The other day I had a private rx from a hospital for amitriptyline and domperidone showing on my PC as severe interaction. Investigated it in stockley's and it was a red interaction leading to prolongation of the QT and potential heart problems. At that point I thought it was my duty to check with the doctor before going ahead and dispensing but the patient's husband said that the doctor is always right. I offered to call the doctor and take a telephone number for the patient and give the patient a ring back when it is ready. But the patient representative wanted the medicine there and then. I refused to take responsibility for this interaction without checking and hence he took the prescription somewhere else. I do not know if it was dispensed or not in the other pharmacy but despite me having had a trainee HCA in the healthcare counter (completed three fifths of her course) and a trainee dispenser (second week in the pharmacy), I did find the time to look out for this interaction which could have easily been missed!
On a similar note, we are given 0.1minutes for a clinical check, but a couple of week ago I received that Rx from the local out of hours for Procyclidine 5mg tabs 1 tds. Procyclicine is not a medicine I see very often and hence unfamiliar with it, I looked it up on BNF! It was for Parkinsonism symptoms and 5mg tds was not a starting dose! I asked the patient representative what was the treatment for. To my surprise she said she has looked the medicines up herself and did not think her partner who has been having a stomach flu for the past week has been prescribed the right medicine. At which stage it clicked on me, the rx must have been for Prochlorperazine 5mg tabs 1tds. Then I had to find the doctor and change that rx. Thought it was a easy job. But it took 4 hours to find the doctor! I did try to ring the local out of hours office but there was no answer. The number at the bottom of the Rx went through a call centre to an unrelated town and they were not very helpful. Tried to find a different number online and it also went through a phone centre. In the end I decided to google the doctor's name and see if he works in one of the local surgeries and whether he remembered doing this rx the previous day. He confirmed that it should have been prochlorperazone 5mg tabs 1tds. But I always think that in this case I am lucky enough to have had an excellent and very supportive dispenser who helped me resolve the issue with the rx. But in a different setting I might have not had the time to spend 4 hours (include the 5 minutes initial clinical check, the 6* 30 minutes of waiting time per phone call, the time waiting for the fax to arrive and the time for the final dispensing of the rx) vs 0.1minute for a clinical check.
I am sharing this video I watched this morning:
https://youtu.be/Ci5noQyQ3oM
On a similar note, we are given 0.1minutes for a clinical check, but a couple of week ago I received that Rx from the local out of hours for Procyclidine 5mg tabs 1 tds. Procyclicine is not a medicine I see very often and hence unfamiliar with it, I looked it up on BNF! It was for Parkinsonism symptoms and 5mg tds was not a starting dose! I asked the patient representative what was the treatment for. To my surprise she said she has looked the medicines up herself and did not think her partner who has been having a stomach flu for the past week has been prescribed the right medicine. At which stage it clicked on me, the rx must have been for Prochlorperazine 5mg tabs 1tds. Then I had to find the doctor and change that rx. Thought it was a easy job. But it took 4 hours to find the doctor! I did try to ring the local out of hours office but there was no answer. The number at the bottom of the Rx went through a call centre to an unrelated town and they were not very helpful. Tried to find a different number online and it also went through a phone centre. In the end I decided to google the doctor's name and see if he works in one of the local surgeries and whether he remembered doing this rx the previous day. He confirmed that it should have been prochlorperazone 5mg tabs 1tds. But I always think that in this case I am lucky enough to have had an excellent and very supportive dispenser who helped me resolve the issue with the rx. But in a different setting I might have not had the time to spend 4 hours (include the 5 minutes initial clinical check, the 6* 30 minutes of waiting time per phone call, the time waiting for the fax to arrive and the time for the final dispensing of the rx) vs 0.1minute for a clinical check.
I am sharing this video I watched this morning:
https://youtu.be/Ci5noQyQ3oM
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου