trailerpark

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1. In MN it says the label must be on the immediate packaging of the drug and if too small like eye drops at least the rx number and patient name must be on it. At my work we open inhalers and wrap the label on them and to me doesn't look good. It fits fine I guess on the bigger Proventil, but the Proair it covers up the dose counter which I don't like. They also open the foil pouch on Ventolin and I really don't think foil pouches should be opened for Ventolin. I'm just glad they don't open the foil on Advair, we label the box, thank goodness. How do you guys handle this?

2. As far as HIPAA, if a wife calls and asks if her husband has something for pickup do you only say yes and not name the specific drug unless she says it first? How do you handle those types of family phone calls and what will you disclose?

3. Is it legal to commingle drugs? For example when we do our return to stock in 10 days the pharmacist puts the drugs back in the stock bottle, but after more than a week it could be a bottle with a different lot number and exp date and I read this weird law question that if you have a bottle of 100 tablets and you return to stock the same tablets which gives the bottle more than 100 tablets it's considered misbranding because if the outside bottle says 100 tablets it can't ever have more than that number inside... In general wouldn't a different lot number be misbranding...

4. If a tech steals a controlled drug tablet, lets say 1, do you immediately call the police, remove them from the pharmacy, ask them to leave? For one tablet would you have to notify the board or DEA with a 106 form? Anyone have a story of a tech caught stealing and what the process was.

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BenJammin

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1 and 3 are silly so I'll address 2 and 4.

2) Technically, the right to privacy protected by HIPAA includes which pharmacy you use. Legally you are violating HIPAA by saying that the husband of the caller uses the services of the pharmacy.

4) Always. Theft must be reported to the DEA. You're probably thinking about reporting "significant loss of controlled substances". Is one pill a significant loss?
 

mustang sally

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1 and 3 are silly so I'll address 2 and 4.

2) Technically, the right to privacy protected by HIPAA includes which pharmacy you use. Legally you are violating HIPAA by saying that the husband of the caller uses the services of the pharmacy.

4) Always. Theft must be reported to the DEA. You're probably thinking about reporting "significant loss of controlled substances". Is one pill a significant loss?

Heh. I don't work in retail, but I'll address 1 and 3 from my viewpoint.

1. I just flag the label if it covers up anything I don't like…dose counters, lot number, expiration date, etc.

3. I don't think you should ever commingle drugs for the exact reasons you mentioned. If I don't know what stock bottle a medication came out of it, it for sure isn't going back into the bottle.
 
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bp2313

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1. When I did my institutional rotation at a Nursing home, what I was instructed to do was folding the label in half, sticking the 2 ends on the inhalers, putting tapes on top of it to prevent falling off.
2. For the sake of Mpje, the answer is no. For the sake of making your life simple, use common sense and follow what other ppl in your pharmacy do.
3. Never ever return the drug back into its "original" bottle, especially liquid.
4. If I recalled correctly, the law says "significant loss OR ANY theft", so technically yes you have to report. But I'm sure each company has its own policy regarding this matter. Usually, you go to your PIC first then DM, and you go from there.
 

trailerpark

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On a MPJE practice question, the question was if you saw a tech steal 1 controlled tablet, what should you do. The answers included "call local law enforcement immediately" and "report to DEA via form 106" and the law does say any significant loss or ANY THEFT. Both answers seem correct though.
 

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1) Why would you open anything? What if it is RTSed? You have random open inhalers in the pharmacy? I know you are not the boss but in your shoes I would suggest that they only label the boxes and stop opening them up.

2) We just answer whatever questions they have. We have lots of old people and often one of the spouses takes care of the other.

3) I have seen pharmacies that do this and I think it is mind-bendingly stupid to pour anything back into a stock bottle. You are just asking for trouble. Is it really that unbearable to have RTS bottles on the shelf?

4) No offense, but who cares what the correct answer is to a MPJE question is now that you are a pharmacist. Better questions would be stuff that you have actually encountered.
 

BidingMyTime

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1. In MN it says the label must be on the immediate packaging of the drug and if too small like eye drops at least the rx number and patient name must be on it. At my work we open inhalers and wrap the label on them and to me doesn't look good. It fits fine I guess on the bigger Proventil, but the Proair it covers up the dose counter which I don't like. They also open the foil pouch on Ventolin and I really don't think foil pouches should be opened for Ventolin. I'm just glad they don't open the foil on Advair, we label the box, thank goodness. How do you guys handle this?

