Oh, looks like someone is having a party.

[PhotoTech]

BG: I work in a pharmacy, primarily in the photo lab. Yesterday I was helping out in the pharmacy. /endBG

I was working the drive through window when a lady drove up and asked about refilling a couple of her prescriptions. One of them was xanax (this is important later.) I finished setting up the refills for her 4 prescriptions and handed her off to the pharmacist for some questions she had. I then went back to what was supposed to be a revision of the vitamin wall. Revisions are supposed to be quick, you throw in a couple of new items, pull clearance items, maybe change a couple of facings. There were 9 feet of vitamins that shifted one shelf down so that a new promotion could take the top shelf. But that is a rant for another day.

I then see xanax lady walking up to the pharmacy area and in her hands is a 12 pack of beer! She set the beer on the pharmacy counter and walked off to continue shopping. I walked over to the pharmacy counter and tell the pharmacist that the beer belongs to xanax lady. He says "Oh, looks like someone is having a party." lol wut?

Me: Are you going to say anything to her?
RPh: Do you really thing she would listen to me?
Me: I meant that maybe she doesn't know. Do you always assume that its intentional?
RPh: Um, yes...

[Sapphire Silk]

I can understand the OP's concern. Mixing alcohol with benzo's can be very dangerous as the effects are often intensified to a dangerous level.

Xanax is one of those drugs that can be very addictive, and it is not uncommon actually to see people on it and similar drugs also self medicating with alcohol.

I always advice people on these drugs not to combine them with alcohol. Someone blatant enough to put a 12 pack on the counter while waiting for a Xanax script clearly isn't firing on all cylinders.

[ArcticChicken]

(I don't even like beer and I buy it all the time because, you know, if my husband actually walked into a grocery store his penis would fall off, right?).

I keep forgetting there are places in this world where you can buy beer at the grocery store.

[Captain Trips]

Pharmacy Tech was wrong to shrug it off like that. He's probably right about her plans, but...

A pharmacist's job includes notifying people of interactions. It IS his job to mention to her that it is inadvisable to be mixing Xanax with alcohol - but then end there, as his job is ONLY to inform her of this. If she chooses to o.d. on Xanax and beer, that's her problem. (Potentially self-correcting, and if she had no kids it can get her a Darwin Award!)

[Shalom]

Pharmacy Tech was wrong to shrug it off like that. He's probably right about her plans, but...

A pharmacist's job includes notifying people of interactions. It IS his job to mention to her that it is inadvisable to be mixing Xanax with alcohol - but then end there, as his job is ONLY to inform her of this. If she chooses to o.d. on Xanax and beer, that's her problem.

That's why I put a sticker that says on the bottle.

Won't stop me from getting sued when she ODs, but as long as I documented the warning, my ass is covered.

[Pagan]

Pharmacy Tech was wrong to shrug it off like that. He's probably right about her plans, but...

A pharmacist's job includes notifying people of interactions.

There was no tech in the story to shrug it off, it was the pharmacist (RPh) that Photo Tech told. This is a grey area for if he should say anything or not, too.

Actually, techs can't tell patients anything about drug interactions, how to take, etc., by law.

[Seshat]

That's why I put a sticker that says on the bottle.

Won't stop me from getting sued when she ODs, but as long as I documented the warning, my ass is covered.

Some of my meds, there are almost more stickers than box!

Don't drive, don't operate heavy machinery, don't take alcohol, don't take more than one aspirin a day, don't stop taking this abruptly, ask before taking any over-the-counter medications, may cause drowsiness, may affect mental alertness and concentration....

That said, I'd much rather know than not.

[Captain Trips]

There was no tech in the story to shrug it off, it was the pharmacist (RPh) that Photo Tech told. This is a grey area for if he should say anything or not, too.

Actually, techs can't tell patients anything about drug interactions, how to take, etc., by law.

Okay, chastisement taken. It wasn't a pharmacy TECH, it was a PHARMACIST.

