Just a few fun quick-hits:

1 ) Y’know? I really like counting Premarin; it’s ovoid shape makes the pills settle nicely on a counting tray. At one time the 4 colors were a bold green, maroon, pink and yellow. They are film-coated (no powdery messes) and they don’t need to be split. As a teaching tool, I have been told that the name itself refers to the original source of the medication and  translates to ‘PREgnant MARe’s urINe’ which is kind of a cool conversation piece whether completely true or not.

2 ) I can’t for the life of me figure out how to best handle multiple-strength dosing.

Once we received an Rx for Seroquel 75mg am, 50mg pm and 200mg qhs. It was filled with 25mg – 3 tabs qam & 2 tabs qpm, and as 200mg qhs. This Rx was refilled multiple times in about a 6-month period and due to recent adjustments, the filling of the 2 strengths somehow became staggered. We didn’t notice that the 200mg were lasting longer than they should and received an angry phone call from the specialist demanding to know why we filled the prescription the way we did: ‘I wanted him/her to take 8x25mg tabs at bedtime. The patient is no longer stable because he/she has decided not to take the night-time dose’. Okay, fine. Point taken.

Fast forward a few weeks. An Rx comes in for Gabapentin 500mg bid + 900mg qhs. Sensing that I may be causing more confusion than necessary, I ask if the doctor prefer I fill the prescription with one or multiple strengths (100mg and 400mg perhaps). Very politely I was asked why in the world  I would have someone take 19 caps a day when they could do it in 7? Um…I thought the same thing but, oh well.

3 ) Tylenol #1’s are a bone of contention for many folks. There must be an awful lot of people with intractable coughs requiring a bottle of these suckers a week. From a regulatory standpoint, I’ll need some convincing. A readily available Schedule II product, when taken in equivalent codeine doses, has the potential to be much more dangerous than its heavily regulated sister products. Ever notice how pharmacy teams treat T1s differently than other Schedule II products like iron supplements or decongestants? You want these products to be available for folks who truly need them, and not have it devolve into policing those that don’t (or would potentially benefit from an alternative therapy).

4 ) To the manufacturers of Concerta and Prometrium: bravo for your creativity in uniquely-shaped pills, but perfect spheres and cylinders are mighty annoying to try to count without them rolling off the counter onto the floor. At least the cylinder you have a good idea which direction it will go and chances are better for a great save or the 3-second rule (kidding).

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.