Re: Nitro Stat and easy open lids

[Guest guest]

> Does'nt that have something to do with how fragile the Nitro

tablets are?

>

> Hi Jeanetta,

> I have a question about Nitro Stat and easy open lids. While

filling

> an order for Nitro Stat, my Pharmacist gave me a FYI note...He

knows

> I am studying for the exams, and said that it is a federal law that

> mandates that we always put an easy open lid on this Rx. I can

> understand the reason why. I asked him if he knew the exact law,

but

> he could not at that moment.

>

> Could it be somewhere in the Child Safety Act?

>

> This may be a good question to have on your practice exam.

> Thanks in advance,

> Donna f

[Guest guest]

Dear Donna,

I do not know the exact law. It may have (probably does have)

something to do with the Child Safety Act which states that all meds

are to be dispensed in containers with child safety caps/lids, except

for those meds dispensed to patients who sign a waiver releasing

pharmacy and pharmacists from the responsibilty if something happens

to a child or grandchild. Patients who sign such a waiver may have

arthritis medication or other meds that would necessitate that the

patient must have quick access and/or ease of opening due to the

nature of the med or the disease state of the patient. (not in these

exact words).

To my knowledge Nitroglycerine or Nitro Stat tabs are packaged and

dispensed in the original in dark amber glass containers with a light

weight metal screw cap which has a specific " inner " (shiny) coating

to prevent metal contact. Has this changed? I have not dispensed

since l999. My last recollection is Nitroglycerine sublingual

tablets such as Nitrostat, are packaged in dark amber glass with such

a light weight metal top.

In addition, patients should bring in their unused nitroglycerine of

6 months old to the pharmacy, whether it was opened or not! The

potency may be weakened over time, especially if the container was

opened. ( I am not sure about billing on this! Retail techs check

this one out!) Many patients fail to do this and many pharmacists

fail to counsel on this.

Now I do not understand how they could be placed in a container with

Flip top plastic lids ( non-safety caps) since all nitro products

should be dispensed in amber glass containers, no plastic as it may

react with the nitro.

Please give a copy of this post to your pharmacist and ask him/her to

comment. In addition please post about what type of container your

pharmacy receives the nitroglycerin tablets in and what type of

container it dispenses it in, please include material and lid (

original or transfered? glass/metal plastic and lid and construction

etc).

Thank you for the question and I would say that this needs further

exploration.

I should like to hear from other retail techs.

Thank you,

Jeanetta Mastron CPhT BS Chemistry

Founder/Owner

i

>

>

> Hi Jeanetta,

> I have a question about Nitro Stat and easy open lids. While

filling

> an order for Nitro Stat, my Pharmacist gave me a FYI note...He

knows

> I am studying for the exams, and said that it is a federal law that

> mandates that we always put an easy open lid on this Rx. I can

> understand the reason why. I asked him if he knew the exact law,

but

> he could not at that moment.

>

> Could it be somewhere in the Child Safety Act?

>

> This may be a good question to have on your practice exam.

> Thanks in advance,

> Donna f

[Guest guest]

To make this clearer, I believe that patients need to get into the

nitroglycerin bottle quickly, that the use of a non-safety cap would

mean plastic and that this is NOT acceptable. I also believe that

the 'screw cap " for the nitro that it is available in 'is not a child

safety cap and yet it is not a plastic 'flip top " either and is

exempt from the child safety act requiement due to the nature of the

disease that the drug is dispensed for (for quick access and use).

Thank You for the question and we shall use it after we get your

pharmacist's input and that of Joe Medina.

Respectfully,

Jeanetta Mastron CPhT BS Chem

Founder/Owner

PS I need you Donna F to show YOUR post andmy two posts to your

pharmacist. I think you may have misunderstoon him/her (or else I

understood your post to mean that a 'plastic flip-top non- safety cap

is to be used. This does not compute with me. Perhaps the screw top

is considered a non-safety top. I can accept this. Thanks Jeanetta

> >

> >

> > Hi Jeanetta,

> > I have a question about Nitro Stat and easy open lids. While

> filling

> > an order for Nitro Stat, my Pharmacist gave me a FYI note...He

> knows

> > I am studying for the exams, and said that it is a federal law

that

> > mandates that we always put an easy open lid on this Rx. I can

> > understand the reason why. I asked him if he knew the exact law,

> but

> > he could not at that moment.

