Dear Pharmacy Customer

[Sapphire Silk]

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.

I agree wholeheartedly. We haven't really studied the "placebo effect" to understand how or why it occurs. Scientists researching new drugs tend to regard the placebo effect as a negative finding, especially since more and more drugs are failing clinical trials because they are no more effective than a placebo.

And don't get me started on Sperolactone (sp?)

Spironolactone (Aldactone). It's actually a potassium sparing diuretic (in English, it makes you pee) . . . reducing fluids in the body can have the effect of lowering the blood pressure.

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.

In other words, they ignored the potential of the placebo effect, and assumed it had to be another medication. Tsk, tsk, such poor science.

[AccountingDrone]

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).

No shit ... it took them almost 4 months to get me stabilized enough for surgery, we went through pretty much everything there is available. We settled on toprol, clonidine and cozaar. I managed to finally get an appointment with a cardiologist, who changed me to clonidine, cozaar, atenolol and amlodipine.

And WTF is it about every freaking doctor I walk into the office of wanting me to get bariatric surgery? I can't eat any freaking less than I do now, the only thing it would do is force me to eat it one freaking ounce at a time all fracking day long. I know that I am FAT it isn't like I am all OMG where did that 300 pounds come from , I sort of realize I am FAT. Yes, I know losing weight would drop my BP [probably] however, if I haven't been able to lose the damn FAT in 20 years, I don't think it is going to happen now without something seriously drastic like checking into a hospital, peeling every inch of skin off my body and slurping the fat out with those lipo thingys. That aint happening either.

[auntiem]

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.)

Thank-you for that! My Dr. said he had never heard of that side effect before, but he belived me and changed it.
For the Spironolactone (thank you for the correct spelling) - I didn't mind the diuretic effect or the "may cause birth defects" effect - there is another side effect to that drug and let's just say it shouldn't be proscribed to pre-menaupausal women unless it is a last resort - who knows - once I cross that line I may go back to it, but for sure not until then.
Accounting Drone - You can tell your Dr. that my BP reached epic purportions (I had the BP of a giraffe) when I was the thinest I had been in years - so harping on your weight may not be very productive. Tell them to treat the patient you are not the patient they want you to be.

[wolfie]

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.

Just curious, but do the red pills work faster?

[BookstoreEscapee]

THAT scares the hell out of me! The clinic on post here is alright, and the pediatricians are excellent, still something good to keep in mind. I hope that pharmacist didn't get in trouble, and that that PA did!

That is scary. I had "borderline" pneumonia last year, and the nurse practitioner I saw gave me an antibiotic (I forget what) and an inhaler (Advair). They apparently don't get along, and when my mom went to fill the prescriptions the pharmacist caught the interaction and called the doctor's office; they changed it to an albuterol inhaler and all was well.

(Actually, while she was at the store I was looking the drugs up on the internet, cuz I'm paranoid like that, and noticed the interaction myself, but I couldn't call my mom to tell her to ask about it.)

This is why everyone in my family has their drug names and dosages listed on cards in their wallet.

My grandmother kept all her meds in a shoebox, along with a list of all her meds and hospitalizations, so when we had to call the ambulance (as happened several times in the 5 years or so she lived with us), we could just grab the whole thing and go.

[Kogarashi]

In other words, they ignored the potential of the placebo effect, and assumed it had to be another medication. Tsk, tsk, such poor science.

I think the stated reason they disqualified Grant's results is because they weren't sure the other failed remedies wouldn't have worked. That he might have convinced himself that the ginger and prescription worked because they worked for Adam, or that the rest failed because they failed for Adam. It wasn't that the placebo worked for him so much as that it showed the rest of his results might not have been accurate.

Personally? When it comes to nausea, at least, I'm all for the placebo effect if it'll get rid of the problem. That's why I have a pair of sea bands for pregnancy nausea even though I don't know for certain if they actually work, medically speaking. They seem to relieve my nausea, and that's enough for me.

[dawnfire]

When I worked in the ER, I encouraged my patients to keep a 3x5 card with all their meds written neatly on it, and to update it at least twice a year. You never know when you might to be able to answer questions about your meds or medical history.

hubby has a more modern card he has a watch with a built in memory stick with his current meds and allergies. all he does is keep a card in his wallet directing people to the watch.

[morgana]

I ran into one of the weirder side effects when I first went on BP meds. Doc put me on her particular favorite, lisinopril.

She and I argued for a couple of MONTHS about the fact that shortly thereafter I started having a persistant cough. Nope, nope, nope, couldn't be the lisinopril, let's get you checked out with the Ear/Nose/Throat dude. ENT even operated on me for a deviated septum. Did it stop the cough? Hah!

