Showing posts with label pharmacy. Show all posts
Showing posts with label pharmacy. Show all posts

Friday, October 6, 2017

What is the shelf life of Naltrexone? pharmacy

My prescription label says to discard after one year, but pretty much all prescriptions say that. The reason I ask is because I'm thinking about stocking up. Naltrexone has been unbelievably helpful in my struggle with alcoholism. I can take a Naltrexone and enjoy an occasional drink or two just like everyone else. I have some anxiety about what will happen if for some reason I ever lose access, but it would be pointless to stock up if it really is only good for a year. Also, way is the best way to store it (freezer, refrigerator, room temp.)?



Submitted October 06, 2017 at 10:01AM by Hummussapian http://ift.tt/2fW7iHd pharmacy

Tuesday, September 19, 2017

Major retail fiasco involving a specialty order -- did I handle this okay? pharmacy

Alright, so this is partially an "off my chest" post, but I want to bounce this off some pharmacists outside of my circle/company before I say anything to anyone of importance.

I'm a retail technician and I worked an 11-7 midshift today. At 5pm, a woman approaches and says that she received a call that her specialty order had arrived, and that it was in the refrigerator. Usually, our specialty orders come in plastic bags and have some paperwork with them that the patient has to sign, and we keep them by the pharmacist's station. I turn the fridge upside down looking for it and nothing is in there. I ask my pharmacy manager (not just a staff pharmacist -- she runs the show), and she tells me she doesn't know anything about it, and tries her best to ignore me and let me sort it out myself. She finally takes a peek in the fridge and doesn't see anything, and she texts the morning pharmacist and two technicians and gets no response. Another harried ten minutes of looking and no luck. She goes back to ignoring the problem, and these people are getting pissed. I ask her what to do, and she says "well what do you think we should do?" So yeah, these people are pacing the waiting room, I tell them we're waiting to hear from the person who must have called them, and they're upset.

Lo and behold, I go to fill something while I'm waiting, and I find a big box tucked in the back of the pharmacy filled with a whole cornucopia of fertility drugs. There was tape across the top saying to open immediately, and I figured out that the morning tech had called her to ask permission to do this, but didn't call back to tell her that nothing was to be refrigerated. So now I have this open box full of syringes, patches, vials -- a ton of stuff. Another ten minutes goes by while my RXM ignores me and the box, and they stare at me from the waiting area. She finally gets off the phone and I'm like "what do you want me to do? We don't know if morning tech left everything alone, or if there's something more to this, or what." She's like, give them the box.

So I walk it out to the waiting area, and tell him the drugs were packed with fridge packs to keep them cool while traveling, but none need to be refrigerated any longer, and that's why they weren't in the fridge. I explained the whole box fiasco and why I couldn't find it, and he was okay. He's like "everything is here, right?" and I said "yes, it should be" to which he replied "okay, well I'll go home and check the invoice and I'll call you if there are any problems."

I then thought to myself this is fucking wrong. This is an unverified package leaving the pharmacy, and I'm going to be responsible for it because my RXM won't do her job and step up and address this. I asked him "would you be okay if we go through this package, inventory the stuff and make sure you're getting everything, and I'll have the pharmacist sign off on it?" and he said "fine, I'll come back tomorrow, just as long as it's here." I walked the box back inside and told my RXM that we were going to wait until after we verify it, and she said "that's a good plan," and then lamented how dumb the system is.

I'm just beside myself right now when I think about what position she put me in. I had to take point on this whole fiasco, and if these people went home and decided they didn't feel like paying for their next round of Lupron and called back saying the box was open and it was missing -- how do we contest that? Yeah, we handed them an open box, didn't verify the contents, didn't do any paperwork, just winged it.

So yeah, this RXM has been on the hot seat lately for a ton of stuff. Tons of drama about scheduling and our patient satisfaction scores and losing a tech after two months of training because this woman ripped her in front of customers. I've kept my mouth shut and tried to just stay out of it, because I don't her coming after me.

My questions for you guys -- did I handle this well? Should I just keep my mouth shut, tell no one and go about my business, or should I talk to my store manager or district manager, or another pharmacist? I just really feel like the position I was put in was wholly inappropriate and I felt super uncomfortable following orders, and then having to choose to ultimately defy those orders. Thanks for whoever takes the time to read through all this.



Submitted September 20, 2017 at 07:39AM by I_luv_twinks http://ift.tt/2wvQjSY pharmacy

Wednesday, June 14, 2017

Missing med process pharmacy

Anyone implemented a particularly effective intervention or process improvement to cut down on nurse requests for "missing" meds you'd be willing to share? I'm about at my wits' end.