> >

> > Could it be somewhere in the Child Safety Act?

> >

> > This may be a good question to have on your practice exam.

> > Thanks in advance,

> > Donna f

[Guest guest]

Hi Jeanetta and Donna,

I hope this helps concerning Nitro Stat and easy open lids:

The United States Poison Prevention Packaging Act (PPPA) was passed

in 1970 and is currently administered by the U.S. Consumer Product

Safety Commission. The Act was decreed to prevent young children

from accidentally ingesting hazardous substances ordinarily stored

about the house. The law requires toxic, corrosive, or irritant

substances to be packaged in such a way that it will be difficult for

children less than 5 years to open them, yet not difficult for adults

to open.

The Act also requires special packaging for both prescription and non-

prescription drugs. Prescription drugs intended for topical or other

non-oral administration do not require child-resistant packaging.

The Act exempts prescription drugs from child resistant packaging if

either the prescriber or patient requests it or if the medication is

on the list of drugs which are exempt; including Nitroglycerin and

sublingual / chewable preparations of Isosorbide Dinitrate, both of

which are used for angina.

[taken from the Tech Lectures Review Manual/Workbook]

Respectfully,

Joe Medina, CPhT

http://www.techlectures.com

[Guest guest]

Dear Joe,

Thank you for responding to my TEXPERT Feeler!

That is exactly what I was looking for! So the screw top is not a

child proof packaging even though it is a screw type cap. But to put

a plastic flip top, a non-safety cap is not acceptable.

Thank you,

Jeanetta

> Hi Jeanetta and Donna,

>

> I hope this helps concerning Nitro Stat and easy open lids:

>

> The United States Poison Prevention Packaging Act (PPPA) was passed

> in 1970 and is currently administered by the U.S. Consumer Product

> Safety Commission. The Act was decreed to prevent young children

> from accidentally ingesting hazardous substances ordinarily stored

> about the house. The law requires toxic, corrosive, or irritant

> substances to be packaged in such a way that it will be difficult

for

> children less than 5 years to open them, yet not difficult for

adults

> to open.

>

> The Act also requires special packaging for both prescription and

non-

> prescription drugs. Prescription drugs intended for topical or

other

> non-oral administration do not require child-resistant packaging.

>

> The Act exempts prescription drugs from child resistant packaging

if

> either the prescriber or patient requests it or if the medication

is

> on the list of drugs which are exempt; including Nitroglycerin and

> sublingual / chewable preparations of Isosorbide Dinitrate, both of

> which are used for angina.

>

> [taken from the Tech Lectures Review Manual/Workbook]

>

> Respectfully,

>

> Joe Medina, CPhT

> http://www.techlectures.com

[Guest guest]

Dear Donna F,

I think th e follwoing link may help you with finding the law:

Office of Drug Safety

http://www.fda.gov/cder/Offices/ODS/default.htm

Jeanetta

>

>

> Hi Jeanetta,

> I have a question about Nitro Stat and easy open lids. While

filling

> an order for Nitro Stat, my Pharmacist gave me a FYI note...He

knows

> I am studying for the exams, and said that it is a federal law that

> mandates that we always put an easy open lid on this Rx. I can

> understand the reason why. I asked him if he knew the exact law,

but

> he could not at that moment.

>

> Could it be somewhere in the Child Safety Act?

>

> This may be a good question to have on your practice exam.

> Thanks in advance,

> Donna f

[Guest guest]

Donna: We do the same thing!! char

Charleen A. CphT

Technician Representative

Spokane Pharmacy Association

&

Pharmacy Technician/Trainer

Sixth Avenue Pharmacy

W. 508 6th Avenue

Spokane, WA 99204

(509) 455-9345 wk.

(509) 953-9308 cell.

[Guest guest]

Hi Jeanetta,

We do not open the original amber bottle, we put that bottle into another vial

because the label is too large to fit onto the amber bottle.

I will ask my Pharmacist about the returning an old rx for nitro...as far as I

know, we have not received any old nitro tabs.

Thanks, for the info.

