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DrgsRmyLife

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Hey everyone, I just wanted to know if anyone uses or knows of a good drug reference that they keep in their pocket. I use Tarscons or whatever it is called and the Stanford guide to antimicrobial therapy, but they dont give me everything i need. I am looking for one that tells me indication, dosage, moa, sfx, and stability and other useful info. Any info would be a help thanks.

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If you have a PDA you can download Micromedex, Lexicomp, or Epocrates.
 
Although I don't ever need to use it, a drug rep for Nexium gave me a pocket "PDR pharmacopoeia Pocket Dosing Guide" which has some useful info.
 
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DrgsRmyLife said:
Hey everyone, I just wanted to know if anyone uses or knows of a good drug reference that they keep in their pocket. I use Tarscons or whatever it is called and the Stanford guide to antimicrobial therapy, but they dont give me everything i need. I am looking for one that tells me indication, dosage, moa, sfx, and stability and other useful info. Any info would be a help thanks.

By the way....its the Sanford Guide - not Stanford - no relation to the university. Its good, updated yearly & given out free to pharmacists - a good reference, but you have to remember - your own hospital's/communities resistance pattern's will be different.

For critical care, I like Critical Care Handbook of the Mass. Gen. Hospital as a starting place for drips I don't use routinely. It won't give stability info - don't know of easy handbook for that which includes other info too.
 
sdn1977 said:
By the way....its the Sanford Guide - not Stanford - no relation to the university. Its good, updated yearly & given out free to pharmacists - a good reference, but you have to remember - your own hospital's/communities resistance pattern's will be different.

For critical care, I like Critical Care Handbook of the Mass. Gen. Hospital as a starting place for drips I don't use routinely. It won't give stability info - don't know of easy handbook for that which includes other info too.

Many pharmacists over 40 can't read the Sanford Guide without the help of bifocals.. I'm starting to believe the Sanford Guide is starting to get too much commercial influence..then again, what do you expect? The trials used to support the data is funded by the Pharm Industry.

I hate that..

btw, the LMWH of choice at Mass Gen is Fragmin... how about that.. even though many of the investigators participated in the ESSENCE and TIMI-B II with Lovenox are from there... Now..that I likes. :smuggrin:
 
SDN-1977.. so I got to thinking... that I'll start a campaign to promote Zosyn over the Carbapenems since their coverages are about the same but Zosyn is cheaper... of course except for the ESBL producing bugs..and some Acinetobacters..

So we'll have immediate savings..now..then once Zosyn goes generic early next year, I'll reap the benefit of cheap cheap Zosyn.. I expect the price drop to be equivalent to the Rocephin drop.. from $40 per gram to $4.50...

I'm thinking and hoping...it will go to $2 to $3 for the 3.375 grams... from $15 ish.
 
ZpackSux said:
SDN-1977.. so I got to thinking... that I'll start a campaign to promote Zosyn over the Carbapenems since their coverages are about the same but Zosyn is cheaper... of course except for the ESBL producing bugs..and some Acinetobacters..

So we'll have immediate savings..now..then once Zosyn goes generic early next year, I'll reap the benefit of cheap cheap Zosyn.. I expect the price drop to be equivalent to the Rocephin drop.. from $40 per gram to $4.50...

I'm thinking and hoping...it will go to $2 to $3 for the 3.375 grams... from $15 ish.

Zpack - I'm thinking you're coming up on the end of your fiscal year & you can't make your budget work :( ! I sense some frustration & a definite bias toward Fragmin! :) Did the Lovenox rep piss you off?

and...btw....I'm over 40 & you can't tell I wear continuous focal lenses ;) altho I knew Sanford didn't have a "t" in it before I needed glasses and my eyesight never influenced my ability to recognize industry bias. Used in conjuntion with yor lab's antimicrobial sensitivity & resistance pattens, it can be a good resource...unless your hospital publishes its own formulary recommendations.....does yours? Mine did not.
 
sdn1977 said:
Zpack - I'm thinking you're coming up on the end of your fiscal year & you can't make your budget work :( ! I sense some frustration & a definite bias toward Fragmin! :) Did the Lovenox rep piss you off?

