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Squeaksmom said:
The committee meeting to decide what to do with me is happening today. I'd appreciate prayers/good thoughts/crossed fingers... whatever ya got! If anyone needs me, I'll be in the corner having a nervous breakdown....
Click to expand...

Sending you all the good juju, Squeaks!! Hang in there.
 
My wedding is in 23 days, fiance's family is being pretty terrible (as expected), graduation, dad on the lung transplant list waiting for a call, moving across the country + starting an internship in a few weeks and hoping fiance finds a job and can join me at some point...I am stressed. On top of all of this, my family dog is ~3 weeks post TTA and catastrophically fractured that leg today, it just broke out from under her during one of her controlled bathroom walks. She's not a very tolerant dog and I worry about how much we're putting her through. The fracture is fixable, but "a doozie" per one of our ortho surgeons. I need her surgery to go beautifully tomorrow or I may explode.
 
pinkpuppy9 said:
My wedding is in 23 days, fiance's family is being pretty terrible (as expected), graduation, dad on the lung transplant list waiting for a call, moving across the country + starting an internship in a few weeks and hoping fiance finds a job and can join me at some point...I am stressed. On top of all of this, my family dog is ~3 weeks post TTA and catastrophically fractured that leg today, it just broke out from under her during one of her controlled bathroom walks. She's not a very tolerant dog and I worry about how much we're putting her through. The fracture is fixable, but "a doozie" per one of our ortho surgeons. I need her surgery to go beautifully tomorrow or I may explode.
Click to expand...
I will send you all the good thoughts, vibes and internet hugs. You can do this
 
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pinkpuppy9 said:
My wedding is in 23 days, fiance's family is being pretty terrible (as expected), graduation, dad on the lung transplant list waiting for a call, moving across the country + starting an internship in a few weeks and hoping fiance finds a job and can join me at some point...I am stressed. On top of all of this, my family dog is ~3 weeks post TTA and catastrophically fractured that leg today, it just broke out from under her during one of her controlled bathroom walks. She's not a very tolerant dog and I worry about how much we're putting her through. The fracture is fixable, but "a doozie" per one of our ortho surgeons. I need her surgery to go beautifully tomorrow or I may explode.
Click to expand...
Sending e-hugs! <3
 
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So I have lots of cats, and technically they are family cats but since I live at home and have lived with them the majority of my life except college they’re my cats. And one of them died. And I feel bad but I’m not as emotional or upset as I thought I’d be. I didn’t post about it on any social media when it happened because my sister who “claimed” this cat was in the middle of her finals so my mom wanted to wait. And now that we’ve told her idk I still feel the same.

This cat was only 9 so relatively young for our household, and she had actually been to the vet recently she was jaundice and he gave her some meds and she seemed to be improving. But she started to become very lethargic and we noticed she had lost some more weight, even though she’d been eating and drinking. So we decided we’d take her back on Monday aka this past Monday. But she actually passed away the Saturday when we were discussing it. It was just so odd. And I was more upset that I didn’t notice more warning signs sooner. I feel like now that I am in a vet’s office regularly my mom expects me to pick up on things with the animals. But then she gets upset after I notice things, because we are good pet owners but being around a vet all the time and hearing what they recommend day in and out makes you want to be better. So I guess she sees it as nit picking. I don’t know. I don’t even know where this post is going I’m just sad and confused with my feelings. But here is Smudge in such a random picture lol.


9C3844C3-001E-4B65-91DD-4484B788B550.jpeg
 
Whose ******* idea was it to name all the cephalosporins “cefa something”

I get making them sound similar but come on
  • Cefazolin
  • Cephalexin
  • Cefadroxil
  • Cefoxitin
  • Ceftiofur
  • Cefovecin
  • Cefpodoxime
  • Ceftazidime
  • Cefepime
  • And then more


Try harder, pharmaceutical companies. You gotta do better than this
 
cdoconn said:
Whose ******* idea was it to name all the cephalosporins “cefa something”

I get making them sound similar but come on
  • Cefazolin
  • Cephalexin
  • Cefadroxil
  • Cefoxitin
  • Ceftiofur
  • Cefovecin
  • Cefpodoxime
  • Ceftazidime
  • Cefepime
  • And then more


Try harder, pharmaceutical companies. You gotta do better than this
Click to expand...
Wait I need to piggy back off of this. Almost messed up majorly yesterday because a generic for antisedan came out (revertidine) and we ordered it. When you’re tired and you need to give reversal, tell me this isn’t an easy mistake to almost make.
262050
 
ajs513 said:
Wait I need to piggy back off of this. Almost messed up majorly yesterday because a generic for antisedan came out (revertidine) and we ordered it. When you’re tired and you need to give reversal, tell me this isn’t an easy mistake to almost make. View attachment 262050
Click to expand...
Oh definitely, there’s a bunch of bottles that look way too similar. Apparently in equine/ food animal it’s worse. Just have to double check all the time.
 
