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-   -   Statins...beta blockers...metformin....OTC!?!? (http://forums.studentdoctor.net/showthread.php?t=908661)

WVUPharm2007 04-30-2012 09:31 AM

Statins...beta blockers...metformin....OTC!?!?
 
Whaaaa...?

This is actually incredibly exciting if true...

WVUPharm2007 04-30-2012 09:32 AM

Yo, mods, I'm on my phone, clean that link up for me.

All4MyDaughter 04-30-2012 09:47 AM

Quote:

Originally Posted by WVUPharm2007 (Post 12457133)
Yo, mods, I'm on my phone, clean that link up for me.


Not even a please? You can get it the next time you log in, Mr. Manners.

WVUPharm2007 04-30-2012 10:02 AM

As usual, the mods leave me underwhelmed.

PharmDstudent 04-30-2012 10:17 AM

Quote:

Originally Posted by WVUPharm2007 (Post 12457130)
Whaaaa...?

[url] m.washingtontimes.com/news/2012/apr/29/fda-may-let-patients-buy-drugs-without-prescriptio/?page=all#pagebreak[url]

This is actually incredibly exciting if true...

http://www.washingtontimes.com/news/2012/apr/29/fda-may-let-patients-buy-drugs-without-prescriptio/?page=all

this???

CUpharmD2013 04-30-2012 10:22 AM

Quote:

Originally Posted by WVUPharm2007 (Post 12457130)
Whaaaa...?

[url] m.washingtontimes.com/news/2012/apr/29/fda-may-let-patients-buy-drugs-without-prescriptio/?page=all#pagebreak[url]

This is actually incredibly exciting if true...

Sweet! No need to spend all those years and money on getting an MD or PharmD, everyone can start diagnosing themselves! This is only the beginning...look for SSRIs, BZDs, and opiates to follow soon. :thumbup:

pharm B 04-30-2012 10:36 AM

Quote:

Originally Posted by CUpharmD2013 (Post 12457302)
Sweet! No need to spend all those years and money on getting an MD or PharmD, everyone can start diagnosing themselves! This is only the beginning...look for SSRIs, BZDs, and opiates to follow soon. :thumbup:

All accessible after you complete a survey online or at a friendly kiosk at your pharmacy. :laugh:

WVUPharm2007 04-30-2012 11:00 AM

I see a door of opportunity opening.

PharmDstudent 04-30-2012 11:10 AM

Quote:

Originally Posted by pharm B (Post 12457364)
All accessible after you complete a survey online or at a friendly kiosk at your pharmacy. :laugh:

It's not really any different from Ameridoc

glory4england 04-30-2012 12:05 PM

Quote:

Originally Posted by WVUPharm2007 (Post 12457133)
Yo, mods, I'm on my phone, clean that link up for me.

/late

Pharmpills 04-30-2012 01:41 PM

Quote:

Originally Posted by WVUPharm2007 (Post 12457130)
Whaaaa...?

http://www.washingtontimes.com/news/...=all#pagebreak

This is actually incredibly exciting if true...

There is aton of problems in letting patients buy these drugs OTC including the fact that doses aren't constant, labs need to be monitored, etc. This to me doesn't benefit doctors nor pharmacists nor patients. Pharmacists can be more liable now esp. with having to fill 300 rx with a lack of staff and cut backs plus vaccines, MTM's, etc and being the primary health care provider the patient sees before getting a drug. Doctors will have less patients and patients will most likely have to pay out of pocket for these drugs which doesn't come cheap.

johnnydrama 04-30-2012 01:44 PM

This only works if they allow patients to get monitoring tests (BMP, CBC, LFTs, Lipids) without a prescription too.

owlegrad 04-30-2012 02:54 PM

I took care of the link for you. :thumbup:

joetrisman 04-30-2012 03:30 PM

I guess this means I might actually use the cholesterol machine that is currently collecting dust at my wags :D

eagles22 04-30-2012 05:06 PM

How does a kiosk know what your A1c or cholesterol levels are?

OTC meds have one thing in common: they treat conditions that produce visible symptoms (i.e. runny nose, itching, pain, cough). Last time I checked, hypertension didn't produce these kinds of unique symptoms. This is just a pipe dream of the pharmaceutical companies.

notafraid87 04-30-2012 05:26 PM

I was wondering the same thing...I don't feel that the majority of the public have a good understanding about statins and such. Remember the tragedy involving with Bengay? You're going to see a lot of people misusing these dangerous medicines, despite advice from pharmacists. They could just come to the pharmacy and buy it w/o any objections. Accidents happen and I believe that you're going to see many cases involved with these drugs in the future.

