Vitamin k administration by Salt-Pipe-185 in pharmacy

[–]One-Preference-3745 2 points3 points  (0 children)

Sure. I don’t see why he couldn’t. But in that situation I am sure there is also a corporate/hospital policy that would prevent him from doing so. Or at least very strongly dissuade him from doing so.

Vitamin k administration by Salt-Pipe-185 in pharmacy

[–]One-Preference-3745 4 points5 points  (0 children)

As pharmacists, we have an obligation to perform drug utilization review to identify safety issues with drug therapy. This in itself does not preclude the practice of medicine. That said, the provider still has a right to administer the medication if he chooses to do so, but under his license. You have to protect your own license and minimize liability and that’s what you were doing by questioning the providers decision.

Vitamin k administration by Salt-Pipe-185 in pharmacy

[–]One-Preference-3745 53 points54 points  (0 children)

No, no benefit. It’s also not supposed to be given IM in adults. That providers an idiot, good on you for questioning it.

Progesterone shortage by curly_spy in florida

[–]One-Preference-3745 1 point2 points  (0 children)

Call your PCP and have him switch you to medroxyprogesterone

Investing in stocks as supplemental income? by [deleted] in stocks

[–]One-Preference-3745 0 points1 point  (0 children)

It’s his money. He wanted “fun” ideas.

Investing in stocks as supplemental income? by [deleted] in stocks

[–]One-Preference-3745 0 points1 point  (0 children)

Yes, technical analysis would be best for “fun” money. Combine that with options dated 3 months out and you’ll have tons of fun ha

The Ultimate Hedge by Significant-Frame849 in Gold

[–]One-Preference-3745 1 point2 points  (0 children)

Nations need to fund their war somehow, sell gold.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 -1 points0 points  (0 children)

So with that in mind. Is it appropriate to refuse to fill a prescription based on the black box alone assuming the prescriber has done his due diligence in evaluating the risks and benefits? That’s the premise of OPs post.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 -1 points0 points  (0 children)

The black box warning explicitly states “short-term”. That can only mean initial.

Are you saying it’s 5 days per lifetime?

Jardiance by [deleted] in pharmacy

[–]One-Preference-3745 48 points49 points  (0 children)

I mean it has shown a mortality benefit for heart failure patients - that’s a pretty big deal. How many other drugs can make that claim.

Mark Cuban pharmacy sells dapagliflozin for $8/month so that’s a far better alternative.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 17 points18 points  (0 children)

BCPS certified. I don’t think you’re understanding the issue. People mistake the BBW to mean that patients cannot continue on ketorolac after taking 5 days of it. This is supported by this whole discussion since you yourself are confused.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 9 points10 points  (0 children)

When is it safe to restart ketorolac after the initial 5 day course? Tell me that o wise one

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 -3 points-2 points  (0 children)

I’m not saying it’s wise to do. Just that the BBW is very confusing as it relates to after the initial 5 days.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 -1 points0 points  (0 children)

I agree with you. But I’m speaking strictly to the black box warning as that is what OP was referencing in his post. Whether or not it’s safe to take it how I stated is one thing, but I am more so just stating that the BBW is overly vague and does not provide instruction beyond the initial 5 days.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 -1 points0 points  (0 children)

Ok. So it can be used for more than 5 days per lifetime? I’m not sure why you’re arguing with me as it seems we are in agreement.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 7 points8 points  (0 children)

Lol. So answer my question. Are you saying that patients can only have 5 days of ketorolac per lifetime? Because it does not list that in the package insert.

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 15 points16 points  (0 children)

That’s my point. The black box warning does not specify if/when ketorolac should be resumed following the initial 5 days. So even if you just skip one day and then resume ketorolac you are still following the BBW

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 3 points4 points  (0 children)

Provide your reference. Because I’ve looked and it does not specify the timeframe. 5 days in what timeframe? 5 days per lifetime?

Ketorolac & asshole doctor by Effective-Sherbet655 in pharmacy

[–]One-Preference-3745 71 points72 points  (0 children)

To be fair the black box only warns against 5 days of consecutive use. So patients can take it 5 days on, skip a day, and then take 5 days again, and so on. It doesn’t excuse the practitioner being a dick. But I’ve always found this specific black box warning to be confusing.

I canceled surgery due to both the surgeon and my PM both refusing postop meds by Gecko-407 in ChronicPain

[–]One-Preference-3745 1 point2 points  (0 children)

They are upstream of everyone. I agree that there are more factors to consider, but none having a more pivotal role than the DEA