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Saturday, January 29, 2011

Follow up: a day in the life of a pharmacist

...Answering a few questions about my rough day last week....
Stephanie asked if I filled the iron prescription whose dose I questioned.
No, I didn't. Pharmacists don't HAVE to fill prescriptions that they feel are not appropriate; I told the mom my concerns and she agreed to bring the rx back to her doctor.
Side note/complaint: There is no earthly reason why a non-medical staff member should be allowed to call in a prescription. A chain is only as strong as its weakest link: I have seen many, many, many errors due to secretaries or receptionists calling in prescriptions or answering questions and not really knowing what they're doing. If a pharmacist has to take the call and write the rx down, a nurse or doctor should have to call the rx in.
Shelly said her dad treated himself with ivermectin from a pet store  for "scabies" and his immune system rebelled. I find that both extremely resourceful and super dangerous! But I bet he saved money on the ivermectin. The human stuff is pricey.
I really want to meet Shelly's dad. I bet he's a hoot. 
Kovas decided to annoy me by referencing Webmd. Two things to say about this: one, as internet sources go, Webmd is actually very good. Two, I don't mind this kind of thing. I keep up with health pop culture so I can talk to my patients and know what they're talking about. People often say, "I read online..." and at least it means they are concerned about their own health!
Although last night a girl called me crying after reading up on her rx for Valtrex. "I got the wrong drug!" She sniffled. "I have a mouth sore, not yucky bumps on my junk!" I respectfully did not laugh but assured her that although Valtrex IS used for genital herpes, it is also used for oral herpes which caused her mouth sore. She told me she was never Googling anything again, she was so upset.
Lindsay thanked me for checking allergies. You're welcome! Just my job! But PLEASE tell your pharmacists your allergies. Many people think telling their doctor is enough, but we are here as a "double check" and we need to know, too!
On Thursday a mom picked up a prescription for Bactrim suspension for her 8 year old. I asked for allergies and she told me her daughter was allergic to Risperdal. No problems there, so I filled her prescription. When she got home she called me and said she read that Bactrim was a sulfa drug. I said yes, it is. "But all my kids are allergic to sulfa!" she cried. " I told my doctor." 
She had told her PEDIATRICIAN but she didn't tell the EMERGENCY ROOM RESIDENT who wrote the rx! And she didn't tell me! Luckily she hadn't given the drug to her child yet.
Lisa was concerned about rx error rates. Yeah. Always double check your medication. A recent 20/20 program discovered a 22% error rate in dispensed prescriptions.That included mistakes all along the chain, from the doctors and nurses to the pharmacists and techs. You should always check your rx before leaving - skim the paperwork to see if the drug treats the condition you have - and ask to be counseled by the pharmacist. I have caught multiple mistakes this way.
The most recent survey of pharmacies indicates a 1% error rate that is attributed to the pharmacy as the cause. The report by 20/20 highlights other errors, too - legal glitches, staff training problems, and failure to counsel. That's not going on at MY pharmacy, but you better err on the side of caution and always assume the worst! Always double check your rx!

I can't believe I'm talking about work on my day off. Ugh. I'm going for a short run to keep my legs fresh for my 30k tomorrow. Have a fantastic weekend!


  1. Your posts always make me LOL. That is all :)

  2. Looking forward to the 30k recap. I can't believe that receptionist would act like she knew what the doc meant. It seems a bit presumptuous and a bit stupid seeing how docs and nurses go to school for years to learn that stuff and she acts as though she has all that knowledge as well. Ugh. Thank goodness you're double and triple checking things!

  3. I hope your 30K went well!! I'm just so amazed at what you do and all you have to deal with it just gives me a HUGE appreciation for my 2 pharmacists!!! I'm so glad you do talk about all this because it's SO helpful!!!

  4. I google health-related stuff a lot but I'm not going to fully believe a website just like I wouldn't necessarily fully believe a doctor. Good call on the allergy reminders - pharmacies keep that info on file right? Or should I say it every time?

    You wouldn't happen to know if birth control pills have soy/any variation on it in them do you?

  5. Haha My dad is a hoot! You'd probably enjoy him telling you all about how cayenne pepper cured his cancer (he had his prostate removed, which probably did the trick- but he swears by cayenne now).