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.
***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***
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:
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!
Crestwood Pharmacy and Soda Fountain is a great small business in Birmingham, AL. And the patrons of this independently owned pharmacy receive quality pharmaceutical service and care.
Taylor: Neither of my parents were able to go to college, so they encouraged my sisters and I to attend college.I had a variety of interests in math and science but narrowed it down to healthcare because I am compassionate and wanted to help people in my daily job.I had a couple of interests within healthcare and got a job at a chain pharmacy in high school. I loved the patient interaction and stuck with that chain all through undergrad, pharmacy school, and even a short time as a pharmacist.
Taylor: I always dreamt of owning my own place eventually, but did not pursue that in school. I just worked at the chain and got through school.I never worked in an independent community pharmacy but had an idea of what I wanted to create.I was intrigued in the old-school way that had all but disappeared. After working for several independently owned compounding pharmacies, I decided to take a chance and do it my way.
Sam: Who are the Pharmacists that have influenced you the most and why?
Taylor: Cynthia Doggett hired me when I was 17 at the chain. I was an idiot and acted like a teenager but she stuck with me and taught me a lot. She showed me what it meant to be a professional, and how important it is to be detail oriented, and how to build meaningful relationships with our patients. I have worked with her off and on since 2003.Kelley Millwood is another. She was just a year ahead of me in school and we knew each other then… but we worked together at a compounding pharmacy and she had prior experience and taught me a lot about compounding.Kay Guess. I had a rotation with Kay in a specialty pharmacy in my last year of pharmacy school. She took me under her wing and taught me the world of specialty pharmacy, which eventually led to a job in that area of pharmacy. She and I both, have since left the specialty pharmacy world, but I am thankful for her teaching me so much during that season. I have a better understanding of specialty pharmacy now and can guide my patients in our community to the pharmacy they need if we can’t serve them in those certain situations.All of the pharmacists I mentioned; they all have a really strong work ethic and don’t quit until the work is done.
Sam: What would you like the readers to know about you, your pharmacy, and the services you are currently providing to the community?
Taylor: We are a full service community pharmacy. We offer traditional retail prescription services along with non-sterile compounding, immunizations, and free delivery. We have a good selection of otc products and some natural and local products as well. In addition to the medical side, we are also doing our twist on the old school Soda Fountain.We have ice cream and old fashioned soda and hope to add food eventually.As far as the community piece goes; my wife, son, and I live in Crestwood South — which is about half a mile from the pharmacy.We hope to be here for a long time.
Taylor: Find an area of pharmacy that you love. There are many options for types of work as a pharmacist and it was hard work and costs a lot of money to become a pharmacist, so do something you love.I love seeing the profession grow and seeing the different types of jobs that pharmacists have. I am Excited to watch the provider status topic and even some prescriptive authority perhaps.
Taylor: I love camping, mountain biking, hiking, music, food, coffee. I would love for everyone to come to the pharmacy and get to know us. Come have a cup of coffee or milkshake!
Images obtained from: Crestwood Pharmacy and Soda Fountain Facebook Page
I will upload my personal lecture audio under this post throughout our 8 weeks together.
The lesson manual includes content covering 8 lessons, quizzes, previous final exams, and information pertaining to how to conduct yourself on externship. Please use this manual as your guide to complete this course. It will take both in class and out of class studying to complete each of the 8 lessons. Each lesson should take you at least 4 hours to cover.
Please refer back to the lessons as needed.
I will not print lessons, it is up to you to follow the material accordingly. The links are below.
Classroom to be used: Ethel Hall Building – Room 201
Time: 9:00am – 10:30am
PDF’s for download:
May 1, 2019 Lecture on Lesson 1 :
May 7, 2019 Lecture on Lesson 2:
May 14, 2019 Quiz 1:
Quiz 1 will be given on May 14, 2019. You will have 45 minutes to complete the quiz (9am – 945am). There will be a brief break and then a review of the quiz by your instructor for the remainder of the class.
