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Changing Capsules and Tablets...ridiculous

Discussion in 'Pre-Pharmacy' started by sozetone, Oct 9, 2018.

  1. sozetone

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    Guys,

    At WM i have to get authorization to change capsules to tablets and vice versa. Now, for simple drugs...amoxicillin, Omeprazole....etc.....does this not make anyone else feel humiliated? what good is my pharmd and experience if i cant even do something as simple as that without over-sight from a doctor/nurse.....dumb. yeah retail really knows how to make you feel valuable....lol
     
    OCDCPhT and Doktor_dud3 like this.
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  3. Doktor_dud3

    Doktor_dud3 CPhT, Pre-Pharmacy

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    I think you meant to post this in the Pharmacy sub forum. But yeah I agree. Most cases the pharmacist should be allowed to change method of delivery (capsules to tabs, etc) You could call the prescriber for a blanket yes/no answer, I guess.

    Does omeprazole come in tablets? I've honestly never seen that. We just always have the 20 or 40 mg DR caps.

    Nice profile picture, by the way, haha.
     
  4. Tommy1234

    5+ Year Member

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    I worked at WM too. It's stupid and waste of time. Yes, it humiliated when a nurse told us "Just do whatever it takes to make a patient happy and stop calling us and waste our time". Some WM policy is ridiculous like counseling every new rx include birth-control pills when patients taking those for years. WM have too many steps that cause delaying of filling prescriptions. Lots of patients transfer their rx to CVS and Walgreen because of fast service.

    WM need to change their policy and focus on customer service
     
    #3 Tommy1234, Oct 9, 2018
    Last edited: Oct 9, 2018
    sozetone likes this.
  5. sozetone

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    Your 100% right most labor intensive system ive worked with. To do 250 daily feels like 400+ , with 4-5 techs, that is inefficient. And counseling? my god...every time you walk away from the counsel window to start working....."pharmacist please!!!" another counsel ...
     
  6. Timbo

    7+ Year Member

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    Omeprazole OTC come in tablets whereas capsules are Rx only. I don't think there are any pharmacokinetics differences between the two forms but correct me if I'm wrong. I've seen some rare instances where insurance would cover OTC tabs but not Rx caps. But yeah I agree... in most cases I change caps <-> tabs all the time without calling. WM has some really strict and dumb rules (they're the ones who first brought up the whole can't transfer controlled Rx unless it has been initially filled). There's only a few instances where I would the doctor. When the caps and tabs are not pharmacokinetically equivalent (e.g. tizanidine and the 20 different formulations of methylphenidate ER off the top of my head). In the case of methylphenidate you can't change drug entity for a C2 so you'll need a completely new script from the doc.
     
    OCDCPhT likes this.
  7. BC_89

    2+ Year Member

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    Glad I don’t deal with that in the VA.

    Well, I should say: of all the red-tape that ain’t one of them (yet).
     
  8. Tommy1234

    5+ Year Member

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    Every time we counseling, it caused distraction and disruption the workflow that causes mistakes to occur.
     
    OCDCPhT likes this.
  9. OCDCPhT

    2+ Year Member

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    I know some pharmacists insist on calling for these issues, the older, more experienced pharmacists usually just allow the change


    Sent from my iPhone using Tapatalk
     
  10. Timbo

    7+ Year Member

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    The older more experienced pharmacists are also now getting fired for bull**** reasons like not opening bottles to verify drugs or dropping pills on the floor.
    We are no longer in the same work environment as we were in just a couple years ago. Due to the overly saturated job market, companies won't think twice about dropping you for a desperate unemployed pharmacist willing to work for $10/h less than you. Pharmacists are as easily replaceable as the part time cashier working front end.
     
  11. BidingMyTime

    BidingMyTime Lost Shaker Of Salt
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    I don't know that this is a WM issue, in IL, it's legally required to contact the dr to change dosage forms. I assume this is true in most states, because different dosage forms aren't considered bioequivalent. Hospitals change stuff all the time without contacting the doctor, because the doctor has signed off and agree to the hospital formulary and interchange practices when they were hired or given admitting privileges. If WM insists it's pharmacist follow the law....well, can you blame them? Would you want to work at a place that encouraged pharmacists to ignore the law?
     
    BC_89 likes this.
  12. APN-59 rph

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    Sooo..lately I have been getting directions like......Augmentin 8.235ml bid..............what do I do?
     
  13. BidingMyTime

    BidingMyTime Lost Shaker Of Salt
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    1) You can either round the 8.235ml down to 8ml.

    2) type it on the label as 8.235ml and let the pt figure it out

    3) call the doctor to remind him of antibiotic resistance, and that the Augmentin RX be cancelled. Then you don't have to fill it at all.
     
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