Semana 4- Clase 2: Sistemas tradicionales de dispensación de medicamentos

Buenos días, muchas gracias por la invitación. Es un gusto concurrir a la facultad de química.

En el día de hoy vamos a, no sé si se escuchan bien el micrófono. En el día de hoy vamos a ver lo que tiene que ver con sistemas de distribución de medicamentos y particularmente lo que tiene que ver con los sistemas tradicionales de dispensación intrahospitalaria. Si ven que no se escucha bien, me hacen saber, por favor.

Entonces, antes de empezar y abordar directamente el tema de distribución interhospitalaria y particularmente sistemas tradicionales, vamos a repasar un poco qué entendemos por dispensación. O sea, el tema va para mucho y desde ya voy adelantando que si bien la dispensación es un proceso central y claramente es uno de los colectivos principales que tenemos a nivel de las farmacias, no es el único proceso ni tampoco es el único fin que tiene la hospitalar.

Entonces, vamos a empezar con qué entendemos por dispensación de medicamentos. Pueden ser ideas y después lo armamos. Otra pregunta, ¿es lo mismo pensar que dar? No, claramente no. Si yo quiero vender algo, estoy claramente en una actitud comercial, ¿verdad? Voy a convencer de alguna manera al cliente de que mi producto es muy bueno, que tiene muchísimas ventajas, que claramente esperemos que así lo sea, pero ante todas las cosas tengo un interés comercial con respecto a la contrarrasto.

Ahora, cuando estamos dispensando medicación estamos en otra actitud. Estamos en una actitud profesional, particularmente a nivel de un profesional de la salud. Entonces, ahí ya no estamos vendiendo. Sí. Entonces, si yo digo que yo dispenso medicación a un paciente, ¿qué es lo que estoy haciendo? O sea, físicamente que entregando. Estoy entregando una medicación. Bien, es un punto central en la distanciación. Hay una entrega de medicación.

Ahora, esa entrega de medicación va acompañada de un montón de cosas para que yo pueda entregar esa medicación. Habitualmente, por lo menos a nivel hospitalario, siempre va a ser así. Me tengo que basar en una indicación médica. Entonces, tal vez inconscientemente, pero esa indicación médica la tengo que interpretar. Si tengo que leer esa indicación médica y tengo que interpretarla, ¿tiene algún tipo de código? Aunque sea algo rápidamente deducible, tiene algún tipo de código que yo tengo que poder entender porque tiene una meditación, a veces incluso se sugiere una marca comercial en particular, tiene una dosis, tiene una posología, tiene una dilución. Esa indicación médica también tiene una vigencia, caduca en el tiempo, no es indefinida. Por más que es un tratamiento crónico, va a haber un tipo de renovación de la indicación médica. Bien, entonces hay un montón de conceptos antes de entregar la medicación, interpretar lo que es la indicación médica.

Entonces, ahí ya tenemos un componente diferente, ¿verdad? O sea, dijimos, no estamos en una actitud comercial, estamos en una actitud profesional y sanitaria. Segundo, estamos interpretando la indicación de otro profesional de la salud. Ese es otro punto. Yo voy a ir a buscar esa medicación. Sí. Puede que utilicemos sistemas automatizados que cada vez son más comunes y sepamos que lo que hacen es auxiliar a la farmacia, no sustituir el trabajo, sino hacerlo más eficiente, más rápido, incluso más seguro y también muchas veces más trazable. Pero más allá de eso, hay un tipo de preparación que está involucrada y yo voy a realizar la entrega de esta medicación al paciente, al usuario o puede ser a un familiar, alguien que vaya a acompañar ese paciente en el proceso terapéutico.

Igualmente mi actu allí, va a continuar porque el paciente puede, en torno a la migración, tener una serie de dudas, de consultas, puede necesitar saber cómo se almacena, cómo la debe conservar en su casa, cómo la tiene que descartar, si tiene que viajar, si tiene algún tipo de acondicionamiento, a qué hora lo tiene que tomar, si puede interaccionar o no con otros medicamentos, qué efectos saludos puede llegar a tener. Muchas de esas preguntas desde la farmacia estamos capacitados para responderlas y muchas otras. Bien, estamos capacitados. Es importante interactuar previamente con el médico. Sí, siempre es bueno trabajar en equipo con los demás profesionales de la salud y actuar en consonancia. Si más allá de que tengamos la información y sepamos perfectamente a qué hora se debe administrar un fármaco, si es con o sin comidas, siempre es importante chequear previamente qué fue lo que habló el médico con la persona. Bien, porque siempre es importante la coherencia y lo que va a percibir el usuario de parte de los profesionales de la salud es su coherencia de todas las cosas. Si empiezan a ver informaciones contradictorias el médico y la farmacia, lo que va a terminar pasando es que se afecte la imagen institucional, ¿verdad?, de la institución de la que estemos hablando y va a generar, ante todo, una incertidumbre en el paciente. Entonces, la coordinación farmacia con el resto de los profesionales de la salud es sumamente importante.

Bien, entonces destacamos este punto que la dispensación ante todas las cosas es un acto profesional de entrega de la medicación al paciente con un análisis previo de la indicación médica y con un asesoramiento que acompaña a la entrega de esa medicación. O sea, el asesoramiento es parte de la dispensación. Eso es sumamente importante, ¿sí? Porque hablamos de dispensación, es de hecho la función principal de las farmacias hospitalarias, pero no es el único rol ni es su único cometido y hay un montón, realmente son muchísimas las acciones y procesos que llevamos a cabo en las farmacias, no solo las hospitalarias, para poder cumplir el cometido entre medicación, pero todo lo demás que fal.

En resumidas cuentas, podríamos decir que el rol de la farmacia es asegurar la disponibilidad de medicación para los pacientes, pero en consonancia de un marco de eficiencia, de seguridad del paciente, de uso racional de la medicación, de trazabilidad de la medicación. Sí. Y lograr todo eso que acompaña la entrega de medicación es lo que justifica o explica la variedad de procesos que llevamos a cabo a nivel hospitalaria.

Entonces, ya respondimos la segunda pregunta. No es lo mismo dispensar que vender medicación. El término distribución se aplica a nivel hospitalario y tiene que ver con cómo llega la medicación a los pacientes. Es decir, cuando un paciente está internado, farmacia no interacciona habitualmente directamente con el paciente, sino que el nexo es enfermería. De hecho, enfermería suele ser la preparación, por ejemplo, en los inyectables. Entonces, hay que reconstituir y diluir la medicación para posteriormente estar disponible para su administración. La medicación parenteral suele tener una preparación un poco más acotada, o sea, sobre todo si trabajamos para el sistema de dosis unitaria, en realidad al paciente le llega prácticamente directamente lo que farmacia preparó, no decir directamente le llega la monodosis a las manos del paciente, pero en muchísimas situaciones enfermería cumple un rol previo de preparar medicación, algún tipo de intermediación entre farmacia y el paciente.

Entonces, esto no sabrán bien, ¿puede realizar la dispensación cualquier persona? No, ¿verdad que no? No me puedo presentar en una farmacia. Hola, ¿qué tal? Terminé de bachillerato. Eh, quiero trabajar en esta farmacia. O sea, como personaje se encarga de dispensar medicación, no todas las personas están habilitadas, ¿verdad? Hay determinadas profesiones que pueden dispensar que son básicamente los químicos farmacéuticos y los auxiliares de farmacias que tengan su título registrado ante el Ministerio de Salud Público, ¿verdad? Esa es la normativa uruguaya.

Esto es una pregunta super importante. ¿En cualquier lugar se puede dispensar medicación? En cualquier lugar, ¿no es verdad? Que ni la feria, ni los supermercados, ni los kioscos son lugares habilitados para descansar medicamentos. Solamente las farmacias habilitadas, permitido de salud pública son lugares permitidos para dispensar medicación.

¿Qué consideraciones debemos tener al momento de dispensar un medicamento? Bueno, un poco lo conversamos, ¿verdad? Hay que analizar la indicación médica, hay que tener en cuenta la posología, hay que tener en cuenta la dosis de la medicación, hay que tener en cuenta que pueden haber múltiples múltiples formulaciones, porque pueden haber de liberación prolongada, liberación convencional, entre otros. Y ya comentamos, es la función principal y única de la farmacia. Es la principal, pero claramente no es la única. Y todas las demás funciones que realizamos van acompañando esa búsqueda de un uso seguro, racional, eficiente de los medicamentos.

Bueno, entonces esta es la definición de transición, después la leen con más tranquilidad, es lo que comentábamos, destaco ciertos conceptos. Es un acto profesional llevado a cabo por la farmacia en el cual se proporciona medicación a un paciente, habitualmente respondiendo a una indicación médica que fue elaborada por otro profesional sanitario. En ese acto farmacéutico se va a informar y orientar al paciente sobre el uso adecuado de esa medicación. Y es importante tener presente la dosificación, cómo influyen los alimentos, cómo se interactúa con otros medicamentos, reconocer reacciones adversas y cómo se debe conservar el producto como punto de partida en la información que acompaña la entrega de esa meditación.