I'm not a pharmacy student yet and don't have much experience, so I have trouble understanding the advantages of this situation. Someone care to help?

chuckle beast 04-30-2012 08:08 PM

Why check cholesterol, high dose statin for all and be done with it.

CUpharmD2013 05-01-2012 03:52 AM

Quote:

Originally Posted by chuckle beast (Post 12459835)
Why check cholesterol, high dose statin for all and be done with it.

Yep. I heard that before we know it, Lipitor is going to be a part of the public water supply.

WVUPharm2007 05-01-2012 06:00 AM

Quote:

Originally Posted by notafraid87 (Post 12458979)
I was wondering the same thing...I don't feel that the majority of the public have a good understanding about statins and such. Remember the tragedy involving with Bengay? You're going to see a lot of people misusing these dangerous medicines, despite advice from pharmacists. They could just come to the pharmacy and buy it w/o any objections. Accidents happen and I believe that you're going to see many cases involved with these drugs in the future.

I'm not a pharmacy student yet and don't have much experience, so I have trouble understanding the advantages of this situation. Someone care to help?

I'm imagining a situation where they aren't in the aisles, but they are behind the counter like Plan B or Sudafed. Bring in your labs...the pharmacist will look at them. You have to read between the lines and see where this sort of thing would wind up if they went down the path...and that's pharmacists potentially gaining access to providing in-depth medication management.

CUpharmD2013 05-01-2012 06:19 AM

Quote:

Originally Posted by WVUPharm2007 (Post 12460969)
I'm imagining a situation where they aren't in the aisles, but they are behind the counter like Plan B or Sudafed. Bring in your labs...the pharmacist will look at them. You have to read between the lines and see where this sort of thing would wind up if they went down the path...and that's pharmacists potentially gaining access to providing in-depth medication management.

Does the increase in OTC sales equate to more pharmacists? If not, there's no way we'll have time for this. Great in theory, but not sure about the practicality. Where are these labs done? Are they going to be more readily accessible than going to the doctor? Are these OTC preparations going to be much more expensive than prescription equivalents? I guess the primary motivation for patients to buy these over the counter will be to avoid having to go to the doctor and be able to get refills when they need them. I know that doctors are overburdened and this is one way to reduce that burden, but will there still be some requirement for patients to routinely see their doctor? Will compliance decrease because people will have to "answer to their doctor" less? I would think, too, that this would increase the licensing requirement for pharmacists as they would have to be more knowledgeable and stay up to date on disease states and medication management. I think there are too many variables and too little extra compensation to make this a reality any time soon.

Pharmpills 05-01-2012 08:38 AM

Quote:

Originally Posted by WVUPharm2007 (Post 12460969)
I'm imagining a situation where they aren't in the aisles, but they are behind the counter like Plan B or Sudafed. Bring in your labs...the pharmacist will look at them. You have to read between the lines and see where this sort of thing would wind up if they went down the path...and that's pharmacists potentially gaining access to providing in-depth medication management.

lol so pharmacists have to fill all those scripts, find time to counsel patients and give vaccines and to interpret lab results?? Whose gonna pay for us to interpret these results because doing it free would make no practical sense and even if patients are charged the pharmacist will still get the same salary bc of all the new grads.

joetrisman 05-01-2012 08:57 AM

Quote:

Originally Posted by Pharmpills (Post 12461400)
lol so pharmacists have to fill all those scripts, find time to counsel patients and give vaccines and to interpret lab results?? Whose gonna pay for us to interpret these results because doing it free would make no practical sense and even if patients are charged the pharmacist will still get the same salary bc of all the new grads.

Could a clinical services oriented pharmacist not develop in community pharmacies? If the demand is there, why not split off the job into separate niches. This has developed with inpatient pharmacy so why not community? As it is, many of the older rphs I work with have no desire to do anything beyond dispensing while a lot of the newer grads are interested in clinical services.

awval999 05-01-2012 09:35 AM

Quote:

Originally Posted by joetrisman (Post 12461474)
Could a clinical services oriented pharmacist not develop in community pharmacies? If the demand is there, why not split off the job into separate niches. This has developed with inpatient pharmacy so why not community? As it is, many of the older rphs I work with have no desire to do anything beyond dispensing while a lot of the newer grads are interested in clinical services.

