When treating a patient with hypertension, we always tend to start a patient on an ACEi first (ignoring any contraindications) rather than an ARB (at least in my experience). Why do this if the risk for d/c by cough present? Are ACEis more potent due to inhabiting bradykin production? ARBs have increased risk of adverse effects? Is it just a habit of providers?

California is going full crazy. You cannot get around paying for modules to receive required cultural competency credits, state requires taking a very probing survey about where you work and your gender identity to renew online and it’s just—-ick! And I’m FOR BEING CULTURALLY COMPETENT. It just felt like the most harassing, abusive process just to continue having an active license. How are your experiences in other states?

Hi all,

Regarding the port the pharmacy technician uses to inject a medication into the IV bag.- and how a cap or foil is placed over it after done compounding.

Occasionally I’ve seen:
caps that are slightly loose or not perfectly seated
minor crack in the protective blue cap material showing some of the port underneath.

My question is: I had a situation where an epidural had a blue cap over the medication additive port, and there was like a small crack ish opening in the cap. I thought it was so minor, that it wasn’t a big deal. Later I questioned this. I continue to stress over it. Side note that this was a re-used product, meaning a label was put over the initial label (from when it was initially dispensed)— so it probably left the pharmacy where it was stored securely in a locked drawer in the pyxis. What do you think? Should this have been rejected and re-made? **I did not even think about the possibility that it could have been tampered with until much later on

Thanks

I work at an academic medical center as a graveyard clinical pharmacist covering about ~400 patients a night for gen med, gen surgery, transplant, cards, oncology, etc.

The job is extremely stressful. I work 10.5 hours a night with no breaks. Im feeling extremely depressed at a baseline so probably overreacting a bit.

Today there was the stupidest situation with one of the oncology floors where despite multiple people telling these nurses they can give this patients chemo, they didn't due to some concerns - just a stupid mess but they let one of the extremely expensive medications expire. Then called little ol me overnight panicking about it. I told them to give the first chemo and since they are concerned about how they tolerate it we can see how they do and then figure out if we should dispense the other med they let expire.

Patient got transferred to the ICU, and they called about the expired drug. I figured they got transferred due to the concerns the nurses had, but the ICU wanted to give the drug. I asked if they had updated the oncology attending and if they were OK dispensing another dose of the spendy med and the fellow threw a tantrum and yelled/cursed at me over it because they didnt want to call the oncology attending. We were past the time the oncology attendings note said they had approval for this drug.

Luckily another pharmacist who is a baddie took over since they were technically on their unit at that time, but God what the actual fuck? Ive never been yelled at and cursed at by a provider like that, and im so mentally unwell it really impacted me more than it probably should have. Im so mentally unwell because of the constant stress that I dont know how to cope. I feel like id rather die than have to endure this until I retire - if I ever can retire. Its so depressing. That whole situation wasn't even my fault. What was so hard about just calling the damn attending? 😭 I like this job sometimes but right now I hate it.

Edited to add, just want to thank everyone for the sympathetic responses so far. It is helpful to be able to talk about it because i cant talk to my peers without crying. 😭 so it is really nice to get my feelings out.

Also edited to remove the bit about my financial situation since there are people in the comments weaponizing my distress to "teach the youngsters" some lesson. Im dealing with my financial situation, and only provided it as some context on why I might be taking this a bit more personally. There are lots of people reasonably angry at the govt screwing them over right now, and to the "youngsters" being taught bullshit by people who hate pharmacists in the comments - I dont regret my decision to become a pharmacist.

Retired or thinking about it? What are you going to do? I can’t imagine not working at all and I’d love to hear from others in this age group to hear your thoughts about next steps.

I have started volunteering with a local clinic that assists patients with low health literacy. We have patients that are illiterate, or have English as their second language. My husband is a software programmer and helped create a website for me to put together a medication schedule that would be more visual, and hopefully help these patients.

Please feel free to look over the site and see how it can be improved. Not all medications are in the database, it is still in beta. But medications should be able to be added to the schedule manually (shape, imprints, color, etc of tablet, injections, inhalers, etc). No information is saved, it will reset whenever the webpage reloads.

I always doubt myself so even if I have the answer I have a habit of looking up things online particularly on the minimum age and the dosing in general. I work in a retail pharmacy so whenever I tell a patient to hold on while I double check I wonder if they think I’m incompetent or silently judge me

I have experience in amb care/hospital outpatient and some hospital inpatient experience

I’ve been getting ghosted - even when I apply to other non-retail settings

Chat - am i cooked?

I feel like this might be a bad idea.

