The Legal Drug Dealer Podcast

Getting Pharmacy as a profession Closer to The Patient

February 11, 2020

Recap & Bare and Beautiful Retreat

With Marilena Grittani, RPh

This is a recap episode of the last 3 episodes as well as some information about me.

I reviewed compounding drugs, hormonal replacement and bioidenticals, and Pre-Diabetes.

Also, I talked about a passion of mine, which is changing the pharmacy laws in the USA, to allow us to practice at the top of our scope of practice. And what the Arizona Pharmacy Association organized at the capitol in Phoenix, with over 300 pharmacists and students.

And lastly, I will tell you how I found the clear plan to become a podcaster, after an executive coaching retreat, with Dr. Carla Michelle

Next week, we will be discussing Geriatrics with Dr. Veronica Riera-Gilley, on an episode so important that you don’t want to miss it!

Hopefully, you like it, and if you have any questions, please email them to comments@thelegaldrugdealer.com, and I will answer them myself!

Listen To The Episode Here

Pharmacist Day at the Capitol In Phoenix, Arizona

Arizona Capitol, Phoenix

Arizona House of Representative Gallery

Arizona Representative Dr. Amish Shah and a bunch of pharmacists, including Eman Kirolos, PharmD

"You can call me a dreamer But I think that if you are making laws to decide, what my profession is going to be doing in the future? You should start out finding out what we do today. What is it that we're capable to do? How are we doing it, even when it's not included in the law, invite pharmacists to the Capitol and ask us questions and allow us to explain to you what is it that we do, and we're capable to do and how we can benefit the community and how we can save money to the state and the cities. And then go ahead and make new laws"

Arizona State Representative Jay Lawrence, a Pharmacy manager from Phoenix
I want to make a special mention to Arizona Representatives Jay Lawrence and Dr. Amish Shah  both strong supporters of pharmacy as a profession.
Thank you Representatives!

"...The insurance Companies (you know, it's not a secret) they don't want to pay for anything. They go by the law. The law says the world pharmacists that are not practicing in a place of pharmacy, they are not to get reimbursed. They don't pay for our services."

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If you think that you or someone you know can benefit from the information shared in this episode, please share it with them. 

And don’t forget that, if you are subscribed to our mailing list, you got the informational sheet that Dr. Angela Solis prepared for you. On this occasion is about Compounding Drugs 

As an attachment to our weekly email, but if you are not subscribed, make sure you subscribe to it, and you will get immediate access to it, and you will be up-to-date for future episodes.

Dr. Carla Michelle and me at the Retreat

Dr. Carla Michelle and a bunch of the ladies at the retreat, Bare and Beautiful

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"Once you take the drug like if you take a pain medication, it takes about what 10-15 minutes for it to start kicking in. And then after four hours, you start feeling the pain again, that means that that kind of drugs do not last more than 4 hours That's why the doctors or we pharmacist recommended to be taking at least every four hours; not sooner than that because you still have enough drug in your system that you don't want to overdo it or get excessive amount of drugs because you know, you can get side effects or adverse effects"

Dr Theresa Morrow, PharmD

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Angela Solis, RPh

Episode Transcripts

Marilena Grittani, RPh 0:08
Hello Marilena Grittani here. I am a registered pharmacist and also your host. Welcome to The Legal Drug Dealer Podcast episode nine.

Marilena Grittani, RPh 0:16
This is my second between quotations solo episode where I supposed to be answering questions but I don’t have any yet you have not sent me any questions so I’m going to do my own thing here.

Marilena Grittani, RPh 0:31
So part of what I wanted to talk to you about today so a little recap of what happened this past three episodes. We had Angela solace that is a compounding expert pharmacist with home I talked about compounding pharmacy or those medications that are designed made and prepares exclusively for you specifically personalized for you. It is a very interesting way to do it is like the old times but with more science and a little bit more of knowledge, dedicated for this, it was a very fun episode. That was episode number six. So you can go listen to it at the legaldrugdealer.com/6.

