It's not like it's a narcotic or anything!

[Gryphon]

First a bit of background, I live in a small town tourist town that gets absurdly busy during holidays, even though we're a few miles away from the beach.

That being said, today was hectic, it was just the pharmacist and myself (normally fine on a Saturday), and I'm quite sick. Then, on top of that, in comes this harpy:

Rph: The poor floater pharmacist who's only worked in my store once before.
Me: The wicked awesome, but miserable Tech
SC: Harpy from hell
SCH: Harpy's husband

SC walks up to the pharmacy pick up window with a prescription in her hand, which is understandable, as half the people do that anyway, so I'm not sensing anything off just yet. She hands me the Rx.

Me: Okay ma'am, I know we don't have [brand colonoscopy prep kit] in stock, but we have the generic.
SC: *getting all huffy* Well, I know for a fact that most generic drugs don't work as well as the brand, and I have to have brand anxiety medication because the generic is only half as effective! My husband got this same medication here six months ago for his colonoscopy!

I mentally roll my eyes, but I'm used to this by now and I let her have her little rant, which lasts a lot longer than I expected it to, as she repeated herself about five times. I ask for all of her information to find her file and get started on typing up the medication when I realize the Dr's name wasn't on the Rx and he hadn't dated it.

Me: *under my breath* Oh man... *to my pharmacist* Hey Rph... We have a bit of an issue here. There's no doc name or date, AND this is an Rx from [a very well known private company that does everything in house that is also well known for not responding to any outside entity within a reasonable time period, or at all].

Rph gives me a long suffering look and takes the Rx out of my hand and goes to talk to SC, I follow for moral support, knowing that there is no way this is going to go well.

Rph: Ma'am, I'm sorry but this isn't a valid prescription, we can't fill this for you without...
SC: *cuts her off, practically screaming* WHAT DO YOU MEAN IT'S NOT A VALID PRESCRIPTION! MY HUSBAND GOT THIS SAME DRUG 6 MONTHS AGO FOR THE SAME THING! BLAH BLAH! *rages more*
Rph: MA'AM! We can't even tell who wrote this! AND it's not dated!

Sadly, at this point, the phone went nuts and I had to leave my pharmacist to deal with SC on her own. But I do catch these gems in between calls:

SC: DO YOU EVEN KNOW WHAT A COLONOSCOPY IS?
SC: HOW AM I SUPPOSED TO KNOW THE DOCTOR'S NAME?
SC: IT'S NOT LIKE IT'S A NARCOTIC OR ANYTHING!

When I finally get off the phone, Rph is about ready to flip her top at SC and I see SCH has arrived and is encouraging his little harpy to keep it up. Rph somehow manages to get away from them for a breather after SC stops screaming and starts crying about how she's not usually like this and she doesn't mean to be so mean. As Rph walks over to me to discuss what we're going to do, I hear:

SC: They won't give me my medication! They say the prescription's not right!
SCH: WHAT? It's not like it's a narcotic or anything!
SC: That's exactly what I said, but they won't listen!

I raise an eyebrow at Rph and she groans. We decide that we might as well try to contact the company, but SC calls us back over. I take the hit this time, because I'm afraid Rph will beat them to death with the register if she has to deal with this any longer.

SC: I'm going to call the Dr's office and find out why they sent me this supposedly not valid prescription. It's not like it's a narcotic or anything.
Me: *handing her back the Rx* That's the best plan, if we don't even know the doctor, there is nothing we can do. It's against the law to fill a prescription without certain information. *if she had been nice about it, I would have spent an hour and a half on the phone pulling teeth and finding that information or getting someone who could give a verbal to my pharmacist, but she forfeited that right long ago*
SC: Well, it's not like you couldn't do it if you wanted to. Politician's break the law all the time, they make their own laws! Why should anyone else follow the law.
Me: *takes a second to compose myself* I'm not a politician, ma'am, I'm a medical professional and we like to follow the law.
SC: *looks like her evil plot was foiled*

As they turned to walk away the old harpy had the audacity to "apologize" to the people waiting behind her:

SC: I'm so sorry for holding you up! I'm sure you're all thinking "won't that old bitch just shut up and move along?" Hahahaha

The two girls she said that to had slightly guilty looks when they walked up to the counter and I knew they had been thinking just that. Thank god they were nice and understood that I needed a minute to collect my brain off the walls.

Who in the world uses logic like that? If I didn't spend so much time reading on this site, I'd be a lot more shocked.

[Nyoibo]

Actually, wouldn't an anti-anxiety med technically be a narcotic? Just not a narcotic in the "Law" sense of the word.

[Sapphire Silk]

Actually, wouldn't an anti-anxiety med technically be a narcotic? Just not a narcotic in the "Law" sense of the word.

It depends. The word doesn't have a precise meaning. Originally, it just meant it induced sleep (well, Benadryl does that). Most medical professionals use it to mean opiates or opiate based drugs. The legal sense of the term broadly uses it to cover all controlled substances which is actually the most precise term because of the Controlled Substances Act and the Schedule of Controlled Substances, which includes opiates, cannaboids, pyschadelics, cocaine and its derivatives, amphetamines, benzodiazapines etc.

What the Harpy doesn't understand is that federal laws controlling medications cover more than the Controlled Substances. The Food Drug and Cosmetics Act of 1938 sets the definitions of what medications require a prescription from a physician, PA or NP (WHO can write a prescription is an issue of state law). The colonoscopy prep is a prescription drug and should be. You don't want people with chronic constipation or anorexia abusing it because of the risk of severe electrolyte disturbances.

