Patients can't pronounce drug names

Discussion in 'Emergency Medicine' started by docB, Apr 28, 2004.

  1. docB

    docB Chronically painful
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    One thing ER docs have to put up with is seeing patients on every conceivable drug, often at the same time. If you're an interinst or an FP and you put your patients on Zocor and don't use Lipitor you'll see patients on Zocor. When I see patients they're on everything. I even have to put up with some people who see docs trained while the Earth cooled that use MAOIs and TCAs (Hi Dr. Dinosaur, your depressed patient just took the 6 months worth of Elavil you gave her. Which pulmonologist would you like me to call to run the vent for you?). But I digress. Have you ever noticed how many patients mispronounce drugs in certain ways? Here's a list:
    atenolol = at-en-ol
    keflex = kee-flex
    fioricet - fire-o-cet
    acetaminophen - act-o-min-fin
    There's probably a lot of regional variation. Note that I'm not even listing the one's like phenobarbital = peanut butter balls.
    Anyway, just an observation.
     
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  2. roja

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    :laugh: :laugh:
     
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  3. mikecwru

    mikecwru M.D. = Massive Debt
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    Most of my patients can't even name the drugs they're on ("they's in the computer") but they mispronounce diseases all the time. One thing I have noticed is that dilaudid and demerol don't easily roll off the tongue. ("That medication... it's the only one that worked.... it began with D.")

    mike
     
  4. Apollyon

    Apollyon Screw the GST
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    Well. "vasoretic" for Vasotec - until I found out there WAS a "Vasoretic" - so now I don't know!

    However, there is a rule I've deduced - if the patient has something rare and/or squirrelly, they'll know it when they hear it, even if they can't say it totally right (like G6P-D or von Willebrand's or TTP, when you start to say it out). I tell them, "if I say it, and you have it, you'll know it. If it sounds like totally nothing or garbled, you don't have it." It hasn't burned me - yet.
     
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  5. Samoa

    Physician Pharmacist 10+ Year Member

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    soamers=Soma (carisoprodol)
     
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  6. jpgreer13

    jpgreer13 Senior Member
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    In my ED, Dilaudid and Demerol (and Percocet) certainly seem to roll easily from the tongue.

    I find that my patients, as a rule, generally don't know squat about their medical histories and that generally the LAST person you want to ask about a patient's medical history is that patient. It's a conversation I have about six times a shift, in general:

    "So, sir (or ma'am), what medications are you on?"
    "I can't call 'em all. There's a sugar pill and somethin' for my high blood and I take some other 'uns."
    "Can you remember their names at all?"
    "Well, one of 'em is pink with a little white stripe on it. What one is that?"
    "Okay. What medical PROBLEMS do you have?"
    "Um, well, I got the sugar, I think, and my pressure's up. I had some surgery too but I don't know what they did, heh, heh."
    "So who is your doctor?"
    "Oh, I see Doctor (random name) in (pick a town that is at least 30 minutes away from Greenville)."
    (now I'm turning red, and steam is about to whistle from my ears and I'm choking back...urge...to...kill...)
    "So...why did you come...all the way here...instead of going to your local...hospital where all your...records are??!?!?"
    "Well, ever'body just says this place is so good I thought I'd come here. Can I get me something to eat?"
     
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  7. MasterintuBater

    MasterintuBater Senior Member
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    :laugh: :laugh: :laugh:
    Yes, my favorite diagnoses by the poor historians are:
    "I got the suga' and the high blood"
    I also think it's hilarious when patients try to sound smart by trying to say what HCTZ stands for. I think 1/100 gets it right. I've had several say that their high blood pressure med also has hydrocortizone in it.
    I also had an ATTENDING who repeatedly referred atenolol as atenetol. It drove me NUTS...not just that he was saying it wroing, but that I felt uncomfortable correcting him. It was like he had mustard on his chin for a month and I couldn't tell him about it.
     
  8. NE_Cornhusker1

    NE_Cornhusker1 12" Member
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    esp. those who are in the er (with no real medical prob. but w/ an addiction issue) who are looking for narcotics.
     
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  9. jpgreer13

    jpgreer13 Senior Member
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    Indeed. Those who like the Dilaudid, I have found, generally ask for it by name.
     
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  10. Harrie

    Harrie Senior Member
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    Yeah, I had a patient who would swear that the nurses gave him hydrocortisone for pain. When I told him that it was hydrocodone, he told me that I was wrong...I gave up after that.
     
  11. beriberi

    beriberi Senior Member
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    I say stupid things that are entirely wrong when talking about my car, my plumbing, my legal needs all while having a poor understanding of my computer security needs.

    I think it is quite silly to give ourselves a pat on the back for knowing more about Medicine and medicines that out patients do. If patients don't know what pills they are on, or why, part of the blame lies with the practitioner who prescribes.

    I remember when I first started a chronic medication as a teenager, I was told that I would need to know the name of my type of medication. My physician made it clear that if I had any problems or questions, the first thing I would need to tell them is the name of my prescription. We went over this many times. I remember the name still.

    Honestly, in the ED (or the floors) it is really not that important which sugar pill someone is on. Don't you treat hyperglycemia/hypoglycemia with sliding scale insulin and then discharge them on home meds? (Maybe not EBM, but the only way I have seen DM managed.)

    Congratulations to all of you for learning how to pronounce medication names while in medical school. The stupid patient stories are funny, but the contempt that people seem to hold less educated patients in is a bit over the top.
     
  12. southerndoc

    southerndoc life is good
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    We've always tried to maintain patients on their previous medicines.
     
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  13. FoughtFyr

    FoughtFyr SDN Lifetime Donor
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    Wow, hope she never finds the "What I've learned from my patients" thread.

    - H
     
  14. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    Well, yes. I sound downright ig'n'rint when I talk about engineering, classical music, and frankly, much of medicine. But I haven't encountered any actual contempt from anyone, despite the dumb stuff I've said, and my experience is that I'm given less slack because I supposedly have a basis for understanding this stuff.

    So when we laugh at the funny pronunciations of drug names, I'd like to respectfully submit that there might be other motivations than "let's laugh at the uneducated."

    When medical people step away from the people they're taking care of, they blow off steam and swap tales like these partly as a way of saying, "can you believe all this weird crap we know?" It's a way of gently acknowledging that we are ourselves an odd bunch, with reams of arcane info in our heads that a normal person would never know.

    I'm just saying, calling attention to the knowledge gap between clueless sick people and medi-nerds doesn't only make fun of the clueless sick person side of the equation.

    Also, "peanut butter balls." Hee hee hee.
     
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  15. Reg

    Reg Junior Member
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    I have so many similiar stories to add...

    Patients who have medical problems (hell, people in general for that matter) should have some personal accountabiliy. If you've had surgery, you should know what kind (period). If you have medical problems (or are on meds) you should know what kind. If you have to write it down...or get the doc to write them down...do it. To come into the ER knowing nothing, but demanding a med refill...is just...stupid. And these people are very frustrating. And sharing stories help diffuse the frustrations we all feel.

    But there is a line to be drawn. And "making fun" of patient's because of their ignorace with regards to the medical field is wrong. So far, it seems that people are primarily joking about the former.

    "they's in the computer"

    "I got the suga' and the high blood"


    But the incorrect grammer, I think, creeps mightly close that that line.
     
  16. spyderdoc

    Physician Moderator Emeritus Lifetime Donor Verified Account 15+ Year Member

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    Oh stuff it beriberi. We are all just getting a laugh...
     
  17. jpgreer13

    jpgreer13 Senior Member
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    Just right off hand, it matters to me if someone comes in with a complaint of hypoglycemia, gets a charge of D50, perks up and then can't even get close to the name of his "sugar pill" and I can't tell whether it's a long-acting sulfonylurea or it's something like acarbose, and it makes his disposition a lot harder. Or let's say my patient comes in bradycardic - it is because his "high blood" pill is a new beta blocker that he's going to metabolize and recover from in a matter of hours if he stops it, or is his med HCTZ and he's got something more sinister going on?

    Perhaps we, or our primary care colleagues, or both, are missing the boat on educating our patients about the importance of knowing these things, or writing them down if you can't remember them well, or even wearing those alert bracelets if you have a significant medical condition that you can't remember you have. Health care is a team effort, and while we have lots of medical education and resources, we need at least a modicum of participation in the process from our patients to be effective. That's what makes it frustrating.
     
