SDN Members don't see this ad. (About Ads) Hey guys. I just started working as a new RPH at CVS but have come across DUR scenarios that I did not receive sufficient training for in pharmacy school and during graduate intern training since my preceptors rarely let me verify. So here are 2 scenarios which I would appreciate some input on: 1) If you were refilling a prescription for gabapentin and the dose was extremely high (4800mg per day) and you could not find any documentation that the MD was ever called (nothing in active notes or forced notes), would you call the MD? I find that a lot of pharmacists at CVS do not document that they called the MD. a. Or should you just assume that the original RPH who filled the gabapentin must have consulted the prescriber? b. Also, is there a way to see how the original RPH got past the DUR (whether they clicked on prescriber consulted or patient consulted)? c. If you assumed the original RPH actually consulted the prescriber before filling the first fill, if an ADR resulted in the future from the high dose, would you as an RPH who refilled the high dose be liable? Or does liability mainly rest with the original RPH? 2) What if you encountered a major drug interaction (say, diltiazem and simvastatin 80mg) when refilling a patient's diltiazem? If both drugs were refills but were from different MD's, I would want to see an active note documented that the MD was consulted. However, if I do not find one, should I call the MD? a. Or should I assume the original RPH did his/her job by calling MD but forgot to document (although the RPH must have clicked on "prescriber consulted" to get past the DUR; therefore, that would technically serve as documentation that MD was consulted, correct?) Any input would be greatly appreciated. Thanks.