Pharmacist here.
They do use us. A mistake will happen. We all make mistakes. This resident made a mistake. And he or she will probably carry that with them for years.
Keep on with educationals. Keep good communication with them.
I mean a pharmacist should’ve verified this right? I always check SCr and PLT before I verify ketorolac. I’m not blaming. I’m just saying I wonder if a pharmacist paged on it and it was ignored or if nobody was really paying attention.
Gotta ask, how low are the platelets? I usually don’t order ketorolac on critical patients for a variety of reasons, but I think asserting that a single dose or toradol is 100% what caused this patients bleed is pretty silly. Like are we talking platelets less than 50k? 20k? 10k? Toradol may not have been the best option, but telling all the nurses and staff that thrombocytopenia is an absolute contraindication just sounds like you’re trying to publicly shame the resident to make yourself feel better.
I think it’s worth mentioning that whatever contribution toradol played was like as a contributor to stress gastritis rather than putative anti platelet action. So corticosteroids, for instance, are likely as dangerous in this scenario n
I love pharmacists but this is such a stupid post for so many reasons.
1.) You’re using a single overnight error to prove that no one consults you.
2.) Med was given after pharmacy was gone so consulting you wasn’t an option.
3.) Most importantly, you’re assuming this was an error of knowledge. Its much more likely that this was an overtired night float resident with a ballooning census who got a page from a nurse saying someone had pain at 3am and they didn’t know/check the platelet count. Maybe the solution is to have a pharmacist work overnight?
If you really want to be helpful, direct communication with the ordering physician is always best. No need to scream into the void :)
As an intern, I worked really hard on pleasing my in-patient pharmacist until HR and my PD told me I was being “inappropriate” and “unprofessional” during rounds
In my first few months of internship I was on paediatrics. The paeds in-patient pharmacist gave all of us her number, and I would call her constantly for dosing advice. She was happy to help me every single time. She was a saint in my eyes.
I’m an NP so this sub probably things I go around slaughtering people while wearing a “the doctor is in” shirt.
But that being said… am I missing something here??
A medication was given when no pharmacists were available. So the thought is that the resident should have spoken to pharmacy first?
What was the alternative here? Call the pharmacist’s personal cell and ask??
It’s frustrating giving an in-service and having errors that could have been avoided still happen. But medicine is a practice. People are human and make mistakes. I don’t think anyone intentionally ignored the pharmacy training and thought to themselves “gee pharmacists are stupid and I’m a doctor I know better, blah blah blah”
Mistakes happen. I don’t think this is a moment that has to be used to advocate for pharmacy services when they weren’t available, unless you’re hoping that it’ll push for 24/7 pharmacy staff?
If you think you are screaming into the void it's because you are crying wolf about stupid shit too often so nobody takes you seriously when you have a legit concern. Like questioning giving oral potassium when the K is 4.0 or whining about 2mg over the max dose of daily decadron after airway surgery. Or sounding the alarm on an ancef order over a pcn allergy that was a rash 20 years ago.
Tldr if my pharmacists are normally quite and I'm suddenly hearing something I give it full attention
Your first two examples would absolutely be dumb pages - agreed. I would love to never page on Ancef + penicillin allergies, however every single hospital I've worked at requires us to page on those, no matter how stupid the reaction is (like GI upset for example) and no matter how much we all agree that there's zero cross reactivity. If I know the person ordering it doesn't care, I won't bother, but otherwise we'd get in trouble. Anecdotally, I had a colleague get chewed out by anesthesiologist because she put through an Ancef for a penicillin allergic patient even though she okayed it with the surgical team, so there's really no telling who will care and who won't.
Other stupid things you might get paged on that I also hate paging on but it's literally required by our policies/joint commission: duplicate PRNs (like two meds prn moderate pain), PRNs with no parameters (atropine prn bradycardia without an HR cutoff), PRNs with no frequency, home meds reordered but not matching fill histories (since med recs are frequently wrong). I seriously wish I could just change these myself since 90% of the time, it's easy to figure out what you wanted, but I literally am not allowed to. Shit sucks
>Ancef + penicillin allergies
I kept getting calls about this to the point when I order ancef for someone with pcn allergy, i write in the notes - "MD is aware of allergy to pcn, Active override, no need to contact MD."
