Quick, Name A Drug Interaction. Any Drug Interaction.

Seriously. The first one that comes to your head. Now, I want you to remember the very first thing you thought of when asked to perform the most basic of tasks that define what it is to be a pharmacist as I dip into tonight's mailbag. OK?

"Dipping into tonight's mailbag" by the way, isn't nearly as fun as it sounds. Anyway, here we go:

I worked for (corporate soul sucking chain) about 7 years before I moved and I worked for (2nd corporate soul sucking chain) about 15 years before that. Neither had unions, but I wish they had. I developed a bit of an edge from all those years of corporate aggravation.When I got home my sweet wife would let me vent, then she'd say something like: "You're over reacting, just do your best and let it go. Hey,supper is ready..let's eat" She probably saved my life by doing that for me all those years

I like hearing someone's marriage got them through the bullshit. Probably because I fairly recently found the most awesome girlfriend in the world.

But it bothers me that the corporate folks do whatever they want without much regard for the people who work for them. A lot of it is not only silly, but just dumb.

And dangerous. Let's not forget dangerous. I'm looking at you 15 minute prescription guarantee.

Here's a little example that happened last week. Might seem little to others, but I think you'll understand: 
In the past, when we dispensed coumadin, we got a little auxillary label that said: "do not take with aspirin unless directed by physician".

How many of you named coumadin/aspirin when I asked you to come up with an interaction quickly? I'm betting most of you. It's probably the most common, most dangerous, drug interaction you'll find in any type of ranking of these things. Pretty basic stuff for anyone with a pharmacy education. Yes?

Read on.

It printed automatically on the peel off spot. One day that label dissappeared and was replaced by two others.One said do not take if pregnant without Dr advice, the other said do not drink alcohol with this med...but the no aspirin sticker was gone. I checked Facts and Comparisons to make sure the aspirin/coumadin thing was still legit. And I found out that they classify the coumadin/aspirin interaction as level 1. (Probable, prompt, and serious). The alcohol/coumadin interaction is classified as level 3 (unlikely, delayed, and not significant).

For those of you playing along at home, here's what the good folks at drugs.com have to say about aspirin and coumadin:

Aspirin, even in small doses, may increase the risk of bleeding in patients on oral anticoagulants by inhibiting platelet aggregation, prolonging bleeding time, and inducing gastrointestinal lesions. Analgesic/antipyretic doses of aspirin increase the risk of major bleeding more than low-dose aspirin; however bleeding has also occurred with low-dose aspirin.

And again, anyone who's spent more than a week in pharmacy school knows this. This is simple, basic stuff.

Back to the letter:

So I called one of the pharmacist who serves on the "advisory board" and she agreed that it might be a good idea to have that level 1 interaction put back on the label. She brought this up on the conference call and was told, "no we can't do that. Medispan would have to redesign our labels and all that and "so, no we can not do that". 
I know it's just a little green sticker on the side of the bottle, but it's my profession.

Correction. It was your profession buddy-boy. Today my friend, you are no longer even capable of judging whether the possibility that someone might bleed to death merits a warning label. Got that?

You are at 14:30 on that waiter on the counter though. better hurry up before someone gets a gift card.

I feel powerless to address this incompetence. I would like to be able to report this to the union and have them call up corporate and say: "Hey what were you thinking? Get that changed right away. Not next week, not after lunch, NOW!" 
But I don't really like unions. I would like to think that they are unnecessary for professional people. I've developed a 2 inch thick folder of gripes like the one I've outlined above, but I don't like the sharp edge that's it's developed in me. I want someone to speak for us, but I don't know who. 
You got any insight into this situation?

Yes, I do. Realize that unions are not perfect, and that as it stands today, they need a lot.....a LOT....of work before they become the type of organization that is able to advocate for our control of our profession. But right now they are the only tool we have. We need to improve the tool.

"Improving the tool" by the way, won't be nearly as much fun as it sounds.

Pharmacists can't even get an aspirin/coumadin warning on the label at one of the major chains that now control pharmacy. Imagine someone had told you that would happen back in 1995 and what you would have thought.

Now imagine what might be happening in 2030. Unless we improve the tool.

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Quick, Name A Drug Interaction. Any Drug Interaction.
Quick, Name A Drug Interaction. Any Drug Interaction.
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