Quiz 2 for May 15, 2019 will be rescheduled. We will instead cover Lesson 3 and go into more depth review of the material thus far. We will also have a lab to get hands on knowledge of the material covered.
Homework — please continue to keep studying the top 200 drugs from your text. You should now be memorizing pages 4, 5, and 6 of the top 200 from your workbook.
The class average for quiz 1 was 68%.
May 15, 2019
May 15, 2019 Audio Part 1:
May 15, 2019 Audio Part 2:
Quiz 2 will be next Wednesday May 22, 2019 over the top 200. Use previous quizzes from last year to study for Quiz 2. There will be 75 questions on quiz 2 and you will have 1 hour to complete the quiz.
To receive extra credit on quiz 2, please look over the top 200 and type up a summary on 25 drugs of your choice. For each medication — list the brand name of the drug, the generic name of the drug, the classification of the drug, and the body part the drug acts on.
For example… ProAir HFA is an inhaler and is classified as a respiratory agent, the generic name is Albuterol HFA and the body part that the drug acts on is the lungs. The drug acts in a manner to open the airways so that a person can breath normally.
If you type up 25 drugs and do it as I’ve asked you, you can receive up to 25 points extra credit on quiz 2. Remember, it must be typed!!! And you must turn this in on Tuesday May 21, 2019 to receive credit.
Please continue to look over the externship material. Sign the final page of the agreement, informing me that you’re committed to a 40 hour externship, and please talk to DHR and/or JCCEO to inform them of your intentions to become a registered pharmacy technician — you need to be registered prior to going on externship. This costs $103.
Tuesday May 21, 2019 we reviewed Lesson 3 and began covering Lesson 4. We finished the first problem in Lesson 5. Please work on the second question in Lesson 5 and read Chapter 6.
Audio from Tuesday May 21, 2019:
Wednesday May 22, 2019 the second quiz for this session was administered.
After taking into account the 25 point bonus — the class average for quiz 2 was 77.8%
A review of Chapter 6 continued during this lecture post quiz. Please continue to work on Chapter 6 and review Lesson 1-Lesson 5 for class next week.
Tuesday May 28, 2019 the third quiz was administered by Janiece. All those present received a 100% on the quiz.
Wednesday May 29, 2019 we completed Lesson 7 — please continue to review Lesson 7. We reviewed Lesson 5.
Lecture Audio May 29, 2019:
For Quiz 4 prepare in this way:
- Memorize section A conversions from Lesson 5
- Be prepared to answer multiple choice questions that relate to prescription examples Baby Girl Roberts, Janet Jackson, and Henry Ford from Lesson 5.
- Lastly, review the Alligation Hydrocortisone example that can be found on page 184 in your text. This example will be used for your quiz.
June 4, 2019 the quiz will be 25 questions. We will then review Quiz 4 –> proceed to a lab on compounding –> and review Lesson 8.
Please review your syllabus, our time together is nearing the end.
June 4 — Quiz 4 and practical compounding lab
June 18 — Final Exam
June 19 — Review of the Final Exam administered on the 18th and Final Grades
- Please continue to study, work diligently on your pharmacy technician registration, work on your resume’, and begin submitting applications to local pharmacies
- If you find a job as a pharmacy technician or as a pharmacy cashier prior to externship, you will not have to complete an externship.
50 point extra credit!!!!!!
Write two paragraphs describing each lesson that we have completed thus far. We have completed Lessons 1, 2, 3, 4, 5, 7.
Give 2 examples from each lesson and why each example is important in becoming a pharmacy technician.
For example in your paragraph you describe Pharmacy Technician Registration in the State of Alabama…
In Lesson 1 we discussed how to become registered as a pharmacy technician. It is important that pharmacy technicians know that in the State of Alabama we register by using albop.com. The annual fee is $103 with renewals occurring in odd years.
Remember 2 examples from each lesson, each example should be 1 paragraph in length. This must be typed. 12 point font. Times New Roman. Double spaced.
