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Friday, April 30, 2010

Subutex shortage

Hear ye! Hear ye!

Subutex and its generic are on back order! The drug companies cannot keep up with the demand. This is NOT MY FAULT! Why the issue you ask? B/C of YOU people sucking it down like its your job!! Why are you so surprised? Well, hell-did you think YOU were the only person taking it? Yeah I know. You are going to an exotic island and NEED IT so if I can cough up a supply you would be willing to pay more. No can do. Deal with it like normal folks and hey-keep calm and carry on...



Thursday, April 29, 2010



Watch this clip from Supernatural and you will experience just what I see with every cold patient that comes in to McDruggie's. I laughed my ass off when I saw it and wonder if the writer of that sequence had shopped at my McDruggie's when one of these patients came in.

For those of you that don't watch Supernatural it is a show on the CW about two sexy brothers that have a bitchin' car and hunt supernatural creatures (ie ghosts, demons, etc.) and are now trying to stop the Apocalypse. They have already offed two of the horsemen and now are after the other two. The end of this episode introduces Pestilence and really pegs what a mucusy mess a cold patient can leave behind.

Wednesday, April 28, 2010

Stating the obvious, over and over

The last few months, I've been away from my store, working on different projects around our district. The biggie was opening a new store. It was a lot of fun, because I was not in my store and hearing my customers, but still, it had its annoyances. Like, before the store could even get shelving in, we were shooing away customers. The lack of anything in the store didn't clue you in that it might not be open yet?
It only got worse as time passed. People were in our parking lot, so that means the store is open, despite the big "Store Close" on the door, right? (one of the SM typed the sign, and then handwrote a 'D' next to "Close". Stay classy.) Eventually all of us helping set up had a 'turned away a yahoo' story to tell. I especially loved the woman that asked me how did I get in if the store wasn't open yet. It couldn't possibly be the fact that I work for the company. One guy managed to get past the workers, open the doors that weren't automatic yet and started shopping before someone saw him taking stuff of the shelves instead of putting stuff on.
It was nice, though, seeing people that had shopped at the store's location back when it was our local chain pharmacy in a strip mall to it's huge freestanding incarnation. I love being in the Midwest.
Now I'm back at my store, where someone actually got mad at me for getting a hair cut. Because I always consult the customers in matters of beauty.

Moron Alert

Most of the time I give a customer the benefit of the doubt. I try to be nice to everyone, even if they are a repeat offender i.e. bothersome drug addict, on my shit list or a holier-than-thou HCP. However, today really pushed my "nice limits".

Oh where do I start?? Maybe it was the DB that kept confusing Suboxone and Subutex after I told him 3 times what the difference is and why a shortage existed for Subutex and its generic. Showed up with a wad of cash the size of Texas yet still bitched about the cost of Suboxone. Seriously dude!!

Perhaps it was the beeyotch that complained about the cost of Plan B. Shit! Have that kid! "18 years...18 years...she got you for 18 years" Look it up! It is the Gold digger song you will be humming soon enough. Like I've said before-if it was up to me, it would be F*R*E*E. Some babies don't need to be born. Maybe you were one of them??

Really, Dr. D? You told a patient citalopram had NO side effects? OMG you need to be punched in the head. The patient almost cried when I went over them with her! Why would you do that?

I cannot read your mind. If you ramble on about your refills, disease of the week, or pizza order, I still don't know who the f**k you are so please, please and for the love of GOD and sweet baby Jesus-start the conversation off with your name. Example: "Hello. My name is _______. I would like to refill my ______. I would like to pick that up by ________. Thank you. You are the best and the cutest pharmacist in the world (brownie points for that). OK bye" Yeah! Be normal! It is not that hard.

Middle aged women-you are not the only ones going through menopause (maybe Big N Tasty is? Ha ha). Don't take it out on me. I will likely add you to my shit list, which is growing longer by the day.

Receptionists-don't waste my time! Fax the PA informatoin over. I don't want to have an epic conversation about JJ's Ensure being approved. It is a "yes" or "no" check on the damn box. "Yes" he can have his chocolate Ensure for the month or "no" way, Jose. If you were on hold for more than 5 minutes, it is your own damn fault. If you listen to the message that interrupts "Brick House", you will hear an option for leaving a voice mail. Leave it! I check it allllll the time.

Now I realize not everyone is perfect like me, but I really wish they were. Sigh.

OK enough bitching. Night!



Monday, April 26, 2010

Things I Didn't Learn In Pharmacy School

I have always been fascinated by crime scene investigation and putting together the evidence puzzle that nails the bad guys. I recently read "Bodies We've Buried" that is a walk-through of what is taught at the National Forensic Academy in Tennessee. I learned some things there that I never learned in pharmacy school.

