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Friday, March 16, 2018


This is where we are.
This is what we have become.
We are a slave to the system.
We are its whores.
We ask "What is thy bidding my master?"
Worse, we are afraid.

When I was an intern, I typed "Inhale 2 sprays in each nostril once a day" as the directions phor Phlonase Nasal Spray.
My Pharmacist Of The Day: You need to fix that.
Padawan CP: Why?
MPOTD: You can't inhale through your nose.
PCP: Come again?
MPOTD: You can only inhale through your mouth.
PCP: Wanna bet?
MPOTD: You only inhale through your mouth.
PCP: You repeating that will not make it true. I bet if I came over there and covered your mouth you'd inhale pretty sharply through your nose. Shall I?
(I was definitely on the path to the Dark Side early in my career.)

Which brings me to this.
Inhale: (verb) Breathe in (air, gas, smoke, etc)
Breathe: (verb) Take air into the lungs and then expel it, especially as a regular physiological process. (The second example sentence is 'breathe in through your nose'.)

But that's not why we are here.
When I started, and until quite recently, oral inhalers would be dispensed with directions as phollows:
"Inhale 2 puffs by mouth every 4 to 6 hours as needed" or
"Inhale 2 puffs by mouth once a day" or whatever the medicine required.

Today, with e-scripts, corporate pharmacy protocols, phear of lawsuits, and new pharmacists being trained to NOT think for themselves, we have to deal with this instead:

"Inhale 2 puffs into the lungs every 4 to 6 hours as needed."

I don't like it. Is there anything wrong with it? Sure. It doesn't say "by mouth" which means they CAN inhale it through their nose.
Phine, what about: "Inhale 2 puffs by mouth into the lungs every 4 to 6 hours"?
Really? Stupid and redundant.
Yet this is what is happening.
If the e-script says it, people are being trained to type it verbatim.
Our job is and has always been to make the directions clear to the general public (read: lowest common denominator). The more you add to something, especially directions, the more complicated it can become.

It's like "swallow your food into your stomach". Where else can it go?

In order to get ahead of the curve, I am going to change all directions phor solid and liquid oral dosage forms to this:
"Take 1 capsule / tablet / teaspoonful by mouth and swallow into the stomach 2 times a day".


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