Donna F (Lealee12; sadiesmom)

Re: Nitro Stat and easy open lids

Dear Donna,

I do not know the exact law. It may have (probably does have)

something to do with the Child Safety Act which states that all meds

are to be dispensed in containers with child safety caps/lids, except

for those meds dispensed to patients who sign a waiver releasing

pharmacy and pharmacists from the responsibilty if something happens

to a child or grandchild. Patients who sign such a waiver may have

arthritis medication or other meds that would necessitate that the

patient must have quick access and/or ease of opening due to the

nature of the med or the disease state of the patient. (not in these

exact words).

To my knowledge Nitroglycerine or Nitro Stat tabs are packaged and

dispensed in the original in dark amber glass containers with a light

weight metal screw cap which has a specific " inner " (shiny) coating

to prevent metal contact. Has this changed? I have not dispensed

since l999. My last recollection is Nitroglycerine sublingual

tablets such as Nitrostat, are packaged in dark amber glass with such

a light weight metal top.

In addition, patients should bring in their unused nitroglycerine of

6 months old to the pharmacy, whether it was opened or not! The

potency may be weakened over time, especially if the container was

opened. ( I am not sure about billing on this! Retail techs check

this one out!) Many patients fail to do this and many pharmacists

fail to counsel on this.

Now I do not understand how they could be placed in a container with

Flip top plastic lids ( non-safety caps) since all nitro products

should be dispensed in amber glass containers, no plastic as it may

react with the nitro.

Please give a copy of this post to your pharmacist and ask him/her to

comment. In addition please post about what type of container your

pharmacy receives the nitroglycerin tablets in and what type of

container it dispenses it in, please include material and lid (

original or transfered? glass/metal plastic and lid and construction

etc).

Thank you for the question and I would say that this needs further

exploration.

I should like to hear from other retail techs.

Thank you,

Jeanetta Mastron CPhT BS Chemistry

Founder/Owner

i

>

>

> Hi Jeanetta,

> I have a question about Nitro Stat and easy open lids. While

filling

> an order for Nitro Stat, my Pharmacist gave me a FYI note...He

knows

> I am studying for the exams, and said that it is a federal law that

> mandates that we always put an easy open lid on this Rx. I can

> understand the reason why. I asked him if he knew the exact law,

but

> he could not at that moment.

>

> Could it be somewhere in the Child Safety Act?

>

> This may be a good question to have on your practice exam.

> Thanks in advance,

> Donna f

[Guest guest]

Jeanetta,

I am sorry if I miss worded my question. To clearly it: We do not open the

amber bottle of nitro,; we place that bottle in a vial so that a proper label

can be affixed to it.

Sorry for the confusion.

Donna F

Re: Nitro Stat and easy open lids

To make this clearer, I believe that patients need to get into the

nitroglycerin bottle quickly, that the use of a non-safety cap would

mean plastic and that this is NOT acceptable. I also believe that

the 'screw cap " for the nitro that it is available in 'is not a child

safety cap and yet it is not a plastic 'flip top " either and is

exempt from the child safety act requiement due to the nature of the

disease that the drug is dispensed for (for quick access and use).

Thank You for the question and we shall use it after we get your

pharmacist's input and that of Joe Medina.

Respectfully,

Jeanetta Mastron CPhT BS Chem

Founder/Owner

PS I need you Donna F to show YOUR post andmy two posts to your

pharmacist. I think you may have misunderstoon him/her (or else I

understood your post to mean that a 'plastic flip-top non- safety cap

is to be used. This does not compute with me. Perhaps the screw top

is considered a non-safety top. I can accept this. Thanks Jeanetta

> >

> >

> > Hi Jeanetta,

> > I have a question about Nitro Stat and easy open lids. While

> filling

> > an order for Nitro Stat, my Pharmacist gave me a FYI note...He

> knows

> > I am studying for the exams, and said that it is a federal law

that

> > mandates that we always put an easy open lid on this Rx. I can

> > understand the reason why. I asked him if he knew the exact law,

> but

> > he could not at that moment.

> >

> > Could it be somewhere in the Child Safety Act?

> >

> > This may be a good question to have on your practice exam.

> > Thanks in advance,

> > Donna f

[Guest guest]

Thank You Joe; I shall print this and show it to my Pharmacist. He will be

pleased that , (with the help from this Study group that I have been praising so

highly)I followed up on this.

