 34 Days), Health Partners will
product that is available generically is
exceptions are noted, all applicable dosage
medication is eligible for coverage. The
prescriber is urged to prescribe in amounts
member, with a copy to the prescriber, an
that adhere to accepted standards of care.
advance written notice of the reduction or
termination of the medication at least 10
determined by the dispensing pharmacist to
days prior to the end of the period for which
Specific limits based on FDA guidelines,
the medication was previously authorized.
The actions of the Health Partners P&T Committee are communicated through
standards of care may apply to medication
Health Partners will respond to the request
the Provider Newsletter to all physicians
for prior authorization within 24 hours from
and posted on our website. Pharmacy
when the request was received. If the prior
providers in the KidzPartners network will be notified through correspondence
ratings of generic drugs are available by
• All brand name medications when there
referring to the FDA reference Approved
is an A-rated generic equivalent available
medication, either alone or along with other
Drug Products with Therapeutic Equivalence
medication that the recipient may be taking,
would jeopardize the health and safety of
• Medications used for non-FDA approved
generic can be substituted with the full
• Prescription costs that exceed $1000
expectation that the substituted product will
produce the same clinical effect and safety
• Prescriptions that exceed set plan limits
This formulary lists all specific strengths and
dosage forms that are covered. When a
• Prescriptions processed by non-network
strength or dosage form is specified,
State laws or regulation may indicate the
only the product identified will be
ability to practice generic substitution for
covered. Other strengths/ dosage forms
selected products or categories of drugs.
of the referenced product are not covered.
that are repackaged or distributed under a
For specific questions please contact the
should always be considered therapeutically
To request a prior authorization the
equivalent and substitutable for the source
physician or a member of his/her staff should contact Health Partners either by fax at 866-240-3712, or phone at 215-991-
Generic substitution is the process by which
4300. All non-emergency requests can be
a generic equivalent is dispensed rather
faxed 24 hours per day; calls should be placed from 9:00 A.M. to 5:00 P.M., Monday through Friday.
therapy. Health Partners will not cover any
drugs by companies that do not participate
business hours, the call should be made to
in the Federal Rebate Program or are DESI
subsequently made a determination of fully
1-888-888-1212. The call will be evaluated
effective for most of these products and they
prescriptions for drugs with A-rated generics
products remain classified as less than fully
The physician may use the Health Partners
effective while awaiting final administrative
Prior Authorization/Medical Exception form
disposition. Also classified as DESI are
or a letter of request, but must include the
The MAC list sets a ceiling price for the
many products listed as identical, similar, or
following information for quick and
prescription drugs. This price will typically
cover the acquisition of most generics but
not branded versions of the same drug. The
products selected for inclusion on the MAC
list are commonly prescribed and dispensed
and have usually gone through the FDA’s
review and approval process. This process
• Days supply (duration of therapy) and
utilized appropriately, Prior Authorization
specific products. These medications may
require Prior Authorization for the following
The FDA has given the generic an “A” rating
• Non-formulary medications, or benefit
determined the generic is therapeutically
exceptions required by medical necessity
• Additional clinical information that may
substitute for the knowledge, expertise, skill
prescriber, Health Partners will render a
his/her choice of prescription drugs. Health
Partners does not assume responsibility for
Director will review each prior authorization
request and make the final decision. After
provider based upon reliance, in whole or in
part, on the information contained herein.
pharmacist will prepare the request for the
denial/approval letter. A denial letter will be
mailed to the member or parent/guardian. A
copy of the member denial letter is also
Administration (FDA) publishes guidelines on
the safest and most efficient ways to use
The information contained in this document
certain drugs. Many drug products on the
If the Prior Authorization/Medical Exception
KidzPartners Formulary have quantity limits
licensing agreement. The information may
based upon the dosage described in product
submit a written appeal to Health Partners’
not be copied in whole or in part without the
Complaint & Grievance Unit explaining the
written permission of Health Partners. All
medical necessity of the medical treatment
Drugs subject to quantity limits may change.
business hours, the prescribing physician
Trade names are the intellectual property of
Step therapy is a process that encourages
the use of medications preferred by Health
Partnersas the first course of treatment. If
the preferred medication is not clinically
Health Partners supports appropriate use of
injectables and has established procedures
for prescribing and suppliers. Under the
direction of the Health Partners Pharmacy
department, the physician provider has the
primary responsibility for obtaining Prior
Authorization for medications included in
responses will be reviewed and considered.
