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Prescription Errors & Decimal Points

Pharmacist — Fri, 23 Jul 2010 11:04:59 +0000

The small decimal point has the power of providing the precise medication for someone or wreaking havoc by providing too much or too little medication to patients. Proper decimal point placement cannot be overstated. Prescriptions that are faxed, written or typed on no carbon-required forms, or written on lined paper all carry the risk of a decimal point being missed.

Decimal points should never be left alone, but always preceded by a zero. This will ensure that the decimal point is more visable. For example, with no leading zero, “Haldol .5 mg” could easily be misinterpreted as “Haldol 5 mg” or “Risperdal .5 mg” easily interpreted as “Risperdal 5 mg”.

Conversely, a whole number should never be followed with a decimal point and a zero. This can easily cause 10 fold overdose. For example, “Coumadin 1.0 mg” can easily be misinterpreted as “Coumadin 10 mg”.

To avoid errors in decimal point placement, the following rules should be in place:

-Any concentrations or strengths less than zero should have a leading zero in front of the decimal point.

-A decimal point and a trailing zero should never follow a whole number.

-Educate staff about the dangers or using naked decimal points and trailing zeros.

-Do not allow staff members to omit leading zeros or trailing zeros when reducing oral prescriptions to writing.

-Ensure that pharmacy and prescriber electronic order entry screens, preprinted prescriptions, and computer generated labels do not use any dangerous decimal dose expressions.

-If a satisfactory alternative is available, eliminate the use of decimal points. For example, use 125 mcg instead of 0.125 mg , 500 mg instead of 0.5 g, and 2 ½ mg instead of 2.5 mg.

-Identify any drugs with 10 fold differences in dosage strength, such as Coumadin 1 mg and 10 mg, Levothyroxine 25 mcg and 250 mcg, and Cytomel 5 mcg and 50 mg. Make sure that any drugs on this list are double checked to ensure correct dosage strength.

-Decimal points can be easily missed when prescriptions are faxed. Have the pharmacist check and verify all faxed prescriptions.

-Eliminate lines on NCR forms so that decimal points are more clearly distinguished.

More information concerning decimal point placement as well as a listing of the ISMP (Institute for Safe Medicine Practices) List of Error-Prone Abbreviations can be found by clicking the following link.

Institute for Safe Medicine Practices

Ten Tips for Weight Loss

Pharmacist — Tue, 13 Jul 2010 12:17:53 +0000

Be realistic. Healthy weight loss is around 1-2 pounds per week. Much more than that is going to be water weight. One pound is equal to 3,500 calories. So, you need to eat 500-1000 calories less a day or exercise to equal that amount. The best way is a combination of both diet and exercise to equal 500- 1000 calories per day.

Avoid drastic diet changes. Think of this as a lifestyle change, not a diet. If you plan to go on a diet and then go back to eating the way you were after you lose the weight, you are setting yourself up for failure. The weight you lost will come right back on when you resume the eating habits that got you there in the first place. Stick with an eating plan that you could see yourself doing 10 weeks and 10 months down the road.

Eat breakfast. Study after study has shown that breakfast eaters tend to lose weight, while breakfast skippers tend to gain weight. Mealsmatter.org

Avoid diet foods. Just because it says “light” or “fat free” does not mean that it is calorie free. All calories add up at the end of the day and many diet foods are not as satisfying as the real thing. Have the real thing if you must, just in smaller amounts.

Eat in. You have control over what you are putting in your mouth. Restaurants tend to go heavier on fat and sugar, therefore calories.

Check your portions. Keep your portion sizes under control will keep your calories under control. A bakery size bagel or muffin can be 4 servings of bread. Check out Allina.com to see what appropriate portion sizes should be.

Count your drinks also. Many fluids that you drink will contain calories also. Make sure that you check the label of what you are drinking to see how many calories your favorite beverages contain. I would personally rather eat my calories, so I avoid any beverages except milk and water. Dietbites.com

Exercise. Even something as simple as a 30 minute walk a day is going to go a long way toward helping you meet your weight loss goal. Exercise increases your metabolism and increases muscle, which burns more fat.

Keep a journal. Writing down what you eat can be a real eye opener in helping you see all the little extras that can pack on the pounds.

Everything in moderation. You can still have the occasional dessert and snack, just make sure to keep the portions small. Try to buy a single portion of your favorite treat so that you do not go overboard.

New Products

Pharmacist — Sat, 26 Jun 2010 12:50:41 +0000

New Drug Products

There are various new drug products on the market or coming to the market soon. New drugs, new OTC’s, new generics and even new indications for current drugs.

New Drugs

PrimaBella- is a therapeutic device worn on the wrist for the treatment of vomiting and nausea during pregnancy. Pulses are gently emitted to the wrist and these travel to the center of the brain that controls nausea. Go to www.PrimaBellaRx.com for more information.

Clonidine ER- treats hypertension and gives the option of titrating, once-daily dosing and use for patients who have difficulty swallowing. Go to www.trispharma.com for more information.

