Medication errors

[Leper Messiah]

What was the allergy, though? A lot of times it's "nausea/vomiting" or "diarrhea" which is not an allergy. I would easily override that and dispense.

She specifically described rash and blistering from a past reaction. Also that he had been diagnosed with the allergy at the ER.

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[njac]

What was the allergy, though? A lot of times it's "nausea/vomiting" or "diarrhea" which is not an allergy. I would easily override that and dispense.

I regularly give cephalosporins to Amox/pcn allergies, but I certainly wouldn't do augmentin without a discussion with the patient/parent.

 

[Carboxide]

I regularly give cephalosporins to Amox/pcn allergies, but I certainly wouldn't do augmentin without a discussion with the patient/parent.

If the allergy was specified as N/V I would and have. Same thing as codeine allergy of n/v...do you hold off on giving hydrocodone? No.

The vast majority of PCN allergies (89%, if I recall) are non-existent. Doesn't mean some aren't serious, but a listed reaction of n/v is a pretty good sign.

 

[zelman]

What retail pharmacies have details about allergies? My system just lists drug or class with no other info.

 

[njac]

If the allergy was specified as N/V I would and have. Same thing as codeine allergy of n/v...do you hold off on giving hydrocodone? No.

The vast majority of PCN allergies (89%, if I recall) are non-existent. Doesn't mean some aren't serious, but a listed reaction of n/v is a pretty good sign.

Right, but the OP didn't mention n/v as a reaction. Just a blind "amoxicillin" allergy without a reaction listed should warrant a discussion.

 

[Leper Messiah]

What retail pharmacies have details about allergies? My system just lists drug or class with no other info.

I *think* CVS has a way to add notes after you enter a drug allergy...

 

[BidingMyTime]

osm=osmostic...its a different release than regular or SR metformin.

 

[confettiflyer]

osm=osmostic...its a different release than regular or SR metformin.

I didn't even know this existed.

 

[zelman]

I *think* CVS has a way to add notes after you enter a drug allergy...

They do not (other than generic notes-nothing allergy specific)

 

[zelman]

I didn't even know this existed.

It's generic Fortamet

 

[Carboxide]

What retail pharmacies have details about allergies? My system just lists drug or class with no other info.

Oh, our system did. Independent pharmacy, though. You could pick from a large selection of choices or type one in.

Right, but the OP didn't mention n/v as a reaction. Just a blind "amoxicillin" allergy without a reaction listed should warrant a discussion.

Totally agree. Didn't even consider the fact that a company would have a system that doesn't allow you to put in reactions for allergies...really? That's nuts.

 

[maria1oh]

Cvs is piloting a new system and it requires you to list reaction for each allergy. Slower and more cumbersome.

 

[confettiflyer]

Right, but the OP didn't mention n/v as a reaction. Just a blind "amoxicillin" allergy without a reaction listed should warrant a discussion.

I once had a patient told me they were allergic to "all antibiotics." When pressed for additional information, she said "I dunno, about 20 years ago they gave me a bunch of antibiotics and I had a reaction."

Conversation went nowhere, so I pretty much just charted allergy to "all antibiotics" and under reaction I put in quotes "a reaction 20 years ago per patient."

Cvs is piloting a new system and it requires you to list reaction for each allergy. Slower and more cumbersome.

This sounds like how it should be, kudos to CVS in being less like a drive-thru.

 

[njac]

I once had a patient told me they were allergic to "all antibiotics." When pressed for additional information, she said "I dunno, about 20 years ago they gave me a bunch of antibiotics and I had a reaction."

Conversation went nowhere, so I pretty much just charted allergy to "all antibiotics" and under reaction I put in quotes "a reaction 20 years ago per patient."



This sounds like how it should be, kudos to CVS in being less like a drive-thru.

I have patients pull that crap all the time. I've started asking "so when you get sick, what antibiotics do you usually get, or what works best for you"

 

[confettiflyer]

I have patients pull that crap all the time. I've started asking "so when you get sick, what antibiotics do you usually get, or what works best for you"

Oh tried that, said they've never been sick and never took anything except some random vitamins. No history in our system on the patient either.

My second favorite allergy, though, speaking of vitamins, was "allergic to everything from Mexico."

 

[owlegrad]

The best allergy is "genetics".

 

[njac]

I've also sat down with some of these patients with 20+ allergies on a slow day and made them recount every single reaction. And also worked on education that not all "mycins" are related etc etc etc.

My goal is basically to annoy them in to not thinking they're allergic to everything.

 

[zelman]

The best allergy is "genetics".

I can beat that. I forget the exact wording, but I saw a patient's chart listing an allergy to "homeopathic medicine".

 

[Ackj]

The best allergy is "genetics".

I've got one who is "allergic" to anything ER, XR, SR, etc. Everything must be immediate release.

 

[sakigt]

Ive heard some great ones: saline, benadryl, all antibiotics, all dyes, etc

Just heard the best one: narcan and suboxone

 

[njac]

Ive heard some great ones: saline, benadryl, all antibiotics, all dyes, etc

Just heard the best one: narcan and suboxone

"Cause it ****s up my high"

 

[Leper Messiah]

They do not (other than generic notes-nothing allergy specific)

Just a follow up, and this may be a new system update, but I was working last night, and I had to update allergy information at drive-thru. I typed "Amoxic", selected AMOXICILLIN from the list, and I was then given the option to select reactions ranging from anaphylaxis to rashes (i think nausea was even on the list). Below that field was a "notes" field.

 

[BidingMyTime]

Does anyone get patients who claim to be allergic to calcium, zinc, vitamin B, or some other substance that is required for life in every other human being? I have seen a handful of these patients...

 

[zelman]

Does anyone get patients who claim to be allergic to calcium, zinc, vitamin B, or some other substance that is required for life in every other human being? I have seen a handful of these patients...

Just iodine.

 

[PharmdA07]

And please don't forget the people who are allergic to specific company-brand. Indeed, some of these patients are legitimate as they don't agree with the dyes used in these different generics (ex. I've dealt are pravastatin from Dr. Ready vs Sandoz or levofloxacin red-color tabs vs white color tabs). But for the people who demand watson norco generic and yell at me that they are allergic to qualifest norco generic: they'll get a piece of my mind LOL. Last week I had a girl who claimed allergy to Tessalon pearles and asked me to call MD for Tussionex and claimed "I've already told her, I don't know why she keeps giving me this !" Well, sorry but you need to call her yourself or go to the ER!

 

[PharmNerdMatt]

Just a follow up, and this may be a new system update, but I was working last night, and I had to update allergy information at drive-thru. I typed "Amoxic", selected AMOXICILLIN from the list, and I was then given the option to select reactions ranging from anaphylaxis to rashes (i think nausea was even on the list). Below that field was a "notes" field.

I don't think it is new, I just think it is bypassed a lot. When I was last at CVS (about 2 years ago as they were rolling out WeCare) this was the way it worked.

 

[zelman]

I don't think it is new, I just think it is bypassed a lot. When I was last at CVS (about 2 years ago as they were rolling out WeCare) this was the way it worked.

This is rolling out in my district next month. I think your timeframe is erroneous.

 

[PharmNerdMatt]

This is rolling out in my district next month. I think your timeframe is erroneous.

Sorry then, I must be misremembering. After a while, the different pharmacy systems start to run together.

 

[Pharmavixen]

Couple of weeks ago, I had one who claimed an allergy to tap water.