Pharmacy pearls…blog#2

The National Drug Code (NDC) of a product is an essential piece in helping you verify prescription orders. Understanding each piece of the NDC is essential in your everyday pharmacy practice. The NDC is 11 numbers, fitting in the following example pattern: 54321-4321-21. The first five digits represent the manufacturer, the middle four numbers represent the drug and strength, and the last two numbers represent the package size of the drug and/or product.

Let’s use Prednisone 10mg as our example. A link to the drug with picture can be found CLICK HERE. The NDC for this product is 59746-0173-06. Barcode technology is essential piece of most pharmacies. With a typical workflow in the pharmacy following this pattern: Prescription Drop Off –> Order entry –> Fill prescription –> Verification of prescription –> Pickup –> Consultation of drug/device product. The part of the workflow that we will focus in on with this blog post is the verification component, but the barcode technology is also often employed with the “Fill” process in many chain pharmacies as well.

So, many folks don’t realize that the barcode of most drug products uses the NDC as it’s  code. To view a comparison of the NDC in relationship to the UPC barcode CLICK HERE and look at the last two columns on the chart. You will notice that the only difference between the NDC and the UPC barcode number is typically the first and last digits. With the first digit in the UPC code being the number “3”.

  • To recap, the NDC and UPC barcodes are essentially the same, and this technology is often deployed to match drug and device products at the fill and verification process. The pharmacist must know how to express this knowledge to pharmacy technicians and staff pharmacists to ensure patient safety. 

Secondly, understanding the NDC can then be used for the drug identification process. Remember the middle four digits represent the drug and strength. So lets compare Prednisone 10mg (NDC:59746-0173-06) tablets produced by Cadista to Prednisone 20mg (59746-0175-06) tablets produced by Cadista. Please click on the links embedded into the names for both Prednisone 10mg and Prednisone 20mg. Look closely at both tablets, and ask yourself whats the same and whats different?

So, both tablets are round. Both tablets have the markings TL embedded into the tablet. The tablets differ by color. The 10mg tablet is white while the 20mg tablet is more off a light orange. Lastly, take a look at your middle four digits of the NDC. For Prednisone 10mg the middle four digits are 0173. For Prednisone 20mg the middle four digits are 0175. The numbers on the tablet for the 10mg tablet is 173 and for the 20mg tablet is 175. Note: this does not apply to all pills that you will identify during the verification step. However, it is very useful to realize that very often the markings that are used on pills oftentimes correlate with the name of the manufacturer and the NDC. Remember though, this does not apply to all all pills, that you will identify during the verification step. 

  • To recap, the middle four digits on an NDC are sometimes used as the numerical markings on the pill. Thus, along with UPC barcode technology, the pharmacist having this knowledge can help he/she better identify and correctly verify pills during the workflow step known as the “verification process”. Thus, ensuring patient safety. 

If you have a question, please do not hesitate to leave a comment.

***Note: Please refer to the FDA package inserts, your pharmacy’s drug information resources, your state board of pharmacy policies, and your clinical judgement prior to dispensing. And if you still have further questions please never hesitate to contact the drug manufacturer. Information in this blog post does not substitute for your own clinical judgement. ***

***Patients, please discuss all medical and pharmacy options with your physician. This blog post does not substitute for an individual one on one consultation with your physician. In all cases of emergency please always call 911***

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Self help… blog#2

Self help… blog#2

Keep pressing forward. As you move forward in this day, remember the following regarding the “spirit of doubt”:

  1. It is human nature to remember the bad instead of the good.
  2. It is human nature to look for whats wrong instead of right.
  3. It is human nature to focus on your failures rather than your success.
  • To move forward in this life you can not bask in the past. You must be present in the here and now to remain motivated to move forward for the sake of your future.
  • Remember your failures, and remember those things that you wish you got right and yet got wrong. But only bask in the remembrance of failures for a moment.

The thoughts of failures in the moment can and should be used in a manner to allow for you to refocus your energies on maximizing your current opportunities. Please use those thoughts as a map. And with that map reroute your position(s) in a manner to help you gain the correct route for success that you desire.

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Pharmacy pearls.. blog#1

Intranasal midazolam and diazepam are now commercially available. You may notice increased demand from your prescribers for these products because patients may feel that the nasal formulation is less intrusive in comparison to rectal diazepam.

Also many providers may choose to use these products instead of diazepam rectal gel because of administration concerns… as the nasal formulations are deemed easier to administer by caregivers and/or school nurses.

