organic chemistry and or a and p

I once heard a very smart line, “If you can’t explain it, you probably don’t understand it”

WTP -“But Health, how is the pharmacist supposed to know who is the competent one and who is not? Even if the incompetent are only, say, 1% – that is still a huge amount of potential error, especially for those whose Dr happens to be in that 1%. Isn’t it better to have the extra check in place? And even competent people can make mistakes.

And as you said, you are checking up on the pharmacist. Better to waste the Dr’s time, and the pharmacist’s time, then to harm a patient!”

You’re correct! My point was that e/o can make mistakes! She/he was saying that the pharmacists’ are the bottom line of protection to the public! It’s a group effort for the public to get better when they’re sick! Not one segment of health professionals!

This is the Borrower of Some Common Sense’s account.

This discussion of the double slit experiment and resonance structures is eye opening. Yes, I know exactly what each one is and how to explain them.

Sparky, overconfidence is the number one cause of mistakes.

Health, I don’t know what your credentials are so I can’t gear my explanation to your specific field. But to answer your questions, every single drug, vitamin and supplement (even ubiquitin) that passes through our hands is checked. Be it simple drugs like Tylenol or Motrin or complicated drugs like vancomycin and phenytoin (the PK on these drugs gets extremely complicated).

You ask why bother checking for simple drugs? But did you know that Zyvox, a wonderful antibiotic, interacts with psych meds? Not many do. Would you consider a drug interaction between high dose Tylenol with valproic acid and carbamazepine (two common mood stabilizer and anti-epileptics)? I would. How about Contrave (weight loss) and Percocet (pain relief)? Okay to take together? There are interactions between even the most common drugs that we are concerned about.

In terms of mistakes, no one is perfect; we have several check points to ensure we get everything right but human error does occur. How many times would you mix up hydroxazine and hydralazine? Clomiphene versus clomipramine? And yes, we are the last line of defense – how often to patients know what drugs they’re taking? Research says that most patients do not know a whole lot about their meds. Take a look. Should they know – absolutely; but do they know – uncertain.

Everyone makes mistakes; the question is how serious and how permanent. Everyone – doctors, nurses, technicians, pharmacy – makes mistakes, everyone.

Some common sense -“Everyone makes mistakes; the question is how serious and how permanent. Everyone – doctors, nurses, technicians, pharmacy – makes mistakes, everyone”

Now you got my drift! I don’t know why you needed your whole Droshoh!

You mentioned vancomycin – there’s a good reason to give it. It and one other drug is used for MRSA.

Now phenytoin (Dilantin), I’m at a loss, why it’s still prescribed.

There are so many better AE’s!

I’m not Some Common Sense.

Health – the point that you’ve missed is that we do much more than most health professionals think. The attitude of “count and pour – lick and stick” that the public and many professionals hold of the function of pharmacy is absolutely false. We aren’t a roadblock for patients to have their medication; we check patient’s drugs/vitamins/supplements from a unique point of view.

MRSA? Two antibiotics? I can think of six! Which two are you thinking of?

Phenytoin is not that common but is used because it works. Just like clozapine. The pharmacokinetic dosing of phenytoin, on the other hand, is a function unique to pharmacy.

“NO MORE talking about drugs thats boring!!”

Another classic Sparkly line

Sparkly –

By memorization I mean exactly what it sounds like. I will give you an example. Conceptually, you need to understand oxidation of alcohols. You need to know the difference between primary, secondary and tertiary alcohols and understand how oxidation of alcohols works. Which ones get oxidized to ketones, which to aldehydes, which to carboxylic acids. Understanding that is conceptual. The memorization aspect comes into play when you are asked HOW to actually do that. Which oxidizing agent should you use if you want to generate butanoic acid from 1-butanol? Which would you use if you wanted butaldehyde instead? What if you wanted to oxidize 2-butanol to butanone? This involves you understanding the concept of oxidation, of course, but also requires that you have memorized a list of oxidizing agents and memorized which is appropriate to use in which situations.

Well I was assuming it stood for pseudomembranous colitis, but that’s a term that people in the know don’t really use, so…

Nah. I don’t see the point.

Huh?

In most cases, medicine heals people, or they die despite the medicine. There are rare cases of fatal side effects or drug interactions. Maybe the pharmacist can prevent/minimize these.

If you are referring to intentional overdose, you can’t blame the medicine or the pharmacist or the doctor. They are still there to help people. It is sad that the person who ODed could not be helped, that his pain was so great that he saw no other options. At this point, Sparkly, you need to try to remember that Hashem is in charge and that His plan for us is good, even if we don’t see it at the moment. Also, remember that you are studying to be a pharmacist to help people, to cure disease and alleviate pain and suffering. You may not have been able to help your friend, but you can help others in other ways. You have a purposeful life ahead of you. Try to keep that in mind, and it may reduce the sadness and loneliness you are feeling.

Sparkly, I will bli neder have you in mind in my tefilos on Yom Kippur.

Best wishes for a Gmar Chasima Tova and I really hope that things get better.

Sparkly-edited The more you write, the more I agree with others that you really should be working these issues out with a competent therapist, ASAP. Perhaps that would be the best tribute to your friend, and something positive to come out of this tragedy- to help yourself so that you can live a happy, productive life, I”YH.

Shouldn’t you ask someone from Touro?