Pharmacy Friday #3 (on Sunday)

This past friday I had an extremely stressful day at the pharmacy. As you my know, I don't have my own pharmacy, I do relief work. Most days I love it; I set my own schedule, I work only when I want shoes a paycheck, and I only work at stores that I like the techs and the customers. I tend to go to the same pharmacies over and over, so a good proportion of the patients know who I am and trust me with their medications.

But this post isn't about me. This is about you. Yes, you. Doesn't everyone go to a pharmacy, at least occasionally if not monthly? Well, maybe if you or your husband is a doctor, then you probably have samples, but for the most part I think a pharmacy has to be at least a small part of your life.

My plea is this: PLEASE DON'T ASK YOUR PHARMACIST TO BREAK THE LAW FOR YOU.

You may be thinking "Me? I'd never do that!" But I wonder if you realize how many times we get asked to do just that.

• Your little sleeping pill that you didn't realize you were out of refills. I can't fill that without the docs ok. I know he's going to say yes, you know he's going to say yes, but I need it authorized offically before I can give it to you. I'm sorry.
• This also goes for the sweet little old lady that I know is not an addict. I really am sorry, but I'm not willing to risk my shoes license over a couple alprazolam.
• To the druggie: I know you're seeking, I know what to look for, I know how to spot a fake script (sometimes I am fooled, mostly I am not). I will not fill it. Furthermore, I will not give it back to you if I can prove it has been altered.  

Here's a good one (and partly the reason for my bad day on Friday).

• If you are going out of town, please take care of medication refills a week ahead of time. I can call the insurance company and get an overide, BUT I might not have time to take care of it right this second. Also, it usually takes a day or two for the insurance co to get it to go thru. And thirdly, while I value you as a patient, you are not my only one. Please understand that I have several things going on at any one time.

And most importantly, KNOW THE LAWS FOR CONTROL DRUGS.

• Heres the scenario: Your son as ADHD and is on a C2 (that's a narcotic that has the strictest laws for dispensing...there are no legal C1s). States differ in their laws regarding C2s and your pharmacist has to abide by those laws. There are also Federal Laws, but if the state law is stricter, then that's the one that has to be followed.
• In my state, C2 prescriptions are only good for 7 days. That's it, no exceptions.
• The C2 rx MUST be handwritten...NO FAXES!! Hospice and emergencies are exceptions, but I'm not talking about those right now.

SOOO, LETS PUT THE STORY TOGETHER:

• I get a faxed C2 rx for an ADHD med that I can not fill.
• This is not hospice or an emergeny
• I call the doc and tell her that I am not filling it.
• She says the mother brow beat her (I'm sorry, which one of you is the professional? ) into writing and faxing the script, but it was my call if I wanted to fill it or not.
• Apparently the family was leaving on vacation and needed the rx, but the mother did have time to drive to get the written prescription.
• I'm sorry, this is my fault how exactly?? How long have you known you were going on vacation?
• I've had a run in on this same issue with this same biotch woman in the past. She says the regular pharmacist would fill it. So I guess I'm irregular?
• I told her I thought it was extremly rude that she'd even ask the regular pharmacist to break the law, but I wasn't doing it.

Here's the facts:

• Does anyone really care? Ummm, only the pharmacist whose license is on the line.
• Do they really take licenses away for that? Maybe not the first time, first there will be a fine, maybe a suspension. It really depends on how many times it happens and how serious the offense is.
• How often do they check? That depends on several things. But at any given time a federal or state agent can come in and check your logs. C2s better be accounted for.
• If I'm not going to break the law for my own husband on his sleeping meds I'm certainly not going to do it for YOU.

I hope this wasnt too harsh sounding and cranky, but it really irritates me that some people think I'm just being mean when I wont give them what they want. It has nothing to do with how I feel about a patient as a person. Pharmacists work very hard to get where they are. Some will bend the rules, some will not. Some go to jail, some do not.

Do you ever get asked to break the law? How would you handle it?

Pharmacy Friday #2

Top 4 Things You Should Know About Your Drugs

1: Know Your Drugs
Seriously. I can't tell you how many times someone has called and said they need their little white pill. Umm, that could be about a thousand different drugs. Try to learn the name. It's not extremely necessary, but it's helpful. However, we know that some of them can be hard to pronounce. At the very least know what it's for. If you call up and say you need your blood pressure pill and I say "you're lisinopril?" A good answer is "Yes, that's it." Not "I dunno"
Plus, it's important to know what you're on if you ever have to go to the hospital.

2: Know When to Take Your Medicine
Depending on which medications you are on, timing can be important.

• Some meds need to have food to work properly- Calcium needs the acid in your stomach to break down correctly, so you need to take it with food
• Other meds need an empty stomach- Prevacid needs to be taken 30 min before meals
• Other meds work better at night- like most cholesterol meds - but not all of them so you need to ask!
• Some need to be taken in the morning - Fosamax needs to be taken first thing in the morning on an empty stomach with a full glass of tap water (yes, tap water)
• Others need to be taken at the same time every day -birth control pills work much better --especially as we age-- if you stay right around 24hrs apart

3: Know What to Avoid While On Your Medicine
These can vary greatly depending on what meds you are taking. Some you need to totally avoid, some you only need to separate by a couple hours. The list is pretty long, but here are some common pitfalls:

• Grapefruit juice needs to be totally avoided if it interacts with your medicine, not just separated by a couple hours.
• Antacids need to be separated by a couple hours if you are on some antibiotics
• Alcohol is a tricky one. Many labels say to avoid it, but some are more serious than others. Confused? Ask your pharmacist!
• Smoking can be dangerous with some medications, mainly estrogens. Seriously, you could die.

4:Know What to Expect From Your Meds

It's important to know what kinds of side effects might occur when you start a new medication. This is especially true with kids. Again, side effects will vary. Some will last the whole time you are on the medication and some will ease up once your body gets used to it. Here are just a couple examples:

• Omnicef, an antibiotic, will make your childs poo reddish in color. That can be scary if you aren't expecting it!
• Steroids can increase your heart rate. Again, scary if you don't know it's gonna happen.
• Ambien will make you fall asleep -- DO NOT try to drive after you take it!