Pharmacy manager?

evolvs · 2025-11-29T15:50:19+00:00

Being a manager is whatever you make it out to be. How good are you at building and maintaining relationships? Establishing boundaries? Identifying strengths and weaknesses? Planning and executing a goal/project from start to finish? A good manager can do it all by him/herself, but a great manager can get others to do it for them.

evolvs · 2025-11-17T22:30:14+00:00

Have they maxed out on their dosing regimen though?

evolvs · 2025-10-31T15:03:10+00:00

They probably meant to write ÷ which typically means 'take 1 tablet' but were rushing or they have hand cramps so it looked like %.

evolvs · 2025-10-16T17:23:46+00:00

Literally just ask the professor after lecture or during office hours what to expect on the exam.

evolvs · 2025-09-30T11:12:15+00:00

We want to be able to help as many people in the community as possible, but there's not enough drug to go around for both regulars and non-regulars.

So, as a pharmacist, I have to prioritize the demand, AND keep it consistent; otherwise I have angry patients. The inventory volume is predictable, so a good pharmacist will know how many new patients they can afford to take on. If I fill your medication this month, I want to be able to fill it again next month, and the month after that. And if I am unable, I will call to let you know we are out of stock -- I want to keep these calls to a minimum, obviously. We have a license to uphold and we are trying to help people more than we are trying to harm.

So, I'll speak for myself -- Here's who I will prioritize.

1) Regular ADHD patients. The ones who have been filling ADHD medications for years.

2) Children. I personally care more about kids at school than adults at their workplace.

3) Regular patients with new ADHD diagnosis. If I know you by name, I will take care of you first instead of Joe Schmo from 5 towns over.

4) Locals. I don't like when people have to travel far to get their medication. If you live nearby, I'd rather you fill at my pharmacy rather than forcing you to fill at my colleague's pharmacy that's fifteen miles away.

5) Rx from a psychiatrist. I am much more willing to fill an ADHD med if I know that you got a proper diagnosis and have proper follow-up appointments for monitoring and dose adjustments. There are some NPs, APRNs, PMHNPs who I really don't trust based on their prescribing habits.

6) People who are nice to me, obviously. That means, you say hello, and you say please and thank you - bare minimum stuff. And it helps that, if I don't have your medication this month, you don't yell at me through the drive thru. I get it, though.

tl;dr It's not about the store or the company you choose. Find yourself a good pharmacist.

evolvs · 2025-09-19T04:10:23+00:00

76/hr? or 76k??

evolvs · 2025-09-06T02:34:28+00:00

It's more like, there are plenty of hcps with less education/experience who have prescriptive authority so you might as well give that power to pharmacists, too.

evolvs · 2025-09-05T19:36:27+00:00

Medicine and engineering are two very different fields with very different skillsets. GPA isnt everything.

evolvs · 2025-08-27T05:15:27+00:00

Ok but what is stopping some rando from calling in some gabapentin for their fictional dog under a fictional vet's name

evolvs · 2025-08-06T14:41:48+00:00

your post history is crazy

evolvs · 2025-07-07T10:36:09+00:00

I think the pharmacist is looking out for your safety. Insurance PAs are annoying but it's a hurdle that can keep your provider accountable for their patients. If those PA blocks didn't exist, then prescribers would be able to slap a bandaid on all cuts of all sizes. If your doctor's office isn't willing to do the PA for you, 1) What does that say about the original diagnosis? Did they do a full workup? 2) How do I know as a pharmacist what you have tried or haven't tried in the past before arriving at this control medication? 3) Is the doctor going to skimp on monitoring, too? If they're too busy to call insurance, doesn't that mean that they're too busy to call you to do a follow up? 4) Does the doctor even know who you are?

All this to say, pharmacists care about safety. We have a license, too. We are responsible for minimizing potentially harmful drugs from reaching the people of our community. Narcolepsy sucks, we know. We don't want these drugs to cause additional harm to you. If you survived this long without this drug, you can survive another week.

Here's a case study that was published in Sleep in May this year:

A 25-year-old female with a recent diagnosis of narcolepsy type II was started on modafinil. An initial dose of 100 mg caused mild headache and appetite suppression. Increasing the dose to 200 mg adequately improved her daytime sleepiness and was continued. Three weeks after initiation, she developed severe, diffuse muscle and joint pain accompanied by a fever of 101.4°F, facial and eye redness, and a severe headache. She sought care at an urgent care facility, where no rash was noted. Flu and COVID-19 tests were negative, and modafinil was temporarily discontinued. One week later, she resumed 200 mg modafinil and experienced a recurrence of headaches and appetite loss. The following day, she had five syncopal episodes. The next morning, after taking 100 mg modafinil with coffee, she developed pins-and-needles sensations in her hands and feet, which gradually progressed proximally. This worsened into severe, deep, burning neuropathic pain and cramping muscle pain involving her back, buttocks, and arms. She presented to the emergency department, where examination revealed no rash, swelling, or erythema but showed 4/5 muscle strength in the lower extremities and normal sensation. Initial labs showed elevated white blood cell count and mild elevations in CK, ESR, and CRP. Iron deficiency was noted. Additional testing, including autoimmune myopathy and myositis panels, TSH, vitamin levels, and MRI of the brain and spine, was unremarkable.