My argument still stands, though - as a health care professional, it is a pharmacist's job to inform about possible interactions.

[Slayer]

I keep forgetting there are places in this world where you can buy beer at the grocery store.

lol, where I live, alcohol is in every dep (convenience store) and grocery store imaginable. Of course, selection differs, but it's there.

When I went on a mini road trip to Niagara Falls with my best friend and sister, I was shocked that I couldn't find alcohol ANYWHERE. Finally found out we had to get to a LCBO (we have SAQ) to buy some.

To this day, we still can't understand it XD We're too used to Quebec!

[Shalom]

Some of my meds, there are almost more stickers than box!

They taught us in pharmacy school not to overload on stickers. Try and limit it to two stickers, because if you put every conceivable warning label that might remotely have something to do with the product, not only will you run out of room and have to go to a larger size container just to fit them on, but eventually patients won't even read the important ones.

The problem is that most modern pharmacy software prints out the stickers automatically together with the package labels. (In fact there's been a built in font on most Lexmark laser printers with these stickers already stored in it for years now.) And many times the stickers that the provider of the medical information select are just totally unnecessary.

Like for example "This medication may be taken with or without food." Yeah? And what would you do differently if that sticker wasn't there? Not take it with or without food?

"It is very important that you take this exactly as directed." You could put that on any drug. Even aspirin.

"Obtain medical advice before taking non-prescription drugs. Some may affect the action of this medication." Good advice, but doesn't usually need to be on a sticker, unless there's an interaction that could kill you. Similarly is "Some non-prescription drugs may aggravate your condition, read all labels carefully, if a warning appears consult your doctor or pharmacist." Often both of these labels show up together.

What I put on are labels that tell you to do something. Take with food/on an empty stomach. Keep refrigerated/do not refrigerate. Take with plenty of water. Do not drink alcohol. Etc. Or, if there's a side effect you should know about, e.g. May cause discoloration of the urine/feces. If you suddenly start peeing blue or pooping bright red, if you didn't know why, you might panic, right? But in general I try to limit it to two. If it needs more, I'll go over and explain it to them in person. (At least that was the theory. Pharmacy practice has changed in the last 15 years...)

(The exceptions are certain antibiotics, specifically the tetracyclines and the fluoroquinolones, which can require up to five labels. E.g. tetracycline itself:
. Fortunately that drug isn't much prescribed these days. Levaquin gets all the above, less the empty stomach, but with added instead. All of those are important.)

[Seshat]

I admit that I don't pay a lot of attention to the stickers themselves except as reminders: what I do instead is read the drug information sheet they give you when you're first taking a new medication.

I also try to listen to the pharmacist, but sometimes (depending on my condition) I can be too woozy or otherwise sick to properly understand. The good thing is that my family cares about me, and they're also there and listening to the pharmacist. So it's no huge deal if I don't understand, they'll explain what I need to know once I'm healthier.

I recently found out that my husband goes one better than that: every week he picks a drug someone in the household is taking, and pops onto one of the reputable drug information websites to refresh himself on side effects, warnings, etc.

[Mishi]

<snip> I do instead is read the drug information sheet they give you when you're first taking a new medication.

I always do that too, but I also like to check with the medicine dictionary that my grandpa gave me as well as online. He's inserted little typewritten notes into it about family health history and medicine reactions. Oddly enough, the reaction I had to prednisone is mentioned in this book but not on the drug information sheet.

[Seshat]

Now THAT is a damned clever thing your grandpa did.

[LadyAndreca]

My migraine medicine has five warnings on it. The big side effects are drowsiness (I have trouble waking up but am fine once I'm awake) and sun sensitivity. I ignored one of those sun warnings on an antibiotic once and wound up looking like I had chicken pox (but it didn't itch). This one's worse--I got hives on a mild sunburn. Mom was more than happy to point me at the websites she gets her parasols from, at least.

[ArcticChicken]

Mom was more than happy to point me at the websites she gets her parasols from, at least.

I could use a good parasol, mind giving me the site?