Doctors: A rant from Pharmacy employees

[AccountingDrone]

@AccountingDrone: There's payment assistance available from the manufacturer if you have no insurance or stupidly high co-pays for Colcrys. See this link for details.

(Colcrys was granted 3 years exclusivity for treatment of gout flares, and 7 years for FMF under the Orphan Drug program. Generic should be available as of 1/30/2012, but don't expect it to be as cheap as it has been heretofore, even then.)

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Luckily I get mine from the navy dispensary system, so it is effectvely free ... but it still sucks ass.

[PepperElf]

may I add one to your list?

** Know whether or not your patient is on a medication that will interact badly with the one you just prescribed. Especially if you just prescribed them two meds that cannot be taken together.


That latter part applied to me. Doc was good but... he prescribed me meds for my allergies and an antibiotic for whatever I was sick with. Thankfully the pharmacist warned me not to take them together, because that particular combination (the specific brand names) was known for causing heart attacks. So I skipped my allergy meds until I was done with the other pills.

[Irving Patrick Freleigh]

Years and years ago, I'm told a doctor nearly prescribed my grandpa a combination of medications that would've induced a massive heart attack.

Only a nurse warded off his certain death.

[jedimaster91]

And is it me, or should they be able to properly spell the drug they're writing for? I had playing "guess the drug".

That is if you can decipher their handwriting to begin with.

Synthroid...? o_O Oh shit, I take that...or maybe "took" that is the proper word to use >_< Scrip ran out and haven't been able to afford a doc visit to get it renewed quite yet. Argh.

Uh...you might want definitely need to find a low-cost clinic or make some sort of arrangements with your current doc. Synthroid is synthetic thyroid hormone, and thyroid hormone regulates several essential bodily functions. Like heart rate. Depending on your level of hypothyroidism, you might be ok, but make sure your doc knows you're out of the stuff.

[AquaGirl]

OMG when I worked at Eckerd, we hated Mondays. Everyone went to the dr on Mondays. Everybody's dr said they would call in their prescription. Everybody came straight to the pharmacy to get said prescription that had not been called in yet because dr actually calls prescriptions in in groups, not one at a time. Everybody got mad and said we were lying. And then rather than going home or sitting down to wait everybody stood in an ever-expanding sea of idiocy right in front of the counter, refusing to part and yowling like a sick cat when poor Jane Doe came to pick up her BP meds that her dr called in yesterday that "I've been here longer than she has!"

[Just Ace]

My favorite example of the drug-price change is Auralgan

Am I right in assuming this is the ear drops with Benzocaine in it? In Oz it's an OTC item - I sell it for $14.95.

Educating the diabetic about insulin and how to give it to themselves is YOUR job

Our job description of a Pharmacist may be different to you guys in the U.S. but here it is actually the Pharmacist job to inform patients on how to use their medication. Granted with Diabetes we do have Diabetes Educators who go to their homes and educated the patient on managing their diabetes, but it is in our Duty of Care to make sure that each person who leaves my pharmacy knows how to use their medication and what side effects may occur.

I always have a real issue with Dr's handwriting. I swear they teach a course in Uni on how to have to worst handwriting M.D. style. But when you get the Dr's that use computer programs to write their scripts, they seem to like selecting the wrong item so either the customer is getting the wrong strength or getting something prescribed that isn't covered by their concession card and they have to pay full price for.

Another one is when Dr's fax scripts for patients S8 (Dangerous Drugs) scripts but don't know that legally we can't dispense these medications off a faxed script. It's always fun when Little Johnny's mum comes in wanting Johnny's ADHD medication (which he hasn't had for 5 days) expecting it to be there waiting for her but sorry, we can't dispense it till the script is in the pharmacy.

[AquaGirl]

Try almost having your child on 6/6/06


I had the child's pediatrician write a scrip for the OTC Children's Claritin so I could use my flex spending account. The Feds passed a law that you can no longer use your flex account to purchase OTC medications starting 1/1/11. What did I do on 12/31/10? I went to Target and spent about $100 stocking up on anything and everything OTC.

My cousin's c section was set for that day. She begged and pleaded and got it changed to the 7th.

[Pagan]

That is if you can decipher their handwriting to begin with.

Should it concern me that I don't have a huge problem with that anymore? Mainly because I spend (+/-)8 hours a day/(+/-)40 hours a week typing in scripts....

[EricKei]

jedi - indeed. He can be a hard dude to get in touch with, however. I currently to take a couple of heart meds (hctz, toprol, zestril, & synthroid/their generic equivalents and levaquil/-quin i THINK), the Synthroid was prescribed for low metabolism (tho it is only logical that the two are intertwined). The pharmacy has tried reaching him more than once to reactivate the refills (they ran out, mostly thanks to my being unemployed for awhile -- I have a new job, but the pay is considerably lower), but he doesn't return their call (or never got the message) nor mine. >_<

May very soon be in the market for a new doc. My uncle is a pain specialist -- this isn't his area, but he can probably recommend someone for me. I will contact him.

