Author Topic: Medical Advice on Prescriptions  (Read 719 times)

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Offline Spirithawk

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Medical Advice on Prescriptions
« on: July 23, 2010, 01:28:33 PM »
A lot of you probably already know these things but I'm sure there are many that don't realise the importance either. These days doctors are quick to write prescriptions. Easier to treat an ailment than cure one. Take my advice and any time a doctor does so, don't just take it for granted that the prescription is one you either need or even want to be on. Read all you can on it and make darn sure it doesn't have adverse effects with illnesses or other prescriptions you have. Doctors and pharmacists are suppose to watch out for you and guard agaisnt such things but trust me they don't. At least mot any where near as you might think or hope for. Know your medical history as well as your doctor does. It could easily save your life. A case in point is my primary care doctor prescribing the pain patch Lidodern for me. He knew I have critical heart disease. He even commented on my "zipper scar" as he applied the first pain patch to my chest himself. Also, the pharmacist had no problem filling the prescription at all. All this while Nicodern can, and does, cause irratic heart rythms and is well know to have adverse effects with one of the regular heart meds I take. Made even worse by it being applied so close to my heart. Were it not for the advice of a couple guys on here I'd probably not have given it another thought. Doctor knows best right? Obviously not always the case. As it was I almost ended up back in the ER and the pain was anything but pleasant. This is something I've run into before with prescriptions as has many other people I know. I'm just speeking from exsperience folks, in hopes of saving someone else some serious trouble or even the loss of their life. Don't lay all your trust in the doctors nor pharmacist. They most certainly will drop the ball.  

Offline gstewart44

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Re: Medical Advice on Prescriptions
« Reply #1 on: July 23, 2010, 01:54:20 PM »
SH,
did you mean NICODERM?   I have never heard of nor can locate "NICODERN" in any of my texts.   I prescribe for pain just about every day and have never seen NICODERN.     NicoderM is prescribed for nicotine withdrawal for those trying to quit smoking.   I have never known of a doc prescribing it for pain.   If it is a nicotine patch, close to your heart, it can most definitely affect the rythm of the heartbeat and your blood pressure.   Let me know for sure - I am curious. 
Prayers go out for you warrior,  may you get relief from your pain. 

GS44
I'm just tryin' to keep everything in balance, Woodrow. You do more work than you got to, so it's my obligation to do less. (Gus McCrae)

Offline Spirithawk

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Re: Medical Advice on Prescriptions
« Reply #2 on: July 23, 2010, 01:58:35 PM »
Sorry. Lidodern (Lidocain is what they gave me) is what I meant. Thanks and also thanks for you good advice. I greatly apreciate it and your kind words.

Offline lrs

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Re: Medical Advice on Prescriptions
« Reply #3 on: July 23, 2010, 02:39:32 PM »
I commented on you lidoderm issue.
I am a pharmacist, and I agree that everyone should be knowledgeable about what ever diagnoses they have, and medications they take. 
I can not comment on what it is like, to walk a day in the shoes of an MD.  But if you could grant me the knowledge and experience, and the licensure they have, I would not have that job for any amount of money.
Having worked in the world of retail pharmacy for a sizeable portion of my life, I can tell you what it's like.
We commonly work 12 hour days, sometimes more.
We are on our feet the whole time.
In days past, we did not get a lunch break, and going to the bathroom is often next to impossible.
Multiple phones are ringing, people are staring at you like angry hawks.  They are sick, and just want their prescriptions filled ASAP.
Numerous interuptions are non-stop and FAST.
Issues such as insurance delays, counseling pt's on their medications, phone calls from Dr's and patients, are a few of the constant things you must confront.
In addition to this, you have to fill the prescriptions.  To this you MUST, WITH NO EXCEPTIONS, screen each pt for drug to drug, disease state contraindications, correct drug, strength, directions, refills.  You can not screw this up.  In addition you must double check the drug you are putting in the bottle, then consciously triple check everything you just did.  If you get lax, you WILL make a lot of mistakes. 
If a pharmacist, or MD, tells you they never made a mistake, they are either lying, or they have been doing their job about 1 day.
You haven't lived, until you come into work one day, to be told you gave someone the wrong medication on the previous day, and they are in the hospital.
This will literally drive you to your knees.
I have been observant of the tasks people perform in their respective jobs and professions.

I have not yet seen any profession that puts as much pressure on an individual as what retail pharmacy does.

One of my colleagues described it, as " trying to cook 1000 hamburgers, while performing brain surgery ".
That ain't far from wrong.
Let me say one more thing.
If any of you or anyone you know has a son or daughter wanting to be a pharmacist, print this post, and give it to them.  Do your best to talk them out of it.