Este es un punto importante. La dispensación es un proceso interactivo. O sea, quien trabaja en una farmacia hospitalaria o en una farmacia en general debe partir de la base de que va a interactuar muchísimo con otras personas. Sea que trabaja a nivel de la farmacia interna, bueno, va a interactuar con sus compañeros, pero va a interactuar muchísimo con la enfermería. Y quien trabaja a nivel ambulatorio, sea comunitario o en una base hospitalaria, va a interactuar muchísimo con los usuarios. Entonces, en realidad el trabajo en la farmacia requiere muchísima interacción humana y por lo tanto, todo lo vinculado al que hoy en día se conoce como habilidades blandas, empatía, atención al usuario, atención profesional, atención calidad humana, son centrales, son realmente bastiones centrales del ejercicio. Pero se alta, si simplemente a veces la forma de actuar, el tono de voz, la actitud de la persona, su propia forma de pararse y y de manifestarse entre el usuario, ¿verdad? Un forma de saludar o incluso de estar dispuesto a ayudar y muchísimo en cómo la persona va a percibir el servicio que le estamos brindando y se va a ir con otra actitud, incluso va a encarar de forma diferente el tratamiento. O sea, es importante que el personal de la salud maneje todo lo que tenga que ver con habilidades de comunicación y de interacción humana, ¿verdad? Porque justamente lo que estamos haciendo es tratar con una persona a quien le estamos entregando medicación, lejos de ser una persona o mejor dicho alguien con una patología, es una persona que está transitando un proceso habitualmente doloroso, angustioso, ¿verdad? Que lo condiciona física, mental y incluso emocionalmente, ¿verdad? Entonces, como profesionales de la salud, los criterios de humanidad tienen que estar sumamente presentes.

Por eso cuando hablamos que el rol de la farmacia es dispensar, no vamos a dispensar medicación, no vamos a decir que nos limitamos a entregar medicación, va muchísimo va a far procesos logísticos que están por detrás, hay procesos técnicos como el asesoramiento que están por detrás y ante todas las cosas hay unos aspectos humanos que están por detrás de esa entrega de meditación mismo. Poder respetar el tiempo de entrega de la medicación hace parte de esa humanidad en el servicio.

Entonces, es verdad que hoy en día estamos en la era de la de la velocidad, ¿verdad? Esperamos eh que que todo sea rápido, no nos gusta esperar, hay muchísima ansiedad y vamos al al supermercado y queremos que la que la fila pase rápido, ¿verdad? Ahora no estamos hablando de una venta, eso no objet debamos tener determinadas condiciones en lo que es el servicio. A ver, estamos de acuerdo que muchos dirán, "Bueno, pero a mí me puede tocar trabajar en tal lugar y qué culpa tengo yo de que hayan eh 200 personas esperando sentadas a que toque el número." Estamos de acuerdo que no somos responsables ni siempre podemos cambiar todo el sistema de salud. Eso es cierto. Eso no quita que busquemos realizar nuestro trabajo de la forma más precisa y ágil que nos sea posible. Sí. Y obviamente los procesos se eh construyen entre todos. Entonces muchísimas veces desde su rol auxiliar de farmacia van a tener la oportunidad de de buena manera realizar sus gerencias, ¿verdad? Y ayudar a mejorar los procesos de las farmacias. A veces tal vez yo no puedo cambiar la cantidad de de usuarios o incluso la cantidad de personal que esté atendiendo en la ventanilla, pero tal vez algún cambio en el proceso puede ayudar a acelerarlo. Sí. Entonces, las farmacias también tienen que estar pensando logísticamente cómo hacer más ágil atención al usuario, ¿no? Y a nivel de farmacia intrahospitalaria lo mismo. A veces hay determinados pasos que tal vez se puedan simplificar, se puedan pensar de otra manera o se puede encontrar una mejor forma de hacerlos que conduzcan a un proceso más rápido y más eficiente. Bien, entonces dependiendo de de cada situación podemos ayudar a encontrar una manera de agilizar. Sí. Y una atención fluida ágil también es importante, también es parte de lo que se buscan los sistemas de dispensación de medicamentos. Y esto a nivel ambulatorio o a nivel intrahospitalario. De las dos maneras, en ambas situaciones hay que buscar la rapidez y la agilidad del proceso.

Bien, este punto central, cuando entregamos medicación, cuando dispensamos medicación, es nuestra obligación interpretar la indicación médica. Si estamos hablando de la farmacia hospitalaria, sea ambulatoria como interna, siempre, en absolutamente todos los casos, no haber una indicación médica que debe estar bien. Las indicaciones verbales no cuentan, o sea, yo no puedo dispensar indicación contra una indicación verbal, ¿verdad? La indicación manual eh será muy rápida, será muy cómoda, pero convengamos que no deja registro, perfectamente puede haber algún tipo de confusión fonética, entonces yo puedo escuchar algo y el médico quiso decir otra cosa. No queda evidencia de lo que me dijeron ni de lo que yo escuché y por lo tanto si ocurre algún tipo de error de dispensación, lo que puede pasar es que en realidad no tenemos ningún tipo de garantía para poder proceder. En todo caso, siempre vamos a tener la normativa nacional que nos va a respaldar y determina que toda disposición hospitalaria debe realizarse una médica. Así que quien no cumpla eso no estaría cumpliendo la normativa. Así que eso es un respaldo importante para las farmacias hospitalarias.

Entonces debemos interpretar esa indicación médica y si detectamos algún tipo de incoherencia o de problema, lo debemos reportar. Obviamente responsabilidad del médico prescribir correctamente, pero como todo ser humano se puede equivocar o puede pasar que no se entienda la letra cuando es una indicación manual, ¿verdad? A ver, las indicaciones manuales van cayendo en desuso en la medida que las instituciones de salud van incorporando la prescripción electrónica. Sin embargo, a nivel de la prescripción electrónica también pueden cometerse errores, o sea, simplemente porque seleccionó mal en el sistema informático el artículo que quería, o sea, la lista desplegable seleccionó mal, ahí pudo cometer un error de de prescripción. Entonces, en ese sentido, como profesionales de la salud, tenemos que tener una actitud alerta y tenemos que tener una actitud crítica en el buen sentido de la palabra, o sea, no crítica de criticar todo, de que todo está mal, sino la actitud de que, bueno, sí puede pasar que otro profesional de la salud cometa un error y es mi responsabilidad actuar como una barrera en el proceso o en el sistema de uso de dispensación de medicamentos.

Tenemos que ver que para que la medicación llegue al paciente no es que hayan compartimentos estancos, sino que más bien hay una cadena, sí, de diferentes sectores y de personas que están involucradas. Y cada eslabón tiene la oportunidad de ser una barrera de seguridad. Sí. De hecho, antes de que el médico prescriba, antes hay un proceso de selección de medicamentos en los cual en el cual participa activamente farmacia, o sea, para que haya un modelo institucional, o sea, la generación de una lista de medicación que se utiliza en la institución, farmacia participó o debería haber participado y muchas veces se puede hacer una selección de los medicamentos muy inteligente, muy estratégica, incluso eligiendo marcas comerciales. Sí, puedo elegir marcas comerciales porque las ampollas son bien diferentes y evitar un error de dispensación. Dos medicamentos se suelen confundir porque son muy parecidos. Ya habrán hablado de medicamentos similares, ¿verdad? Entonces puedo estratégicamente decir, bueno, cambio uno de ellos por otra marca comercial porque el rotulado es radicalmente diferente y ahí puedo bajar el riesgo de confusión de esos medicamentos, sobre todo si la confusión era visual. Bien, entonces la selección de medicamentos antecede a la prescripción médica. Entonces, ahí ya tenemos la farmacia participando antes de la prescripción médica. Y ustedes dirían, pero eso le corresponde al químico, que va a comprar la medicación. Sí, pero como auxiliares es deseable que tengan una actitud proactiva y le comenten al químico farmacéutico, realmente noto que estos dos medicamentos son sumamente muy parecidos. Podríamos buscar alguna estrategia que puede ser simplemente guardarlos en lugares separados, utilizar algún tipo de rotulado, ¿verdad? Algún tipo de estrategia que evite esa confusión a nivel de la farmacia, pero también podría ser cambiar una de las marcas si fuera posible, siempre se puede, para evitar esa confusión.

Entonces, seguidamente viene la prescripción médica y como les digo, el médico se puede llegar a confundir, por ejemplo, por un fallo de atención o porque marcó mal en el sistema o tal vez puede ser por incluso un error de concepto que podría llegar a ocurrir. Entonces, como profesionales de la salud tenemos que tener esa actitud de vigilancia, esa actitud de alerta.