Marilena Grittani, RPh 1:15
Then we had Dr. sharzad green. She is a hormone replacement expert. She also works with other areas like sexual dysfunction for males and females. And she also is a compounding pharmacies. So we discussed general information about hormonal replacement, and it was very enlightening. We will be talking to her one more time about sexual dysfunction for male on our next episode with her, it’s about five or six weeks away, but we will get this done for you. I promise! It’s going to be super interesting.

Marilena Grittani, RPh 1:50
And last week, we talked to Dr. Theresa Morrow that is another pharmacist that talked about diabetes and her dedication to Diabetes and why is the personal and why she’s so committed to help patients with this type of disease and the whole country and actually the world she wants to take over the world with this. So it was a very interesting, very informative, and she actually as well as the other two pharmacists prepare document for you that had a little recap and a little key points of what we discussed with each one of them.

Marilena Grittani, RPh 2:25
So the one that Angela prepared was about compounding what you need to know and what you need to be prepared what to expect when you use a compounding pharmacy and that you can get it at the legaldrugdealer.com/6, that is the show notes for that particular episode. You can download it there.

Marilena Grittani, RPh 2:45
Then we had another one that was made by Dr. Sharzad Green talking about hormonal replacement, and that you can download thelegaldrugdealer.com/7 and the one that Teresa prepaid That is about diabetes and pre diabetes, about diabetes and pre diabetes, you can download that at thelegaldrugdealer. com/8. Now, I will not let this ladies put a shade on me, I will prepare my own document for you. Actually, I already did!

Marilena Grittani, RPh 3:19
So this week, I want to talk to you about why drugs are supposed to be taken every four hours, or every six hours or twice a day, and then you forget, and then you take it a little bit earlier later. Why do you have to wake up in the middle of the night to take something? Why is it so annoying that the baby finally went to sleep and you have to wake him up to give the medication? Why is this happening? Why do we have to do it this way?

Marilena Grittani, RPh 3:48
I’m not going to get into that much detail today because, I promise I will develop an episode talking about each one of the areas of this particular conversation but generally speaking we have to follow certain patterns. For example, there is medications that have certain length of time before it gets in a lower concentration on our system so much that it doesn’t cause the effect anymore. What am I trying to say with this?

Marilena Grittani, RPh 4:20
Once you take the drug like if you take a pain medication, it takes about what 10-15 minutes for it to start kicking in. And then after four hours, you start feeling the pain again, that means that that kind of drugs do not last more than 4 hours, they only last 4 hours. at the most. Well it depends on the patient Of course, but generally speaking is about that that’s why the doctors or we pharmacist recommended to be taking at least every four hours; not sooner than that because you still have enough drug in your system that you don’t want to overdo it or get excessive amount of drugs because you know, you can get side effects or adverse effects, what we talked about episode number two, and that could be detrimental for yourself. So that’s one of the reasons.

Marilena Grittani, RPh 5:07
Other recent antibiotics this day is is way more comfortable than the old times you can ask grandma about it, that she used to take all the antibiotics every four to six hours because, that’s the time that they would be effective against those bugs that are causing the infection. These days, we have new technology and they work differently. But technically what it is, is that the antibiotic you take, whether it’s a liquid, an injection, or tablet or capsule, it goes through your tummy, it dissolves there, you absorb it in your gut, and then it goes to your blood. So they travel in the “freeway” of our blood to the place where the bacteria are or those microbes are causing that infection. And then they go there and they just battle them in a “big war” and they kill most of them, but they don’t kill them all. Some of them are still there. And then the antibiotic, it gets weakened.

Marilena Grittani, RPh 6:04
And then there’s no more effect the same way that happens with pain medication after four hours, they have no more effect, similar to that, but in this case antibiotics are killing bacteria, then those bacteria that stayed alive that survived, they are mean, and they start having babies really quick and they reproduce one more time; a bunch of bacteria are build up again. So when you take the next dose, that medication goes again through the blood and then gets there to have another battle, and then kills most of them, but not all of them. This time, it was at least half of the ones that survived the first time.

