Blogs

Phenytoin IV Dilution

By Gail Sanchez posted 8 days ago
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Hi ASHP Community, Anyone willing to share how you are diluting IV phenytoin doses in order to have a final concentration of no less than 5mg/ml? Thanks so much! Gail Gail M. Sanchez, PharmD, BCPS, DPLA Cambridge Health Alliance
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city depopulation

By Dennis Tribble posted 12 days ago
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One of the benefits of being retired is that I have more time to read. One article from Popular Mechanics described research indicating that our cities are losing population and may lose as much as 23% of their population by 2100. While the article seems a bit sensational, I found it worth of a read, and it made me wonder whether our long-term healthcare planning was based on economic and population models that may turn out to be wrong. The article asserts that the most significant depopulation will likely occur in cities in the Northeast and Midwest, some of which may experience population collapse. If true, the article points out that the impact of that ...
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Use of GLP-1 Receptor Agonists Prior to Surgery: When to Hold

By Lindsay Rakowski posted 28 days ago
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Hello, my name is Lindsay, and I am a PGY-1 inpatient pharmacy resident. I am currently doing a drug investigation on when to hold GLP-1 receptor agonist injections (Trulicity, Ozempic, Mounjaro/Zepbound, etc.) prior to any surgery. At my institution, the practice has been to hold off on giving the injection for 7 days prior to surgery. The question has become, is 7 days enough time for the GLP-1 RA to not have an effect on the return of bowel function after surgery? And, if it is given sooner, will that effect the patient's outcome after surgery? I was wondering if there are other practitioners on here that have had experience with this subject and how long ...
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Professional Development Connect Blog Series: Unique Leadership Opportunities

By Deanna Laughlin posted 11-01-2024
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Embracing Growth Through My Role as IPSF Regional Project Officer Stepping into the role of Regional Project Officer for the International Pharmaceutical Students’ Federation (IPSF) PARO Regional Working Group has been one of the most rewarding, unique, and challenging experiences of my pharmacy journey. This position has not only broadened my understanding of global health but also instilled in me the principles of a growth mindset—the belief that challenges, feedback, and continuous learning drive personal and professional development. Leading with Purpose As the Regional Project Officer, I’ve had the privilege of coordinating projects across multiple ...
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Is Healthcare nutty?

By Dennis Tribble posted 11-01-2024
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Although retired, I continue to monitor publications about healthcare in general, and pharmacy in particular. Most recently (1-26-2024) I encountered an article in Becker's Health IT and CIO Report in which it is reported that Amazon CEO Andy Jassy described modern healthcare (not the journal) as "just kinda nutty" . I must confess that my knee-jerk reaction before I actually read the article was that this was going to be how making healthcare more like a business would make it better. I was wrong. The focus of this brief article was about all the inconveniences our current healthcare systems impose on patients. He describes "making an appointment sometimes ...
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Professional Development Connect Blog Series: Research Projects

By Deanna Laughlin posted 10-25-2024
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Ready to dive into the world of pharmacy research? Whether you're aiming to boost your CV, explore your interests, or contribute to cutting-edge advancements in healthcare, finding the right research project can make all the difference. Embarking on a research project as a pharmacy student can be both exciting and daunting. Many students struggle with where to start, how to find the right opportunities, or feel overwhelmed by the process. Leverage faculty connections! Ask professors about opportunities to join their projects or if they can connect you with their colleagues Choose a topic that interests you! Explore something that aligns with your ...
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Professional Development Connect Blog Series: Networking

By Deanna Laughlin posted 10-18-2024
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Networking can be a scary process because it means that you need to put yourself in the limelight. Be confident in your abilities and show that other person that you are valuable of their time. Pharmacy students start with a set number of metaphorical “doors” when they enter pharmacy school. The difference between growth opportunities when you start and when you graduate is the networking you do while you are still in the learning years. Networking is a skill that will serve you long after graduation, into your profession, so what better time to start than now? As you have probably heard by now, pharmacy is a small, small world. We are a impactful and evolving ...
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Professional Development Connect Blog Series: Finding an Internship: A Crucial Step for Pharmacy Students

