Non-Drowsy Claritin
"My husband has been sick for the last month. He's had a really bad congestion, headache, sneezing, itchy/watery eyes, and been unable to sleep. We've tried a bunch of stuff. Does he need to try that Mucinex stuff I've been seeing ads for?"
"No, no...absolutely not. Mucinex is for chest congestion, and based on what you told me, your husband is not having that problem. First, is he taking any prescription medicines? [NO]. Okay then. What have you tried?"
"Well, we've tried the Tylenol cold stuff [There's no telling which product they got], and he's been taking 24-hour Wal-Phed."
"I think he's probably having some allergy problems -- It's not a cold since it's been going on for a month. I'd say he needs to try taking a generic Claritin every day. He could also use some Benadryl at bedtime to help him sleep. I'm betting he's having trouble sleeping because the products you've tried have Sudafed in it -- which can cause people to have trouble sleeping. By taking that Claritin, we can get ahead of the symptoms and prevent them from occuring. It's a better route that treating the congestion once it's a problem."
"Okay. Great. Can you show me where these product are?"
"No problem. Here's the Claritin. One of those a day. It'll take about two weeks for that to reach it's full potential -- and he should just take that until the end of this allergy season which is roughly the beginning of winter in this area. The generic Benadryl is right here. It will help him sleep since it causes drowsiness. It is an antihistamine as well, but because of the drowsiness, it's best to take that at night until the Claritin kicks in. For his congestion, he can try using this generic Afrin nasal spray. Limit that to 5 days though otherwise it will make the congestion worse."
"Now, this Claritin says 'non-drowsy.' He's already having trouble sleeping and you want to give him something that is a stimulant?"
"Ohh no -- not at all. Sudafed has pseudoephdrine in it, which is essentially a low grade amphetamine. It is what is keeping him up. Claritin isn't stimulant or sedative. It's neutral. He won't notice anything except his allergies clearing up and those symptoms subsiding."
"Yes, but it says NON-DROWSY right here!"
"I see that, but that doesn't mean it will keep a person awake. It just means that it won't make him sleepy. That's why we're gonna give him this Benadryl -- to help him sleep and treat overnight allergies until the Claritin kicks in in about two weeks or less. It won't keep him awake."
"Then why do they put this on here?"
"Well, that's because all these other allergy medicines can cause drowsiness -- it's usually known that Benadryl causes people to get drowsy -- it's used as a sleep aid as well. You've probably heard of Unisom. It's just Benadryl and repackaged. They just want people to know that this product is different from those. It's a newer generation antihistamine, so it doesn't cause the drowsiness."
"That's confusing. You should tell them to take that off of there."
"Okay. I'll send them a note. Hope he feels better!"
-=+=-
Has anyone else had this issue? Do people really think that NON-DROWSY means insomnia?
Does Non-Profit mean that an organization is designed to LOSE money?
Just wondering...
The last day I'll ever be questioned…
Scumbag came in recently and wanted 12-hour pseudoephedrine. My tech asked him for his license, and he knew the routine and handed it to her...along with $5.79 (or whatever it costs...exact change -- no paper trail). She knew he was a dirtbag and a frequent Sudafed-Man as we call them. We've recently received intel from the our local DEA agent (and pharmacist) that if the laminant on the license is broken or tattered in any way, it is not a legal license (at least in my state of residence). It is a ticketable offense, apparently. We can refuse sale at this point, and the DEA agent made it seem like we should. I made this known around the pharmacy that this was our new policy.
Well, the man, probably used to being turned away, accepted his fate and slumped away. A few minutes later, he and one of our front-end assistant managers came back in a sort-of triumphant march. The look on Sudafed-Man's face was a I-got-you-now-motherfucker glare...as if this Assistant Manager was going to put me in my place.
"So, what's the deal here with this man's license." ~Dumb Ass. Manager [My tech conceded to me.]