Marilena Grittani, RPh 6:46
And that’s the way that it works for at least seven to 10 days, depending on the antibiotic that you are taking or the infection that we’re treating. So basically what we’re doing is decreasing the amount Bacteria there is they’re causing the infection, every single time with every single dose that you take; there is no way that one single dose will kill most of them. And then the ones that are left out at the last dose , the immune system is able to catch it up then say you have to surrender. Get out of here don’t “bug” us anymore, literally.

Marilena Grittani, RPh 7:21
So that’s why the time is settle. Some drugs are good for 12 hours. So they have battles for 12 hours, antibiotics versus bad bacteria. Some drugs are good 24 hours, so they battle during 24 hours and it’s easier for it to continuously work against the bacteria. So those are the ones that we prefer, because they’re so comfortable and we don’t forget to have them but there are some old antibiotics that are still use for certain infections that the bacteria is only sensitive to them that are to be taken four or five times a day. Those are the most “pain in the butt ones”. If you take them in intervals. Longer than four hours, the number of bacteria that are left, reproduce and create so many new bacteria babies that to neutralize that infection is going to take way longer.

Marilena Grittani, RPh 8:14
And then the problem with bacteria and antibiotics is that the bacteria are smart. After a certain number of doses, the bacteria is like, I’m not gonna let you kill me, and then it doesn’t work for that particular bacteria anymore. So that’s why two reasons you have to take antibiotics in this way, one way because is how the drug is active against them. And the other way is because you don’t let the bacteria learn how to defeat the antibiotic.

Marilena Grittani, RPh 8:43
Because this is the solo episode and part of it is for you to know me a little bit. I wanted to tell you about something that I did this week, the Arizona pharmacy Association organized a visit to the House of Representatives and the Senate for pharmacist. It was Beautiful event, it was a ton of people there. Student pharmacists, newly grads and older people like me; that we just want to support the agenda that the Arizona association of pharmacists has.

Marilena Grittani, RPh 9:15
So basically, they’re advocating for vaccinations age, by pharmacist from children from 13 years old to 6 years old. They’re also advocating for pharmacists to dispense contraceptive via protocol.

Marilena Grittani, RPh 9:32
So basically what it is, is that we organize the protocol but we need to follow what it is we questions that we have to ask communications that we need to do directly with the practitioner that the patient goes to, of course, the education that the patient needs that is with the intention of reduce unwanted pregnancies and of course, practicing more safe sexual life.

Marilena Grittani, RPh 9:52
And the last one, which is the one that I really, really care about, is about the scope of practice. Let me just give you an idea of what we’re talking about here, if you have listened to my episode since the beginning, I think you understood what pharmacists do now. We’re not dispensing drugs all the time.

Marilena Grittani, RPh 10:12
Yes, there is pharmacists that, that is all what they do, whether it’s in a hospital in a retail pharmacy in a close to us pharmacy. But then it’s a bunch of pharmacists like me, that even though we’re not dispensing medications, we’re still practicing pharmacy.

Marilena Grittani, RPh 10:26
The other good example that you have is Sharzad Green. The person that was talking to us about bioidenticals and menopause and hormonal replacement. She does not work in a pharmacy per se. She has an office in a pharmacy but she does not dispense any drugs. The other side of her business, she does it from a home office. And then we have Theresa Morrow, she’s trying to do the same. She has this new business that she is developing by educating pre diabetic patients. that need the education, that she is going to provide.

Marilena Grittani, RPh 11:03
So does that mean that we’re not pharmacist? Does that mean that we’re not providers? Does that mean that we don’t get to be reimbursed by insurances? Because we are not dispensing drugs? Well, because that is the law. That is the case. The law says that pharmacists, the only thing that we are supposed to do, at least here in Arizona, is to dispense medications and talk about interactions; But you, my dear listener, have understood that that’s not what we do. This time in age anymore.

