numbers different

[Da Alchemist]

If, for example the doctor prescribed written on a discharge patient paper phenobarbital tab 60(no mg written) 3pills each morning. You goto your local CVS to pick up the pills. you pick up the pills and it says 64.8 mg tablequa 3x every morning on the bottle label... is there something wrong here? 60 and 64.8?

and what does tablequa mean?

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[sdn1977]

The difference between 60 & 64.8mg of phenobarbital is not a problem.

Most prescribers (I'm assuming its a physician) will prescribe phenobarbital as 30mg, 60mg, 90mg - in the old days...they used to write 1/2gr, 1gr, 1&1/2gr...etc.....

The drug is available only as 32mg, 64.8mg, etc....so therapeutically - we are giving what the prescriber actually wanted (the pt probably got 64.8mg in the hospital as well - the prescriber just didn't write it that clearly).

Note: here we get into JCAHO issues - it is supposed to be written exactly as its dispensed & administered - the pharmacy will dispense 64.8mg & the nurse will give 60mg, but the chart reads 60mg. As pharmacists...we could harrass this neurologist or hospitalist or we could just change it per "hospital policy" or "product availability" or whatever phrase your P&T committee agrees upon......but, I digress off on a rant

I'm not sure about tablequa, but when my computer program translates tablets into spanish it comes out as "tabletas" & that is how my spanish speaking colleagues use it as well....so dunno.

btw.....better post this time !

 

[piyi]

I listened while a pharmacist explained the answer to your question a little while ago. They said something along the lines of how some manufacturers measure phenobarbital in grains and some in mg and that 60 and 64.8 is the same. I'm sure one of the pharmacists on here can exlpain it a lot better, but I remember that grains/mg was the cause of the discrepancy.

 

[Da Alchemist]

Sdn, I dont know how the forum will live without you. lol @ better post. thanks.

 

[sdn1977]

I listened while a pharmacist explained the answer to your question a little while ago. They said something along the lines of how some manufacturers measure phenobarbital in grains and some in mg and that 60 and 64.8 is the same. I'm sure one of the pharmacists on here can exlpain it a lot better, but I remember that grains/mg was the cause of the discrepancy.

yep, yep...this is the difference between the apothecary & avoirdupois system. In this drug, particularly, it is a real holdover from the old days. You still might see thyroid products labeled this way as well or see 10gr of calcium (give 600mg orally - close enough).

But...when you actually get into your rotations, particularly in neurology - the drugs are dosed in mg, but we need to deliver what is manufactured.

There are EXCEPTIONS (after all - we're talking pharmacy - the profession of exceptions!). In NICU, PICU - you must give the actual mg ordered - no rounding based on mg/gr conversions. You learn this with experience - when you must be exact & when you don't.

No worries - you'll get there....

 

[Caverject]

yep, yep...this is the difference between the apothecary & avoirdupois system. In this drug, particularly, it is a real holdover from the old days. You still might see thyroid products labeled this way as well or see 10gr of calcium (give 600mg orally - close enough).

hmmm does this say a lot about your experience or age??

For anybody that cares, the old school thyroid products are the "natural" thyroid products like Armour Thyroid. Not synthroid or levoxyl. Also, for anyone that is going to dispense Armour Thyroid, I highly suggest sniffing the bottle. It's a heavenly scent! Kinda gives you that "high" feeling as well if you sniff it long enough...

 

[GatorRxGirl]

hmmm does this say a lot about your experience or age??

For anybody that cares, the old school thyroid products are the "natural" thyroid products like Armour Thyroid. Not synthroid or levoxyl. Also, for anyone that is going to dispense Armour Thyroid, I highly suggest sniffing the bottle. It's a heavenly scent! Kinda gives you that "high" feeling as well if you sniff it long enough...

you're just mean.

 

[sdn1977]

you're just mean.

No he's not!!! He just likes to harrass - I'm all good. I know I can run rings around him pharmacy-wise, at least right now...not so sure in a few years though.

But...his avatar....gosh - I really think I am old...but very, very experienced !

Drug "smells" - my most favorite is spironolactone. My least favorite is metformin - makes me nauseous (& about 70% of the folks who take it too!).

 

[GatorRxGirl]

No he's not!!! He just likes to harrass - I'm all good. I know I can run rings around him pharmacy-wise, at least right now...not so sure in a few years though.

But...his avatar....gosh - I really think I am old...but very, very experienced !

Drug "smells" - my most favorite is spironolactone. My least favorite is metformin - makes me nauseous (& about 70% of the folks who take it too!).

The mean comment was directed at telling people to sniff the thyroid. Now metformin smells AMAZING. much better then Benicar.

 

[sdn1977]

The mean comment was directed at telling people to sniff the thyroid. Now metformin smells AMAZING. much better then Benicar.

sorry!

You like metformin ?

I can't say I've noticed the smell of Benicar - something to sniff next time I work. (They frown on that when I count the CII's - something about the cocaine they object to )

 

[All4MyDaughter]

Now metformin smells AMAZING. much better then Benicar.

Metformin, haha.

Benicar is awesome. Buttered popcorn, yum!
I also like spironolactone.

 

[ageldred]

Metformin, haha.

Benicar is awesome. Buttered popcorn, yum!
I also like spironolactone.

I must make a list of drugs to sniff next time I go to work.


Armour Thyroid is smelly, I don't go out of my way to smell it, it just wafts up to my nose...ick.

Amoxicillin smells bad too in my opinion....I do think I sniffed that as a kid for some reason.

 

[GatorRxGirl]

sike! metformin smells like rotten garbage. benicar really does smell like buttered popcorn. mmm mmm.

 

[DrugDealer]

I like the prenatal vitamins that smell like marshmallow fluff.

 

[Farmercyst]

Isn't there already a thread about drug sniffing somewhere?

 

[All4MyDaughter]

sike! metformin smells like rotten garbage. benicar really does smell like buttered popcorn. mmm mmm.

I think metformin smells like fish food...icky.

I like the prenatal vitamins that smell like marshmallow fluff.

Oh, I know what you are talking about. Except I think they smell like cake frosting.

I must make a list of drugs to sniff next time I go to work.

I also like to sniff a little camphor or menthol when I'm compounding. Especially when I have a cold. On the other hand, when I use coal tar it stanks up the entire pharmacy and everyone gripes at me to work faster.