Gorillacillins to treat those primal infections

If you've ever heard that term, then the topics and treats in my posts this summer may not be new to you. Gorillacillin essentially does embody the world of pharmacy opened up to you when studies are over and practice begins. A term to describe something reserved, unchallenged, but changes with each generation. I'm Tom, it is my summer between P2 and P3 year, and I'm an intern at Henry Ford Wyandotte Hospital's inpatient pharmacy.

For a real quick orientation, Wyandotte is a 379 bed hospital downriver from Detroit. It has one outpatient and one inpatient pharmacy, where the staff pharmacists help each other to pump out Rx orders from the floors and clinics, and to cover clinical duty. Clinical duty is where they attend each floor and act as the pharmacy resource for the nurses and physicians. The major job clinical duty brings is the responsibility of handling the floors anticoagulant therapy and antibiotic therapy. This involves monitoring the heparin, warfarin, vancomycin, amikacin and aminoglycoside treatments for those patients. And this is where I come in.

I started there last year as an intern but mainly focused on filling the role of a tech, and ensuring I know their role to the fullest. At our hospital and many others alike, the techs make the IV's, deliver the medications, and pretty much troubleshoot the day to day issues that hit the pharmacy. This summer, however, my intern position takes on even more responsibility while I do clinical duty. It wasn't until now that I really see how integral techs are to not only the operations of the pharmacy, but the sanity of the pharmacists.

My first day of clinical duty was actually quite interesting; key things including a car accident, a double lung transplant, lots of reading, and gorillacillin. I'll revisit my first day along with my first month next post but before I go; gorillacillin is a slang term used to describe the antibiotic that will take out a pathogen, and like a gorilla, will put a strong beatdown on any infection. Penicillin used to be one, so was chloramphenicol, these days carbapenems fit the bill.

Clinical: Not Always the Hospital Setting

So this is my first week at Prime Therapeutics in Bloomington, Minnesota. I am doing the AMCP/FMCP/Pfizer Managed Care Summer Internship and am already learning a wealth of information. Currently I am rotating through the Drug Formulary Development department, and seriously putting my evidence based medicine skills to use.

Updating/maintaining the drug formulary is a year long process. Each pharmacist is responsible for a few therapeutic topics, and have to make sure their respective chapters are complete and up to date. What does this involve? Looking at the literature, clinical guidelines, FDA reviews, etc. and applying their clinical knowledge to evaluate the value of a medication in therapy. The pharmacists also review new drug products as they are approved by the FDA and released. My preceptor asked if I knew Ampyra, and I quickly ran through my mind all the meds I learned in therapeutics. When I couldn't recall it, he said it was just released 2 months ago. I find it really cool that the pharmacists know about the drug products as they are released. They are on top of the information because they need to evaluate the safety, efficacy and uniqueness of new medications to see if such medications should be placed on formulary.

When talking to pharmacists within the department, they each emphasized to me how their job is very clinical. Before starting this internship, I did not realize that managed care is very clinical. When I hear the word "clinical" I used to think of the pharmacist working in the hospital setting, and I am sure many students think this as well. At Prime, the pharmacists definitely use their clinical skills in evaluating medical literature and making judgment to ensure that patients' drug therapy is safe, efficacious and cost efficient.