Comments on: Are You a Pharmacist?

By: admjas

admjas — Mon, 14 Sep 2009 02:02:29 +0000

My sister was a nurse,and every night she would come home crying.My hats off to all you care givers.

By: leafs

leafs — Sun, 22 Feb 2009 05:24:45 +0000

A pharmacist needs to follow explicit directions with no hint of ambiguity when filling a prescription. If there is something to be concerned about, the prescriber must be contacted, discussion ensued and documentation noted. Judgement calls lead to three types of action: refusal to fill, calling the prescriber to change the script or filling the script following the exact directions. The doctor should have decided on a strength since he knows the patient history well or have discussed the choices with the patient and potentially a pharmacist before writing the prescription (triad relationship).

My mother is a nurse and I know she doesn’t know the legalities behind pharmacy practice. From another perspective, it may seem like the pharmacist is acting irrational, but there are lots of laws (some silly) that can’t be overrided.

By: Phat

Phat — Tue, 27 Jan 2009 15:57:37 +0000

Honestly a lot of what that was dealt with the fact that it was a controlled prescription. I have no idea what state you work in, but in one of the ones I have worked in you can get your ass handed to you for a simple dispense mistake like that on a controlled prescription. I understood it, but it wasn’t worded the best.

Then again the pharmacist could have just been a dumbass (which is equally possible), but I think the latter is just as likely.

By: Beth Spazek

Beth Spazek — Mon, 11 Feb 2008 17:08:10 +0000

I got a kick out of your blog! My father is a pharmacist and deals with the same issues time and time again. On a different topic, I am a meeting planner for a CME company in Boston, MA. I am researching what it is that will get pharmacists excited about coming to our meetings. As a pharmacists you need so many CME’s per year. Do you get them online or do you prefer to go to live meetings? If you were to go to a live meeting, what would entice you to go? Is it the food? Content? Certain people in the industry? Etc. Any insite would be appreciated. Thank you!

By: medicineman

medicineman — Sat, 03 Nov 2007 19:13:48 +0000

anybody know the size of a 1mg ativan? try cutting it in half.

By: RXGIRL

RXGIRL — Thu, 27 Sep 2007 14:10:09 +0000

I am a Pharm D and in both states I have practiced in, the order has to be clear on which strength tab to give on controls.Glad to see in the end everyone seems to be on the same page.
On another note…Wow, we must be starved out there for more pharmacist blog lines. 8-|

By: Lisa

Lisa — Thu, 06 Sep 2007 21:40:10 +0000

Neil – at least it is considerate spam Address the post first… spam second. perfect.

Considering that I wrote this post more than three years ago after a very long, exhausting shift with home hospice – I can see and understand the different points of view here. Contrary to popular belief, I respet the hell outta pharamacists (usually.) :-\”

By: Neil

Neil — Thu, 06 Sep 2007 20:08:32 +0000

Honestly, I think the situation had everything to do with the quantity. Is the pharmacist being instructed to dispense twenty of the 0.5mg tablets or twenty of the 1mg tablets?

However, at 2am, there’s no need to call the physician. Nothing else in the order (as described above) was questionable.

Instead, the pharmacist should have dispensed the equivalent number of 0.5mg tablets indicated, and in this case, in the form of split 1mg tablets. (So, if the quantity was in fact twenty tablets, the pharmacist should have split and dispensed ten 1mg tablets.)

The End.

Actually, not really.

Lisa, I found what you stated above a tad alarming (and you wrote it more than once):

“I still contend that itâ€™s not much of a leap to make the decision to fill it with half tabs and advise the patient to take one-two tabs.” January 2004

“Again, I still say that filling the script with 1/2 tabs and instructing the patient (or his caregivers) to dose him with one or two tabs, as needed is easier for this patients situation.” October 2006

If the order is filled with split 1mg tablets and the order calls for a 0.5mg to 1mg dose, then saying take one to two tabs (1mg to 2mg) is not the same as saying take 1/2 to one tablet (0.5mg to 1mg), the correct dose.

Anyway, if anyone’s interested in listening to a super fine hour of booty-shaking Latin music, go online to http://www.ritmolatino.org or subscribe to the podcast (Ritmo Latino) in iTunes.

Now that’s what I call Web 2.0 spam.

By: Cathy (pharmacist, registered)

Cathy (pharmacist, registered) — Sat, 12 May 2007 01:42:46 +0000

Too many folks get their panties (undershorts) in a wad , and it’s especially bad if it occurs on night shift. There’s enough freakin’ at the wee hours, wherever. Yea, it sounds like a RN was looking out for best interest of patient, physician, etc., but the pharmacist was covering his/her heinie as well. As was explained later, the quantity was mentioned. Good. Why a hundred in a hospice patient? And, why not lorazepam liquid? And, c’mon, it was controlled after all, it should have made a difference if the physician specified # 100 of the 0.5 or 1 mg tablets. In my dispensing area, we have blue scripts that are not not photocopyable and have little checkboxes for specific quantities. Round and round was ridiculous, though. If I find myself going round and round more than once, I try to rephrase or use other words to get my concern across, and it might make perfect sense to the other person; they might see my point. (A little habit I picked up from my foreign-speaking husband, and later curious children.) If it’s any solace, I’m sure that the pharmacist was thinking it was the night from the netherworld, as well.

By: Lisa

Lisa — Fri, 06 Apr 2007 16:37:30 +0000

And I still contend that unless you have worked at the bedside of a home patient who is terminally ill, in their last few hours of life – - it doesn’t matter what the script is written for, at that point. The priority is the patient comfort… by the time the damn script gets sorted out at 2am with a pendantic pharmacist… the patient will have died… uncomfortably.

I understand the semantics when it comes to just a regular script, for regular patients. Dying, terminially ill patients are a different story – in my opinion, the pharmacist in this situation should recognize the dynamics at play. That’s just my personal.