Dear Pharmacy Customer

[AccountingDrone]

Try being allergic to zinc ointment base ... you know how many glops that stuff ends up in? Hubs gets at least 3 or 4 rounds of poison ivy per year, and the damned hydrocortisone cream is the first thing they always give him. He just goes and wraps up in a sleeping bag on the couch.

[BeeMused]

Brings up an interesting point about the placebo effect, though, doesn't it?

And the size and colour and shape of the pill seems to matter too. Big pills work better than small ones apparently. And if the pill is given by a doctor it works better too. There even seem to be placebo effects with surgery!
The human mind is a strange thing indeed.

Oh and that 3x5 card is a good idea! I'm making one as soon as my body and the doctors finally agree on my hypertension medication. I'm currently loosing weight, so my blood pressure begins to come down on its own. Who woulda thunk it, me visiting a doctor and complaining about low blood pressure.

[MadMike]

I have had a pharmacist refuse to a fill a prescription because the doctor (PA acutally) had grossly overdosed a child and when he was called about it refused to admit his mistake and change the directions. (And it is against the law for the pharmacist to change the prescription without the doctor's consent.)

I've seen people who refuse to admit when they're wrong, but risking someone else's health -- maybe even their life -- that's pretty messed up. Someone like that should not be a doctor.

My brother's a pharmacist, and up until he became one, I had no idea what was involved. I thought they simply dispensed pills, and that was it. But from what he told me, they're actually expected to know the medications just like a doctor does. And if the doctor makes a mistake, they're supposed to catch it. If they don't, and something bad happens, both the doctor and the pharmacist can get sued.

It's good to know that I'm not the only "drug dealer" on here!

LOL, when my brother became a pharmacist, my dad joked about him being a "drug dealer" too.

I have an allergy to one particular brand of antihistamines because of an additional ingredient in the pill. (I know what it's called but not if it's a filler, colourant or whatever)

My son had a bad reaction to children's aspirin once. It must have been the base that they used in the chewable pills, because up until then I had been giving him liquid and there was never a problem. He told me his throat swelled up -- didn't close completely, thankfully, but it made him very uncomfortable until it wore off. I ended up throwing the rest of the bottle in the trash. Thankfully, he turned 12 not too long after that, which is old enough to take most adult medicines.

[Sapphire Silk]

And the size and colour and shape of the pill seems to matter too. Big pills work better than small ones apparently. And if the pill is given by a doctor it works better too. There even seem to be placebo effects with surgery!
The human mind is a strange thing indeed.

When I worked as a correctional nurse, the jail physician would often order "Ceboset" for patients he thought were drug seekers. Ceboset was a placebo . . . a "sugar pill". They came in these little yellow capsules. It was amazing how often the inmates would come to prefer the "ceboset" to actual narcotics . . . the doc would tell them it was better than most narcs and could only be given in a controlled setting like a hospital . . . or a jail. The inmates would actually ask me for it when they came back to jail on a different charge.

Technically, giving someone a placebo is unethical (you're not supposed to lie to your patients). But I wish I could go back in time and collect some data on this to do a study

Oh and that 3x5 card is a good idea! I'm making one as soon as my body and the doctors finally agree on my hypertension medication. I'm currently loosing weight, so my blood pressure begins to come down on its own. Who woulda thunk it, me visiting a doctor and complaining about low blood pressure.

You're welcome My dad had a similar problem with his blood pressure after his open heart surgery. He got put on a new blood pressure med to keep his BP down so his grafts could heal. I had concerns it was TOO low . . . he later passed out at home.

Medications are funny things . . . sometimes they work TOO well.

[trailerparkmedic]

Hmm. I thought they pulled it because of the Tylenol content: 650mg per tablet. Many docs would write for 2 tabs q4-6hrs, which meant each dose would exceed the max safe dose of Tylenol (1 gram) and max daily dose (4 grams).

