Beyond Medical Cannabis: Considerations for Updates to Hospital Policies and Procedures

Cannabis (marijuana) is classified as a schedule-I controlled substance, currently not accepted for medical use and with a high potential for abuse. As stated in a previous P&T article, although marijuana remains illegal at the federal level, 33 states have legalized its medical use for certain indications and 10 have legalized its recreational use.
 
Among those states are differing laws that regulate the possession or supply of usable marijuana, with certain states providing more flexibility than others when it comes to using medical marijuana.

Regulatory and Legislative Disparities With Cannabis Present Challenges to P&T Committees and Health Care Providers

Over the past several years, the legal status of cannabis has been determined by regulatory changes affecting its use, as well as the use of cannabidiol (CBD). Prior to 2018, CBD, along with all forms of marijuana, was considered a Schedule I controlled substance (CI), indicating that these drugs had no medical use and presented a high potential for abuse. On June 25, 2018, the Food and Drug Administration (FDA) approved Epidiolex (cannabidiol) for the treatment of Lennox-Gastaut and Dravet syndromes. Upon approval, …

Forensic Pharmacist Report in a Coumadin Death Case

THIS ARTICLE. AS part of the Forensic Pharmacist issue, presents a series of reports of opinions, case summary, citations to standards of practice, and pharmacy rules and regulations, as applied and utilized in a forensic evaluation by this author in a death caused hy a Coumadin dispensing error; Cogentin had been prescribed. An interesting part of the case was the deception by the defendant pharmacist, who denied knowledge of the error when the death was investigated by the hospital treating the patient as well as by the Board of Pharmacy investigators.

The case is made interesting further because, in Pennsylvania, the state in which the error occurred and the suit was brought, experts must express complete reports, and depositions of experts are, by custom, not taken. All of the experts’ opinions must be fully expressed in reports, or they will be precluded in trial. Because Coumadin errors are the mosr frequent cause of lawsuits against pharmacists …

Alcohol: Gastrointestinal and Other Toxicities

This article will focus on the two areas of alcohol injury: first, the gastrointestinal system, primarily liver toxicity and cirrhosis, and second, the human toll in injury, examining injury epidemiology information that estimates alcohol’s involvement in trauma. Any pharmacist consulting in any capacity, especially related to gastrointestinal disorders, will need to understand the significant sociological, pathological, pharmacological, and psychological impact of alcohol.

Pharmacists providing care, including dispensing many different drugs to patients, should be cognizant of the interacting effects of alcohol and the need to warn patients. Finally, the reader will Jearn of a case in which a pharmacist was sued for not warning about the use of alcohol with a central nervous system depressant, and the resultant litigation after that lawsuit.

Policies and Procedures – Enhancing Pharmacy Practice and Limiting Risk

Let’s face it—health care settings, including pharmacies, can be legal land mines because patients and the public can and do get hurt. As a policy-recommending body to the medical and administrative staff in health care organizations, P&T committees have a primary
role of maintaining a limited list (formulary) of medications approved for use that meet the needs of clinicians and their patients as well as those of the organization. 1 Because most members of P&T committees are not pharmacists, a primer on policies and procedures (P&Ps), including an emphasis on their importance for pharmacists, may be helpful for P&T
committees in executing their duties.

Drug Shortages Pose Problems for P&T Committees in Accountable Care Organizations

For more than a decade, drug short¬ages have made headlines. Shortages also have forced P&T committees in many hospitals and health care delivery organizations to make contingency plans for providing safe and effective therapies when conventional and preferred drugs are not available. An article published in P&T in 2011 described several concerns associated with drug shortages and substitutions, including safety risks, cost implications, and the domino effect that shortages can have when the inability to acquire one agent leads to unexpected demand for another.

The passage of health care reform legislation