As I reflect on my Professional life of the last 30 plus years in this great, but needlessly floundering Profession of Pharmacy I am simply amazed at really how little national pharmacy organizations like APHA. ACCP and ASHP have done for the Pharmacy Profession.

Basically all they have done is advocate for Pharmacists Provider status which is something most Pharmacists including me don't want.

In ACCP's case they spent a lot of time opining and white papering about how to qualify would be Pharmacy providers before any type of meaningful Pharmacist Provider status was passed.

While doing this look at the things lost. Tens of thousands of independent Pharmacies have closed as have slower retail locations

PharmD students brainwashed that hospital pharmacy after doing a residency is the only pathway. Community Pharmacy abandoned.

PBMs destroying our profession

Health systems destroying our Hospital's

Another Pharm D school open. Nothing but crickets and conventions by the big Pharmacy organizations

Where are any of these organizations on the future of AI in Pharmacy?

Thanks big Pharmacy Organizations for nothing!

Throughout pharmacy school (at least in my experience), Pgx was touted often as this 'next big thing' where precision medicine was gonna change the paradigm of patient care. However, even professors that was the idea back even EARLIER in their practice.

The only thing 'carrying' PGx from what I can observe is namely oncology (targeted therapy eligibility), and a few variants to test for in order to prevent severe, catastrophic adverse events (HLAs, DYPD).

However, and it could be reporting bias, I rarely see it ever used unless it is one of the above, usually at an institution "spearheading PGx". I'm curious to know if providers will mention or consider a CYP2C19 test when considering which PPY12 inhibitor to choose, or 2C9 for warfarin.

I have yet to see in my experience someone factoring in say, CYP2D6 polymorphisms in their beta-blocker selection, or CYP2C19 in their PPI selection.

If anyone works in specialty, is PGx testing done if it is part of the FDA's package label requiring testing for dose adjustments? Does anyone use the available CPIC guidelines in practice?

Just seems PGx is a great thing for an academic career, hard-pressed to say its being used irl...

Does anyone have experience with IM levothyroxine? I’ve got a patient with refractory hypothyroidism and isn’t absorbing oral tablets. Provider wants to try once weekly IM injections. From what I’m seeing there is some evidence showing the weekly dose can be administered, but that would be a large volume (15mL).

Patient with the same last name was given Fentanyl instead of estradiol patches…

Does anyone here currently work as a Utilization Management Pharmacist at Capital Rx? If so, I’d love to hear about your experience. How are the productivity metrics and overall workload? Is the role manageable, and how has your work-life balance been? Any insights would be greatly appreciated.

Contacted her and she confirmed she really want to start at this dose...

I’m looking into compounding as a route that I’m interested in pursuing, and I was wondering what the pharmacist’s role typically looks like in a compounding pharmacy. Do pharmacists actually get to compound and prepare medications themselves, or do compounding pharmacists primarily verify prescriptions and review the formulas and procedures?

I know this will be state specific, but I am wondering if any Minnesota-based pharmacists are administering IM or SQ meds to patients when you get a prescription for it (Prolia, vit B12, etc.). The mental health meds I know we have specific legislation on and has been established, but I am curious about others and if there is any specific protocols or considerations to factor in.

I work as an RN at a privately owned outpatient oncology infusion center. My training and experience is from a very well respected cancer research center . Since I moved and started at this private physician owned center I’ve struggled at the lack of safety protocols and double checks. In the 18 months I’ve worked here I have caught (and reported) multiple medication errors when drugs come out from the pharmacy. Today a drug came out with a label saying it was 248ml total volume to be infused over 1 hour. As I was hanging the bag with the 2 RN bedside check, I realized it was actually in a 100ml bag. So the drug wasn’t diluted appropriately. And it would have infused at 2.5x the ordered rate.

This, along with multiple other safety issues I’ve been advocating to change, gets ignored/brushed under the rug by management. I have lots of email documentation about it. It’s time to escalate.
Who do I call? Department of Health? We aren’t regulated by JCHAO.

I tried taking vacations to see if it’s just a phase. I love my pharmacy team so much and my manager is beyond amazing. It’s just when I deal with patients my mood is put off and I become very robotic. It’s like a few bad apples ruined my whole mood for everyone. I’m going to talk to my therapist about this. I started YouTube and made my first $100 I might take the risk and quit and become a full time YouTuber

Currently working in a corporate 503b and wondering which is a better or more stable career path? Would you rather take the opportunity to work alongside a knowledgeable PIC who's willing to train you to manage/lead a new and unknown 503a or stay within large corporate 503b with chaotic operations and blind leading the blind feeling. How much would the compensation difference have to be to choose one or the other? Don't want a grass is greener syndrome but want to account for each positive/negative for them.

I just finished the online portion and I wondering if I need to hardcore study the entire thing tomorrow. Was it difficult? Also since I did the online portion, how long will the on hands session take?

