What do other institutions utilize to meet the above requirements?

We are doing between 20-30 annual Critical Point modules (through Simplifi) and they are brutal. Seems scammy 😅

I am working on a pharmacy project (not school related) that has to do with the colors and shapes of pharmacy.

I could really use some help recalling as many colorful and different shaped drugs as possible because it’s been about 8 years since I’ve worked in the retail/outpatient setting.

Thanks everyone 🩵💊

edit to add If you can also include the color(s)/shape next to the drug name, it will really help me when I begin to organize my list!

If amiodarone was not given during resuscitation but ROSC is achieved, what doses are you giving? 300mg IVP or 150mg IVPB over 10 minutes?

Example: Patient who has cardiac arrest but is now in ROSC and v-tach was suspected prior to arrest, or patient who is now ROSC after CPR and now is in v-tach

Context. Working a 10 hour shift. Peds ED script comes by for auvi q that is not covered. I offer RN that we can do a PA but pt can pay out of pocket for rx and then we can rebill later if approved. 15 min till close dad comes to pick up and we do not have in stock. I didn’t realize it at the time I spoke to RN otherwise I wouldn’t have needed to bother explaining how to do a PA.

Dad is pissed bc they leave out of town tomorrow. Idk what allergy 22 month old has but when I suggested to dad rx can be sent to pharmacy they are going he said they can’t leave without it bc child will be exposed to all sorts of things in the airport.

Another location has it but I tell dad they close at 6 and they won’t stay over. He asked me to call and ask. I call and tell Rph “feel free to say no but dad wants to know if you can stay 20 min”. I already told dad they prob won’t. Rph tells me she has had a day so no.

Dad hears me say that part and is annoyed I didn’t tell them he’s been here for 3 hours and no one told him it was not in stock. All other pharmacies closed at 5 (it’s a Sunday).

It was my fault for not noticing we didn’t have it but it’s been a day for us too and I let that slip through the cracks. How bad should I feel bc I feel shitty for 1) not realizing it was out of stock & 2) I said that out loud and pt heard me.

Hoping you all might shed some light on this for me, as my team is in a disagreement about the correct way to bill for oral suspensions when dispensing stock bottles.

Theoretical: When typing and billing for things like augmentin suspension, the bottle would theoretically hold let's say a 10 day supply but sig is for a 7 day therapy. Obviously the pt is receiving a 10 day supply but discarding the remainder.

Half have been taught to bill for day supply of entire bottle, other half were told to bill for only the day supply the pt is using. Which way is right or where can I access that information? TIA

Looking for creative and profitable business ideas in healthcare/pharma after completing B.Pharm. Any suggestions beyond retail pharmacy or wholesale? Open to niche or innovative ventures. Thanks!

Hello everyone.

I just graduated last year and started my first job as a PRN retail pharmacist for Walgreens last month. So far it’s not as bad as I was expecting. I love the staff I’m working with, the stores I float at aren’t very far from home and the busier stores I’ve floated at are well managed despite high queue numbers.

However even after my training I still can’t shake off that feeling that I’m now a pharmacist. It’s not a whole lot different as working as an intern but with more responsibilities. There have been moments where my mind draws a blank on decision making moments when a patient has a problem with their prescription or when a tech needs help with something I’m not familiar with. I also feel very slow or take too much time on a particular task when it’s a lot simpler and quicker than how I did it.

I know it’s definitely going to take time getting used to but I wanted to know if anyone else had that same experience as a graduating pharmacist.

I am curious what the current hourly/salary pay is for pharmacists in the east coast. I’ll start first. $65/hour, hospital pharmacist, Michigan. Roughly 10 years experience.

Still in school but we had a lecture on the placebo effect + how to account for it in research to show true drug efficacy etc. I found it interesting and decided to do some digging and found this article: The neurobiological underpinnings of placebo and nocebo effects. I found this quote interesting and super surprising:

“When an unconditioned stimulus (US), e.g. the effect of a drug, is paired with a conditioned stimulus (CS), e.g. a gustatory stimulus, after repeated pairings, the CS alone can mimic the effect of the drug (conditioned response, CR). Since the CS is a neutral stimulus, it can be conceptualized as a placebo in all respects. Immune mediators, like interleukin-2 (IL-2) and interferon (IFN)-gamma, can be conditioned in humans. After repeated associations of a CS with cyclosporine A, which produce IL-2/IFN-gamma decrease, the CS alone can induce the same immune responses [14]. Therefore, these effects are similar to those obtained by drugs acting on the immune system.”