Entonces, ¿qué qué podemos hacer? Bueno, si yo conozco bien la medicación con la que estoy trabajando, tengo muchas más probabilidades de detectar un error. Por ejemplo, si yo sé cuál es la dosis habitual de un medicamento, tengo bastante más probabilidades de darme cuenta de que una dosis está bien o está máxima. Por ejemplo, si yo les digo 800 mg, capaz que todavía no han visto tanto dosis como para conocerlo. En AINEs se usan dosis de entre 40, 80 mg o por lo menos estas son las presentaciones comunes, sí. Y suele tener una administración cada 24 horas. Vamos a inventar una cosa. Imaginemos que la prescripción dice insertar 800 mg. Bien, o sea, 10 veces más que la dosis habitual. Existen a veces dosis que son sumamente más altas que las habituales. Están dentro de un margen terapéutico, dentro de un rango que se pueda llegar a utilizar terapéuticamente, pero no suele ser lo común. O sea, me tiene que llamar la atención. No quiere decir automáticamente esos temas, pero me tiene que llamar la atención.

Entonces, ¿qué voy a hacer? Chequear la dosis, voy a ir a una fuente de información confiable y voy a verificar si esa dosis está dentro de las dosis permitidas o no. Si no lo está, lo voy a reportar, por ejemplo, al químico que esté presente y vamos a realizar algún tipo de acción de contactar al médico, sea que lo haga el propio auxiliar o lo haga el químico. Y entonces se va a llamar a ese médico prescriptor y se va a verificar la dosis. Si efectivamente la dosis estaba mal, se le va a pedir una nueva indicación. Bien, entonces esa actitud de alerta, puse un ejemplo exagerado, pero se puede aplicar en casos más sutiles también. Esa actitud de alerta la tiene que mantener el auxiliar de farmacia. Sí, siempre que esté trabajando con indicaciones médicas.

Muchísimas veces ocurre que por un tema de acelerar lo que es la la logística a nivel hospitalaria, que existen tratamientos prolongados, tratamientos crónicos y en esos casos eh si bien obviamente que para el usuario puede ser más cómodo porque le evita la consulta médica y a veces no es tan fácil conseguir acceso al médico y mismo especialistas y demás, ocurre que las recetas se realizan por muchos meses y en ese sentido es una buena oportunidad para la farmacia y no preguntarle al paciente siempre que sea posible cómo va con el tratamiento, porque es una buena oportunidad de detectar efectos adversos, interacciones, interacciones con alimentos, ¿verdad? Porque muchos efectos adversos se empiezan a presentar en forma crónica, ¿verdad? O es cuando se empieza a visualizar la necesidad de cambio en la indicación médica. Obviamente que si detectamos algún error, lo que vamos a hacer es aconsejarlo al paciente que concurra al médico, no vamos a proceder a decirle, "Bueno, suspenda la medicación, cambie la medicación, no vamos a dar ningún tipo de indicación, ¿verdad?, de cambio de tratamiento ni de suspensión, pero sí vamos a aconsejarle que concurra al médico porque puede estar habiendo un problema con la medicación.

Dado que todo medicamento puede generar efectos adversos, esto es un grupo clave, ¿verdad? Eh, una un concepto base en lo que es la seguridad del paciente es que toda medicación puede generar efectos adversos. No importa que sea venta libre, no importa que sea de margen terapéutico, siempre se puede generar efectos adversos, incluso con suplementos nutricionales pueden haber efectos adversos. Entonces, teniendo eso presente, es sumamente importante que todo proceso de dispensación ante todas las cosas sea seguro. Sí, es el requisito fundamental de todo proceso de dispensación, sea dispensación ambulatoria, sea dispensación intrahospitalaria y no importa qué tipo de sistema de dispensación estemos hablando.

Entonces, lo básico para un sistema de dispensación seguro es que se logren las 13 correctas, que son el medicamento correcto, para el paciente correcto y en el tiempo correcto. Ustedes dirán, "Bueno, si el medicamento correcto tiene un montón de sentido, pero no le puedo errar al paciente." Bueno, sepan que es un error relativamente común. Sí, le puedo hablar al paciente. Si estoy en ventanilla y de pronto se atendieron dos pacientes simultáneamente, vamos a suponer que puede pasar según la la distribución, la disposición en en la zona del mostrador, podría llegar a cruzar la medicación. Y me fui, fui a preparar, no recuerdo muy bien quién era el paciente, traigo la medicación, supongamos de cadena de frío, en una conservadora y se la entrego a otro paciente que no es el correcto. Podría ocurrir en forma ambulatoria. Entonces, lo correcto en ese caso es voy, preparo y antes de cerrar vuelvo a interactuar con el paciente y chequeo, estoy interactuando con la persona, ¿verdad? Fulano de tal, hablo con su nombre, ¿verdad? Este, la identificación del paciente y ahí sí puedo cerrar lo que acabo de preparar.

Y a nivel interhospitalario, usar las camas es sumamente común. Sí, sobre todo porque se trabaja con cajas, ¿verdad? y se suele cada compartimento es una cama, entonces voy poniendo medicación en los diferentes compartimentos y ahí puede pasar de que uno por otro, por ejemplo, por error, me confundí por X motivo. Entonces, ¿qué hay que establecer ahí? Estrategias de control, bien, sea control cruzado dentro de farmacia como en controles con la enfermería. O sea, antes de desligarme dije, bueno, ya terminé, ya preparé la medicación, ya se la enfermería, hay que hacer algún tipo de contralor, ¿verdad? Y verificar que esa medicación que preparé es para ese paciente en particular.

Y por otra parte, el tiempo correcto. ¿Qué tiene que ver esto en buena medida con la demora? A nivel ambulatorio dijimos tiene que ser ágil para no aumentar las esperas, para no aumentar la fila de la cantidad de personas que están esperando, pero también está en lo que tiene que ver con la disponibilidad de. Y ese punto es crucial, o sea, ahí aparecen procesos que se llaman de soporte que están por detrás de la dispensación. Nadie ve cuando la farmacia compra, nadie ve cuando la farmacia recepciona, ni cuando almacena, ni cuando controla los cimientos, ni cuando hace los controles del stock. Esos son procesos que ocurren a la interna de farmacia, pero lo que sí se ve es cuando no hay medicación. Y no lo digo solo por la imagen, lo digo porque si no tengo medicación para dispensar, hay un tratamiento que no se puede realizar y por lo tanto o no se puede iniciar o se interrumpe y de esa manera lo que está pasando es que terapéuticamente estamos perjudicando al paciente. Entonces el tiempo no solamente tiene que ver con mi velocidad de respuesta, con la fluidez del trabajo, sino que también tiene que ver con disponer de la medicación al al tiempo que es necesario, en el momento que es necesario. O sea, simplemente la gestión del stock que está por detrás y previa a la dispensación.

El tema de los correctos asociados a la dispensación lo podemos ampliar más allá de los tres correctos que mencionamos, o sea, el medicamento del paciente y la hora, porque también tenemos que ser precisos en la dosis, en la vía de administración, en el registro y en el motivo que acompaña esa dispensación. Sí, el motivo tiene que ver con el uso que se le va a dar a los medicamentos, tiene un poco más que ver con la indicación médica y que debería estar bien especificado en la indicación médica si hay más de un motivo posible.

La dispensación, como dijimos, puede ser realizada o bien por químicos, perdón, o bien por químicos farmacéuticos como por auxiliares de farmacia con su título debidamente registrado y habilitado. La dispensación es un acto que puede ser delegado del químico farmacéutico a los auxiliares de farmacia siempre y cuando se realice bajo la supervisión correcta y habiendo diseñado los procesos de forma correcta. Ese diseño de los procesos, yo siempre digo, no están escritos en piedra los procesos. Los procesos mientras existen los procedimientos se tienen que respetar. Bien, tengo que cumplir los procedimientos que están establecidos. Eso no quiere decir que no se puedan modificar nunca. Sí, pero para modificarlos hay que trabajar en consenso, hay que construirlos, hay que trabajar en equipo y muchísimas veces hay que interactuar con otros sectores como la enfermería, la dirección técnica, el cuerpo médico, etcétera. Porque recordemos, farmacia no es una isla dentro de la institución de salud, sino que es una parte más del equipo de salud pública.

Entonces, tenemos que ver que todos los eslabones, por llamarlo así, están concatenados. Sí. Entonces, para poder realizar una dispensación segura y rápida, tenemos que poder garantizar haber analizado la orden médica. Sí. No voy a ser un autómata que dice tal cosa y entrego, ¿sí?, sino que va a haber un análisis involucrado. Por eso el auxiliar de farmacia tiene que saber de farmacología, tiene que conocer la medicación con la que trabaja. Le doy un consejo. Siempre que se enfrenten a un medicamento que nunca han conocido antes, antes, tómense un minuto para leer de esa medicación. ¿Para qué sirve? ¿Qué dosis se usan, qué relaciones tiene? ¿Qué efectos adversos tienen? Realmente llega un minuto o 2 minutos, pero van a ver que van a contar con una información que les va a garantizar muchísima seguridad. Sí, muchísimos errores de dispensación de parte de la farmacia surgen del desconocimiento de la medicación con la que se trabaja. Muchísimo. Sí, porque me confundí los nombres, porque me confundí las dosis, porque me confundí el uso y porque mandé una medicación a un sector que no era, ¿verdad? Hay otros capaces que se cambian las camas, se confunden el paciente, que son más de atención, pero lo que tiene que ver con errarle al medicamento muchísimas veces tiene que ver porque desconocí la medicación. Otros tienen que ver porque los nombres eran parecidos, porque la la apariencia era parecida, pero ahí capaz que lo que falló es que no se chequeó, ¿verdad? que no se control interno dentro de farmacia, que no se controló con la enfermería, o sea, no se cumplieron cabezas porocías.