Ask them to take this to 100 pharmacists, and see if any disagree.
NONE WILL
" we are screwed "

Offline 30-30man

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Re: Medical Advice on Prescriptions
« Reply #4 on: July 23, 2010, 02:40:28 PM »
You have to be careful.  My sister was prescribed OZMOPREP for a routine colonoscopy.  It shut down her kidneys and now she is on dialysis.  If the doctors would have taken the time to read into the med, it was a no no for people with diabetes.  Now it's off the market because of all the problems it caused.  She wishes now that she would have double checked the doctor. No amount of money can replace your kidneys.

Offline Spirithawk

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Re: Medical Advice on Prescriptions
« Reply #5 on: July 23, 2010, 02:46:53 PM »
Thanks too lrs. Your advice saved me grief. I blame the doctor more than the pharmacy, but am I wrong in thinking though, that a pharmacy's computer systom is suppose to recognise drug interactions concerning customers now adays? Particularly a big chain like Walgreens?

Offline lrs

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Re: Medical Advice on Prescriptions
« Reply #6 on: July 23, 2010, 03:11:08 PM »
I would encourage you to discuss this with the pharmacy.
I think you have swerved into something that could prove to be helpful.
I'm thinking their computer system, and perhaps others, might not be programmed to screen for d/d interactions, and disease state contraindications, with lidoderm, b/c it is applied topically, rather than taken internally.
I did not read your full story.
If you truly experienced any harmful or uncomfortable side effects, I can assure you, they would want to know. 
It might prove to be an educational opportunity for many health care professionals.
" we are screwed "

Offline mtbugle

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Re: Medical Advice on Prescriptions
« Reply #7 on: July 23, 2010, 04:34:01 PM »
 From a pharmacists perspective......
You can bet that the computer for a large chain like Walgreens came up with the interaction. But probably several more also all being potentialy contraindicated interactions. The Lidoderm patch is designed to only have pain control of the immediate area covered. The systemic lidocaine levels are minimal. Thus if you were using the patch almost anywhere else you would probably not have had an issue.I would also venture to guess that each of your heart meds, and probably cholesterol, B/P, and/or diabetes meds all show interactions with each other already. My point is that almost all medications are interacting with each other and someone will have a reaction to that one interaction, but 999,999 others won't. Keep this in mind as you are reading the drug interactions technical information. I wish I had a nickle for each time a patient came to me way concerned about drug interactions they read and didn't understand the applicable value of the interaction. If you don't believe that a simple medication we use all the time can be scarey to read about, just read the side effects and drug interactions for everyday aspirin.
thanks Don.

Offline mechanic

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Re: Medical Advice on Prescriptions
« Reply #8 on: July 23, 2010, 04:36:56 PM »
You are spot on Hawk.  I never fill a prescription until I first come home and research it.  Then if there are questions, I can ask the pharmacist before I fill it.  It's not pleasant to fill a $300.00 prescription, then realize you can't take it.  I also buy a small amt. at first, maybe a couple days worth and try it first if it's an expensive drug. 

Never trust a doctor to know all the interactions with medications.  Read first, then ask the pharmacist. 

Been there and done that....

Hope you are ok friend.

Ben
Molon Labe, (King Leonidas of the Spartan Army)

Offline gstewart44

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Re: Medical Advice on Prescriptions
« Reply #9 on: July 23, 2010, 04:50:11 PM »
I commented on you lidoderm issue.
I am a pharmacist, and I agree that everyone should be knowledgeable about what ever diagnoses they have, and medications they take. 
I can not comment on what it is like, to walk a day in the shoes of an MD.  But if you could grant me the knowledge and experience, and the licensure they have, I would not have that job for any amount of money.
Having worked in the world of retail pharmacy for a sizeable portion of my life, I can tell you what it's like.
We commonly work 12 hour days, sometimes more.
We are on our feet the whole time.
In days past, we did not get a lunch break, and going to the bathroom is often next to impossible.
Multiple phones are ringing, people are staring at you like angry hawks.  They are sick, and just want their prescriptions filled ASAP.
Numerous interuptions are non-stop and FAST.
Issues such as insurance delays, counseling pt's on their medications, phone calls from Dr's and patients, are a few of the constant things you must confront.
In addition to this, you have to fill the prescriptions.  To this you MUST, WITH NO EXCEPTIONS, screen each pt for drug to drug, disease state contraindications, correct drug, strength, directions, refills.  You can not screw this up.  In addition you must double check the drug you are putting in the bottle, then consciously triple check everything you just did.  If you get lax, you WILL make a lot of mistakes. 
If a pharmacist, or MD, tells you they never made a mistake, they are either lying, or they have been doing their job about 1 day.
You haven't lived, until you come into work one day, to be told you gave someone the wrong medication on the previous day, and they are in the hospital.
This will literally drive you to your knees.
I have been observant of the tasks people perform in their respective jobs and professions.