medications, although not limited to, can be
obtained through the retail pharmacy benefit
GENERIC NAME BRAND NAME
fluphenazine decanoate Prolixin Decanoate
KidzPartners Formulary and its appendices
is provided by Health Partners solely for the
convenience of medical providers. Health
TABLE OF CONTENTS ANALGESICS . 1 ANALGESIC, NON-SALICYLATE & BARBITURATE COMB. . 1 ANALGESIC,NON-SALICYLATE,BARBITURATE,&XANTHINE CMB. 1 ANALGESIC/ANTIPYRETICS, SALICYLATES . 1 ANALGESIC/ANTIPYRETICS,NON-SALICYLATE . 1 ANALGESICS, NARCOTIC AGONIST AND NSAID COMBINATION . 1 ANALGESICS, NARCOTICS . 1 ANTIMIGRAINE PREPARATIONS . 3 NARC.& NON-SAL.ANALGESIC,BARBITURATE &XANTHINE CMB . 3 NARCOTIC & SALICYLATE ANALGESICS, BARB.& XANTHINE. 3 NARCOTIC ANALGESIC & NON-SALICYLATE ANALGESIC COMB . 3 NSAIDS, CYCLOOXYGENASE INHIBITOR - TYPE. 3 URINARY TRACT ANALGESIC AGENTS. 4 ANESTHETICS . 4 LOCAL ANESTHETICS . 4 URINARY TRACT ANESTHETIC/ANALGESIC AGNT (AZO-DYE) . 4 ANTIARTHRITICS . 4 ANALGESIC/ANTIPYRETICS, SALICYLATES . 4 ANTI-ARTHRITIC AND CHELATING AGENTS. 4 ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS . 4 ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR. 4 ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS INHIBITOR . 4 COLCHICINE. 4 GOLD SALTS . 4 HYPERURICEMIA TX - XANTHINE OXIDASE INHIBITORS . 4 NSAIDS, CYCLOOXYGENASE INHIBITOR - TYPE. 4 URICOSURIC AGENTS . 6 ANTIASTHMATICS. 6 BETA-ADRENERGIC AGENTS . 6 BETA-ADRENERGIC AND ANTICHOLINERGIC COMBINATIONS . 7 BETA-ADRENERGIC AND GLUCOCORTICOID COMBINATIONS . 7 GENERAL BRONCHODILATOR AGENTS . 7 LEUKOTRIENE RECEPTOR ANTAGONISTS . 7 MAST CELL STABILIZERS . 7 MONOCLONAL ANTIBODIES TO IMMUNOGLOBULIN E(IGE) . 7 MUCOLYTICS . 7 NASAL MAST CELL STABILIZERS AGENTS . 7 XANTHINES . 7 ANTIDOTES. 8 NARCOTIC ANTAGONISTS . 8 ANTIHISTAMINE AND DECONGESTANT COMBINATION . 8 1ST GEN ANTIHISTAMINE & DECONGESTANT COMBINATIONS . 8 ANTIHISTAMINES . 8 ANTIHISTAMINES - 1ST GENERATION . 8 ANTIHISTAMINES - 2ND GENERATION . 8 EYE ANTIHISTAMINES . 9 ANTIINFECTIVES . 9 ABSORBABLE SULFONAMIDES . 9 AMINOGLYCOSIDES. 9 ANTITUBERCULAR ANTIBIOTICS . 9 CEPHALOSPORINS - 1ST GENERATION. 9 CEPHALOSPORINS - 2ND GENERATION . 10 CEPHALOSPORINS - 3RD GENERATION . 10 LINCOSAMIDES . 10 MACROLIDES . 10 NITROFURAN DERIVATIVES . 11 PENICILLINS. 11 TETRACYCLINES . 12 VAGINAL ANTIBIOTICS . 12 VAGINAL ANTIFUNGALS . 12 VANCOMYCIN AND DERIVATIVES . 