Marilena Grittani, RPh 11:35
Actually, things changed when pharmacy became a doctorate degree. We have way more clinical information to deliver to patients interact with physicians, with practitioners, and actually to see patients ourselves the way that Sharzad does it the way that I have done it. So why are we not paid for that?

Marilena Grittani, RPh 11:58
Well, because the insurance Companies (you know, it’s not a secret) they don’t want to pay for anything. They go by the law. The law says the world pharmacists that are not practicing in a place of pharmacy, they are not to get reimbursed. They don’t pay for our services. comfortable. Hmm. Fair. ha?.

Marilena Grittani, RPh 12:16
No, it’s not. It is not fair. There’s a lot of changes that are occurring in the country in the US these days with pharmacists, the profession, and I’m very proud to be one of the pharmacist that is supporting this. So for those pharmacists that are listening to this podcast, I invite you to participate to make your voice heard; for those people that are representatives, Senators, or they have any power work with them part of their team. I want to have you open your ears to what we have to say and maybe listen to the first four episodes of my podcast and then understand what we do.

Marilena Grittani, RPh 12:56
You can call me a dreamer But I think that if you are making laws to decide, what my profession is going to be doing in the future? You should start out finding out what we do today. What is it that we’re capable to do? How are we doing it even when it’s not included in the law, invite pharmacists to the Capitol and ask us questions and allow us to explain to you what is it that we do, and we’re capable to do and how we can benefit the community and how we can save money to the state and the cities. And then go ahead and make new laws

Marilena Grittani, RPh 13:31
Research, what is it that the community is going to need in the future and find out if pharmacists can do it? And then if that is something that is part of our training, even if we have to modify our school classes will do so. But help us, by listening and by researching, you don’t get to make decisions about our profession without even knowing what we do? I think is fair. I’m just saying,

Marilena Grittani, RPh 13:55
Okay, enough with that.

Marilena Grittani, RPh 13:56
Now, I want to tell you something that is very personal And is mainly the reason why I’m doing this. I’m working as a podcaster now, and I’m dedicating my professional life to help the community to understand healthcare and what you can do or what you shouldn’t be doing with drugs.

Marilena Grittani, RPh 14:16
This was not an easy transition to make. And partially, Dr. Carla Michelle, which is my executive coach is the one that helped me realize that this is what I needed to do. She never knew that this was a possibility for me, neither did I. But she helped me think about options. And what is it that I wanted to do? And what was my real why in life? what Miss Oprah Winfrey called, The reason why you’re here in this world. After two days that I spent with her in a retreat that she did in Palm Springs last year; she with her bare and beautiful event. She allowed me to dig inside of myself. I’m finding Why I was doing what I was doing. Why was I frustrated not finding a job? Why didn’t I want to work for anybody else? What was it that I wanted to do? It was a very introspect research that I did those days. With a bunch of females we were 10 ladies there, in a beautiful house in Palm Springs with the sun with palms lovers with a pole, excellent food. We didn’t have to lift a plate, nothing, everything was done for us.

Marilena Grittani, RPh 15:27
We were just there to analyze ourselves to help ourselves understand, what is it inside of us? And what is it that we really want to do? You have so much to do during the day that you know, allow those thoughts to come to you. You just neutralize them because you’re too busy doing other stuff. When you take the time in a situation and a place like this, where you’re guided, oriented and supported by therapists with tons of experience and they bring it to the place that you need to find out internally what Is it that you want to do and how you want to do it? Things become really clear.

Marilena Grittani, RPh 16:04
While I was there, I understood certain road blocks that I put on my own professional life and how to move them. The following month or two months after that my brain went into overload like, Okay, this is what we’re doing. This is how we’re doing it. And it became super clear to me, what is it that I wanted to do. True, I am on my middle age phase, and I’m trying to do what makes me happy. What I can do professionally speaking to help people the way that I wanted to do it, but also, I wanted to do it in a way that was comfortable and it was meaningful for me and my family. So after a lot of thinking and a lot of research inside of myself, I found out that what I wanted to do was to educate the community and the first step was to create a podcast and here I am.

