Top of the Tray

Once-weekly insulin #2 is here

Expect prior auth and formulary back-and-forth as plans pick favorites. FDA announcement 

Pull It:

Recalls that need action

• 0.9% Sodium Chloride 100 mL (Otsuka ICU Medical), Lot 1042188. The bag inside may be concentrated potassium chloride. Hospital and infusion: quarantine and return now. Details

• Dexmedetomidine 400 mcg/100 mL premix (Par), Lots 87558 and 88802. Particulate matter. Hospital: stop use and return. Details

• Thyroid Tablets 30 mg (Vitruvias), Lot 504950. May be too strong. Community: check if you dispensed it and call the prescriber. Don't tell patients to stop suddenly. Details

• Epinephrine 30 mg/30 mL multi-dose vials (American Regent), 3 lots. Cracked vials and particulate. Clinics, EDs, crash carts: check stock. Auto-injectors aren't affected. Details

• Compounded glutathione, Myers' Cocktail, and Tri-Immune Boost (Centric Compounding). High endotoxin, 9 adverse events. Stop use and discard. Details

Quick Hits

• Injectafer now has a boxed warning for low phosphate. Check levels before repeat courses. FDA

• Kybella label now warns against use outside the chin area and adds a nodule risk. FDA

• Juvmo (tavapadon) approved for Parkinson's disease. FDA

• Two rare-disease firsts: Emcitate for MCT8 deficiency and Fayuvi, the first gene therapy for Sanfilippo syndrome type A. Specialty only.

• Pharmacist pay bill gets a hearing. H.R. 3164 would let Medicare Part B pay pharmacists for some testing and treatment. It's a proposal, not law. Congress.gov

Tech Tip:

Weekly insulin will light up your phones

When a patient used to daily insulin gets a month of Onswik, it looks like a short fill. Before it leaves the counter:

1. Confirm the sig says once weekly, not daily.

2. Add a bag sticker with the patient's injection day.

3. Set the refill reminder to a monthly cadence.

4. Get the pharmacist for any type 1 profile or an "I inject every morning" answer.

Counterpoint

It's Pharmacists Month and Tech Day is coming. What would actually make your team feel appreciated?

Last issue's results: This is our first issue, so there's nothing to report yet. Vote now, and we'll share what the counter said in two weeks.

Mark Your Calendar

• Oct 15: Medicare open enrollment starts. Expect plan-change questions through Dec 7.

• Oct 21: Diphenidine becomes a permanent Schedule I drug. Federal Register

• Dec 31: DEA telemedicine prescribing flexibilities for controlled substances expire unless extended. DEA

Know a pharmacist or tech who'd want this? Forward it their way. Counter Culture: Voices from behind the counter.

Bonus: Tech Day gift guide, from an actual tech

National Pharmacy Technician Day is Tuesday, Oct 20. Skip the mug. Here's what techs actually want:

• A real lunch that isn't pizza, with coverage so people can sit down and eat it.

• Paid certification renewal or CE. It says "we're investing in you."

• A gift card for good shoes or insoles. We stand all day.

• A specific thank-you that names something they did, said in front of the team.

• Time: leave early, a longer break, or first pick on the holiday schedule.

Forward this to your manager. We won't tell.