And of course what I mean by "saves my ass" is "wastes my fucking time"....and yours.
Someone deep in the bowels of my employer's IT department decided it would be a good idea not long ago to add a new DUR warning to our system. DUR warnings stop the prescription filling process in its tracks. They must be overridden by me, and if they actually pointed out things that a pharmacist genuinely should be concerned about, they would be a good thing. The latest batch of DUR updates released into our system though, included one for the anti-acne med Accutane.
"Isotretinoin should be used with caution in women of childbearing age" says the warning that I must override every single time a prescription for Accutane or one of its generics is filled. Thanks. Fucking thank you for that. How about a warning next that sleeping pills may make you drowsy?
Real life sometimes steals your best material. There actually is a drowsiness warning label that prints out with every Ambien prescription filled at my store.
For those of you not in the profession, let me recap what happens before a female of penis-receiving age gets any Isotretinoin into her grubby little hands.
-She needs to be on two different forms of birth control. Not all types of birth control cut it. No female condoms, No progesterone-only birth control pills.
-She needs to be on the two different forms of contraception for 1 month before a prescription is issued.
-Her doctor must document this and enter the information into the database of a "risk management" program called iPledge.
- iPledge then issues an authorization number that allows no more than a 30-days supply of Isotretinoin to be dispensed.
- She brings the prescription to me. I have to call the iPledge mothership to get her authorization number.
- Authorization number has to be recorded on the prescription as well as in our computer.
-She needs to have a negative pregnancy test every month while taking isotretinoin, and this information must be entered into the iPledge database, a new prescription must be issued, and a new authorization number obtained. Every month.
-Men have to get an authorization number as well. Just in case they're hiding some ovaries.
AFTER ALL THIS. Some numbnut at the company that employs me has now decided it would be a good idea to stop the prescription filling process seconds before it is complete to tell me "Isotretinoin should be used with caution in women of child bearing age"
I forgot to mention I counted at least five different places on a box of Isotretinoin where there is a picture of a woman with a big 'ol belly surrounded by a red circle with a slash through it above the words "CAUSES BIRTH DEFECTS -DO NOT USE IF PREGNANT"
The reasons your prescription takes so goddamn long to fill just keep on a 'comin. Release the scotch.
11 comments:
The override I really love getting is the one that tells us that the birth control we're dispensing right now will interact with the antibiotic we had dispensed to this patient back in 1999. I just have this feeling it's left her system by now.
I can beat that. When a prescription is "reassigned" in my pharmacy computer software (we faxed the doctor for refills, they were approved), the pharmacist has to override a "therapeutic duplication" warning, meaning that the patient has had the medication before. Well, duh: we're reassigning the prescription. Only the pharmacist can override this warning. On every single refill we have approved. Arghhhh
http://cowateni.blogpharm.com
My system always puts a hard stop on birth control with the warning
"oral contraceptive should be used with caution in women of child bearing age."
if the woman is a little on the old side of poppin kids out i get this hard stop:
"oral contraceptive should be used with caution in menopausal women."
The only time i dont get it is if the patient is a youngin (~under 16)
It makes me die a little.
I'm a tech, and I can override DUR's.. like your mom.
In my hospital's software, I get an allergy warning if an order being verified contains a drug in the SAME PHARMACOLOGIC (NOT CHEMICAL) CLASS as the drug the patient is allergic to. For example, acetaminophen (an analgesic) will trigger a warning if the patient is entered as being allergic to morphine (an analgesic).
those ambien warning labels are my favorite. they print out at my pharmacy as "may cause drowsiness or dizziness." i kind of want to put one on a bottle one of these days... at least i would if i wasn't certain that my pharmacist would rip it off 5 seconds later.
Good God! Pour me a drink, too, Drugmonkey. Let's drown our pain together.
@IndieTech: I always used to wonder about those drowsiness warnings on sed/hyp drugs. I mean, isn't that what it's *supposed* to do, make you drowsy? It eventually occured to me that maybe they're talking about the next day. Less of a problem with a short-acting drug, e.g. Sonata, but Dalmane has a half-life of 47 to 100 *hours* (active metabolite). You take one of those, you've still got more than 3/4 of the initial dose in your circulation when you wake up the next morning (assuming you do in fact wake up the next morning).
Does it do that for all category X drugs, or does the software just really hate accutane?
Yep.
Kudos to a great and funny blog from a mere pharmacy tech... who DOES put that "may cause drowsiness" warning on every bottle of zolpidem or Lyrica I fill. (And the pharmacist has never objected!)
I had a "why does your prescription take so damn long" day yesterday, just after I had discovered your blog. The best one was the lady who wanted us to print her out something to take to another pharmacy (who were, for some reason, unable/unwilling to call us for a transfer, in spite of state law requiring just that) so she could get a month of two of her meds over there.
And society wonders why have the people that work back there have to be on some anti anxiety meds or antidepressant its because this profession will seriously drive you nuts i mean how can a pharmacist work 14 hours straight and not wanna pull their hair at the end of the day at least thats the way it is at my store no lunch break no nada its work work work so THEY(CVS) can get their bonus at the end of the year nothing but greediness and selfishness and what all boils down to is its always the pharmacists fault if the drug goes out wrong because some foreign dr doesn't know how to write a damn rx and you cant read it when you're helping the 400 druggies that come in and hassle you about non-legitimate things.....uhhhh
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