Are You Kidding Me?

My mouth just dropped open.  It's obvious to me that physicians do NOT read medication reconciliation forms for home meds at all.  The ones that do, kudos, but the ones that don't make my job more interesting and at times really get to me. Case-in-point:  50-something presenting to the hospital with lower GI bleed.

The doctor signed off to CONTINUE HER HOME MED OF PHENTERMINE FOR WEIGHT LOSS.  Are you kidding me?

I guess the nurse could have written "Purina Dog Chow - take one cup by mouth daily" and the physician would have signed off on it.

Way to go Joint Commission on putting in a requirement with no means of adhering to any sort of THINKING for anyone involved.

Except for the pharmacist of course to wade through the BS and find what is really needed.

I really like the one where the physician wanted to continue the patient's viagra while in the hospital.  THAT should keep the nurses on the floor on their toes running from a man who is looking for some fun.  Not good.

Medication reconciliation forms.  The bane of my existence.

Dakota Fanning Here...

Well I had a pingback in my email this morning from The Angriest Pharmacist.  Somehow he views my post as "another enemy" and "cheap shot." Gosh, not hardly.  My post, if you read it is what you would label as satirical sarcasm.... in other words, how deep does this rivalry go?  Apparently deep at the reaction I received from him.  Yes, I rank low (sorry guys and gals, I don't blog for anyone but myself really, and I know I know... that's a bad blogger, you should really think of your audience when blogging ;)).  Yes I post things that are boring to most of you... but there's are a few of us that keep up with FDA stuff...  No, I'm not quite as witty and angry.  I don't have customers or patients yelling in my face.  I'm not in a rivalry with The Red Pharmacist, The Brunette Pharmacist, or heck even the other female pharmacists out there.  Who has the time really?  Dakota Fanning is cute ;)

But anyway, suffice it to say the Angry, Angriest, Anger, and so forth runs deep in the pharmacy blogosphere.  LOL  You can't really drag the Blonde into it.  Because really insults and rankings don't really bother this one.  In fact, it just made me smile this morning on a long ten hour day... of course, I'm kicked back in my PJs, reading the paper, eating some Cocoa Puffs, and getting ready to log into some hospitals to do my job for the next twelve hours sans any sort of crap from patients demanding a 3 minute turnaround on their xanax refill.

Really Angriest, I'm a fan, not an enemy... I actually read your blog!  I need to come up with the kind of post you COULD interpret as enemy and picking a fight material so that the next time you'll be able to take off your angry colored glasses and see that in reality this is what you call "jest," "facetious," etc...  ;) And the rankings? I graduated from high school many years ago... I really don't get very motivated by popularity contests, unfortunately. Maybe I WOULD have a better blog if I did!

Oh and just in case my reply to him does not get published:

Blonde Pharmacist says March 26th, 2008 at 7:14 am Your comment is awaiting moderation. You are really hilarious. My post is tongue-in-cheek… an enemy? I hardly think so! I think if your readers read my post, they’ll see it’s what you would call facetious, no hardly enemy material… I really don’t mind if there are other bloggers with Blonde in the name… As far as popularity on the net goes? That is yet another thing that doesn’t matter to me. I don’t scour the internet trying to find where I rank, but thanks for letting me know. LOL

What is really funny here is your reaction to a post in jest. I find it funny and ironic that there was even a fight between two bloggers that use different forms of the word angry! It cracks me up actually…

Considering I am not angry enough to really elaborate on a short post noticing the two of you… wondering who came first, the chicken or the egg… I find it even MORE amusing that you inserted your own anger into my post to interpret it as a FIGHT?

A fight? No, sweetie… Blonde Pharmacist isn’t picking a fight. I’m just noticing something that made me chuckle awhile back and thought I’d post about it (for myself) - and then later see who is still left standing in the end. Not that it matters, but more for my own innate curiosity.

Yours truly, Dakota Fanning ;)

I don't know... is it just me... or maybe it's the "semi-jacking" of the name that makes me think that perhaps either the attention was GOOD for their ratings (if ratings DO matter) OR is it that a creative, witty, ORIGINAL name (not claiming I have that either) would be more apropos?

Patients Like Me...

Yes, MySpace move over... there's now an online site for patients with the same afflictions.  Interesting!

Some pharmacists give us all a bad name...

There's nothing worse that grates under my skin as a pharmacist than to drive to a retail pharmacy and find a pharmacist digging in the trenches with a sourpuss expression and basically giving us ALL a bad name.  We're not ALL miserable. Here's a post about waking a retail pharmacist up only to find out she had the wrong drug.

Not that we cannot make mistakes... but please.