Hello, guys . I’ve been working remotely for almost 4.5 years and lately been job hunting and looking to make a jump into another role internally with my employer . I currently work in patient consultation. I found a PA position with my employer and within hours , nearly 500 people applied . The advantage I have is that I am already an employee with the company and had my name referred to the hiring managers . Question- if hired and offered a selection of schedules , would you work four 10-hour shifts and have Friday, Saturday, and Sunday off or work Monday through Friday working 8 hour shifts ? The 4 10’s seems enticing because of a long weekend every week but it’s also a longer and potentially more tiring day . Anybody here who can chime in or maybe does PAs all day who can tell me what it would be like working 10 hour days four days in a row ? Any other benefits I’m not thinking of at this time ? Thanks .

Would like advice on GLP-1 only compounding pharmacies (503a) and future

I just interviewed and was offered a position at a GLP-1 only compounding pharmacy. However I'm concerned about the Eli Lily lawsuit and future. GLP-1s are not on backorder anymore, and there's the new bridge GLP-1s for Medicare.

These are the articles I found.

https://www.goodrx.com/classes/glp-1-agonists/compounded-glp-1-going-away?srsltid=AfmBOorkE7ODRZHikfmbc2IF4tXDu4UVn4ZdkBMGdZ0F6czOr9vCjIcb

https://www.houstonchronicle.com/news/houston-texas/health/article/glp-1-lawsuit-empower-pharmacy-eli-lilly-22233199.php

https://www.pharmacytimes.com/view/fda-narrows-compounding-rules-for-glp-1s-how-pharmacists-should-respond

https://www.pharmacytimes.com/view/fda-moves-to-permanently-close-the-door-on-compounded-glp-1s

Anyone have guidelines on switching from Wegovy HD 7.2 to Zepbound? I have a prescriber going straight to Zepbound 10 mg and all I can find is you should restart at 2.5 or 5 mg dose.

Currently working as a clinical specialist (10 yoe) in MCOL earning $170k/yr (40 hrs/wk, fully remote). I feel fortunate to be in the position I am in, but I cannot help thinking there must be options for career growth.

Looking to my pharmacy colleagues for advice/options to consider for further advancement and earning potential. For those that took the next step (management, industry, etc) has the juice been worth the squeeze?

Thanks in advance!

Bit of a nuanced situation, though I'm sure I'm not the first. I was licensed as a Canadian pharmacist in Michigan over a year ago using the state specific clause that allow for Canadian trained pharmacy graduates to be licensed in Michigan using PEBC Qualifying exams. I am FPGEC certified, as well. I am hoping to get licensed Washington State through license transfer, I am wondering whether or not I will be required to do the NAPLEX in order to be licensed there, or whether it will simply be sufficient to pass the MPJE, or I suppose the UMPJE now. My assumption is that I would need the US examination baseline, however, this information is not clear from the information available. Has anyone gone through this avenue before?

Hello! I am an intern helping my preceptor advocate for better pay for her employees. If you wouldn’t mind, please tell me what you make, your region, and hospital chain/name if possible. Looking for info about pharmacists, technicians, and buyer/in-house supply technician roles

We switched from McKesson/Health Mart Atlas to Cardinal/Leadernet on July 1st because leadership got talked into it with a big sign-on bonus. It’s been almost a month now and Cardinal is reimbursing almost nothing (we’re down -$1,623,663.93 net so far).
On top of that, we’re still receiving large ACHs in the bank from McKesson.
Is this normal during a switch? Nobody at the company seems concerned but me.

I have also heard they do not cover Caremark with their Leadernet grouping, is this factual? If so that’s not good for us if we have to negotiate our own contract with one of the biggest payers there is.

I work in a small town mom&pop pharmacy, and we have a parata machine that counts, labels and bottles scripts. I am just a cashier but part of are weekly tasks, is to clean the cells (were the pills are stored in the back of the machine.) and the air filters. We have been doing this for as long as i've been hear ( ruffly six month) and every time I clean the parata I get headaches, runny noses, itchy eyes, and a cough. Now I have been reassured on multiple occasions, by techs and pharmacists that this is safe but we use compressed air to clean them, no masks we dont go outside, and we keep countless different drugs in this parata, narcotics, controles and everything else. We mostly store tablets and not just the film coated ones, I am really starting to worry that this is dangerous. what do yall know?

Hi, I have an upcoming interview with Uhealth (UM) for a pharmacist role. Can anyone share their experience or questions asked?

In my IV room we use dispensing pins or dispensing spikes to draw up doses into syringes for pediatric patients from either commercial available bags like zosyn or vancomycin premixed or compouded stock solution like ampicillin or cefazolin. USP 797 doesn't mention if these bags should remain in the iso class 5 PEC or should be discarded once removed from the hood. In my site, we use the dispensing pin, it is checked by a pharmacist outside the hood, then returned to the clean room. It is dated and discarded within 12 hours. I was curious to see how your site deals with these bags.