Pharmacists, be careful when dispensing the 15mg and 20mg intranasal diazepam products — please note that each intranasal dose is 7.5mg per nostril for the 15mg product and 10mg per nostril for the 20mg product. This can be somewhat confusing initially as the 5mg and 10mg products do not follow the same pattern of being one-half of the listed dose per nostril (please read package insert to better understand).

Lastly, please refer to the package inserts of each product to ensure dosing is appropriate. In particular for pediatric patients. Please ensure that your prescribers directions are accurate, and that your patients and caregivers understand how to administer the product. Access to these products may be slower than normal due to the pandemic; thus make sure your patients know which pharmacies in their community dispense the product, so that they can make informed decisions prior to and after discharge from the hospital.

FDA guidance intranasal diazepam

FDA guidance intranasal midazolam

***Note: Please refer to the FDA package inserts, your pharmacy’s drug information resources, your state board of pharmacy policies, and your clinical judgement prior to dispensing. And if you still have further questions please never hesitate to contact the drug manufacturer. Information in this blog post does not substitute for your own clinical judgement. ***

***Patients, please discuss all medical and pharmacy options with your physician. This blog post does not substitute for an individual one on one consultation with your physician. In all cases of emergency please always call 911***

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Self help.. blog#1

Self help.. blog#1

I am a first generation pharmacist. I didn’t grow up knowing pharmacists. And I never considered the profession until my high school chemistry teacher told me to consider it as a career path. Once I got to college, I was filled with self doubt as to if I could even accomplish the goal of becoming a health care professional.

I dabbled with various career paths: medicine, physical therapy, etc.. But in the back of my mind, I kept considering what my high school chemistry told me.

I had a college professor my junior and senior year that often spent time coaching us “students” prior to his lecture. At the time I really think much of it, but after self reflection, I realize now that he was offering us “self help” sessions. He wanted us to reach our goals, He wanted to coach you people up to reach their full potential. I naturally gravitated to his candor, spirit, teaching prowess, and charm. And it was simply because he cared.

3 Points to consider: 

  1.  Listen to your family and friends when it comes to what they tell you are your natural strengths.

  2. Listen carefully to the people that you respect, and carefully begin crafting a list of what you’re naturally gifted at.

  3. Be persistent 

Summary of why these ideas are important

It’s very tempting in this life to focus on what you’re not got at. You may even spend alot of time on the things you’re not good at, attempting to overcompensate for your lack of talent in that particular facet of life. However, it’s best that you focus your energy on your God given gifts.

So you’re saying, “forget what you’re not good at?” Nope… I’m not saying that. You still must put the work in to become a well rounded individual; use your time wisely and take advantage of your gifts to maximize your potential.

Once you have reached a conclusion about your strengths, weaknesses, and goals — you must stay focused on the the process that must be undertaken to reach your endpoint. For example, to reach my goal of becoming a pharmacist, one of the endpoints I had to reach was gaining admission to pharmacy school. Write down the process that you must undertake to get from Point A to Point Z. Once the steps have been written down and confirmed with much thought, begin using checklists and a calendar to determine how much time it will take you to reach your desired goal.

Leave no steps in the process blank. Think of what will go right and what will go wrong? Prepare yourself for an outcome that you may not even like, but all the while — remain persistent in achieving what you have determined to be the endpoint.

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

 

Business blog series… blog#3

Books are invaluable. Once again, I was listening to an audiobook on one of my favorite free apps the “Libby App“. The latest book on my audiobook shelf is The Infinite Game by Simon Sinek. In one of the first chapters of the book, the author discusses the difference between a finite game and an infinite game.

Finite games the authors states are games that have an endpoint (sports); while infinite games (politics or business) do not have endpoints, the game continues to be played with or without your presence.

In business, we dub the “cream of the crop” as organizations that have solid foundations in which the structure of the business allows the company to be relevant through both transitions in leadership, times of adversity, and shifts in market supply and/or demand. These businesses remain solvent even during the lean years. Lastly, these organizations in my opinion display a confident “agility to adapt” to customer demand and market variances.

Ultimately the “cream of the crop” have many attributes, but for brevity, these are some of their characteristics:

  1. The end user receives a product free of defect
  2. The product is made with quality and the product is priced to sell
  3. Customers receive satisfactory customer service, that ensures their return and lifetime usage of the product.

The third point is the glue. You can make and/or create a great product, but if that product is on the backend of “shotty” customer service — the service will overshadow the product.