@cdoconn @ajs513 Do y'all have any method of double checking the meds you grab other than a visual check? In pharmacy it's basically a given that you have a computer check that you have the right drug in your hand. Most retail pharmacies do some variant of scanning the prescription label then scanning the stock bottle, and the system beeps angrily at you if it's wrong. (Tbh it can get annoying because the 100 count bottle and the 500 count bottle of the same drug technically have different NDCs but it'll still reject. But I digress.) Then the pharmacist at final verification has to scan the label on the bottle (and/or the label) and check that a photo of the med on file matches the med they have in their hand.
 
ajs513 said:
Wait I need to piggy back off of this. Almost messed up majorly yesterday because a generic for antisedan came out (revertidine) and we ordered it. When you’re tired and you need to give reversal, tell me this isn’t an easy mistake to almost make. View attachment 262050
Click to expand...
Well that's ****ing terrifying.

My brain is solidly green=snooze, orange=wakey wakey lol.
 
capri1722 said:
@cdoconn @ajs513 Do y'all have any method of double checking the meds you grab other than a visual check? In pharmacy it's basically a given that you have a computer check that you have the right drug in your hand. Most retail pharmacies do some variant of scanning the prescription label then scanning the stock bottle, and the system beeps angrily at you if it's wrong. (Tbh it can get annoying because the 100 count bottle and the 500 count bottle of the same drug technically have different NDCs but it'll still reject. But I digress.) Then the pharmacist at final verification has to scan the label on the bottle (and/or the label) and check that a photo of the med on file matches the med they have in their hand.
Click to expand...
I work in a very small SA GP hospital that only has 7 employees total including the owner and only 3-4 people in the building at a time. We fill maybe 10 prescriptions a day. We don’t have hundreds of medications either. So it’s usually not necessary. The doctor tells me what to fill, I create the label, check the label, take the bottle off of the shelf and double check that I have the right medication and strength, and then count how much I need. There are far fewer checks in place to prevent a mixup than there would be in a large human pharmacy. But given that I’m typically filling medications for a patient I’ve just seen 30 seconds before, I know which medication I need to fill regardless and can figure out if a medication I’ve grabbed is obviously wrong. Like if a 2 year old 100 lb dog came in with a limp, I know I definitely need to grab Vetprofen 100 mg and not Vetmedin. That would be pretty impossible to mix up, especially since it takes time to get the bottle, check it, count them out, put them in the bottle, put the label on, and explain it to the owner.

With injections, there’s a little more chance for error since things can sometimes happen very fast, but typically you also know what you need to get and most vials don’t look too similar. In fact, some drugs that pair together like dexdomitor and antisedan are very different in color, probably on purpose. When it’s a clear aqueous solution in a nondescript vial, that can be a little more difficult but I just make sure to triple check everything before I give it.
 
capri1722 said:
@cdoconn @ajs513 Do y'all have any method of double checking the meds you grab other than a visual check? In pharmacy it's basically a given that you have a computer check that you have the right drug in your hand. Most retail pharmacies do some variant of scanning the prescription label then scanning the stock bottle, and the system beeps angrily at you if it's wrong. (Tbh it can get annoying because the 100 count bottle and the 500 count bottle of the same drug technically have different NDCs but it'll still reject. But I digress.) Then the pharmacist at final verification has to scan the label on the bottle (and/or the label) and check that a photo of the med on file matches the med they have in their hand.
Click to expand...
Definitely not for the hospitals I've worked at. Here's how prescriptions work:

Dr orders a prescription and leaves, tech/ assistant creates the label, grabs the bottle, counts them out (usually once), puts them in a bottle, slaps a sticker on it and calls it a day. Exception: controlled drugs.

There's really not that much double checking- I don't think we even have scanners in the hospitals for that. You just kinda do it and just make sure you do it right and not mess up. The doctor rarely saw the drugs, unless they were handed to them to give to the client on their way in.
 
Trilt said:
Well that's ****ing terrifying.