1. The medical examiner has far better stories than I do. For example: The world of the medical examiner is a strange one-a very strange world indeed. One day, the ME might perform an autopsy on an adolescent who has overdosed on Oxycontin, and the next day extract a gourd from the rectum of a cross-dressing traveling salesman who has accidentally strangled himself while masturbating with a Bic pen jammed into his penis (we kid you not). You just never know.

2. Blood will not pool where there is pressure or clothing when you die. For example: The commode is a common place for even the best of us to die (remember the king dying on his throne). If the person dies and remains on the toilet for some time, this person will form the most ungodly and unbelievably pale ring in the shape of the toilet seat-the rest of the undercarriage will be purple.

3. Sperm is spunky! For example: Sperm can survive for up to three days in the vagina of a living person, and has been known to survive for over three years in the rectum of a frozen cadaver. Another example: Hundreds of sperm heads have been known to survive between the cheek and gum for up to six hours after ejaculation.

4. We could be a valuable food source to urban foragers. For example: Furthermore, animals are attracted to a decomposing body in succession, much as insects are. Larger carnivores (raccoons, possums) arrive first, devouring most of the flesh. When most of the meat is gone, along come the smaller animals, like rats, whose interest lies solely with the joints of the cadaver. This is where the fattiest nutrients reside within the marrow. Next come the herbivores, such as squirrels. Squirrels nibble away at the small bones, like those in the ribs, searching for calcium and other minerals.

It makes me sad that only law enforcement officers or current crime scene techs are allowed to attend the school. Maybe they could be swayed by a sizable cash donation...come on Powerball numbers! I may have to make a career change because this book sounds far more interesting than what I do for a living!

Infection,scourge of the computerverse

Friday and Saturday were spent not in the pursuit of pharmacological excellence, not in stamping out disease, pestilence, and paperwork, but in hunting down and eliminating an evil computer virus. I am not even vaguely a computer geek, although I'm related to several. This required all the time, quiet, and patience you rarely get in a retail pharmacy. It also required the help of not one, but two experts.

But, after being tricked into thinking the virus had been crushed on Friday, I would not be a victim again on Saturday. At 5 minutes til close, the evil worm was finally vanquished, deleted, detroyed.

This was a victory for me in several ways, because I am not a techno-idiot, but there is a reason I'm in the Life Sciences: I'd rather read a real book, use a real typewriter, and not have to fight with the computerverse to get my work done.

So, a curse upon the twisted creators of computer viruses, and thanks again, you computer geeks.

Saturday, April 24, 2010

Raise Your Lighters!

I will raise my lighter and hold it high until I burn my little fingers as an offering to the hair band gods to help the medical personnel do their very best to get Bret Michaels and his weave back in touring shape. He suffered a brain hemorrhage a few days ago and has been in intensive care ever since.

I hearken back to the days of my youth when I had all Poison's albums and saw them in concert several times. I even had a friend go with me to see Poison on their reunion tour a few years ago. He made me promise not to tell anyone at work that he was dancing and singing along but I did anyway. It was a good time. What is the point of having a good time if you can't brag about it?

I am also pulling for Bret because his devotion to Diabetes awareness and research has been a lifelong endeavor as he is an insulin dependent diabetic. He has done many things publicly to promote and raise funds for a good cause. I am also endeared by his poor reality show dating choices as they make me feel not so bad about my own. How can you not adore someone who is so shameless, so selfless, and so damn entertaining?

So let's all pull for Bret in the hopes that he will be entertaining us and educating the public for years to come!

Update 4/14/2010: Bret Michaels is in physical therapy and hopes to be back on tour in a few weeks. Yay!

Monday, April 19, 2010

An Interesting Judgement-(no more animals for you- JUST HUMANS)

Do you remember when this happened last year? It turned out that a tech (although a trusted 12 year veteran) compounded 10x the selenium, and it went unchecked by the RPh. It just gives me chills, thinking that it might have been on MY watch, being a little too trusting of my senior tech, and this might have been something for a hospital. Sorry to sound so abraisive, all of our excellent techs out there, but this is an unforgettable example as to why we need to double check EVERYTHING.

The U.S. Food and Drug Administration wants a Florida pharmacy to stop making animal drugs after it mixed a brew of supplements that killed 21 elite polo horses as they prepared for a championship match last year.

The FDA has asked a federal judge to issue an injunction against the pharmacy, Franck's Compounding Lab in Ocala.

