Street's Health Discussion. Volume 1 Issue 1

[J epworth]

Originally Posted by Sr. Mints

Broke my back a few years ago, and I've been taking a ton of meds for leg pain, including Nortriptyline. I've been going to the same Pharmacy since the '90s at least, but switched this week to a local Shoppers Drug Mart because it is more convenient.

Anyway, I dropped off my prescriptions on Monday and picked them up on Tuesday. When I got home, I notice instead of Nortriptyline I was given Amitriptyline. I thought it was maybe a generic version or something. Reading online, it sounded to me like it was similar, though it did look quite different.

Yesterday something in my mind had me call Shoppers. They said they'd pull the original prescription and call me back. About an hour later a pharmacist called and his first question was "have you taken any of the Elavil (Amitriptyline)?" I said I didn't think so. Well it's the wrong prescription. Oh, okay. Fine. #### happens. They'd refund me for the Amitriptyline and give me the Nortriptyline for free.

Today I got a call from the owner of that Shoppers, who was profusely apologetic, and again she asked me if I had taken the medication. I honestly forgot to check. I put all my pills in those 7-day sorter things. I told her I'd be in tonight to trade the pills in, and she told me the pharmacist who made the screw up would be working.

Tonight I went in, and he knew who I was and had everything ready. He was apologetic, etc., etc. I told him not to fret it, and I could tell he probably got in deep ####. And again, he asked if I had taken any of the pills. I just lied and said no, even though I still wasn't sure as I went straight from work to the store.

Get home, and it appears I took the two 25 mg Amitriptyline pills two nights ago. No big deal, I'm still alive and my urine isn't fluorescent purple or anything.

But just out of curiosity, I wonder what kind of liability the company would face? I have no plans to call them and tell them I've taken any. The matter is closed in my book. But they kept asking if I'd taken any, and that is nagging in my mind.

Presciption drug errors are one of the most common filed malpractice suits, so the individual who filled the prescription and the entity that they work for (Shoppers) would probably both be held liable. Funny you mentioned those drugs, I just switched form Elavil to Nortriptyline at the start of 2013 for migraine prevention, felt absolutely no difference between the two drugs, Nortriptyline was just a little less expensive so made more sense for me. Weird for the pharmacist to mess it up too, as Elavil is a small blue pill and Nortriptyline is a capsule.

[Street Pharmacist]

Originally Posted by Sr. Mints

Broke my back a few years ago, and I've been taking a ton of meds for leg pain, including Nortriptyline. I've been going to the same Pharmacy since the '90s at least, but switched this week to a local Shoppers Drug Mart because it is more convenient.

Anyway, I dropped off my prescriptions on Monday and picked them up on Tuesday. When I got home, I notice instead of Nortriptyline I was given Amitriptyline. I thought it was maybe a generic version or something. Reading online, it sounded to me like it was similar, though it did look quite different.

Yesterday something in my mind had me call Shoppers. They said they'd pull the original prescription and call me back. About an hour later a pharmacist called and his first question was "have you taken any of the Elavil (Amitriptyline)?" I said I didn't think so. Well it's the wrong prescription. Oh, okay. Fine. #### happens. They'd refund me for the Amitriptyline and give me the Nortriptyline for free.

Today I got a call from the owner of that Shoppers, who was profusely apologetic, and again she asked me if I had taken the medication. I honestly forgot to check. I put all my pills in those 7-day sorter things. I told her I'd be in tonight to trade the pills in, and she told me the pharmacist who made the screw up would be working.

Tonight I went in, and he knew who I was and had everything ready. He was apologetic, etc., etc. I told him not to fret it, and I could tell he probably got in deep ####. And again, he asked if I had taken any of the pills. I just lied and said no, even though I still wasn't sure as I went straight from work to the store.

Get home, and it appears I took the two 25 mg Amitriptyline pills two nights ago. No big deal, I'm still alive and my urine isn't fluorescent purple or anything.

But just out of curiosity, I wonder what kind of liability the company would face? I have no plans to call them and tell them I've taken any. The matter is closed in my book. But they kept asking if I'd taken any, and that is nagging in my mind.

There is full liability for the dispensing pharmacist who will carry malpractice insurance. The pharmacy may also be liable.

Having said that, to my legal understanding, there would have to be actual damages. It is very, very unlikely that this error would have caused any problems unless the doses were wildly different. Speaking as a pharmacist myself, they were likely far more worried about your safety than liability, though it's a concern of course.

[Street Pharmacist]

Originally Posted by J epworth kendal

Presciption drug errors are one of the most common filed malpractice suits, so the individual who filled the prescription and the entity that they work for (Shoppers) would probably both be held liable. Funny you mentioned those drugs, I just switched form Elavil to Nortriptyline at the start of 2013 for migraine prevention, felt absolutely no difference between the two drugs, Nortriptyline was just a little less expensive so made more sense for me. Weird for the pharmacist to mess it up too, as Elavil is a small blue pill and Nortriptyline is a capsule.

Sounds like the error would not have been from putting the wrong pill in the wrong bottle, but from transcription from the original ie. The pharmacist likely read the prescription as Amitriptyline instead of Nortriptyline

[puckluck2]

Why is it important to finish all the pills in a bottle even after you're better?

[Street Pharmacist]

Originally Posted by puckluck2

Why is it important to finish all the pills in a bottle even after you're better?

Depends on what we are talking about, but likely you're referring to antibiotics.

Just because you're feeling better, does not mean the bacteria are gone. Stopping early means you've had bacteria that have come into contact with the antibiotic, and if some resistance had developed, that can be passed on. Research suggests that incomplete duration leads to increased resistance

[Raekwon]

Originally Posted by Street Pharmacist

Depends on what we are talking about, but likely you're referring to antibiotics.

