This is one feature from Diabetes
Clinical Mastery that I enjoy. This does not always give me
ideas for blogs, but occasionally there is a brief article that
speaks volumes and points out some of the problems within our medical
system. This article is not an exception and shows what happens when
patients do not fill their prescriptions at one pharmacy, or provide
their pharmacy of a complete list of medications they are taking,
This is one reason that more doctors
are asking patients to being in all their medications in the
containers in which they were received. Even then, some patients try
to avoid doing this – to the point of endangering their health.
The patient in this article did as she was asked and this may have
saved her life. The author found two prescriptions for lisinopril.
One prescription was for 20 mg and one for 40 mg, each to be taken
daily.
She explained that the 20 mg was for
her kidney and the 40 mg was for her hypertension. When the labels
were examined, that was the case and each had been filled at
different pharmacies. This explained why she had complained of being
dizzy and afraid of falling when she rose from her chair. The doctor
had her stop the 20 mg and her problems cleared.
The lesson learned by the author is
that the same medication may be prescribed to a patient for different
reasons and patients are most likely unfamiliar with the reasons for
the medication. At least this author recognizes the fact that
patient education is necessary to prevent the patient from either
discontinuing the medication or like this example overdosing on a
medication.
Even though this is listed as one
lesson learned, the author did not forget that patients need to be
encouraged to fill all prescriptions at one pharmacy. By doing this,
the pharmacist should have recognized the problem and advised the
different doctors at least or advised the patient of the problem.
There are other lessons to be learned
from this example. First, every doctor should be aware of other
doctors treating the patient and for what. This I make sure of and
have the cooperation of all doctors concerned. I also provide at
their request all medications I am taking, the dosage, when I am
taking each, and who is prescribing the medication. The doctors do
confer and I have only two doctors renewing my prescriptions. When a
new one is needed, the conflicts are determined and the prescription
issued if there are no conflicts. If the prescription if for the
short-term, which all recently have been, the doctor concerned does
the prescribing.
Another lesson is that patients often
do not tell their doctor about supplements they are taking. Since
many may conflict with medications, this always needs investigation.
The last lesson is that some patients will not fill prescriptions at
the same pharmacy for reasons only they are aware of. Others do not
want one pharmacist to know all the medications they may be taking.
Still others are receiving prescriptions that they in turn are
selling for money. These are major problems within out current
medical system.
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