Don't live in MN, so I have no answer, but I like the one above that talks about folding the label to fit.

2. As far as HIPAA, if a wife calls and asks if her husband has something for pickup do you only say yes and not name the specific drug unless she says it first? How do you handle those types of family phone calls and what will you disclose?

Yes, never say the name of the drug. This is asking for trouble, and I have seen techs stir up a lot of trouble by giving a name of a medicine to a spouse, when the spouse didn't know their spouse took that medicine. Also, how do you even know its the wife or spouse, and not an employer, nosy neighbor, or who knows who?

3. Is it legal to commingle drugs? For example when we do our return to stock in 10 days the pharmacist puts the drugs back in the stock bottle, but after more than a week it could be a bottle with a different lot number and exp date and I read this weird law question that if you have a bottle of 100 tablets and you return to stock the same tablets which gives the bottle more than 100 tablets it's considered misbranding because if the outside bottle says 100 tablets it can't ever have more than that number inside... In general wouldn't a different lot number be misbranding...

No. Drugs that are returned to stock, should be kept in a separate vial and not poured back into a stock bottle. For a myriad of reasons.

4. If a tech steals a controlled drug tablet, lets say 1, do you immediately call the police, remove them from the pharmacy, ask them to leave? For one tablet would you have to notify the board or DEA with a 106 form? Anyone have a story of a tech caught stealing and what the process was.

If you are certain a technician stole a tablet, if you are a chain, you should report it to your district manager and proceed from there. If you are an independent, then yes I think it should be reported to the police, although I know a lot of independents wouldn't, because they wouldn't want to spend the time dealing with the issue. Obviously, once you know they are stealing, they should be asked to leave the pharmacy (you don't want to leave them in the pharmacy stealing more things.) One lost tablet does not have to be reported to the DEA, but if you know for a fact that 1 tablet was stolen, then that must be reported. Personally, I would hesitate to accuse anyone of stealing, if you are only talking about 1 tablet, unless you have video showing them stealing it or something.
 

trailerpark

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1) Why would you open anything? What if it is RTSed? You have random open inhalers in the pharmacy? I know you are not the boss but in your shoes I would suggest that they only label the boxes and stop opening them up.

2) We just answer whatever questions they have. We have lots of old people and often one of the spouse takes care of the other.

3) I have seen pharmacies that do this and I think it is mind-bendingly stupid to pour anything back into a stock bottle. You are just asking for trouble. Is it really that unbearable to have RTS bottles on the shelf?

4) No offense, but who cares what the correct answer is to a MPJE question is now that you are a pharmacist. Better questions would be stuff that you have actually encountered.

1. Yes I have seen an opened ventolin sitting on the shelf next to the boxed ones. Eye drops too because they take them out of the box and put them in vials... I especially hate opening ventolin because they're in foil.

2. The techs wont tell a wife what medication her husband has in pickup, only that he has one, but they confirm the drug if she says the name.

3. One of the other pharmacists said only he pours back into the stock bottle to make inventory easier.
 

BidingMyTime

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1. Yes I have seen an opened ventolin sitting on the shelf next to the boxed ones. Eye drops too because they take them out of the box and put them in vials... I especially hate opening ventolin because they're in foil.

That's scary. I've never seen that done in a retail pharmacy. In hospital, where I have seen that routinely done, we have to put a foil seal or something over the inhaler, so if the seal is broken, we can assume the inhaler has been used. Now, one would hope your pharmacists/technicians aren't randomly using inhalers & putting them back on the self, but without a seal, there is no way to know. That is surely a health violation. Also, taking something out of its seal, changes the expiration date, another reason to avoid taking something out of its seal, but if you are, the date it was opened needs to be marked on it, so the new expiration date can be figure accordingly, which will vary depending on the product.
 

SClENCE

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Being as it's state law I personally would have all immediate product labeled as there is no reason not to, just make sure all patient info is removed on return to stocks or you will have people calling wondering why someone else's name is on their drug

As far as HIPPA use common sense. If it is clearly not the patient, I would say something like, "Okay let me pull up his/her profile here, do you know what medication that he/she is expecting?......" Usually they will spout of 5 medications on the profile which is enough confirmation for me

And drugs from different stock bottles shouldn't be mixed on the shelf and a RTS should never go back into any stock bottle
 
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