Continuing Education: Keeping your Certification

After becoming a certified technician, you must complete continuing education courses to recertify. The PTCB, this most common certification agency, requires 20 hours of approved continuing education, one of which must be in the area of pharmacy law. For technicians still in college, or in a position to easily take college courses, certain science and math courses will count toward up to 15 CE hours every recertification period. Recertification sounds a lot scarier than it actually is, and too many techs make it even worse by waiting until the last minute to collect their CE credits.

FDA Update: 6/26/2011

There isn't a lotout of the FDA to note today, but there were a couple of things worth noting. First...

Risperdal (risperidone) and Risperidone: Recall - Uncharacteristic Odor

Ortho-McNeil-Janssen Pharmaceuticals is recalling a lot of Risperidal 3mg tablets and a lot of risperidone 2mg tablets due to potential contamination causing an uncharacteristic odor. The risperidone 2mg tablets are packaged under the manufacturer Patriot. The odor could be caused by 2,4,6 tribromoanisole (TBA). TBA is a fungus which causes a foul. Ortho-McNeil-Janssen is a subsidiary of Johnson & Johnson and has seen a number of recalls related to TBA (including of many of their over the counter products such as Tylenol and Motrin).

Unit Conversion in the Pharmacy

Conversion of units is one of the dryest topics in the pharmacy. And like abbreviations, there is no "fun" or "easy" way to learn them. The good news: there are a few basic conversions that are truly the most important ones. The bad news? The English system, also called the standard system, is messy.

Polypharmacy: The Dangers for Your Pharmacy and Your Patients

Some patients think that pharmacies want a patient to only use one pharmacy out of greed. While this is not actually the case, convincing them otherwise can take some effort. Sometimes they just don't understand or feel they have no choice, or sometimes they are deliberately attempting to mislead pharmacy staff. With $4 drug lists, there are an increasing number of elderly who use large chain pharmacies to get the medications that are eligible for the $4 list and will go to a locally-owned pharmacy for everything else for the "human touch" or just because they know the pharmacist. Many aren't aware that most locally-owned pharmacies are willing and able to match the $4 prescription list. Sometimes all you have to do is ask.

There is an inherent danger to both the patient and the pharmacy when a patient chooses to use multiple pharmacies. While the danger to the patient may seem obvious, and the danger to the pharmacy trivial, both will be discussed here.

Drug Classes: Bile Acid Sequestrants

Used to treat: Primary hypercholesterolemia, complications of elevated bile acid levels

Mechanism of Action: Bind bile salts in GI tract, resulting in decrased bile acid clearance

Contraindications: Complete biliary obstruction, children (increased risk of intestinale blockage, possibly deadly)

Navigating the Wide World of Dosage Forms

While there's nothing fun or interesting about learning the various dosage forms (and believe me, there's a lot), learning them will help you to avoid mistakes. There is nothing more confusing to a patient than when their label says capsule and there are tablets in the bottle and vice versa. And knowing the difference between forms makes you better at your job. The dosage form can tell you which auxiliary stickers to affix or alert you to medication errors. If the form and the route don't match according to the prescription, the doctor may have prescribed the wrong medication.

Drug Classes: Fenofibric Acid Derivatives

Used to treat: In conjuction with diet and exercise to lower LDL, total cholesterol, triglycerides, & apolipoprotein

Mechanism of Action: Inhibit triglyceride synthesis

Contraindications: Hepatic impairment (including biliary cirrhosis), gallbladder disease, severe renal impairment, may increase effects of warfarin and HMG-CoA Reductase Inhibitors

The Dispensing Process: Intake to Ringing Up

A lot of work goes into getting a prescription in and out in a reasonable amount of time, and more importantly, right. All while Mrs. Jones is telling your her tablets look different than last time, Mr. Smith is asking where the hemorrhoid cream is and Mrs. Brown's child is ripping up the magazines in the waiting room... again. The phone's ringing and the fax machine is out of paper and the pharmacist is on the phone with a doctor's office taking another call in. Many pharmacies are fast-paced environments with spacial limitations and it's vital for you to know how to streamline the work and prepare it to ensure that no errors happen.

It is important to note that federal and state laws may differ and I will always default to federal law. When in doubt, always err on the side of caution. When federal and state law differ, follow whichever is more strict.

Abbreviations in the Pharmacy

Abbreviations are used in the pharmacy for just about everything and knowing what they mean is critical to filling a prescription accurately and quickly. There are abbreviations to cover just about everything. Unfortunately this blog will be a little dense... there's no "fun" way to write them up. The abbreviations are separated as follows:

• Time of Day
• Frequency of Administration
• Route of Administration
• Dosage Forms
• Dosage Size
• Diagnosis
• Miscellaneous Other Abbreviations

Drug Classes: HMG-CoA Reductase Inhibitors

Used to treat: Primary hypercholesterolemia, mixed dyslipidemia, secondary prevention of cardiovascular disease in patients with multiple risk factors

Mechanism of Action: Inhibits the liver enzyme HMG-CoA Reductase, which catalyzes one of the initial steps in the production of cholesterol

Contraindications: Pregnancy, Grapefruit juice use, liver disease, certain antifungals

Extended and Delayed Release Medications: Using Technology to Increase Medication Compliance

Time released medications are more frequent in medicine today and are a useful dosage form for patients and providers. While they are usually at least slightly more expensive than their immediate release counterparts, they reduce the dosage frequency and increase the likelihood of medication compliance.

Time released medications are available in just about every therapeutic class on the market - from urinary incontinence to pain management, seizures and psychosis, to hypertension and diabetes.

Lipid Dysfunction: High Cholesterol and Its Effects

High Cholesterol, hyperlipidemia, hypercholesterolemia, dyslipidemia - while not completely interchangeable, they're all commonly used to refer to the same problem. High cholesterol, however is actually a misnomer. There are two types of cholesterol, high-density lipoprotien (HDL) and low-density lipoprotein (LDL) (Technically there is a third "very low density lipoprotein," but for the purposes of this discussion, we're going to include them in the LDL). LDL is the "bad" cholesterol and when the doctor refers to patient as having high cholesterol, this is the number that they're worried about. HDL is good cholesterol and doctors typically want this number to be high.

Drug Classes: Other Antihypertensives

Contains information about:

• Centrally-Acting Anti-Adrenergics
• Vasodilators
• Renin Inhibitors
• Peripherally-Acting Anti-Adrenergics