http://www.ncpanet.org/home/find-your-local-pharmacy
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“healthcare ” Walmart style – Part TWO
Posted on October 2, 2018 by Pharmaciststeve
Conspiracies Against Wellness 8PM EDT TONIGHT 10/02/2018
Posted on October 2, 2018 by Pharmaciststeve
“healthcare” WALMART STYLE ?
Posted on October 2, 2018 by Pharmaciststeve
Combat veteran Ross F. is about to have his 2nd back surgery and after taking his Rx to the pharmacy at Walmart in Deerfield Beach they would not fill his Rx for post op pain, which surgery is scheduled in 2 days. Ross is an avid herbalist and advocate for kratom. He is also father, husband, disabled combat veterans and a psychotherapist. He said “They want to know why we use kratom, this is why!” He said he’s not even in recovery and now he knows what his patients feel. He said with the level pain he understands why going to buy dope is a viable option being treated and profiled like a drug seeker seems like a viable option. This is why military veterans sought kratom and other healing herbs. This is why educating and protecting safe access to kratom is so much more important now more than ever.
Link below will help you find a independent pharmacy – that WON’T PLAY GAMES WITH PT’S MEDICAL NEEDS
http://www.ncpanet.org/home/find-your-local-pharmacy
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Message to President Trump !
Posted on September 30, 2018 by Pharmaciststeve
Filed under: General Problems | 2 Comments »
Health professionals for patients in pain
Posted on September 29, 2018 by Pharmaciststeve
Health professionals for patients in pain
https://healthprofessionalsforpatientsinpain.org/
Health Professionals Call on the CDC to Address Misapplication of its Guideline on Opioids for Chronic Pain through Public Clarification and Impact Evaluation
Authors: Health Professionals for Patients in Pain (HP3)
Date: September 24, 2018
Any professional who cares for patients, including physicians, pharmacists, nurses, psychologists and social workers, is invited to sign on to this letter, as are any professional organizations that wish to endorse formally.
I. In 2016, the Centers for Disease Control and Prevention, CDC, issued a Guideline for Prescribing Opioids for Chronic Pain for primary care physicians. Its laudable goals were to improve communication between clinicians and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy. The Guideline reflected the work of appointed experts who achieved consensus on the matter of opioid use in chronic pain.
Among its recommendations are that opioids should rarely be a first option for chronic pain, that clinicians must carefully weigh the risks and benefits of maintaining opioids in patients already on them, and that established or transferring patients should be offered the opportunity to re-evaluate their continued use at high dosages (i.e., > 90 MME, morphine milligram equivalents).
In light of evidence that prescribed dose may pose risks for adverse patient events, clinicians and patients may choose to consider dose reductions, when they can be accomplished without adverse effect, and with possible benefit, according to some trial data.
Nonetheless, it is imperative that healthcare professionals and administrators realize that the Guideline does not endorse mandated involuntary dose reduction or discontinuation, as data to support the efficacy and safety of this practice are lacking.
II. Within a year of Guideline publication, there was evidence of widespread misapplication of some of the Guideline recommendations. Notably, many doctors and regulators incorrectly believed that the CDC established a threshold of 90 MME as a de facto daily dose limit. Soon, clinicians prescribing higher doses, pharmacists dispensing them, and patients taking them came under suspicion.
Actions that followed included payer–imposed payment barriers, pharmacy chain demands for the medical chart, or explicit taper plans as a precondition for filling prescriptions, high-stakes metrics imposed by quality agencies, and legal or professional risks for physicians, often based on invocation of the CDC’s authority. Taken in combination, these actions have led many health care providers to perceive a significant category of vulnerable patients as institutional and professional liabilities to be contained or eliminated, rather than as people needing care.
III. Adverse experiences for these patients are documented predominantly in anecdotal form, but they are concerning. Patients with chronic pain, who are stable and, arguably, benefiting from long-term opioids, face draconian and often rapid involuntary dose reductions. Often, alternative pain care options are not offered, not covered by insurers, or not accessible. Others are pushed to undergo addiction treatment or invasive procedures (such as spinal injections), regardless of whether clinically appropriate.
Consequently, patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use. Others have experienced preventable hospitalizations or medical deterioration in part because insurers, regulators and other parties have deployed the 90 MME threshold as a both a professional standard and a threshold for professional suspicion. Under such pressure, care decisions are not always based on the best interests of the patient.
lV. Action is Required: The 2016 Guideline specifically states, “the CDC is committed to evaluating the guideline to identify the impact of the recommendations on clinician and patient outcomes, both intended and unintended, and revising the recommendations in future updates when warranted”. The CDC has a moral imperative to uphold its avowed goals and to protect patients.