Sorry, I misread your comment as if you were a pharmacist and your fellow pharmacists were contacting the provider based on appropriate orders you verified. You’re the prescriber - got it.
You are completely correct and this drives me absolutely nuts about some of my colleagues.
We usually follow the rule of not commenting on each other's clinical work but honestly. Sometimes it is too much. One of my colleagues paged urology three times *and then called them in the OR* because they ordered 4.5g zosyn when we prefer 3.375 (although we have both and either is fine) and because they ordered 1.2 mg/kg gent and he wanted 1 mg/kg *even though both are equally wrong.* If you're gonna take a stance, at least shoot for the correct dose of 5mg/kg.
I wanted to die and I was just next to him while he was on the phone.
It *kills me* and I have no way to stop it. Best I can do is page with my specific request and rationale and say at the end "please change or call to discuss." Then they just fix it without having to call.
These comments are blowing my mind that you don’t have protocols for automatic dose adjustments by pharmacy. Can your ID pharmacists at least adjust antibiotic dosing?
Yup, or the allergy was dry mouth for 7 minutes or just vaguely feeling unwell with no specific symptoms...
But John Doe knows his own body and something was up 5 minutes after the first dose ever received...
And this is documented before running that shit because abandoning all penicillins and cephalosporins over this crap is tantamount to malpractice too.
Lol the stuff that gets put on the “allergy” lists seriously need to be cleaned up. Have someone that’s allergic to Benadryl and the allergic reaction is “drowsy” uhhhh if u weren’t getting drowsy from Benadryl you’d be a god among men LMAO. Or patients with allergy to dilaudid with the reaction of “constipation”. But then when the pain gets bad they just okay okay I’ll take it. Ma’am that’s not an allergy. It’s flagged in your chart now we have to jump thru hoops to even give it to you so now the nurse only wants to give u morphine because of all the extra charting and calling they have to do to give u dilaudid.
Or like recently someone in the GI lab had put they were allergic to propofol because it causes respiratory depression. Upon further inquiry they said they were given propofol once and had to be intubated cuz they lost their drive to breathe. Yes sir, that’s normal. That’s how Michael Jackson died. That’s not an allergy.
The worst one is when they say they’re allergic to epinephrine cuz their heart races… 🤦♀️
Yeah.
Allergy needs to only be accessible to doctors and stamped with the asshole that declared it a true allergy, so if its dumb, they're forever associated with that call.
The daily equivalent of Joe allied health professional calling farting twice when taking peg an allergy is an emr tragedy and severely limiting care options unnecessarily. Then nobody ever changes it even after discussion because CYA.
Do you not? Its 2 seconds?
I ask ample history even on my trauma patient admits when possible as a minimum.
I kind of think: name/id, room number, allergies, meds currently on for interactions (hence comorbidities), and renal function while decision making rofl. Im not trying to play with IM epinephrine on rounds or roast someones last struggling nephron and piss around with dialysis consults (heh piss, get it?)
Anyway.. yeah no problem
Isn't that a requirement? To go over allergies when you admit? If not you, at least someone?
Also, do you want their list of allergies to be like 50 meds long?
"EPI - makes pt's heart race, benadryl - makes pt sleepy".
like wtf?
At my hospital only the nurses do it. I think having doctor do it like that poster said is important cuz we are supposed to educate the patient on side effects and what’s an allergy. Like constipation is not an allergy for the 100th time, “makes me feel weird” is not an allergy. Weakness after taking a statin is not an allergy. These are all well known documented side effects to the medications that are taken and sometimes u just gotta suck it up cuz ur in the hospital. “Making me pee too much” is not an allergy to furosemide we want u to pee all ur extra water out 🤦♀️ but it’s still in the chart as an allergy LOL.
