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  • #1

    "Can you do me a big favor?"

    No. Not that one, at any rate.

    I'm part-timing in a small independent pharmacy, and I get a phone call that starts with "Can you do me a big favor?".

    Uh-oh.

    Small favors, like running a prescription out to the front door because she's got the kids in the car and this place is too small for a drive-through window, I don't mind so much. When someone asks for a big favor, though, it's probably something illegal or therapeutically inappropriate. This one turned out to be both.

    So I ask her what's on her mind. She says, "Well, the doctor gave me 250mg of Cipro to take for ten days, but I know I've got a UTI, [that's urinary tract infection, for the non-medical readers] so I've been taking 500mg instead. So of course I ran out, so I need you to give me another 20 tablets for the next 5 days."

    Um, no. Can't do that.

    She sounds shocked that I refused to accommodate her. "You won't do that for me?"

    Well, no. I can't change the dose without a new prescription from the doctor.

    "But the doctor's not in today. Can't you just give them to me?"

    No, I can't.

    She keeps arguing, like that would make any difference. I tell her that what she's asking me to do is illegal; either she's asking me to prescribe, which is not within my scope of practise in this state, or alternatively to dispense a legend drug without a prescription, depending on how you look at it. Either one could cost me my license. I dunno if the previous pharmacist who I replaced would have caved on something like this; she sounded like she actually expected me to say yes.

    Finally she says "Well, thanks anyway!" and hangs up. I told the techs about this call and we had a good laugh over it; even the tech I mentioned in the CoC thread was outraged that she'd have asked for something like that.

    (As an aside, I've had customers go even further than that. When I tell them that I won't put my license in jeopardy for a lousy 20 tablets, they invariably say "But no-one will ever know!" Well you say that now, but if you suffer some sort of side effect or bad reaction to the drug that you're asking me to illegally give you, I will bet anything you name that your lawyer will be down at the Board of Pharmacy early the next morning waiting for them to open the doors so he can file the complaint against me in person, and I wouldn't have a leg to stand on.)
    Tags: None
  • #2
    Just shameful on her part.
    Customers should always be served . . . to the nearest great white.

    Comment

    • #3
      Do you know what it would have done to her?
      "Is it the lie that keeps you sane? Is this the lie that keeps you sane?What is it?Can it be?Ought it to exist?"
      "...and may it be that I cleave to the ugly truth, rather than the beautiful lie..."

      Comment

      • #4
        Why would anyone double the dosage of their antibiotics!? If your UTI was THAT bad, you'd be on something stronger than Cipro!
        We are actors! We are the opposite of people! -Tom Stoppard, Rosencrantz and Guildenstern Are Dead

        All we can do is hate. And they ALL deserve it.

        Comment

        • #5
          "No, but I can sell you cranberry juice."
          Seshat's self-help guide:
          1. Would you rather be right, or get the result you want?
          2. If you're consistently getting results you don't want, change what you do.
          3. Deal with the situation you have now, however it occurred.
          4. Accept the consequences of your decisions.

          "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

          Comment

          • #6
            Quoth teh_blumchenkinder View Post
            Do you know what it would have done to her?
            It could cause a number of problems. Aside from the problem of a massive allergic reaction (which often occurs on later doses rather than the first), Cipro specifically can cause a very specific and deadly heart problem called torsades de pointes. Steven Johnson syndrome (an equally deadly reaction caused by many medications) is another potential problem. Floroquinalones are highly effective antibiotics, but also one of the more dangerous classes.

            There are real reasons why you have to get a prescription for meds and why you must get one from a doctor. Any time you take medication you are putting complicated chemicals in your body you are taking the chance those chemicals might not work the way they were intended to. When you don't follow the instructions for taking those medications, you increase that risk.

            Most medicines are relatively safe when taken as directed. When not taken as directed, you are playing Russian Roulette with your body.

            Quoth Tsiyeria View Post
            Why would anyone double the dosage of their antibiotics!? If your UTI was THAT bad, you'd be on something stronger than Cipro!
            Cipro is actually a fairly strong drug. Doubling the dose, however, will not get rid of the infection faster. In some cases, though, it is not the best antibiotic.

            That's why when the doctor does the urine test, he also sends for a Culture and Sensitivity. The culture identifies the kind of bacteria causing the infection. The Sensitivity tells him what antibiotics work best. Because this test takes about 3 days to come back, most doctors will order a broad spectrum antibiotic and then change it if it is not the best one for that particular culture.