and...btw....I'm over 40 & you can't tell I wear continuous focal lenses ;) altho I knew Sanford didn't have a "t" in it before I needed glasses and my eyesight never influenced my ability to recognize industry bias. Used in conjuntion with yor lab's antimicrobial sensitivity & resistance pattens, it can be a good resource...unless your hospital publishes its own formulary recommendations.....does yours? Mine did not.


you're right. I hate Lovenox... Do you know Fragmin accounts for 50% of the LMWH usage in the world excluding the US? Because Fragmin didn't have a marketing force in the US, it allowed it to be much cheaper than Lovenox...and Aventis was very arrogant about Lovenox... I took it off the formulary at 2 different hospitals.

I used to publish ABX recommendation along with our antibiogram...but I'm a a new hospital... no, not at the end of the fiscal year.. and the co I work for isn't very concerned about the drug cost... which constitute 75% of pharmacy cost.. but they are quick to look at the salary $ which only account for 25%.. My frustration is that my clinical program can save 20% off my drug cost... as long as they leave my staffing alone.
 
ZpackSux said:
you're right. I hate Lovenox... Do you know Fragmin accounts for 50% of the LMWH usage in the world excluding the US? Because Fragmin didn't have a marketing force in the US, it allowed it to be much cheaper than Lovenox...and Aventis was very arrogant about Lovenox... I took it off the formulary at 2 different hospitals.

I used to publish ABX recommendation along with our antibiogram...but I'm a a new hospital... no, not at the end of the fiscal year.. and the co I work for isn't very concerned about the drug cost... which constitute 75% of pharmacy cost.. but they are quick to look at the salary $ which only account for 25%.. My frustration is that my clinical program can save 20% off my drug cost... as long as they leave my staffing alone.

Yep - and no amount of documentation of clinical activities means anything to the bean counters I'm guessing. I can't tell you how many of those crazy forms I've filled out over the years. The mind set is - your pharmacists will do what they need to do no matter what and if we reduce the staff by 1 FTE, that can easily be absorbed within the remaining staff. But....it just takes one F*&^ up in a chemo dose with a resulting lawsuit to toss the whole staff savings out the door. But...the bean counters are in the game of risk management - they are betting the worst won't happen.....and...it usually doesn't. The problem is....the rare times it does - you get your name in a journal!

I can appreciate your Lovenox issue. Are you old enough to remember the Synthroid scandal??? The research documenting the use of Synthroid as the gold standard and non-interchangeable was done at a major west coast school & significant information was suppressed because the studies were funded by the manufacturer - this was back in the 60's... It goes on and on and on. The best advice - become critical in evaluating articles & don't take one as gospel. IMO - too many students come out of school not able to read a scientific paper critically & become "rote" clinicians.

Good luck with your staffing!
 
There was a Synthroid Scandal? Did it involve sex, drugs, and rock&roll? :love:
 
ZpackSux said:
There was a Synthroid Scandal? Did it involve sex, drugs, and rock&roll? :love:
No. It involved advertising which promoted Synthroid as the "standard in thyroid replacement therapy" when it wasn't the RLD. It's currently RLD for a few strengths, but those were latecomers. I'm not sure if those came about before or after the FDA came down on them and mandated a gradual reduction in market share. This whole thing happened int he late 90's and sanctions began in about 2000.
 
bananaface said:
No. It involved advertising which promoted Synthroid as the "standard in thyroid replacement therapy" when it wasn't the RLD. It's currently RLD for a few strengths, but those were latecomers. I'm not sure if those came about before or after the FDA came down on them and mandated a gradual reduction in market share. This whole thing happened int he late 90's and sanctions began in about 2000.


Do you always take things so seriously?
 
ZpackSux said:
There was a Synthroid Scandal? Did it involve sex, drugs, and rock&roll? :love:

Oh my gawd! Do you know all those other "cheap thrills" Janis used to sing about???????????? :eek:

You must be close to my era! Janis was definitely alive & well in the Synthroid scandal era.
 