El error de dispensación o mejor dicho los errores de medicación en general, como todo error que depende de la acción humana son inevitables. O sea, siempre que el ser humano actúe hay algún porcentaje de error posible si es inevitable llevarlo a cero. Pero sí podemos reducirlo a los niveles más bajos posibles. Sí. E incluso podemos llevarlo a niveles de gravedad muy bajos también, pero eso lo voy a lograr con estrategias combinadas, involucrar un buen diseño de procesos, respetar los procesos, conocer la medicación que estamos con la que estamos trabajando, ¿verdad? Realizar los controles que correspondan. Entonces, un montón de estrategias en conjunto bajan muchísimo la ocurrencia de errores de medicación. ¿Y por qué los queremos bajar? Porque al final de todo esto hay una persona que va a recibir la medicación y que una medicación equivocada le puede generar un perjuicio de leve a muy grande, incluso fatal. Bien, entonces es super importante tener la conciencia de la seguridad al momento de dispensar y manejar medicación.

Entonces, esa indicación médica la analizo, debo interpretarla correctamente, si es necesario, voy a interactuar con el médico prescriptor. Sáquense el miedo de la vergüenza porque vamos a tener que interactuar muchísimo con este otros profesionales de la salud. Hay que hacer controles de lo que se dispensa en tiempo real o a veces en forma diferida y sin lugar que registrar eh todo lo realizado y si hubo algún tipo de error lo tengo que registrar y corregir. Y si cometí algún tipo de error, no yo sola, el equipo lo tenemos que utilizar como una fuente de aprendizaje. Bien, me equivoqué. Bien, a nadie le gusta equivocarse, pero vamos a analizar por qué se dio el error, qué se puede corregir para que no vuelva a suceder y qué puedo corregir yo individualmente para que no me vuelva a suceder.

Entonces, estas son algunas estrategias, después las van a leer con más tranquilidad porque quiero ir llegando más al foco de la clase de hoy, pero hay algunas estrategias para eh lograr la seguridad en lo que es la dispensación de medicamentos. Un punto importante es seguir los pasos especificados, sí. O sea, ya les digo, los procedimientos periódicamente deben ser realizados y actualizados si hace falta, pero mientras existen los tengo que respetar y como auxiliar de farmacia tengo que estar bien informado de cómo es el modo correcto de proceder. Siempre habrá formas mejores de hacer las cosas, pero mientras exista un procedimiento que está especificado, lo tengo que eh cumplir. Cumplir con los dobles controles, cumplir con el control cruzado con la enfermería, eh controlar lo que se entregó más cerca de la dispensación y no tan cerca de la administración. Es decir, cuando se prepara medicación es mejor que el control esté se dice más cerca de farmacia que más cerca del paciente, ¿verdad? En ese eje farmacia, enfermería, paciente, es mejor que el control se dé entre farmacia y enfermería y entre enfermería y el paciente, ¿nos chicos? Como en línea de tiempo cronológico. O sea, ¿qué quiere decir? Cuanto más cerca de la administración haga los controles, más probable es que el error llegue al paciente. En cambio, si se realizan los controles en etapas previas, es más factible que el error se detecte y se corrija a tiempo y que por lo tanto no llegue al paciente, que es lo más importante.

Aparecen también involucrados en juego muchos procesos que ya les digo no se ven, como por ejemplo el almacenamiento, pero que influyen muchísimo. O sea, ya les digo, nadie va a ver al que le toque el rol de reponer medicación en farmacia o o guardar medicación, o sea, el proceso de almacenamiento. Tal vez desde afuera no los conozcan tanto, no sepan quién son, pero van a jugar un rol super importante en la seguridad porque un medicamento mal guardado, un vencimiento mal gestionado puede impactar directamente en la seguridad del paciente porque puede hacer que el compañero que va a dispensar se equivoque o entregue una medicación que está en el almacenamiento influye tanto en la seguridad del paciente como en la dispensación. Todos los procesos tienen que ser seguros y todos tienen que tener en foco la seguridad del paciente.

Si hay errores, hay que registrarlos. El error en vez de esconderse se tiene que mostrar, se tiene que dejar por escrito y se tiene que aprender del error con un análisis previo. Entonces el error, si bien es una experiencia dolorosa, ante todas las cosas permite el aprendizaje. Entonces, más que crear una cultura que se llama punitiva, o sea, te equivocaste y vas a tener una sanción que muchas veces podría llegar a corresponder. Lo que hay que abordar es que, bueno, no hubo un error, se equivocó el equipo, ¿cómo lo vamos a corregir? Bien, o sea, mal, qué falló. Capaz que, bueno, sí, pero es que estos dos medicamentos eran idénticos. Me me justifica que me equivoqué, ¿no? Pero es tal vez el motivo por el cual me equivoqué. Entonces, ¿qué tenemos que hacer? Bueno, buscar una estrategia para que esos medicamentos que son tan parecidos dejen de confundirse, separarlos, poner carteles, eh rotularlos, comprar una marca diferente. Hay muchas estrategias.

Un personal de farmacia que esté bien capacitado tiene, como les decía, muchas menos chances de equivocarse porque tiene más probabilidades de detectar errores, tiene más probabilidades de detectar errores propios, no solamente de la prescripción. Entonces, sumamente importante, reitero, que conozcan bien la medicación con la que están trabajando. Sí, tómense 2 minutos para leer la medicación y asegúrense que la medicación que tengan en farmacia con la que estén trabajando digan, "Bueno, a todos, por lo menos tengo una idea para qué sirve, cuáles son las dosis y cuál sería el efecto adverso principal." Con esos tres puntos ya tienen un montón de de conocimiento a su favor. Va a jugar siempre a su favor.

Importante tener bien presente todo personal de la farmacia, la cultura de la seguridad, no la cultura punitiva. Me equivoqué, me van a a sancionar. Lo central es que queremos una forma de trabajo segura, porque por detrás hay una persona que va a recibir esa medicación y que si se comete un error, sea de farmacia, del médico, de enfermería, no importa de quién, puede realmente llegar a ser fatal. Y tener presente que si tengo alguna duda ante la indicación antes de proceder a dispensar por delante está la seguridad. O sea, es verdad, es importante la actividad, es importante la rapidez al trabajar, pero más importante que la velocidad es la seguridad del paciente. Sí. Entonces, si tengo dudas, hay una indicación que no me convence, de una medicación que no me cierra, vamos a informarnos previo, preguntar muchísimas veces y hacer las correcciones si es una indicación equivocada, si hace falta.

Entonces, la farmacia tiene que trabajar muchísimo para lograr todo esto. Por un lado, la gestión del stock. Ya les digo, medicación que no esté disponible es medicación que no se puede dispensar, son quiebres de stock, es un tratamiento que no se puede hacer. Una gestión de vencimientos que no esté realizada correctamente puede llevar a que se dispense medicación vencida, que es por un lado eh un daño al paciente, ¿verdad? No se puede utilizar medicación vencida. Eso también por normativa no se puede dispensar medicación vencida, pero ante todas las cosas, vamos a suponer que no le llevo a entregar la medicación vencida, lo detecto antes de dispensar. Es como que no tuviera, se me vence toda la medicación de un medicamento, es como que no tuviera, es igual un de stock, entonces no estoy pudiendo asegurar la continuidad del tratamiento.

La farmacia para eso tiene que estudiar consumos, identificar gastos, gestionar bien los pedidos que recibe, tiene que ser eficiente en los pedidos que está recibiendo, tiene que hacer una selección de medicamentos inteligente, estratégica, sea por para evitar similitudes de medicamentos, puede ser por precios, puede ser por disponibilidad de proveedor. Hay veces que hay proveedores que sistemáticamente quieran esto. Tendrá productos muy buenos, excelente rotulado, buena calidad, buenos precios, pero si sistemáticamente un proveedor falla de stock, tengo que tener un respaldo porque hay medicamentos que no puedo quebrar stock, que los tengo que tener. Sí, sobre todo a nivel hospitalario, que la muchísimos medicamentos son esenciales, o sea, si no los tengo realmente puede generar un problema clínico, hay medicación que la tengo que tener. Entonces, si un proveedor sistemáticamente falla de stock, quien está encargado de las compras, tiene que tener la estrategia de tener un respaldo, sí. De buscar una alternativa y un plan B para asegurarse de esa medicación a tiempo, ¿verdad? Que no llegue a cero.

