What would you guys have done in this situation?

[twester]

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I'm an intern at Walgreen's. As I was selling a pt a script for cephalexin, a DUR popped up. I asked the pharmacist to look at it and he told me to advise the patient to stop the medication if he "itched" since the patient was "allergic" to penicillin.

I didn't think to second-guess him, but looked it up when I got home. It turns out cross-reactions are possible. I have an image in my head that I helped send someone straight down the road to anaphylaxis.

I did describe anaphylaxis to the patient and told him to seek immediate medical attention if it happened. Did I do my job properly?

 

[Doctor M]

I'm an intern at Walgreen's. As I was selling a pt a script for cephalexin, a DUR popped up. I asked the pharmacist to look at it and he told me to advise the patient to stop the medication if he "itched" since the patient was "allergic" to penicillin.

I didn't think to second-guess him, but looked it up when I got home. It turns out cross-reactions are possible. I have an image in my head that I helped send someone straight down the road to anaphylaxis.

I did describe anaphylaxis to the patient and told him to seek immediate medical attention if it happened. Did I do my job properly?

Cross reactivity is like 5-7%. And why would you second guess him? This occurs a few times a day and the patient is always counseled. You did the right thing by counseling but patients usually tolerate cephalexin pretty good.

 

[ZpackSux]

I'm an intern at Walgreen's. As I was selling a pt a script for cephalexin, a DUR popped up. I asked the pharmacist to look at it and he told me to advise the patient to stop the medication if he "itched" since the patient was "allergic" to penicillin.

I didn't think to second-guess him, but looked it up when I got home. It turns out cross-reactions are possible. I have an image in my head that I helped send someone straight down the road to anaphylaxis.

I did describe anaphylaxis to the patient and told him to seek immediate medical attention if it happened. Did I do my job properly?

Yup... but 16 years in Pharmacy and 12 years as a pharmacist, I think I can count with one hand where patient who is allergic to PCN had a cross sensitivity to cephalosporin...even though the literature says 5 to 15%...

 

[twester]

Yup... but 16 years in Pharmacy and 12 years as a pharmacist, I think I can count with one hand where patient who is allergic to PCN had a cross sensitivity to cephalosporin...even though the literature says 5 to 15%...

Thanks for the quick replies. I feel better. I probably second-guessed just because of the pharmacist's personality, my own noob-ness and the craziness of this particular location.

 

[Doctor M]

Thanks for the quick replies. I feel better. I probably second-guessed just because of the pharmacist's personality, my own noob-ness and the craziness of this particular location.

No sweat...thats what were here for...🙄

 

[ZpackSux]

No sweat...thats what were here for...🙄

chit...we're hear for threadjack!

 

[Doctor M]

chit...we're hear for threadjack!

muuaahhhh

 

[Doctor M]

the alcohol is wearing off. Im a light wieght

 

[twester]

the alcohol is wearing off. Im a light wieght

Your liver thanks you for locking the liquor cabinet and throwing away the key.

 

[Doctor M]

Your liver thanks you for locking the liquor cabinet and throwing away the key.

I had 1, one, uno, glass of wine. One, not two, one glass of wine and i was loopy for a good hour. Now Im wide awake. More

 

[twester]

The thread is yours. I got my question answered. Open another bottle... 🙄

 

[Doctor M]

The thread is yours. I got my question answered. Open another bottle... 🙄

ehh, im tired again.

 

[ZpackSux]

ehh, im tired again.

what a wuss..

 

[Doctor M]

what a wuss..

im still up...👎

 

[twester]

ehh, im tired again.

Obviously... The extended right pinkie is a real ATP-burner.

Sorry, I never learned not to criticize a drunk's typing skills. 😉

 

[Doctor M]

Obviously... The extended right pinkie is a real ATP-burner.

Sorry, I never learned not to criticize a drunk's typing skills. 😉

not drunk...one glass of wine...just sleepy again... until later today...lata...yeah, im a wuss😀

 

[tussionex]

wish i had been drunk all night posting....once again, just say no to double shifts!

ps - to the OP, we have a policy to NOT call the MD in the case of cef's for PCN-allergic patients. and the risk decreases also as you go up in cef generations.

 

[ForcedEntry]

Why the hell wasn't I informed of this sooner?

 

[cycloketocaine]

Yup... but 16 years in Pharmacy and 12 years as a pharmacist, I think I can count with one hand where patient who is allergic to PCN had a cross sensitivity to cephalosporin...even though the literature says 5 to 15%...

I'm allergic to both, and am also allergic to quinolones. It made for a fun time when I got my wound infection....🙄

 

[Doctor M]

I'm allergic to both, and am also allergic to quinolones. It made for a fun time when I got my wound infection....🙄

that sucks! my grandmother would have recommended to rub some butter on it. that was her remedy...rub some butter on it.

 

[alwaystired]

that sucks! my grandmother would have recommended to rub some butter on it. that was her remedy...rub some butter on it.

i had a patient tell me how he was putting honey on his wound 😱

 

[cycloketocaine]

that sucks! my grandmother would have recommended to rub some butter on it. that was her remedy...rub some butter on it.

I would have had to rub a LOT of butter on it....the wound was down to the fascia.

 

[Doctor M]

i had a patient tell me how he was putting honey on his wound 😱

Actually I heard Honey has some antimicrobial activity or something like that. Saw it on the animal channel on Emergency vet.

 

[Doctor M]

I would have had to rub a LOT of butter on it....the wound was down to the fascia.

Be sure to use real butter, not the "I cant believe it's not butter" crap! j/k. What were you given?

 

[no-see-um]

 

[cycloketocaine]

Be sure to use real butter, not the "I cant believe it's not butter" crap! j/k. What were you given?

Tigacycline and Flagyl. And lots of it.