I read on some medical website a few months ago that the FDA is trying to get the manufacturers of most opioid + Tylenol pills to lower the amount of Tylenol over the next few years to avoid this. Maybe that's what you were thinking of? I know Darvocet was pulled for EKG changes because I had a "discussion" with a professor about that just recently.

</threadjack>

[Seshat]

My favorite allergy reports are when I'm told that "I'm allergic to those white hydrocodones but not the blue ones." Really? Or I can only take those somas with an M on them.

As some have said, it might be the filler or the dye.

Technically, giving someone a placebo is unethical (you're not supposed to lie to your patients). But I wish I could go back in time and collect some data on this to do a study

I SOOOOO badly want a placebo. My most severe problem is chronic pain, and what's the best way to relieve the suffering from chronic pain with no side effects *at all*? Yeah. Placebo. At least for those patients it works for.

Problem is, I'm one of those annoying patients who reads the info sheets the pharmacist hands out, and the info sheets inside the box, and checks the online info for the drug, and ....

[BeeMused]

Technically, giving someone a placebo is unethical (you're not supposed to lie to your patients). But I wish I could go back in time and collect some data on this to do a study

As long as the patients aren't in danger... why not use the power of placebos. That data could be valuable, indeed. I think many doctors underestimate the placebo effect.

Medications are funny things . . . sometimes they work TOO well.

BP medication seems to be extra tricky, esp. since weight loss/gain *sigh* has a direct influence on the BP. And the mean thing about hypertension is that you don't really notice when the BP rises slowly over time. Oh what fun, when you start taking medication and your BP is on normal level again: mushy brain, headaches... It took me a while to get used to it. And now it feels better than before! That's why I highly recommend to get your BP checked, hypertension doesn't hurt at first, but strokes and heart problems can be the long term results.

[auntiem]

BP medication seems to be extra tricky, esp. since weight loss/gain *sigh* has a direct influence on the BP. And the mean thing about hypertension is that you don't really notice when the BP rises slowly over time. Oh what fun, when you start taking medication and your BP is on normal level again: mushy brain, headaches... It took me a while to get used to it. And now it feels better than before! That's why I highly recommend to get your BP checked, hypertension doesn't hurt at first, but strokes and heart problems can be the long term results.

My 3x5 card currently in my wallet is kinda funny (funny to me now anyways) I spent months and months w/ two doctors trying to get my BP to respond and also dealing with the side effects. There are so many dosages and pills crossed off and/or adjusted that I finally just turned it over to "start over".
Once you get the right "cocktail" it feels great though and totally worth it. The getting to that point sucks.
BeeMused - feel free to PM me if you want to comiserate about dealing with BP issues / side effects. Apparently I reported the weirdest and most specific side effects - one pill made me "uncreative" so badly that I complained and they switched it to something else then I felt creative again after a few weeks. And don't get me started on Sperolactone (sp?) I'm sure it does its job well, but oh man the side effect sucked!
Oh, and BTW the "mushy brain" effect goes away after a year or so - basicly once your body learns to function with the lower (and healthier) BP and you learn to schedule your day around the "dizzy times" (if you have those).

[Sapphire Silk]

I read on some medical website a few months ago that the FDA is trying to get the manufacturers of most opioid + Tylenol pills to lower the amount of Tylenol over the next few years to avoid this. Maybe that's what you were thinking of? I know Darvocet was pulled for EKG changes because I had a "discussion" with a professor about that just recently.

</threadjack>

That's right . . . . I remember about the EKG thing now that you mention it.

</end ending threadjack>

[Shalom]

Apparently I reported the weirdest and most specific side effects - one pill made me "uncreative" so badly that I complained and they switched it to something else then I felt creative again after a few weeks.

You are not the first to report this symptom. I can't remember the name, but one of the golden age SF authors died somewhere around 1951 of malignant hypertension, because he'd stopped taking his BP meds for this very reason. He said he'd rather have a short but productive life than a long stifled one.

Anybody remember who that was? Not Cyril Kornbluth, I don't think. (edit: yes it was, and it was 1958. The wikipedia page on him doesn't mention this; I read it somewhere on a dead tree.)

