Khaliah Shaw. Lamotrigine

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MrBonita

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Has anyone read the article. She took a wrong dose dispensed by a pharmacist and got really sick with Steven Johnsons Syndrome. None of the articles state the dosage taken and why didn't the rph state the most obvious adverse reaction to her.

Woman's skin 'melts off' after medication error

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Ehhh, I wonder what they mean exactly by "wrong dose"
 
Has anyone read the article. She took a wrong dose dispensed by a pharmacist and got really sick with Steven Johnsons Syndrome. None of the articles state the dosage taken and why didn't the rph state the most obvious adverse reaction to her.

Woman's skin 'melts off' after medication error
Wow!!! Steven Johnsons Syndrome is terrible. I am curious about this "wrong dose". There needs to be some clarity on this. I am sure if the adverse reactions were explained, the melting of the skin would not be a part of it.
 
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SJS can happen at any dose from what I understand. I read into it some and it seems the MD prescribed the wrong dose, the pharmacist filled it without question, and now the media wants to put all the blame on the pharmacist.
 
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Glad I just signed up for Pharmacists Mutual lol


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Wow!!! Steven Johnsons Syndrome is terrible. I am curious about this "wrong dose". There needs to be some clarity on this. I am sure if the adverse reactions were explained, the melting of the skin would not be a part of it.
If you dispense Lamictal for the first time and don't talk about severe skin reactions, you're not doing your job. If you dispense it without a medication guide, you're also not doing your job.
 
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If you dispense Lamictal for the first time and don't talk about severe skin reactions, you're not doing your job. If you dispense it without a medication guide, you're also not doing your job.

I bet the pharmacist said if you develop a rash.... blah blah blah and the patient (well, let's be honest, it wasn't even the patient picking up) nodded their head so they could get out faster. Then this happens and all of a sudden it's, "well nobody told me!"
 
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We don't even know for a fact if she received the wrong dosage. A side effect of a drug shouldn't be attributed as an error on part of either the pharmacist or physician. Blame your immune system.
 
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We don't even know for a fact if she received the wrong dosage. A side effect of a drug shouldn't be attributed as an error on part of either the pharmacist or physician. Blame your immune system.

Adverse event... Adverse event never changes
 
Need to know dosage.

SJS is real with Lamictal, and I know it needs to always be titrated very slowly. Every single time I get an order for a new patient for lamotrigine and it's above 25 mg, and I see no history of a patient being on it, I call and make sure it's their home medication and that they have been on it the day before they came into the hospital.
 
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Is SJS dose related?
 
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Is SJS dose related?
Higher dose increases the risk, however, lower dose reduces the risk, which is why dose should be titrated gradually. The ultimate deciding factor is the immune system's sensitivity to the drug. In regards to this woman, any dose could have caused her SJS, thus this is an adverse event, as noted by @CetiAlphaFive.
 
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Higher dose increases the risk, however, lower dose reduces the risk, which is why dose should be titrated gradually. The ultimate deciding factor is the immune system's sensitivity to the drug. In regards to this woman, any dose could have caused her SJS, thus this is an adverse event, as noted by @CetiAlphaFive.
For the most part I agree with you - the only area where I think the RPh could have some liability is if they knew (or determined through counseling) that this was a new start, and the dose was not started low and titrated up.

That being said - without knowing most of the facts we are all playing arm chair quarterback and I think we can all agree this article is 98% sensionalistic.
 
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