Donna F

Re: Nitro Stat and easy open lids

Hi Jeanetta and Donna,

I hope this helps concerning Nitro Stat and easy open lids:

The United States Poison Prevention Packaging Act (PPPA) was passed

in 1970 and is currently administered by the U.S. Consumer Product

Safety Commission. The Act was decreed to prevent young children

from accidentally ingesting hazardous substances ordinarily stored

about the house. The law requires toxic, corrosive, or irritant

substances to be packaged in such a way that it will be difficult for

children less than 5 years to open them, yet not difficult for adults

to open.

The Act also requires special packaging for both prescription and non-

prescription drugs. Prescription drugs intended for topical or other

non-oral administration do not require child-resistant packaging.

The Act exempts prescription drugs from child resistant packaging if

either the prescriber or patient requests it or if the medication is

on the list of drugs which are exempt; including Nitroglycerin and

sublingual / chewable preparations of Isosorbide Dinitrate, both of

which are used for angina.

[taken from the Tech Lectures Review Manual/Workbook]

Respectfully,

Joe Medina, CPhT

http://www.techlectures.com

[Guest guest]

Yep?!This is what we did to at our outpt window in the hospital.

Floors (in pts) did not get the outer plastic vial.

Thanks

Jeanetta

> Donna: We do the same thing!! char

>

> Charleen A. CphT

> Technician Representative

> Spokane Pharmacy Association

> &

> Pharmacy Technician/Trainer

> Sixth Avenue Pharmacy

> W. 508 6th Avenue

> Spokane, WA 99204

> (509) 455-9345 wk.

> (509) 953-9308 cell.

[Guest guest]

Dear Donna,

Thanks for the clarification! I was going nuts wonder how this could

have changed so drastically! Hee!

Glad to know that my information was on target and correct with the

exception of the exact name of the Law whiich Joe Medina provided us

with.

Thanks for the question. Obviously a good one!

Love ya,

Jeanetta

> > >

> > >

> > > Hi Jeanetta,

> > > I have a question about Nitro Stat and easy open lids. While

> > filling

> > > an order for Nitro Stat, my Pharmacist gave me a FYI

note...He

> > knows

> > > I am studying for the exams, and said that it is a federal

law

> that

> > > mandates that we always put an easy open lid on this Rx. I

can

> > > understand the reason why. I asked him if he knew the exact

law,

> > but

> > > he could not at that moment.

> > >

> > > Could it be somewhere in the Child Safety Act?

> > >

> > > This may be a good question to have on your practice exam.

> > > Thanks in advance,

> > > Donna f

>

>

>

[Guest guest]

Joe-

Bearing the PPPA in mind, which I think is an awesome safety net...

Do you think that some pharmaceutical company will ever produce a

unit dose pkg under those specifications for hospitals? I mean we

waste so many bottles when parameds open it up for one pill for a ER

case, or if its a PRN med... I mean we can place a par level of 10

in an ER bag and a minimum for the patient's drawer... I dont know

just an idea...

Pankey, CPhT

> Hi Jeanetta and Donna,

>

> I hope this helps concerning Nitro Stat and easy open lids:

>

> The United States Poison Prevention Packaging Act (PPPA) was

passed

> in 1970 and is currently administered by the U.S. Consumer Product

> Safety Commission. The Act was decreed to prevent young children

> from accidentally ingesting hazardous substances ordinarily stored

> about the house. The law requires toxic, corrosive, or irritant

> substances to be packaged in such a way that it will be difficult

for

> children less than 5 years to open them, yet not difficult for

adults

> to open.

>

> The Act also requires special packaging for both prescription and

non-

> prescription drugs. Prescription drugs intended for topical or

other

> non-oral administration do not require child-resistant packaging.

>

> The Act exempts prescription drugs from child resistant packaging

if

> either the prescriber or patient requests it or if the medication

is

> on the list of drugs which are exempt; including Nitroglycerin and

> sublingual / chewable preparations of Isosorbide Dinitrate, both

of

> which are used for angina.