[BeeMused]

Oh, and BTW the "mushy brain" effect goes away after a year or so - basicly once your body learns to function with the lower (and healthier) BP and you learn to schedule your day around the "dizzy times" (if you have those).

My brain "unmushed" (is there such a word?) after about a month and I had no dizzy times, just now as my BP starts to drop I get dizzy. So now my doc and I start to tweak my medication. Drop this pill or that pill, lower the dose of this pill or that pill. I feel we're almost there. So far I don't have bad side effects, luckily there are so many different BP medications around nowadays, that you can switch around until you find the best combination. And it's totaly worth it!

Hopefully I can drop all pills soon, if I manage to keep my healthy diet and keep loosing weight. (I was close to a BMI of 50, now I'm at 45, next goal is 40, etc) But if I have to continue taking the pills, no problem.

[Shalom]

As long as the patients aren't in danger... why not use the power of placebos. That data could be valuable, indeed. I think many doctors underestimate the placebo effect..

Had a patient once taking placebo. This was back when I was an intern, and it wasn't yet mandatory to give out the patient info leaflets. I was checking for outdates in the pharmacy one day, and found a bottle labeled "Сеbосар #1". Impressive looking capsules, one side blue, the other side clear, full of these little white granules, made by Forest Pharmaceuticals (same guys that make Celexa). Active ingredients: sugar and starch. I asked the pharmacist what on earth this was doing on our shelf? Is anybody actually using these, and what for?

She said, "Yes, we have one patient on them. She had been taking unGodly amounts of Vicodin [averaging 12 per day, which is double the usual maximum], plus Robaxin, plus Flexeril, and her doctor finally said, Look, we've got to get her off of this. Can you find me some kind of placebo that we can give her? So I searched the catalogs, and found these. Doctor said fine, give her those, and label them, "1 capsule every two hours as needed". Then we stuck on the "May Cause Dizziness" warning sticker for good measure. And the funny thing is, not only does she get relief of her pain from them, but she didn't even get any withdrawal symptoms, even though she'd been taking the Vicodin long enough to be well and truly hooked on it. We have to be very careful what we say to this patient."

I said, "So how come we've got two different sizes in stock?" [There was also a partial bottle of Сеbосар #2 there, which were a little smaller and green instead of blue.]

She started laughing. "Oh, that's the funniest part of the whole story. One time the wholesaler was out of the blue capsules, and we could only get green ones. We didn't know what she was going to do, but Margaret [the other pharmacist] had a great idea... she told her, `These are the half-strength capsules, so you'll need to take two of them!'"

(The original brand name was "Obecalp", which is of course just Placebo spelled backwards. Eli Lilly & Co were the original manufacturers of Obecalp, but they discontinued it years ago.)

The interesting thing is that the name actually comes from a Biblical verse (Ps.116:9). The literal translation is "I shall walk before G_d in the lands of the living", but the Latin translation used "Placebo" (I shall please) rather than "Ambulavero" (which is how Goofle translates "I shall walk" into Latin). Not sure why they translated it this way.

[Thuringwethyl]

In the line of unusual allergies:

My mother developed an allergy to estrogen after she gave birth to her second (and last) child. According to her, all of the medication available to reduce the symptoms were estrogen-like so she was unable to get relief.

I can say with certainty that once she hit menopause she never looked back.

[BeeMused]

@Shalom
WOW what a story! As long as she believes the caps are working, they do. It makes me wonder how much of the real medication healing powers is actually pure placebo effect, despite all the double blind testing.

[Kogarashi]

Reminds me of when Mythbusters was testing motion sickness remedies. They tried just about anything you could hope for on Adam and Grant (the two team members who actually got seasick), and only the ginger pills and prescription meds worked. Then they decided to test a placebo. Adam still got horribly sick, while Grant felt better, so they decided that Grant's results couldn't be trusted because some of the remedies might have worked if they hadn't failed for Adam.