Could you imagine going to a restaurant with a great chef, that has a five star menu but once you get there — the hostess berates you prior to finding you a table to sit?

All great companies have workflow diagrams to maintain consistency in their products. Customer service should not be any different. demands a workflow

Example: Workflow diagram for customer service at Point of Sale

Greeting the customer (upon entry into your establishment)–> asking the customer how you may assist them –> understanding your products and their needs (cost of each product to quickly and effectively answer their questions)  –> completing the transaction in a timely manner –> making eye contact with the customer and thanking the customer for giving you the opportunity to serve their needs

As with all things, there are breakdowns in communication. There can be a misunderstanding or miscommunication with the customer on what is an appropriate expectation/outcome for the requested service. Many things go wrong in a given day, and sometimes these breakdowns lead to bad reviews, negative feedback, and customers that will berate you. But we must always remember that customer service is an “infinite game”. The bad reviews can be painful, but they can open the managers eyes to how to more effectively manage, lead, and understand organizational missteps & shortcomings.

We build trust daily with our clients. Each day, each month, each year you must continue to fight to earn your customers business. There will be times in which your service may be less than optimal, but during those moments — make sure that your customers know how to contact you, so that they can quickly inform you of the given issue. Hopefully you will be able to provide them with a reasonable resolution.

More often than not, I’ve found that many customers simply want to be heard. It is important during these tense moments that you listen with intent. Ultimately, the customer is helping you if the feedback is constructive. If you can take that feedback and change appropriately, you too can become the “cream of the crop”.

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

Healthy Dose Interview

The Healthy Dose ®, is a radio show/podcast hosted by Anthony Bolus, PharmD.

On 12/17/2020 the episode entitled “Flavor or not to Flavor: Getting kids to take their medications” was published, and I was fortunate to appear as Anthony’s featured guest. When I listened to the finished product, I could really tell the effort Anthony puts forth into the production of this show; the quality of his podcast is excellent!

I really enjoyed the opportunity to speak with him, and it’s great to see a pharmacist like himself continue to push the profession forward through his practice of podcasting.

You can view the episode at the following links:

Anchor.fm website

Spotify

iTunes

After you review that episode, please also take the time to view the bank of podcasts Anthony has taken the time to produce in the past!

Thanks for your time!

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Business blog series… blog#2

A great book for business leaders is The CEO Next Door. In the book the author describes the characteristics of folks that have made it to the top of the corporate food chain as CEO of the company.

Of the many characteristics discussed the one that stuck with me the most, is that an effective leader helps people reach their full potential.

But first things first. My mind began to rumble with the following issues… When you’re hiring how do you even know if qualified candidates fit the energy of your company? And once you trust your gut to hire the candidate; how can you determine they’re a good fit to be groomed for mentorship to reach that “full potential.”

In my years of managing people, one of the things that you can do to set your search engine to filter, is by giving the potential candidates looking to move up within the hierarchy of the organization tasks to complete.

Time after time, if you give each person enough opportunities, the cream will certainly rise to the top. Do not give meaningless tasks. Everything should count fair and square. With your focus always being transfixed on bettering your customer service and reducing defects for the consumer of your product. Thus, give the employee a task and deadline to complete the project.

And of course simply completing a project is just the beginning.

Do they complete the project with purpose? Do they complete the task in a manner that makes the business better, and fulfills the customer’s need? Is the work sloppy or is the work timely and on point? Thus, as the leader — your job is constantly to be the teacher. Grading out their work. Asking yourself constantly is this bad work, good work, above average, or great? Is this a bad idea, good idea, above average idea, or great idea?

As a mentor and servant leader you hope that they take your knowledge and push forward with their own ideas and fight for the causes that make them wake up early in the morning. All the while, you keep feeding them with your history and understanding of how things work and operate in the marketplace. Understanding that as you help them, they help both you and the customer.

In summary, servant leaders pass on the knowledge to those that are able to retain the knowledge, work hard and complete tasks in a timely manner. These folks are the type of people that push the needle forward to create better products and customer satisfaction for the consumer of the goods that your business offers.

Thus, to keep your business thriving.. you must Keep fighting for your customers business , keep serving the customer as you best know how, and keep sharing the knowledge with your employees that have ears that listen!

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Business blog series — blog #1

February 2016 I wrote an email to Tony Hsieh who at the time was the CEO of Zappos. I read articles and viewed videos where he discussed his philosophies on business and the management of people while completing my studies for my MBA.

