Friday, October 26, 2012

Best Pharmacy Advice for All of Pharmacy!

This is some of the best pharmacy advice I have ever seen! I had to repost it. The original post is from The Redheaded Pharmacist.

Today I think it is time to give a little advice to pharmacy students and graduates. I’m no expert on what it means to be a pharmacist but I’ve worked in the field long enough to learn a few valuable lessons. I hope these words will help someone.

1. Take your time. Contrary to popular belief, community pharmacy is not about filling prescriptions as fast as humanly possible. No one will ever come after your license for taking the time necessary to fill each prescription correctly. Don’t worry about how other pharmacists pace themselves, they may or may not be doing as thorough of a job as you should be with each prescription order.

2. Talk to patients. Talking to patients is the good part of my job. I admit that I have my fair share of patients who make me so angry I could scream. But at the end of the day patient counseling is one of the most rewarding parts of being a pharmacist. Don’t be afraid to go talk to patients even if it isn’t in your nature to be an outgoing person.

3. Learn from more experienced pharmacists. Pharmacy school instructors, preceptors, and colleagues have a lot of knowledge to share. Learn from pharmacists who have been around the block. Mistakes and experience are the best teachers, but mentors aren’t a bad choice for gaining knowledge about the profession of pharmacy either.

4. Get Involved and Stay Informed. The days of passively pursuing your own career while ignoring the bigger picture are long gone (if they ever existed). Keep a pulse on the developments that impact the profession of pharmacy any way you can. Being informed will better prepare you for the next wave of change. Joining organizations, going to board of pharmacy meetings, or writing letters to politicians are all ways to become more involved.

5. Learn from your mistakes. Despite the expectations of perfection, pharmacists are human. We make mistakes just like everyone else. I’ve made more than my fair share of prescription mistakes and judgement errors. Although I freely recognize that I’m not perfect, I desperately attempt to learn from my mistakes in the hopes that I won’t be repeat them in the future.

6. Have fun. I’m not immune to the negatives of my job or the frustrations that come with being a pharmacist. But I also try to have fun at work. With the right people and the right attitude and outlook, you can enjoy the job of pharmacist. Some days I am better at keeping my frustrations at bay. Other days those frustrations can get the best of me. It’s easy to get lost in a sea of negativity surrounding pharmacy. My goal is to remember the positives so those moments can get me through the negatives.

7. Ask questions. Don’t ever make assumptions. With people’s lives at stake, assumptions could literally kill. If a dose looks wrong, call the prescriber. If a patient is confused about how to take a medication, explain it to them even if you’ve done so already in the past. There is a circle of care involving the patient and all the healthcare providers that treat that individual. We should all be on the same page.

8. Follow your own path. It’s your career, find what you enjoy and pursue those opportunities. Don’t be afraid to try something completely out of your comfort zone either. You never know where you will find that dream job or golden opportunity.

Being a pharmacist is a demanding but rewarding job. In the end, you have to trust your abilities and hope that you can help every patient as much as possible. Anyone that asks more than that from you is simply demanding too much.

Tuesday, October 23, 2012

Some Pharmacy Changes Are Coming

Are you ready? Pharmacy changes are about to take place. We, pharmacists, are going to be able to counsel everyone! All these 30 second phone wait, 15 minute guarantees, auto refills, select decline to counsel, and other metrics will fall by the wayside. Filling as many scripts as possible with as little help as possible will gradually fade away. We have to counsel and take our time to fill prescriptions correctly. The profession of doctor of pharmacy is about to change.

We are going to do what we were taught in our colleges and schools of pharmacy. Counsel patients about their medications to increase compliance and have great clinical outcomes. We will even be able to tell patients not to drink milk with their antibiotics. Sometimes I feel like I do not even have time for that. Who is ready for restroom breaks? I cannot tell you how many times I have held my bowel movements and urine until there was a pause. If I go to the restroom, patients will complain because their prescription will take longer to fill. Thus, when they do the survey, they will say their Rx was not filled within their time limit.

Some pharmacies close for lunch. All pharmacies should close for lunch! I heard that patients complain that they had to wait 30 minutes to get their prescription filled because the pharmacy was closed. The patients said the pharmacy should never close for lunch for emergencies. I know they waited at the doctors office for an hour. I guess drive thru's make it seem like it should be fast food. I want my prescription now, just slap a label on it. What if the prescription is Coumadin? You will die if you take too much or take it with aspirin! People just do not care. By the way, I cannot wait to counsel. Pharmacy is about to change!