It's safe for a one time use before a procedure. Regular use would kill you.

Having an invalid prescription is NOT a little thing. It is a very big thing.

And it makes me wonder: was the doc simply sloppy when he wrote it, or was there something more going on?

And while there are SOME people who do better on brand name drugs rather than generics, it is uncommon and having to take a brand name on ONE med does not mean you have to with EVERY med.

The Harpy sounds like a snob.

I wouldn't have given the guilty look had I been in line behind her. I'dve looked her in the eye and said, "next time exercise some self control."

Your final answer to her, btw, was golden. You handled it just right.

[dalesys]

And it makes me wonder: was the doc simply sloppy when he wrote it, or was there something more going on?

Known conditions: FOS.

[Gryphon]

She didn't even have any other medications with us, except for one from an ER Dr like a year and a half ago. She usually goes to the all-in-one doctor/hospital/pharmacy/gated community of medicine that is the only insurance we don't take! I was like WTF are you doing here lady and why are you bothering me instead of them?

And the situation makes me laugh now that I'm not so mad about it.

[morgana]

I've had five, count 'em, FIVE colonoscopies. If I'd been there when she was going off on the pharmicist about "do you even know . . .?", she wouldn't have needed the prep kit. Her doctor would have been able to study her colon first hand . . .

[RayvenQ]

"Here you go Ma'am, just this once I'll break the law for you, take these cyanide pills twice a day and your colonoscopy will be no worry at all."

[Pagan]

Actually, wouldn't an anti-anxiety med technically be a narcotic? Just not a narcotic in the "Law" sense of the word.

Most people have no idea of the laws that pharmacies, phamacists, and pharmacy techs are bound by.

Having an invalid prescription is NOT a little thing. It is a very big thing.

And it makes me wonder: was the doc simply sloppy when he wrote it, or was there something more going on?

Don't get me started on doctors and writing scripts. More than once, one of the pharmacists where I used to work would say, "What are they trying to do? Kill them?"

[Captain Trips]

Quite often, even doctors don't know all the laws regarding prescriptions....

Just because a pharmacy looks like a store, doesn't mean that they can sell you anything (other than narcotics) if they wish...

Why the hell would anyone want to forge a 'script for a prep kit? Those things are nasty! (I had my first colonoscopy a couple of years ago, and am not looking forward to my next one. Thanks to Versed, the procedure is nothing -- but the prep the night before is horrendous!)

If I had been behind her?
Her: "I'll bet you are wondering 'when will that old bitch shut up and move on?'"
Me: "Well, you're close -- but I was thinking even worse. It ain't THEIR fault that YOUR doctor doesn't know what HE'S doing! Call him up, have him write a PROPER prescription, and CALL the pharmacy to see if they only have the generic -- and DON'T rip them a new one if that's the case, it's NOT THEIR FAULT!"

[Mikkel]

Why the hell would anyone want to forge a 'script for a prep kit? Those things are nasty!

I present to you: Blutone, the only man ever to be addicted to bum explosions .

No, I don't think anyone will take those without it being necessary. I luckily got them at the hospital, together with some adult diapers .

[Shalom]

Had a patient once who was addicted (and I use that word advisedly) to laxatives.

It's possible to become dependent on some laxatives, if you use them for too long, but this woman was addicted. She'd been getting lactulose on prescription, and she'd gone through 6 months worth of it in only three months time. Finally Medicaid (of course) cut her off.

Her friend had called in the refill, and I tried filling it and told him it wouldn't go through. He said "You better tell her that yourself, I'm not telling her." So she got on the phone and I told her the situation. She started screaming. I don't mean yelling at me, just literal screaming without words. "AAaaaaugh! Aaaaaaugh!" I told her if she didn't stop shouting at me I'd hang up the phone, and ten seconds later did so.

She called right back, and all of a sudden she's all sweetness and light. "I know you're gonna help me out, because I could tell that you're so nice and such a helpful person..." I interrupted her. "Lady, I have Aspergers' syndrome. I can spot being manipulated a mile off, so cut it out and let's see if we can come up with a solution to your problem." She switched it right off again, and was all business for the remainder of the call. I could hear her thinking "Oh well, I tried."

(Oh yeah. She also tried to tell me that if I refused to give her the stuff, she'd start making herself throw up again. What is she, threatening me? I told her that I had nothing to do with that, that if she wanted the lactulose before her insurance was willing to pay for it, she'd have to pay cash. Of course she didn't want to do that. In the end I wound up selling her a bottle of sorbitol, which works similarly and doesn't require a prescription, but I told her this was only a stopgap and she really did need to speak with her physician about this issue.)

[Mikkel]

Had a patient once who was addicted (and I use that word advisedly) to laxatives.

It's possible to become dependent on some laxatives, if you use them for too long, but this woman was addicted.

Isn't abuse of laxatives a symptom of anorexia?
I could see her, with her mental problems, trying to get some preparation kits for colonoscopies - and probably dying from dehydration or worse.

[laborcat]

Isn't abuse of laxatives a symptom of anorexia?
I could see her, with her mental problems, trying to get some preparation kits for colonoscopies - and probably dying from dehydration or worse.

Especially with her threat of making herself throw up again... that's what it sounds like to me (remember, I'm not a doctor)

[dalesys]

...but I told her this was only a stopgap...

...wouldn't a laxative be more of an unstopgap?

[Jay 2K Winger]

Especially with her threat of making herself throw up again... that's what it sounds like to me (remember, I'm not a doctor)

Actually, with the throwing up, I think that's bulimia. (I am also not a doctor.)