13 ANTIINFECTIVES/MISCELLANEOUS . 13 AMEBACIDES . 13 ANAEROBIC ANTIPROTOZOAL-ANTIBACTERIAL AGENTS . 13 ANTHELMINTICS. 13 ANTIFUNGAL AGENTS. 13 ANTIFUNGAL ANTIBIOTICS. 13 ANTILEPROTICS . 13 ANTIMALARIAL DRUGS . 13 ANTI-MYCOBACTERIUM AGENTS . 13 ANTIVIRAL MONOCLONAL ANTIBODIES. 14 ANTIVIRALS, GENERAL . 14 ANTIVIRALS, HIV-SPEC, NON-PEPTIDIC PROTEASE INHIB. 14 ANTIVIRALS, HIV-SPEC, NUCLEOSIDE-NUCLEOTIDE ANALOG . 14 ANTIVIRALS, HIV-SPEC., NUCLEOSIDE ANALOG, RTI COMB . 14 ANTIVIRALS, HIV-SPECIFIC, FUSION INHIBITORS. 14 ANTIVIRALS, HIV-SPECIFIC, NON-NUCLEOSIDE, RTI. 14 ANTIVIRALS, HIV-SPECIFIC, NUCLEOSIDE ANALOG, RTI . 14 ANTIVIRALS, HIV-SPECIFIC, NUCLEOTIDE ANALOG, RTI . 15 ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITOR COMB . 15 ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITORS. 15 ANTIVIRALS,HIV-1 INTEGRASE STRAND TRANSFER INHIBTR. 15 ARTV CMB NUCLEOSIDE,NUCLEOTIDE,&NON-NUCLEOSIDE RTI. 15 CHEMOTHERAPEUTICS, ANTIBACTERIAL, MISC. . 15 HEPATITIS C TREATMENT AGENTS. 15 QUINOLONES . 16 ANTINEOPLASTICS. 16 ALKYLATING AGENTS . 16 ANTIANDROGENIC AGENTS . 16 ANTIMETABOLITES . 16 ANTINEOPLASTIC - AROMATASE INHIBITORS. 17 ANTINEOPLASTIC LHRH(GNRH) AGONIST,PITUITARY SUPPR. . 17 ANTINEOPLASTICS,MISCELLANEOUS . 17 SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERM) . 17 SELECTIVE RETINOID X RECEPTOR AGONISTS (RXR) . 17 STEROID ANTINEOPLASTICS . 17 TOPICAL ANTINEOPLASTIC & PREMALIGNANT LESION AGNTS. 17 ANTIPARKINSON DRUGS. 17 ANTIPARKINSONISM DRUGS,ANTICHOLINERGIC. 17 AUTONOMIC DRUGS. 17 ADRENERGICS, AROMATIC, NON-CATECHOLAMINE. 17 ANAPHYLAXIS THERAPY AGENTS . 18 BETA-ADRENERGIC BLOCKING AGENTS . 18 BETA-ADRENERGIC BLOCKING AGENTS/THIAZIDE & RELATED . 19 PARASYMPATHETIC AGENTS . 19 BIOLOGICALS. 19 ANTISERA. 19 BLOOD. 19 ANTICOAGULANTS,COUMARIN TYPE . 19 ANTIFIBRINOLYTIC AGENTS. 20 HEMATINICS,OTHER . 20 HEMORRHEOLOGIC AGENTS . 20 HEPARIN AND RELATED PREPARATIONS . 20 PLATELET AGGREGATION INHIBITORS. 20 CARDIAC DRUGS . 21 ANTIARRHYTHMICS . 21 CALCIUM CHANNEL BLOCKING AGENTS . 21 DIGITALIS GLYCOSIDES. 23 VASODILATORS,CORONARY. 23 CARDIOVASCULAR. 23 ACE INHIBITOR/CALCIUM CHANNEL BLOCKER COMBINATION . 23 ACE INHIBITOR/THIAZIDE & THIAZIDE-LIKE DIURETIC . 24 ALPHA/BETA-ADRENERGIC BLOCKING AGENTS. 24 ANGIOTENSIN RECEPTOR ANTAG./THIAZIDE DIURETIC COMB . 24 ANGIOTENSIN RECEPTOR ANTGNST & CALC.CHANNEL BLOCKR. 24 ANTIHYPERLIPIDEMIC - HMG COA REDUCTASE INHIBITORS . 