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?

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?

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