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Wednesday, June 2, 2021

Is It?

CPP: What is something you thought was stupid, or redundant, that you later learned may not be as bad as originally perceived? 
CP: Directions. Specifically route of administration. 
CPP: They are necessary. 
CP: I agree. But how often do you need to state "by mouth" within the directions set? 
CPP: We were always taught that once was sufficient. 
CP: Correct. And I've adhered to that my entire career. It gets to be redundant, not to mention wordy, to write on a Prednisone taper: 
"take 6 tabs by mouth on day 1, then 5 tabs by mouth on day 2, then 4 tabs by mouth on days 3 and 4, then 3 tabs by mouth. . . " 
"Take 1 tablet by mouth every morning and take 2 tablets by mouth at bedtime."
CPP: Especially on labels at Conjugal Visits with Satan where you're only allowed 100 characters. You have to be efficient. How else are you going to take it? 
CP: I firmly believed in the power of minimalism; K.I.S.S for the average pharmacy patient. 
CPP: Until? 
CP: Until I started working at a new pharmacy that entered the route after every verb. If the directions said to take something 3 times a day, different doses mind you, the directions would read: "Take 1/2 tablet by mouth every morning, take 1 tablet by mouth at noon, and take 2 tablets by mouth at bedtime". 
CPP: That wouldn't fit on a Chronic Vaginal Secretions label. 
CP: Precisely. But then I started thinking. What's your favourite medication? The one you query all the interns about? 
CPP: Lactulose. 
CP: Why? 
CPP: Because it can be dosed orally or rectally and produce the same resul. . . oh. I get where you're going. 
CP: I'm not saying I'm in favour of it. I still think it's overly wordy, verbose, and redundant but. . . with medications like Lactulose, Prometrium, et al, there is the possibility they could be administered via different routes alternately throughout the day. 
CPP: In which case we will spell it out on the label and counsel the patient because it will be the first time either of us have seen it. 
CP: True. I'm not changing all of my Albuterol directions on the rare chance a patient "Uses 2 puffs orally every morning and rectally every evening". I'm really hoping they'd be given two separate inhalers for that. 
CPP: Or at least a spacer.

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