Irrational behavior

One pretty fresh in my mind. This lady came up for her refill of Yasmin Generic which as we all know is Ocella…same med by same company, they didn’t even have the decency to change the numbers on the tablets. She states “please dont give me the generic this time. “I HAD THE MOST MISERABLE MONTH OF MY LIFE LAST MONTH ON THAT GENERIC.”.

Yaz = Drospirenone 3mg, Ethinyl Estradiol 0.02mg by Bayer
Yasmin = Drospirenone 3mg, Ethinyl Estradiol 0.03mg by Barr/Duramed/Pliva (owned by TEVA)
Ocella = Drospirenone 3mg, Ethinyl Estradiol 0.03mg by Bayer

A good question is: Is Ocella AB rated for Yasmin? If it is, why isn’t in AB Rated for Yaz as well?

Let’s look at the record. You are revered by the commentators as a member of the “most trusted profession.” You are charged by a professional oath to help the public. You are time-honored as the most accessible healthcare professional. Pray tell—how many times has your public TOLD YOU that they will follow your advice? I count, for myself, maybe two or three times in the 15 years I was in retail.
How about that pregnant opening question, “What’s good for a cold?” I kept assuming that the asker wanted a thorough assessment of their problem. “What symptoms are you having?” I would ask. They’d tell me their story. I’d suggest a particular OTC. THen another. Then another. To each suggestion, I would get the response, “I’ve tried that. What else do you have?” So, the question, “What’s good for a cold?” is really asking, “What’s NEW for a cold , ie., what’s a hot new item, that will let me tell myself I’m doing something different and therefore effective because it is different?” They’re not asking what’s effective, they’re asking for a special new goodie, as if you are, really, not a thinking clinician, but just a snake oil salesman. After a number of years, I finally figured out that this was just a charade, and I didn’t want to waste any more time. Upon hearing the question, I would go right to the shelf that contained the latest fad. When Drixoral went OTC, I handed the fellow an Drixoral with the lone obligatory question about blood pressure and motor vehicles. Today, I’d do it with Zyrtec-D, and would have the added prop of them having to sign for it (some company even used that crap to advertise, “So strong, you have to get it at the pharmacy counter!”)

They don’t want a pharmacist, they want a sorcerer. I should dress up with a pointed hat with stars and crescent moons on it, to make it official.

Awesome. TOA has a way of putting things that is, well, awesome!

Irrational you ask…. pt’s med changed from 1 qd #30, to 1/2 qd #30 and demands that since she has to pay the extra copay amount that we should cut her pills in half for her… her copay amount $3 for each month… hmmm yeah, isle 3 for the pill cutters maam…

I’d tell that bitch, “I’d be happy to do it, but it’s going to take three days. I also have to add a 5-dollar processing/compounding fee to the final price of the product.” Since we’ve adulterated it from what the manufacturer intended (especially if the tablets are not scored — which shouldn’t technically be split anyway), it is a compound. Pharmacists are charging for less these days (Like taking a patient’s BP).

Standard (cheap) generic heart med. Pt is refilling early for whatever reason. Insurance won’t put it through and my Rph isn’t comfortable just “giving” them some due to the time early which is what the patient wants.

I price out what exactly 7 days worth would be. Not even 10 bucks. I tell them. They stare at me.

“FINE! I guess I’m just going to have to DIE!!” *storm off*

I could have paid for my organic book if I had a dollar for every time I’ve heard that or something like that.

People lived for thousands of years without Coreg. I think you can make it a few days. Heck, those extra doses she’s been sneaking in ought to cover her, right?

Yaz/Yasmin/Ocella: YAZ is cheaper out of pocket than the latter two. Bastards jacked up the price right before the Ocella release. all over 0.01 mg.

Once a Medicaid lady’s baby was out of refills for Mylicon drops.

It was a Monday and we were inundated with calling MD’s with refill requests. This lady was calling every hour to see if the Mylicon was ready! We kept telling her to call the MD herself to make it go faster, but she refused and kept saying her baby was sick. I told her she could just buy it, for God’s sake. The store brand was less then 5 bucks. She refused and kept calling us saying her baby really needed it. Until finally we got it. Ugh.

Forgot this one. Pt calls in for a compound. Has to have it in two hours. This is not possible. At all. I told her we need 24 hours for compounds. She has to have it NOW. It’s a topical compound, it’s not like “surprise! you’re out!”

/sigh

I’ve got ONE guy who shows up every other month or so wanting 2 boxes of Congestac. We’ve all tried to convince him to try Mucinex D or anything else we regularly stock that’s cheaper, and all we get is a “nope, this is the ONLY thing that works for me.” I stopped trying and just order him his 2 boxes of congestac and watch him throw his money away now.

I just posted a story like this the other day on my own blog. Enjoy!

