Saturday, January 27, 2018

Damn it All, Give Me my Tramadol!

Welcome to the Twilight Zone of Pharmacy!

This is where we invent new math that turns a two to three day supply of medication into 14 days!

In four days the patient will return to the pharmacy and declare that we shorted them. Why? Because they're OUT of their medication! The label will clearly show "for 14 days" as we're required to have on the label. So what happened to the rest of the medication?

Swearing, finger-pointing, weeping, wailing, and gnashing of teeth will then ensue. Gift cards will be activated along with lots of "I'm sorry" statements, all because someone at the physician's office either can't calculate or because the physician neglected to tell the patient to make it last two weeks.

A clump of my hair just fell out.



Anonymous said...

Aside from the doc being apparently unable to do 4th grade math, one hopes he knows whether the patient is CYP2D6 deficient. Given the addiction potential, though, a 14 day supply at 2q4h (that is, 168) might be a tad generous...or profitable. So maybe it wasn't a calculation error after all. More of a, ah, calculated error. Or, perhaps, a simple typing/transcription error ("4" not "14"). Still, there's an opportunity to upsell; gonna need a giant economy size bottle of laxative. If I knew the pt, and knew he wasn't a complete idjit (neither guaranteed in big box retail pharmacy), I'd probably take 5 minutes to point out the math problem, the side effects, and suggest that low dose APAP-ibuprofen might be almost as good, way safer, cheaper, and widely available. With a caution about liver tox, of course. That presumes the luxury of time to actually counsel, but if it avoids a 15 minute flap three days from now it might be a worthwhile investment- in a rational patient.

ScanningHertz said...

Anonymous@10:38 -- you just put together two words that cannot be put together -- rational, and patient. you cannot use those two words in the same sentence!

Kassy said...

Or the doctor wrote the Sig and quantity intentionally, advised the patent to taper, discussed how to do that, advised it was to last 2 weeks, and then the patient went 'Oooh, candy!!mmm,mmm,mmm'