Doctors: A rant from Pharmacy employees

[Sapphire Silk]

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?

Hmm. Rash and swelling of a particular part . . he doesn't need Viagra. He needs penicillin.

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.

That's a good question. Not being a pharmacist, I have no idea but I'm betting the answer is, "no." Corporate won't want to lose business: those patients will simply choose other pharmacies and not come back.

[LadyAndreca]

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.

Yeah, "you haven't had it in so long it could kill you" was how Mom explained it when I asked her as a teen. I have a piece of paper in my wallet listing my allergies and blood type, and I should probably put that on my phone too. (My phone is usually in my pocket, and my wallet in my purse, so I'm thinking my phone is more likely to be with me.)

Interesting info on the adverse/allergic scale. I'm not sure if I'm truly allergic to latex, then--I get horrible itching that doesn't stop until I scrub the affected area, but no visible rash or swelling from brief exposure. Long exposure, say, from a bandaid that's been left on for hours, causes blisters to form under the bandaid. (Grossness warning!) Last time, when I peeled the bandaid off the surface layer of skin came with it! I had to stop using latex completely after that, because even picking up a pair of latex-coated gloves at work (and we sell a ton) means I have to wash my hands or itch until I do.

Once our insurance for the year is settled, I really ought to go see an allergist and get all these questions officially settled.

[Sapphire Silk]

Interesting info on the adverse/allergic scale. I'm not sure if I'm truly allergic to latex, then--I get horrible itching that doesn't stop until I scrub the affected area, but no visible rash or swelling from brief exposure. Long exposure, say, from a bandaid that's been left on for hours, causes blisters to form under the bandaid. (Grossness warning!) Last time, when I peeled the bandaid off the surface layer of skin came with it! I had to stop using latex completely after that, because even picking up a pair of latex-coated gloves at work (and we sell a ton) means I have to wash my hands or itch until I do.

I'm very concerned to hear this. It does sound like a latex allergy. You should avoid wearing latex gloves from now on. If you have to wear gloves for work, get a note from your doctor: your employer will be required by law to provide you with non-latex gloves (either nitrile or vinyl) for work. Latex reactions are very dangerous. Don't risk it.

With the bandaid, it could either be the latex or an allergy to the adhesive. My suggestion is to buy tefla dressings that can be cut to size, and secure it with paper medical tape (you can buy it at most pharmacies now).

[Seshat]

In my home, for minor injuries, we're using 'spray bandaid'. Basically, it's superglue in a spray bottle.

Clean the injury. Apply betadine. (I think it's iodine - certainly it's an antiseptic that works well for all of us.) Then prepare to wince, aim the spray-bandaid at the cut, and curse for a few seconds while it stings like hell.

About the same time the 'spray bandaid' peels off, the wound has healed. And in the interim, nothing's had a chance to get into it from the outside.

I don't think we've had any large injuries for a while. If we did, we'd break open one of our sterile gauze and sterile wadding packs, and - as Panacea suggested - tape it down with medical tape.

Anything larger than that, of course, goes to our family doctor, emergency clinic, or the ER. (Depending on who's open. Family doctor for preference, emergency clinic next, ER if it's ohgod AM. Or if we're risking loss of limb, I suppose.)

[LadyAndreca]

Oh, I stopped using latex completely after that one incident. And I only use bandaids to keep cuts covered while I'm working, or to keep blood off of the customers--the adhesive on most non-latex bandaids gives me welts too. At least THAT doesn't itch! I did find one brand that was okay, but I've never seen it again. Mostly I try to let things just scab over naturally if I can.

Spray bandaids...I dunno, it's FAR too easy to get an infected cut at work, but I'll look into it. Medical tape can't be easily slipped into my apron like a bandaid can, and won't stay clean in there (maybe I can get a really thin roll and a ziplock bag?) but it's not a bad idea for my home kit.

And you bet I made my managers give me non-latex gloves. I insisted that if corporate thought coated gloves were so important that there was an entire bin full of them for us to use as necessary, they could mark down a single pair of non-latex ones for me. They knew they couldn't really argue with me.

[Dragon_Dreamer]

I don't have a latex allergy, thank goodness, but any form of acetone will cause rashes, swelling, all sorts of ickiness. And yes, it IS in superglue and liquid bandage. I use the latter on a wound, and it's pussy and gross within the hour. >.< Very annoying to explain to doctors, and I hope I never have an ER/hospital visit where they might use the stuff. I've heard it's even used in some surgeries. >.<

[Seshat]

Medical tape can't be easily slipped into my apron like a bandaid can, and won't stay clean in there (maybe I can get a really thin roll and a ziplock bag?) but it's not a bad idea for my home kit.

Our medical tape comes in a little roll-holder-thingy that keeps it clean. Check your pharmacy.

I didn't think of the issue that food preparation standards (and other such standards) may require wound coverings to be highly visible. Again, check with your pharmacy tech - I'm sure someone can help with that.

I don't have a latex allergy, thank goodness, but any form of acetone will cause rashes, swelling, all sorts of ickiness. And yes, it IS in superglue and liquid bandage.

They're all variations of cyanoacrylate. Acetone is an effective solvent for cyanoacrylates.

It's also possible to be sensitive (or, I presume, allergic in the 'produces a histamine reaction' sense) to cyanoacrylates themselves.