24 ANTIHYPERTENSIVES, ACE INHIBITORS . 25 ANTIHYPERTENSIVES, ANGIOTENSIN RECEPTOR ANTAGONIST . 25 ANTIHYPERTENSIVES, SYMPATHOLYTIC . 25 ANTIHYPERTENSIVES, VASODILATORS . 26 BILE SALT SEQUESTRANTS . 26 LIPOTROPICS. 26 CNS DRUGS . 26 ANTICONVULSANTS . 26 CONTRACEPTIVES . 28 CONTRACEPTIVES,INJECTABLE. 28 CONTRACEPTIVES,ORAL. 28 CONTRACEPTIVES,TRANSDERMAL . 29 COUGH/COLD PREPARATIONS. 29 ANTITUSSIVES,NON-NARCOTIC . 29 DECONGESTANT-EXPECTORANT COMBINATIONS. 29 NARCOTIC ANTITUSS-1ST GEN. ANTIHISTAMINE-DECONGEST . 30 NARCOTIC ANTITUSSIVE-1ST GENERATION ANTIHISTAMINE . 30 NARCOTIC ANTITUSSIVE-ANTICHOLINERGIC COMB. . 30 NARCOTIC ANTITUSSIVE-EXPECTORANT COMBINATION. 30 NON-NARC ANTITUSS-1ST GEN. ANTIHISTAMINE-DECONGEST . 30 NON-NARC ANTITUSSIVE-1ST GEN ANTIHISTAMINE COMB. . 30 DIAGNOSTIC . 30 BLOOD SUGAR DIAGNOSTICS . 30 URINE ACETONE TEST AIDS. 30 URINE MULTIPLE TEST AIDS . 30 URINE TEST AIDS,MISCELLANEOUS . 31 DIURETICS . 31 CARBONIC ANHYDRASE INHIBITORS . 31 LOOP DIURETICS. 31 POTASSIUM SPARING DIURETICS . 31 POTASSIUM SPARING DIURETICS IN COMBINATION . 31 THIAZIDE AND RELATED DIURETICS. 31 EENT PREPS. 32 EAR PREPARATIONS, MISC. ANTI-INFECTIVES. 32 EAR PREPARATIONS,ANTIBIOTICS . 32 EAR PREPARATIONS,LOCAL ANESTHETICS . 32 EYE ANTIBIOTIC-CORTICOID COMBINATIONS . 32 EYE ANTIINFLAMMATORY AGENTS. 32 EYE ANTIVIRALS . 33 EYE SULFONAMIDES . 33 EYE VASOCONSTRICTORS (RX ONLY). 33 MIOTICS/OTHER INTRAOC. PRESSURE REDUCERS. 33 MYDRIATICS. 33 NASAL ANTI-INFLAMMATORY STEROIDS. 34 NOSE PREPARATIONS, MISCELLANEOUS (RX) . 34 OPHTHALMIC ANTIBIOTICS . 34 OPHTHALMIC ANTI-INFLAMMATORY IMMUNOMODULATOR-TYPE . 34 OPHTHALMIC MAST CELL STABILIZERS . 34 OTIC PREPARATIONS,ANTI-INFLAMMATORY-ANTIBIOTICS . 34 ELECT/CALORIC/H2O . 34 ELECTROLYTE DEPLETERS . 34 FLUORIDE PREPARATIONS . 35 HYPERGLYCEMICS . 35 IODINE CONTAINING AGENTS . 35 POTASSIUM REPLACEMENT . 35 URINARY PH MODIFIERS. 35 GASTROINTESTINAL . 35 AMMONIA INHIBITORS. 35 ANTICHOLINERGICS,QUATERNARY AMMONIUM. 36 ANTICHOLINERGICS/ANTISPASMODICS. 36 ANTIDIARRHEALS . 36 ANTIEMETIC/ANTIVERTIGO AGENTS. 36 ANTI-ULCER PREPARATIONS. 36 ANTI-ULCER-H.PYLORI AGENTS . 37 BELLADONNA ALKALOIDS . 37 BILE SALTS . 37 CHRONIC INFLAM. COLON DX, 5-A-SALICYLAT,RECTAL TX . 37 DRUG TX-CHRONIC INFLAM. COLON DX,5-AMINOSALICYLAT . 37 HISTAMINE H2-RECEPTOR INHIBITORS . 37 INTESTINAL MOTILITY STIMULANTS . 38 LAXATIVES AND CATHARTICS . 38 PANCREATIC ENZYMES . 