Clinical Interventions

[admin]

Originally Posted by Zoggite

The BNF does list Itraconazole 200mg BD for 7 days as a licensed use for treatment of onychomycosis, tinea pedis and tinea manuum.
I'm only standing up for Sporanox because it was originally developed in Belgium!

Sorry I was writing from a note I made at the time. Again it's just what happened in this case. I can't remember what the patient had, but it wasn't anything that I felt would need such a large dose, so I phoned the Dr and he admitted he had copied the letter incorrectly.

I'm just putting down things that caused me to be suspicious at the time, and the result of me contacting the GP's involved. I guess I could have left it and assumed that the dose was correct, but after speaking to the customer it aroused my suspicious nature, and I called the GP. The script was written for 400mg take 1 daily, so that also made me feel it could be wrong at the time.

Would you have dispensed it at that dose of 400mg take 1 daily? Do you think I'm being too pickey? I only call GP's if I feel there may be a problem, not for the fun of it.

[Zoggite]

here's one I'd like to pick your collective brains about: has anyone ever come across "Zomig 2.5mg 30 tabs, Take one daily"?
Guess what: the surgery receptionist told me at 2.45pm today that "the doctor's on the 'phone at the moment, I'll get him to call you back"... Of course, I'm still waiting.
Is that a pig looking for a runway?

[Steve G]

Here's one: warfarin 10mg bd for two days. Contacted another GP at the surgery who very quickly agreed to change it.

[Steve G]

And another: one of the nomad patients I'm looking after during my pre-reg almost had her fluoxetine (60mg a day) stopped by a psychiatrist because he didn't look at all of the backing sheet and she did'nt tell him she was still taking it.

[Steve G]

And also numerous times GPs have inadvertently changed patients from propaderm 10% in WSP to propaderm alone... and then still write the script wrongly after you've told them exacty how to write it!

[admin]

To Steve and Zo thanks - all input is great, and we can all learn a lot from this.

I have had a Zomig one like that, I think.

Here's my personal favourite from an old guy in the hospital.

Metronidazole and Brandy!

[admin]

Here's another I just remembered from the hospital. It's not a drug intervention, but a rather strange sequence of events.

1. A man had an ACE inhibitor Rx for his hypertension
2. The drug caused him to have a nagging dry cough
3. The GP Rx amoxicillin for the cough
4. The man had severe sickness and diarrhoea from the amoxicillin
5. He became severely dehydrated from this
6. He ended up in the hospital on a drip!

Poor guy!

[admin]

Originally Posted by Steve G

Here's one: warfarin 10mg bd for two days. Contacted another GP at the surgery who very quickly agreed to change it.

In Hull there has been for quite a time somebody selling blue warfarin tabs off as diazepam 10mg.

One of the lads on methadone took 60 of these!

He just kept taking them as he "felt" no effect.

At the local A @ E they told him he was a few hours away from death!

[admin]

I used to run a needle ex scheme. A lad came in (amphetamine - speed - abuser) all jittery and just couldn't stop moving.

He told me he thought he had hit his femoral artery in his leg with a long green needle.

He would not stay still, go to see any Dr, A @ E etc or even just lay down and put pressure on his leg.

I think he lost about 2 pints of blood in it before a clot formed!

I don't know if he still has both (or any) of his legs!

[kemzero]

Dear comrades

Keep up the good work and more grease to your elbows......

The clinical pharmacy bit can contribute towards our CPD requirements (its been beneficial to me) it also proves that you need more than an HNC to do this job.

Kudos to you all