[Dragon_Dreamer]

Nail polish remover with acetone will cause the same reaction. The symptoms started around the time I worked in my college's chem lab, preparing experiments. I started getting rashes whenever I cleaned things that had held acetone, and things went downhill from there. :/

[Andara Bledin]

I've found that for very small wounds (paper cuts, staple stabs) if I clean it, dry it, and slap a bit of regular tape on it, it works rather well. But I work in an office environ where tape is just an arm's reach away, and injuries are almost non-existent.

^-.-^

[wolfie]

In my home, for minor injuries, we're using 'spray bandaid'. Basically, it's superglue in a spray bottle.

Clean the injury. Apply betadine. (I think it's iodine - certainly it's an antiseptic that works well for all of us.) Then prepare to wince, aim the spray-bandaid at the cut, and curse for a few seconds while it stings like hell.

About the same time the 'spray bandaid' peels off, the wound has healed. And in the interim, nothing's had a chance to get into it from the outside.

I don't think we've had any large injuries for a while. If we did, we'd break open one of our sterile gauze and sterile wadding packs, and - as Panacea suggested - tape it down with medical tape.

Anything larger than that, of course, goes to our family doctor, emergency clinic, or the ER. (Depending on who's open. Family doctor for preference, emergency clinic next, ER if it's ohgod AM. Or if we're risking loss of limb, I suppose.)

I use the "NuSkin" brand of brush-on bandage (they also make a spray), and I'd like to add a couple pointers:

1. If a cut is actively bleeding (even oozing), use a regular band-aid. The liquid/spray won't dry fast enough to stop the bleeding.

2. If the cut is near a joint, flex or extend the joint so that the cut is stretched as far as it will go, and keep it in that position until the bandage dries. Otherwise, flexing the joint will pull the bandage loose.

3. Even for simple cuts (i.e. paper cuts), they heal a LOT faster, and stop hurting almost immediately, when protected by a liquid bandage than when unprotected.

4. If an injury can be treated with either a liquid bandage or a regular one, go for the liquid. Regular ones get dirty/wet (even from sweat) too easily.

[ShinyGreenApple]

My pharmacists have caught a handful of deadly reaction scrips in my time back there. More often though, I see them telling a parent they can't fill little Kaitlyn's medicine because it was written for an unusually large dose and could harm her. I think my worse reaction was when a father exploded with "WHAT?! Is this a common thing with _____ establishment, this is the second time a pharmacy has told me this!"

I'd just really hate to be working at these medical centers when the angry parents go back to complain, not that they don't have reason to.

[Misanthropical]

My pharmacist once freaked and called my doctor. She told me later that if she had filled my insomnia medication the way it was written I would have never woke up again. Things like that are why I get all my scripts filled at the same pharmacy.

I carry a list of all medications I take and my blood type. When I was in the hospital they got my medications all screwed up. The nurses were on the phone yelling at the doctors that I can't just stop taking some of my medications while I'm in the hospital since it was dangerous to just cut the meds off like that.

The nurses had to fight tooth and nail to get all the medications I take ordered for me so I didn't have to go through harsh withdraws. I tried to give the hospital my list of medications when I signed in for the surgery but they told me they didn't need it.

I hate having to stand behind someone who is asked for $5 for the brand name medication that I would have to pay $100 for and they freak the hell out that it's their last $5 but they drive a much better car than I do and have all the luxuries dripping off of them while screaming obscenities at their kid and throwing the candy bar the child just had in it's hand and was chewing on back in the sale rack.

I was once yelling at my doctor about not faxing over my script and found out later the pharmacy never got it off the fax machine.

I once made a complaint to a pharmacy that I was asked to pay $150 for my big guy's script while another only charged me $20. The head guy told me to go there then, so I pulled all the scripts and did just that. That pharmacy closed down not to long after that.

[EricKei]

a father exploded with "WHAT?! Is this a common thing with _____ establishment, this is the second time a pharmacy has told me this!"

I sure as hell hope so! If I were in the line behind that guy, I would have asked him why he had to be told this TWICE -- as that implies that he DID NOT LISTEN the first time, and was therefore placing his kid in danger!

Kudos to you, Apple, for standing your ground!

[sstabeler]

I sure as hell hope so! If I were in the line behind that guy, I would have asked him why he had to be told this TWICE -- as that implies that he DID NOT LISTEN the first time, and was therefore placing his kid in danger!

Kudos to you, Apple, for standing your ground!

I get the impression the establishment the guy was referring to was the place that the guy got the pescription from, and this was the second time he'd had this problem with pescriptions from said establishment. NOT that the guy had got a refusal from one pharmacy and tried another.

I.E. he was asking if the establishment was known for writing dangerous pescriptions, so he could avoid them in future

[ShinyGreenApple]

I get the impression the establishment the guy was referring to was the place that the guy got the pescription from, and this was the second time he'd had this problem with pescriptions from said establishment. NOT that the guy had got a refusal from one pharmacy and tried another.

I.E. he was asking if the establishment was known for writing dangerous pescriptions, so he could avoid them in future

^ Yes, that. He wasn't angry with us, but needled the pharmacist as to whether this was a common thing with that pediatric center. I wish people would focus on quality of service rather than trying to process as many patients as possible in one day, things like this wouldn't happen, you know?