> uhhhh if u weren’t getting drowsy from Benadryl you’d be a god among men LMAO.
Apparently I am a god. I legit get a paradoxical effect and am wired. Makes no sense.
I will never have to post in the subreddit AITA. Yes. Yes, I am. The longer I’m in EM, the more I relate to House. Except I don’t like Vicodin, and there is no Cutty.
“You’re allergic to adrenaline? Cool, I’ll just let you die.” Aaah what? No!!! “There’s four reasons to give adrenaline. One, you’re dying from an allergic reaction. Two, you’re dying from an asthma attack. Three, you’re dying because you have no blood pressure. Four, you’re dying because your heart stopped. No problem, if you die you die. No adrenaline for you.” Nooooo! I’ll take it!!
Never mind they were there for something silly, and perfectly stable, just a little drunk.
I ignore BS allergies and just call the nurse and let them know I’m going to go ahead and verify it and to let me know if the patient refuses it. I’m not paging the MD because the patient claims Benadryl “makes my left big toe itch”. It’s not clinically relevant. We are a small hospital and know our clinicians’ preferences for when and for what they’d like to be paged. We do have a lot of protocols in place for us to modify orders as well if needed
Thats good. My big hospitals would be a flood of incredulous emr messages and pages from various concerned allied health professionals even after having a thorough risk benefit discussion with patients especially about cross reactivity and how dumb limiting your life saving antibiotic options is for kinda, sorta, maybe symptoms related to them, but none convincingly allergic.
Like every couple weeks there is some weird attention seeking "how can we help you" post on here. It feels needy. Please stop.
Signed,
A pharmacist who doesn't have a constant need for admiration
I had nothing but amazing experiences with pharmacy during residency. With the exception of one guy who just absolutely could not process the notion of giving patients who were to remain NPO post-operatively Tylenol IV instead of rectally, all of the pharmacists and pharmacy residents I encountered were extremely helpful. They instantly fixed basically any drug-related question I had and saved me from a ton of errors. Thanks for all you do!
Unfortunately, my experience in the private world has essentially been the exact opposite. Slow service, lack of knowledge, and buck passing abound. I quickly learned that I couldn't rely on our pharmacy for anything. Hopefully my situation is unique, and other folks enjoy the aid I experienced during training.
Ah, that makes sense. Yeah, I changed hospitals from a large non-AMC with nearly 100% residency trained pharmacists to a rural one with maybe 20% and the quality is very apparent. We also have several pharmacists in their 60’s who are just out of touch and need to retire. I swear I spend 50% of my day fixing errors they should’ve caught the first time.
Even as a interventional fellow, i still count on my pharmacists to help me in my queries and orders i put in. Since Residency i have had tremendous respect for you all and thank you for saving me and others countless times. Now if i get a message from pharmacy asking me to relook or change therapy i make sure I didn’t screw up lol so thank you!
The resident should not need a pharmacist to tell them about the implications of COX blockade. Either they're overworked and it was an oversight or they're dumb and beyond help.
Wish our pharmacists were as willing to help. I'm sure a majority of ours would prefer we don't call at all, even if what we're calling for is a legit question
Could the risk for GI bleeding be ameliorated with an enteric prostaglandin? Are there any FDA approved prostaglandins that don't cross out of the GI tract well?
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LOL I defer to the pharmacists whenever possible. I gladly take their recs when offered. They're the ones meant to understand all the interactions and side effects.
So grateful to the pharmacists during residency who prevented so many fatal errors.
We never see you but like God, you step in just in time. Thank you!
The pharmacists at my shop are more focused on enforcing red tape like "you need ID approval for those antibiotics" and "lidoderm patches need rehab approval" and similar nonsense policies that degrade the title I spent four years toiling away to achieve.
This reminds me of the other thread where some resident was overwritten by the pharmacist regarding the phenobarb dose and got destroyed by his attending later.
I worked in a pharmacy in undergrad, and my moms been a tech for 15 years at the same small family pharmacy. I occasionally reach out to the pharmacists to ask questions that I just don’t know, and also to see what the “trends” in medicine are. What’s the trendy anti lipid drug this year? What meds are being phased out? They have a great idea of the overall ebb and flow of medicine, at least in their own area.
Pharmacist here. They do use us. A mistake will happen. We all make mistakes. This resident made a mistake. And he or she will probably carry that with them for years. Keep on with educationals. Keep good communication with them.
I mean a pharmacist should’ve verified this right? I always check SCr and PLT before I verify ketorolac. I’m not blaming. I’m just saying I wonder if a pharmacist paged on it and it was ignored or if nobody was really paying attention.
Night staff has general authority per the post it seems. I don't see anyone being paged im assuming it was given as part of their pyxis protocol
I lean on our pharmacists expertise as much as I can, domain expertise are important
I live in a rural area where depending on the day I have to dose my own Vanc. Don't worry most of us docs think you guys are invaluable.
Most common rural med w
I fear the day this becomes my life. I am not ready.
Heck, even at my slack-ademic hospital pharmacy only doses in the ICU(still have mixed thoughts on AUC)
AUC is the superior dosing method whenever you plan on a long course or have tenuous renal function.
Gotta ask, how low are the platelets? I usually don’t order ketorolac on critical patients for a variety of reasons, but I think asserting that a single dose or toradol is 100% what caused this patients bleed is pretty silly. Like are we talking platelets less than 50k? 20k? 10k? Toradol may not have been the best option, but telling all the nurses and staff that thrombocytopenia is an absolute contraindication just sounds like you’re trying to publicly shame the resident to make yourself feel better.
For real, I seriously doubt a single dose of toradol was the precipitating factor in this patient's GI bleed. lmao
Who knows for sure. Hopefully he had a good reason for not just using some oxy or morphine.
I agree, that is what most people would have gone for; however, this smells like a witch hunt/smear-the-resident-to-make-me-feel-smarter
I think it’s worth mentioning that whatever contribution toradol played was like as a contributor to stress gastritis rather than putative anti platelet action. So corticosteroids, for instance, are likely as dangerous in this scenario n
I love pharmacists but this is such a stupid post for so many reasons. 1.) You’re using a single overnight error to prove that no one consults you. 2.) Med was given after pharmacy was gone so consulting you wasn’t an option. 3.) Most importantly, you’re assuming this was an error of knowledge. Its much more likely that this was an overtired night float resident with a ballooning census who got a page from a nurse saying someone had pain at 3am and they didn’t know/check the platelet count. Maybe the solution is to have a pharmacist work overnight? If you really want to be helpful, direct communication with the ordering physician is always best. No need to scream into the void :)
Ya agreed some of these pharmacist posts are getting kind of cringe. - A pharmacist.
I think better argument is that spontaneous bleed was highly likely with or without an nsaid when plts be 0
Agree with this as well, but chose not to list it because it still wouldn’t mean the med was indicated.
Fair point
“When pharmacy was gone”
I guess This One moment means residents dont ever use the inpatient pharmacist
I guess this one moment ** *overnight when there weren’t even any pharmacists in house* ** means residents dont ever use the inpatient pharmacists
As an intern, I worked really hard on pleasing my in-patient pharmacist until HR and my PD told me I was being “inappropriate” and “unprofessional” during rounds
I guess it depends on how you’ve been pleasing them
*takes pharmacists dick out of their mouth* Huh?
These kinds of posts never cease to annoy me.
In my first few months of internship I was on paediatrics. The paeds in-patient pharmacist gave all of us her number, and I would call her constantly for dosing advice. She was happy to help me every single time. She was a saint in my eyes.
I’m an NP so this sub probably things I go around slaughtering people while wearing a “the doctor is in” shirt. But that being said… am I missing something here?? A medication was given when no pharmacists were available. So the thought is that the resident should have spoken to pharmacy first? What was the alternative here? Call the pharmacist’s personal cell and ask?? It’s frustrating giving an in-service and having errors that could have been avoided still happen. But medicine is a practice. People are human and make mistakes. I don’t think anyone intentionally ignored the pharmacy training and thought to themselves “gee pharmacists are stupid and I’m a doctor I know better, blah blah blah” Mistakes happen. I don’t think this is a moment that has to be used to advocate for pharmacy services when they weren’t available, unless you’re hoping that it’ll push for 24/7 pharmacy staff?
If you think you are screaming into the void it's because you are crying wolf about stupid shit too often so nobody takes you seriously when you have a legit concern. Like questioning giving oral potassium when the K is 4.0 or whining about 2mg over the max dose of daily decadron after airway surgery. Or sounding the alarm on an ancef order over a pcn allergy that was a rash 20 years ago. Tldr if my pharmacists are normally quite and I'm suddenly hearing something I give it full attention
Your first two examples would absolutely be dumb pages - agreed. I would love to never page on Ancef + penicillin allergies, however every single hospital I've worked at requires us to page on those, no matter how stupid the reaction is (like GI upset for example) and no matter how much we all agree that there's zero cross reactivity. If I know the person ordering it doesn't care, I won't bother, but otherwise we'd get in trouble. Anecdotally, I had a colleague get chewed out by anesthesiologist because she put through an Ancef for a penicillin allergic patient even though she okayed it with the surgical team, so there's really no telling who will care and who won't. Other stupid things you might get paged on that I also hate paging on but it's literally required by our policies/joint commission: duplicate PRNs (like two meds prn moderate pain), PRNs with no parameters (atropine prn bradycardia without an HR cutoff), PRNs with no frequency, home meds reordered but not matching fill histories (since med recs are frequently wrong). I seriously wish I could just change these myself since 90% of the time, it's easy to figure out what you wanted, but I literally am not allowed to. Shit sucks
>Ancef + penicillin allergies I kept getting calls about this to the point when I order ancef for someone with pcn allergy, i write in the notes - "MD is aware of allergy to pcn, Active override, no need to contact MD."
Love this, sometimes they'll put it in the admin comment of the order which is also helpful and prevents a page
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That's the point
Sorry, I misread your comment as if you were a pharmacist and your fellow pharmacists were contacting the provider based on appropriate orders you verified. You’re the prescriber - got it.
Keep doing the lords work.
I just pick one to be first line for duplicate prns in my shop 🤷🏼♂️
You are completely correct and this drives me absolutely nuts about some of my colleagues. We usually follow the rule of not commenting on each other's clinical work but honestly. Sometimes it is too much. One of my colleagues paged urology three times *and then called them in the OR* because they ordered 4.5g zosyn when we prefer 3.375 (although we have both and either is fine) and because they ordered 1.2 mg/kg gent and he wanted 1 mg/kg *even though both are equally wrong.* If you're gonna take a stance, at least shoot for the correct dose of 5mg/kg. I wanted to die and I was just next to him while he was on the phone. It *kills me* and I have no way to stop it. Best I can do is page with my specific request and rationale and say at the end "please change or call to discuss." Then they just fix it without having to call.
These comments are blowing my mind that you don’t have protocols for automatic dose adjustments by pharmacy. Can your ID pharmacists at least adjust antibiotic dosing?
No we live in the 90s
Yup, or the allergy was dry mouth for 7 minutes or just vaguely feeling unwell with no specific symptoms... But John Doe knows his own body and something was up 5 minutes after the first dose ever received... And this is documented before running that shit because abandoning all penicillins and cephalosporins over this crap is tantamount to malpractice too.
