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Monday, 26 October 2009
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Hospital pharmacy can be so,so tough.
Yesterday, a patient in ICU "coded" Emergency staff all rushed to his room and he was given the works: CPR, cardio-shock, epinephrine IV push, adenosine IV push, magnesium, potassium...etc. They called down to have us make some more IV's STAT
I gowned up and rushed to make these. My heart was racing as I filled up saline bags with levophed, vasopressin and who knows what else. I made them as quickly as I could (without compromising sterility) and called ICU let them know the meds were ready.
2 minutes later, they called back to say the patient didn't make it. Oh! So sad! He was only 44!
Tuesday, 15 September 2009
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PPIs
OK I saw an order yesterday for Kapidex. I've been out of retail for a while and I honestly had no idea what this was. There are so few drugs that begin with the letter K, so my first instinct was that it was something like Kadian (boy was I off base)
So Kapidex is yet another Proton-Pump inhibitor. Really, do we need another one? I am not thinking clinically, just realistically. When I did work retail, I often fantasized about making flash cards to match up which insurance company paid for which PPI This would be handy so when that random patient walked into your pharmacy with a new shiny prescription for NEXIUM you could pretend to be psychic and warn them that it would be changed to omeprazole. And since that was OTC, it really wasn't covered at all. Poo.
Since I work in a hospital, I have the *authority* to change the order to Protonix, because that's what our formulary PPI is. Dr wants Prevacid, we switch to Protonix. Patient was already taking Aciphex, we switch to Protonix. Patient has Medicare and is hoping for generic omeprazole, we give 'em Protonix.
And we only carry 40mg Protonix, so if you were taking Protonix 20mg, guess what? We're doubling your dose without telling your doctor, so nyeh! This formulary protocol thing has a "mad scientist" feel to it.
Wednesday, 09 September 2009
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Need help with Outlook
OK this post is totally not related to pharmacy.
I need to know how to set up Outlook on my computer.
I have 3 main e-mail addresses, and they are all with Yahoo. To access them, I go to www.yahoo.com and click on 'Mail" and sign in from there. I sign out of each account before signing on to the next. I am perfectly comfortable with this and never felt the need to use Outlook.
I also have a Samsung SmartPhone (cell phone) I do not use the cell for internet or e-mail. Just phone calls, text messages, notes (like to-do lists, account numbers, etc) appointments in the calendar and keeping addresses and phone numbers. That's it.
I'm always worried the phone will crash and I will lose all the info. I've TRIED to backup the phone, or rather, sync the phone to my computer. I have successfully done this in the past with my previous cell phone (Blackberry) When I try to sync it (using Samsung's software), a window pops up telling me I have to set up Outlook on my computer. Otherwise, I cannot backup the files from the phone.
First of all, I'm not sure why I'd need Outlook since I'm not using the phone for e-mail anyway. I guess maybe since I have addresses and phone numbers of contacts, that the cell phone feels I should have Outlook to sync those files.
Secondly, OK, I don't feel the need to run Outlook, but I will do it for the sake of backing up my cell phone files. But, I don't know how to set up Outlook! I'm no computer expert, but I'm fairly handy with basic computer and internet stuff.
Outlook will ask me for POP and STMP outgoing and incoming servers. I don't know what Yahoo uses for these. I tried looking them up and I think you need to be a Yahoo Premium member to access this info. This is crazy. I just want to have a safe way to not lose important data on my phone. I carry that phone with me constantly and I always take notes on it. If it were to crash, it'd be impossible to remember/recover all the data on my own.
Any help much appreciated!
PS - It's Outlook Express on my computer, if that matters
Sunday, 30 August 2009
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One of my favorite techs
We have this one tech who cracks us all up. I'll call him "Darth Vader" because he has this deep, deep voice and he's so damn tall too.
Anyway, here are two recent chats:
RPH: So that patient in ICU is only being kept alive for organ harvesting.
Darth Vader: What does that mean?
RPH: Well, his brain is non-functional, but his organs are in perfect working order.
Darth Vader: You mean... he's a nurse????
(apologies to nurses everywhere)
RPH: My in-laws are coming in from Rome tomorrow.
Darth Vader: So are you going to take them to Little Italy?
RPH: No! They're coming FROM Italy! They don't want to see more Italy! They want to see America!
Darth Vader: Oh, so you're taking them to the unemployment line?
OK OK, you had to be there.
Sunday, 12 July 2009
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Pitocin drips
We compound Pitocin (oxytocin) drips for the good folks in the Labor and Delivery department. I forget the exact dose, but it's something like 1 vial of pitocin for every liter of Lactated Ringer's.
Yesterday, the IV tech prepared 10 bags of pitocin drip. I had to do the final check. So, there were ten bags before me, but only nine vials of pitocin. This was my first time doing final check on this med, so I wondered if this was some kind of test? Or do we play Russian Roulette and play tricks on laboring women?
None of the above. Turns out each vial of Pitocin is overfilled so you don't need all ten vials since there'll be enough in the nine. I tell you, I learn something new every day.
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About Me
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I am a pharmacist in a long-term care setting. (We service nursing homes) I worked retail pharmacy for ten years and HATED it. I love LTC now! See my blog!