As a bit of background, we: 1) tube all stat non-controlled meds, first doses, and anything due inside an hour 2) make hourly deliveries to patient-specific bins in Pyxis/refrigerator, goal is to have the dose available on the floor at least 2 hours before due

Note: we're a peds hospital and about 50% of all doses are compounded or drawn up for specific patients vs. taken out of Pyxis in a ready-to-use form.



Submitted June 15, 2017 at 12:25AM by taRxheel http://ift.tt/2sbD70e pharmacy

Missing med process pharmacy

Anyone implemented a particularly effective intervention or process improvement to cut down on nurse requests for "missing" meds you'd be willing to share? I'm about at my wits' end.

As a bit of background, we: 1) tube all stat non-controlled meds, first doses, and anything due inside an hour 2) make hourly deliveries to patient-specific bins in Pyxis/refrigerator, goal is to have the dose available on the floor at least 2 hours before due

Note: we're a peds hospital and about 50% of all doses are compounded or drawn up for specific patients vs. taken out of Pyxis in a ready-to-use form.



Submitted June 15, 2017 at 12:25AM by taRxheel http://ift.tt/2sbD70e pharmacy

Sunday, May 28, 2017

Clidamycin oral suspension pharmacy

So refrigeration can mess with the consistency which the bottle says but it says no where that the actual medication would be ruined. Can anymore confirm if you take it out of a refrigerator the medication would be unharmed?



Submitted May 29, 2017 at 03:41AM by m0228 http://ift.tt/2s4XDPG pharmacy

Wednesday, May 10, 2017

Questilions From A Prepper/Author pharmacy

I'm writing a short story about the aftermath of an electromagnetic pulse (EMP) where there will be almost no electronics functioning. I'm trying to be as factual as possible so I have a few questions!

Question One: Approximately how much insulin is going to be in a small town (population 2000) the day they're set to get a delivery? Are they down to a few boxes? For example would the sentence, "April counted 30 assorted vials and 12 boxes of insulin pens on the refrigerator shelves and worried how long they'd last in the July heat with no way to keep them cool." be super low balling or is it typical to drop in stocks the day of delivery? Question Two: How many brands of insulin are in the normal fridge? I know of Lantus, novalog, Humulin, etc and they they come in both pen and syringe but are there many more types typically filled each week? In my story it's a small community and since 3% of USA has insulin using diabetes, approx 60 ppl will have been getting prescriptions in this pharmacy of 2000 people community. If prescription normally lasts a month and there's 60 total, would ordering day most likely only have a couple of types and a couple boxes/vials left or does a pharmacy try to stay ahead of the curve and have several of each etc. Question Three: how many types of antibiotics would normally be on shelves and how many total prescriptions on the last day before a shipment to this drug store? Question Four: same question but for pain meds. Question Five: would you assume a lock down in place for pharmacy staff if a nuke went off 100 miles away or locking up and going home? Question six: do you have a protocol for an EMP or nuclear attack on USA whereby all communications are decimated?

Thanks in advance



Submitted May 10, 2017 at 05:21PM by AliciaRyann http://ift.tt/2qqNFuf pharmacy

Thursday, October 6, 2016

Flu Vaccines at Room Temperature pharmacy

Our flu vaccine protocol went live 9/23. Since then, we have been stocking them in nearly every Pyxis in our hospital (about 150 consoles) and sending them also as patient specific new orders.

When these are sent on delivery runs, sometimes the runs stretch over the course of two hours, and our vaccines remain out of the refrigerator, in a locked cart for longer than the recommended 30 minutes.

From what I understand, the flu vaccine cannot be out of the fridge for more than 30 minutes without losing its viability.

I've raised this concern to my coordinators and they don't seem to be too concerned.

What is the course of action here? Is it true that they can only remain out of fridge for 30 minutes?



Submitted October 07, 2016 at 03:29AM by beeschki http://ift.tt/2diwst7 pharmacy

Tuesday, September 13, 2016

Looking for feedback on a new product for pharmacies called the 'smart thermometer' pharmacy

Hey Everyone,

I am currently developing a new product for my company called the 'smart thermometer'. The basic idea of the product is that it automatically records refrigerator and pharmacy temperatures throughout the workday, eliminating errors in manual record keeping and freeing up time for the staff. The system will also alert you automatically by email, phone and text message when the temperature falls outside of a desired range, ensuring that you do not lose valuable stock.

Since everyone here is heavily involved in the industry, I would love to have your feedback on this idea. I've set up a 5 minute survey on survey monkey and it would be great to hear your thoughts on the product. I'm also going to do a draw for a $200 visa gift-card just to say thank you for participating.

