January 18, 2013

Medication Problems from Duplication

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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