"We no longer accept license that have a broken laminate. It's not a legal license, and it's a ticketable offense per our local DEA Agent." ~TAestP
"Well, that doesn't make sense to me. All the information is clearly readable and we'd accept this if he were trying to pass a check." ~Dumb Ass. Manager
"That's all well and good, but we're not passing checks here. We're selling a substance that is controlled by federal law and regulated by national legislation." ~TAestP
"I don't understand. I used it last week to buy some 4-hour Sudafed!" ~Sudafed Man
"Okay. I understand. This laminate deal just came to our attention very recently. How bout this. I'll sell you this box now, but from this point forward, it is the policy of this store that your license is illegal and will not be honored. You need to have a new one printed." [Then I glared at the Dumb Ass. Manager] "And you stick around. I want to talk to you for a second."
So, I made the sale. Then junior and I went into a secluded aisle.
"So, do you know what just happened here?"
"Well, I just..." [I cut him off here -- The crimson hue of my face should have told him to shut the fuck up]
"I'm sorry. That was a rhetorical question. I'm going to do the talking, and you just listen. Since you felt the need to come back here and defend a scumbag, you undermined my professional judgment. I understand that you accept that to verify checks. I'm not dealing with checks back here. I'm dealing with dangerous chemicals. Now, that man is going to take the dangerous chemical and make it into a VERY dangerous chemical by mixing it with a ton of OTHER dangerous chemicals and sell it for people to inject into their veins and get high. It's called methamphetamine.
You front end managers think you are doing people a solid by coming back here and challenging my decisions day in and day out, but all you are doing is causing MORE problems for me. You give stupid fucking idiots validation in their flimsy arguments against my professional decisions as the pharmacist on duty and the pharmacist in charge. You, by merely coming back and inquring, are saying that you and some fucking idiot are right and that I may be wrong.
From this point forward, you and the rest of your front-end staff are NEVER to come to my pharmacy and inquire about anything with related as to decisions I, or my staff have made. Your response from now on is the following: 'You are going to have to talk with the pharmacist on duty. If you don't agree with him you can ask for the pharmacist in charge or inquire about when he will be returning.' Even if I told a little old lady to shove a broom up her asshole, you tell people their only recourse is to talk to the pharmacist. You have no say in the pharmacy and you will get no say until you complete your doctorate of pharmacy in an accredited pharmacy school.
Are we clear?"
"Yes, sir. Absolutely." ~Dumb Ass. Manager
"Okay. Please pass this information on to EVERYONE else in this store that is not in the pharmacy....Good talk."
-=+=-
Now...That was fucking brutal wasn't it? You bet your ass it was.
I nearly made him cry, and I'm not shitting you all, that's almost word for word what I said to that poor bastard. And no, I'm not going to apologize or recant in any way.
That's once small step for a pharmacist and one giant leap for the profession. Never again will I let someone without R.Ph or Pharm.D after their name even attempt to question the policies and procedure I institute in my pharmacy.
Just Questions
Every day I ask myself questions. Most are rhetorical...but they are pertinent questions. I will share these with you now. Feel free to comment with some of your own. OR Check Out Pharmacy Chick's version of this same exact thing from February 2008.
Why do old, toothless people always appear to be chewing on something?
Why is it than if someone is walking to my pharmacy, I can predict with 99% accuracy that they want to buy 12-hour Pseudoephedrine?
Why is it that someone that wants a script filled 10 minutes before closing will have had that prescription for no less than 7 days?
Why does the person wanting a rare, expensive C-II drug come to my pharmacy each month wanting it only to find out that I still don't have it and won't order it for them unless they fill it with me once and wait for the order to come in?
Why does someone on Medicaid give me their card only to ask me to "just fill it for cash" -- knowing full well that I'm going to bill it to Medicaid FIRST?
Why is it that people think they need Watson brand Hydrocodone/APAP? Nevermind - I know the answer to this one...more street value cause it can be identified by pill-heads.