Las personas de farmacia se tienen que capacitar continuamente. Ustedes se van a recibir, van a ser auxiliares de farmacia, pero sepan que a lo largo de su vida deben eh buscar la capacitación continua. Sí, sea bien porque se brinda directamente en las farmacias, que la mayoría de las farmacias brindan algún tipo de capacitación en forma permanente o bien por su cuenta. Sí, el contexto cambia muchísimo y si estamos mirando de 5 años para atrás, el mundo farmacéutico es otro. Hoy en día hay medicamentos que hace 5 años eran algo raro. Sí. Y hoy en día son sumamente comunes. Si hablamos de todo lo que es biotecnología, medicamentos biológicos, ha crecido y va a seguir creciendo de un modo excepcional. Todo lo que es medicación de alto costo cubierto por el Fondo Nacional de Recursos, Ministerio de Salud Pública, es impresionante el avance que tiene y los tenemos que conocer tanto como los medicamentos convencionales.

El servicio de farmacia debe comunicarse en forma permanente con otros profesionales de la salud y con los pacientes. Sí. Eh, como les digo, es un trabajo en equipo, es un trabajo interactivo, un trabajo donde la humanización es sumamente importante, la interacción humana es sumamente importante y sepan siempre que por detrás de esa entrega de medicación hay una persona, sí. Sea que interaccione directamente o no con ella, siempre hay una persona.

La farmacia tiene que estar integrada con el equipo asistencial. Las mejores decisiones se toman en equipo, la mejor selección de medicamentos se toma en equipo, los mejores procesos de control de seguridad del paciente se logran construir en equipo. Y hay muchísimos ejemplos en los que la farmacia se puede integrar. Optimización del uso de antibióticos, farmacovigilancia, eh bueno, los comités de farmacia terapéutica, diseño o rediseño de sistemas de distribución de medicamentos que ahora vamos a ver. Si bien la farmacia tiene un rol de liderar el sistema de distribución de medicamentos, la interacción con los demás eh sectores es sumamente importante, sobre todo con enfermería.

Y ser muy estratégicos al almacenar medicación, o sea, más allá de las condiciones ambientales, la temperatura, la humedad, la protección de la luz, te la tengo que cumplir porque si no lo hago, la medicación probablemente se degrade y puede generar ineficacia o toxicidad. Tengo que ser también estratégico al almacenar medicación. Tengo que elegir una forma del criterio de almacenamiento que me permita ser rápido y ser ante todas las cosas seguro.

Tenemos que entrar siempre en un proceso de mejora para mejorar, o sea, el en la filosofía de que siempre se puede hacer las cosas mejor, esa es la realidad. Si siempre se puede mejorar, capaz que ahora logro muy buenos resultados, excelentes resultados, pero mañana el contexto va a ser otro. Sí, la pandemia fue un ejemplo, teníamos procesos aceitados y de pronto realmente cambió todo, cambió la logística, cambió la edad, la demanda de medicación, medicamentos. Hablo, por ejemplo, en nuestro caso que utilizaba, voy a poner un ejemplo, 100 ampollas por mes, sí, por mes, pasaron a haber pacientes que en dos días utilizaban esa cantidad. Si si hablamos de noradrenalina, que es un vaso constrictor, sí, cambió en ese sentido. Entonces, imagínense el nivel de adaptación que tiene que tener la farmacia. Ah, bueno, eso es un contexto drástico para nosotros, pero realmente puede un momento para el otro cambiar. Sí. Sin irnos a una pandemia puede haber una guerra, cambia la disponibilidad de medicación, cambia la logística en el mundo. Hay medicamentos que se quieren tocar. Los hemoderivados, por ejemplo, todo lo que venga de la sangre, inmunoglobulina, factores de la coagulación, etcétera. ¿Saben que con la pandemia bajó la cantidad de voluntarios que donaban sangre en el mundo, por lo tanto, la fuente de hemoderivados bajó drásticamente. Entonces, todos esos medicamentos, ¿qué pasó? O los proveedores quebraban stock o subían los precios. Y ahí tenemos un cambio en la logística, en este caso mundial, no pasó solo en Uruguay, que a nosotros nos afecta. Entonces, ¿qué tenemos que hacer? Bueno, tenemos un proceso muy aceptado, bárbaro, parece que todo funciona bien, pero siempre hay que tener un plan B para poder responder. Si ese contexto se va a mantener en el tiempo, voy a tener que

Read me, I'm going to have to modify my process. It can also happen that my process is not good, that something is not working correctly. So, then, what do I have to do? Implement changes so that it works well. And how do I implement the changes? I have to do an analysis, and to do an analysis I need data, and to have data I have to measure, and to be able to measure I have to record. Therefore, the main source for improvement is recording. That's why I tell you, if dispensing errors are made, they must be recorded. Not only to learn from the error, but to be able to analyze that data and use it as input for improvement. The head of continuous improvement must be in pharmacies. Yes, it must be in the pharmacy above all else, not only for the quality of service, but for patient safety. Briefly, this is what is called the Deming cycle or the continuous improvement cycle. Everything begins with planning. I will think about the objectives, the resources, I will communicate them. We all have to be well aligned on what the plan is. I will do it, I have to execute the processes, the activities, I will generate products or services. We actually generate eh services above all else, and there I will measure, I will verify to see if things are working as expected. With that measurement I will generate numbers, okay? I will generate numerical values, which are the indicators. The indicator will tell me how I am working. If I go and check my blood glucose, right? Blood sugar level, it will give me a value, it's a number. What can it guide me on? Well, it can tell me how my carbohydrate metabolism is doing. You for what, well, to see if I am at risk of diabetes or not. Yes, it's a number. An isolated number says nothing, but in a context it can give me a series of information. Yes, the same happens with indicators. Indicators are like taking a blood test of the processes and knowing how they are working. If my dispensing error percentage is 5%, I am failing. Yes. If out of 100 dispensations I have five that are wrong, I should really be at one percent, below 2%. That would be quite good. So I have to lower that indicator, why am I making so many mistakes? And that's where the questions come in, but to ask myself the questions and get answers, I need to have measured beforehand. Ah, that's why I need the record. Based on the indicators I obtain, I will replan and generate some type of action. Yes, I will analyze it, I will implement corrective actions, and I will start again by planning, doing, checking, and acting. And that's why, well.

So, let's delve into medication distribution systems. The term medication distribution applies at the hospital level. What does it mean? Basically, it's about how medications move, how they travel within healthcare institutions, from the pharmacy to the patient. Nursing is usually involved in between. Yes. Sometimes the doctor too, because there are some medications that a specialist administers directly, but in most cases, nursing administers and prepares them. So, there are different medication distribution methods. Each has advantages and disadvantages. A priori, although there is an evolution over time, meaning a chronological appearance of the different systems we will see, the last one is unit dose, and in principle, each system that has appeared has achieved improvements over the previous one. All are applied today, and all are applied today because they have some advantage. Yes? And now we will see under what conditions and in what situations I can prefer one method over others. Well, we've already said that they have advantages and disadvantages. We've said it, and I reiterate, the main objective of the pharmacy is to dispense medication. That's the essential thing we have to achieve, it has to be efficient and it has to be safe. Yes, however, it's not the only thing we have to do. What is clear is that it's the essential thing we have to achieve, and we have to do it well. And once we've done it well, once that process is well accepted, then we can expand, grow in other areas. For example, one can say, "Well, I'm going to start doing pharmaceutical care, right?" It's similar to a medical consultation, but with the pharmacist, for example, meaning there's a one-on-one interaction with the patient regarding the pharmacological treatment the patient is receiving. Great, if I do it. Now, if my dispensing process, let's say outpatient, is failing, it's not really very useful, because the first thing the patient will encounter is that the medication they needed wasn't there, they dispensed it incorrectly, I asked a question at the counter and they couldn't answer me. So, let's go to the essentials first, which is that it's dispensed correctly, that the medication is available, and from there we can say, well, we are in a position to grow into other areas if desired. Which expand the pharmacy's potential or expand the services the pharmacy provides.

So, these medication distribution systems must all, no matter which one, no matter its design, meet these requirements. The medication must be available. Yes, I have to ensure that that medication is ready to be dispensed or used when needed. It must be able to reach the correct place and under the correct conditions. If it's temperature, humidity, protection from light. It must arrive in a timely manner. If the medication is needed for today at 3 PM, it cannot arrive at 5 PM, it cannot arrive tomorrow, it must arrive today before 3 PM at the correct place. It must be delivered safely, meaning the medication the doctor prescribed, not another one. I cannot make a mistake in the medication I am delivering. The doses and pharmaceutical forms must be correct. If it's an LP, if it's conventional release, conventional release, if it's a transdermal patch, a transdermal patch. I must also be precise in the pharmaceutical form and not to mention the route of administration. Yes, there are medications that can only be administered intravenously and others only intramuscularly. So, penicillin G benzathine, the famous Benzathine, I say the brand name because often that's how it's known. Intramuscular. Perfect. Yes. Penicillin G benzathine, only intramuscular. Now, penicillin G sodium can be administered intramuscularly as well as intravenously. This confusion has generated many medication errors worldwide. Yes? So, there we are talking about knowledge of the medication. Yes? So, do you know why I give you this medication? It saves lives. Yes. So, for the pharmacy assistant to know how to identify the permitted route of administration for a given medication, yes, can really prevent many dispensing errors. Well. So, in a medication distribution system, I have to ensure that the medication is available, prevent or minimize administration errors, and be efficient in the resources, in the working hours of each of the involved parties. What does this mean? Pharmacy has its role, and nursing has its role. Nursing's central role is to care for the patient. That is nursing's central job, administering medication, hygiene care, taking body temperatures, among others. Pharmacy's central role is to manage medication. So, when a medication distribution system is designed, we will now see the chronological evolution. In part, it seeks to achieve the goal that pharmacy manages and has most of the actions related to medication management, and nursing has more time available to care for the patient.