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  18. jws1911

    jws1911 New Member

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    Are you all serious???? You're mad at beriberi for pointing out that you're all being a bunch of pretentious a-holes? Boy, I can't wait for one of you to be my doctor! How many of you would have so many funny jokes to tell if you had to crack them in your patients' presence? In fact, what's the point of even taking care of patients if you have such contempt for them? Take your gigantic brains and use if for something you really care about and let the people who give a d**n (such as beriberi) take care of patients. Surely you can figure out a way to inflate your egos without involving sick people.
     
  19. mikecwru

    mikecwru M.D. = Massive Debt
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    I guess we could make fun of you.
     
  20. GCS:3

    GCS:3 Allegheny grad
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    My favorite was this OBVIOUS drug seeker. You know, the one whose orthopedist is on vacation:
    Pt: "I'm allergic to all them NSAIDs"
    Me: "So what do you take?"
    Pt: "Well, I was on that Vicodan, but now I'm allergic to that, too."
    Me, a bit more sarcastically: "Wow, you seem to be allergic to a lot of medicines"
    Pt: "Listen up doc, I ain't got time for this crap. I'm on the big stuff now."
    "And what is that?"
    Pt: "All I take is morphine. Oral morphine. That's it. You gonna give it to me or not?"

    He left empty handed and angry.
     
  21. jpgreer13

    jpgreer13 Senior Member
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    All I EVER want is Dilaudid. I want a PCA with no lockout. I'm allergic to all oral meds, in fact.
     
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  22. docB

    docB Chronically painful
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    This thread was started to point out that patients seem to use some common mispronounciations. As it evolved it morphed into a discussion of how much ER docs are frustrated by patients who don't care enough about their own health to know their meds and histories. I and all of my colleagues are fine with a list carried by the patient if they can't remember. The fact is that when they don't know anything I have to guess. If they were on Dig and didn't know it and I admit them they will no longer be on Dig. That's suboptimal.
    As for contempt, do I have contempt for some of my patients? Yes. Do I still treat them to the best of my ability? Yes. We all do this despite their conditions being induced by poor choices. When they do stupid things, come to my ER, can't give me any info about their history or meds and say fix me or I'll sue you, I get mad. This board provides a decompression chamber just like the break room at the ER and the kitchen at the fire hall. I, and many others have said unkind things about patients here to blow off steam. It is annomyous, harmless and totally appropriate.
     
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  23. mikecwru

    mikecwru M.D. = Massive Debt
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    If you think about it, most of the stuff we die from in America is our own fault: we eat too much, drink too much, smoke too much crack, piss off the person with the bigger gun, bang the wrong people, drive unsafely, smoke cigarettes. It's not like we're dying of infectious diseases because we have unclean water, etc. The homeless people in this country have it way better than a lot of third world countries.

    Emergency Medicine --- fighting Darwin one day at a time.

    mike
     
  24. spyderdoc

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    :sleep: Laughing is a great way to reduce stress. Better than beating the spouse, eh? The venting has to occur...might as well be laughter. :laugh:
     
  25. Neuron

    Neuron Aequanimitas.
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    There are 1,339,704 individual posts on this board, made over many, many years.

    They are intelligent, insightful, warm, funny, sad, stupid, silly. Some are angry and hateful. A few are astonishingly arrogant, the products of such blustering bragadocio, such smug self-righteous priggishness that you cringe to think these anonymous thoughts might have come from that resident you consulted yesterday, that medical student you taught last week. Our friends. Our colleagues.

    A lot of this may be "blowing off steam", as someone here put it. And if that is what it is, coming from people who do their best after studying for many years to become something so different than what they first dreamt, maybe that is good. Maybe that is OK.

    Maybe it is OK to make fun of patients who never went beyond the 3rd Grade when they call zyprexa ze prickers. Maybe it is "totally appropriate" to get angry at the not very intelligent who knew they went for some type of surgery, but don't know what it was. Certainly the highly educated surgeon who did that surgery must have sat down with her, and, holding her hand, had an hour long discussion with her about what it was, explaining it gently in terms she could understand, being there with her emotionally and intellectually when she hadn't the wits about her to decide. Surely he did. Surely she should know.