Of the topics he discussed, The Quit Now Bonus fascinated me the most. The idea was that you would give employees an incentive to quit immediately if they felt as though they were trapped or in search of professional opportunities elsewhere.

From a business perspective this killed two birds with one stone. The business would relinquish an employee that no longer wanted to work at the company on good terms with a bonus payment to help them transition to the next phase of their professional life.

From the employees perspective, you couldn’t blame the employer for not giving you an out. And from the employer’s perspective — they couldn’t be seen as trapping you in a contract that you couldn’t get out of. In effect, employers would be helping the employee secure opportunities elsewhere — perhaps even in another state or country by giving you a “quit bonus”.

Thus, from the very beginning, if you took a job at Zappos, there was an unspoken understanding that the relationship was built on the terms of mutual benefit.

Employees would be compensated at a fair wage and benefits and the employer had expectations that you would provide excellent performance and service. If at any point there was a breakdown in trust, and the employee felt they needed to move on professionally, you would give them the incentive to leave immediately rather than languish on with poor performance.

I never expected an email back from Tony, but I wanted to leave him a note thanking him for his efforts. He was letting his ideas become openly shared for public consumption. Which isn’t the easiest thing to do. And because of his ideas and efforts, he was making the lives of business leaders that much more easy by rendering us pieces of his “playbook” on how to manage people.

The toughest thing that you can do in any business is the management of people. Building a motivated workforce that can meet the daily demands of customers while providing excellent communication and customer service is difficult. And, I felt that Tony was running a business in which he understood that building a happy workforce that did not feel trapped or constrained was a key ingredient in building a successful brand and therefore a successful business.

Two weeks later, Tony’s chief of communications emailed me back. He thanked me for my encouraging words and offered me Tony ‘s book for free. The book that he wrote is entitled Delivering Happiness: a path to profits, passion, and purpose.

Sadly, Tony Hsieh passed away November 27, 2020. However, his legacy and achievements in the business world live on. His business philosophies on how to effectively manage people will certainly be studied and mimicked by future business leaders.

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

“Our thoughts.. create our realities”

In my previous post I discussed a mnemonic that I’ve begun to use to stay focused on maximizing my daily activities. I’m also currently listening to the audiobook Atomic Habits. I’ve only started it recently, but it’s definitely a good audio book to have. You can listen to it while completing tasks around your home. I thoroughly enjoy self help books, and the genre typically manifests itself into one overarching theme.

That theme as you may have guessed it, is that your thoughts create your realities. And that once you begin to accept that outlook; you can manifest yourself into the person you believe yourself to be. Your family understands you to be that person, your friends, your peers, even strangers will begin to see you as the person whom you recognize yourself to be.

What’s great about the book Atomic Habits, is that the author gives us a framework for how these subconscious ideas of who we think we are set the foundation for the habits we begin to take on in keeping with this identity.

As I’ve state previously, DR. CC provides me with a gentle reminder to hold firm in the notion that dependability, reliability, consistency, and seeing things to completion are the necessary habits to take the thoughts I have about who I am, and turn these thoughts into positive outcomes and performances.

In short, examine your thoughts. Because this is the first step in altering your current reality. Put the appropriate inputs into your mind, to create the outputs you desire; because simply put…you are who you believe yourself to be.

Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

DR. CC — a mnemonic device for INPUTS to get improved OUTPUTS

I call it DR. CC. It’s a mnemonic device that I use to remind me to stay focused on the things that I feel like I can control in this fast paced life.

  • D stands for Dependable.
  • R stands for Reliability.
  • C, the first C stands for Consistency. 
  • C, the last C — stands for see things to Completion. 
  1. To be dependable and reliable are one in the same. In terms of how I place it in a sentence as a use to reflect upon daily duties and tasks to complete, I think of the following… Be as dependable and reliable as a Toyota Camry. We can all agree, the only thing that most Camry’s need are gas, an occasional oil change, and maintenance.
  2. Never get to up or down. Remain consistent in your daily tasks, and strive for daily outputs that match or exceed the outputs you put forth the day before. As they say, Rome wasn’t built in a day.
  3. Last, but not least… Complete the tasks that you’ve started once you’ve begun. This is particularly important in pharmacy, because it reduces error. See things to completion both at work and at home.

Thanks for taking the time to review this message. And maybe you’ll remember the mnemonic DR. CC! Hopefully it can help you create small improvements in your work and personal life that can help you improve your daily outputs and maximize your potential.

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