However, the FDA has accused Franck's of illegally creating copies of similar drugs. The agency also says the pharmacy is mixing brews outside of federal guidelines and is compounding animal products from drugs that have not been approved for use in the U.S.

Franck's disputed the FDA's allegations.

"The business of Franck's Compounding Lab is both legal and medically vital," the pharmacy said in a statement Monday, adding that it would fight the FDA's filing.

Bernadette Dunham, director of the FDA's Center for Veterinary Medicine, said in a statement Monday that the agency recognizes the benefits compounders can provide for patients.

"But when compounders like Franck's circumvent, and thus undermine, the statutory drug approval process by manufacturing drugs under the guise of pharmacy compounding, we are concerned that poorly compounded drugs can jeopardize the health of animals," she said.

The International Academy of Compounding Pharmacists also takes issue with the FDA's stance.

The group says there is nothing in federal law that specifically regulates the use of bulk ingredients in the compounding of drugs for animals not used in food production.

"Their assertion doesn't hold the weight of law," said Sarah Dodge, the group's vice president of government affairs.

The FDA's complaint was filed April 16 in federal court in Ocala by the U.S. Justice Department.

Franck's came under intense scrutiny last year after 21 polo horses died before a championship match near West Palm Beach. The horses from the Venezuelan-owned Lechuza Caracas team had just been given a cocktail of vitamins and minerals compounded by the pharmacy on order from the team's veterinarian.

Franck's later acknowledged using too much selenium in the mix. Florida's top veterinarian blamed the deaths on an overdose of the mineral often used to help horses recover from fatigue.

The horses' owners have since sued the pharmacy.

The FDA says Franck's was warned in 2005, four years before the horses' deaths, that it was compounding animal drugs illegally. The agency warned the pharmacy again in December 2009, according to the complaint. Franck's first promised to "comply immediately and completely with any and all FDA and other legal requirements," but later said it disagreed with the FDA's interpretation of the law.

In response to the horses' deaths, the United States Polo Association has since begun random drug tests for horses in polo matches in the U.S

Friday, April 16, 2010

Has this ever happened to you?

Well, first off, I apologize for the awful quality.

But today, we got sent 30 bottles of generic Depakote ER 500 mg. I use the passive voice, because this was auto-ordered by the replenishment system. We haven't used this much of this drug since it came out!

::grumble grumble::

--Fries With That

Why bother?

Why, oh why, do people bother putting "See ID" on their credit cards, especially their HSA cards, if they're going to share them with a spouse? Or possibly a not-spouse, am I supposed to be a handwriting expert as well as everything else? The evil side of me says, "Reject it!" the realistic side of me knows I don't have time for the argrument.

Thursday, April 15, 2010

I am a pharmacy clairvoyant.

Over the course of my three years in pharmacy I think I have developed pharmacy clairvoyance. Maybe its a side effect of coming into contact with so many idiots, or pill powder, who knows, but I now have this super human power of being able to tell what a patient is bringing in before the script is in my hot little hands.

Take for instance the other day. A very young mom of two comes in, hands me her "insurance" card, immediately my super power kicks in and narrows the drug choices down to VD or Prenatal. VD won out in this battle.

Then we have the young men coming in for needles for Grams or Pop-Pop. Not buying what they're selling, but can see them coming from the front door. Lets just say I really liked my Grandma, but I wouldn't buy her needles.

Just remember, this super human power also works for forgeries.

- McFury, CPhT

Wednesday, April 14, 2010

OTC products on Medicaid

I'm not sure how laws work in other states regarding what is and is not covered on Medicaid, but our OTC stuff being billed on there is about to drive me up the wall. We have actually ordered pint stock bottles of acetaminophen, ibuprofen, and diphenhydramine elixirs/suspensions JUST for Medicaid. I know that they are dirt-cheap... but that's the point! They are dirt cheap! Let the boogers get their $2.00/120mL bottle of generic Benadryl on the regular counter! I think it probably costs us more in labor to do the damn Rx than we are making on it. I can ALMOST get along with the loratadine prescriptions, since it is 6 or 7 bucks out there, but still grumble a little every time I have to pour that stuff up.

Maybe I'm just not a fan of seeing the system gamed, or maybe it is objectively ridiculous to bill cheap OTC's to Medicaid.

This post, by the way, was inspired by me having to send a refill request to someone's MD for acetaminophen elixir today - we didn't hear back on it, but if I worked at the doctor's office, it'd be fairly low priority for me also.

And maybe I'm cranky because it's day 3 of a new workout regimen and I'm sore. Who knows.

TAP has a post about a very similar topic from a few months ago as well.

--Fries With That.