So, these are the three systems or methods of intrahospital medication distribution. The first to emerge is the stock system, also called the traditional system. Subsequently, the patient order system emerges, and finally, the unit dose system. We can add a fourth, which we will mention at the end, related to the use of automated systems. Although these automated systems are usually, if you will, an automation of the unit dose system, meaning we could differentiate between the manual unit dose system, which is the conventional one, the one applied in most cases, or automated. Yes, later we will see in what cases we can apply it and how. So, stock and patient order systems are the so-called classic systems. Let's start with this first one. The stock system or traditional system. If we go back before the 1970s, hospitals were not as large, there were not so many beds, there was not so much medication. This is another point. The pharmaceutical industry began to grow in the second half of the 20th century. In reality, for us now, medication is very common. It is a widely used therapeutic tool, at least in Western medicine, but before that, it was not so common to have so much medication. So, we didn't talk so much about the concept of "pharmacy," yes, management was different. Now, in the 1970s, the amount of medication began to grow, and it is clearly defined that there is a pharmacy. Now, that pharmacy, which is still in its infancy compared to today, that pharmacy somehow acts as a supply room, meaning today hospital pharmacies in most cases have a supply room or at least a sector that acts as a supply room. What is a supply room? Well, it's who buys medication from suppliers, receives commercial units, manages them, stores them, and transfers them to another sector, let's call it the internal pharmacy, which is responsible for getting the medication to nursing and the patient. Or the same day it will deliver the medication to the outpatient pharmacy sector, which is responsible for delivering the medication directly to the patient. But well, at that time, we didn't have this distribution: supply room, internal pharmacy, outpatient pharmacy, but rather there was a pharmacy that acted directly as a supply room. And what did it do? Well, it had the medication stored, and nursing would order medication from that pharmacy in a generic way, meaning by stock, in bulk. They would order 10 blister packs or 10 boxes of paracetamol, 1g tablets, and so on for each medication. Nursing would use that medication and replenish it as it was used, but it would replenish it not by stock, but by period. Yes. So, what nursing does is, I have expenses, I see that this has gone below the stock level, and therefore what I will do is order more from the pharmacy, but the pharmacy in this system never knows what the medication was for. Yes, simply in bulk. The one responsible for preparing the medication per patient based on the stock it has is nursing itself. We can say that in this system, the internal pharmacy is in nursing. Let me explain what the pharmacy's role is today, which is to prepare per patient, receive an order and deliver it to nursing. At that time, it was in nursing itself. So, that role of selecting bulk medication and preparing it per patient was fulfilled by nursing. Yes. In the systems that emerged later, that role was acquired by pharmacy. So, thinking about the distribution of roles, this system for now has a management pharmacy, but it doesn't prepare for the patient. The one who prepares for the patient in this system is nursing itself. It therefore requires nursing to have a quite significant stock, it's not a medicine cabinet, it's not a small supply room, it's a peripheral pharmacy in this case, and therefore it requires nursing to do very good stock control. Therefore, in this system, nursing, in addition to preparing per patient, has to handle considerable stock management. In summary, this system works like this. The doctor makes an order. If they visit the patient, the patient needs such medication, they prescribe the medication. Nursing will interpret that medical order, go to their stock, select the medication they need, prepare it per patient, and administer it. And then, in the stock control processes, nursing will detect, "Ah, well, this has been consumed, the stock level has dropped, I will go to the pharmacy and replenish it." And in this system, the pharmacy doesn't know who the medication was for. Yes, that's why it's called a stock system. The only case where nursing goes to the pharmacy with a named order, meaning by name and surname for a specific patient, is when it's a very specific medication that nursing doesn't have in stock and that is only in the pharmacy.