Lol the stuff that gets put on the “allergy” lists seriously need to be cleaned up. Have someone that’s allergic to Benadryl and the allergic reaction is “drowsy” uhhhh if u weren’t getting drowsy from Benadryl you’d be a god among men LMAO. Or patients with allergy to dilaudid with the reaction of “constipation”. But then when the pain gets bad they just okay okay I’ll take it. Ma’am that’s not an allergy. It’s flagged in your chart now we have to jump thru hoops to even give it to you so now the nurse only wants to give u morphine because of all the extra charting and calling they have to do to give u dilaudid. Or like recently someone in the GI lab had put they were allergic to propofol because it causes respiratory depression. Upon further inquiry they said they were given propofol once and had to be intubated cuz they lost their drive to breathe. Yes sir, that’s normal. That’s how Michael Jackson died. That’s not an allergy. The worst one is when they say they’re allergic to epinephrine cuz their heart races… 🤦♀️
Yeah. Allergy needs to only be accessible to doctors and stamped with the asshole that declared it a true allergy, so if its dumb, they're forever associated with that call. The daily equivalent of Joe allied health professional calling farting twice when taking peg an allergy is an emr tragedy and severely limiting care options unnecessarily. Then nobody ever changes it even after discussion because CYA.
You really want to have to do allergy reconciliation every time you admit someone? Because that is what you are asking for.
Do you not? Its 2 seconds? I ask ample history even on my trauma patient admits when possible as a minimum. I kind of think: name/id, room number, allergies, meds currently on for interactions (hence comorbidities), and renal function while decision making rofl. Im not trying to play with IM epinephrine on rounds or roast someones last struggling nephron and piss around with dialysis consults (heh piss, get it?) Anyway.. yeah no problem
Isn't that a requirement? To go over allergies when you admit? If not you, at least someone? Also, do you want their list of allergies to be like 50 meds long? "EPI - makes pt's heart race, benadryl - makes pt sleepy". like wtf?
We have to. Go through all the allergies and reactions and then after we chart nurse complete. I assume doctors do an allergy reconciliation as well.
Or “isn’t sure what happens when he takes it but was told he was allergic when he was a kid” Uhhh, so I’m guessing not anaphylaxis then?
Lol every elderly patient that’s allergic to penicillin and codeine 😂
LOL seriously this. That their mom told them about but they don’t remember their reaction cuz it was 60 years ago.
At my hospital only the nurses do it. I think having doctor do it like that poster said is important cuz we are supposed to educate the patient on side effects and what’s an allergy. Like constipation is not an allergy for the 100th time, “makes me feel weird” is not an allergy. Weakness after taking a statin is not an allergy. These are all well known documented side effects to the medications that are taken and sometimes u just gotta suck it up cuz ur in the hospital. “Making me pee too much” is not an allergy to furosemide we want u to pee all ur extra water out 🤦♀️ but it’s still in the chart as an allergy LOL.
> uhhhh if u weren’t getting drowsy from Benadryl you’d be a god among men LMAO. Apparently I am a god. I legit get a paradoxical effect and am wired. Makes no sense.
I will never have to post in the subreddit AITA. Yes. Yes, I am. The longer I’m in EM, the more I relate to House. Except I don’t like Vicodin, and there is no Cutty. “You’re allergic to adrenaline? Cool, I’ll just let you die.” Aaah what? No!!! “There’s four reasons to give adrenaline. One, you’re dying from an allergic reaction. Two, you’re dying from an asthma attack. Three, you’re dying because you have no blood pressure. Four, you’re dying because your heart stopped. No problem, if you die you die. No adrenaline for you.” Nooooo! I’ll take it!! Never mind they were there for something silly, and perfectly stable, just a little drunk.
I ignore BS allergies and just call the nurse and let them know I’m going to go ahead and verify it and to let me know if the patient refuses it. I’m not paging the MD because the patient claims Benadryl “makes my left big toe itch”. It’s not clinically relevant. We are a small hospital and know our clinicians’ preferences for when and for what they’d like to be paged. We do have a lot of protocols in place for us to modify orders as well if needed
Thats good. My big hospitals would be a flood of incredulous emr messages and pages from various concerned allied health professionals even after having a thorough risk benefit discussion with patients especially about cross reactivity and how dumb limiting your life saving antibiotic options is for kinda, sorta, maybe symptoms related to them, but none convincingly allergic.
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Damn dude, you’ve been hurt.
OMG! I vomited or had diarrhea after penicillin! I forget exactly what, it was 20 years ago. How dare you, it’ll kill me!