Tuesday, April 13, 2010

Love Is In The Air

This is a McDruggie's version of Love Is In The Air by John Paul Young sung from an afflicted male point of view. Enjoy!

Love is in the air
Valtrex is generic now
Love is in the air
My copay went way way down

And I spend more than one season
Without painful lesions
But it's something that's not cured
And it's there when I touch your thighs

Love is in the air
Aldara is generic now
Love is in the air
My copay went way way down

Now I can burn off those clusters
Without being flustered
But it's something that's not cured
And it's there when I look in your eyes

Love is in the air
Love is in the air
Ow ow ow
Ow ow ow

Love is in the air
When is generic Viagra out
Love is in the air
My copay will go way way down

Cuz it's getting real expensive
To play with the misses
But it's something I must look forward
For spending cash there'll be more of

Love is in the air
I'm getting real excited now
I'm gonna get super-thin condoms
So I feel what I wanna

But it's something I must believe in
So it don't burn when I'm peeing

Love is in the air
Love is in the air
Ow ow ow
Ow ow ow

Love is in the air
Love is in the air
Ow ow ow
Ow ow ow

Thursday, April 8, 2010

What Wilts My Lettuce

You know what wilts my lettuce? Please refrain from bringing your dog with you to the pharmacy. That tea-cup Pomeranian ain't no service dog and I don't appreciate being growled at, barked at, or having my fellow employees snapped at.

This also isn't Petco or Petsmart or Pet Supermarket. We aren't mopping up your precious little fur ball's excreta and if you leave it for us to clean up and I know where you live, expect it to be waiting on your windshield. Not to mention the kid that mops the floor at night is Muslim and I would hate to be part of an anti-pooch jihad.

Maybe I am wrong and your adorable little fur ball is just recognizing and giving a shout out from one b*tch to another but I still want you to leave your I-am-so-special-and-interesting-because-I-have-this-little-dog-so-you-should-talk-to-me at home because bringing it with you, well that really wilts my lettuce and if you leave it in the car somebody's gonna steal it.

Monday, April 5, 2010

The lure of the mighty dollar.

This is a story about one of the guys who bought out my father's pharmacy a few years back. It's rather lengthy, but I just can't believe that these idiots threw away all of that school for money. He just got popped doing this:

A Medicaid auditor stopped by unannounced one day at the Rx Shop pharmacy in Clearwater.

Owner Jatin Patel feared he might be caught.

He had been stealing from Medicaid, Medicare and Tricare, the military insurance program, by submitting fraudulent reimbursement requests for prescriptions he never filled.

Somehow, he persuaded the auditor to leave and return the next day.

Then he called two other pharmacists and asked them what to do.

The two, Rajnish Mehta and Satender Singh, had given him the names of beneficiaries he used to submit fraudulent claims for $260,000, Patel later told investigators. He said he split the money with them.

Mehta and Singh arrived the next day with a stack of forged prescriptions to support the claims,according to court documents.

All three men, as well as two other pharmacists, have since been arrested and charged with perpetrating what authorities say is an emerging type of fraud – using fabricated prescriptions to steal from government health insurance programs

Targeted by a regional Medicare Fraud task force, the pharmacists are accused of stealing more than $1.5 million from government insurance programs by submitting hundreds of false prescription claims between 2006 and 2008.

The use of prescription billing to defraud the government is becoming pervasive, especially since the enactment of Medicare Part D, the prescription drug program created in 2006, authorities said.

"The more you look, the more you find," said Ryan Lynch, assistant special agent in charge of the Tampa office of the Office of Inspector General, the law enforcement arm of the U.S. Department of Health and Human Services.

Patel, 37, of Seminole, pleaded guilty to making a false statement to a federal health care program and is serving seven months in federal prison.

He received a lower sentence because his cooperation helped lead to the other arrests, according to the U.S. Attorney's Office.

Mehta, 33, of Trinity, is trying to negotiate a plea deal, his attorney said.

"I don't think he's going to go to trial," said Bjorn Brunvand.

Singh, 34, of Summerfield in Marion County, is awaiting trial, as is pharmacist Naresh Jain, 37, of Trinity
The fifth defendant, Sachin Amin, 35, of Largo, pleaded guilty to two counts of lying to a federal health care program and is serving 18 months in prison. Like Patel, he cooperated with authorities.

After emigrating from India in 1997, Amin built a mini business empire in Pinellas County, including a pharmacy, an assisted living facility, a restaurant and an ice cream franchise.

He used his Madeira Beach Rx Shop pharmacy to fraudulently bill Medicare and Medicaid for more than $738,000 worth of prescriptions he never filled, documents state.