Also, Ocella isn’t AB to Yaz for reasons other than that “0.1 mg of estradiol.” Yaz actually has three estradiol tablets during week 4 and only four placebo tablets. So not only is the dose per tablet different, the regimen is also different. According to the manufacturer, the estradiol tablets help reduce the severity of withdrawal bleeding. I don’t know if they should’ve gotten a new patent for that, but whatever.

This is one from the uk. one of my staff sold some one co-codamol, 15-20min later she came back looking for the co-codamol with out paracetamol. no amount of effort could convince her that co-codamol actually gets its name from the fucking paracetamol in it!! (and no it wasnt an ibuprofen based one etc. its the one that says co-codamol on the box but doesnt have paracetamol in it)

To clarify (since most readers are American)”
Co-Codamol is like Tylenol #3 — It’s 30mg Codeine/500mg Acetaminophen.
Paracetamol is another name for Acetaminophen.

It’s apparently OTC in the UK.

I had a mother call me at work tonight, and telling me she picked up cherratuss and azithromycin liq for her son. She’d given him a few doses, and his tongue turned blue. In stunned silence for a few seconds I stare at the phone before informing her I was putting her on hold to consult the pharmacist (I’m in my 6th year) Pharmacist and I are looking through Facts, Lexi and clinical pharmacology. We find that a **rare** side effect zithromax is tongue discoloration–but alas, no information as to what color. So I ask her “what shade of blue are we talking” and get a response “bright blue, like aqua”. Back on hold she goes, i relay this information and say “So, can I just ask her what her kid ate that he isn’t telling mommy about” Naturally, that’s a no go. Pharmacist gets on the phone to relay that there is a RARE s/e of tongue discoloration. Mother is freaking out about “Should i take him to the ER??” Puts that pharmacist on hold, and calls the pediatrician. Eventually get’s back on with us. Informs us that her son had a Kool-Aid guzzler after medicine to take the taste out of his mouth… But it was Kiwi-Strawberry, so it wouldn’t be blue. Pharmacist suggests checking the color.

It’s blue.

After we spent a good 10-15 minutes scouring dye ingredients and side effects… it clearly never occurred to her that KOOL-AID would discolor a child’s mouth. It must be the PINK medicine he was getting….

You can’t make that shit up!

Here’s a link to another story about an irrational bitch I wrote a while back:

http://www.theangriestpharmacist.com/2007/12/30/movie-review-and-a-stupid-bitch/

We had a Regional VP in the pharmacy and a customer came to ask where the glycerin suppositories were. So the VP wanted to show us how to help customers and went out to the aisle to show her. We all started laughing as this customer is very demanding and very rude. She was demanding to be shown where the brand name glycerin suppositories were. So the VP(also a RPh) showed her the Fleet Suppositories and the customer started screaming she wants brand name glycerin. She could not be conviced that glycerin was not a brand name. We watched for a few minutes and finally sent our pharmacy manger out to take care of it. Our pharmacy manager has a way with this crazy old bird. The VP came back in the pharmacy and asked how we deal with these kind of people everyday? LOL

I can forgive the mother freaking out about her son’s blue tongue more than the other ones in this thread. Sure, she lacked some clear thinking, but isn’t one allowed to do so when fearing for their child’s life? Which she truly, though not necessarily correctly did. And isn’t it a bit flattering that, given the numerous health care options available to her, she trusted you with her child’s life? Says a lot about her view of the pharmacist’s profession.

Another one from the UK here. While in a store over here I had two ladies looking through out OTC analgesics. One appeared to be giving the other advice on what to get. After a while they got my attention and asked if our brand of co-codamol had aspirin in it. I replied that it didn’t as co-codamol is only paracetamol and codeine. They replied that the Boots brand has aspirin. I assured them it did not as aspirin with codeine was sold under the generic name of co-codaprin and I had not seen any for a few years in any case (I think it was discontinued back aroung 2000). I couldn’t convince them of this (I’m only a pharmacist so I won’t know about drugs will I …) but they seemed to want some sort of NSAID so started ignoring me and looking though the ibuprofen. One came over and asked which colour our ibuprofen was. Apparently the purpose of this was to determine which of them would upset her friends stomach; pink coated ibuprofen contains riboflavin and that will upset your stomach. This was news to me (I remember making roboflavin tablets and capsules and they weren’t pink) and I’m fairly sure the ibuprofen is more likely to give you stomach ache than riboflavin. They decided to leave shortly after, thankfully.

By the way, re: Emmet’s post. There are two strengths of co-codamol available in the UK. We have Co-codamol 30/500 which as TA*est*P says is equivalent to Tylenol #3 which is available only with a prescription. We also have co-codamol 8/500 (8mg codeine ..) which can be bought from a pharmacy under the supervison of a pharmacist.