Nonsense! Prescribe the kid the oral tablet, have the parent cut it (we’ll tell them how & tell them how to mix it in something the kid can tolerate) & you won’t waste the rest.

When those drug reps come calling at least ask how the dissolution factors work!

Zofran 4mg tabs are available in generic form for a lot less if you go to the right pharmacy in your area. We prescribe Zofran for kids all the time — the trick is to tell parents which pharmacies charge the lesser amount.

Here in AZ, Fry’s, Walmart and Target pharmacies have all agreed to only charge between $5-6 per tab. Because many of the kids I prescribe it for take only 1-2mg doses, I ask the pharmacist to halve or quarter the ODT tabs. Works really well.

– Peds EM doc

We’re simply guessing about the facts of the Vermont case beyond the sketchy summary. This is a case about FDA preemption. THAT is the point of this case. The rest of the posts about other issues that might result from this cases are simply guesses and idle speculation, primarily from people who clearly haven’t read the case.

You can say deep pockets, and to an extent you’re probably right. But that’s kind of a silly statement, since it’s not like the drug industry, and the medical industry in general, isn’t about profit. Profit is why drug companies exist. And most are quite good at creating it.

Matt, you’re totally missing the point. Yes, someone should be liable if harm is done and it satisfies malpractice criteria. But in this case, the drug company? Given that they already had a warning about intrarterial injection, how are they liable for a misadministration of the drug by an individual, especially when it’s been known for years not to give it in an artery. It makes no sense. Deep pockets is the only reason I can think of.

The point is that the hospital response will be to pull the drug because they don’t want to take that very small chance of someone screwing up.

The harm to a tiny few takes precedent over huge benefit to the masses.

Knowing that chance is there do you still cross the street?

But if the hospitals leave it in formulary, and it gets misused, the hospitals and the pharmaceutical companies get shafted. They have the deep pockets, not the idiot tech. It hasn’t happened with other drugs, but there are fewer and fewer out there.

It’s like airport security. Flying loaded airplanes into buildings? Done that already. But TSA is busily locking the barn door, and the horse is over the horizon. The next attack will be something different. And the risk managers and the lawyers can ALWAYS second-guess the practicioners. There is no way not to be at risk from SOMEONE who wants a legal piece of you.

Matt, to answer your question, no provider would KNOWINGLY give the medicine in an artery, but by leaving in on the formulary, the hospital is risking the chance that someone could inadvertently inject it in the wrong vessel. Distinguishing between artery and vein, although most of the time is easy, is not 100%. So it’s easier to just pull it off.

The only thing that will come from this is that sick people will have lesser choices of medicines available to them.