OD's and oral meds

[PharmDr.]

Im a pre-opt. student and have shadowed 4 different ODs already in different areas and absolutely love the profession. In my state of florida, oral meds are not allowed by OD's and im curious as to how those in states that do allow it are fairing. From what I researched Ive found that anti-histamines,analgesics,anti-virals,antibiotics, and even anti-inflammatories like corticosteroids are allowed. When you are trained to prescribe in this fashion, how do you check for side effects that can manifest. Say, on their next appointment that you are evaluating them, how do you check and examine the rest of the body? One of the OD's I shadowed today said that he has a friend in Georgia that Rx P.O.

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[PBEA]

Im a pre-opt. student and have shadowed 4 different ODs already in different areas and absolutely love the profession. In my state of florida, oral meds are not allowed by OD's and im curious as to how those in states that do allow it are fairing. From what I researched Ive found that anti-histamines,analgesics,anti-virals,antibiotics, and even anti-inflammatories like corticosteroids are allowed. When you are trained to prescribe in this fashion, how do you check for side effects that can manifest. Say, on their next appointment that you are evaluating them, how do you check and examine the rest of the body? One of the OD's I shadowed today said that he has a friend in Georgia that Rx P.O.

PharmDr, you are a troll, the rest of your posts stink of ulterior motive. I cast way your sheep's clothing

 

[PharmDr.]

How am I a troll PBEA? How about you can message me and I can give you names and references for the OD's I shadow. They are legit and I have better things to do in my life than to make things up on an internet forum. Are you talking about my infamous post in the allied health section about DrNP programs that everyone dislikes b/c of this and that. Well if you are b/c I was accepted to Nova's BSN program and was planning on becoming a NP I was interested in hearing your guys opinions on the new "doctoral" degree. All I got was grief about it and my intentions were not to degrade medical doctors. I have become interested in optometry now as I never thought about becoming a OD. I am entitled to change my major a few times. Please grow up before stating things like "hes a troll" so that my posts are discredited. Thank you very much....

 

[stevec]

Prescribing oral meds is legal for ODs in SC. My dad prescribes stuff. As far as checking for side effects and examing the rest of the body, I don't think ODs prescribe anything hardcore enough for that to really matter. He knows the side effects of the drugs if any and knows what other meds they are taking and any allergies they might have. My answer probably sucks, but that's the best I can do right now.

 

[cpw]

there are only about 10 states in the US that you CAN'T Rx oral meds (at least on limited forumulary) Florida is one of them.

 

[cpw]

Prescribing oral meds is legal for ODs in SC. My dad prescribes stuff. As far as checking for side effects and examing the rest of the body, I don't think ODs prescribe anything hardcore enough for that to really matter. He knows the side effects of the drugs if any and knows what other meds they are taking and any allergies they might have. My answer probably sucks, but that's the best I can do right now.

um... you ask the patient about side effects. And in some states, like NC, you can prescibe anything. So, you do have to know side effects and have to look for them. (no matter what state you practice in) MANY drugs have ocular side effects you're going to have to know. You also should know drug side effects to make sure your patients internists aren't double dosing them. (which is a possibility for someone with lots of systemic issues seeing multiple docs)

 

[PharmDr.]

thanks guys for your replies. Just curious, what if the OD prescribes a corticosteroid in the glucocorticoid class like methylprednsolone for uvetitis or episcleritis not responding to topical therepy. How do you check for adverse reactions like osteoporosis, diabetes mellitus, or increased sodium and water retention, increased potassium excretion...the list goes on. Also, since this medication inhibits the immune response, it can mask the signs and symptoms of other serious infections occuring at the same time. I can see how a OD can ask about any side effects they are having such as insomia, but how do you check for the serious side effects listed such as intestinal perforation?

 

[Richard_Hom]

thanks guys for your replies. Just curious, what if the OD prescribes a corticosteroid in the glucocorticoid class like methylprednsolone for uvetitis or episcleritis not responding to topical therepy.."QUOTE]

1. Episcleritis is a self-limiting clinical entity that rarely needs systemic corticosteroid therapy.

2. Intractable uveitis is best treated from the underlying systemic condition which is the province of the PCP or the rheaumotologist/immunologist. More serious uveitis wouldn't necessarily benefit from oral steroid therapy

3. Side effects for all medications are monitored by either physical examination or laboratory studies or both. Most,if not all optometrists can perform these procedures or order and interpret these lab studies.

4. I believe that your notion of optometric education and skill level requires an update.

Richard

 

[PBEA]

How am I a troll PBEA? How about you can message me and I can give you names and references for the OD's I shadow. They are legit and I have better things to do in my life than to make things up on an internet forum. Are you talking about my infamous post in the allied health section about DrNP programs that everyone dislikes b/c of this and that. Well if you are b/c I was accepted to Nova's BSN program and was planning on becoming a NP I was interested in hearing your guys opinions on the new "doctoral" degree. All I got was grief about it and my intentions were not to degrade medical doctors. I have become interested in optometry now as I never thought about becoming a OD. I am entitled to change my major a few times. Please grow up before stating things like "hes a troll" so that my posts are discredited. Thank you very much....

liar, liar, set your pants on fire

 

[PharmDr.]

I was not aware that OD's can order and interpret lab results. That would answer my questions pretty well. Im just learning about the optometry profession and I like hearing it from people like you Dr. Hom. I would like to know more about OD's ability to manage patients in these instances. Are you a practicing OD also PBEA? I am opened eared to hear your side of the optometry profession but just dont want you to feel as though I am "insulting" your profession as I am not.

 

[rpames]

ODs are trained to asses the entire body. We are not going to check someone prostate or give breast exam, but we can check you out. Don't got me wrong and think I'm saying we are fully trained to give a physical, but we can check out what we need to.

Just last week we learned how to give the "mini-mental status" exam, of course a 5 year old could do it. We also did a full Cranial Nerve exam and the Rinne & Weber Test. This next week we will learn how to test the motor system, coordination/gait/equilibrium, reflexes, and sensory system. We will be studying many other diagnostic testing through out the quarter.

As far as checking out someones labs...we can send them out for testing and get the results sent to us. We look at the levels and if they off and we can't fix it by removing them from the drugs we put them on, we will send them to an internest.

We are better trained than most think.