June 4 2019
June 4 2019 Audio —
If anytime remains we will begin covering Lesson 8.
Externships will be emailed out this Friday June 8, 2019. It is your responsibility to contact the Pharmacy Managers/Lead Technicians to setup days that you can complete your 40 hours of training. You will have 3 weeks to complete training. You are exempt from externship if you have found a job in Pharmacy.
June 11 2019 — Janiece will cover Lesson 8/Discuss Externship
June 12 2019 — Practice Final Examination/Discuss Externship
Link to practice final exam — please use your books and internet to study
The final exam will be 60 questions, you will have the full class session to complete.
Topics to cover: pharmacy workflow, prescription benefit card, math conversions, sig codes, pharmacy law, brand/genetics, and pharmacy math!
June 18 2019 — Final Exam/Questions/Discuss Externship — we need copies of your pharmacy tech registrations!
June 19 2019 — Final Grades/Review Final Exam/Questions/Discuss Externship
Tim: I attended Phillips High School (now Phillips Academy) and graduated from Auburn in 1976.
Tim: I was influenced by the two pharmacists that worked at Cowgill Drug in North Birmingham, where my mother worked as a clerk. The owner, Franklin Little, was classy and professional, highly respected by everyone in the community. Everyone called him “Doctor Little”. The staff pharmacist, George Thompson, was a happy-go-lucky guy that seemed to enjoy his job immensely. I admired both very much and decided that I wanted to be a combination of the two.
Tim: In addition to the two already mentioned, I had the privilege of working a number of years for Jimmy Harrison, president of Harco Drugs, and Jerry Thomas, vice president of Harco. They made working for Harco seem like a family business, where everyone was important. When I decided to go back to work for Harco after Big B Drugs was bought out by CVS, I received a personal phone call from Mr. Harrison, telling me how excited he was that I was back. When he made the difficult decision to sell Harco to Rite Aid, he personally hand wrote a letter of apology to each of his pharmacy managers, explaining why he made the decision. It meant so much to all of us. He taught us the right way to treat employees and patients.
Tim: In addition to working at Cowgill as a teenager, I worked at Campus Drugs in Auburn (a Harco store) while in school. After graduation, I did my internship with K-Mart Pharmacy in Huntsville. After I received my license in 1977, I returned to Harco, working briefly in Talladega before opening a new store in Alexander City. I became homesick for my family and friends in Birmingham, and started working for Big B in 1979. I stayed with them for 17+ years until they were bought by Revco, then eventually CVS. By then, Harco had locations in Birmingham and I received an offer from them in 1997. I was glad to be back with the Harco family, but the Rite Aid deal was not long after. I stayed with Rite Aid for about another year. I began hearing rumors about Walgreens coming to Alabama, and started checking about possible employment. I had been told many years before “if you ever get a chance to work for Walgreens, take it!” I had the honor of being one of 3 pharmacists hired to open their first Alabama store, in Pelham. I now have 20+ years with Walgreens.
Tim: The PharmD degree has much more clinical component than the old Bachelors degree. In my opinion, at first, there was a shortage of practical experience with the PharmD students, but I believe that has been addressed and corrected now. When I graduated, the requirements were different in that we had to get the majority of our intern hours after graduation, which gave us about a year of practical experience under supervision. I probably learned as much in that year as I did in 3 years of pharmacy school. The PharmD students get great experience on their rotations in their final year. I think it would have been fun to do that while I was a student. For the most part, I’ve received nothing but respect from my students. They recognize that 40+years of experience counts for something, and that I know what I’m talking about (most of the time).
Tim: I think, over the years, the one rule that causes the most confusion, is the “two signature lines” rule. Technically, if a prescription blank does not have that, it’s not a valid prescription. I understand there is some talk about eliminating or modifying that rule.
Tim: I would tell a new grad that patient safety is the most important thing. If something is unclear, whether it is the drug prescribed, directions for use, potential interactions or contraindications, you must get it right. If you don’t get it right, it doesn’t matter how fast you got it to the patient. Ours is one of the few, if not the only profession, you have to bat 1000, or there’s a problem.
