Pharmacists are one of the most accessible health care providers in the United States.1Manolakis P.G. Skelton J.B. Pharmacists' contributions to primary care in the United States collaborating to address unmet patient care needs: the emerging role for pharmacists to address the shortage of primary care providers.Am J Pharm Educ. 2010; 74: S7Crossref PubMed Scopus (118) Google Scholar To encourage discussions about the roles of pharmacists beyond dispensing medications, we relate the experience of having a severe asthma attack inside a community pharmacy as experienced by one of the authors (MC). Late in the afternoon, one Thursday, I took my usual 2.7-mile bicycle ride into campus. As I was nearing the end of my ride, I felt my breathing becoming shallow. I had developed exercise-induced asthma several months earlier and sometimes needed to use my inhaler at the end of my commute. My asthma began after exposure to the coronavirus, and I had been prescribed a metered-dose albuterol inhaler. As I was rounding the corner to my building, I knew that I was going to have to use my inhaler that day. Then I realized I didn’t have it—I kept my inhaler in my lunch bag, which I did not have. As I was entering the office suite, I suddenly felt faint, with momentary loss of vision and dizziness. As I walked to my office, my breathing was becoming more difficult. It was nearly 6:00 pm. The urgent care center on campus was closed, but the university pharmacy that filled my albuterol prescription was in the adjacent building, just a short walk away. Once I arrived at the pharmacy, I walked up to an open counter, handed over my university ID, and focused on getting out 3 pieces of information: I had a prescription for an inhaler, I didn’t have it, but I needed it, and I am about to pass out. My recollection of the next events is blurry. I remember the woman at the counter asking for my birthdate. She said there were no refills. I remember the edge of the counter and then moving toward the chair across the room. I have only a few fragmented memories of what happened next. Sporadic tunnel-like vision. Jumbled thoughts. I am on the cool floor, wondering what that gasping noise is. All I can think is, “Where is the inhaler?” The image of the Visa logo bounces around and I realize that maybe that is what they are waiting on before helping me. At some point, a voice from above says, “Do you need an ambulance?.” I knew I needed an inhaler, not a white van with flashing lights. I think and perhaps say, “no”. And now I am in a video game, on a quest to find an inhaler. I must leave this room because I cannot get one here. I see golden letters spelling out “Journey into the World” over an image of a big red inhaler. I am on my feet. I retrieve my ID card from the counter. No one is there. I head out the door toward the vision of a big red inhaler. At some point, I am on the concrete outside, contemplating how white the concrete is and how green the plants are. Eventually, my breathing began to improve a bit, more like my usual shortness-of-breath attack. I still haven’t completed my journey in this video game and I decided my best chance is to go to my house to get the inhaler in my lunch bag. I unlock my bike from the rack and start walking home. Once home, I retrieve my inhaler. My mind is numb. Based on the time I returned home, I later calculated that the worst of my episode on campus—from the time I first felt faint until I began walking home—had lasted between 45 and 60 minutes. I woke up the next day with a mix of emotions: I was confused. Angry. Scared. My chest was also rather sore due to straining to breathe the day before. My thoughts were not coming together very well. I needed a better strategy to make sure I could access an inhaler no matter where I was (one for “home,” one for “away”) because the lunch bag strategy was not good enough. The Advanced Practice Registered Nurse who saw me that afternoon at the urgent care clinic said there was a prescription renewal request for an inhaler waiting in their system that morning. Learning that the response of the pharmacy to my situation was to send a renewal request didn’t make me feel better about my experience. I was also told I could only have one inhaler at a time, but we would pretend that the first was empty so that I could get a refill to have a second one. In the following weeks, I found myself struggling to think clearly and unable to read or write productively. My worry shifted from having another severe asthma attack to wondering when my brain would begin to cooperate. It took a month to begin to return to my normal work routine. I suspect I experienced mild hypoxia. (Of course, it didn’t feel “mild” to me because it took about 3 months to recover.) Hypoxia would explain my disordered thinking and hallucinations.2McFadden Jr., E.R. Lyons H.A. Arterial-blood gas tension in asthma.N Engl J Med. 1968; 278: 1027-1032Crossref PubMed Google Scholar,3Hammond N. Leonard J. What to know about brain hypoxia. Medical News Today.2018https://www.medicalnewstoday.com/articles/322803Date accessed: March 6, 2023Google Scholar Pharmacists have the skill set and legal authority in many states to provide care to patients beyond dispensing medications. Pharmacists in the state of Kentucky may diagnose minor infections and dispense anti-infective therapies,4Kentucky Board of Pharmacy. Board Approved Protocols. Acute Group A Streptococcal (GAS) Pharyngitis Protocol, version 4. Available at: https://pharmacy.ky.gov/Board%20Authorized%20Protocols/Acute%20Group%20A%20Streptococcal%20Pharyngitis%20Infection%20Protocol%20Approved%20May%2016%202018%20Modified%20COVID%20July%2027%202021.pdf. Accessed March 6, 2023.Google Scholar,5Kentucky Board of Pharmacy. Board Approved Protocols. Acute Influenza Infection Antiviral Therapy Protocol, version 5. Available at: https://pharmacy.ky.gov/Board%20Authorized%20Protocols/Acute%20Influenza%20Infection%20Antiviral%20Therapy%20Protocol%20Approved%20December%2012%202018%20Modified%20COVID%20July%2027%202021.pdf. Accessed March 6, 2023.Google Scholar may evaluate appropriateness for and dispense emergency contraceptives,6Kentucky Board of Pharmacy. Board approved protocols. Self-Care Conditions Protocol: Emergency Contraception. Available at: https://pharmacy.ky.gov/Board%20Authorized%20Protocols/Selfcare%20Protocol%20Emergency%20Contraception%20Approved%20September%2030%202020.pdf. Accessed March 6, 2023.Google Scholar and initiate and administer medications related to the treatment of opioid use disorder.7Protocol to initiate dispensing of an opioid antagonist for opioid overdose prevention and response. Available at: https://pharmacy.ky.gov/Board%20Authorized%20Protocols/Naloxone%20Protocol.pdf. Accessed March 6, 2023.Google Scholar Kentucky statute KRS 217.215(3) allows pharmacies to dispense an emergency supply of medication under specific conditions when no refills remain.8Kentucky General Assembly. Regulation:175. Available at: https://apps.legislature.ky.gov/law/kar/titles/201/002/175/. Accessed March 6, 2023.Google Scholar A pharmacist may dispense greater than a 72-hour supply for medication if the drug is used for the treatment of a chronic respiratory prescription and if the supply dispensed is equal to the standard unit of dispensing for the drug. In this case, an inhaler could have been dispensed as an emergency supply, and the situation would have quickly resolved. If a situation requires a higher level of care, pharmacists and pharmacy technicians should call for emergency services. However, it is important that pharmacists understand how they might provide safe and effective care in time-sensitive situations. Melissa D Clarkson, PhD, Assistant Professor, Division of Biomedical Informatics, University of Kentucky, Lexington, KY Thomas L Platt, PharmD, PhD, MBA, Associate Director, Quality and Outcomes, Assistant Adjunct Professor, University of Kentucky College of Pharmacy, University of Kentucky Specialty Pharmacy and Infusion Services, Lexington, KY