Vagifem 10mcg- treats atrophic vaginitis as a complication of menopause. Currently available at 25mcg, the 10mcg will be helpful as a lower dose. Go to www.vagifem.com for more information.

New OTC’s

Quick Defense Liquid Phyto-Caps- a blend of herbs that helps the immune system when symptoms first begin. Quick acting, only needed for short periods of time when there are respiratory and sinus problems. Go to www.gaiaherbs.com for more information.

Zegerid OTC- full 24 hour treatment for frequent heartburn. Uses the most effective acid reducing medications available. Go to www.ZegeridOTC.com for more information

Lactinol HX- moisturizers to help debride dead skin cells, increase water content to the skin and aid in overall skin health. Go to www.pedinol.com for more information.

New Generics

Nizatidine Oral Solution- used to treat heartburn, GERD, any excess acid secretion conditions, and to treat and prevent ulcers. This is equivalent to Axid Oral Solution. Go to www.amneal.com for more information.

Donepezil Hydrochloride orally Disintegrating Tablets- used to treat dementia related to Alzheimer’s disease. Equivalent to Aricept. Go to www.urlmutual.com for more information

Calcipotriene Solution 0.005%- used as a topical solution for chronic psoriasis of the scalp. Equivalent to Dovonex Scalp Solution 0.005%. Go to www.us.sandoz.com for more information.

Hydromorphone Hydrochloride tablets- used as an opioid analgesic for pain management. Equivalent to Dilaudid tablets. Call 1-800-325-9994 for more information.

New Indications

Cymbalta- approved for generalized anxiety disorder maintenance treatment. Currently used for treatment of major depressive disorder, GAD and fibromyalgia. Go to www.cymbalta.com for more information.

Seroquel XR extended-release tablets- approved to be used as an adjunctive treatment to antidepressants in those with MDD (major depressive disorder). Go to www.seroquelxr.com for more information.

Prescription Savings Ideas

Pharmacist — Sun, 23 May 2010 14:01:51 +0000

How do you save on prescription drugs? Get your pharmacist and pharmacy technician involved. That is what we are here for! As a pharmacist, I have come to know some of the tricks to getting the right drug therapy at the right price. For example, both of my daughters have had several ear infections and both have had tubes put in. Once the tubes were in, a prescription for a brand name ear drop Ciprodex was written for. As a pharmacist, I knew to fill the prescription as written it was going to cost over $100 out of pocket. There is no generic for this drug, but I also knew that it is actually just ciprofloxacin (antibiotic) mixed with dexamethasone (steroid). Each of these are available as generic eye drops. After asking the ear doctor if we could instead have a prescription for generic eye drops, he readily agreed and I walked out paying $3 vs $100 with the same drug needed to fight the infection. Had I not mentioned it, our doctor told us that he would not have thought of prescribing that, although it is just as effective.

Another example, a friend had a Bactroban cream prescription for an infected toe that was going to cost $50 out of pocket. There is no generic for this formulation, but there is a for Bactroban ointment. It has the same percentage of the active drug (mupirocin) and would have the same expected clinical response, again the difference being cream versus ointment. The other difference would be the cost, $3 vs $50. A quick call to the doctor’s office and they were happy to change from a cream to an ointment.

So, what can you do to save on drug costs?

-First ask your doctor if there is a generic to the drug that he or she is prescribing. If there is, you will pay much less. If your doctor tells you that there is not, ask your pharmacist for advice. There may not be a generic, but there may be something that is similar for a much lower price. Most physicians are happy to write a different prescription to save you some money.

-Always ask your doctor if they have any samples, especially if this is a one time prescription. Your doctor is more likely to have some samples on hand.

-Consider filling your prescription via the internet. Internet sites do not have the same overhead that retail stores have and can therefore offer bigger discounts. To avoid internet fraud, always use the National Association of Boards of Pharmacy (www.nabp.net) to find an internet pharmacy, as they carry a list of recommended internet pharmacy sites that are legitimate.

-Join your retail pharmacy’s drug discount program. They will provide better savings for people who are not enrolled in Medicaid or Medicare.

-Check some of the programs available online. One good program is www.caregiversmarketplace.com . For a one time fee, they provide rebates on items that are typically not covered by insurance. Vitamins, pain relievers, skin care products, and other items fall into this category.

-Finally, always ask your pharmacist or certified pharmacy technician!

Manufacturer Listing

Pharmacist — Fri, 07 May 2010 14:39:18 +0000

I’ve created this blog entry to provide an index of the major drug manufacturers and their associated websites. For each manufacturer you will see links to yahoo finance as well.