I could see a role for BCPS certified ambulatory care and/or pharmacotherapy cerfified pharmacists. Still, they would have to compete with NP wages. Then again maybe they would have their own clinic space at Walgreens and some would take the $80-90K salary to do it. We are still not diagnosticians though. And never will be.

notafraid87 05-01-2012 09:46 AM

Quote:

Originally Posted by awval999 (Post 12461613)
I could see a role for BCPS certified ambulatory care and/or pharmacotherapy cerfified pharmacists. Still, they would have to compete with NP wages. Then again maybe they would have their own clinic space at Walgreens and some would take the $80-90K salary to do it. We are still not diagnosticians though. And never will be.

This is why our profession will never make progress. I chose to become a pharmacist to be an expert in medicine, but sometimes I wish the pharmacy school curriculum would give us some training in diagnosing patients. Whenever we would come up with an idea to add more roles for our profession, it seems as if other health professionals would snatch it away from us...:(

mipharmd 05-01-2012 10:09 AM

Instead of jumping to OTC shouldn't FDA, Lawmakers, Boards of Medical/pharmacy practices maybe consider pharmacist being able to if at the very least prescribe the medication for a month until the patient can see the doctor.

awval999 05-01-2012 10:36 AM

Quote:

Originally Posted by notafraid87 (Post 12461661)
This is why our profession will never make progress. I chose to become a pharmacist to be an expert in medicine, but sometimes I wish the pharmacy school curriculum would give us some training in diagnosing patients. Whenever we would come up with an idea to add more roles for our profession, it seems as if other health professionals would snatch it away from us...:(

We're just not diagonisticians.

I mean the best, realistic theory is for an MD to write a diagnosis on the prescription and then then PharmD to prescribe the medication to conform with patient's allergies, insurance, brand/generic desire, etc. But it's just not ever gonna happen.

And personally the idea of Joe Sixpack patient being able to buy beta-blockers without an Rx is just laughable. The general public thinks OTC meds are completely safe and taking 4-5 or even 6 of any of them is no big deal. Why is Tylenol the #1 cause of liver failure admissions in this country?

ACE Rx 05-01-2012 10:38 AM

Quote:

Originally Posted by notafraid87 (Post 12461661)
This is why our profession will never make progress. I chose to become a pharmacist to be an expert in medicine, but sometimes I wish the pharmacy school curriculum would give us some training in diagnosing patients. Whenever we would come up with an idea to add more roles for our profession, it seems as if other health professionals would snatch it away from us...:(

Depends on what your pharmacy school emphasizes. At my school, they are preparing us for basic diagnosis....excuse me evaluating of patients so definitely more emphasis on clinical here.

But yeah. Stagnant pharmacists who refuse to change are the ones who are ruining our profession right now.

meister 05-01-2012 02:08 PM

yeah let's shift more drug payment responsibility onto patients

eagles22 05-01-2012 03:09 PM

Quote:

Originally Posted by awval999 (Post 12461848)
We're just not diagonisticians.
I mean the best, realistic theory is for an MD to write a diagnosis on the prescription and then then PharmD to prescribe the medication to conform with patient's allergies, insurance, brand/generic desire, etc. But it's just not ever gonna happen.

I wish this would happen since it makes sense to have the med experts do the med decisions.

Problem is you'd need a full chart. Patient just comes to the pharmacy with a rx saying "HTN", you have no clue what else is happening with that patient. You don't have the labs or the history or a physical exam. I, for one, wouldn't feel comfortable just prescribing to the diagnosis without seeing the reason the diagnosis was made. And patients can't be trusted to bring an insurance card, so they're sure as hell not going to bring a chart. Maybe this could work in a hospital setting. No way it flies in retail.

awval999 05-01-2012 03:25 PM

Quote:

Originally Posted by eagles22 (Post 12463049)
I wish this would happen since it makes sense to have the med experts do the med decisions.

Problem is you'd need a full chart. Patient just comes to the pharmacy with a rx saying "HTN", you have no clue what else is happening with that patient. You don't have the labs or the history or a physical exam. I, for one, wouldn't feel comfortable just prescribing to the diagnosis without seeing the reason the diagnosis was made. And patients can't be trusted to bring an insurance card, so they're sure as hell not going to bring a chart. Maybe this could work in a hospital setting. No way it flies in retail.

Agreed.


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