What struck me is that my perception prior to reading this was that placebo affects were almost exclusively found in symptoms (subjective experience), such as pain, mood, fatigue, nausea, appetite, etc..These are definitely real and associated with legitimate pathology, but limited in an ability to measure and assess in a clinical context due to their subjectivity, and more make the placebo effect useful for symptoms of certain conditions vs true mechanisms, heavily limiting its utility in clinical applications outside of clinical trials. But these demonstrates the phenomenon extends very far beyond on symptoms, into measurable signs and treating the mechanism in a disease, like triggering a measurable immune response. Obviously this is like no where near close to becoming a concept applied to clinical care. But this would be, if somehow standardized, such an interesting new approach to medicine, and could reduce adverse outcome risks accepted with current options.

But it opens a can of worms. Lets say decades from now, after this has extensively been standardized and proven to be an effective treatment option for very serious conditions (triggering an immune response is not usually a desired treatment for like a sprained ankle), how would this work? Currently, in the US the FDA must provide some basic explanation of the mechanism to the public (if I am interpreting the labeling requirements correctly some basic or "essential" information is required, that is not misleading) and UK regulations have similar approval expectations.

The knowledge of conditioning and manipulation of placebo effects seems to me like it would limit it's maximum effectiveness considerably -although deceiving patients about it would not only be illegal, it is (I would argue) unethical outside of a clinical trial context where it is known placebo could be the treatment received-the patient would be unaware of this possibility and perceive themself to be receiving a pharmaceutical compound, and also hard to not accidentally trigger. If you are going to make it possible for the trigger to not be an external factor but intrinsic to taking the medication (so taste like the example used), how could you realistically avoid that triggered with a similar tase signal with unrelated day to day behavior?

*Hi this pill might taste bitter, unrelated as a side effect please avoid all bitter foods as they could impact the medication effectiveness, for these totally plausible reasons...*Some people wouldn't question it (and probably proceed to eat bitter food) and some would, I doubt it would be something that could be maintained without people identifying this isn't a logical part of the medication, and there was something amiss. The fallout would be pretty catastrophic, and the public would justifiably be en ranged, even if the intention was not malicious deception, it is deception. Intention would get so lost.

Lets say you find a work around to that last question and you can make the conditioning aspect so it's part of the medication experience and not likely to be triggered by other living aspects. How could the pharmaceutical industry legally and ethically put this treatment in practice? Is it even possible? There are some studies* that indicate placebos are already used in clinical care outside of research -is that legal/ethical in their current use, and how prevalent is this?

Any other wild placebo science that will surprise me?

It is a wild concept, and this is only one quote from the article -highly recommend it, also interesting things on neurotransmitter implications and receptor interaction that I genuinely didn't know about.

For more of the genetics piece there's also this study on placebo effects and the molecular biological components involved

*IE One study found "that 97% of UK GPs have used placebos in clinical practice" but not a very strong source of comparison to example used of placebo to trigger immune response, because it stated most of those GPs were including impure placebos in this answer (IE homeopathy) rather than a "pure placebo" (IE sugar pill, much more deceptive and adjacent to example used).

These questions are assuming it's proven to be safe, effective, yadyayada like years down the line.... the science part is figured out. It's the legal and ethical implementation I am wondering is even feasible regardless of it being effective since there's a long way to go there.

Sorry I don’t practice inpatient normally. Covering today in acute care facility.

I’m used to DDAVP for bleeding as 20 mcg IVPB

Nurse said they always push it.

Does anyone have experience on this area? What is preferred or best for acute bleeding episodes?

Apixaban and aspirin were discontinued

Is it true that unionized workers have a fixed salary based on years of experience and cannot be negotiated upon hiring? 62 hourly for a community hospital in PA Thoughts on this rate? Thanks!

This is the weekly thread to highlight anything new you learned last week!

Links to studies and articles are great, but so are anecdotes and case reports. Anything you learned in the last week you want /r/pharmacy to know goes here!