Therefore, we call upon the CDC to take action:
1. We urge the CDC to follow through with its commitment to evaluate impact by consulting directly with a wide range of patients and caregivers, and by engaging epidemiologic experts to investigate reported suicides, increases in illicit opioid use and, to the extent possible, expressions of suicidal ideation following involuntary opioid taper or discontinuation.
2. We urge the CDC to issue a bold clarification about the 2016 Guideline – what it says and what it does not say, particularly on the matters of opioid taper and discontinuation.
Signatories here represent their own views, and do not purport to reflect formal positions of their employing agencies, governmental or otherwise. For questions regarding the letter please contact Stefan G. Kertesz, MD, Professor of Medicine at University of Alabama at Birmingham School of Medicine (skertesz@uabmc.edu)
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Meds associated with Stevens-Johnson syndrome
Posted on September 28, 2018 by Pharmaciststeve
RM Alert: Medication Misadventure – Stevens-Johnson Syndrome
Background
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are a group of hypersensitivity reactions that are very rare, serious and potentially fatal. Carbamazepine is the drug most commonly associated with the disease although some antiretroviral drugs, sulphonamides, penicillins, fluoroquinolones, and NSAIDs have also been known to cause the reaction.
The initial symptoms of the reaction are fever, muscle aches, and general weakness for one to three days. Subsequently, the skin develops painful open blisters. If the rash develops, the medication must be stopped immediately. Treatment is much like that of a burn victim including fluid replacement, infection prevention, and pain management. Treatment can last up to a year and many times permanent scaring results.
Lessons
• Carbamazepine is associated with Stevens-Johnson syndrome/toxic epidermal necrolysis in carriers of the human leucocyte antigen (HLA) B*1502 gene.
• The HLA B*1502 gene is most frequently found in Asian populations (Indians, Han Chinese, Thais and Malays). This population has a 10 times greater risk of developing SJS/TEN than Caucasians exposed to carbamazepine.
• The HLA A*3101 allele has been associated with reactions in Northern European populations.
• In 2007, the FDA recommended genetic screening of individuals of Asian ancestry prior to the start of carbamazepine.
Recommendations
• Ensure screening in genetically at-risk populations prior to initiating therapy.
• Review all signs and symptoms of SJS/TEN with all new prescriptions for carbamazepine.
Other insights
The increased use of carbamazepine, especially for control of pain, may be the reason for the increased incidence of SJS/TEN with it.
Awareness of such drugs implicated in life-threatening drug reactions will help physicians in preventing them by judicious use of the drugs.
For patients who are HLA-B*15:02 and HLA-A*31:01 positive, oxcarbazepine, phenytoin, fosphenytoin, eslicarbazepine acetate, and lamotrigine may also be associated with drug-associated cutaneous adverse reactions so these medications may need to be avoided as well.
For Tools & Resources to help you manage risk, members can access the Pharmacists Mutual Risk Management Center (RMC) from the Pharmacists Mutual Member Portal. Visit www.phmic.com, click on “My Account” & follow the on-screen prompts to set-up your free account.
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Opioid crisis impacting pet care
Posted on September 28, 2018 by Pharmaciststeve
LANCASTER, Pa. (WHTM) – Inside Pet Pantry of Lancaster County, there is a logbook for every time a doctor has to use opioids.
“We do use a lot of opioids such as fentanyl and some other things in hospital as anesthetic agents for these immediate operating times,” said Dr. Bryan Langlois, the clinic’s medical director.
Langlois is also the president of Pennsylvania’s Veterinary Medical Association. He said because of the opioid epidemic, drug companies are making less of the drugs and veterinarians are getting less of them.
“The human hospitals are getting the first crack at things,” he said. “We in the veterinary profession are left trying to get what we can.”
The issue is creating a supply and demand problem, which is turning into higher bills for pet care.
“Some prices are going to go up through distributors to be able to get those products,” Langlois said.
Prices aren’t skyrocketing, but some veterinarians are changing their protocols and seeking other options.
Langlois said that’s an issue because he believes opioids work best for pets.
