nurse prescriber's mistake.

[ramroum]

I took my niece (6 year old) to see the asthma nurse for a review the other day.
My niece was on regular becotide 100 inh. BD, the nurse told me that these inhalers will be discontinued soon, therfore she prescribed Quvar 50 instead, but I told her after signing the script that Quvar is off licenced for children under 12, she became embaressed after looking at the BNF, so she swaped it for Clenil modulite 50 mcg, I think it should be 100 mcg but I didn't say anything!

[kemzero]

I took my daughter (6 year old) to see the asthma nurse for a review the other day.
My daughter was on regular becotide 100 inh. BD, the nurse told me that these inhalers will be discontinued soon, therfore she prescribed Quvar 50 instead, but I told her after signing the script that Quvar is off licenced for children under 12, she became embaressed after looking at the BNF, so she swaped it for Clenil modulite 50 mcg, I think it should be 100 mcg but I didn't say anything!

You should have told her.. we all make mistakes and she'll probably learn something and hopefully not repeat the same mistake

[ramroum]

Thanks Kemzero,
You are right, every one makes mistakes, but if a pharmacist made similar prescribing or dispensing mistake, he/she would be struck off.
I didn't tell her because I wasn't sure that Becotide and clenil are equipotent (I am still undergraduate).

[Zoggite]

Sounds like Becotide and Clenil are equipotent, but not Qvar!
This might help:
http://www.psnc.org.uk/index.php?type=more_news&id=2088

[johnep]

So what do you give when Dr prescribes Beclomethasone 50mcg cfc free?
At one pharmacy they gave Qvar 50,
johnep

[ramroum]

Thanks dear Zoggite for the site.

Johnep: I think the doctor should write "extra fine" next to beclomethasone if he wanted Quvar to be dispensed, otherwise it should be becotide or clenil.

[ferretmanabu]

To be fair, majority of patients do not demand striking off either when pharmacist mistakes are made.

[Zoggite]

Thanks dear Zoggite for the site.

Johnep: I think the doctor should write "extra fine" next to beclomethasone if he wanted Quvar to be dispensed, otherwise it should be becotide or clenil.

Not becotide, it's not cfc-free.
In my PCT (or LHB as they're known here in Wales), beclometasone inhalers are on the list of drugs to be prescribed under a brand namerather than generically, in order to avoid confusion; Also on that list are nifedipine MR preparations, lithium preps, diltiazem MR, carbamazepine MR, and DRESSINGS: I have an apoplectic fit when I get a script for semi-permeable hydrocolloid film-faced with adhesive border etc... etc...8.3x7.9cm!!!!

[ramroum]

Thanks Zoggite for the info. this is why Becotide's been discontinued,because it is not CFC free.
Ferretmanabu: I hope you are right. Time ago I read on this forum a story of a pharmacist(at Lloyds or Boots) who dispensed an american script of steroid which its dose was increased by the prescriber, and because this pharmacist didn't question the patient..... I think he was punished, you will probably remember the story better than me, that's why a mistake could have bad consequences....

[admin]

Thanks Zoggite for the info. this is why Becotide's been discontinued,because it is not CFC free.
Ferretmanabu: I hope you are right. Time ago I read on this forum a story of a pharmacist(at Lloyds or Boots) who dispensed an american script of steroid which its dose was increased by the prescriber, and because this pharmacist didn't question the patient..... I think he was punished, you will probably remember the story better than me, that's why a mistake could have bad consequences....

Here's the link about the case: -

http://news.bbc.co.uk/1/hi/england/s...es/6136660.stm

[admin]

To be fair, majority of patients do not demand striking off either when pharmacist mistakes are made.

No thats true. What happens is they want some cash, go to a "no win no fee" lawyer, and they tell them to go after the pharmacist, as he/she's the easiet one to get!

[N.T]

Here's the official line on it:

http://www.mhra.gov.uk/home/idcplg?I...rgetNodeId=389

Qvar is twice as potent as Clenil

Not sure how many pharmacists know that. I'm sure the wrong one's been given out plenty of times.

Always challenge nurses (diplomatically, unless they're arsey) - remember YOU know more about drugs than they do. Don't doubt yourself. Arrogance seems to be taught at Dr and nurse school, pharmacists are taught self-doubt.

Sad fact of pharmacy-life: pharmacists are easy targets for being sued - nurses and Docs both have been representative bodies.