Calling a Dr. about drug interactions and allergies

[tompharm]

Can someone please clarify for me when it is appropriate to call a Dr. about Drug interactions and allergies. I know the most important DUR checks to look for are contraindications and possibly QT prolongation and drug allergies.

I also know there are exceptions such as maybe not calling on QT prolongation if they are both prescribed by the same Dr. and also not calling for drug allergies if they have already been on the drug with no problems.

I know to look for things like Viagra/Cialis/revatio with nitrates and alpha blockers.

Can some please clarify for me because it is hard to get ahold of the doctor to explain these things and most DUR checks are worthless.

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[Digsbe]

Just ask "if I don't call and something happens will I be held liable?" If yes, call. Making a physician angry isn't worth both of you winding up with a lawsuit and it's better to put the patient's health first above possibly upsetting someone else, I think most physicians do care about their patients and likely wouldn't mind if it's a serious call. Just look out for your patients, a lot of the "should I call or not" develops as professional judgement matures. Then again, I'm a student so I can't speak too much to that yet.

 

[Dred Pirate]

I work in a hospital and I have these conversations multiple times per day - your status says pre-pharmacy - is this an old status or current? If you just have not updated, tell us about your work environment, retail vs hospital? Honestly it will depend on your situation. In the hospital world it requires me to look up from my desk and say "Hey Jon, did you mean do to this?" vs calling an office and dealing with that BS

 

[pinipig523]

Not sure about others but I don't mind getting calls at all. It's better that way.. in case I missed something. Anytime a pharmacist calls the ER to talk to me to clarify a script, I always let them know that I appreciate their call and that I'd rather them call me than me miss an allergy or an interaction.

The pharmacist is my safety net.

 

[zelman]

The vast majority of computer flagged DURs in retail are junk. Actually evaluate them to determine the likelihood of something bad happening considering timing and dose. Then, if it's something the patient can monitor for and you trust them, just counsel the patient (and document it). If the patient is not sufficiently competent, or the negative outcome may be severe, undetectable or death (including all allergies where the patient hasn't had a similar allergen before) call the doctor.

 

[BenJammin]

Last thing you should ever care about, as a retail pharmacist, is worrying about making a prescriber angry over a phone call.

 

[Gombrich12]

Most of the time when I get an allergy DUR I will check if they have received the same drug or class in the past. If that doesn't work then I call the patient to ask them about their allergy if they aren't around. Finally, I call the prescriber if I can't get a hold of the patient. There is no reason to call a doctor on every allergy.

 

[VA Hopeful Dr]

I want these calls. Some of my local pharmacists will tell the patient "This new medicine can interact badly with one of your existing meds". Then the patient comes to me pissed off and usually unwilling to listen to me explain why its OK for them to take it. I'd rather the pharmacist call me and we can work it out.