But I’m Just a Tech!!

Pharmacy Shenanigans from the Technician’s point of view.

Another Cox-2 withdrawn from the Canadian market

Filed under: Uncategorized — justatech at 9:13 pm on Friday, October 5, 2007

Prexige (lumiracoxib)… released not all that long ago, has already been withdrawn from the Canadian market. I read the Health Canada warning about it, but since I am not in the position to make judgements, I can simply say, the company issued recall that we got said “not due to safety concerns–quality issue”. The recall issued by Health Canada says it has withdrawn market authorization.

The decision to withdraw market authorization for Prexige follows a review of additional safety information submitted by the drug manufacturer, Novartis Pharmaceuticals Canada Inc. The information was requested after Prexige was removed from the Australian market in August 2007, following reports of serious liver adverse events that were linked to the drug at doses of 200 mg and 400 mg daily. The experience of other international regulators is a potential source of safety signals for new drugs when the Canadian real world safety information is limited.

As a result of its review, Health Canada has concluded that the risk of serious liver-related adverse events with Prexige cannot be safely and effectively managed at the 100 mg daily dose.

I wonder if the pharmaceutical companies are releasing these medications far too quickly to accurately judge whether or not they are safe. This is the third Cox-2 inhibitor that has been withdrawn…along with Vioxx (rofecoxib) and Bextra (valdecoxib). Celebrex (celecoxib) has recently been changed from a drug that is freely covered by most drug plans, to a special authorization medication because of higher incidents of heart related issues. Do the benefits of this class of drug outweigh the contras?? As one who doesn’t suffer any type of joint pain…and a technician without the full knowledge of how the drugs work, I couldn’t say.

On a side note..we have all heard the sayings “for every doctor there is a pharmacist out there who saves his ass” and “for every pharmacist there is a tech who saves his ass”…. I was that tech today. We had an rx brought in today for levaquin 1QID X40. A pharmacist typed up the rx. I went to count it and said “WHOA!! Levaquin four times a day??? That’s not normal!! Can they do that??” to which a second pharmacist replied” I’ll call the doctor back.” Sure as shootin’, the doc wanted once a day dosing for 10 days. I think if I hadn’t caught it and counted out 40 and moved it down the line (back to the same pharmacist who had typed it up) and let them check it.. the patient would have walked out the door with the wrong amount of medication (and a HUGE bill to boot). I saved a few asses today. <pats self on back>


2 Comments »

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Comment by Shalom

October 10, 2007 @ 1:14 pm

Re: the ass you saved… One pharmacist I know got in trouble for something like this, but it wasn’t entirely his fault. The prescription was for one of the QD fluoroquinolones (I think Tequin) and was in fact written correctly: the sig read “tab i QD PC”. He entered that into the computer, which expanded the shorthand for him. Problem is that on this particular system, “PC” expands to “after meals”. Note that last letter. The patient saw “Take one tablet every day after meals”, and misinterpreted that to mean after *every* meal. So she took three a day, and experienced adverse effects therefrom.

So whose fault is that? Partly the patient’s, partly the guy who programmed the computer, and partly the pharmacist’s for not catching that, although it apparently didn’t occur to him that someone would interpret the sig that way. I guess they’ll have to let the lawyers decide that one.

(Personally I don’t like using the shorthand, except for simple things like “1TQD” or “1DTID”, etc. I’ve seen techs scratching their heads over the documentation, trying to build a complex sig, and asking me what’s the sig code for “before breakfast” or something. Why not just write it out? Last time I tried building a sig that way, I put “I1-2PQIDPRNAS”, which I thought would get me “Inhale 1 to 2 puffs four times daily as needed for asthma”. Unfortunately “asthma” on that system was `AT’, so the sig read “… as needed in left ear.” Good thing I caught that before hitting print.)

You always have to assume that you’re filling a prescription for Amelia Bedelia, and make things as unambiguous as possible. Look at the sig cockeyed, saying “How (many ways) can this possibly be misinterpreted?” and then reword it so it can’t.

(You remember her, the maid who took everything literally. “Dust the furniture” resulted in furniture covered in dusting powder, and when they asked her about that, she said something like “Well, if you wanted me to undust the furniture, why didn’t you say so.”)

Shalom (it’s “AJ”, for ante jentaculum, by the way)

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Comment by pharmgal

October 11, 2007 @ 1:43 pm

Good save! That patient’s tendons thank you (I will speak for them as you saved them from rupturing). - pharmgal

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