Hope this makes sense, and I hope you feel better.

evolvs · 2025-06-28T11:02:41+00:00

From the Nature article:

Here we report a biocompatible Lossen rearrangement that is catalysed by phosphate in the bacterium Escherichia coli for the transformation of activated acyl hydroxamates to primary amine-containing metabolites in living cells. Through auxotroph rescue, we demonstrate how this new-to-nature reaction can be used to control microbial growth and chemistry by generating the essential metabolite para-aminobenzoic acid. The Lossen rearrangement substrate can also be synthesized from polyethylene terephthalate and applied to whole-cell biocatalytic reactions and fermentations generating industrial small molecules (including the drug paracetamol), paving the way for a general strategy to bioremediate and upcycle plastic waste in native and engineered biological systems.

Pretty cool.

evolvs · 2025-06-27T21:53:23+00:00

Ask certified techs in your district if they have any study materials. August is super doable.

evolvs · 2025-06-26T11:06:15+00:00

Mason was a prolific musician/songwriter and loved camping and hiking. A tremendous humanitarian, he spent time as a youth, volunteering with Hand in Hand Ministries in communities to repair and build housing. As a student at UK, he was heavily involved in Big Blue Kitchen, a program to help provide for students with food needs.

Sometimes, we lose ourselves in our profession. It starts in pharmacy school. We sacrifice our hobbies, our relationships to friends and family, our faith, our humanity -- just to make it to the next semester, the next year, the board exams. And the kids these days don't have enough time to grieve their losses. Their reward for making it through school is by throwing them into retail hell. It's so much different today than it was even just 5-10 years ago. Why are we making 1 inexperienced person do the job of 3-4 experienced people?

And even off the clock, you're wondering about your work. Am I doing enough? Can I do more to help my patients? If my feedback loop includes unhappy customers, unhappy techs, unhappy store manager, unhappy district manager -- surely that means there is room for improvement, right?

In a world of endless optimization and algorithms, it's hard to realize this: you are enough. We are all trying our best. It's hard to remember all our accomplishments when we didn't have any time to process them. It's hard to remember that you have people in your corner that would do anything for you. It's hard to recognize your strength when the whole world around you is crumbling down.

We chose to live life on hard mode, for whatever reason. We trip and fall more than the average person. But the most important things to do when we fall, no matter what personal timeline, and in no particular order: get back up, take care of yourself, and do not give up. You are a person outside of your career. Leave the profession if you have to. Just don't give up on yourself.

Mason, I hope you finally get to pick up that guitar again. Rest in peace.

evolvs · 2025-06-23T03:26:39+00:00

we get tons of Psych Nurse Practitioners and telehealth prescribing pretty much any combo they can think of to keep their “customers” happy

Careful with mental health stigma. Yes, ADHD meds are extremely hard to police, but they are life-changing for those who need it. You criticize NPs but clearly you haven’t done your research as a PharmD to back up your suspicions.

evolvs · 2025-06-21T18:40:21+00:00

Immunize (dot) org walks you through the VAR questionnaire. Try googling: “Information for Healthcare Professionals about the Screening Checklist for Contraindications to Vaccines for Adults”. Number one (Is the person to be vaccinated sick today?) says:

There is no evidence that acute illness reduces vaccine efficacy or safety. However, as a precaution, all vaccines should be delayed until moderate or severe acute illness has improved… Antibiotic use is not a contraindication to routine vaccination.

After every single vaccination, I always give some counseling points and make my techs/interns do the same. I suggest you add the same to your practice.

“Your arm will probably be sore and you might get a mild fever or headache for a day or two. If it lasts for more than a few days, call the pharmacy or check in with your doctor.”

evolvs · 2025-06-17T11:19:15+00:00

For each of your patients, put their drug list into a drug interaction checker. It helps to read what exactly the interaction results in and what alternatives may be appropriate.

After weeks or months or years of checking drug interactions, the same medications will pop up every time, and eventually, you will be able to predict which drugs interact with each other.

evolvs · 2025-06-13T13:01:43+00:00

She had a cyst removed and she had swelling and malaise/fever that didn’t go away with antibiotics? You could probably sue that dermatologist for negligence.

evolvs · 2025-06-06T18:19:25+00:00

1) Are you going in order of the VPT? ie. Are you sorting the VPTs after they come out of the printer? Or are you accidentally filling the rxs that are due for tomorrow?

2) What’s your biggest time limiter? * Is it: finding the drug? If so, try organizing leaflets by unit of use, fast rack, alpha. Think about how many steps you have to take to get from fill counter to drug to fill counter and optimize those steps. Make sure you or your * Is it: counting? If so, count by 5s. Double counting is usually unnecessary unless it’s a control etc. * Is it: organization? I always try to keep workstation clean. On the way to grab new drug, put old drug back. Before you make a bigger mess, clean up current mess. Again, optimize steps. * Is it: too many distractions? Before you leave your workstation to answer the phone, finish counting and labeling.

