General Medical issues thread

[Pushka]

I don't know. 2 different pharmacists were reluctant to provide and said there are 3 other brands suitable for infants. I'll call the pediatrician today.

That is a nonsense that a pharmacist over rides the script provided by a paediatrician.

 

[blackcat20]

That is a nonsense that a pharmacist over rides the script provided by a paediatrician.

Not according to an article I read in the paper over the weekend. The pharmicist dispensed medication from a script that they knew to be incorrect and it had serious consequences, and I think is currently before the courts. The pharmacist has a far better understanding of the drugs.

 

[Pushka]

Not according to an article I read in the paper over the weekend. The pharmicist dispensed medication from a script that they knew to be incorrect and it had serious consequences, and I think is currently before the courts. The pharmacist has a far better understanding of the drugs.

I can understand that when the script has been written with an incorrect dosage but refusing to supply the drug itself? I do recall a situation where the pharmacist called the Dr before dispensing one of the drugs a family member was on. Surely they have to call the Drs and not flat out refuse?

 

[JohnK]

That is a nonsense that a pharmacist over rides the script provided by a paediatrician.

Pharmacist didn't override. It was more of "are you sure that's what you want?" which I think is a good thing.

 

[Pushka]

Pharmacist didn't override. It was more of "are you sure that's what you want?" which I think is a good thing.

I'd prefer they check with the prescribing Doctor. How on earth is the patient expected to know. It creates a level of distrust that may or may not be appropriate.

 

[Hvr]

That is a nonsense that a pharmacist over rides the script provided by a paediatrician.

|And if there is a clear contraindication between the prescribed medications then surely the pharmacist has a duty of care to the customer not to issue without further checking?

The idea of doctor being always right has led to many avoidable deaths.

The issue of captain(to insert a flying example)/doctor not being able to be questioned is fatal and when done respectfully ensures that the patient receives the best care.

 

[Renato1]

Renato, if you don't mind: why is Tramadol considered non-addictive? I wasn't aware of this.

Sorry, I should have said it was not highly addictive, rather than non-addictive.

This article describes it,
Is Tramadol Addictive? Can It Cause Withdrawal?
and says,
"As a result, many people who have become addicted to stronger opioid medications have also become addicted to tramadol.

When it was first introduced, tramadol was considered to be a relatively safe alternative for managing pain. Unlike other opioid drugs, it was thought that tramadol’s low level of opioid medication would give it a lower addiction potential than other pain medications"

It would seem from this description that Tramadol is relatively non-addictive, to people who haven't become addicted to something else first.
Regards,
Renato

 

[Pushka]

|And if there is a clear contraindication between the prescribed medications then surely the pharmacist has a duty of care to the customer not to issue without further checking?

The idea of doctor being always right has led to many avoidable deaths.

The issue of captain(to insert a flying example)/doctor not being able to be questioned is fatal and when done respectfully ensures that the patient receives the best care.

I've stated previously they should check with the Doctor if they have concerns and not simply ask the patient if that is what they want.

 

[drron]

I was involved with a case a few years ago.There is an interaction between ACE inhibitors-for BP or heart disease-and aspirin.The combination though has been shown to save lives.The patient having been started on an ACE inhibitor was advised by his young pharmacist to stop aspirin.About 2 weeks later the patient had a severe stroke-exactly what the aspirin was to prevent.The doctor was never advised of the advice.
So always check back.

 

[Pushka]

I was involved with a case a few years ago.There is an interaction between ACE inhibitors-for BP or heart disease-and aspirin.The combination though has been shown to save lives.The patient having been started on an ACE inhibitor was advised by his young pharmacist to stop aspirin.About 2 weeks later the patient had a severe stroke-exactly what the aspirin was to prevent.The doctor was never advised of the advice.
So always check back.

Exactly. The pharmacist may not get the full medical info at the time from the patient. They may forget something. Get something wrong. It isn’t up to the pharmacist to override anything that Dr has prescribed without checking first.

 

[JohnK]

I'd prefer they check with the prescribing Doctor. How on earth is the patient expected to know. It creates a level of distrust that may or may not be appropriate.

This is not a prescription. It is over the counter medication. Dad went Saturday and pharmacist called while I was at golf.

 

[suze2000]

I read an article this weekend (I think the same one Blackcat20 is alluding to) about a case where the Dr prescribed the wrong dose of a very potent drug and the pharmacist rang the Dr and questioned it, but the doctor was adamant, the drug was dispensed, and the patient died. So yeah, the pharmacist being reluctant to dispense is a good thing. It's worth noting that I've had specialists prescribe drugs to me that were meant for some other condition - the pharmacist in the second case was surprised I was given something meant for kids, but he said it was unlikely to hurt me (because kids), and he'd read about such uses (didn't really fix my problem though!).