Tim: Student pharmacists are so well educated these days. I feel that sometimes I learn more from them than they do from me. As far as being harder or easier to teach, it depends on the student. Some come to me with no experience in retail. There is a learning curve for them. Five or six weeks is not long enough to learn everything we have to deal with. The ones with retail experience are usually the easiest. I would estimate that I have had close to 500 students, including students on rotation and students that worked part time. I often wish that I had kept a scrapbook of all my students over the years.
Tim: Yes, and no. Pharmacy, especially retail pharmacy has changed so much over the last 42 years. I never dreamed that I would be administering immunizations. I never imagined the impact that third party payors would have on the profession. I never thought I would have to deal with a drive thru window.
Tim: The profession has been good to me. It has given me a nice income, and a sense of being a part of something that helps people. I have derived much satisfaction from mentoring students that went on to be good pharmacists, and any time a patient thanks you for what you do for them, well, it doesn’t get any better than that.
October is American Pharmacist Month. Every October comes and goes, and typically I’ve never celebrated this fact when it comes to Pharmacy. I always liked Halloween parties, but never discussed Pharmacy much outside of the Pharmacy. Only in the past few years have I thought about purchasing food for my staff and/or honoring a fellow Pharmacist with kind words and acknowledgement about our shared calling and responsibilities to the communities that we serve through the practice of pharmacy. I remember discussing Pharmacist Month in school vaguely, but it never really was on my radar.
A few weeks ago, I thought — wouldn’t it be cool if I could interview some pharmacists that I respect and do a brief profile of their careers to celebrate their accomplishments and acknowledge openly my appreciation to what they’ve given to the profession. Simply stated..how can we as a profession move our profession forward if we never discuss our admiration for each other, and/or discuss openly how to create a more open dialogue about how to create a fair market for both consumers and the practicing pharmacist.
Over the next month, I hope to profile up to 8 Pharmacists. Each profile will consist of an interview and picture of the Pharmacist in their practice setting. I hope you as the reader gain an appreciation for the art and science of pharmacy and the people who encompass our profession.
Our first Profile in Pharmacy is of Brad Schmidt, PharmD
Brad graduated from the University of Minnesota in 2001 with his Doctor of Pharmacy. He earned his Bachelor of Arts in Chemistry from Gustavus Adolphus College in 1995. He is the Staff Pharmacist for Peds Rx Pharmacy Solutions and has been my work partner at the Pharmacy since we opened in September 2013.
Sam: How did you come about pharmacy?
Brad: I grew up in a small town — thought about becoming a physician — then got more interested in chemistry when I went off to college — I ended up talking to my local pharmacist in town and got more into the profession from there.
Brad: I got out of pharmacy school — I floated in a retail chain for a while — but, I really didn’t find that rewarding or something I enjoyed (CVS Pharmacy 1 year). So, once an opportunity to work at a pediatric outpatient pharmacy came about I took it (Children’s of Alabama 7 years). Some years went by when I wanted to try something different, so I found a job as a Clinical Pharmacist at UAB (1 year). Then I left that position and took a job doing mail order (CVS 2 years). Mail order was a nice hourly job that was family conducive, but then the facility closed down. Then I moved onto working in Home Infusion (Walgreen Home Infusion 2 years). Then in 2013 we met, and I’ve been at Peds Rx for the past 5 years (Pediatric Outpatient Pharmacy for Children’s of Alabama). So all in all, I have 12 years of pediatric outpatient pharmacy experience. I do like different things, I like changes, and I never wanted to do the same thing for 30 years — so I’ve always believed that you never know your true passion until you try something. Thus, I’ve tried different things over the years.
Brad: Well my wife, she’s a pharmacist, so she understands what I do. In regards to the dispensing role, she understands that we are a resource for information for the hospital, and help patients get their medications situated for discharge from the hospital, do prior authorizations and overrides, and overall increase access for patients to receive appropriate pharmaceutical care… so that’s my wife…But Everyone else in my family thinks I just count drugs and make kids feel better.