Coming through internship to being an early career pharmacist in Australia and we are seeing a saturation of overseas pharmacists. The issue I’m concerned about is that these overseas trained pharmacists are not competent for Australian standards, and have been considered competent for practice by the board of pharmacy. The exams are way too easy, and the likes of whatsapp message groups are filled with pharmacists asking basic questions while working. These are questions a pharmacist would easily know, and could easily google the answer. It’s actually concerning and to be frank, putting patients lives at risk.

I'm looking for a research position and have applied to a few at the university near where I currently live.
I have no research experience from college or pharmacy school, so I don't have anything about it on my CV. I did have one APPE research rotation, but it wasn’t really research.
One of the labs I applied to for a post-doc position contacted me and asked if I had any research experience. Is it likely they'll turn me down?
How did you all get into a research position?
I honestly want to leave retail and am looking for any research job.

Is LinkedIn and Indeed really the best way now? I'm looking for something that makes 60+$/hour that's not community (retail or independent)

I’m a little confused on the contraindications section for AIS: if a patient received an anti-Xa inhibitor within the previous 48 hours, does their INR/other lab have to be abnormal for tnkase to be contraindicated? Or does just receiving one of these meds, regardless of lab results count as a contraindication?

Not goodRx, but BetterRX. Anyone have any experience working there? Anyone process claims for their patients?

Tried to search the subreddit, didn’t come up with anything.

Currently a P3 and looking at residency options. Has anyone worked or had experience at an Indian Health Services hospital? Their benefits seem to be great, plus I’m used to living/being in more rural areas, so I’m drawn into it! Just curious what the actual work environment would be like. ?

Naltrexone, for instance, has a 4-5 hours half life but a duration of action that is much longer (depending on the dosage, from 24 to 72 hours or more). Can someone help me understand these concepts better?

To all the LA pharmacists, hope you guys are doing ok! Scary times out there right now.

Is anyone else having trouble getting these or does Morrison & Dickson just plain suck at keeping stock?

Hi everyone,

Recently graduated PGY-1 residency in June and looking to see if anyone here would be willing to share their study materials for the exam who took it more recently (ACCP/HYMR/ASHP).

Unfortunately at the hospital I work at I’m the youngest and all my coworkers took their exam many years ago and don’t have their study materials anymore.

Thank you!

Hi everyone,

How would you prep for this interview?

My background is staffing inpatient with occasional outpatient shifts in a smaller hospital but the same hospital system as this TOC position (which is in the biggest hospital of the system).

What resources/suggestions would be useful to prepare?

Thank you!

I am looking to relocate to NYC in about six months. Looking for some feedback on job availability and salary range for someone with Pharm.D, BCPS and 30 years of experience. Also, If any one of you work for the systems listed below, i would appreciate it if you share your experience at that health system with me. NYU Langon, NY Presbyterian, NYC Health, Lenox Hill, and Mount Sinai.

I have argument with doctor about concomitant use of multiple NSAIDs in muscle injection. I couldn't find any source justifying use of two or more systemic NSAIDs. Doctor claims that there is article about safty of short-term use but I found any. There is something about general safty in short term use of single NSAIDs, but for me concomitant use of multiple NSAIDs is plain stupid. Higher risk of adverse effect with no beneficial factors or maybe I don't know something?

So, I just had a thought while staring off into space as I was doing something in my own pharmacy, lol. But I have a question: can you turn your tech license into a pharmacist license? Meaning like the license number changing it over? Like, is that a thing?

How much more do you feel like you should make than someone who is newly hired into the job?

This question is rooted in the fact that raises were granted recently to "bring everybody up," because hiring at the current rate has been difficult.

So now, me being there over 5 years will make 3.4% more than a new hire AFTER being brought up to my "fair market value."

I feel like that's not enough, but I'm curious about other perspectives.

Hello, I am a new pharmacist who has graduated in May. Currently I am a floater retail pharmacist and I absolutely hate this job. This job doesn't bring me happiness and I don't find it rewarding whatsoever. In addition, I'm not seeing how this job allows me to grow into the career that I actually want. I feel like I'm starting to forget all the clinical knowledge that I've spent 4 years learning and between working long hours and a long commute home, I'm too exhausted to look at guidelines or any new clinical trials. I was wondering if anyone has been in a similar situation and wondering how you transitioned into other roles in pharmacy without a fellowship or residency. TIA!