 

[cove]

I am quite impressed with my new cardiologist despite the fact that he looks like he rarely eats. My previous cardiologist gained some kilos as he headed towards his well earned retirement. I am continuing on the Lo Co Do heart drug trial without any issues.
Getting my blood pressure in the 125/65 range is purely by medication and I have learned how to visit the US and not gain any weight.
Just coming up to 24 years since my heart by pass operation so I think I have listened and acted on what my specialist tells me.

 

[Pushka]

My sons friend had his surgery the other day. 12 hours of it. I understand that whilst they are satisfied they removed all the gross tumour, they have taken bladder and prostate as well. He already had a stoma, I’m presuming most of the bowel has gone. He is in intensive care obviously. A huge recovery road ahead. At just 33 he is having to make massive changes to everything one would normally expect to be able do at his age. I hate cancer.

 

[love_the_life]

My sons friend had his surgery the other day. 12 hours of it. I understand that whilst they are satisfied they removed all the gross tumour, they have taken bladder and prostate as well. He already had a stoma, I’m presuming most of the bowel has gone. He is in intensive care obviously. A huge recovery road ahead. At just 33 he is having to make massive changes to everything one would normally expect to be able do at his age. I hate cancer.

Assuming that the cancer has been removed, a lot of his recovery I think will depend on how he is able to adjust to the fact that he has a stoma and now bladder and prostate removed. My mother has had an ileostomy bag for almost 45 years but she knows of many who have not been able to cope with the idea and have had the bowel rejoined (often not very successfully). Our friend who died of bowel cancer a few months ago was like that. He just couldn't bear the thought of the stoma and bag (his wife did all the handling of it for him) and insisted it be removed.
It's a big challenge for him and I hope he is able to come to terms with it.

 

[Katie]

After almost two years of blotchy patches on my face, I finally went to a dermatologist last week. My GP put me on doxycycline. I'd been taking the doxycycline for 5 weeks when I saw him. He diagnosed roasacea, rosacea acne actually, and was pretty surprised my face didn't look better after 5 weeks on doxycycline.
He's put me on Minomycin instead, and Soolantra cream at night.
I go back for review in 6 weeks' time, and will see one of the other doctors in his practice. He said Roaccutane is a possibility if my face hasn't improved. I took roaccutane back in 2000 when I got married, so that I wouldn't have cycstic acne in my wedding photos (at the insistence of a relative).

Had the review yesterday, with a colleague of the original derm, as he was on hols. I could only tolerate the Minomycin for about a week, and stopped taking it - made me nauseous, and as I'm prone to motion sickness, stopped taking it the day before flying to Orlando for a week.
Yesterday's derm was quite gung ho about me giving up red wine/alcohol - she used the terms interchangeably. She also mentioned roaccutane. I eventually told her due to the side effects I had back in 2000, I was not willing to take it. So, she's given me a different antibiotic to try, I'm going to try eliminating red wine, and maybe other alcohol, until the next checkup in 6 weeks. We'll see how this other antibiotics goes - apparently it also causes tummy upsets, so she wasn't 100% confident I'll tolerate it.

 

[love_the_life]

Had the review yesterday, with a colleague of the original derm, as he was on hols. I could only tolerate the Minomycin for about a week, and stopped taking it - made me nauseous, and as I'm prone to motion sickness, stopped taking it the day before flying to Orlando for a week.
Yesterday's derm was quite gung ho about me giving up red wine/alcohol - she used the terms interchangeably. She also mentioned roaccutane. I eventually told her due to the side effects I had back in 2000, I was not willing to take it. So, she's given me a different antibiotic to try, I'm going to try eliminating red wine, and maybe other alcohol, until the next checkup in 6 weeks. We'll see how this other antibiotics goes - apparently it also causes tummy upsets, so she wasn't 100% confident I'll tolerate it.

Hopefully you will be able to tolerate the side affects and the change of antibiotic (and removal of alcohol from the diet for a time) work for you. The nausea that some strong antibiotics can cause is certainly not pleasant.

 

[Pushka]

Hopefully you will be able to tolerate the side affects and the change of antibiotic (and removal of alcohol from the diet for a time) work for you. The nausea that some strong antibiotics can cause is certainly not pleasant.

Augmentin is one of those. Gives both of us wacking headaches.

 

[Pushka]

Sons friend is still in intensive care. He is experiencing nerve damage from the surgery, being hung upside for so long, that he has little feeling in his arms and hands. It’s all the unknown extras that keep on piling in. Butterfly effect.

 

[love_the_life]

Sons friend is still in intensive care. He is experiencing nerve damage from the surgery, being hung upside for so long, that he has little feeling in his arms and hands. It’s all the unknown extras that keep on piling in. Butterfly effect.

That's not good to hear. Hope that the nerve damage is temporary issue and that his feeling returns soon. As you say, it is the unknowns that are thrown up that really make it hard. Such a worry. Fingers crossed