Saturday, June 30, 2018

Drugs You Never Knew Existed: TRIZANIDINE!


This would be a great drug if it actually existed. It doesn't, but that didn't stop one lady from asking for a refill on it. Imagine, a benzodiazepine and a muscle relaxant all in the same medication. No more complaining about back pain for you! 

Ask your doctor or pharmacist about Trizanidine!

Wednesday, June 27, 2018

There is a Place for Conscientious Objection

The story from Fox News:

An Arizona woman whose doctor told her she would miscarry said she was deeply upset after a Walgreens pharmacist refused to provide her with medication to induce an abortion because it went against his personal beliefs.

 Nicole Mone took to Facebook Friday to explain that just days earlier, her doctor had said she was going to suffer a miscarriage.

"Unfortunately on Tuesday we found out the baby's development had stopped and I ultimately will have a miscarriage," Mone, who said she'd had a miscarriage before, wrote.

When offered the option of undergoing a hospital procedure or taking prescribed medicine, Mone accepted the latter.

The woman went to Walgreens in Peoria, roughly 13 miles northwest of Phoenix, to pick up her prescription, but said the pharmacist refused to give her the meds.

"I stood at the mercy of this pharmacist explaining my situation in front of my 7 year old, and five customers standing behind only to be denied because of his ethical beliefs," Mone wrote. 

Mone, who said she "left Walgreens in tears, ashamed and feeling humiliated by a man who knows nothing of my struggles," said her prescription was transferred to another Walgreens across town, where she was able to pick it up without issue.

The mother said she contacted the store manager "who did not seem happy about what happened," and also reached out to Walgreens' corporate office. Mone said she also filed a complaint with the Arizona Board of Pharmacy.

Walgreens company policy, according to Fox 10, allows pharmacists to reject prescription requests if they have moral objections, but they're still required to refer the prescriptions to other pharmacists or managers on duty.

Walgreens in a statement said the company was "looking into the matter to ensure that our patients' needs are handled properly." See LINK.

If you haven't seen the Facebook post yet, you probably will shortly. It's all over Facebook and Twitter. 

In a moment I'll give you my thoughts on the matter. But first a little background: 

I understand the situation all too well. Years ago my wife (at the time) and I went through the exact same thing. After having two healthy boys, we were excited to find out that a third baby was on the way, only to have that excitement completely destroyed when we found out it was not a viable pregnancy. There was no heartbeat.

In similar fashion the OB/GYN prescribed medication to end the pregnancy. When I initially gave the prescription to my pharmacist, he expressed concern about filling it, UNTIL I explained the situation to him. Then it was no longer an issue. 

As a pharmacist I'm well aware of the medication and what it does not only from my education in pharmacy but also as someone who has lived through the same thing. So I'm VERY familiar with the issue, from BOTH sides.

There are a number of things that bother me about this story:

* The first thing that frustrates me is that as of now we're only hearing her side of the story and we have to accept that since the pharmacist has not spoken out that what Nicole Mone said happened then it did indeed happen as stated. 

* In the state of Arizona a pharmacist has the ability to refuse to fill a prescription based on personal moral objection but is also required to transfer the prescription where someone else without a moral objection will fill the medication. This Walgreens pharmacist did that. 

I have a problem with the news article that reports Ms. Mone had to drive "across town" to get the medication filled. A simple Google Maps search quickly shows that there is one Walgreens pharmacy two miles west of that location, AND three Walgreens pharmacies four to five miles east of that location. See map:

Two to five miles is not "across town." That sensationalizes the story to make it seem like the patient was really put out to fill the medication. I find that ridiculous.

* I have a huge problem with Ms. Mone publishing the name of the pharmacist that refused to fill the medication. With this story now having gone viral, I fear this pharmacist has likely received a number of threats and if he hasn't been transferred already, he will be shortly. He may even have to quit Walgreens and move. This kind of "revenge" is hateful, to say the least. Whether Ms. Mone knew her story would get the attention it did or not, publishing his name feels a lot like she's trying to extract revenge.

* There's this general idea out there that a pharmacist's job is just to blindly fill medication for patients without regard to any other issue. Add to that a huge number of misconceptions out there about "moral objection," the law, and the role of the pharmacist. Here's some examples:

* Considering this story, there's other factors which bother me even more. People seem to forget that our country, THIS country, the United States of America, was founded on ideals of freedom, one of them being religious freedom (See LINK). The pharmacist is protected under the First Amendment to have his personal beliefs. Arizona law and Walgreens policy protect those beliefs WHILE allowing an option for the patient. The pharmacist followed protocol exactly.

Moral objection is a religious freedom guaranteed by the First Amendment. Suppose for a moment that this was about a viable pregnancy; that the patient was trying to terminate her pregnancy. In Pro-Choice circles that's considered her right. No rights are extended to the unborn baby. The pharmacist's Pro-Life stance would not even be considered. The "morals" of her "rights" are more "moral" than his "morals." 