    The crux, I suppose, is this: we can say one thing, and do another. Can't we? "We are professionals". We can say that that patient is not worth 2 minutes of our time, but still "treat them to the best of my ability". We can call them names (behind their backs of course), but save their lives the very next minute. Despite their not really deserving it. Because we are good. We are great and good.

    We should pat ourselves on the back. We should.
     
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  26. docB

    docB Chronically painful
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    Reread entire post without sarcastic tone and I'd agree completely.
     
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  27. MasterintuBater

    MasterintuBater Senior Member
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    I think we all agree that anonymous "patient-bashing" is just a coping strategy to blow off steam. But for those who think that this is inappropriate or hypocritical, I'd like to know what your better coping strategies are for decompressing from the kind of patients we are discussing. Hopefully you have something better than "SERENITY NOW!"
    For me, venting like this is harmless and benign....doesn't hurt my patients, doesn't hurt you, doesn't hurt me....seems like a decent way to blow off steam while feeling some comraderie and support from others having the same experiences as me.
     
  28. girlwithaknife

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    I wonder whether beriberi, jws1911, and neuron would rather see us decompress in front of our patients. Maybe we are being cruel, but if so, this is the forum for it. I think very few people would find it appropriate to express these thoughts out loud to our patients. No, it's not fair to make fun of people for being less educated and less intelligent than we are. It's also not fair to allow people to continually abuse the health care system and the medical personnel who are trying to care for them by not making an iota of an effort to participate in their own care.

    Maybe we have done a poor job of educating people about their medications and what is important in their medical histories. However, plenty of people out there can at least carry a list of their meds and allergies in their wallet. What do they know that everyone else doesn't know?
     
  29. DrQuinn

    DrQuinn My name is Neo
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    hahaha. "bang the wrong people..."

    :smuggrin:
    Q, DO
     
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  30. Homunculus

    Homunculus SDN Caveman Administrator
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    what's even more funny than patients mispronouncing drug names is medstudents doing it, lol. at least patients have an excuse :)
     
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  31. tabasco

    tabasco Member
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    There are a lot of uptight people with no sense of humour all over the place. It looks like quite a few gathered here. Fortunately, I can almost bet they aren't into emergency.

    The main point these people are missing is that the most of the laughing posters aren't laughing at the patients. They are laughing at the mispronounced names - and they are funny - they are laughing at the ridicule of the situation, and they are laughing at themselves and the way the deal with it.

    I agree with those that said that this is the place to vent. Laughing is harmless, healthy and restoring. Laughing at the bad things that happen help you get over them and get up again the next morning. Laughing at yourself teaches you to do better next time. Laughing at awkward situations makes them easier to bear. FYI, humour is a superior coping mechanism of the ego, up there with altruism. Unfortunately, some people are lacking it.
     
  32. Dr JPH

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    You want to make fun of ME now. Totally inappropriate and uncalled for. I know less than you and you want to use me to get your jollies.

    I outta stuff my foot, with tibula and fibia included, up your butt.
     
  33. docB

    docB Chronically painful
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    Send me the xray of that one. I can add it to my portfolio of rectal foreign bodies.
     
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  34. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    Yes!! Another inappropriate form of humor!
     
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  35. Caverject

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    We get them too in pharmacy...

    Rintintin = Ranitidine
    Glybirdie = Glyburide


    Here is an image for you

    [​IMG]
     
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  36. docB

    docB Chronically painful
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    Cool. I'll file that in my HLNAFOS file (Hanging Lamp Naked And Fell On Something).

    Why do patient's always call it "sugar diabetes." Are PMDs calling it this. Is there a big problem with diabetes insipidus patients being treated for regular diabetes.

    Another fun conversation is to try to figure out what a patient means by "I had 3 bypasses." Did they have 3 operations or 3 vessels. Or did they have 2 vessels once and then another vessel. They always seem offended when I don't care how many vessels. I only care about when it was done.

    For the self rightous out there I point out that I appreciate that the patient knows that they had a surgery and what it was for.
     
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