My brain is solidly green=snooze, orange=wakey wakey lol.
Click to expand...
Where I used to work we had the brand names so I thought the same thing. Except we use TTDex for most routine procedures with no contraindications, and we bought revertidine recently when it came out and ran out of antisedan. So now my brain defaults to “baby blue=reversal.” So I stuck the needle in and caught a glimpse of “dex” and was like uuuuh this is wrong.
 
Oh and also @capri1722 I am actually quite aware of the scanning system and yet, it still didn't stop a nurse from trying to PUT MY ALBUTEROL INHALER IN MY NOSE post surgery.

you know, this one?
262052


I have asthma, and so when I had my jaw surgery they asked me to bring it, just in case. The overnight nurse came in at like 3 am with my inhaler in hand, muttering that she needed to give my intranasal meds.

So my mom says "uhhh then what are you doing with that?" "it's for her nose" "... no..?"

SO she kept scanning it over and over again, and it wouldn't scan [probably because it wasn't the right drug] and she started talking about just giving it anyways and my mom like went into momma bear mode.

My nares really appreciates her not trying to put that in my nose...
 
ajs513 said:
I work in a very small SA GP hospital that only has 7 employees total including the owner and only 3-4 people in the building at a time. We fill maybe 10 prescriptions a day. We don’t have hundreds of medications either. So it’s usually not necessary. The doctor tells me what to fill, I create the label, check the label, take the bottle off of the shelf and double check that I have the right medication and strength, and then count how much I need. There are far fewer checks in place to prevent a mixup than there would be in a large human pharmacy. But given that I’m typically filling medications for a patient I’ve just seen 30 seconds before, I know which medication I need to fill regardless and can figure out if a medication I’ve grabbed is obviously wrong. Like if a 2 year old 100 lb dog came in with a limp, I know I definitely need to grab Vetprofen 100 mg and not Vetmedin. That would be pretty impossible to mix up, especially since it takes time to get the bottle, check it, count them out, put them in the bottle, put the label on, and explain it to the owner.

With injections, there’s a little more chance for error since things can sometimes happen very fast, but typically you also know what you need to get and most vials don’t look too similar. In fact, some drugs that pair together like dexdomitor and antisedan are very different in color, probably on purpose. When it’s a clear aqueous solution in a nondescript vial, that can be a little more difficult but I just make sure to triple check everything before I give it.
Click to expand...
cdoconn said:
Definitely not for the hospitals I've worked at. Here's how prescriptions work:

Dr orders a prescription and leaves, tech/ assistant creates the label, grabs the bottle, counts them out (usually once), puts them in a bottle, slaps a sticker on it and calls it a day. Exception: controlled drugs.

There's really not that much double checking- I don't think we even have scanners in the hospitals for that. You just kinda do it and just make sure you do it right and not mess up. The doctor rarely saw the drugs, unless they were handed to them to give to the client on their way in.
Click to expand...
Interesting. I guess I'm more interested in this topic right now because the vet called yesterday asking if we brought home the right med for my dog (30mg vs 60mg Vetoryl capsules; the former is correct) and it ended up being that it was the correct med, correct manufacturer packaging, correct capsules and everything, but it was mislabeled as 60mg capsules, and thus entered into their system that way.
 
cdoconn said:
Oh and also @capri1722 I am actually quite aware of the scanning system and yet, it still didn't stop a nurse from trying to PUT MY ALBUTEROL INHALER IN MY NOSE post surgery.

you know, this one?
View attachment 262052

I have asthma, and so when I had my jaw surgery they asked me to bring it, just in case. The overnight nurse came in at like 3 am with my inhaler in hand, muttering that she needed to give my intranasal meds.

So my mom says "uhhh then what are you doing with that?" "it's for her nose" "... no..?"

SO she kept scanning it over and over again, and it wouldn't scan [probably because it wasn't the right drug] and she started talking about just giving it anyways and my mom like went into momma bear mode.

My nares really appreciates her not trying to put that in my nose...
Click to expand...
I feel like what most likely happened is someone put "inh" for "inhaler" and it got mis-translated as "IN" which is "intranasal." I cannot explain why that nurse did not have enough sense to know that a med that is almost always classified as a "fast mover" is NOT supposed to be given intranasally.
 