Abbott Labs
Home Page | Profile | Recent News | Message Board

Alcon
Home Page | Profile | Recent News | Message Board

Altana AG (AAA)
Home Page | Profile | Recent News | Message Board

Amgen Inc. (AMGN)
Home Page | Profile | Recent News | Message Board

Andrx Corp. (ADRX)
Home Page | Profile | Recent News | Message Board

Barr Pharmaceuticals Inc. (BRL)
Home Page | Profile | Recent News | Message Board

AstraZeneca plc (AZN)
US Home Page | Profile | Recent News | Message Board

Bristol-Myers Squibb Co. (BMY)
Home Page | Profile | Recent News | Message Board

Dr. Reddy’s Laboratories Ltd. (RDY)
Home Page | Profile | Recent News | Message Board

Eli Lilly & Co. (LLY)
Home Page | Profile | Recent News | Message Board

Forest Laboratories Inc. (FRX)
Home Page | Profile | Recent News | Message Board

Genentech Inc. (DNA)
Home Page | Profile | Recent News | Message Board

Glaxosmithkline plc (GSK)
Home Page | Profile | Recent News | Message Board

ICOS Corp. (ICOS)
Home Page | Profile | Recent News | Message Board

Johnson & Johnson (JNJ)
Home Page | Profile | Recent News | Message Board

King Pharmaceuticals Inc. (KG)
Home Page | Profile | Recent News | Message Board

KOS Pharmaceuticals Inc. (KOSP)
Home Page | Profile | Recent News | Message Board

Merck & Co. Inc. (MRK)
Home Page | Profile | Recent News | Message Board

MGI Pharma Inc. (MOGN)
Home Page | Profile | Recent News | Message Board

Millennium Pharmaceuticals Inc. (MLNM)
Home Page | Profile | Recent News | Message Board

Mylan Laboratories Inc. (MYL)
Home Page | Profile | Recent News | Message Board

NitroMed Inc. (NTMD)
Home Page | Profile | Recent News | Message Board

Novartis AG (NVS)
Home Page | Profile | Recent News | Message Board

Novo Nordisk A/S (NVO)
Home Page | Profile | Recent News | Message Board

Pfizer Inc. (PFE)
Home Page | Profile | Recent News | Message Board

Par Pharmaceutical Companies Inc. (PRX)
Home Page | Profile | Recent News | Message Board

Sanofi-Aventis (SNY)
Home Page | Profile | Recent News | Message Board

Santarus Inc. (SNTS)
Home Page | Profile | Recent News | Message Board

Schering AG (SHR)
[note - this is the German Schering, not to be confused with Schering Plough]
Home Page | Profile | Recent News | Message Board

Schering-Plough Corp. (SGP)
Home Page | Profile | Recent News | Message Board

Sepracor Inc. (SEPR)
Home Page | Profile | Recent News | Message Board

Shire Pharmaceuticals Group plc (SHPGY)
Home Page | Profile | Recent News | Message Board

TAKEDA PHARMACEUTICA (TKPHF.PK)
Home Page | Recent News

Teva Pharmaceutical Industries Ltd. (TEVA)
Home Page | Profile | Recent News | Message Board

Wyeth (WYE)
Home Page | Profile | Recent News | Message Board

Probiotics

Pharmacist — Fri, 07 May 2010 05:24:37 +0000

Probiotics are defined as live microorganisms that are similar to beneficial microorganisms found in the human gut. Probiotics are available in both foods and dietary supplements. Foods containing probiotics include yogurt, some juices and soy beverages, miso, fermented and unfermented milk, and tempeh. The bacteria can be added or may have been present originally in both foods and supplements. Probiotic dietary supplements take the form of powders, capsules or tablets. In America, spending on probiotics has tripled from 1994 to 2003.

Interest in the use of probiotics has grown due to promising reports of potential prevention and treating of certain health conditions. A 2005 conference of the National Center for Complementary and Alternative Medicine (NCCAM) and the American Society for Microbiology found encouraging evidence for the use of probiotics. The following are some examples:

-Treatment of diarrhea, especially diarrhea from rotovirus

-Prevention and treatment of urinary tract infections

-To shorten an intestinal infection caused by Clostridium difficile

-To reduce recurrence of bladder cancer

-To treat irritable bowel syndrome

-To prevent and treat pouchitis

-To prevent and manage eczema in children

More research needs to be done to determine firmer conclusions. The safety of probiotics has not been thoroughly studied scientifically. Although, probiotic potential side effects tend to be mild such as bloating or gas. There is a potential that probiotic use could cause infections or could stimulate unhealthy metabolic activities.

Most likely consuming yogurt or other foods containing probiotics daily would not be harmful. As far as probiotic supplements, these are considered dietary supplements and there are currently no guidelines on recommended amounts. It is imperative that you consult your health care provider before taking probiotics as a treatment or let your health care provider know if you are currently taking them.

Bottom line, moderate daily use of probiotics in foods should be fine and you could see several potential benefits. If you are considering taking probiotic supplements, definitely consult your health care provider first and do not use as a substitute for prescribed medication.

How To Become a Pharmacy Technician

Pharmacist — Mon, 25 Jan 2010 16:03:28 +0000

Getting Recertified?

Pharmacist — Sun, 29 Nov 2009 17:02:00 +0000

Pharmacy technicians must recertify every two years. A minimum of 20 hours of continuing education (CE) is required for recertification. This keeps technicians up to date with the most recent industry standards and practices.