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They are totally stuck between a rock and a hardplace and it's going to take 1 person getting hurt with out of date drugs being even remotely responsible and there will be hell to pay on all ends. so in the end, YAY CAPITALISM!
Sucks, but I understand both sides of the argument. Most beyond use dating is based off of old data, but what else are we supposed to do? If we start overstepping our bounds and using out of date medications we are putting our licenses at risk.
I don't understand both sides. How many drugs are actually dangerous past their expiration date vs less potent? Where do these beyond-use dates even come from? A drug isn't going to turn into a pumpkin after 30 days out of the fridge. Why aren't things labeled for 53 days or 17.72 hours? What makes a single-dose PF vial turn bad after 24 hours? If I had to choose between getting potentially less potent chemo or no chemo, I would obviously choose the chemo. How would you prove harm in a lawsuit? Get the consent of the patient, let them be part of the decision process. It's part of the benefit risk analysis made with literally every drug you put in your body every time. Where did this drug come from? Was in manufactured properly? Transported and stored properly, prepared aseptically? Is the pump working right, did the nurse swab the site correctly? Is the port-a-cath clear of contaminants? There are hundreds of potential risks in the pathway and I don't see why this is more of a risk than all of those other things. Manufacturers are no help at all in this either.
We have used things beyond their expiration date with approval from P&T. If there is no alternative and no other treatment, what are you going to do?
When it become available again. At least that's what we're doing for some single use injectable products.Where do we draw the line on when to not give a drug, if not the expiration date/beyond use date?
I agree. The patient should be given the choice. As long as all the information is given to them and they understand, what's the problem? A drug with 90% potency versus no drug? This is common sense.
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But those are pretty few and far between. Aside from the tetracyclines, I'm not aware of any.For one thing, some drugs form toxic compounds when broken down in the storage form. So that's an issue.
For one thing, some drugs form toxic compounds when broken down in the storage form. So that's an issue.
I think the pharmacist is right to throw them away. The NUMBER ONE RULE of pharmacy is ALWAYS PROTECT YOUR LICENSE. Dispensing knowingly expired drugs that is against the law is NOT protecting your license.
I'm certain that a practicing pharmacist would know which are safe and which are not. I get that part. But as others have mentioned, what's the harm giving it a month or two after the expiration date? It's a tough situation and I believe it is within our scope to be a part of those decisions with the best interest of the patient in mind. In a hospital setting, you're not going to be the only one involved in the decision...so I'm not sure the fear of lost license has basis. As long as the patient is aware and agrees, I can't see us denying a life saving therapy.
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I'm certain that a practicing pharmacist would know which are safe and which are not. I get that part. But as others have mentioned, what's the harm giving it a month or two after the expiration date? It's a tough situation and I believe it is within our scope to be a part of those decisions with the best interest of the patient in mind. In a hospital setting, you're not going to be the only one involved in the decision...so I'm not sure the fear of lost license has basis. As long as the patient is aware and agrees, I can't see us denying a life saving therapy.
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Oh, I don't know. I'm a practicing pharmacist and I couldn't tell you whether specific drugs are safe past their expiration date because there is no data about it. Some things I know aren't safe. Most things, we're somewhat guessing.
I don't advise patients to take expired drugs. Ever. But I work outpatient and we are not talking about chemo or other lifesaving scarce drugs. That makes it easier for me.
What would hold up best in court or in a hearing with the Board of Pharmacy? Hard to say, isn't it? Anything we do something outside of established practice, we're taking a risk.
My #1 rule is to act in the best interest of the patient. Any time I would give out a "loaner" drug in the retail world, I'm doing something that's not exactly within the scope of the laws but is in the best interest of the patient. When you get out and practice, you'll see that things are not so black and white.For one thing, some drugs form toxic compounds when broken down in the storage form. So that's an issue.
I think the pharmacist is right to throw them away. The NUMBER ONE RULE of pharmacy is ALWAYS PROTECT YOUR LICENSE. Dispensing knowingly expired drugs that is against the law is NOT protecting your license.
Aspirin turns into zit treatment.But those are pretty few and far between. Aside from the tetracyclines, I'm not aware of any.
The fact is we cannot answer these questions right now, and we can't take a guess while we claim to practice evidence based medicine.
Oh, I don't know. I'm a practicing pharmacist and I couldn't tell you whether specific drugs are safe past their expiration date because there is no data about it. Some things I know aren't safe. Most things, we're somewhat guessing.
I don't advise patients to take expired drugs. Ever. But I work outpatient and we are not talking about chemo or other lifesaving scarce drugs. That makes it easier for me.
What would hold up best in court or in a hearing with the Board of Pharmacy? Hard to say, isn't it? Anything we do something outside of established practice, we're taking a risk.
True story.. We've done many things procedure wise at my institution where there is zero data. Zippo.
Any time you knowingly violate state laws - within company policy or outside of them - your license is at risk. If someone died because a drug was improperly used or was seriously injured, your license would be gone so fast you wouldn't even get to kiss it goodbye.
You only get one license. One. Once it's gone, it's gone forever. My goal: to not **** that up.
The wholesalers and manufacturers can give you an estimate but I generally take it with a grain of salt.Do pharmacists usually know when the supply of a scarce drug will be replenished?