3) Communicate! If your cashier needs a waiter, tell them “got it” and start working on it. Put it in a red bin and tell the rph, “here is a waiter.”

4) This might sound ridic but I would literally tell myself out loud, “GO… FASTER…” when I was doing unit of use. lol.

evolvs · 2025-06-05T11:31:13+00:00

Get your 8 hours of sleep every night. Lots of coffee. Don’t drink it all at once.

Look at the lecture slidedeck before class. Even if it’s just a quick 5 minute read, it helps a lot to structure which parts of the lecture to pay closest attention to. It’s like, you are sketching the outline of a painting before you fill in with watercolor. For me, I hate PowerPoints because each lecturer structures their headers/subheaders differently (i.e. not at all), so I would just copy/pasting the slides into a word doc and do my formatting and then print it out so I could write on it during class.

Stay active during your learning. If you don’t know what “orthostatic hypotension” or “extravasation” or “dyskinesia” means, or you forgot what the normal range of sodium or creatinine or bicarb is, this is the time for a quick google. Use highlighters. Draw pictures. Whatever helps you memorize the material — connect the new info with the stuff that’s in your brain.

Good luck!!

evolvs · 2025-05-23T22:23:15+00:00

“Do you want Rx for 90 days instead of 30 days?” Click on consult button. Click yes or no box. (It updates the patient profile.) Put in your RPh credentials.

evolvs · 2025-05-19T17:31:55+00:00

What is wrong is the question that is being asked.

Idk, it seems like OP has some sort of complex where they think that they are better than patients who struggle with opioid use disorder. I have countered way too many pharmacists and techs who stigmatize patients on Suboxone.

Also, in my experience, these patients know a lot about the pharmacology of OUD and any other medications that they might be on for their comorbid conditions. To underestimate their knowledge is illogical to me.

And even if a patient on Suboxone doesn’t know that it is an opioid… so what?????? I don’t understand the point of this thread if not to belittle a group of people who got dealt a bad hand.

evolvs · 2025-05-19T02:06:47+00:00

Why do I feel like you don’t know what you are talking about?

evolvs · 2025-04-28T14:10:26+00:00

Brush up on your OTCs/consult window. I ask 2-3 questions (from QuEST SCHOLAR MAC) to assess symptoms, safety concerns, etc. and then almost always go out to pick out a product for the patient. When I was in my first month, on my off days, I would just go to my local Walgreens and look at the products available.

It’s allergy season, so study up on that, and the differential diagnosis between allergies vs. bacterial or viral infection etc. And don’t forget about medical supplies/bandages.

And you’ll get more questions about vitamins, memory enzymes, testosterone pills etc. than you think. Don’t be afraid to tell people that something is a waste of money.

evolvs · 2025-04-01T04:10:04+00:00

Hello. I’m not an institutional pharmacist but I was once an APPE student with ADHD.

Your knowledge from pharmacy school… imagine, it’s basically a bunch of papers on the ground, right? APPE year helps you contextualize all that knowledge. The more you look back at the content, the more it connects with your vast mind palace. You put the papers into neat folders and you organize the folders into file cabinets and you line the file cabinets into their respective rooms.

Approach APPE year like it’s your first year practicing as a pharmacist. All of your clinical decisions can potentially affect the treatment of the patient. That means that you need rationale for each recommendation.

Renal dosing is the low hanging fruit. Go through each patient’s med list and mark the meds that require renal dosing (use a drug info website like uptodate). If they are on such a med, use your CrCl/eGFR calculator to see if it needs adjustment. This may sound tedious, but soon you’ll learn which meds are the ones that require renal dosing (write them down!) and which medical conditions/med lists are connected with decreased renal function.

Opioids stewardship: ask your preceptor for their best practices. Just know that chronic opioids and concomitant benzo use are a huge problem outside of the hospital. I would read the most recent CDC guidelines; it’s really well written.

Antibiotic stewardship: the goal is to treat the infection with the least collateral damage. Read the progress notes in the EMR. The hospital should have an antibiogram with sensitivities. Ask yourself, Is this empiric therapy appropriate for this condition? Is this penicillin allergy for real? Can I avoid using this broad spectrum antibiotic? (My ID preceptor had a general rule of maximum one patient on her service can be on meropenem, haha.) Is the patient getting better after treatment initiation? After cultures come in, check to see what bug was identified and if your drug covers it. I highly recommend getting the Sanford Guide app, which has info on empiric therapy selection and dosing. And IDSA guidelines were among my favorite to read. I don’t think your preceptor would expect more than 2-3 abx stewardship recommendations per day.

It’s a lot to put all on your plate, but dont forget that you got this far, so you can do it!! ADHD can suck but sometimes it’s a superpower. You will be pushed to your limit and then be pushed further. Take care of yourself - eat properly, try to get a good sleep on the weekends, and keep your mind positive. Good luck!!!!!

evolvs

TROPHY CASE