IV to PO conversions

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gly...

I am far left on iv to po philosophy and don't always agree with my colleagues..... too much effort for small return...

I will let you think about this one but will give you some examples later.
 
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metrarx said:
Sometimes we do it sometimes we don't. Depends if we have time or not. The big one that we can do without calling is protonix.

But z please elaborate if you don't mind. Is it certain drugs or....?
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so Protonix IV costs $3.50...and oral costs $1.50.. unless you're 340B/DSH hospital. So every IV to PO Protonix saves $2 per day.. Oh... so you can do about 10 to 20 of those a day..and save a whopping $20 to $40... whoopeee.. meanwhile that pharmacist using the excuse"I'm on my clinical run doing IV to PO" runs around the hospital and spends 4 hours.. Do the math. What did you really accomplish?

Ok, convert Zyvox IV to PO... that saves about $40 per day. That's significant. Do it. But you convert Levaquin 750mg IV to PO, did you know PO costs more?

I know....but no IV means less risk...and decreased lenght of stay.. but are you sure? Just because Protonix went from IV to PO, will it mean the patient's IV is D/C'd and will go home????

No.

So why not concentrate on evaluation of patients who should have IV DC'd.. instead of trying to convert Pepcid IV to PO..

Dog should wag the tail..not the other way around.

Better yet, utilize pharmacists to perform more cost effective clinical activities.. renal dosing...abx streamlining etc.. and some IV to PO.

But look at the big picture. Don't waste your time chasing knick knack IV to PO.
 
WVUPharm2007 said:
I think the inquiry is for references providing conversions. Not the utility of structured evaluation of patients on IV meds.
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I know that.

But when someone asks for a direction to the end of rainbow, I like to explain what causes the visual illusion of rainbow and that the tale of leprechauns isn't real.
 
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metrarx said:
The way we do it is by floor. So whoever is decentralized to that particular floor only does those pts. There's a daily email with roughly 10 to 20 conversions that we don't have to call on in order to change. Usually takes the person 15 to 20 minutes to do it. No, we don't spend hours and hours b/c, as you said, that would be a wasted effort. You're right, there's much more important stuff we can be doing than that.
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that's ideal for decentralized pharmacists to take care of their floor..usually taking care of 50 patiens or so... I'd want them to first renal dose for safety and efficacy. If renal fxn improves, then you better increase the dose also..right?

Then I want them to review every C/S to make antibiotic streamline recommendations... then PK....

Then if you got time, do some IV to POs... but cocentrate on Zyvox and Vfend..
 
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metrarx said:
Vfend, yes that's the other one I forgot to mention.

Didn't realize what a cost difference it is with zyvox. We have a cheat sheet posted on the pharmacy resource page with iv and po costs. I should start reviewing it to see if I can save some cha ching. Seriously, thanks for the great tips.
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Typically Zyvox 600mg IV costs $80 to $85 per bag. Zyvox 600mg tab costs $60 to $65 per tab... hence $20 per dose and $40 per day difference. If you're good, you'd convert Zyvox to Vanco IV... $170 per day to about $10 per day.

Just go to your whoelsaler's website and look up the pricing dude. Or ask your purchaser for the prices of all the antibiotic and what not.

Because I deal with this all day long, I got pricing memorized for typical top 30 drugs... except for oncology stuff..
 
StaviZFingerZ said:
If you're good, you'd convert Zyvox to Vanco IV... $170 per day to about $10 per day.
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Vancomycin is no good for ORSA (the Pfizer rep told me so), that drug is soooooo 1956.
 
StaviZFingerZ said:
:meanie: oh lawd..

Did you eat that free sammich from Pfizer?
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That has nothing to do with my opinion. I can eat and be jacked off by the Pfizer rep at the same time, and still make unbiased decisions in the best interest of my patients. People who find this strange "just do not understand," I am magical.....
 
Priapism321 said:
That has nothing to do with my opinion. I can eat and be jacked off by the Pfizer rep at the same time, and still make unbiased decisions in the best interest of my patients. People who find this strange "just do not understand," I am magical.....
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Shut up...you talk too much. :meanie:

More often than not, Vanco is still very potent against ORSA everywhere I go... once in a while I see MIC > 2ug/ml. Rare.. Now VRE is rampant tho. Then again I'm starting see more and more LRVRE.
 
Priapism321 said:
That has nothing to do with my opinion. I can eat and be jacked off by the Pfizer rep at the same time, and still make unbiased decisions in the best interest of my patients. People who find this strange "just do not understand," I am magical.....
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You actually talk to them? I just pretend I'm an intern or a tech, roll in, get my free Panera sandwich and coffee, then sneak out before they realize I have a license.
 
WVUPharm2007 said:
You actually talk to them? I just pretend I'm an intern or a tech, roll in, get my free Panera sandwich and coffee, then sneak out before they realize I have a license.
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Dude, I haven't talked to them or ate their food for years. Been a card carrying member of the following site for quite some time as well:

www.nofreelunch.org
 
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MountainPharmD said:
I miss getting free meals from drug reps.
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You know... when we were young and hung out with cool friends..there was always that one outcast kid that wanted to be part of the crowd??