>

> [taken from the Tech Lectures Review Manual/Workbook]

>

> Respectfully,

>

> Joe Medina, CPhT

> http://www.techlectures.com

[Guest guest]

Hi Jeanetta and All,

We dispense nitroglycerin tablets 100 count in the original glass bottle with

the pharmacy label on the outer box. Nitroglycerin 25 count bottles come 4 in

the box and if all 4 bottles are being dispensed at the same time we place the

pharmacy label on the box. If we get an Rx for only 1 bottle of 25 count

nitroglycerin we take the glass amber bottle from the manufacturer and place it

intact in one our plastic amber vials with a non-safety cap because it is the

only way we can label it.

Funny you should mention returning old nitro tabs, I just had a customer come in

today with a bottle (expiration date still good 02/03) and the tablets had

disintegrated. He just asked for a refill not a refund at his request. He said

he usually gets the box of 4 - 25 count bottles and doesn't use them that often

so he requested only 1 bottle of 25 this time.

Re: Nitro Stat and easy open lids

Dear Donna,

I do not know the exact law. It may have (probably does have)

something to do with the Child Safety Act which states that all meds

are to be dispensed in containers with child safety caps/lids, except

for those meds dispensed to patients who sign a waiver releasing

pharmacy and pharmacists from the responsibilty if something happens

to a child or grandchild. Patients who sign such a waiver may have

arthritis medication or other meds that would necessitate that the

patient must have quick access and/or ease of opening due to the

nature of the med or the disease state of the patient. (not in these

exact words).

To my knowledge Nitroglycerine or Nitro Stat tabs are packaged and

dispensed in the original in dark amber glass containers with a light

weight metal screw cap which has a specific " inner " (shiny) coating

to prevent metal contact. Has this changed? I have not dispensed

since l999. My last recollection is Nitroglycerine sublingual

tablets such as Nitrostat, are packaged in dark amber glass with such

a light weight metal top.

In addition, patients should bring in their unused nitroglycerine of

6 months old to the pharmacy, whether it was opened or not! The

potency may be weakened over time, especially if the container was

opened. ( I am not sure about billing on this! Retail techs check

this one out!) Many patients fail to do this and many pharmacists

fail to counsel on this.

Now I do not understand how they could be placed in a container with

Flip top plastic lids ( non-safety caps) since all nitro products

should be dispensed in amber glass containers, no plastic as it may

react with the nitro.

Please give a copy of this post to your pharmacist and ask him/her to

comment. In addition please post about what type of container your

pharmacy receives the nitroglycerin tablets in and what type of

container it dispenses it in, please include material and lid (

original or transfered? glass/metal plastic and lid and construction

etc).

Thank you for the question and I would say that this needs further

exploration.

I should like to hear from other retail techs.

Thank you,

Jeanetta Mastron CPhT BS Chemistry

Founder/Owner

i

>

>

> Hi Jeanetta,

> I have a question about Nitro Stat and easy open lids. While

filling

> an order for Nitro Stat, my Pharmacist gave me a FYI note...He

knows

> I am studying for the exams, and said that it is a federal law that

> mandates that we always put an easy open lid on this Rx. I can

> understand the reason why. I asked him if he knew the exact law,

but

> he could not at that moment.

>

> Could it be somewhere in the Child Safety Act?

>

> This may be a good question to have on your practice exam.

> Thanks in advance,

> Donna f

[Guest guest]

Dear m

Yes this is just as we dispensed in the hospital that I worked at.

Apparently nothing has changed.

My interpretation of the question and the way the question was

written led me to believe that the packaging may have changed in the

last 3 years. Thank Goodness it has not!

I hope that your pharamcist counseled the patient to return in 6

months whether he had opened the bottle or not, whether it is expired

or not.

Thanks for your input,

Respectfully,

Jeanetta

> >

> >

> > Hi Jeanetta,

> > I have a question about Nitro Stat and easy open lids. While

> filling

> > an order for Nitro Stat, my Pharmacist gave me a FYI note...He

> knows

> > I am studying for the exams, and said that it is a federal law

that

> > mandates that we always put an easy open lid on this Rx. I can

> > understand the reason why. I asked him if he knew the exact law,

> but

> > he could not at that moment.

> >

> > Could it be somewhere in the Child Safety Act?

> >

> > This may be a good question to have on your practice exam.

> > Thanks in advance,

> > Donna f

>

>

>

>