By Deanna Laughlin posted 10-13-2024
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Finding an Internship: A Crucial Step for Pharmacy Students For pharmacy students, one of the most important milestones in our professional journey is securing an internship. Whether it’s within a community pharmacy, hospital setting, or a specialized area like infectious diseases or oncology, internships provide valuable, hands-on experience that complements our academic learning. As someone who has gone through this process, I’ve realized that internships are much more than just a requirement—they are a critical opportunity for growth, skill development, and career exploration. Why Internships Matter for Pharmacy Students Pharmacy is a dynamic ...
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Professional Development Connect Blog Series: Why Joining Student Organizations is Vital for Pharmacy Students

By Deanna Laughlin posted 10-04-2024
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Why Joining Student Organizations is Vital for Pharmacy Students Pharmacy school is a challenging and transformative experience, filled with countless opportunities to learn, grow, and prepare for a fulfilling career. Amidst the rigorous coursework and clinical rotations, one of the most enriching experiences for any pharmacy student is involvement in student organizations. As someone who has had the privilege of leading and participating in several student groups, I can confidently say that joining these organizations is more than just a resume booster—it’s an invaluable part of shaping your personal and professional identity. Why Student Organizations ...
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Reimagining acute care medication distribution

By Dennis Tribble posted 09-07-2024
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I need to state up front that these are my opinions which are a bit off the beaten path. You are welcome to disagree with me, as I know many will. This year contains the 50th anniversary of my graduation from pharmacy school, and my 50th year as a member of ASHP. During those 50 years, I have the opportunity to work within a completely floor-stock based medication delivery system (nursing was in charge of it all), individual in patient prescription systems (both with, and without a patient profile), the origins of unit-dose drug distribution (including cart exchange), the introduction of pharmacy-based IV admixtures, and the introduction and use of automated ...
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Double checking AI

By Dennis Tribble posted 09-01-2024
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I read an interesting piece in Beck e rs this morning (9/11/23) from the Wall Street Jou rnal about a health system that is teaching its employees to double-check AI and is even considering enforcing signoffs on activities. I will admit to a bit of ambivalence about that if only because in healthcare there is rarely someone whose job it is to do double-checks. In my experience, it is more common that someone stops rendering care to double-check another’s work, whether it be a human or AI. I worry about what happens when one adds an administrative burden ( e.g., signing off on a ...
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What is the Future of Telehealth and Pharmacy Practice?

By Addison Ragan posted 08-22-2024
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This is a question I have been pondering lately as more and more data suggests alarming future healthcare worker shortages. The US Department of Health and Human Services healthcare workforce projections published this year estimate there will be a 23% shortage of primary care providers and a 55% shortage of psychiatrist by 2036 1 . The projected provider gaps are worse in regions of the country deemed medical care “deserts”. Is this an opportunity for pharmacists to help fill these provider gaps using telehealth modalities? The pandemic served as a forcing mechanism requiring all healthcare providers including pharmacists to pivot from traditional face-to-face ...
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Redefining Influence: Beyond Social Media in Pharmacy Practice

By Sierra Richard posted 08-19-2024
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Written by Alissa Clayton, PharmD, Sierra Richard, PharmD, BCPPS, and Hope Rockett, PharmD, MS The concept of "influencing" in the modern era often conjures images of social media stars and digital trendsetters. However, in pharmacy, influencing extends far beyond Instagram and X (formally known as Twitter). This paper aims to reimagine and challenge the traditional notions of influence within the world of pharmacy, highlighting the multifaceted ways professionals in this field can impact their community, health systems, and healthcare at large. Through redefining pharmacy's influences, we highlight the essential role of pharmacists in driving healthcare ...
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Recent article on AI

By Dennis Tribble posted 08-04-2024
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Just got my most recent paper edition of AJHP (July 15, 2024) and read Steven Smoke's commentary entitled Artificial intelligence in pharmacy: a guide for clinicians . In this article he articulates five principles that seem quite appropriate. His fifth principle, Pharmacists must use AI responsibly is one that I think deserves special attention. I respect that responsible use of AI must include appropriate use and citation if generative AI is used to prepare any kind of publication. I was disappointed that the discussion of responsible use stopped there. As noted in a previous blog , our historical use of automation (in my experience) indicates that we ...
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Automation gone wrong: Misalignment of tools and outcomes

