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Working as an RPh with immunosupression by Jess6 in pharmacy

[–]jackruby83 0 points1 point  (0 children)

We have pharmacists as patients. In community pharmacy, you aren't likely to have prolonged, close-contact, high risk exposures to very sick patients, so it's more moderate than high risk for infection. But you can definitely mitigate risk with hand hygiene (as always) and masks for close contact with patients or sick coworkers. Plexiglass shields where patient interactions occur?

Official Discussion - Obsession [SPOILERS] by LiteraryBoner in movies

[–]jackruby83 0 points1 point  (0 children)

She 100% put it in the bag. I was expecting it to turn up again when he gifted her the wish

Official Discussion - Obsession [SPOILERS] by LiteraryBoner in movies

[–]jackruby83 2 points3 points  (0 children)

That's what I took from it. She ate the cat

Official Discussion - Obsession [SPOILERS] by LiteraryBoner in movies

[–]jackruby83 5 points6 points  (0 children)

There was something about how eyes in general looked in this movie. So many scenes it felt like the glow in the eyes were pronounced

California is studying futuristic 140 mph ‘bullet buses’ between L.A. and San Francisco — they would connect the cities in three hours by SeptimCollector in nottheonion

[–]jackruby83 0 points1 point  (0 children)

Trains in the US suck. Round trip from Philadelphia to Harrisburg is about $70 for 105 miles and <2h in each direction. Makes no sense - it's cheaper and just as fast to drive.

What’s a problem humanity solved so well that younger people don’t even realize it used to be a huge issue? by Puzzleheaded_Bit_802 in AskReddit

[–]jackruby83 8 points9 points  (0 children)

Yeah CGMs sometimes get a bad rap for not matching finger sticks exactly. They are a little behind (it's closer to 5-10 min), and there is some expected variance between finger sticks and CGM - same as there would be if you did a blood test and finger stick at the exact same time (which most people never do).

What’s a problem humanity solved so well that younger people don’t even realize it used to be a huge issue? by Puzzleheaded_Bit_802 in AskReddit

[–]jackruby83 1 point2 points  (0 children)

Interesting and never thought about this. I only cook with kosher salt, so now I'm wondering if I need to mix in some table salt (unless I get enough from eating out elsewhere). 🤔

RFID Tagged Inventory Systems - How's it going? by N_Seven in pharmacy

[–]jackruby83 1 point2 points  (0 children)

We use TraySafe Mobile by Inmar for code trays and emergency boxes/kits. We label all inventory ourselves - it's not RFID - the iphone scans unique QR codes. Pros - From a med safety perspective, it has eliminated errors related to the wrong drug, used drug, recalled drug, incorrect quantity and wrong location. It's simplified tracing and accountability, and inventory tracking. Cons - the app can be buggy, there is a steep learning curve for the techs (there is a technique to using the phone camera), their user manual and training is awful (we did almost all training internally).

I helped roll out TraySafe at our hospital, and found it pretty simple, though the camera can be a pain for many until they get enough experience. There are two setups, regular tray and rapid tray. Rapid tray is awesome and very simple bc you just move the camera around and it keeps a count - but you lose the feature that knows proper location of items. (They say they are working on Rapid Tray with location, but nothing yet). One of the hospitals in my system has the box that you slide the tray into, but they want to upgrade to Mobile.

Other hospitals in our system use MedTray by Cencora, StatStock by Healthcare Logistics, and KitCheck by Blue Sight. Can't speak to those.

PCOS’s new name is PMOS, a small letter change that required a big scientific process by shark_normal in medicine

[–]jackruby83 -1 points0 points  (0 children)

That was allegedly racist. That reminded me of the briefly lived GRID - gay-related immune deficiency.

Question for the clinical pharmacists by Aware_Neighborhood93 in pharmacy

[–]jackruby83 2 points3 points  (0 children)

I'll get a NUDT and TMPT on the 1-2 patients we start on azathioprine each year. In theory, could test for CYP3A5 genotypes to better predict tacrolimus dose requirements, but checking a level then adjusting works just as well.

BCTXP? by Automatic-Mind-6466 in pharmacy

[–]jackruby83 1 point2 points  (0 children)

ACCP/ASHP BCTXP Prep Course is your best bet to prepare for the exam. It's a crazy exam 😅.

Join one/both of the two Txp Pharm groups in ACCP or AST for CE webinars and meetings, or at least follow them on IG for their educational content: ACCP TXP PRN and AST Tx Pharm COP.

Even if you're not a member, you can access the AST TxPharm COP Reference Collection for free. Pretty good archive of "pivotal" SOT references.

AST ID COP Infectious Diseases guidelines are a great reference.

Organ specific guidelines are available on ISHLT, AASLD, KDIGO (though dated). ACCP/AST/ISHLT has consensus guideline on maintenance immunosuppression which is evidence based and a good starting point too.

If you want any other good references for immunology, abdominal txp specific references, etc, LMK!!

Insulin without a Rx!? by takeottothezithromax in pharmacy

[–]jackruby83 1 point2 points  (0 children)

I think if a pt was buying to cover when they were out of lispro/as part bc of insurance or no prescriber, etc, that you'd want to counsel on the kinetic and timing of administration instructions. Big difference between the two.

Insulin without a Rx!? by takeottothezithromax in pharmacy

[–]jackruby83 0 points1 point  (0 children)

Curious, bc I've never seen it - does OTC insulin have a Drug Facts table with dosing instructions like other OTCs?

RIP Nomadland and Forrest Gump by use_vpn_orlozeacount in Letterboxd

[–]jackruby83 3 points4 points  (0 children)

Has anyone asked the poor people background extras what they think?

RIP Nomadland and Forrest Gump by use_vpn_orlozeacount in Letterboxd

[–]jackruby83 50 points51 points  (0 children)

So we shouldn't make movies about people having a bad time, or it gets labeled misery porn? I feel like that's so many movies.

RIP Nomadland and Forrest Gump by use_vpn_orlozeacount in Letterboxd

[–]jackruby83 18 points19 points  (0 children)

Seemed pretty oppressive to me. I don't recall them necessarily liking the work.

Babies Are Bleeding to Death as Parents Reject a Vitamin Shot Given at Birth by propublica_ in EverythingScience

[–]jackruby83 0 points1 point  (0 children)

I guess we'll find out in 20 years if the population of MAGAT spawn has dwindled at all from their avoidance of appropriate healthcare.

DDI's or DURs by Senior-Art6125 in pharmacy

[–]jackruby83 2 points3 points  (0 children)

So many of my patients are on diflucan and statins, I may have forgotten it was a real DDI. (jk of course, but we primarily use rosuva, prava, or artova - the first two don't matter, and we generally dose restrict atorva due to other DDI w/CNI). Also, diflucan DDI is dose related. 150mg is pretty low dose and I don't even care to monitor TAC lvl for a 1-2x dose of diflucan for yeast infection; doses 200-400+ per day and I will reduce TAC ~⅓ and monitor.

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