I have not yet seen any profession that puts as much pressure on an individual as what retail pharmacy does.

One of my colleagues described it, as " trying to cook 1000 hamburgers, while performing brain surgery ".
That ain't far from wrong.
Let me say one more thing.
If any of you or anyone you know has a son or daughter wanting to be a pharmacist, print this post, and give it to them.  Do your best to talk them out of it.

Ask them to take this to 100 pharmacists, and see if any disagree.
NONE WILL

+1 Irs.....our pharmacists tell me the same thing.
I'm just tryin' to keep everything in balance, Woodrow. You do more work than you got to, so it's my obligation to do less. (Gus McCrae)

Offline The Hermit

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Re: Medical Advice on Prescriptions
« Reply #10 on: July 23, 2010, 06:51:44 PM »
Spirithawk, in a way I wish you never posted this about drugs as it brings back sad memories about a lost one due to improper medications, but your post is very timely and appreciated. I won't bore you with the horror stories.
It can't be said often enough, BEFORE you take any pill, please do your research. Buy all your pills from the same source.

  The Hermit

Offline Dand

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Re: Medical Advice on Prescriptions
« Reply #11 on: July 23, 2010, 11:10:34 PM »
Some foods will cause reactions with medications too. One I experienced was grapefruit and a now discontinued med called Seldane.  I'd get all dizzy in the morning after taking it and having a grapefruit at breakfast. Since then it has been found that grapefruit and its juice will cause some drugs to be absorbed more quickly and other effects. It pays to really listen to the pharmacists.  In my experience the pharmacy folks are more in tune with drug interactions than the docs.  Like the previous poster said, get all your meds at one place. That can help them know what all you're taking and watch for mis-matches. My mom was getting meds from different places and it was a lot harder to check for safety. She starting keeping a list and showing it to the pharmacists - which helped a lot. They were always good about taking time to go over her med list with her. Even so, some docs would give her samples etc. Toward the end we had a private nurse review the meds and she found some drugs that were canceling each other out - a lot of expense for no good effect. It sure is complicated these days.
NRA Life

liberal Justice Hugo Black said, and I quote: "There are 'absolutes' in our Bill of Rights, and they were put there on purpose by men who knew what words meant and meant their prohibitions to be 'absolutes.'" End quote. From a recent article by Wayne LaPierre NRA

Offline Mikey

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Re: Medical Advice on Prescriptions
« Reply #12 on: July 24, 2010, 01:42:04 AM »
Hopefully your pharmacist can help determine if there are any contraindications with your illness and the medications you have been prescribed but if your pharmacist is not tied into a large computer based quality assurance system that lists all known meds and all known complicating factors, he or she will have to research out that particular med and others that you are on to determine if it is safe for you to take or not.  Doctors do not always know, rarely ever look or research, and really don't give a schmidt these days.  If you have a reaction to a med or combo of meds or meds and food or meds and anything, they like to pass it off and blame it on someone/something else - for a doctor to admit culpability with medications misadministration is the same as saying that you can sue his insurance company if you live long enough. 

My late wife died from complications caused by medications, her lung illness and poor medical management.  Since this happened at one of the 100 'best' hospitals in the US rated by the joint commission on hospital backslapping, she was dead and the hospital was still golden, or so it thought. 

My neighbor died when he was 61 because his doctor had misprescribed a medication, twice, that shut down his kidney.  One other neighbor died also at 61, from a brain tumor, which was exascerbated by poor medications management.

Look at it this way - if a doctor prescribes you a medication and if you do not understand any of the warnings on the information that comes with the medication, first ask the pharmacist who fills the prescription to explain it to you and if he or she cannot, then have the doctor explain it to you.  If he cannot, don't take it, period.  If the doctor can't explain it to you then (1) bill him for the cost of the prescription (deduct it from his bill or have your insurance company do that as they love doing that) and return it to the pharmacy.  Far too many doctors today are neither smart enough or truthful enough to admit they do not know what some meds do, even when they prescribe them.  One reason why so many doctors work in hospitals is because their malpractice insurance is paid for.  Your lives are not in their hands, they are in your own.  jmtcw.

