Thanks to Ontario's recent expansion in scope for injections, one of our pharmacists had the opportunity to administer today's drug. Make sure you're ready with the relevant counselling pearls before agreeing to administer a drug by giving our Cue Cards a quick glance!
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1. Pictured Counselling Cue Card: a free sample of our counselling reference
2. Patient Consultation: exactly what a pharmacist may say to a patient picking up this medication, with formatting to show where the information is coming from on the cue card
Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with an example of how a pharmacist may counsel a patient. Basic counselling tactics (e.g. showing the patient the labeled medication as you read it, having the patient repeat the information in their own words, double checking allergies, and so on) may not be depicted in the interest of keeping the content concise.
RPh: Hi! Is this medication new for you?
Patient: Yes.
RPh: Ok. What has (prescriber) told you?
Patient: They said it would help my fevers after chemo.
RPh: Ok. This medication is called PEGFILGRASTIM, also known as FULPHILA or the original brand name NEULASTA, you'll take it (as directed), generally at least 24 hours after your chemotherapy is done to ensure it works best. It's in the family of what's called a granulocyte colony-stimulating factor, but basically it helps prevent fevers by boosting a part of your immune system called neutrophils, something your chemo can negatively impact, leading to neutropenia. It can be administered yourself once you're trained and comfortable, otherwise a trained healthcare provider should give it to you. The main side effect is bone pain. Let us know right away if it becomes bothersome. This medication may not be right for you if you have certain allergies. Keep it refrigerated, though it does last 72 h outside the fridge. Do not shake it.
RPh: Did you have any questions?
Patient: Can you train me?
RPh: Absolutely! This injection goes under the skin. Make sure you inject in different places each time to minimize irritation. First, leave it out of the fridge for 30 minutes (warmer injections tend to hurt less). During this time, choose where you'd like to give it to yourself; either on your abdomen at least 2" around the belly button or on your thighs. It can also be given in the upper outer arm and upper outer buttocks, but it's best to have someone give it to you in those places to be safe. Use an alcohol swab on the area, remove the grey cap, pinch the area and insert the needle at a 45 to 90 degree angle (or just straight in, to put it simply), push down on the plunger all the way down, then release. The needle will automatically be covered once you're finished. Always dispose in a sharps container.
Patient: Thanks!
We hope you have found this useful, and please reply to this email with any feedback or topic suggestions you can. It will be the key to making this newsletter the best it can be.
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