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PDF Editor FAQ

Why can't my local pharmacy order medicines for me that they can order for others, on the same day?

It depends on the type of medication. Non-controlled medications CAN be ordered for same day delivery if the order is placed early enough in the day. Some controlled medications (schedules III thru V) can be ordered for next day delivery. Schedule II medications (opiates, amphetamines, etc.) require a special order form that cannot be delivered to the wholesaler electronically AND requires the signature of the DEA registrant for that particular pharmacy. This means that the order must:be manually written or typed in triplicate on a DEA-222 form, and then this form must be signed by the registrant (usually the managing pharmacist), and then delivered to the wholesaler.The delivery driver for the wholesaler will collect these forms when he drops off orders and return them to the wholesaler to be filled. These drugs are the ones that can take 2 to 7 days to be delivered to your drug store.When delivered to the pharmacy, the order itself is delivered with both an itemized receipt and 1 of the triplicate copies of DEA-222 form sent to the wholesaler. The receipt and the pharmacy copy of the 222 must be kept filed for 5 years. The other 2 copies of the 222 form are also kept (one by the wholesaler and one is sent to the regional office of the DEA.)So, as you can see, the process for ordering more tightly controlled medications is much more time and labor intensive than ordering a bottle of amoxicillin or a few z-packs (which can be done electronically with literally a few keystrokes.)

Is it a protocol for a pharmacist at a large retail pharmacy, like CVS, to simply say they are out of stock rather than do what is reasonable to get that drug delivered from another location as soon as possible?

I worked for years in a hospital and we traded back and forth with some of the local pharmacies. We also did that back in the early 70’s when I was a USAF pharmacist, and yes it is legal for a pharmacy employee to transport drugs in their private vehicle. If they should be stopped by law enforcement for any reason, a simple call will show that they are transporting under proper conditions.Now scheduled drugs, specifically Schedule II, which requires proper paperwork, ie a federal order form, DEA form 222, which must be initiated by the receiving(purchasing) pharmacy and presented to the supplying(selling) pharmacy. I did some relief work for a small chain that had two stores in the area, both not in the town where I lived. I was working in one, and we did not have enough of an item for a prescription so we initiated a form 222 which I carried home with me that night, went by the other store the next morning picked up the medication, completed all the paperwork and I carried it back to the store where I was working and the medication was needed. I had transfer documentation with the medication every step of the way and was totally legal. Now schedule II medications can be ordered electronically but I am not familiar with the procedure, but it is somewhat similar.Bottom line is that those medications have to be transported numerous times before arriving at the final pharmacy, and always by delivery personnel from wholesalers, or large chain warehouses, or by common carrier, over the road freight, ups, fed ex ect, so have problem with someone saying a clerk or tech cannot carry something across town store to store. What about all the delivery programs from pharmacy to patient’s front door.Someone needs to think about their answers.

Why does the US use 5.56mm instead of 7.62mm or an in-between?