As part of their sentences, Amin and Patel were ordered to repay the money they stole.

Amin also likely faces deportation, said his attorney, Brunvand.

Attorneys for the other pharmacists either couldn't be reached or declined comment.

According to court papers, the five pharmacists have ties to each other.

After interning with Amin at Madeira Beach Rx Shop, Singh worked part time at Patel's Clearwater pharmacy. He then joined with Mehta to open Pasco Pharmacy in New Port Richey.

Mehta and Jain operated the Drugstore Healthmart pharmacy in Hudson, and Mehta and Singh opened Rx Care Pharmacy in Lady Lake in April 2007.

The pharmacists often shared the names of patients who subscribed to government insurance programs, using the names to bill for expensive drugs that were never provided.

Mehta told investigators he stole Tricare patient names from a chain pharmacy where he worked for two years before opening his own business, court records state.

Between November 2007 and September 2008, Mehta submitted 40 claims totaling $25,700 for a Tricare patient for his Port Richey pharmacy, according to a complaint affidavit. Investigators said the patient had never been to Mehta's pharmacy but had gone to the chain where Mehta used to work.

In some cases, authorities say, the pharmacists made up customer names to bill for prescriptions. In other cases, they used the names of their customers to bill for drugs the patients never received.

Lynch said the investigation continues to grow.

"We've identified a new area of fraud in our community," he said. "We're on the cusp of it."

Saturday, April 3, 2010


26 year old white homosexual male

On his parents prescription insurance

Living in an expensive condo on South Beach

Paid $70 copay for 4 Viagra 100mg tablets

Paid with EBT card (food stamps) for orange juice while talking on the phone to the friend whose party he was heading to with the Viagra & juice.

How the f*ck is this world fair when this sh*twhore gets food stamps and I have co-workers that work 2 full time jobs to support spouses and children, can barely make ends meet, but do not qualify for food stamps. The whole system is F*CKED!

Friday, April 2, 2010

The Joke's On You, America!

A co-worker whose 3 year old daughter needed to see her pediatrician for severe vomiting and diarrhea was denied the visit because her insurance did not have the pediatrician as her primary care physician. Mom applied to get the physician changed 14 days ago but it can take up to 8 weeks to get the primary changed. Mom was going to pay cash but the doc's office cannot take any cash payments if the child has insurance due to the new health care law that just came out.

The office explained that all patient social security numbers could be run through a database that shows what insurance coverage they have. If a patient already has coverage and a different primary care physician then they cannot even take the patient on as a cash paying patient. This is the new system.....WTF were our politicians thinking? They weren't because the people that wrote this bill don't know jack or sh*t about how our health care system works.

The office also told her some other things about government regulation and limitation that better not be true if we are to have any hope at all. Basically it sounds like a LOT of patients are going to end up at the ER because it will be a virtual clusterf*ck to get your primary physician changed if you don't like them for any reason.

Mom had to wait until after office hours to take her daughter to the ER so she could be admitted and her physician could see her on his rounds at the hospital until her insurance changes to him on her policy. I am happy she finally got to see her physician of choice even though it was a b*tch of an Easter Egg hunt to get there. I foresee this to cause lots of problems and worsen the ER wait times in the future.

Holy Sh*t! We are in for a very rude awakening when all of this is implemented!

***I am disheartened that no one appreciated my stint channelling the Republican alarmist bullsh*t like Rush Limbaugh does. When I develop my own Oxycontin habit you will receive my words as the gospel from a priest.

Thursday, April 1, 2010

Now I've seen it all

For about a week, there has been a problem with our staff bathroom commode. So, when the plumbers came and started their work, we assumed that they would do their rooter thing and be gone in a few hours. When 5pm came around, the plumber was still mystified as to why they couldn't clear the drain, and why he was pulling pound after pound of gravel out of the line, even though the snake thing he was running didn't hit anything solid. Then they started investigating the parking lot and discovered a wet spot in the snow. So they dug down at that spot, and found what appeared to be a sewage filled sinkhole. After pumping out this 'sink hole', it became apparent that it was actually a TUNNEL being dug, running right under the pharmacy floor. As it turned out, the ambitious little thieves had gotten right up under the slab and had started chipping away at the underside before they broke the underground sewage line and flooded their little venture. I can only imagine them down there, lying on their backs, and suddenly get a facefull of sewage and a sudden, overwhelming urge to retreat. They must have been at it for months, seeing that the ground is still frozen, and the tunnel started under the dumpster slab 150 feet away.
I wonder if anyone has been treated for e-coli in the local area?