Top-Class Member
1) presciption says: warfarin 1mg 1t od 28
pharmacy label: as take as per INR, if something go wrong, pharmacist taking the responsibility of changing doctor direction?
2) prescription says: microgynon 30 1 daily 63
will you change it to: take 1 daily for 21 days followed by 7 pill free days?
Last edited by DavidS; 28th, August 2009 at 09:51 PM.
Thousand Plus Poster !!!
1- label as what script says, if in doubt, confirm with patient or ask to see their yellow card, which no one seems to carry, and i personally would not know how to respond to the INR ( need to do more reading and will put it as CPD).
2- yes always change it to the right dose, as it is clear there should be a 7 days pill-free break. ( unless they have missed some pills and therefore should have been advised by the prescriber to carry on.........).
King Amongst Members
Originally Posted by howe928
Absolutely not! Never! The person may be taking it without the break for several months for endometriosis, or "tricycling" ie taking for 3 months without a break then 4 day break if taking enzyme inducing epilepsy drugs. In the first instance the symptoms will not be adequately relieved. In the second the patient with epilepsy ends up pushing a pram with a poor little mite with cleft lip/spina bifida because they had no way of knowing they were at risk of pregnancy,low folate levels etc.
Newly registered in 1981
Suggest talking to patient, establishing if there are any 'special circumstances'.
Put a note on PMR or do intervention (Cegedim Pharmacy Manager lets you do one on patient, drug or interaction).
That way, you can follow up next time they appear with the same script etc.
Had a patient once on Microgynon 30, 2 od once. She was on Carbamazepine and Phenytoin high end doses. No PMR of either as she had just been stabilised by hospital.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
Who is number 1?; You are number 6.
What do you want?;..................
King Amongst Members
Yes, I've also seen noriday 2od for a lady who was "overweight". I think 11st is the point to increase the dose from, but I'm not sure without a BNF handy.
(PS. I have no intention of asking women on noriday 1od if they are under or over 11 stone)
Tai Chi Enhanced Member
Hey Pharmanaut,
Hi,
can't see your avatar at the moment, but I know you still have it in your profile. How's that?
Also, can't send you a private message either. Accidental or intentional?
regards
d
....just my opinion
Newly registered in 1981
Nothing done intentionally.
Seems to have happened after the site makeover.
I can't send PMs either.
Not worried about it as pharmanaut's information maxim takes over.
"If you can't find out how to do it in 10 minutes, go away and come back later, then it will be obvious".
That's the clean version - it loses a lot without the expletives.
Where am I?; In the Pharmacy.
Who are you?; The new Number 2.
Who is number 1?; You are number 6.
What do you want?;..................
Thousand Plus Poster !!!
used to press on select all msgs to delete them in one go, not working anymore. now i have to select and delete one by one.
having said that, i am still using the old style version.
Tai Chi Enhanced Member
The problem is common to all the new Golden Pharmacist group. My magical powers don't extend to changing group permissions.
Admin will fix it in a few days, I dare say.....
....just my opinion
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