Marilena Grittani, RPh 16:52
So Dr. Carla, Michelle, thank you for that. If any of you have the opportunity to go to a Retreat that is oriented to executive coaching, specifically for females that are entrepreneurs and they have highly motivated brains that just want to be successful. Don’t doubt it! When you’re surrounded by people like you like minded, that are not your friends, that are not going to sugarcoat anything for you that are as raw as they could be in front of you. The only thing that it does is that allows and helps you to do the same. And when you do that, when you let down every single shield, or wall of protection that you have … you find you and it’s way easier to understand what your future is. That is what Miss Carla Michelle and also Marilyn did for me in the retreat called bear and beautiful the red tent experience. That’s how she called it.

Marilena Grittani, RPh 16:56
It was 10 females and we did it in a way that I would never forget. I wanted to talk about this Because Carla Michelle is having another retreat. That is called bold and beautiful on April the third of this year. And you know what she’s coming on the podcast she’s talking about fear and how to let it go, I will absolutely recommend that you listen to that so you understand her.

Marilena Grittani, RPh 18:23
But I wanted to talk about bold and beautiful because she is going to give anybody that register before the end of February $400 discount for the whole pack. And again you get to stay in a luxury room with everything taking care of with food, everything for you plus all the therapies that you will have until midnight because she’s not gonna let you go and wake you up early so you do yoga and relax.

Marilena Grittani, RPh 18:49
It is absolutely worth it. My professional mine destiny and path have absolutely improve and change things to this experience. I would not even think about, it just jump for it before is too late because she has very, very few openings. So take advantage of this run there. I am going to put links here on the show notes and also on the podcast page thelegaldrugdealer.com/9.

Marilena Grittani, RPh 19:18
And also I’m going to put their her Instagram my goodness you need to follow her… oh my gosh, she is so good. So good. And so positive and so motivational at she’s thebest. Also we’ll get there her podcast she also has a podcast which she has invited me to attend.

Marilena Grittani, RPh 19:35
She’s going to interview me very soon and I will let you know about that too. It is somebody that you want to keep close by that you want to listen to, and you want to support.

Marilena Grittani, RPh 19:46
Don’t forget about and beautiful April the third 2020 with Dr. Carla, Michelle, in Palm Spring.

Marilena Grittani, RPh 19:54
So that is it for this episode. Thank you so much for listening. Please subscribe to the podcast give us a review. And if you have a question send them to me at comments@thelegaldrugdealer.com. I will respond to you directly or I will include it on my next solo episode, where I will answer all your questions.

Marilena Grittani, RPh 20:14
Also, visit the legal drug dealer calm. look around and see what I have there for you and follow us on Instagram. Join our private Facebook group community and subscribe to our mailing list, so you will not miss a detail.

Marilena Grittani, RPh 20:29
Next week we will be talking about geriatrics and I will be interviewing somebody super knowledgeable and very sweet. Her name is Veronica Riera-Gillet. she happens to be a clinical pharmacist that is board certified in geriatrics. The conversation is very smooth, and it turned a little bit to an area, that is not what I expected, but kind of is related. Very interesting episode and I believe That you will enjoy it and learn a lot from her, at the end you will be grateful that we did this she also have prepared for you a very interesting document so you cannot miss that episode.

Marilena Grittani, RPh 21:12
Okay, so I am done.

Marilena Grittani, RPh 21:15
But before I go and just in case no one has told you today, I wanted to take a minute to remind you of how awesome you are, and how lucky are those that have you in their lives. Thank you for being the awesome you that you are.

Marilena Grittani, RPh 21:29
Have a wonderful rest of your day.

Marilena Grittani, RPh 21:31
This is Marilena Grittani The Legal Drug Dealer.

Marilena Grittani, RPh 21:34
Bye for now.

Transcribed by https://otter.ai

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