capri1722 said:
@cdoconn @ajs513 Do y'all have any method of double checking the meds you grab other than a visual check? In pharmacy it's basically a given that you have a computer check that you have the right drug in your hand. Most retail pharmacies do some variant of scanning the prescription label then scanning the stock bottle, and the system beeps angrily at you if it's wrong. (Tbh it can get annoying because the 100 count bottle and the 500 count bottle of the same drug technically have different NDCs but it'll still reject. But I digress.) Then the pharmacist at final verification has to scan the label on the bottle (and/or the label) and check that a photo of the med on file matches the med they have in their hand.
Click to expand...
This is going to vary a lot by clinic. Personally our pharmacy was organized by drug type (antibiotics, cardiac drugs, etc.) for the most part, and when we filled prescriptions the vet or one of the techs would double check the printed prescription against the prescription in the chart and the actual bottle the drugs came out of. Injectables were grouped similarly, and someone else would always double check those as well. So we had a couple checks in place, but that's not always the case.
 
cdoconn said:
Oh and also @capri1722 I am actually quite aware of the scanning system and yet, it still didn't stop a nurse from trying to PUT MY ALBUTEROL INHALER IN MY NOSE post surgery.

you know, this one?
View attachment 262052

I have asthma, and so when I had my jaw surgery they asked me to bring it, just in case. The overnight nurse came in at like 3 am with my inhaler in hand, muttering that she needed to give my intranasal meds.

So my mom says "uhhh then what are you doing with that?" "it's for her nose" "... no..?"

SO she kept scanning it over and over again, and it wouldn't scan [probably because it wasn't the right drug] and she started talking about just giving it anyways and my mom like went into momma bear mode.

My nares really appreciates her not trying to put that in my nose...
Click to expand...
Ugh wtf??? 😵
 
capri1722 said:
I feel like what most likely happened is someone put "inh" for "inhaler" and it got mis-translated as "IN" which is "intranasal." I cannot explain why that nurse did not have enough sense to know that a med that is almost always classified as a "fast mover" is NOT supposed to be given intranasally.
Click to expand...
But like
She should know what an inhaler looks like. How tf you fit that in a nostril
 
Caiter92 said:
This is going to vary a lot by clinic. Personally our pharmacy was organized by drug type (antibiotics, cardiac drugs, etc.) for the most part, and when we filled prescriptions the vet or one of the techs would double check the printed prescription against the prescription in the chart and the actual bottle the drugs came out of. Injectables were grouped similarly, and someone else would always double check those as well. So we had a couple checks in place, but that's not always the case.
Click to expand...
Mine was like this too
 
capri1722 said:
Interesting. I guess I'm more interested in this topic right now because the vet called yesterday asking if we brought home the right med for my dog (30mg vs 60mg Vetoryl capsules; the former is correct) and it ended up being that it was the correct med, correct manufacturer packaging, correct capsules and everything, but it was mislabeled as 60mg capsules, and thus entered into their system that way.
Click to expand...
That has absolutely happened. Only a couple times, but I’ve definitely put a label for the wrong strength on the right medication. And the only medication I ever sent home incorrectly was nexgard. It was just one weight class smaller and the owner immediately noticed when she walked out the door and caught it. I told her it was my mistake and gave her the higher weight class for no extra charge because I didn’t want her to think that we were disorganized or something, and she had already checked out. The doctor approved that before I let her have it, or course.
 
Yeah, at my internship (corporate private practice) we had people double check. I'd say what to fill, someone filled it, they had to take the original bottle and the filled bottle to a second person who verified it was the right med and strength (usually didn't recount though), and both put their initials on the label that way if there was an issue we knew who filled it. Controlled meds were filled by a vet or one of only a couple of the most senior technicians and were obviously also verified by someone. The GPs I worked for didn't have any double checking at all really, for better or worse, but they also had really limited stock so it was less of an issue.
 
ajs513 said:
Where I used to work we had the brand names so I thought the same thing. Except we use TTDex for most routine procedures with no contraindications, and we bought revertidine recently when it came out and ran out of antisedan. So now my brain defaults to “baby blue=reversal.” So I stuck the needle in and caught a glimpse of “dex” and was like uuuuh this is wrong.
Click to expand...

You may already know this, but you can contact the FDA if you think two drug labels are easy to confuse and they can ask companies to change them.

No idea how fast they move, how often they decide a change needs to take place after review, or how much clout they actually have with companies (can they only ask companies for a change, or can they force one?)... But, here's more info if you're interested in filing a report: Veterinary Medication Errors
 
britzen said:
You may already know this, but you can contact the FDA if you think two drug labels are easy to confuse and they can ask companies to change them.