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sdn1977 said:
Oh my gawd! Do you know all those other "cheap thrills" Janis used to sing about???????????? :eek:

You must be close to my era! Janis was definitely alive & well in the Synthroid scandal era.


ehhhh...slightly before my time. I just turned 39...

starting to think happiness is a titanium silver convertible Porsche 911... :cool:
 
ZpackSux said:
ehhhh...slightly before my time. I just turned 39...

starting to think happiness is a titanium silver convertible Porsche 911... :cool:

You're just a kid....but, fortunately....I'm not old enough to be your parent :oops: !

And yes....I agree....happiness is a convertible - mine's red - along with the sex, drugs & rock and roll :D !
 
sdn1977 said:
You're just a kid....but, fortunately....I'm not old enough to be your parent :oops: !

And yes....I agree....happiness is a convertible - mine's red - along with the sex, drugs & rock and roll :D !


You have sex in your convertible? :idea:

Hmmm...that's putting sunblock on the area that doesn't see the sun often.. :smuggrin:
 
:laugh: hahahaha....just wait till you get your convertible!

But...you live in the heat of Texas I think - way too hot!
 
sdn1977 said:
:laugh: hahahaha....just wait till you get your convertible!

But...you live in the heat of Texas I think - way too hot!


We do have Spring and Autumn you know...

So sdn really stands for Sex Drugs and Nudity.... :smuggrin:
 
ZpackSux said:
We do have Spring and Autumn you know...

So sdn really stands for Sex Drugs and Nudity.... :smuggrin:

You really are toooooo funny! :laugh: :laugh: :laugh:

Its a loooooong time until autumn.......here in CA we are having a very enjoyable summer :D - & yes.....I have been "top down" since the warm weather began ;) !
 
sdn1977 said:
You really are toooooo funny! :laugh: :laugh: :laugh:

Its a loooooong time until autumn.......here in CA we are having a very enjoyable summer :D - & yes.....I have been "top down" since the warm weather began ;) !


Well.... I did drive a Jeep while getting through rx school down in Sothern Cal.. yes I drove around with my top down like a fool.. was fun as heck..

Except, I used to be really smart... then with my noggin getting knocked around in my jeep, my IQ dropped down to 89 or so.

You must be near the Bay. While living near Sacramento, my buddy and I used to commute...except he would pick me up in his little red gayata..I mean Miyata and i used to frown.. He and I just didn't look right in it.. people probably thought we were gay lovers or something..

I kinda preferred his F-350 Powerstroke dually.. but.
 
sdn1977 said:
You really are toooooo funny! :laugh: :laugh: :laugh:

Its a loooooong time until autumn.......here in CA we are having a very enjoyable summer :D - & yes.....I have been "top down" since the warm weather began ;) !

Define "Top Down" and this post is useless without a picture!!! :smuggrin:
 
ZpackSux said:
Define "Top Down" and this post is useless without a picture!!! :smuggrin:

You want a picture of my car with the top down? :p I can send you the whole owner's manual if you want....

But...if you were referring to something else...well....a pharmacist such as yourself with an extensive knowledge of the pharmacology, pharmacokinetics & medical & prophylatic uses of sunblock would know all the various places it is best applied. And...you know what they say...fantasy is far better than.... ;)

And please...don't send a pic of your JD - I left tractors when I left undergrad at UC Davis & really don't find them at all attractive in anyway but a farm-like sense, but I'm sure you look great on yours :D .
 
How did this thread in which the poster asked a very insightful question degenerate into this???? :(

I do apologize.... :oops:
 
sdn1977 said:
You want a picture of my car with the top down? :p I can send you the whole owner's manual if you want....

But...if you were referring to something else...well....a pharmacist such as yourself with an extensive knowledge of the pharmacology, pharmacokinetics & medical & prophylatic uses of sunblock would know all the various places it is best applied. And...you know what they say...fantasy is far better than.... ;)

And please...don't send a pic of your JD - I left tractors when I left undergrad at UC Davis & really don't find them at all attractive in anyway but a farm-like sense, but I'm sure you look great on yours :D .

heh.. we're both Aggies.. :thumbup:
 
Since I was the one who did start the original post..I would like to say thank you for all the info regarding question...and would like to also thank everyone for all of the other info you added in.....at least my post created some discussion and thats always good.

Laters
 
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