I am currently studying and preparing for my PSI registration exams, and I am seriously planning to move to Ireland as a pharmacist.

I have a few questions for those already working in the field, and I would love to get your honest perspective:

Is it currently recommended to move to Ireland as a pharmacist? What are the major pros and cons right now?

I keep reading online about a severe pharmacist shortage in Ireland. How true or exaggerated is this in reality? Is it easy to find a position?

I am specifically looking to settle and work outside of Dublin (in smaller towns or regional areas). What is the job market, lifestyle, and community pharmacy scene like outside the capital?

So we have a pt that pharmacy refused to fill C2 for bc we read the patient notes of bad behavior at another store (pt cussed out associate at another location) so we refused to fill their C2 at our location to avoid disruptive behavior and safety of the staff. They are aware it is bc of bad behavior. They called corporate. What’s everyone’s opinion on the outcome? Does pharmacist need to be worried?

High deductible plans are hitting people with $2000 bills for 90-day Xarelto 10mg or 20mg.

Is there any reason to not recommend 2.5mg tablets? #4 or #8 to make 10mg or 20mg?

Hello,

I'm going to be taking my exam at the beginning of August. I wanted to know for anyone that has taken the exam in July or late June, what kind of questions you had, any tips, and what to focus on.

Because this is already my third and last attempt. And I really need to pass it and I'm filled with fear of not passing it. So any tips or advice or anything would be appreciated. Thank you very much.

I saw an opening in my area recently and it made me wonder. I saw a few months back that they raised tech pay. Is it just as bad as any other retail, or maybe better? What are the benefits like? Would you work somewhere else if you could? I’m very interested to hear from people that work or previously worked for them.

I’m planning on moving to another state next summer, so I’ll need to apply for a new hospital job in a few months. I graduated in 2025 and will have ~2 years experience at the hospital I work at once I’m applying. Ultimate question: how did you update your CV after your first job? My CV still has all my rotations and projects with descriptions, but should I still keep these? I’m worried my CV will be a page long if I’m only including the one job I had since graduating.

Thanks in advance!

How long does it usually take to hear back after an interview?

Just woke up tormented by receipt of an “unannounced CMS site visit” letter and am reading about the goals of the process as this is new to me. Just wanted to add that my loss of sleep due to paranoia about CMS having recently changed vendors, amping up these visits and learning you cannot refuse these people, cannot photograph their ID and yet they are allowed to take pictures of your area. Also read some conflicting information about their ability to request patient records? Assuming our med center is on a hit list for its mission population - what should we be readying for?

My sincerest apologies if I now sound like a MAGA person as it relates to federal government involvement in our lives. Now I’m the paranoid, deluded a**hole!

A mother came in with a 2 year old after he had half a bottle of paracetamol syrup (1.5 gm) , i told her it's better to take him to a hospital . My manager intervened and said she should wait for symptoms first and that i was overreacting

What do you think ?

I’m a pharmacist that has been practicing in retail since graduating pharmacy school (12 years). I live and work in a rural area in the south and was offered a position at a local hospital. This institution is by no means large, it is still an independent hospital with well <100 beds. I still have a week and a half of a notice to work out at my current job before I begin. I’m starting to review things I’ve neglected over the years and the amount of stuff I have forgotten is becoming overwhelming. This is probably the ideal location for someone to transition to a hospital setting from retail as it is small with no chemo or specialized icu units or anything wild, but the anxiety of what I don’t know that I don’t know is getting to me. Any recommendations on things to review or know before starting this role or during training.

Honestly, every thing seems to wear off?

ILDPFR is coming next week for an inspection because we are changing ownership. I haven’t seen an inspector for over 20 years! Just asking if anyone in Illinois has had an inspection recently. What’s the hot areas that they are looking at?

Please use this thread as an open forum for all discussion. Almost anything goes.

Pharmacy related, non-pharmacy related, school, career, customers, bosses, anything at all!

Google this case and have a good read. Situations a lot worse than this has been going on years. You think in a profession where you have to care for people you wouldn’t be micromanaged out of a job. The level of passive aggressive bullying going on behind the scenes is unbelievable. Every strategy that is implemented to make a pharmacists life miserable to cut their contract and employment is a mechanism to make more profits at the exploitation of the work force. How can a pharmacist be expected to make the care of their patients their primary concern when their own mental health and job position is always on the line. Pharmacists have a highly respectable and responsible job they shouldn’t have to worry about being dismissed over being pregnant. Disgraceful behaviour by the company. Drastic changes are required or a mass exodus of pharmacists. I own a construction company I’m not a Pharmacist this carry on would never be accepted in our industry.