38 PROTON-PUMP INHIBITORS . 38 RECTAL PREPARATIONS . 38 HORMONES . 39 ANDROGENIC AGENTS. 39 ANTIDIURETIC AND VASOPRESSOR HORMONES . 39 GLUCOCORTICOIDS. 39 GROWTH HORMONES. 40 LHRH(GNRH) AGONIST ANALOG PITUITARY SUPPRESSANTS . 40 LHRH(GNRH)AGNST PIT.SUP-CENTRAL PRECOCIOUS PUBERTY . 40 MINERALOCORTICOIDS . 40 OXYTOCICS. 41 PROGESTATIONAL AGENTS. 41 RECTAL/LOWER BOWEL PREP.,GLUCOCORT. (NON-HEMORR). 41 HYPOGLYCEMICS . 41 ANTIHYPERGLY, (DPP-4) INHIBITOR & BIGUANIDE COMB. . 41 ANTIHYPERGLYCEMIC, ALPHA-GLUCOSIDASE INHIB (N-S) . 41 ANTIHYPERGLYCEMIC, DPP-4 INHIBITORS . 41 ANTIHYPERGLYCEMIC, INSULIN-RELEASE STIMULANT TYPE . 41 ANTIHYPERGLYCEMIC, INSULIN-RESPONSE ENHANCER (N-S) . 42 ANTIHYPERGLYCEMIC,BIGUANIDE TYPE(NON-SULFONYLUREA) . 42 ANTIHYPERGLYCEMIC,INSULIN-REL STIM.& BIGUANIDE CMB. 42 ANTIHYPERGLYCEMIC,INSULIN-RESPONSE & RELEASE COMB.. 42 ANTIHYPERGLYCM,INSUL-RESP.ENHANCER & BIGUANIDE CMB. 42 INSULINS . 42 IMMUNOSUPPRESANT . 43 IMMUNOSUPPRESSIVES . 43 TOPICAL IMMUNOSUPPRESSIVE AGENTS . 44 MISCELLANEOUS MEDICAL SUPPLIES, DEVICES, NON-DRUG . 44 DIABETIC SUPPLIES . 44 DURABLE MEDICAL EQUIPMENT,MISC(GROUP 1). 44 RESPIRATORY AIDS,DEVICES,EQUIPMENT. 44 MUSCLE RELAXANTS. 44 SKELETAL MUSCLE RELAXANTS . 44 PRE-NATAL VITAMINS. 44 PRENATAL VITAMIN PREPARATIONS . 44 PSYCHOTHERAPEUTIC DRUGS . 46 ALPHA-2 RECEPTOR ANTAGONIST ANTIDEPRESSANTS . 46 ANTI-ANXIETY DRUGS . 46 ANTIPSYCH,DOPAMINE ANTAG.,DIPHENYLBUTYLPIPERIDINES. 47 ANTIPSYCHOTICS, ATYP, D2 PARTIAL AGONIST/5HT MIXED . 47 ANTIPSYCHOTICS, DOPAMINE & SEROTONIN ANTAGONISTS . 47 ANTIPSYCHOTICS,ATYPICAL,DOPAMINE,& SEROTONIN ANTAG. 47 ANTIPSYCHOTICS,DOPAMINE ANTAGONISTS, THIOXANTHENES. 48 ANTIPSYCHOTICS,DOPAMINE ANTAGONISTS,BUTYROPHENONES . 48 ANTIPSYCHOTICS,DOPAMINE ANTAGONST,DIHYDROINDOLONES. 48 ANTI-PSYCHOTICS,PHENOTHIAZINES. 49 BIPOLAR DISORDER DRUGS . 49 MAOIS - NON-SELECTIVE & IRREVERSIBLE . 49 NOREPINEPHRINE AND DOPAMINE REUPTAKE INHIB (NDRIS) . 49 SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRIS) . 50 SEROTONIN-2 ANTAGONIST/REUPTAKE INHIBITORS (SARIS) . 50 SEROTONIN-NOREPINEPHRINE REUPTAKE-INHIB (SNRIS) . 50 TRICYCLIC ANTIDEPRESSANT/BENZODIAZEPINE COMBINATNS . 51 TRICYCLIC ANTIDEPRESSANT/PHENOTHIAZINE COMBINATNS. 51 TRICYCLIC ANTIDEPRESSANTS & REL. NON-SEL. RU-INHIB . 51 TX FOR ATTENTION DEFICIT-HYPERACT(ADHD)/NARCOLEPSY . 52 TX FOR ATTENTION DEFICIT-HYPERACT.(ADHD), NRI-TYPE . 52 SEDATIVE/HYPNOTICS. 