Well, let's do an exercise. I told you, although there is a chronological evolution, all the systems we are seeing have advantages and disadvantages. We are not seeing them for a historical review, but because they are used today and they are used for a reason, they are used because they have some type of application and advantage, meaning we will find at least one advantage for all of them. So, let's do an exercise. I will ask you to think, you can work in pairs, yes, in threes with the colleagues nearby. Regarding what we've seen of this system, what are the advantages and disadvantages it has in terms of patient safety, efficacy. Efficacy has to do with the use of resources, meaning, how well do they achieve objectives with the least possible use of resources. Resources are many. Time, medication, money, the time of each of the sectors, what margin is there for controls at each stage before it reaches the patient, the use of nursing time, stock control, and the speed and availability of the medication when it is needed. We will give you 3 minutes to think about it, and we will discuss it together. So, you can begin. Colleague. Could you show the previous slide again? This takes much more time and administrative effort. Well, very good. Looking at each case. What do you think about it? Yes. So, an idea to compare, to imagine what could be better, but still, even if you don't want to, what opportunities for improvement do you see in safety in this process? What process? This traditional system. Yes, yes. For me, it's a for me it's a regular system that is neither very good nor very bad because being so close to the patient, when errors occur, well, what we talked about today is that it has, as long as the errors are corrected quickly, if not, no. Perfect. The system where medication is prepared for the patient, meaning interpreting the medical order, taking it from stock, and then doing all the preparation. Pharmacy doesn't participate. Pharmacy only buys the medication, stores it, keeps it as stock, and when nursing needs stock, it gives it in bulk, but pharmacy doesn't participate in the dispensing itself. So, in terms of safety, we give it a low score. This process is not very good in terms of safety. Regarding safety, well, precisely, it's a weakness of this. What about efficiency? Using it hand in hand with efficiency and the use of nursing time. Efficiency, resource management. Yes. I consider that, based on what you can also say, it is extremely safe because nursing is extremely, normally, only controlling this more than material, whether it's medication, or not, there you have something to rely on between nursing, which can also lead to the medication not being stored properly. That could also lead to another problem, so it has more advantages than disadvantages. Despite what can be said, by having nursing more directly involved with the materials in larger quantities, it can access them more directly, but the advantages do not compensate. Well, all of that is true. In some cases, yes. Now we will see what could be considered, but it's true that we are talking about a classic inpatient floor, that system doesn't work because there are other options that compensate for this disadvantage, but there are situations where it might work, think about it. Clearly, we are answering this producer. Speed is a very important advantage in the system. The medication is already where it will be needed. Nursing is already there, and there is no travel for the pharmacy, because that travel has already occurred. So, availability in time. Here we give it a very good score. The availability, as the colleague said, the speed is there. Now, efficiency has to do with how I achieve my objectives with the minimum use of resources. What are resources? Time, medication, money, right? Colleague, no? To say that perhaps in polyclinics it is more viable than in a hospital. Well, well, perhaps in some sectors. But let's see which ones. But in terms of efficiency, the use of nursing time, it's not a good system. Why? Because it takes away from patient care. Exactly. Nursing spends a lot of time managing medication. In fact, it may require one or more people exclusively dedicated to this. Pharmacy doesn't do it, it's not their central training. We agree. So, that also affects safety, right? Psychologists are largely trained in this regard, but it's true that they are not pharmacy personnel, they are not trained for it. And above all, it's not nursing's central mission. Nursing's central mission is to care for the patient. So, in terms of nursing time, we give it a low score, right? The same as safety, we can give it a low score, and in efficiency, the same. It uses too much time for something else. It requires high stock levels in nursing units, right? Therefore, high stock means I have to buy a lot of medication, keep it in the nursing unit, right? And therefore, money that I have converted into medication, so economically it's also not favorable, more risk of expiration, because as I told you, this measure requires more time to control medication, and therefore more risk of it expiring. So, I have more risk of loss. Another reason why it's inefficient is that it's not used for that purpose. No, I was going to say that it's a higher expense. Exactly. Well. So, clearly it's better than the medication. One thing is that there isn't just one nursing unit, usually there are many. The first floor, the wards, have one or more nursing units, so if I'm going to have a high stock level in each nursing unit, if I add up all the stock, whereas if all the stock is centralized in the pharmacy, think that the pharmacy acts as a central hub, so I don't have to increase the stock so much because the higher stock is not in all the nursing units. So, all of that makes it a system that is inefficient. The distribution, how is the distribution? The distribution, I said exactly how it is organized throughout the institution. It's not a very efficient system. It demands a lot, right? Of control, precisely what we were discussing. So, in this sense, it's also not very convenient. Right? Yes, colleague, it's better that the control is done closer to the pharmacy and closer to the patient, meaning as far from administration as possible and closer to delivery by the pharmacy. Here, it will clearly be just before, if it exists, just before administration, therefore there is some possibility, but it wasn't. Yes. My question is, when applying this system, how would it be used, for example, to measure and not run out of stock? I mean, it's very, very slow and ineffective. Totally. Nursing has to do it. Pharmacy doesn't do it, it's nursing. Okay. Pharmacy can, if I ensure a higher stock, which if nursing never has stock to respond, but that implies more efficiency because you have to increase pharmacy stock more to respond to nursing stock. It's different if pharmacy has all the stock and pharmacy responds for its own stock. Well, so this system, the advantage it has, if it has anything in its favor, is this: the medication is already available when it's needed. So, when will I apply this system? Exactly. When I need the application. Yes. The medication. The colleague says, "This system is used, for example, when I need to respond quickly in emergencies to an intubation, for example." If it's used in all sectors that need to respond quickly and there's no margin to go get the medication from the pharmacy and make a named order. Yes. So, in reality, in an emergency, the doctor doesn't stop to write down all the orders, but it's adrenaline, the antiarrhythmic, right? It's much faster. So, anything that involves a medicine cabinet, yes, for example, an emergency mobile unit, will use the system. The pharmacy doesn't know who will use it beforehand, it will give it a stock. So, this system is applied when I'm going to stock a medicine cabinet, for example, an emergency. The supply rooms, for example, ICU has supply rooms. Ah, intensive care units are in the same situation. They need to respond very quickly. A patient can decompensate very quickly. Going to get medication from the pharmacy. Even if the pharmacy is very fast, it takes minutes, and those minutes often make the difference between life and death. And so, an ICU unit will always have stock, always at all times. Emergencies will have stock at all times, and operating rooms too. Yes. Because of the logistics and because they often have to perform quick procedures in the operating rooms as well. And well, we can extend it to pediatric ICU, for example, units, all sectors that need to respond extremely quickly need to have stock, and the pharmacy will dispense medication in bulk, will dispense by stock, and they will have the job of managing that stock. Well, that's why I tell you, all these systems we are seeing are applied today, they have some advantage, and that's why they still exist. Yes, clearly it's not the system of choice for a moderate care floor, a common inpatient floor. And in that case, there is time available for nursing to go to the pharmacy, retrieve the medication, go to the floor, and deliver it for administration with prior patient consent. However, nursing units do have medicine cabinets. Why? To facilitate the dynamics a bit more, because let's assume a patient develops a fever and needs an antipyretic, it's used. How many cases are there per day and how many times is it needed per day? Many. If nursing, for every new order that arises and needs to be started immediately, has to go to the pharmacy every time, nursing also loses a lot of time in travel to get the medication. The pharmacy has more off-hours, right? So, to respond to those situations where it's not possible, either because it's very urgent or the need for medication delivery is relatively agile, this will explain what type of medication is needed. It won't have the entire pharmacy, nor will it have medication that is not for immediate use. For example, a moisturizing cream won't be there. I mean, moisturizing creams are important because they prevent skin diseases, especially in patients who have been lying down for a long time, but it's not the type of medication we need in an emergency, yes, but rather the profile of medication that cannot be hydrated because often they are for massive use, for example, an antipyretic, perhaps it's not a matter of life or death to give it immediately, but it's used so much that it can prevent a cold, an antihistamine, exactly, a corticosteroid, an antiarrhythmic, a vasoconstrictor, even an inhaler, right? A bronchodilator. All are examples of medications that must be in the nursing stock. Well, this is what we mentioned. Then you read the material in more detail and we conclude. This system is especially useful when I need quick action, right? Mention also the use of this system in polyclinics, and also polyclinics are often far from the pharmacy, unlike inpatient floors that have the pharmacy nearby, right? At a distance from the center. Often the polyclinic is blocks or kilometers away from the pharmacy. So, the polyclinic, due to its distance, may also need stock, and often certain medications need to be administered in the polyclinic. Yes. So, in those cases, also due to distance, to ensure that it can respond relatively quickly, a medicine cabinet is available. Requirements for applying this system: stocks must be defined beforehand. And to define stocks beforehand, I have to do it with a criterion, I have to know how much will be consumed. I cannot say, well, everyone is assigned the same quantity of paracetamol blister packs, of analgesics, according to the expected demand. This can be measured historically. And I know that historically it consumed so much, I expect it to continue or if it expands to so many beds or expands its operation, it will grow by x percent. So, I have to estimate how much will be needed, and based on that, I will define the stock level and the frequency of replenishment. Yes, I will replenish it several times a week, daily, once a week, once a month. Yes. Depending also on the distance and the courier service available. If the courier goes once a week to such a polyclinic to the central building where the pharmacy is, I have to increase the stock. On the other hand, if they go every day, I don't need that much stock, right? But I have to analyze that beforehand, and that's an agreement made between the pharmacy and the corresponding nursing sector. When a prior analysis is done, it must be based on data. Yes, it's not that I imagine how much it will be, but I have to measure it beforehand, and it will depend on each of the nursing units in question. This must be recorded, a list of the sector's medications must be compiled with their quantities, the frequency of replenishment, even at what time, right, it can be done, and who will be responsible for checking the stock and how the replenishment to the pharmacy will be done. So, by what method will the order be placed? By email? By an IT system? Will I send an order form? Yes, I'll add one more thing. In some situations, that stock, although sent in bulk, the replenishment is named. For example, often within what is needed for stock, we need psychotropic drugs and narcotics, which are controlled medications, controlled by regulation. They are psychotropic medications that national regulation defines as psychotropic drugs or narcotics. That a substance is a psychotropic drug is a psychotropic drug because national regulation defines it as such, and a substance because national regulation defines it as such. Clearly, they will have some effect on the central nervous system, those substances, right? But national regulation defined it as such beforehand. So, these medications require special control, and among those controls is medication traceability. So, if a sector needs fentanyl or morphine, for other patients, they can have stock, not because they are controlled medications will they not have them. If a person with an open fracture arrives at an emergency room, they won't just give them paracetamol because it won't be enough. They will give them a psychotropic drug like tramadol or a narcotic. So, there, the pharmacy must have stock of controlled medications. Now, how does the pharmacy replenish it? There, it will send a consumption report, or rather a report, a record of the consumptions that occurred. It will send it in a specific way. Yes. So, it will replenish by name and patient, even though the pharmacy previously saw it by name. Yes. So, in some situations, it's replenished only in bulk, in some situations, like controlled medications, replenishment is by name, and then forms arrive, for example, from the sector, and it says, "Well, John Doe used 10 ampoules of morphine, patient A used two, patient B used three, patient C used two, patient D used three, so that adds up to 10, I'll give you the 10 ampoules against a consumption report of 10." Well, but if we're talking about paracetamol, in those cases, it's not mandatory for the sector to declare who it was used for because it will be recorded in the medical history anyway. So, the pharmacy can dispense it in bulk without requesting the consumption report in return.

Let's move on to the next process, which is the patient order system. In this case, something changes. The order arrives at the pharmacy from nursing or from the doctor. The pharmacy will dispense knowing who this medication is for. It no longer dispenses by stock, it no longer dispenses in bulk, but rather it's for a specific person. So, an individualized medical order arrives at the pharmacy, which the pharmacy will interpret, sometimes in a transcription, and the pharmacy will dispense, and in principle, it will cover at least 24 hours of treatment. If it can dispense exactly 24 hours, great, according to what was agreed, but if not, it will dispense at least 24 hours. What can this imply? That the pharmacy has to deliver lists. That is, with ampoules it's simpler, the dose is already there. But for oral medication, which usually comes in pharmaceutical form, it will deliver a list of medication, meaning it will deliver an excess compared to 24 hours, but it has changed compared to the previous one, which was per patient, yes, it's a change from an order per patient, so it's no longer correct. So, in this case, the pharmacy dispenses individually, meaning per patient. Nursing will receive it, will use that stock, which it will also store in individualized drawers per patient. It no longer has bulk medication, or rather, the shelf is not organized with drawers or small compartments arranged by medication, but rather nursing here has a small drawer, a space for each patient. Yes, we ourselves in unit dose, sometimes the medication wasn't there, we thought of unit doses, if a dual dose was requested that wasn't available, it was done manually and 24 hours were not delivered. Clear, there are times when they are delivered. If there is unit dose, it should not be. This system does not have unit dose yet. Ah, we are looking at the system. Exactly. The patient order system. Ah, it's an evolution compared to the stock system that delivered to the... In this case, what is being done is delivering an order in a named way per patient, but still in general, no, the pharmacy does not have a dose production process here. We are seeing a chronological evolution of the systems. So, what do we achieve in this case compared to the stock dispensing system? Lower levels in nursing units. Nursing no longer has to have almost a replica of the pharmacy, right? In its sector. In this case, it can reduce its stocks to a mere small medicine cabinet for emergencies, and everything else it orders per patient from the pharmacy. Okay. So, the idea of what is being done is becoming clear, right? Yes. Uh, let's see, we start with the situation, first process in bulk. What's in the nursing units? I have the shelf with a small pharmacy with medication stock. Well, second process. Here it's different. The pharmacy receives a medical order per patient, and the pharmacy will deliver the medication in a named way. I don't have unit dose yet. What do I have? Delivery of medication. In the case of ampoules, it's a bit simpler. I have it to deliver. What has changed for nursing? Now it will have small drawers per patient. Ah, and it will store the medication that the pharmacy gave it per patient. Chronologically, it emerges after the stock system and brings advantages. Yes. And the main advantage it brings is that nursing lowers its stock levels. It will have the basics in a medicine cabinet, which it had with the stock system, but otherwise, it has reduced its stock levels because the pharmacy is now the one that centralizes. Now it's the pharmacy. All the orders from the nursing units arrive, which it will deliver against patient orders. The pharmacy participates here because to go from this medical order to the medication being in the nursing drawer, the pharmacy interpreted the medical order, which didn't happen in the stock system. Well. Yes, patient, because in case that couldn't be said, the patient should be... this is done, the colleague says, I had more expenses. For example, this can be used for our patient, it's done, there's a return process that goes back to the pharmacy, the surplus. Let's assume nursing uses three tablets during the patient's stay. The remaining six are returned, received, and it's available again for use. Ah, it doesn't stay in the medicine cabinet with them, but rather it should be returned. Yes, if something is left over, it should be returned. Yes. And analyzed, it can be put back or discarded. Perfect. Yes. Now, it has to be checked to be legible because it can be erased. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it can be seen what it is. Well, it should be clearly legible, it must have the lot number, it must have the expiration date, it must be in good condition. If it's worn out or it's clear that the cold chain hasn't been maintained, right? In those cases, it cannot be returned, but if it's intact, it's reused, it's returned to the pharmacy, but if the pharmacy returns it, there's a return process, it's an additional process. But it's used, it's not discarded. The fact that it's returned and checked to see if it can be reused. I think when you start taking out many tablets, the aluminum goes away and it