Hello!
 
WVUPharm2007 said:
Yeah...but if you eat their food and don't talk to them...then it costs them money...and you don't talk to them. I mean, c'mon...
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In my opinion, it costs patients money, so I politely inform them that I am a grown man and can feed myself. I actually think it is insulting that they think I need their food, and I am especially happy when I coincidentally buy the same food they bring, and secretly laugh at everyone lining up like ****ing sheep to get the drug rep's chicken nuggets.
 
metrarx said:
Wow, you hospitals still allows this?

At my hospital, reps can't setup any luncheon within a 100 yard radius from the hospital.

Sometimes we see them at street corners distributing pamphlets to little interns and have to chase them off.
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Hell yeah we do...
 
Priapism321 said:
In my opinion, it costs patients money
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But does it? Sure, you can say that it hypothetically inceases costs for the manufacturer...but do you honestly think that the marketing departments don't get a certain budget each year? Do you honestly think the money spent on my sub from Quizno's wouldn't be spent on TV ads if said opportunity to give me free food wasn't an option. At least this way its guaranteed to go into a black hole with no return on bread and meat investment.
 
Priapism321 said:
In my opinion, it costs patients money, so I politely inform them that I am a grown man and can feed myself. I actually think it is insulting that they think I need their food, and I am especially happy when I coincidentally buy the same food they bring, and secretly laugh at everyone lining up like ****ing sheep to get the drug rep's chicken nuggets.
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Merck hates me for killing Invanz. They probably have me on a dart board.

Astra Zeneca tried to assasinate me when I emailed 180 DOP to take Merrem off the formulary or reserve it for special case.

Amgen reps have seizures when they hear my name for costing them 10's of millions of dollars in Aranesp utilization reduction.

Y'all kiss my ass! :meanie:
 
StaviZFingerZ said:
Merck hates me for killing Invanz. They probably have me on a dart board.

Astra Zeneca tried to assasinate me when I emailed 180 DOP to take Merrem off the formulary or reserve it for special case.

Amgen reps have seizures when they hear my name for costing them 10's of millions of dollars in Aranesp utilization reduction.

Y'all kiss my ass! :meanie:
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Because of you we can all eat free drug rep food and not feel quilty.
 
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StaviZFingerZ said:
Merck hates me for killing Invanz. They probably have me on a dart board.

Astra Zeneca tried to assasinate me when I emailed 180 DOP to take Merrem off the formulary or reserve it for special case.

Amgen reps have seizures when they hear my name for costing them 10's of millions of dollars in Aranesp utilization reduction.

Y'all kiss my ass! :meanie:
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I got double coupons up to $1.50 at the Giant Eagle Supermarket last week.
 
WVUPharm2007 said:
But does it? Sure, you can say that it hypothetically inceases costs for the manufacturer...but do you honestly think that the marketing departments don't get a certain budget each year? Do you honestly think the money spent on my sub from Quizno's wouldn't be spent on TV ads if said opportunity to give me free food wasn't an option. At least this way its guaranteed to go into a black hole with no return on bread and meat investment.
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If you honestly think this way (I mean, I call it rationalization), you keep sticking it to 'em man....
 
MountainPharmD said:
It is getting pretty close and I am actively looking. I don’t have to stand in the cool kids circle but could I hang around the outside and pretend I am cool? You know laugh every now and then like I know what is going on.
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How's the job search going?
 
does anyone have any good studies showing how much "money" these things save.

for example: renal dosing saves X amount of hypothetical dollars per intervention

im looking for something covering renal dosing, antibiotic stuff, iv to po, and whatever else clincal pharms do

any help would be appreciated
 
Qwerty Man said:
does anyone have any good studies showing how much "money" these things save.

for example: renal dosing saves X amount of hypothetical dollars per intervention

im looking for something covering renal dosing, antibiotic stuff, iv to po, and whatever else clincal pharms do

any help would be appreciated
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I spend a bulk of my working hours analyzing data pertaining to what you're asking.

This is a very complex analysis and very involved.

If anyone can tell you how much money is saved per intervention, you can bet it's wrong.
 
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MountainPharmD said:
There are a few opportunities out there. I am sending my resume out. We will see if I can over come 5 years of working retail. Maybe someone will feel sorry for me and give me a chance.
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Could you please do us all a favor and start a thread letting us know where you are trying to find work, so we can tell you if the area is saturated?
 
Priapism321 said:
Could you please do us all a favor and start a thread letting us know where you are trying to find work, so we can tell you if the area is saturated?
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Thanks to this forum I know it is saturated everywhere. I am trying to get on at half the normal salary or I may volunteer for a while.
 
metrarx said:
Tons of money, but unfortunately you won't see any of it yourself. You'll get an "atta boy" followed by a light slap to the ass. Isn't that so Z??
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that's right..Y'all won't see any of the money you saved. But I do.. :meanie:
 
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