New Beginnings

As a pharmacist in a hospital (inpatient) setting, medication reconciliation has become one of the most important ways a pharmacist can impact patient care. In larger cities and most level 1 trauma centers a pharmacist staffs in the emergency room. They, along with nurses, are responsible for attaining and verifying any medications the patient is currently taking. Usually this calls for verifying with a home prescription list if available and many times calling the pharmacy the patient fills at. This becomes difficult since many ER patients are not residents of your area, and most use multiple pharmacies. It is important to do this relatively quickly, as hospitalists and primary rounding teams want to order home medications as soon as possible. Getting the corrent medication, dose, and any antibiotic durations are important.

This led me to thinking today as I was driving to work, how much Michael Jackson's medication reconciliation for that poor pharmacist would have been:

Drug Route Dose Last Filled Pharmacy
Demerol IV ?? Never ???????????????
Propofol IV ?? ????? ???????????????
Vicodin PO 5mg/325mg 6/20/09 ???????????????

It would have been a nightmare to try and determine MJ's drugs/dosages/pharmacy. He more than likely got "samples" from personal doctors/friends, or filled at multiple pharmacies via other people getting the prescriptions for him, or under other names/aliases as to avoid public knowledge.

Another thing, recent reports said that investigators have found Propofol at his home, and a nurse discusses this topic.


Propofol is a short-acting IV sedative agent used for induction of general anesthesia for adults. It can be addictive and is NEVER USED at home. Only under the immediate care in a hospital. Every hospital seems to have encountered a nurse, pharmacist, or physician that have abused propofol as a recreational drug.

http://www.rxlist.com/diprivan-drug.htm

It will be interesting to see how this all unfolds.