Brad: I see pharmacists as being dispensers being phased out — and more medication therapy management reviews like whats being done with Medicare Part D.. I see the role of technology increasing — remote dispensing will continue to push forward — more centralization of pharmacy with Amazon and Big Chains. Less corner store drug stores — less chain stores and more automation with central pharmacies. Independents will continue to fill the void with a niche market.
Brad: I would probably say umm… I would say starting off yes, but after practicing for 18 years — things have changed — there’s less focus on the patients and things have become more number driven. The scope of practice ( clinical positions) isn’t what I expected. Which is good. Residencies were just starting when I was graduating but now most of the graduates look into residencies now. The thing that surprised me is that it’s become less patient focused with the financial pressures due to the market constraints that has created a barrier for entry to the little guy. Which we as pharmacists have to fight for. In school we talk about pharmaceutical care and patient wellness — and in the real world it’s more like fill 500 scripts and just get the work done..
Brad: Unfortunately I think that most times — maybe only a 1/4 to 1/3 of the places I’ve worked at even celebrated Pharmacists month — most of management, patients, and even the parents didn’t know about Pharmacists Month. And even within the profession there’s not a lot of recognition. Only 25 to 30 percent of the time have I received a thank you or been given recognition for Pharmacists Month.Overall I’m glad it’s there, but in reality it’s not as recognized as some of the other professions. We’re not a very organized profession — we’re divided in some ways and because of this there’s division in how we celebrate the month. The nursing association and medical associations bring about the importance of their professions — but when was the last time our association did something to recognize the profession through something like a commercial. The month comes and goes and we go to work and go home. But hopefully as the years go forward we will become more organized and united for the month of October.
Brad: Since they already graduate then it’s too late 😉 laughter…There’s a lot of opportunities out there — the PharmD degree has many opportunities and there’s a lot of diversity within the profession — thus there’s alot of things to be involved in and ways with which you can be challenged. I tell new grads to always take your time in the final check and always go with your gut instincts and don’t get distracted during that final verification step. Pharmacy is a small world so don’t ever burn bridges. Even if you don’t like someone part peacefully. Don’t burn bridges — pharmacy is a small world.
Brad: They are definitely focusing on residency and clinical opportunities — unfortunately they have gotten away from the traditional roles which has caused a bit of a learning deficit. They’re beginning to lack some of the basic skills of pharmacy practice, like understanding dosage forms, etc.. Which causes the newly practicing pharmacist to not immediately understand how to dispense or compound.In terms of the business side — the schools hurt the profession a bit. From 2001-2005 they added pharmacy schools and in 2009 during the recession the job market became tighter. Thus, from a business standpoint the market has become slightly over saturated with pharmacists.
Brad: Only thing I would like to add, is that I’m proud to be a Pharmacist, I’m proud to have made relationships with Patients and staff — but as far as moving forward we need to be more united as a profession and have organization and be united. The times have changed — and we must be united. If we don’t carve out our niche in the new world we could be wiped out as a profession. We need to come together so that we’re not eaten up..
Congratulations on being complete!
Session 2 was successful. Six students completed this non-credit course and did well. They are now prepared to become registered pharmacy technicians and begin the process of becoming functional/capable assistants to practicing Pharmacists in a community pharmacy setting.
The final session consisted of talking, encouragement, and a review of the Session 2 — Final Exam.
Review the Audio of this Session:
The final day of class we took pictures:
If you enjoyed this session please continue to follow my blog and share your reviews of the lecture materials. Review Session 2 Materials if you would like to have a RECAP. T-Shirts commemorating this session are available for purchase on Amazon.com. BUY MERCH — T-SHIRTS SOLD on AMAZON
Lastly, the highlight of the session is when the students took over and became the teachers of the material — that really shows their passion and grasp of the material covered. Check it out yourself!
Thanks again for the memories and congratulations to those that completed the session!
August 1st 2018 😉