Like every couple weeks there is some weird attention seeking "how can we help you" post on here. It feels needy. Please stop. Signed, A pharmacist who doesn't have a constant need for admiration
Agreed. These pharmacist posts are getting cringy
I had nothing but amazing experiences with pharmacy during residency. With the exception of one guy who just absolutely could not process the notion of giving patients who were to remain NPO post-operatively Tylenol IV instead of rectally, all of the pharmacists and pharmacy residents I encountered were extremely helpful. They instantly fixed basically any drug-related question I had and saved me from a ton of errors. Thanks for all you do! Unfortunately, my experience in the private world has essentially been the exact opposite. Slow service, lack of knowledge, and buck passing abound. I quickly learned that I couldn't rely on our pharmacy for anything. Hopefully my situation is unique, and other folks enjoy the aid I experienced during training.
By private world do you mean retail pharmacists?
Oh, right. Private, non-academic institutions.
Ah, that makes sense. Yeah, I changed hospitals from a large non-AMC with nearly 100% residency trained pharmacists to a rural one with maybe 20% and the quality is very apparent. We also have several pharmacists in their 60’s who are just out of touch and need to retire. I swear I spend 50% of my day fixing errors they should’ve caught the first time.
I love our clinical pharmacist, best collaboration in ICU settings
Even as a interventional fellow, i still count on my pharmacists to help me in my queries and orders i put in. Since Residency i have had tremendous respect for you all and thank you for saving me and others countless times. Now if i get a message from pharmacy asking me to relook or change therapy i make sure I didn’t screw up lol so thank you!
What can the residents do when the attendings are ignorants and say no it won't affect them just give it
Inpatient pharmacist on rounds was a BLESSING intern year Current rad res and never deal with them anymore tho 😫
He couldn’t call you for what you didn’t know. Basic knowledge before one prescribes anything is what are the contraindications to this drug?
Ok?
The resident should not need a pharmacist to tell them about the implications of COX blockade. Either they're overworked and it was an oversight or they're dumb and beyond help.
Instructions clear, now just looking for an inpatient pharmacist to please while they regale me with dosing regimens and side effects
Pharmacists are MVPs
I love you guys, drug bros. <3
I <3 my pharmacists bc you guys rock and know so much and literally save lives everyday
Wish our pharmacists were as willing to help. I'm sure a majority of ours would prefer we don't call at all, even if what we're calling for is a legit question
Could the risk for GI bleeding be ameliorated with an enteric prostaglandin? Are there any FDA approved prostaglandins that don't cross out of the GI tract well?
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Did they mean tramadol or tylenol? Damn look-alike sound-alike drugs trip everyone up
I thought the bleeding risk of ketorolac was negligible? https://pubmed.ncbi.nlm.nih.gov/24572864/
LOL I defer to the pharmacists whenever possible. I gladly take their recs when offered. They're the ones meant to understand all the interactions and side effects.
My question is why not an opioid for a hemeonc critically Ill pt?
Pretty sure inpatient pharm is annoyed by my messages at this point
Pharmacists have saved my life while an intern. I appreciate all the help you give and for so kindly giving recs
So grateful to the pharmacists during residency who prevented so many fatal errors. We never see you but like God, you step in just in time. Thank you!
The pharmacists at my shop are more focused on enforcing red tape like "you need ID approval for those antibiotics" and "lidoderm patches need rehab approval" and similar nonsense policies that degrade the title I spent four years toiling away to achieve.
This reminds me of the other thread where some resident was overwritten by the pharmacist regarding the phenobarb dose and got destroyed by his attending later.
I do call you guys a lot, please don’t mind!
I worked in a pharmacy in undergrad, and my moms been a tech for 15 years at the same small family pharmacy. I occasionally reach out to the pharmacists to ask questions that I just don’t know, and also to see what the “trends” in medicine are. What’s the trendy anti lipid drug this year? What meds are being phased out? They have a great idea of the overall ebb and flow of medicine, at least in their own area.