I told Doc that either she put me on something else, or I found a new Doc. She put me on Atacand. Five days later, no cough.

Guess what is one of the listed-on-the-package-insert side effects of lisinopril?

Doc listens to me now. She'd better.

[Shalom]

For the Spironolactone (thank you for the correct spelling) - I didn't mind the diuretic effect or the "may cause birth defects" effect - there is another side effect to that drug and let's just say it shouldn't be proscribed to pre-menaupausal women unless it is a last resort - who knows - once I cross that line I may go back to it, but for sure not until then.

If it's the side effect I'm thinking of, your menopausal status won't make much difference. It does that to men also.

hubby has a more modern card he has a watch with a built in memory stick with his current meds and allergies. all he does is keep a card in his wallet directing people to the watch.

I've got it in my cell phone directory under "ICE" (In Case of Emergency), along with the ICD9s for my current medical conditions. Hopefully if G_d forbid it becomes necessary, the EMTs will look there. (edit to add: I never thought of putting a card in my wallet to tell them where to look; thanks for that idea.)

I ran into one of the weirder side effects when I first went on BP meds. Doc put me on her particular favorite, lisinopril.:

Aha. That's as far as I had to read, I knew exactly what you were going to say next.

Persistent cough is one of the best-known side effects of the ACE inhibitors, and if you're one of those who are susceptible to it, changing to another one won't help because the entire class does it.

(The mechanism is complicated: I won't be insulted if you skip this. There's a hormone called angiotensin which works at the kidneys to constrict blood vessels all over the body and thereby raise the blood pressure. The hormone as originally synthesized is inactive, called angiotensin-I; there's a mechanism called ACE (Angiotensin Converting Enzyme) that converts it to the active form, which is called angiotensin-II. One of the ways the body regulates its blood pressure is by modulating how much of this conversion takes place. If you've got high blood pressure, you can drop it somewhat by blocking the conversion, so the kidneys never get the message to shrink the blood vessels. The location where this conversion takes place just happens to be in the lungs, so if you mess with it, it's not surprising that the lungs get irritated enough to start a cough. Atacand is in a relatively new class called angiotensin-receptor blockers, or ARBs. They work similarly to the ACE inhibitors, but instead of blocking the conversion of angiotensin-I to angiotensin-II, it simply blocks up the receptors at the kidneys. Doesn't matter then how much gets converted, as it doesn't do anything when it gets to its target.)

[BeeMused]

@AccountingDrone
I hate it when doctors only see the Fat and not the person, and I will change doctors, if they ignore my problem and just tell me loose that fat and stop smoking. As for not being able to loose weight... did you get checked for Hashimoto's thyroiditis? This is thyroid gland disorder that can make weight loss really hard.

@Wolfie
Pills with go faster stripes...
I don't remember which colours worked best.

Today my doc and I decided on yet another combination of pills, we'll see. Still, I'm patient, I know that I'll be better off once we've found the mix that currently works best. It's funny, though, I haven't lost that much weight, but my BP acts up. The problem isn't that my BP gets too high, but it gets too low and I'm dizzy.

Persistent cough is one of the best-known side effects of the ACE inhibitors, and if you're one of those who are susceptible to it, changing to another one won't help because the entire class does it.

I have a persistant cough, so far I've been told: Stop smoking! But I will talk to my doc and mention this, since I have an ACE inhibitor in my pill mix.

Ha! This is a good thread! I've learned a lot already.

[auntiem]

If it's the side effect I'm thinking of, your menopausal status won't make much difference. It does that to men also.



Aha. That's as far as I had to read, I knew exactly what you were going to say next.

Persistent cough is one of the best-known side effects of the ACE inhibitors, and if you're one of those who are susceptible to it, changing to another one won't help because the entire class does it.

On the first one - ok I think I know what side effect you are talking about, but the one that bugged me was it shortened my cycle to 16 days instead of the normal (for me) 28 days. TMI I know.

As for the lisinopril - morgana I'd change Dr.s, like Shalom said that is a well known side effect - my Dr. even warned me about it when I was put on it so your Dr. should at least know that.
Also for what it is worth - for those of you with that side effect be careful about what time of day you eat chunky soup - I finally figured out that if I had chunky soup for lunch I was more likely to aspirate a little liquid and that made my cough sound much worse (wet cough vs. a dry cough) and made it harder to pin on the medication - i.e. "you just have a little chest cold".