Monday, October 8, 2012

Expensive Erectile Dysfunction Medications: Viagra, Levitra, and Cialis

I cannot believe it took the human species, or a man, so long to find a chemical that would cause an erection. Sex is the basis to life. We need it to reproduce. When we found that sex could feel good, we needed to have it all the time. People just lived in frustration if their husband or lover could not "perform" anymore. Finally, in 2003, a new chemical that was going to be used for blood pressure that caused a significant side effect, an erection. The chemical was introduced to the market as sildenafil, or as we know it, Viagra! Viagra was marketed for erectile dysfunction. It took about 20 minutes to an hour to start working, and some patients would see a blue hue to know it was time to go at it. I think getting an erection would tell you it was time to go. The medication could last 4 hours. Quickly, we had three expensive erectile dysfunction medications, Viagra, Levitra, and Cialis, available. They range in price from $25 to 35 dollars per pill! Sometimes the copay is outrageous or not even covered by prescription insurance!

Pharmaceutical companies started to adjust certain parts of the chemical to make the side effect longer lasting, and then, Cialis was born. Cialis could start working in 15 to 20 minutes and last up to 36 hours! I sell mostly Viagra and Cialis. Viagra is supposed to be going generic very soon. There goes another multibillion dollar medication for Pfizer. Lipitor was their previous money maker that went generic in November 2011.

There are some new medications like Staxyn and Stendra. Staxyn is an orally disintegrating tablet of the popular drug Levitra. Stendra lasts up to 6 hours and starts to work in about 15 minutes.

Wednesday, September 19, 2012

Can You Believe There Is a Flu Shot Song!

There is a flu shot song out now called hit me with a flu shot. It is a Pat Benatar parody to her hit song Hit Me With Your Best Shot. This song was floating around the emails at a pharmacy. Has it really come down to this about vaccinations? I cannot believe there is a song about it. Here are the lyrics to the song:
What you're a real tough virus with a long history
Of changing into forms that are hard to treat
That's okay there's nothing to it
Roll up my sleeve and let the vaccine do it
Hit me with the flu shot
Why don't you hit me with the flu shot
Hit me with the flu shot, fire away
You come on all a'sudden
You don't fight fair
But that's okay because I'm aware
Knock me down, it's all in vain
'Cause I've had the shot for the new flu strain

Hit me with the flu shot
Why don't you hit me with the flu shot
Hit me with the flu shot, fire away
Well you're a real tough virus with a long history
Infecting healthy lungs like the ones in me
Before I get exposed with a cough in my face
I'm going to make sure I put you in your place

Hit me with the flu shot
Why don't you hit me with the flu shot
Hit me with the flu shot, fire away
Hit me with the flu shot
Why don't you hit me with the flu shot
Hit me with the flu shot, fire away

This flu shot song is kind of catchy. I think it is because I like the real song, already. Have you heard of any flu shot songs are crazy pharmacy songs? I think I'm going to make a song about OxyContin!

Tuesday, September 11, 2012

Where Were You?

I will never forget going to class at pharmacy school, and the Dean of Students and Admissions telling us class was cancelled because a plane had hit one of the towers. I went to the library to study and paused to watch the news on a television at the entrance. About five students stopped to watch with me and then the second plane hit. I could not believe it! I stood there shocked as they replayed it over and over. I will never forget!

Monday, September 10, 2012

Use the Pharmacy's Systems And Do Not Come in at the Last Minute!

     What is the deal with running out of your medication? Come in early, call ahead, or use the phones' automated system. At my pharmacy, a pharmacy technician can process a refill of your medication. You do not need the pharmacist to look you up in the system to refill your medication. I had one of my old patients come in and say that she read an article about calling in using the automated system instead of calling and asking for the pharmacist. The article said, it wastes about five minutes of the pharmacist's time when I could be doing something else like counseling instead of trying to get her prescription refilled. I wish I knew what the article was, so I could print it off and give it to all of my patients.

     Nobody can ever find their Rx number. I know you have the excuse that you cannot find the prescription number. If you would stick with one pharmacy, then maybe you could learn where it is on the bottle. I understand that some patients forget their bottle, and they are at work. But, I know this is not always the case. Also, driving in the car trying to refill your medication is probably not the smartest thing to do. The patient, then says, that they are in the parking lot and coming in the store. "Can you have it ready?" Heck no, it will not be ready! If no one is waiting already, then it will probably be at least 10 minutes.

     Why do customers and patients wait until the last minute to come to the pharmacy? Almost every night they come in  with five or less minutes left before we close. It always seems to be a new patient that has never been to the pharmacy before. No, I cannot fill your prescription. By the way, this is the same phrase I say to people with their Oxycontin 30mg with a quantity of #180. It will take at least 15 minutes to put you in the system, insert your insurance, enter in your prescription, make sure it goes through your insurance, pull and count the medication, label the bottle, check the prescription, and ring up your Rx. Oh, I almost forgot, they will hand you a drug coupon at the register, and you will have to reprocess the Rx again. Usually, if it is an antibiotic or one of my regulars, I will fill the prescription. There is a reason for 24 hour pharmacies and my pharmacy is not one of them!