Offline slim rem 7

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Re: Medical Advice on Prescriptions
« Reply #13 on: July 24, 2010, 03:22:21 AM »
my wife just passed while in the care of brian center in salisbury n.c.
 she would have some sort of problem an then would come the statements of how the care givers
caused it..i m not much to point fingers of blame ,with no real knowledge of the issue..
 i stayed there many many hrs..in 7 months of them caring for her ,i had two complaints to tellum about..
 thats a pretty good record ..7 months an one of my complaints was unjustified..
 id go in on different shifts,to get to know the staff ..but also to surprize any care giver,not doing thier job..
 i highly recommend the brian center if you have a loved one[in this area] that can t be kept at home..
 angels doing gods work in my opinion..i ll never forget lela. first day ,she spent hrs. trying to straiten karrys hair out..i knew id found the right place..yep ,i knew lela got fussed at,by seniors about it.. she told me don t worry about that end. i ll handle that..they all earned thier wings in my opinion though
  haveing said that,i do recommend family input an constant observance of thier loved ones care..
you know a lot more about the person than the person just reading a chart..

Offline drdougrx

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Re: Medical Advice on Prescriptions
« Reply #14 on: July 24, 2010, 04:14:11 AM »
Another Pharmacist here.....I'm sorry things happen the way they do sometimes.  we ALL...your healthcare professional and YOU...have the responsibility for your healthcare.  It's really not a good situation at all...managed care tells us what we can and cannot dispense depending on your coverage.  Forget paying out of pocket!!! 

But more so...do you have any idea how many folks really have NO idea about what they take and for what medical reason...even after YEARS!!!!!  I take a pink pill or a blue and kinda brownish capsule..they say...

A pharmacist is BUSY and that's NO excuse to refuse healthcare information to anyone.  They are usually busy correcting and clarifying issues that should be simple...like how your prescription is written so that it either complies with the law or your current insurance.  You may need to ASK...they'll tell you.  If they can't they should find out and call you back.  Just remember...most physicians feel any question of their decisions on anything is generally met with less than an enthusiastic response.  Some are fine...some are not.

Patients complicate the issues as well.  They think they are in the Dunkin Donuts and should get the prescription in less time than it takes to getta a cuppa coffee.  Just slap a label on it...huh...that's the easy part.  Oh and don't folks ever think that MAYBE there's a patient or two in front of you???  Really...I'm in a hurry...or...I'm very busy how long will this take???  Howd ja like to deal with that 300 times a day??

Everyone needs to be pro-active about their healthcare....the days of just accepting what the Doctor prescribes are long over.  Even the Docs are under tremendous pressure to precribe meds that are either generic or in a particular, select catagory based on cost, or they could suffer both professionally (by being dropped from common patient health insurance plans) or financially. And BTW...as stated before...research you meds on the internet like new rifle......

You've seen it in TV and I'm telling you like it is....ASK YOUR PHARMACIST!  (oh and if he or she is too busy at that very moment...ask them to call you back or call them later in the day or early evening if it's that important to you).

BTW....IRS and mtbugle...where did you guys go to school???  Me...MA Coll pf Pharm 1981.
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Offline lrs

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Re: Medical Advice on Prescriptions
« Reply #15 on: July 24, 2010, 04:58:31 AM »
University of Houston, class of 1988.
I was in the first group that took the NABPLEX ( National Association of Boards of Pharmacy Licensure Examination ).
Our program was still a Bachelor of Science program, while many of the other pharmacy schools had a Pharm D program.
We all took the same exam.
I made one of the highest grades in the country, scoring a 99.
I went to Austin, Tx 3 days before the exam, and camped out in a roach hotel, eating vienna sausages, sardines, summer sausage, crackers and cheese, and studied about 16 hours a day.
I had so many textbooks and pharmacy journals, the back end of my truck was sagging.
The day I received my license, the culmination of 6 years of hellish effort, against overwhelming odds, was the proudest day of my life.
" we are screwed "

Offline gstewart44

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Re: Medical Advice on Prescriptions
« Reply #16 on: July 24, 2010, 05:18:15 AM »
[quote  eating vienna sausages, sardines, summer sausage, crackers and cheese, and studied about 16 hours a day.

[/quote]

Boy does that ever bring back memories of college ....  ;D ;D ;D  Things were tough but simple in dem days... ;)
I'm just tryin' to keep everything in balance, Woodrow. You do more work than you got to, so it's my obligation to do less. (Gus McCrae)

Offline drdougrx

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Re: Medical Advice on Prescriptions
« Reply #17 on: July 24, 2010, 12:41:35 PM »
Hey Irs...I hear ya!  Was in the 5 yr program and have the BS as well.  My daughter is going into year 5 of the 6 year PharmD...like reliving it all over again!
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Offline 45454

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Re: Medical Advice on Prescriptions
« Reply #18 on: July 25, 2010, 03:18:05 PM »
I do thank you guys for being here. ;D
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Offline mtbugle

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Re: Medical Advice on Prescriptions
« Reply #19 on: July 28, 2010, 09:37:55 PM »
I graduated in 2000. Montana. Working in Washington since.