eficiencia, con los niveles de stock que hay en las enfermerías, ¿verdad? Con el buen uso de recursos, con la posibilidad de realizar controles respecto al sistema por stock, es un crecimiento, es un avance. No es tan bueno en todos estos parámetros como la dosis unitaria, claramente que no.

¿Cuándo se usa? Cuando todavía la dosis unitaria no se pudo llegar a establecer. ¿Por qué? Porque todavía no hay un proceso de producción de un iOSis que esté funcionando. Sí. La dosis unitaria llega más tiempo para farmacia que este sistema. Entonces, cuando la farmacia todavía no tiene tantos, tantas personas o tantas posibilidades de recursos para tener una unitaria, este sistema se usa eh y todavía se utiliza.

Estos son todos comentarios que ya estuvimos viendo. Y antes de terminar quiero comentarles que hoy en día lo que son los sistemas de distribución de medicamentos, particularmente la dosis unitaria, cada vez más acompañados del uso de tecnología y como les comentaba, tecnología para cortar y para ambasarosis, pero también tecnología para dispensar medicación.

Entonces, en ese sentido tenemos dos grandes tipos de uso de la tecnología. Por un lado, a nivel centralizado, es decir, en la farmacia, y por otra parte a nivel descentralizado periférico, es decir, en las enfermerías.

Entonces, ¿cómo son estos sistemas? Bueno, en la farmacia para preparar más rápido por dosis unitarias se utilizan los carruseles verticales. Todavía en Uruguay no está tan extendido, pero en el mundo sí se hace, sí se utiliza. Es bastante común. Lo que se hace es se recibe la indicación médica en el sistema informático. Esto va acompañado de prescripción electrónica, o sea, que hay una informatización de los procesos también. El auxiliar de farmacia interpreta esa indicación médica y le manda la orden. En realidad da la baja, por ejemplo, tiene paracetamol 1 g cada 8 horas. Bueno, va a necesitar para 24 horas tres comprimidos. Bueno, da la orden al sistema, eso viaja, llega al equipo que se llama carrusel vertical, ¿sí? Llega al software del equipo y lo que va a hacer ese equipo es recopilar. Bien, este ISO tengo eh 20 pacientes que utilizan paracetaboid. La cantidad total de comprimidos que esto me suma son, vamos a poner 60 comprimidos de paracetamol. Entonces, así con cada uno de los medicamentos, cuando la persona va a preparar, lo que va haciendo el equipo es que se va parando en cada una de las gavetas, ¿verdad? Y la persona va tomando, se lo va indicando en la pantalla, va tomando la cantidad de medicación que corresponda y la va distribuyendo según se le indica el equipo. Le dice, "Dos para esta cama, tres para esta cama, cuatro para esta cama y así sucesivamente." Bien, y así con todos los medicamentos que tenga para ese entonces.

¿Qué se logra con esto? Una velocidad cuatro veces mayor, eh, literalmente cuatro veces mayor que preparar a mano, digámosle. ¿Por qué? Porque cuando preparo Manuel voy a preparar este paciente y me recargo toda la farmacia levantando los medicamentos que va a necesitar. Sí. En cambio, acá diferente. Acá el equipo entrega por medicamento y la persona lo va distribuyendo. Pasamos el siguiente medicamento, distribuyo los que lo necesitan. Sí. Y además el carrusel se tiene que almacenar de forma tal que se dejan en las posiciones que requieran menos movimiento, porque esto rota, ¿verdad? Acá ven, esto puede rotar. se deja en las posiciones de menos movimiento lo que se usa más y en las posiciones más alejadas lo que se usa menos. O sea, que estadísticamente lo que busco es minimizar la cantidad de vueltas que el equipo.

Lo que importante que les hoy mañana tengan la oportunidad de utilizarlo, este lo van a ver en su momento, pero lo que quiero que lesen es que lo que hace este equipamiento es aumentar mucho la velocidad de preparación a nivel de la farmacia. Las equipos que cortan y envasan aceleran laoniosis y lo que hace este equipo es acelerar la preparación de parte del farmacé y además de eso es más seguroso, ¿sí? Porque la tasa de error tiene una serie de controles involucrados que lo que hacen es disminuir eh la tasa de error.

Y por otra parte, como ejemplos de sistemas descentralizados, o sea, los que están en las enfermerías, este, tenemos este tipo de de equipamiento que podríamos llamarlo armarios inteligentes de alguna manera, que también recibe una computadora la orden de lo que yo necesito, por ejemplo, a partir de la indicación médica y se va a abrir o se va a iluminar o se va a marcar de alguna manera la gavetita específica donde está la medicación. Sí, podría esto cargarlo por algo que no sea unidos que fuera, por ejemplo, listas. Sí lo podría hacer, pero no sería tan tan eficiente porque el lista tiene un sobrante justamente no lo puedo estar recortando. O sea, que son sistemas muy compatibles con la dosis unitaria, o sea, que saco exactamente la cantidad que necesito, o sea, con las monodosis. Bien, bien.

Bueno, no sé si tienen alguna consulta. Sí, por allá. Eh, lo que recién es máquinas y utilizo más en hospital y todo. Sí, sí, sí, sí, sí. En unidosis se utiliza en hospitales en el sistema dosital. A nivel comunitario, hay espamiento. También eh hay algunas instituciones que tienen eh farmacias que utilizan el equipamiento que son más bien robots. Sí, creo que la española. En la español básicamente hay una estantería, la medicación también se ordena eh le ordena el sistema de informático. En realidad según frecuencia y movimiento por que hay un brazo que se mueve, entonces se ordena de forma táctica. Lo que más se mueve está más cerca para que el brazo no se desplace tanto. Entonces lo que va haciendo el brazo es tiene tal indicación, lo va a buscar, lo agarra, lo trae y así por cada uno de los pacientes. Entonces, claro, ¿qué hace? de farmacia desde la computadora, pero se desplaza volver a la farmacia a buscar la migración e incluso lo puede manipular el propio usuario. Entonces es mucho más rápido. Sí, lo que se hace es hacer el trabajo y también es seguro porque está todo bien cargado en informático, no deberían haber errores. Sí.

Pero bueno, sí, la tecnología es algo que crece, ¿no? Quiero más allá de que crezca la tecnología, todo lo que vimos antes de la seguridad de la humanidad, de la atención profesional, de la atención cálida y humana, del conocimiento de farmacología, todo eso es insustituible, no importa que haya tecnología. Como filiales de farmacia ustedes los conceptos los tienen que tener sumamente presentes. Sí, porque para cargar toda la información la máquina y para interactuar con el usuario también, ¿verdad? para responder a las consultas que les generen. También puede que el trabajo cada vez se evolucione más a trabajar junto con la tecnología, no contra junto con la tecnología, pero todos los conceptos que acabamos de ver lo vamos a aplicar siempre, haya tecnología o sea manual. Sí.

Bueno, hasta que y el robot piense, pero vos sabes que no nos vas a sustituir nunca. esperemos por no los puede sustituir porque la humanidad no la puede dar un robot. Entonces, recuerden esa parte, el ser humano eh el proceso es un proceso ante todas las cosas de de humanización, sí, de empatía de comprensión del usuario y la persona va a buscar también que otra persona ahí social que habis.

Bueno, cualquier cosa a las órdenes.