            This woman was a dumb bunny. She should have taken her prescription as directed. If she was having symptomatic issues, cranberry juice would indeed help. So would Azo, which is available over the counter. She could have asked for something for the symptoms when she saw her doctor and got the antibiotics. Or she could have talked to Shalom about that specific aspect. Pharmacists are great resources for that kind of thing.
            They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

            Comment

            • #7
              Quoth Panacea View Post
              Pharmacists are great resources for that kind of thing.
              Abso-fraggin'-lutely!

              When I got my mysterious rash, the doctor provided me with the steroids to (hopefully) resolve the rash. The pharmacist and pharmacy assistant provided creams to help improve the healing and ease the itching.

              I also tend to ask a pharmacist when I'm in doubt about whether a problem is a simple one or a doctor-visit one. Sometimes they can say 'sure, follow me - here's what you need'. Sometimes, it's 'try this for (X days), if that doesn't fix it, see a doctor'. And, of course, sometimes it's 'no, that's definitely a doctor problem'.
              Seshat's self-help guide:
              1. Would you rather be right, or get the result you want?
              2. If you're consistently getting results you don't want, change what you do.
              3. Deal with the situation you have now, however it occurred.
              4. Accept the consequences of your decisions.

              "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

              Comment

              • #8
                Quoth Seshat View Post
                "No, but I can sell you cranberry juice."
                I'd recommend canceling her membership with the Piss and Moan club but that's just me.

                Comment

                • #9
                  Quoth Panacea View Post
                  It could cause a number of problems. Aside from the problem of a massive allergic reaction (which often occurs on later doses rather than the first), Cipro specifically can cause a very specific and deadly heart problem called torsades de pointes. Steven Johnson syndrome (an equally deadly reaction caused by many medications) is another potential problem. Floroquinalones are highly effective antibiotics, but also one of the more dangerous classes.

                  There are real reasons why you have to get a prescription for meds and why you must get one from a doctor. Any time you take medication you are putting complicated chemicals in your body you are taking the chance those chemicals might not work the way they were intended to. When you don't follow the instructions for taking those medications, you increase that risk.

                  Most medicines are relatively safe when taken as directed. When not taken as directed, you are playing Russian Roulette with your body.



                  Cipro is actually a fairly strong drug. Doubling the dose, however, will not get rid of the infection faster. In some cases, though, it is not the best antibiotic.

                  That's why when the doctor does the urine test, he also sends for a Culture and Sensitivity. The culture identifies the kind of bacteria causing the infection. The Sensitivity tells him what antibiotics work best. Because this test takes about 3 days to come back, most doctors will order a broad spectrum antibiotic and then change it if it is not the best one for that particular culture.

                  This woman was a dumb bunny. She should have taken her prescription as directed. If she was having symptomatic issues, cranberry juice would indeed help. So would Azo, which is available over the counter. She could have asked for something for the symptoms when she saw her doctor and got the antibiotics. Or she could have talked to Shalom about that specific aspect. Pharmacists are great resources for that kind of thing.
                  "Dumb bunny" doesn't even begin to cover it!! We're only just starting to learn antimicrobials and resistance in Microbiology now (and doing susceptibility testing in the lab) but even without that "book learning", *I* know never to double an antiboitic without the say-so of a Doctor. She's damn lucky she didn't end up hosptialized.
                  The large print giveth, and the small print taketh away.

                  Comment

                  • #10
                    Doctor, always, for dealing with the major issue, and for any supportive treatments which need prescriptions.

                    Pharmacist or pharmacy tech for supportive treatments that don't need scripts. (Assuming the pharmacy tech is intelligent enough to refer you to the pharmacist if he's unsure.)
                    Seshat's self-help guide:
                    1. Would you rather be right, or get the result you want?
                    2. If you're consistently getting results you don't want, change what you do.
                    3. Deal with the situation you have now, however it occurred.
                    4. Accept the consequences of your decisions.

                    "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

                    Comment

                    • #11
                      there's also the issue of misusing the big gun style antibiotics creating a resistance later on to lower grade bugs. always follow the scrip to the letter, unless a pharmacist spots an issue and amends the orders.

                      i'm not a doc or pharm, nor would i ever pretend to be one...
                      look! it's ghengis khan!
                      Sorry, but while I can do many things, extracting heads from anuses isn't one of them. (so sayeth the irv)

                      Comment

                      • #12
                        are you allowed to also notify her doctor that the woman was abusing her medications?

                        Comment

                        • #13
                          Quoth PepperElf View Post
                          are you allowed to also notify her doctor that the woman was abusing her medications?
                          I don't know about pharmacists, but as a nurse I do so all the time.
                          They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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