Ammunition container size.The Russians developed their intermediate-power cartridge largely by chopping down the 7.62x54mmR cartridge that had just won WWII on the Eastern European Front and China. The final design, as you can see below, ended up significantly different to facilitate rapid firing and feeding, but that was the basic idea; a slower, lower-recoil Mosin Nagant round. The result was the 7.62x39mm, or 7.62 Soviet, that fed the AK-47 and most AK-pattern rifles until the Berlin Wall fell.7.62x39mm on the left; in the center is the 7.62mm NATO I will discuss next.The Americans originally adopted a smaller but roughly equally-powered cartridge to the .30–06 Springfield that they used for WWI and WWII, the .308 Winchester, in NATO metric terms the 7.62x51mm, which first saw service in early Vietnam with the M-14..308 above, .30–06 belowThe size difference was achieved mainly by “right-sizing” cartridge energy; the .30–06 was based on an older cartridge with a round-nose ogive, the .30-03, but was then modified to use the now-common Spitzer-ogive bullet which had much better aerodynamics, and as a result retained more energy than was typically needed. The .308 has a little less oomph than the older cartridge, but still plenty to get the job done, and further aerodynamic refinement of the bullet has improved this round more than the older .30-06 due to differing constraints on overall length.The high energy, however, proved a problem against Vietnamese soldiers fielding Chinese copies of the Russian AK. The M-14 had better long-distance accuracy, but at closer range the AK’s automatic fire was more controllable than the M-14’s. The U.S. kept the 7.62 as a medium machine gun round and for distance work in sniper rifles like the M24 (based on a civilian Remington 700 bolt-action), and uses it to this day, but very early in the Vietnam conflict it began looking for a replacement for the .308 to issue to the rank and file.The platform that would become the M-16 and the civilian AR-15 was developed jointly by Fairchild Industries (now largely out of the arms business) and Remington along with other firms to fill a spec requested by the Army. The requirements dictated a “small-caliber, high-velocity” cartridge, which “cheats” the physics of projectile ballistics a little by focusing on the velocity component of kinetic energy, thus achieving very high muzzle energies with very little recoil. I say “cheats”, because the disadvantage comes at the other end; collisions, aka terminal ballistics, are calculated using momentum, where mass and velocity are equal contributors, so a larger slower bullet (say, the .45ACP) has less energy but more momentum. This was known, but the Army reasoned that if automatic fire is the wave of the future, it better be as easy as possible for the soldiers to control.Anyway, the cartridge developed was originally called the .222 Special, however as there were a lot of .22 caliber cartridges, they renamed it the .223 Remington to avoid confusion. That then became NATOized as the 5.56x45mm. Military rounds ended up slightly hotter than the round released to civilians (this is typical; the 9mm NATO is also slightly overloaded compared to SAAMI “standard” loadings for 9mm Luger, though the civilian .308 is actually the hotter round compared to its NATO counterpart), but the cartridge dimensions are identical.One of the major advantages of the 5.56mm round is carrying capacity:On the left, an AR/M-16 30-round magazine for 5.56mm NATO. On the right, an AK-pattern 30-rounder for 7.62x39mm Soviet. Given that standard battle loadout is currently 7 30-round magazines, which of these two would you rather be humping through the jungle or across the desert along with 6 of its friends and one in the gun? The denser arrangement allows NATO troops to carry more ammunition in a lighter package than the Soviets and their allies.Now, there have been rumblings from soldiers and civilian analysts that the U.S. went too far in squeezing energy out of such a small round; those terminal ballistic disadvantages I mentioned made the 5.56mm seem wimpy compared to the larger Soviet round, but the space efficiency of (and standardization around) the 5.56mm sure was handy. Tests in ballistics gel and pig carcasses show the 5.56 is definitely a round you don’t want to get hit with (the high energy in fact sets up fairly significant hydrostatic shock for such a small round), but concerns over facing enemies wearing more advanced armor (the U.S. has never really faced more than flak jackets since adopting the round) and having to shoot through light cover and over longer ranges than the 5.56 was designed for remain valid issues.Several “hybrids” of the two approaches have been developed since the ‘50s, designed to fit in “STANAG” magazines and thus feed into an AR and many other NATO rifles with only modifications to the barrel, bolt carrier group and buffer required. These rounds include the 6.5mm Grendel and .300 Blackout, both specifically designed for use in the Armalite Rifle (M16) pattern:7.62 NATO, 6.5mm Grendel, and 5.56mm NATOThe Grendel traces its lineage over to the Russian side; its official parent case is the .220 Russian, which is a 7.62x39mm case necked down to a 22-caliber (5.5mm) bullet. The Grendel’s designers flattened the base-to-shoulder ratio (very cone-shaped for the Russian rounds, which aids in extracting the case from the chamber but requires that highly-curved magazine), and widened the neck back out for a 6.5mm bullet. The result is very close to a necked-down AK round, and AK-pattern rifles have been built to accept it (with no magazine change), but it will also fit in STANAG magazines (though losing 4 rounds capacity in a 30-round magazine to the 5.56mm).The .300 Blackout is, in simplest terms, a direct hybrid of the 7.62mm NATO and 5.56; it uses the cartridge diameter and overall length of the 5.56, but the bullet of the 7.62. This can actually cause some problems, because .300 Blackout will fit in STANAG magazines intended for the .223, and will also fit a .223 chamber (not properly), but as you could imagine, not out the barrel. Ka-Boom.Neither of these rounds have been widely adopted, though various special forces operators are giving both rounds a test run. We’ll have to see if they think it’s worth a wider adoption or even a changeover. The military has considered a hybrid round before, the 6.8mm Rem SPC which is still in very limited service with some military units and an option for the DEA, but overall the Army and Marines just have too much invested in the little cartridge that could. The U.S. Armed Forces has somewhere on the order of 3 million M-16 type rifles in its armories, and just signed a contract with H&K to procure thousands of M27 light automatic rifles based on the HK416 piston-driven AR. That’s a lot of uppers and barrels to replace if the Army should decide to switch, and if they chose the .300 AAC it would pretty much have to be a full changeover to avoid SNAFUs with mismatched firearm chamberings.

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