And that's a very dangerous thing, folks. When one segment of society believes that their mores are morals are more "moral" than others, then we're in trouble. Big trouble. Looking at the big picture, we can all step back and definitely say that certain things are unconscionable. Genital mutilation, beating women and children, slavery... anyone with any kind of moral compass will quickly say these things are WRONG, WRONG, WRONG. BUT it's not so easy when you're talking about whether an unborn fetus is a person or just a mass of tissue. It's reasonable to allow and expect that a certain number of good, intelligent, and "moral" people can and will therefore object to certain treatments for patients. These objections are endemic to a well-rounded society of FREE-thinking people unfettered by the mob-mentality that we're seeing in this particular case.

There is a place for conscientious objection: "The argument in favour of allowing conscientious objection is that to fail to do so harms the doctor and constrains liberty. This is true. When a doctor's values can be accommodated without compromising the quality and efficiency of public medicine they should, of course, be accommodated. If many doctors are prepared to perform a procedure and known to be so, there is an argument for allowing a few to object out." (See LINK). 

This article goes on to summarize as follows:

So in this case, the pharmacist acted within his rights, Walgreens protocol, the law, and in my estimation, he acted appropriately. Sadly, this pharmacist and pharmacy in general is getting blasted all over the Internet simply for him invoking his First Amendment rights.

Tuesday, June 26, 2018

Take it Until.... Until What?

Yes, I know it says "Until Gone," but the tech thought it was "Until Sue."

Until you sue the person that caused you the injury? 

Or until your name changes to Sue? 

Or is it "Until Sure"? Sure of what?

Surely, all I know for sure is this is really bad hand writing.

Monday, June 25, 2018

The Facial Hair Emergency

Saturday, 3:01pm

Ring... ring....

"Thank YOU for calling Goofmart Pharmacy, where we nix Shingles with Shingrix, how may I help you?"

"Yeah, this is Doug from down the street. You have Vanish-kwah in stock?"

I have no idea what he's talking about. I ask him to spell it.


"Oh... no, I doubt that. I've never even dispensed it before." I type on the computer to make sure. "No, we don't have it. BUT you could order it and have it for your patient on MONDAY."

I have to keep reminding Doug of this fact because he always, ALWAYS calls us about ANYTHING he's out of stock on. We're past the point of it being overwhelmingly annoying. We just live with it now. We've given up.

"The lady needs it right away. She wants to start using it today!" he says, as he hangs up.

We don't have the medication. I doubt anyone does. Why? Because it's an obscure product to treat women with unwanted facial hair. Oh, I'm sure it started out as a drug that was actually for something important then they discovered it has this side effect and now it's marketed for that. So I read all about it. It takes 4-8 weeks before most people see any improvement.

Obviously getting the medication started on Saturday would make all the difference in the world.

Saturday, June 23, 2018

Drugs You Never Knew Existed: VALBUTRIN!


Awhile back I had a new prescription brought into the pharmacy. Yep, it said "Valbutrin," which I clarified with the physician. He actually meant to write "Wellbutrin," but wouldn't that be a marvelous product if it existed? You get a Herpes or Shingles outbreak and you get prescribed "Valbutrin" to treat the outbreak AND the depression you feel from having such a wicked virus!

Here's the actual prescription:

Friday, June 22, 2018

Graphic of e-Scripts and Filling Prescriptions

It takes time to fill a prescription. It is NOT an instantaneous process. This graphic clearly illustrates the passage of time and how going to your pharmacy IMMEDIATELY after leaving the physician's office is not only non-productive, it actually ADDS time to the filling process.

Thursday, June 21, 2018

Jan, the INSANE Employee

You've all worked with someone who isn't just quite right... you know, the elevator doesn't go all the way to the top floor or whatever cliche you want to use...

And then there was Jan...

Jan interviewed well. She seemed like a hard worker. I thought she had a great sense of humor and humility. She'd worked retail before so I thought she would fit in well. She was pleasant, friendly, and hardworking. She was on time.

But after a few weeks it became obvious that Jan just wasn't quite right. She was paranoid. She was upset that customers would ask for me (after being here for years) when she thought they should be asking for her. She detested when I finished a sale when it didn't matter who finished the sale. Over the course of the next two years, she:

1. Kept telling me she was going to quit

2. Kept faxing me "I quit" from her fax machine at home

3. Quit nine times and then asked for her job back

Other times I would come to work and she wouldn't talk to me. I had no idea what I did to upset her or why she was upset. She would be normal with the customers but acted like I was invisible. I didn't care if she liked me or not because she was good with customers and that was good for business. The next day she would act like nothing odd had happened.

But the final straw was one day she came back from lunch inebriated. She proceeded to get down on the floor and bark like a dog at the customers. That was it.

So for all you folks out there dealing with insane employees at your place of work, I salute you.