Why does every person that I would idenfity as a drug seeker use "I have fibromyalgia" as the excuse for their early refill or other behavior?
Why does every complaint go to a non-pharmacist store manager rather than to me?
Why does every doctor's voicemail message have the same bullshit message that I can't skip over (they can press ZERO to get to me!)? "Leave the patient's name, date of birth, drug name with spelling, strength, quantity, last fill and pharmacy call back number."
Why do people have to ask for the pharmacist to give a refill number?
Why will people have pizza delivered to their home in an hour and be happy with that wait time but want their prescription in 15 minutes or less?
Why do people want name brand drugs then be completely happy with store brand soda, chips, water, clothes, and everything else?
Why would someone present a prescription for a child then refuse it when the copayment is anything more than free?
Why would someone call me a 'stupid fucking cocksucker' during one trip to the pharmacy then yell at me during their next trip when I use the word 'shit' in front of their child?
Why do I have to concern myself with HIPAA when any patient would be willing to yell, "Yeah my name is Fred Jones...3-14-51. Doctor Smith called in my Viagra refill this morning"?
"Sir, are you taking any other medications?" No.
"No OTC meds?" No.
"No Vitamins?" No.
"Any herbals?" Nope.
"No other medicines at all?" Well, I've been taking this Saint John's Wort for depression.
Why is the answer always, 'NO' to "Do you have any questions for the pharmacist" only to have the patient call the pharmacy back in 10 minutes later?
There are 24 hours in the day. Why does everyone have to spend their 30 minutes in the pharmacy on the cell phone?
Why does every patient with a new insurance card present that card at the cash register rather than the pharmacy drop off window when the read the sign that says "Please present your insurance card when you drop off your prescription"?
Why is it that 1 out of every 100 patients feel the need to poor their pills out on the counter and count them right there in front of all of us?
Why do Americans have the words, "I want to talk to your supervisor" into their brains for use at the first sign of a problem, dissent, friction, or trouble?
Why is there a direct correlation between the number of items in a person's shopping cart and the likelihood they will want them rung up in the pharmacy?
Why is there a direct correlation between the number of scripts filled in my pharmacy and the amount of alcohol I ingest every evening? Nevermind -- I know the answer to this one too...
Why is there a direct correlation between a patient's lack of teeth and oral hygiene and the likelihood they will present a medicaid card?
Why do I have to be the person to explain to some people that BEER cannot be paid for with Food Stamps?
I have a feeling this post has instant classic written all over it...
Transient People or Societal Degradation?
Maybe it means the profession has grown where everyone trusts every pharmacist (and pharmacy) fully, or maybe it means our society has degraded into a transient grouping of people with no urge to support a single pharmacy or better their healthcare experience by staying true to a single pharmacy or pharmacist, but today, I encountered something that lies somewhere in the middle.
I received a bottle for a script from some small town outside of Indianapolis. Not such a weird occurance. I’m pretty near to a major interstate. Here’s where it gets silly. The script was written by a doctor in Atlanta, Georgia. The first fill was in Milwaukee, Wisconsin where it was subsequently transferred to the store in Indiana. The man lives in Iowa. Maybe he’s a truck driver? I don’t know, but he used three different chains in all.
Of course, it was for Viagra, and he wanted only one tablet. Again, not that weird, but we’re talking several thousands of miles between all the different pharmacies.
Is there anyone that is a diehard Walgreens, CVS, Walmart, or Costco customer anymore? Even if they end up somewhere else, they still go to that pharmacy? I don’t know anymore.
What does it mean? Someone explain it to me…
-=+=-
Why does someone want to buy 96 tablets of 30-mg Pseudoephedrine before they go on vacation? I got that today and was perplexed. You’re gonna be gone for 7 days, and you think you’re going to take 13 tablets of PSE per day? C’mon! I don’t even take that much in a year.
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