“These drugs are some of the safest ones out there for us to do these procedures with,” he said. “We want to be able, for people’s pet safety, we want to provide the best and safest option that’s out
Where is PETA and ASCPA aren’t they suppose to stand up for the abuse/mistreatment of animals. Neither of these organizations have a DEA license.. thus the DEA has no lethal authority to threaten their existence – like they do prescribers who have DEA licenses if they stand up to the abuse by them.
ACLU seems to also be reluctant to take a stand for the hundred of millions of chronic pain pts that are being denied adequate pain management.
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Time to get your flu shot – it is not all about just you
Posted on September 28, 2018 by Pharmaciststeve
Filed under: General Problems | 6 Comments »
I Demand Justice !!!
Posted on September 28, 2018 by Pharmaciststeve
Filed under: General Problems | 3 Comments »
FDA Offers Pharmacists Opioid Training
Posted on September 27, 2018 by Pharmaciststeve
FDA Offers Pharmacists Opioid Training
http://www.drugtopics.com/fda/fda-offers-pharmacists-opioid-training
The FDA’s new opioids Risk Evaluation and Mitigation Strategy (REMS) plan offers training to pharmacists and nurses for the first time, and adds new labeling for all opioids.
The agency’s final Opioid Analgesic REMS includes several measures to help better communicate the serious risks about the use of opioid painkillers to patients and health care professionals, including pharmacists.
Notably, the new REMS subjects immediate-release opioids analgesics—which account for around 90% of prescribed opioids—to a more stringent set of requirements as well as adds new labeling for all opioids, says FDA Commissioner Scott Gottlieb, MD, in a statement.
The new labeling includes information about REMS-compliant education in the Boxed Warning and Warnings and Precautions sections of labeling and strongly encourages providers to complete a REMS-compliant education program. The labeling also emphasizes to patients and their caregivers the importance of reading the Medication Guide every time it is provided by their pharmacists.
In addition, the expanded REMS requires that 347 opioid analgesics intended for outpatient use be subject to REMS, versus the 62 that were previously required.
The new REMS requires that the education for pharmacists, nurses, and other healthcare professionals cover broader information about appropriate pain management, including alternatives to opioids for the treatment of pain.
“Many people who become addicted to opioids will have their first exposure in the medical setting. Providers have a critical role to play in making sure these products are appropriately prescribed to patients,” Gottlieb says.
The FDA believes that all healthcare providers involved in the management of patients with pain should be educated about the safe use of opioids, “so that when they write or dispense a prescription for an opioid analgesic, or monitor patients receiving these medications, they can help ensure the proper product is selected for the patient and used with appropriate clinical oversight,” Lyndsay Meyer, an FDA spokesperson, tells Drug Topics.
The FDA’s goal is to reduce unnecessary and/or inappropriate exposure to opioids by making certain that prescribers are properly informed about appropriate prescribing recommendations, that providers understand how to identify abuse by individual patients, and know how to get patients with opioid use disorder into treatment, Meyer says.
“The crisis of opioid addiction is a public health tragedy of enormous proportions. The FDA’s goal is to reduce serious adverse outcomes resulting from inappropriate prescribing, misuse, and abuse of opioid analgesics, while maintaining patient access to pain medications,” she says.
Continuing education training under the modified REMS will be available to health care providers by March 2019.
There is no mandatory federal requirement that prescribers, pharmacists, or other healthcare professionals take the training provided through the REMS and completion of the training is not a precondition to prescribing opioid analgesics to patients, according to Meyer.
“However,” she adds, “the FDA’s Opioid Policy Steering Committee continues to consider whether there are circumstances when the FDA should require some form of mandatory education for healthcare providers and how the agency would pursue such a goal.”
This is a “can of worms”… The new REMS requires that the education for pharmacists, nurses, and other healthcare professionals cover broader information about appropriate pain management
If you notice that prescribers are not included in this statement, is the FDA trying to impose some reasoning on healthcare professionals that dispense and/or administer opiates to pts become the intermediary to “monitor” the prescribing of opiates to pts and perhaps become an “obstacle” between the prescriber and the pt and the pt getting the opiates that have been prescribed to them ?
Could this be another “CDC guideline” type play by a federal agency since There is no mandatory federal requirement that prescribers, pharmacists, or other healthcare professionals take the training provided through the REMS and completion of the training is not a precondition to prescribing opioid analgesics to patients, according to Meyer.
Is this something for the DEA to ‘hang their hat on” to go after prescribers and pharmacist that have not completed the course to accuse them of inappropriate “corresponding responsibility” because of their failure to take the course that is not mandatory ?
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