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

[Sapphire Silk]

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

(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.)

Odds are this lady has an eating disorder, which IS an addictive behavior, even though she technically wasn't addicted to the laxatives themselves. She's addicted to the behavior.

Sounds like she has a history of bulemia, which explains the threat of "making herself throw up."

Anorexia is starving yourself. Bulemics eat normally, but purge either with laxatives or through vomiting.

The two syndromes often go hand in hand.

I don't know if Shalom had a choice in selling her the sorbitol. But she probably would have been better off without it.

Or better still, in a treatment program.

[Eisa]

I think it's also possible to be anorexic with a purging sub-type. Which is basically that you restrict what you eat AND purge it...as opposed to binging and purging.

[Rapscallion]

From what I understand, it's possible to become dependant on laxatives.

The gut requires certain signals to evacuate its contents. If it becomes used to different signals, it doesn't react to the normal ones. I have people wanting advice on using psyllium husk as a laxative and bulking agent - I always tell them that they need to speak to a trained medical professional.

Rapscallion

[MelodiousBubbles]

Add in working on a brand new system that only two stores in our company use at the moment, and you've described the last few times we've had floaters in my pharmacy.

I love being a tech; it beats the hell out of being on the FE.

However... I would not trade places with the pharmacist for the world most of the time since in the end, they're the one that has to deal with really, really bitchy customers.

[Seshat]

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.

For example, my generic diazepam has a 'contains lactose' warning. There are people who cannot digest lactose; therefore they should probably avoid this particular generic. A different generic might not have it. Heck, the brand name might have lactose - in which case the patient would do better on a generic that doesn't.

As I understand it, the reason to take/avoid generics/brand names usually has to do with the fillers and coatings used to allow the delivery of the drug; not the actual drug itself.

[Sapphire Silk]

For example, my generic diazepam has a 'contains lactose' warning. There are people who cannot digest lactose; therefore they should probably avoid this particular generic. A different generic might not have it. Heck, the brand name might have lactose - in which case the patient would do better on a generic that doesn't.

As I understand it, the reason to take/avoid generics/brand names usually has to do with the fillers and coatings used to allow the delivery of the drug; not the actual drug itself.

Correct! The generic makers use different fillers, but the active ingredient has to be the same as the brand name version.

[Naaman]

Correct! The generic makers use different fillers, but the active ingredient has to be the same as the brand name version.

Also, the item must conform to certain specifications (in the UK they're from the British Pharmacopoeia) in regards to solubility, absorption, salts and other stuff for it to get a product license - functionally the brand and generic are identical

[Seshat]

Yes - an 'extended release' generic must provide the same 'extended release' as the brand name, and so forth.

You're getting the same medication with the same conditions: basically, you're getting what the doctor prescribed. But the supportive stuff used to make it a pill shape, or the capsule gel, or the flavouring for a solution for liquid medication, may be different.

Vegans, people who keep kosher/halal, strict Buddhists, & people with severe allergens/sensitivities are likely to care about different delivery mechanisms.
There may also be drug companies with "greener" production techniques than others.
Finally, there's the argument about research funding & approval costs (which probably should go to Fratching: it can get long and involved.)

Otherwise, I really don't see any reason to care which you get.