52 BARBITURATES. 52 SEDATIVE-HYPNOTICS,NON-BARBITURATE . 52 SKIN PREPS. 53 ACNE AGENTS,SYSTEMIC. 53 ACNE AGENTS,TOPICAL . 53 ANTIPERSPIRANTS . 53 ANTIPRURITICS,TOPICAL. 53 ANTIPSORIATIC AGENTS,SYSTEMIC . 53 ANTIPSORIATICS AGENTS . 53 ANTISEBORRHEIC AGENTS . 53 EMOLLIENTS . 53 HYPOPIGMENTATION AGENTS . 54 IMMUNOMODULATORS . 54 KERATOLYTICS . 54 ROSACEA AGENTS, TOPICAL . 54 TOPICAL ANTIBIOTICS . 54 TOPICAL ANTIFUNGALS. 55 TOPICAL ANTI-INFLAMMATORY STEROIDAL . 56 TOPICAL ANTIPARASITICS . 57 TOPICAL ANTIVIRALS. 58 TOPICAL LOCAL ANESTHETICS. 58 TOPICAL SULFONAMIDES. 58 VITAMIN A DERIVATIVES. 58 VITAMIN A DERIVATIVES, TOPICAL COSMETIC AGENTS . 58 SMOKING DETERRENTS . 58 SMOKING DETERRENT AGENTS (GANGLIONIC STIM,OTHERS). 58 SMOKING DETERRENTS, OTHER . 59 THYROID PREPS . 59 ANTITHYROID PREPARATIONS . 59 THYROID HORMONES. 59 UNCLASSIFIED DRUG PRODUCTS. 59 AGENTS TO TREAT MULTIPLE SCLEROSIS. 59 ANTI-ALCOHOLIC PREPARATIONS. 59 APPETITE STIM. FOR ANOREXIA,CACHEXIA,WASTING SYND. . 59 BULK CHEMICALS. 60 CHEMOTHERAPY RESCUE/ANTIDOTE AGENTS. 60 DENTAL AIDS AND PREPARATIONS. 60 METALLIC POISON,AGENTS TO TREAT . 60 URINARY TRACT ANTISPASMODIC/ANTIINCONTINENCE AGENT. 60 VITAMINS . 60 FOLIC ACID PREPARATIONS . 60 NIACIN PREPARATIONS . 60 PEDIATRIC VITAMIN PREPARATIONS. 60 VITAMIN B PREPARATIONS . 60 VITAMIN B12 PREPARATIONS . 61 VITAMIN D PREPARATIONS . 61 VITAMIN K PREPARATIONS . 61 ANALGESICS ANALGESIC, NON-SALICYLATE & BARBITURATE ANALGESIC,NON- SALICYLATE,BARBITURATE,&XANTHINE CMB ANALGESICS, NARCOTIC AGONIST AND NSAID COMBINATION ANALGESIC/ANTIPYRETICS, SALICYLATES ANALGESICS, NARCOTICS ANALGESIC/ANTIPYRETICS,NON-SALICYLATE NARC.& NON-SAL.ANALGESIC,BARBITURATE &XANTHINE CMB NARCOTIC & SALICYLATE ANALGESICS, BARB.& XANTHINE NARCOTIC ANALGESIC & NON-SALICYLATE ANALGESIC COMB CYCLOOXYGENASE INHIBITOR - TYPE ANTIMIGRAINE PREPARATIONS URINARY TRACT ANALGESIC AGENTS ANESTHETICS ANESTHETICS ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS INHIBITOR URINARY TRACT ANESTHETIC/ANALGESIC AGNT (AZO-DYE) COLCHICINE ANTIARTHRITICS ANALGESIC/ANTIPYRETICS, SALICYLATES HYPERURICEMIA - XANTHINE OXIDASE ANTI-ARTHRITIC AND CHELATING AGENTS INHIBITORS ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS CYCLOOXYGENASE INHIBITOR - TYPE ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR URICOSURIC ANTIASTHMATICS BETA-ADRENERGIC BETA-ADRENERGIC AND ANTICHOLINERGIC MONOCLONAL