#phocusedonpharm

The pharmacy technician accepts your prescription and gives you a wait time of 20 minutes. You sigh and accept it as you head to sit down in the waiting area.

The technician quickly checks to see if the prescription is valid and enters it into the computer system. They also quickly check that the drug, dose, directions and quantity to dispense is correct. Once it’s entered, it moves on to be filled. Uh oh. Severe interaction. 

The interaction is between ramipril and Septra.

You’re taking ramipril for high blood pressure. However, when Septra is taken at the same time as ramipril it can produce a potentially life threatening increase in potassium. This could lead to muscle weakness, an abnormal heart rate, palpitations, and even death. 

Your pharmacist doesn’t want you to have to experience this. She picks up the phone and calls your doctor. The receptionist puts her on hold. While on hold she moves on to check other prescriptions so that she doesn’t fall behind. 

Oh look, an interaction with another patient’s prescription. 

Your doctor picks up the phone and your pharmacist explains the nature of the interaction and what could possibly result. She asks if the doctor would still like to continue with this antibiotic, as sometimes it is the only choice. He doesn’t and asks her what would be a suitable alternative. She suggests MacroBID for 5 days. The doctor accepts and she takes a verbal for the order. It goes back to entering and filling by the technicians. No interactions this time!

You arrive back at the counter at exactly 20 minutes. The cashier explains that the pharmacist is just checking the prescription and bagging it, and that she will be right with you.

As a student pharmacist, I’ve heard people say so many things when you tell them that their prescription is going to take 15+ minutes to get ready. For example:

“It’s only a couple of pills in a box - can’t you just stick a label on it?”

“I’m not feeling very well, can you give me one of the pills now and I’ll pick up the rest tomorrow?”

Imagine the implications in this scenario if your pharmacist just stuck a label on the prescription you just handed in. Or even if she just gave you one pill to get you by.

A lot of doctors don’t think about drug interactions when they’re prescribing. Their job is to diagnose. A pharmacist on the other hand deals with these drugs on a day to day basis. They have the knowledge to understand drug interactions and act on them appropriately.

Your pharmacist’s main job is to ensure that your prescription is right for you. This means that they check to make sure your new medication’s dose is appropriate, that it doesn’t interact with medications you are currently taking, with an allergies you may have, or with your medical conditions. 

Your pharmacist understands that you’re in a hurry, that you’re not feeling well. And most of the time, most pharmacists will speed along the process as much as they can. But when a pharmacist reaches a roadblock where things need to be changed, we need more time. In this story, the pharmacist was able to get the doctor within the timeframe the technician gave luckily. But often times, the doctors are with other patients and cannot take the call. At our pharmacy, the pharmacists writes a note and faxes the doctor about the issue because if the pharmacist waited on the phone all day, no one would get their prescriptions.