This last week, I had the great pleasure of using my pharmacy technician license (CPhT) for the first time! This was very exciting because I had no previous employment experience in a pharmacy setting. I shadowed community and clinical pharmacists before, but this was a chance to witness how prescriptions were processed, manifested, and delivered to the patient.
Because of my master’s program and my incoming status as a pharmacy student, I was luckily hired by a long-term care pharmacy. Our facility prepares over-the-counter (OTC) meds, prescription meds, controlled meds, and IV meds for patients living in senior living homes or acute care facilities. I am beyond excited for this opportunity because of the chance to expand my skills into controlled medication policy and IV sterile compounding. It is also great because I am surrounded by PharmDs who are consistently ensuring the quality of prescribing, billing, and packaging. They are in constant communication with the external facility nurses and often are called to consult patients about their care.
So how did I survive my first week?
1. Utilize Clinical Pharmacology to double-check generic/brand names.
This was a huggge learning curve (and will continue to be one). Though I had practice with the Top 200 drugs from my scribing experience, the use of brand vs generic name depended on the software used to keep track of all prescriptions, the formulary, and current stock. This also depended on the provider ordering the medication. Depending on the sig (the directions in how to take the medications), I may be required to type in Mucinex DM or Gauifenesin. We also learned how to interchange medications, or the act of swapping out an equivalent medication that is covered by insurance or available in stock. I challenged myself early on to write down every medication I did not recognize, so I could double-check ClinicalPharmacology.com for drug equivalents and mechanism.
2. Own up to your mistakes by asking how you made the mistake and learning what is the proper protocol moving forward.
I made a lot of mistakes during my first week. Thankfully, my supervisors understood that I would make them! I had no comprehension of how intricate the drug and device supply chain could be. For my CPhT test (the PTCE), I learned that insulin should be kept in a fridge between 36°F and 46°F. This holds true in-person, and I didn’t really understand how to handle these orders initially. With the help of a very patient pharmacist, I learned how to package each individual pen in refrigerator bags and how to calculate day supplies based off insulin Units. I’m still struggling with this two weeks in, but with 34.2 million Americans with diabetes, I enjoyed the challenge of learning how to handle this important drug.
3. Be aware of how to properly dispose of medications, and be aware of dangerous medications.
Unbeknownst to me, my pharmacist was pale in the face to realize I had packaged “bulk” Nitroglycerin 0.4 mg sublingual tablets in clear, plastic blister packs (the packs that you pop pills out of). They explained that the drug could be unstable and must be kept in dark bottles in order to work. I will never make this mistake again, but at least it was a good introduction into how to dispose of pharmaceutical waste! Other common medications I encountered as a scribe included Warfarin. This drug also provided a great learning opportunity in how to handle and dispose of safely as it is classified as a National Institute for Occupational Safety and Health (NIOSH) drug.
4. Always check the NDC!
That’s it. That’s the CPhT tip. Always ensure you are completing your task with the correct National Drug Code (NDC), because if that drug manages to get sent to the patient, you risk causing great harm.