ANTIBODIES COMBINATIONS IMMUNOGLOBULIN E(IGE) BETA-ADRENERGIC AND GLUCOCORTICOID MUCOLYTICS COMBINATIONS NASAL MAST CELL STABILIZERS AGENTS XANTHINES GENERAL BRONCHODILATOR AGENTS LEUKOTRIENE RECEPTOR ANTAGONISTS MAST CELL STABILIZERS ANTIDOTES NARCOTIC ANTAGONISTS ANTIHISTAMINE AND DECONGESTANT COMBINATION ANTIHISTAMINE & DECONGESTANT COMBINATIONS ANTIHISTAMINES ANTIHISTAMINES 1ST GENERATION ANTIHISTAMINES 2ND GENERATION ANTIHISTAMINES ANTIINFECTIVES ABSORBABLE SULFONAMIDES AMINOGLYCOSIDES ANTITUBERCULAR ANTIBIOTICS CEPHALOSPORINS - 1ST GENERATION CEPHALOSPORINS - 2ND GENERATION LINCOSAMIDES MACROLIDES CEPHALOSPORINS - 3RD GENERATION NITROFURAN DERIVATIVES PENICILLINS ANTIFUNGALS TETRACYCLINES ANTIBIOTICS VANCOMYCIN AND DERIVATIVES ANTIINFECTIVES/MISCELLANEOUS AMEBACIDES ANAEROBIC ANTIPROTOZOAL-ANTIBACTERIAL ANTILEPROTICS ANTIMALARIAL ANTHELMINTICS ANTIFUNGAL ANTI-MYCOBACTERIUM ANTIFUNGAL ANTIBIOTICS ANTIVIRAL MONOCLONAL ANTIBODIES ANTIVIRALS, ANTIVIRALS, HIV-SPECIFIC, FUSION INHIBITORS ANTIVIRALS, HIV-SPECIFIC, NON-NUCLEOSIDE, ANTIVIRALS, HIV-SPEC, NON-PEPTIDIC ANTIVIRALS, HIV-SPECIFIC, NUCLEOSIDE PROTEASE INHIB ANALOG, RTI ANTIVIRALS, HIV-SPEC, NUCLEOSIDE- NUCLEOTIDE ANALOG ANTIVIRALS, HIV-SPEC., NUCLEOSIDE ANALOG, ANTIVIRALS, HIV-SPECIFIC, NUCLEOTIDE ANALOG, RTI ANTIVIRALS,HIV-1 INTEGRASE STRAND TRANSFER INHIBTR ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITOR COMB NUCLEOSIDE,NUCLEOTIDE,&NON- NUCLEOSIDE RTI CHEMOTHERAPEUTICS, ANTIBACTERIAL, MISC. ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITORS HEPATITIS C TREATMENT AGENTS QUINOLONES ANTIANDROGENIC ANTIMETABOLITES ANTINEOPLASTICS ALKYLATING
Case 1:06-cv-00678-SLR Document 20 Filed 12/13/2006 Page 1 of 5 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF DELAWARE RICHARD F. KLINE, JR., PLAINTIFF, CIVIL ACTION NO. 06-678 SLR CORRECTIONAL MEDICAL SERVICES, WARDEN RAPHAEL WILLIAMS and NURSING TRIAL BY JURY DEMANDED DEPARTMENT, DEFENDANTS. RESPONSE OF DEFENDANT, CORRECTIONAL MEDICAL SERVI
Trigeminal Neuralgia and Persistent Idiopathic Facial Pain Definition Trigeminal neuralgia (TN) is a unilateral painful disorder that is characterized by brief, electric-shock-like pains, is abrupt in onset and termination, and is limited to the distribution of one or more divisions of the trigeminal nerve. The International Headache Society (IHS) differentiates between classical trig
2010 Formulary