Well, we're dipping into the VBB mailbag once again. This time, we have a follow up to our previous post, Pharmacy Phun.
Joe the Pharmacist writes:
I found your blog through Dr. Grumpy and have enjoyed it. I am a pharmacist and thought I would write and give you the view from our side of the counter.
Unless pharmacy school has changed since I graduated, there is nothing taught about veterinary medicine. I remember being told that we weren't allowed to substitute generics on vet prescriptions unless specifically told to do so, but that could be state specific. I don't know. I don't really have a clue when it comes to dosing a medication for an animal. I'm going to defer to the vet every time. I might have suggestions occasionally, but not very often. Here are some rebuttals to your post and comments:
The DEA number: I know I don't need it for non-controlled substances. I certainly wouldn't push for it. I will ask for it because I might need it in the future. It is especially helpful to have if you get a CS prescription handed to you or on voice mail that doesn't include the DEA. You may always remember to give it, but your agent calling it in might not and some of your MD counterparts suck at it. I can't even count how many times of gotten a CS prescription from Big Teaching Hospital in different city from doctor I've never heard of, with no DEA number. Also, you called me, a licensed professional with a degree, I didn't call you out of the blue demanding your DEA number.
Amoxicillin isn't labeled 25mg/ml. I know 125mg/5ml is the same but sometimes brain farts happen. We're so used to seeing it prescribed one way that we want to be sure we are doing what you want. However, it would only take one phone call for me to realize what you mean and I wouldn't bother you any more.
For a long time, the only way to get hydrocodone was in combination with acetaminophen. There are various acetaminophen strengths and now you can get it with ibuprofen as well. As of this writing, you still cannot get hydrocodone as a single ingredient product. Pharmacist should have called to verify, but I could also argue vet should have known as well. [NB: there is a product called Tussigon, which is hydrocodone/homatropine, which is typically prescribed by vets - that's probably what the original vet was hoping to get. Anyway. Not that important right now... -VBB]
We are very limited to what we can substitute for humans, much less animals. If the doctor prescribes amoxicillin, I can't just give cephalexin instead. Pharmacists doing that could get into some real trouble.
As far as pharmacies dispensing vet products, just wait until Wal-Mart jumps on the band wagon and starts offering them for four dollars.
One of your vets mentioned she should have gone into pharmacy instead. Don't be disillusioned. I find a remarkably similar theme to your vet blog and some pharmacy blogs. Large school loan debts, lack of respect from patients and big chains stealing business away with low prices and poor service. Add poor reimbursement by third party plans and insurance card problems and you have my job.
Thanks for the compliment about our expertise in medications. I'm sorry your colleague has had such poor interactions with other pharmacists. Love the blog. To see the idiocy that we deal with, check out Drug Monkey, The Angry Pharmacist, Pharmacy Chick and the many other pharmacy blogs. I don't have a blog. Maybe soon. For now, you can sign me as:
Joe, we thank you for your words of wisdom, and look forward to that blog you're promising to start any day now!