The filling of methadone - QT prolongation concerns...

[aboveliquidice]

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Knee deep in Naplex prep - came across an interesting blurb about the filling of methadone scripts.

As a retail pharmacist, you are not responsible for verifying that the prescribing authority has checked the QT interval. Is this correct?

I rotated with a pain specialist pharmacist (VA with prescribing authority). It was always checked before prescribing - however it was also very easy to verify such information with the VA's system.

In a retail establishment, this would be much more difficult to verify.

What do you all see in practice?

 

[Ilikechemicals]

Well in retail the MDs dont even write the patients date of birth 70% of the time, let alone QT times. So I would say no you are not responsible (But I'm sure a lawyer would find a way to sue you). You would be responsible if the patient has a heart med on their profile and you didnt do your DD.

The question I have is: you get an unajusted dose prescription for Macrobid for a 70,80ish old women. How many rphs just fill that without calling the MD about renal function?

 

[nnguyenc]

what's renal function?

 

[Ackj]

Well in retail the MDs dont even write the patients date of birth 70% of the time, let alone QT times.

The rph i was working with was actually saying that they miss the triplicates, because then at least the md took the time to fill out the rx carefully. Now you don't get a dob, mdd, etc. We had an rx last week (not controlled, but still): "Lovenox 1mg/kg sq q12." Okay, so we're going to weigh your pt when they get here? And how many are we dispensing? I'm seeing a lot of "qs" rather than # also, which is kind of worrisome. I think that the # is a good sort of double check, for example #60 verifies that it's bid and not tid/qid/whatever else that scribble could be.

 

[aboveliquidice]

The rph i was working with was actually saying that they miss the triplicates, because then at least the md took the time to fill out the rx carefully. Now you don't get a dob, mdd, etc. We had an rx last week (not controlled, but still): "Lovenox 1mg/kg sq q12." Okay, so we're going to weigh your pt when they get here? And how many are we dispensing? I'm seeing a lot of "qs" rather than # also, which is kind of worrisome. I think that the # is a good sort of double check, for example #60 verifies that it's bid and not tid/qid/whatever else that scribble could be.

Lovenox w/o a weight is gonna get a call from me - immediately

 

[Sparda29]

Lovenox w/o a weight is gonna get a call from me - immediately

You could store supply a weighing scale.