By Dennis Tribble posted 08-01-2024
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I just opened a daily blast from Beckers and happened across an article in which John Halamka, MD of Mayo Clinic reports “going from paper charts to fully digital ended up losing the hearts and minds of clinicians and nurses.” He goes on to describe that physicians were handed an automated record that requires them to type data into 140 data fields for every patient visit (which apparently average about 11 minutes). How does the physician actually see the patient with any empathy at all and still manually enter data into 140 fields? I have tended to experience this from “the other side” of the discussion (as a patient) in which it felt like my physician ...
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the undervalued department

By Dennis Tribble posted 07-29-2024
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My morning cruise through Becker's this morning (7/29/2024) yielded an article from last Tuesday entitled An untapped opportunity within health systems . Not surprisingly, it talked about Pharmacy with discussions from Patrick Falvey (COO Baptist Louisville, KY) and Michael Evans (CPO Geisinger). A little interesting history in the article. What caught my attention was that I thought we were past this. In this same publication I have seen lists of Chief Pharmacy Executives and other discussions that seemed to indicate that we had arrived; that our value was recognized and understood. This article made it seem like there is still a long way to go. Before ...
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Clinical pharmacists in high demand

By Dennis Tribble posted 07-14-2024
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In reading through Becker's this morning, I happened upon an article entitled Healthcare's most in-demand, fastest-growing jobs . This article has two lists of 10 job titles each: Healthcare's most in-demand jobs Healthcare's jobs with the fastest growing demand Not surprisingly, many of the jobs on the first list (7 out of 10) are nursing jobs. Interestingly, the role "Clinical Pharmacist" was listed as one of the ten jobs with the fastest growing demand. The article gives no indication whether the list is ordered by any criteria, so it is hard to say whether the position of that role (9 out of 10) indicates its speed of growth compared to ...
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Should payors determine what is on a formulary?

By Dennis Tribble posted 07-01-2024
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I just read in a newly released edition of Pharmacy Practice News where many practitioners believe that formulary content for high-cost drugs may be determined by payors. The notion in this article seemed to be that something should not be on the formulary if some payors will not pay for it or may require an extensive pre-approval process. This seems to me to conflate to essentially unrelated issues: Whether the drug is deemed useful and appropriate for use in the health-system Whether the drug will be fully or partially reimbursed for particular patients While cost-effectiveness is always part of the formulary decision, it seems to have been given ...
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Drug Supply Chain Security Act (DSCSA) 201 (Part 2): Pharmacy Advanced Overview FAQ

By Stacy Carson posted 06-26-2024
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Drug Supply Chain Security Act (DSCSA) 201 (Part 2): Pharmacy Advanced Overview FAQ Authors: Sang Kit (Stephen) Wat, PharmD, MPH, MS, BCPS; Zachary Hagen, PharmD, MHA, BCSCP, 340B ACE SAG: Operations and Automation; Workgroup: DSCSA 1. Who does the DSCSA authorized trading partner requirement apply to? a. Manufacturers, repackagers, wholesale distributors, third-party logistics providers, dispensing pharmacies 2. What are the requirements of becoming an authorized trading partner? a. Licensure – Trading partners must either be appropriately licensed or hold a valid ...
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Quiet Ambition

By Dennis Tribble posted 05-31-2024
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I read an interesting article in Beckers today about what some are calling ‘quiet ambition’ entitled “Quiet ambition could spell trouble for succession plans”. To quote the article, quiet ambition “is the idea that workplace achievements should not be chased just for the sake of them, and the acknowledgement that a company's bottom line might not align with one's personal definition of success.” This is not to say that they reject the responsibility to be productive. Rather, it is an indication that an individual may have personal goals with which “climbing the ladder” would interfere. Some of the statistics were interesting. In a survey of 1,000 U.S. employees ...
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