This is sad.

[MountainPharmD]

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http://drugtopics.modernmedicine.co...Article/detail/576665?contextCategoryId=47443


In many ways but specifically this quote:

Long did offer a bit of good news for the industry, including the growth of anti-psychotic and anti-seizure medications. Sales of anti-psychotic pharmaceuticals grew by 14 percent in 2008....

The good news is we are selling more anti-psycotics?...awsome....👎

 

[All4MyDaughter]

Yeah, because they are prescribing them for so many other conditions now. One of my classmates got Seroquel to help her sleep.

 

[WVUPharm2007]

That's just cuz I got prescription drug coverage this year...

 

[MountainPharmD]

Yeah, because they are prescribing them for so many other conditions now. One of my classmates got Seroquel to help her sleep.

Honestly....thats all I ever see it prescribed for.

 

[meister]

How do you know what these are prescribed for? Do you really ask every single patient about their diagnosis? Just curious.

 

[BMBiology]

Antipsychotic for sleep? Man, you are going to loss some sleep when you gain 5 pounds from quetiapine.

 

[WVUPharm2007]

How do you know what these are prescribed for? Do you really ask every single patient about their diagnosis? Just curious.

Well..if its prescribed qHS.....usually its for sleep...though not always...

 

[BMBiology]

Well..if its prescribed qHS.....

It is prescribed bid or qhs so qhs may mean that the psychotic pt may have trouble sleeping at night or to avoid drowsiness/orthostasis hypotension during the day time. But if the patient is not psychotic, then another drug may be more appropriate for sleep. It is like 2 birds with 1 stone.

 

[PumpkinSmasher]

How do you know what these are prescribed for? Do you really ask every single patient about their diagnosis? Just curious.

Just masters of deduction, if it is being dosed just in evening and not 2-3 times/day then most likely using it to help with sleepy time.😉

 

[All4MyDaughter]

and because a lot of doctors write the sig like so: take one qhs for sleep 😛

 

[Hels2007]

And for sleep it's typically very low doses. Such as Seroquel 25mg 1/2 tablet qhs prn sleep...

 

[aboveliquidice]

One of my first questions is "why has your physician prescribed this for you?"... That doesn't have to be my first question - but I'm nosey 😎

~above~

 

[MountainPharmD]

How do you know what these are prescribed for? Do you really ask every single patient about their diagnosis? Just curious.

Yes....In case you were unaware that’s what we do. Is called patient counseling. You may have heard of it. You know making sure the patient understands what they are getting, how they are to take it and major side effects to look for. Stuff that 90% of the time the doctor fails to mention when they write the prescription.

 

[MountainPharmD]

One of my first questions is "why has your physician prescribed this for you?"... That doesn't have to be my first question - but I'm nosey 😎

~above~

That is not being nosey at all. That is also my first question when counseling a patient. Especially on a med that has multiple indications. You would be surprised how many times I get a blank stare or a "I don't know he just wrote and didn't say anything."

You only make this mistake once. "Sir the medicine the doctor has prescribed for you is typically used as an antidepressant...." The patient proceeds to blow up and refuse to take the medication because he is not depressed but has diabetic neuropathy, fibromyalgia or anxiety. With antidepressants and antipsycotics I always start my counseling very carefully.

 

[meister]

Yes....In case you were unaware that’s what we do. Is called patient counseling. You may have heard of it. You know making sure the patient understands what they are getting, how they are to take it and major side effects to look for. Stuff that 90% of the time the doctor fails to mention when they write the prescription.

Well maybe I just worked in a terrible pharmacy (we didn't have interns or new grads who actually cared about doing well or caring for patients) but my pharmacists rarely ever asked anyone why they were prescribed something, and very often didn't consult.

 

[WVUPharm2007]

Well maybe I just worked in a terrible pharmacy (we didn't have interns or new grads who actually cared about doing well or caring for patients) but my pharmacists rarely ever asked anyone why they were prescribed something, and very often didn't consult.

That's what's known as "typical."

 

[meister]

Yeah I know, but you'd never tell if you read SDN.

The dichotomy in this profession is unbelievable.

 

[Moxxie]

That is not being nosey at all. That is also my first question when counseling a patient. Especially on a med that has multiple indications. You would be surprised how many times I get a blank stare or a "I don't know he just wrote and didn't say anything."

You only make this mistake once. "Sir the medicine the doctor has prescribed for you is typically used as an antidepressant...." The patient proceeds to blow up and refuse to take the medication because he is not depressed but has diabetic neuropathy, fibromyalgia or anxiety. With antidepressants and antipsycotics I always start my counseling very carefully.

I've made sure to ask this question as well ever since I started counseling a mom about her 14-year old daughter's spironolactone, going over HTN info, etc, and she gave me this really scared look, saying, "But it's for her acne!" (I had asked the pharmacist why a 14-year old would be taking spironolactone, but she just shrugged it off).

 

[meister]

Maybe she was a M->F pre-op. 😱

 

[Glycerin]

Antipsychotic for sleep? Man, you are going to loss some sleep when you gain 5 pounds from quetiapine.

And lose even more sleep when you become a diabetic, orthostatic, and develop QT prolongation from quetiapine.

But to answer meister's question, as has been done before this post, usually if you see a dose for quetiapine 25mg po qhs (or some low-dose variation), it's a safe bet it's for sleep.

 

[Hels2007]

Spironolactone is commonly used for polycystic ovaries syndrome. Also, not uncommon to use low dose for acne if there is high testosterone level in girl's blood. So there are cases of young women taking spironolactone. I have seen as much as 50mg BID for that, but QD is more common.

 

[Moxxie]

Spironolactone is commonly used for polycystic ovaries syndrome. Also, not uncommon to use low dose for acne if there is high testosterone level in girl's blood. So there are cases of young women taking spironolactone. I have seen as much as 50mg BID for that, but QD is more common.

I'm not sure if this girl had PCOS, but the spironolactone definitely had an acne indication (25mg qd btw). This encounter occurred before I'd really had any endocrinology and had just finished a CV module, so all I could think was "aldosterone antagonist = antihypertensive." I learned my lesson not to assume that a med has a specific indication!

 

[meister]

Wow spironolactone can be indicated for PCOS? I didn't know that.

It's amazing how little knowledge I gained as a technician in six years.

 

[Glycerin]

Wow spironolactone can be indicated for PCOS? I didn't know that.

It's amazing how little knowledge I gained as a technician in six years.

So can metformin.

 

[Praziquantel86]

Go to www.soulcysters.com if you want to see some more fun facts about PCOS.

Evidently, a decent amount women with that condition are touting Soy as a replacement to their clomiphene therapy.

 

[Farmercyst]

Called a psychiatrist once because they wrote seroquel 1 tab prn qhs. We were wondering why you'd take an antipsychotic as needed😕 For sleep as mentioned, but it was weird seeing it as a prn script.

 

[meister]

So can metformin.

😱

Go to www.soulcysters.com if you want to see some more fun facts about PCOS.

Evidently, a decent amount women with that condition are touting Soy as a replacement to their clomiphene therapy.

So...metformin, spironolactone, and soy. Got it.