Just because you're feeling better, does not mean the bacteria are gone. Stopping early means you've had bacteria that have come into contact with the antibiotic, and if some resistance had developed, that can be passed on. Research suggests that incomplete duration leads to increased resistance

If I stated taking Antibotics on Thursday for Strep and then found out Monday its not Strep should I finish the course of antibiotics? I've read conflicting answers online.

[Street Pharmacist]

Originally Posted by Raekwon

If I stated taking Antibotics on Thursday for Strep and then found out Monday its not Strep should I finish the course of antibiotics? I've read conflicting answers online.

You should've never started! Haha. By chance did your doctor tell you to wait?

Anyways, most resources recommend finishing the course, but don't give a compelling reason. If anything, one would think that less exposure would mean less chance of resistant organisms developing, so stopping would be my advice. No clear protocol though.

[Raekwon]

Originally Posted by Street Pharmacist

You should've never started! Haha. By chance did your doctor tell you to wait?

Anyways, most resources recommend finishing the course, but don't give a compelling reason. If anything, one would think that less exposure would mean less chance of resistant organisms developing, so stopping would be my advice. No clear protocol though.

This ones my fault, I second guessed the doctor and went to a walk in before the results came back, in my defence I went on Wednesday and didn't find out until Monday.

Edit: Also I agree on stopping now, I think they will do more harm than good at this point, I know my stomach will thank me.

[Street Pharmacist]

Originally Posted by Raekwon

This ones my fault, I second guessed the doctor and went to a walk in before the results came back, in my defence I went on Wednesday and didn't find out until Monday.

Edit: Also I agree on stopping now, I think they will do more harm than good at this point, I know my stomach will thank me.

You should've read this thread first. Remember, search CP before making any decisions, big or small.

Seriously though, the big thing I try to point out to my patients is that even with all hallmark symptoms of strep (fever, swollen glands, pus, absence of cough), it's often still viral. Most people feel that the worse it is, the more they are likely to need antibiotics, which couldn't be more wrong

[ranchlandsselling]

Had what seemed like a cold about to come on for the past two+ weeks - but nothing more than a minor irritation.

Over last 6 days coughing has become very heavy, deep and frequent. As if I'm a smoker or asthmatic. No phlegm, or if any it's just thick white/clear spit, not green or anything. But the coughing is keeping me up all night, giving me a sore brain and stomach/chest.

Went to Dr. today, he suggested a lingering viral chest infection from what was probably a cold that didn't get me very sick.

Gave me an inhaler salmeterol zinafoate/fluticasone and some codeine (which apparently is a cough suppressant too). Said to come back in a week if not better.

Anyway, not really planning on taking the Codeine until bedtime as I'm not in that much pain and I'm not fond of the stuff. Might help me sleep

But the inhaler is 60 doses. That's 30 days of use. How long should I be using it for?

thanks Street Dealer... err Pharmacist

[Street Pharmacist]

Originally Posted by ranchlandsselling

Had what seemed like a cold about to come on for the past two+ weeks - but nothing more than a minor irritation.

Over last 6 days coughing has become very heavy, deep and frequent. As if I'm a smoker or asthmatic. No phlegm, or if any it's just thick white/clear spit, not green or anything. But the coughing is keeping me up all night, giving me a sore brain and stomach/chest.

Went to Dr. today, he suggested a lingering viral chest infection from what was probably a cold that didn't get me very sick.

Gave me an inhaler salmeterol zinafoate/fluticasone and some codeine (which apparently is a cough suppressant too). Said to come back in a week if not better.

Anyway, not really planning on taking the Codeine until bedtime as I'm not in that much pain and I'm not fond of the stuff. Might help me sleep

But the inhaler is 60 doses. That's 30 days of use. How long should I be using it for?

thanks Street Dealer... err Pharmacist

Use it until your better. It's just a medicine to open the airways. If your airways are open without it, no need to keep using it.

[Robotic]

I was prescribed Amoxicillin Trihydrate on Monday (1 pill 3 times a day). This was for a throat infection. I still haven’t been able to swallow properly. No appetite as it’s painful to eat. When should the antibiotics kick in and help the throat infection?

Clinic took a throat swab and no call back. So I'm assuming it was nothing serious.

[Street Pharmacist]

Originally Posted by Robotic

I was prescribed Amoxicillin Trihydrate on Monday (1 pill 3 times a day). This was for a throat infection. I still haven’t been able to swallow properly. No appetite as it’s painful to eat. When should the antibiotics kick in and help the throat infection?

Clinic took a throat swab and no call back. So I'm assuming it was nothing serious.

The swab was to see if it's bacterial. If no call, it's likely viral and did not require antibiotics. Do you have any other child symptoms (sinus pain, runny nose, congestion, cough)? If so, more likely viral.

Either way, you should be feeling a bit better in the next 2-3 days

[Robotic]

Thanks for the quick reply. I am coughing. I had a headache that lasted for about 5 days. Doc seemed to think the throat infection was causing the headaches. However the headaches seemed to have gotten better the last day or 2.

[Robotic]

Oh and my Thyroids are swollen, and hurts to touch. Dont know if that helps with anything.

[Street Pharmacist]

Originally Posted by Robotic

Oh and my Thyroids are swollen, and hurts to touch. Dont know if that helps with anything.

That's your lymph nodes. If your thyroid gland was swollen that would be very serious. Sounds like vital pharyngitis to me, but hard to say.

Either way, Dr Should've done swab and got back to you if you needed antibiotics. You should be fine in a few days