By: Jim Fitzgerald, RPh<\/p>\n
–<\/p>\n
James Fitzgerald is a SUNY Buffalo School of Pharmacy graduate from the class of 1980. He is currently the supervising pharmacist at Pathmark Pharmacy of Baldwin in Long Island, New York. Mr. Fitzgerald is also a community pharmacy preceptor with St. John\u2019s University and a longtime member of the Rho Chi Society. <\/i><\/p>\n
There are many decisions that pharmacists must make each and every day at the pharmacy.\u00a0 Should I refill this narcotic prescription early?\u00a0 Did the physician evaluate the risk of a drug interaction when he or she wrote this prescription?\u00a0 The EpiPen Jr. prescription on file has no refills, but the patient\u2019s mom says her child is having an anaphylactic reaction RIGHT NOW – do I refill it anyway?<\/i>\u00a0 Of course, the first reaction in each situation is to contact the prescriber to get his or her authorization and input \u2013 but this approach frequently fails because the prescriber is not easily-accessible.\u00a0 Now what?<\/i><\/p>\n
Many years ago, when I began working as a pharmacist, one of my patients was a medical malpractice attorney.\u00a0 When I first realized his occupation, I was somewhat apprehensive about filling his prescriptions \u2013 I feared that he would find some minor issue to litigate about.\u00a0 Over time, I developed a rapport with him, and as it turned out, he gave me a bit of advice that I use on a daily basis in my pharmacy practice. \u00a0He advised: ask yourself, \u201cAm I acting in the best interest of the patient?\u00a0 Would a reasonable person agree that the pharmacist treated the patient with his\/her best interest in mind?\u201d<\/i>\u00a0 If the answer to those questions is yes, then document the facts and proceed.\u00a0 For example, in the case of the anaphylactic patient, I personally would dispense the EpiPen Jr. and also call for an ambulance.\u00a0 Additionally, I would also follow up with the patient\u2019s pediatrician during normal business hours the next day.<\/i><\/p>\n
The corollary to my patient\u2019s advice was \u201cnever act solely on the profit motive, especially if it puts the patient\u2019s wellbeing at risk.\u201d<\/i>\u00a0 The early narcotic refill (mentioned above) fits this scenario – filling the prescription would surely improve the pharmacy\u2019s daily numbers, but could hurt the patient.\u00a0 As for the drug interaction risk mentioned above, that is often a tough call.\u00a0 The risk of delaying treatment has to be weighed against the risk of the interaction causing harm. Communication with the patient may help to clarify if the prescriber considered possible interactions.\u00a0 It is a tough judgment call, and just one of the many reasons why pharmacists are healthcare professionals and not merely medication dispensers.<\/p>\n","protected":false},"excerpt":{"rendered":"
By: Jim Fitzgerald, RPh – James Fitzgerald is a SUNY Buffalo School of Pharmacy graduate from the class of 1980. He is currently the supervising pharmacist at Pathmark Pharmacy of Baldwin in Long Island, New York. Mr. Fitzgerald is also a community pharmacy preceptor with St. John\u2019s University and a longtime member of the Rho…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,8],"tags":[1822,343,198,13,2227,314,14,363,968,1625,19,12,11,628,36,16,1061],"class_list":["post-300","post","type-post","status-publish","format-standard","hentry","category-featured","category-advice-opinions","tag-against","tag-and","tag-daily","tag-drug","tag-ebola-virus-disease","tag-for","tag-medication","tag-of","tag-one","tag-or","tag-patient","tag-pharmacist","tag-pharmacy","tag-right","tag-risk","tag-treatment","tag-with"],"views":535,"_links":{"self":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts\/300","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/comments?post=300"}],"version-history":[{"count":0,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts\/300\/revisions"}],"wp:attachment":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/media?parent=300"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/categories?post=300"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/tags?post=300"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}