The survey is available at this link: http://ift.tt/2cKG5Ro

Thanks everyone! I hope to hear from you!



Submitted September 13, 2016 at 10:47PM by FI2017 http://ift.tt/2cBVN3L pharmacy

Wednesday, May 11, 2016

The state of a CVS employee refrigerator pharmacy

http://ift.tt/24N2Tor

Submitted May 12, 2016 at 04:29AM by djblade1501 http://ift.tt/1WqH8tu pharmacy

Friday, August 7, 2015

Refrigerator broke in the middle of the night. What next? pharmacy

I work retail and overnight the refrigerator storing all cold drugs died. Was 68F when the store opened. Anyone been in this situation before? I was hoping there is a good cheat sheet that shows how long certain medications can stay at room temperature and still be good. Otherwise, it might just be throwing out $50,000 worth of meds.



Submitted August 07, 2015 at 08:56PM by alexd632 http://ift.tt/1UtaLGo pharmacy

Monday, May 18, 2015

Cefdinir left out of refrigerator pharmacy

This seems like an interesting pharmacy controversy. We have an aux sticker that goes on the bottle that says "DO NOT REFRIGERATE" but the sticker was put on the box instead of the bottle and the parents took the bottle home and threw it straight in the fridge.

They called this morning and I asked the mother to inspect the product. Is it still an even looking suspension? Anything noticeably off about it? Nothing out of the ordinary, per her report. Package insert just says to store it at room temp. Most drugs are more stable refrigerated than at room temp, so one might assume ...

But we are pharmacists and we do not like to assume. So I called the manufacturer and asked them if product stored in the fridge was usable. They provided me with the useless non-answer, "We have no stability data". I had the Dr. approve a refill and tried to call the insurance, who refused to pay for it. Mom was willing to pay out of pocket.

I'm finding conflicting info from googling:

  • PL says Omnicef (the brand product only?) can be stored in the fridge OR at room temp Link

  • This site purports to have an MD specializing in pediatrics saying to use it temporarily, but to get a replacement Rx

  • GoodRx agrees with PL

  • No consensus at StudentDoctor.net



Submitted May 19, 2015 at 09:38AM by aelephant http://ift.tt/1AbJcM2 pharmacy

Friday, May 8, 2015

What did you learn this week? pharmacy

Sore throat

For patients coming in with a sore throat, I always recommend Cepacol lozenges or the generic equivalent. Seems obivous, but never occurred to me to recommend ice or ice chips to help sooth it as well.

I also usually ask them, "Have you seen a doctor yet? Sometimes sore throat can be caused by strep and you might need to be on antibiotics" but that is the extent of it. I'm going to add a bit of differential diagnosis to this. "How fast did it come on?" and "What other symptoms are you having?" are good questions. If it came on suddenly and they have fever, it is more likely to be strep. If they have swollen glands and/or headache, they should be referred to a doctor.

Constipation in an infant

Corn syrup / Karo syrup is an old home remedy, but modern corn syrup probably doesn't work. First thing to try is adding water or fruit juice in between feedings. If they eat solid foods, you can try adding pureed pears or prunes. If the baby is 6 months old or older, the doctor might prescribe an osmotic laxative like Polyethylene glycol (Miralax) or lactulose. Mineral oil, stimulant laxatives, and enemas are not recommended.

Fridge items

Gabapentin solution is an item you might not expect to find in the refrigerator. I see this prescribed to pets sometimes and an important point to keep in mind is that Xylitol is poisonous to them. The product made by Hi-Tech contains it, but the Amneal version is safe.

FIRST®- Omeprazole Compounding Kit is now kept in the refrigerator BEFORE compounding. Blew my other pharmacist's mind when I told him. "You mean, after you mix it?" "No, before" Whaaa...

How about you? Encounter anything new or interesting in pharmacy this week?



Submitted May 08, 2015 at 08:15PM by aelephant http://ift.tt/1JTWrUq pharmacy

Wednesday, February 18, 2015

Prescription Drug Storage in Freezer? pharmacy


Is there any reason to NOT store prescription drugs such a armodafinil and lunesta in air tight containers or zip locs (with silica gel packets for moisture) in the freezer or in the refrigerator?


Armodafinil suggest 2 - 8 C .... which is about refrigerator temp, but would putting it in the freezer hurt it?


What about prescription in general? Is putting in refrigerator or freezer in air tight, moisture controlled jars going to help preserve medications?







Submitted February 18, 2015 at 10:18PM by sarasayswhat http://ift.tt/1CJAYrM pharmacy