A Continuation On Communication (Side Effects And Allergic Reactions)

Some True Experiences Taken From
http://www.drugnet.com.hk/joke/joke_pharmaracy.html
One guy I worked with back in the early 80's tells of one patient and his med. Well you see some medication require that the patient not stop taking them without the advice of their  MD, since sometimes the patient has to be weaned down on the dose slowly before they can get off the med.
One doctor had put on this patients prescription (and wanted it put into directions on the bottle) that the patient was not to stop taking the med abruptly.
So being a good pharmacist my fried typed the label:  "Take one tablet twice a daily. Do not stop abruptly."
The patient gets his prescription and takes out the bottle and reads the label and comes back to the pharmacist and says I have a question.
Pharmacist says, "sure what can I do for you?" (being a good pharmacist we are ALWAY ready and willing any question posed by our patients).
The patient says I see here that the directions say  "not stop abruptly" but what if something runs out in front of my car?
I'm sure glad this guy asked before heading home cause I'd have hated to have him go through his life slowing down while walking up to a corner or into a checkout line at the store.   (actual source unknown)
Another pharmacist tells of kidding with one of his patient who took him seriously:
The pharmacist typed the label of an eye drop: "Place on drop in both eyes twice daily."
The patient got the prescription and read the label and asked?  "How am I supposed to get the same drop in both eyes?  How do I get a half a drop?"
Okay, my friend figures he this guy has got to be kidding so he tells him how to do it.  Do you know?  Well it is something they don't teach you pharmacy school...but this guy had an answer.  He said, "Well first you get a razor blade and position it up between your eyes.  Then you take the dropper and get one drop on the end of the dropper and kinda flip the drop up in the air.  When it comes down you get underneath it and make sure it hits the razor blade right in the middle.  The 2 halves of the drop will go into each eye at the same time."
to which the patient replies straight faced and serious, "I don't think I can do that".  Makes you worry about where these pharmacist work and you'll ever have to encounter them on the other side of the counter some day. (Actual source unknown)
All I know is if this pharmacist worked  for me, he or she would have been seeking new employment the next day.
Please forgive the spelling and grammar I pulled these stories as is from the above referenced web site.
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Sharing another personal experience.

I just wanted to share one more story of the many that have happened to me over the course of my career.  I will share more of these stories with you in future blogs if I feel they are appropriate and tie into the topic I am blogging about.
I was just out of pharmacy school and working at my cousin's pharmacy on Saturdays.  I had a woman come into me to complain about the prescription she had filled two days earlier.  The prescription was for promethazine suppositories and the directions the pharmacist typed on the label read "Remove foil prior to using one suppository four times a day for nausea and vomiting."  The problem she had was two fold,  First she said they were not very effective and second they were to large and had to be chewed before she was able to swallow them.  She explained that not only did they taste bitter and make her want to vomit, but they were leaving a waxy paste all over her teeth and wanted to know if we sold a special toothpaste or a toothbrush with stronger bristles to remove the wax from her teeth.  I apologized to her explaining that the pharmacist should have explained that the suppositories were to be inserted rectally not orally.  First I assured her that taking it this way although not as effective it would not hurt her in any way.  Then I apologized to her explaining that the pharmacist should have explained to her that they were to be inserted rectally when she picked them up.  Even though not typed on the label the words "for rectal use only" was printed twice in bold letters on the box.  She said it was not really are fault because her husband  picked them up on his way home from work and did not bother to ask any questions of the pharmacist because he was rushing to get the medication home to his wife.
I learned a valuable lesson that day.  First always apologize to the patient no matters who is at fault and never take the defensive position.  It helps calm the patient down and let them  know that you are empathetic to their needs and concerns.  The second was never take anything for granted when it came to the wording on the prescription label, e.g. "Remove foil or wrapper prior to inserting one suppository rectally (,vaginally, etc.) four times a day as needed for nausea or vomiting."
Remember always ask questions!  If you feel uncomfortable about asking questions on the spot, like when picking up your prescription(s), then go home  carefully read the information (monograph(s)) supplied by law with each prescription.  The Monograph contains information you should know about medication(s) you have picked up.  Next, make up a list of questions so you are prepared and know precisely what information you want to be clear about.  Call your health care professional and ask for a few minutes to clarify the information you have been given.  No question is to trivial or inconsequential when it comes to understanding your health care concerns.  If your health care professional makes you feel like you are waisting his or her time or makes you feel like you question is trivial or ridiculous it is time to find a new health care professional.  Being a great health care professional is only part of the equation the second part is one that takes a true genuine interest in their patients.  It may sound like I took it a little bit too far, but during the seventeen years I owned and operated my pharmacy I would try attend either the viewing or funeral service of each of my patients that past away. I would send little baby baskets (with powder, lotion shampoo, etc.) to the families of newborns and send a get well cards to those who were sick. It is your body and you should feel comfortable about how and who you are being treated by and what treatment course(s) you are being asked to follow or medication(s) you are ingesting.
It is important to remember that a lot of times there is an initial adjustment period where you may experience side effects when starting a new course of therapy, a new medication, or a regimen of medications.  It is always a good idea to check with your pharmacist or doctor to check if these initial side effects will pass or if they are something you will be able to live with. Most times the body will adjust to side effects of a new medication or medication, other times it can be as simple as having your doctor make a dosage adjustment.
However, sometime these side effects can not be alleviated and that is when you need to talk to your pharmacist or doctor about alternatives. Many times it is just a matter of finding a different medication in that category of drugs that does not produce the side effect you're experiencing. Remember, this not only corrects the disease state being treated, but it does not detract from your quality of life.  This in turn enhances compliance and your health.

Knowing the difference between a side effect and an allergic reaction.


Allergic reactions is your bodies immune systems attempt to reject a substance it considers foreign and dangerous to your body.  Whether it be pollen from a plant or flower, pet dander, a fruit or food, an insect or animal bite, a medical treatment modality, a chemical, or drug.  The list of things that people can be allergic to are endless.  An allergic reaction can also happen at anytime when coming in contact with allergic substance (antigen).  For example you could eat citrus fruit all of your life thousands of times over with no reaction and then one day out of the blue you could develop an allergic reaction to citrus fruit.  The same with medication you could take penicillin fifty different times then on the fifty first encounter you could suffer from an allergic reaction.  Although, it is uncommon it does occur.  However, let me make it clear that if you are taking a maintenance medication every day this is something that would not occur.  It is rare and only seen when there have been extended periods of time between when the medication is given. It is very important to be able to determine between side effects and allergic reactions such as rashes, itching, and swelling of various body parts (like your lips, gums, tongue, throat, or extremities), changes in vision or shortness of breath.  These are common allergic reaction, but are not all of the allergic reaction that can occur so make sure to check the information that accompanies each prescription you receive.  The life you save could be your own.  It is always a good idea to keep a quick acting as well as a short acting antihistamine on hand at home when starting a new prescription or over the counter medication.  Benadryl (diphendydramine HCl) is my preference.  Allowing that you do not have any pre-existing conditions which preclude you from taking the antihistamine, then at the first sign of what you perceive to be  allergic reaction take the doseage of the antihistamine prescribed on the bottle or box.  Then use your best judgement in determining whether to call your pharmacist, doctor, 911, or head for the nearest emerganency room.

EDUCATE YOURSELF, KNOWLEDGE IS POWER AND THAT POWER CAN NOT ONLY INCREASE THE QUALITY OF YOUR LIFE, BUT IT COULD EVEN SAVE YOUR LIFE OR THAT OF A LOVED ONE.