[Andara Bledin]

It makes me wonder how much of the real medication healing powers is actually pure placebo effect, despite all the double blind testing.

I know for a fact that when I take Vicodin for pain relief, I get a distince placebo effect; I start feeling better before it's actually physically possible for the Vicodin to have taken effect, yet. Which is much better then what happens when I take codeine, which is utterly and absolutely nothing, which I found out the hard way. Thankfully, it wasn't a particularly troublesome injury, so I was able to tough it out, with only the first night being really unpleasant.

Personally? When it comes to nausea, at least, I'm all for the placebo effect if it'll get rid of the problem. That's why I have a pair of sea bands for pregnancy nausea even though I don't know for certain if they actually work, medically speaking. They seem to relieve my nausea, and that's enough for me.

I'm of the opinion that if it can be counted on to work for a specific patient, then who cares if it's because it's effective because of the medicine, or because of the belief of the patient.

The effect is more important than the cause, in such cases.

hubby has a more modern card he has a watch with a built in memory stick with his current meds and allergies. all he does is keep a card in his wallet directing people to the watch.

I'd stick with the card, too. It's faster to glance at a card than it is to glance at a card, then find the watch (hope it's still there and still working), then get to a computer that can be hooked up to the watch to get to the information that could have been on the card in the first place.

Same thing goes with the cell phone, later on. Definitely have that info there, too, but be aware that if you do keep it there, than anyone who gets ahold of said cell phone will also be able to learn all of that private information that you generally don't want to share, particularly with the sorts of people who would go snooping in someone's cell phone data.

^-.-^

[Sapphire Silk]

I think the stated reason they disqualified Grant's results is because they weren't sure the other failed remedies wouldn't have worked. That he might have convinced himself that the ginger and prescription worked because they worked for Adam, or that the rest failed because they failed for Adam. It wasn't that the placebo worked for him so much as that it showed the rest of his results might not have been accurate..

I'll have to see if I can catch a repeat of that episode; I'm curious to see this one.

hubby has a more modern card he has a watch with a built in memory stick with his current meds and allergies. all he does is keep a card in his wallet directing people to the watch.

Now that's cool.

[Pagan]

I think that that covers all of the questions that I get asked on a daily basis plus some good advice whether you want it or not.

All of this is why I'm now at a mail order pharmacy.

He wouldn't believe me when I tried to correct him, after all he was a pediatrician, with a whole six weeks of pharmacology under his belt, whereas I was just a lowly pharmacist with three years of it... his tune changed when he finally went and looked it up in his PDR (not my choice

At the end of my 2nd pharmacology course (for Pharm Tech), my prof said, "You all now know more about drugs than most doctors."

This is also why I trust RPhs and don't really trust doctors when it comes to drugs.

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

Oh, there's a bunch on here. There's also the "CS Pharm Tech" in the Social Groups.

When I worked in the ER, I encouraged my patients to keep a 3x5 card with all their meds written neatly on it, and to update it at least twice a year. You never know when you might to be able to answer questions about your meds or medical history.

This is where I have it easy. I'm only on one drug and that's a birth control pill.

Seeing clearly the agony I was in, they upped the scrip to Vicodin. And I spent the next three days blissfully looped out of my mind.

I honestly don't understand how people get addicted to hydrocodone. I had and Rx for it last summer. After the reaction I had to only taking one, the rest promptly go flushed. Anyway, the aspirin was taking care of any pain I was having.

The only drug I take semi-regularly (besides alcohol, of course!) is ibuprofen, for two reasons:

People don't believe me when I tell them I can't take ibuprofen....because it gives me a headache.

[LadyAndreca]

At the end of my 2nd pharmacology course (for Pharm Tech), my prof said, "You all now know more about drugs than most doctors."

This is also why I trust RPhs and don't really trust doctors when it comes to drugs.

This is something I learned from reading the forum. It never occured to me to talk to a pharmacist about reactions to medications, but after learning this from you guys, I did.

Which reminds me, I need to go talk to my pharmacist about one of the new nasal sprays I'm on. It burns my nose, ranging from 'kinda irritating' to 'a battle of wills to not blow my nose and get this stuff OUT of there'. >_<

I honestly don't understand how people get addicted to hydrocodone. I had and Rx for it last summer. After the reaction I had to only taking one, the rest promptly go flushed.

One of those controlled painkillers makes me so disoriented I can barely function. When I had my wisdom teeth pulled, I was told I HAD to take them. It was a couple days before I managed to come up with the idea to read the label on the bottle. The second I saw the words "as needed" the rest got flushed - I don't believe I'd needed them since the first night.