You never know what you are going to get...

U.S. health officials have identified a contaminant in batches of the blood thinner heparin associated with 19 deaths and are trying to determine how the chemical got into the drug.

The lots of heparin, whose key ingredient was imported from China, were recalled Feb. 28, and Food and Drug Administration officials said Wednesday that no new deaths have been reported since that time.

Dr. Janet Woodcock, head of the FDA's Center for Drug Evaluation and Research, said the contaminant is oversulfated chondroitin sulfate, a chemical that does not occur naturally.

Chondroitin sulfate is a natural compound that occurs widely and is used as a dietary supplement but the oversulfated version has not been widely studied.

''We cannot rule in or out whether this was accidentally or deliberately introduced into the product,'' Woodcock said, ''We are investigating how it got in.''

The usual...

Boehringer Ingelheim and FDA notified healthcare professionals that ongoing safety monitoring has identified a possible increased risk of stroke in patients who take Spiriva. This product contains tiotropium bromide and is used to treat bronchospasm associated with chronic obstructive pulmonary disease. Boehringer Ingelheim reported to the FDA that it has conducted an analysis of the safety data from 29 placebo controlled clinical studies (“pooled analysis”). Based on data from these studies, the preliminary estimates of the risk of stroke are 8 patients per 1000 patients treated for one year with Spiriva, and 6 patients per 1000 patients treated for one year with placebo. This means that the estimated excess risk of any type of stroke due to Spiriva is 2 patients for each 1000 patients using Spiriva over a one year period.

Angry vs. the Angriest...

Ok, just want to post something I noticed here.  Angry Pharmacist was here first, right?  Why is there an Angriest Pharmacist?  How about another name Angriest or Angry?  Do the right thing in this case, I implore you to change your name.  It seems like to me you lose a lot of cred hanging in the same circles as someone you are copying.  Is this even true? Or maybe my true theory is correct.  You are one and the same -- you just have so much anger, you want to be angry and angriest!  Where in the hell is angrier then?  We need an Angrier Pharmacist! 

Accutane and Side Effects

One of the news programs at night had a documentary on a murder that happened where the perpetrator had mental issues and had taken a few doses of accutane prescribed by a doctor a few years earlier.  He promptly discontinued the drug after experiencing headaches, etc... but spent the next few years on a message board ranting about the drug and ultimately tracked down the doctor that prescribed it and murdered him. If I remember correctly, the guy only took two days of it.  Having taken accutane myself for 6 months in 2000, I realize that there are some nasty things about accutane that have made it a very controlled drug as far as obtaining it.  But, for me the drug was very useful.  In my case, I had severely oily skin not so much acne.  What accutane did was to shrink my oil glands a bit.  I don't struggle in the same way but maybe being a pharmacist helped the dermatologist treating me (same age as me in fact) collaborate on a "cure" for what I was trying to accomplish.

When I saw the news last night showing this young man in his twenties literally having a psychotic breakdown, I could see how perhaps accutane could have had some role, but at the same time the murderer already had a history of mental illness.  Perhaps accutane and the doctor that prescribed it were merely a part of his obsessions with his instability.  I shudder to think that he could have included the pharmacist that filled the medication.  Luckily somehow, that person fell out of the loop.

Here's the link to the family's website about their murdered father (physician).

Here's a link to write a letter for the murderer to be extradited back to the US to face charges.

Commercial Drug Mascots

One of the most annoying things about pharmaceutical commercials is branding.  I cannot stand the Nasonex bee.  I'm serious, when I see the little bee flying around talking about the great things about Nasonex treating all sorts of allergies, I want to scream!

Doesn't he look cute and make you want to go out and buy this fabulous product?

Then of course the wonderful ending:

Side effects were generally mild and included headache, viral infection, sore throat, nosebleeds, and coughing. NASONEX® is available by prescription only. Maximum effect is usually achieved within 1 to 2 weeks. Talk to your doctor to find out whether NASONEX® is right for you or your child. It is important that you take it regularly at the time recommended by your physician, since its effectiveness depends on regular use.

I think personally I would rather have some allergies than headaches, viral infections, sore throat, nosebleeds, and coughing.

And isn't it ironic that bees are another form of allergen... yet it's the MASCOT for Nasonex!?

Illegal alien...

I found it strange this morning to get an order for a drip that usually will run a fairly long amount of time.  In other words, we will compound a large volume to run, but I was told to just make a 250 mL bag of it.  Turns out the man in the hospital today is in his early 40's, an illegal alien, and they are keeping him from completely crashing to harvest his organs. So who shows up to sign the papers for that one?  Does the family receive American citizenship for his valor?