Thursday, August 23, 2012

Flu Shots, Already?

Well, here we go again. Flu shots are available, and we are starting to stick patients in their deltoid, again. Doesn't it seem early to be shooting the dead influenza vaccine into people's shoulders. All my patients are asking, "are flu shots early this year?" Yes, and we have tons of the vaccine!
I tell them, "no, same time as last year, and the CDC recommends to get them as soon as they are available. Would you like to get one!"
They say, "how long will it take, how much is it, is it going to hurt and will I get sick from the shot?"
I say, "15 to 20 minutes," the price, "it depends, and usually not."
Patients say, "ok, let's get it over with."
I say, "left or right arm. If you flex your muscle, it will probably hurt. If you stay relaxed, it does not hurt as bad. Always use the muscle by doing exercises that work the deltoid."
The symptoms you get from the flu shot are minimal and weak flu-like symptoms. I usually recommend acetaminophen if you have some symptoms of fever and body ache.
We received our flu shots at the end of July, and we started injecting our associates and patients the first week of August. Fluzone and Fluvirin are the two brands of injections we use. We give Fluzone HD for patients that have Medicare Part B. Oh and by the way, Medicare Part B pays for it entirely! It is essentially free for ages 65 and up. Medicare advantage only pays for the regular flu shot. If you have insurance, we need to see your insurance card and process it to see if the flu shot is covered.
"What is flu shot HD," you say? It is the influenza vaccine High Dose. It is supposed to illicit a quicker immune response, so the patient is protected from the flu faster than the regular flu shot. I believe you will have a full immune response and be protected from the flu in 7 to 10 days with Fluzone HD. The regular flu shot takes 2 weeks to be protected against the influenza virus.
For 2012-2013, flu shots have 2 new variants to the previous flu shot of 2011-2012. We did not have a huge breakout last year. Probably because most people received their flu shot and there was no crazy variation at the end of the flu season. The bird flu or avian flu of 2008 and the swine flu of 2009 caused major flu pandemics. They caused shortages of flu shots and Tamiflu, which fights the flu virus. The past couple of years we have had enough flu shots and no shortage. A lot of people have been getting their flu shots at local pharmacies and taking advantage of the easy access. Pharmacies are able to give shingles vaccine shots and pneumococcal vaccine shots. I will elaborate on Zostavax, the shingles vaccine, in another post. Don't forget to get your whooping cough vaccine, the pertussis shot. Elderly patients about to have new grandchildren need this pertussis vaccination. Again, most pharmacies have pharmacists that are certified immunizers. Visit your local pharmacy to get your vaccinations, today! By the way, you can get two shots in one day. It has to be a dead virus, like the influenza vaccine, and a live virus, like shingles vaccine. Two dead viruses like the flu shot and pneumococcal vaccine.

Wednesday, August 8, 2012

PCAT Prep: Do it or fail!

Of course, I am a registered pharmacist with a Doctor of Pharmacy degree, now. So, I took the Pharmacy College Admission Test, also known as the dreaded PCAT. When I took the PCAT exam, you could pass the test with just the knowledge you learned from high school and your pre-pharmacy courses at an undergraduate college. There were a couple of books available you
could study, but for the most part, it was not a very hard test. The hardest part was finishing the PCAT exam in the time allotted. We were only given about 30 minutes for each section with no clock in the room! I know. I forgot my watch. Doing sixty math problems in 30 minutes was pretty difficult, but I passed the test easily, about 85th percentile overall.
When I arrived at the pharmacy school, I was told by a few classmates and upper classmen that there was a book available at the time to pass the test with 99th percentile on all subjects. If you read the book tirelessly and memorized everything in it, you would pass with great ease. There were also PCAT practice exams in the book to hone your skills. I was shocked and wished that someone would have told me before I took the PCAT test what that book was. How could there be a book that not only helped you pass, but you could pass in the 99th percentile on all categories. I did not pay very close attention to what the book was or how to attain it. After all, I was already in pharmacy school.
I did not have to prepare for the PCAT or do PCAT prep, but I would have if I knew the scope of the test. Especially, if I was trying to get into pharmacy school now, I would study endlessly. It is extremely difficult to be accepted to pharmacy school now! You have to have close to a 4.0 GPA in undergraduate school and score a 75 or above on the PCAT. This is just the minimum scores! Most schools will not accept below 80 on the PCAT. I believe this book, 2012-2013 Kaplan PCAT, and this CD course, 2012 PCAT Audio Learn, will help you pass the PCAT with great scores in every category. These PCAT prep lessons are essential to passing the test. This will allow you to master the PCAT and eventually get into a great pharmacy school. You will then begin your journey in the profession of pharmacy.