No idea how fast they move, how often they decide a change needs to take place after review, or how much clout they actually have with companies (can they only ask companies for a change, or can they force one?)... But, here's more info if you're interested in filing a report: Veterinary Medication Errors
Click to expand...
That’s a great idea. Thanks for letting me know! Especially given that these are two medications that would be given to the same patient but do literally opposite things.
 
britzen said:
You may already know this, but you can contact the FDA if you think two drug labels are easy to confuse and they can ask companies to change them.

No idea how fast they move, how often they decide a change needs to take place after review, or how much clout they actually have with companies (can they only ask companies for a change, or can they force one?)... But, here's more info if you're interested in filing a report: Veterinary Medication Errors
Click to expand...
Omg do you know if there's a way to do this for human meds??? A lot of manufacturers make their bottles look similar but obviously they try to distinguish them a bit to, y'know, reduce errors. (Mylan levothyroxine is visually pleasing to me, personally.) And then there's Accord.
Anastrozole looks the same too. Once found one stocked with the allopurinol. Or maybe it was the other way around.
kgCxvit.jpg
 
capri1722 said:
Omg do you know if there's a way to do this for human meds??? A lot of manufacturers make their bottles look similar but obviously they try to distinguish them a bit to, y'know, reduce errors. (Mylan levothyroxine is visually pleasing to me, personally.) And then there's Accord.
Anastrozole looks the same too. Once found one stocked with the allopurinol. Or maybe it was the other way around.
kgCxvit.jpg
Click to expand...
I was looking at the drugs and like “wow! So similar I wonder if they’re similar effects” and then I immediately saw clopidogrel next to clonazepam

nope nope nope, f that
 
capri1722 said:
Omg do you know if there's a way to do this for human meds??? A lot of manufacturers make their bottles look similar but obviously they try to distinguish them a bit to, y'know, reduce errors. (Mylan levothyroxine is visually pleasing to me, personally.) And then there's Accord.
Anastrozole looks the same too. Once found one stocked with the allopurinol. Or maybe it was the other way around.
kgCxvit.jpg
Click to expand...
I’m thinking generics may be exempt from that haha
 
ajs513 said:
Wait I need to piggy back off of this. Almost messed up majorly yesterday because a generic for antisedan came out (revertidine) and we ordered it. When you’re tired and you need to give reversal, tell me this isn’t an easy mistake to almost make. View attachment 262050
Click to expand...

Yup, I'd tape a giant ****ing orange sticker to that reversal bottle.
 
SkiOtter said:
Ha...have you never seen thyro tabs for dogs....?
Click to expand...
Oh yea of course. I actually like the thyro tabs bottle design better. But they don’t have the picture of the pill on the bottle so it doesn’t spark weird connections like that.
 
capri1722 said:
Omg do you know if there's a way to do this for human meds??? A lot of manufacturers make their bottles look similar but obviously they try to distinguish them a bit to, y'know, reduce errors. (Mylan levothyroxine is visually pleasing to me, personally.) And then there's Accord.
Anastrozole looks the same too. Once found one stocked with the allopurinol. Or maybe it was the other way around.
Click to expand...

The FDA only came to talk to our class about veterinary medication errors, but I'm sure they care about hoomans too 😛
 
cdoconn said:
Whose ******* idea was it to name all the cephalosporins “cefa something”

I get making them sound similar but come on
  • Cefazolin
  • Cephalexin
  • Cefadroxil
  • Cefoxitin
  • Ceftiofur
  • Cefovecin
  • Cefpodoxime
  • Ceftazidime
  • Cefepime
  • And then more


Try harder, pharmaceutical companies. You gotta do better than this
Click to expand...
i mean...they are all the same class of drug...so it should help you remember that at least
 
dyachei said:
i mean...they are all the same class of drug...so it should help you remember that at least
Click to expand...
They are! But it could be really nice and be like the macrocyclic lactones where they end with the same name.

I’m imagining their naming system is “cefla *keyboard smash*”
 
cdoconn said:
They are! But it could be really nice and be like the macrocyclic lactones where they end with the same name.

I’m imagining their naming system is “cefla *keyboard smash*”
Click to expand...
Ceflateosox

Hey did I just invent a new drug?
 
for those of us allergic to cephlasporins, it is easier to go realize that is what the drug is, and go "uh doc, can't have that"
 
cdoconn said:
They are! But it could be really nice and be like the macrocyclic lactones where they end with the same name.

I’m imagining their naming system is “cefla *keyboard smash*”
Click to expand...
It's like biologics in hooman med!
Infliximab, adalimumab, golizumab, vedolimumab, certolizumab, just smash the keyboard a few times and slap a -mab ending on it!
 
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