Altho -- re the other post that mentioned more dangerous drugs...I used to take some form of Seldane back in the 80's (briefly) for a eustachian (sp?) tract problem (sinus issue ended up affecting my hearing) -- it did the job quite well, tho it seems that I seem to have had eternally "slightly-stuffed-up-sinuses" ever since >_<. Imagine my joy when I found out that certain varieties of it had been banned...and I can't recall which one I took way back then. ~_~ Fortunately, I was only on it for a brief time, and stopped long before they banned the stuff.

[SongsOfDragons]

Years and years ago, I'm told a doctor nearly prescribed my grandpa a combination of medications that would've induced a massive heart attack.

Only a nurse warded off his certain death.

Apparently, when I was about fourteen and they were trying to swap my epilepsy meds to one that doesn't cause spina bifida, my mum caught that they had given me the wrong meds - something else beginning with L that wasn't Lamotrigine, but aimed more at mental disorders. (She can't remember if it was Lithium or not, but that's the only one that fits the bill that I can think of...) Not entirely sure whose mistake that was...

Might not have done much, I don't know. But they had to swap me back to my old stuff because Lamotrigine just made my fits worse...

[LadyAndreca]

I once had a doctor hand me a script for one of the weird-sounding '-cillin' medications. I looked at it, recognized the ending, looked at him, and said "Are you sure I can take this? I'm allergic to penicllin." He turned an interesting color of pink, took it back, tore it up, and wrote me something I could take.

It's always interesting answering "What's your reaction to penicillin?" though. I haven't had it since I was six. My sister and I got sick, we both got penicillin, she got better, and I broke out in a rash. Mom's allergic too so she hauled me into the doctor pronto to get it confirmed and on record. Usually they accept the "family history" and "haven't taken it in over 20 years" without comment.

[Ironclad Alibi]

It's always interesting answering "What's your reaction to penicillin?" though. I haven't had it since I was six. My sister and I got sick, we both got penicillin, she got better, and I broke out in a rash. Mom's allergic too so she hauled me into the doctor pronto to get it confirmed and on record. Usually they accept the "family history" and "haven't taken it in over 20 years" without comment.

When Mrs. IA was 4, she was given the largest dose of penicillin ever given to a child. She had a near death experience because of it.

[Sapphire Silk]

I once had a doctor hand me a script for one of the weird-sounding '-cillin' medications. I looked at it, recognized the ending, looked at him, and said "Are you sure I can take this? I'm allergic to penicllin." He turned an interesting color of pink, took it back, tore it up, and wrote me something I could take.

It's always interesting answering "What's your reaction to penicillin?" though. I haven't had it since I was six. My sister and I got sick, we both got penicillin, she got better, and I broke out in a rash. Mom's allergic too so she hauled me into the doctor pronto to get it confirmed and on record. Usually they accept the "family history" and "haven't taken it in over 20 years" without comment.

Better safe, than sorry. Next dose could end up killing you.

Some people refer to adverse reactions as an "allergy." Adverse reactions include everything from nausea and constipation to restless legs, anxiety reactions, etc.

A true allergic reaction includes the following: a rash, swelling (of anything), difficulty breathing (usually wheezing). The medication causes a massive histamine reaction that can lead to anaphalaxsis.

Interestingly, the first or even second dose of a medication may not cause this. It takes some exposure for the body to go into overdrive with the histamine reaction.

Don't ever take penicillin again unless you are in the hospital and the physician plans to pump you up with lots of Benadryl, an H2 blocker like Pepcid, Tagamet, or Zantac, and steroids.

[AccountingDrone]

Our job description of a Pharmacist may be different to you guys in the U.S. but here it is actually the Pharmacist job to inform patients on how to use their medication. Granted with Diabetes we do have Diabetes Educators who go to their homes and educated the patient on managing their diabetes, but it is in our Duty of Care to make sure that each person who leaves my pharmacy knows how to use their medication and what side effects may occur.

.

My endocrinology clinic has a nurse that trains you in how to take your meds, and a pair of nutritionists who hold classes in the whole food deal, portion control, how to read labels, the actual nutritionist sits down with you and formulates the personalized food pyramid for each patient personally - I have had several consults over the past 29 years. I can tell you exactly what I need to eat and at what times, and I sit down and menu plan for the entire week ahead. I can actually call up and set an appointment with either team without having to go through the endocrinologist [unless it is something like my ideosyncratic reaction to byetta]

[wolfie]

A true allergic reaction includes the following: a rash, swelling (of anything), difficulty breathing (usually wheezing).

Does this mean that Viagra should be a "don't even think of taking it a second time - you're allergic" situation for all men?

As for the "patient gets to the pharmacy before the doctor phones in the prescription" situation, can a pharmacy legally "blacklist" a doctor from phoning in prescriptions (i.e. only accept a written prescription brought in by the patient) for the worst offenders? After all, by having the patient get there before the prescription (especially if the doctor tells the patient when it'll be ready, not knowing or caring whether there's a rush at the pharmacy, or even if they have the medication in stock), the doctor is causing problems for the pharmacy.