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	<title>Comments on: Another Cox-2 withdrawn from the Canadian market</title>
	<atom:link href="http://justatech.blogpharm.com/2007/10/05/another-cox-2-withdrawn-from-the-canadian-market/feed/" rel="self" type="application/rss+xml" />
	<link>http://justatech.blogpharm.com/2007/10/05/another-cox-2-withdrawn-from-the-canadian-market/</link>
	<description>Pharmacy Shenanigans from the Technician's point of view.</description>
	<pubDate>Wed, 07 Jan 2009 07:02:43 +0000</pubDate>
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		<title>By: pharmgal</title>
		<link>http://justatech.blogpharm.com/2007/10/05/another-cox-2-withdrawn-from-the-canadian-market/#comment-221</link>
		<dc:creator>pharmgal</dc:creator>
		<pubDate>Thu, 11 Oct 2007 20:43:13 +0000</pubDate>
		<guid isPermaLink="false">http://justatech.blogpharm.com/2007/10/05/another-cox-2-withdrawn-from-the-canadian-market/#comment-221</guid>
		<description>Good save!  That patient's tendons thank you (I will speak for them as you saved them from rupturing).  - pharmgal</description>
		<content:encoded><![CDATA[<p>Good save!  That patient&#8217;s tendons thank you (I will speak for them as you saved them from rupturing).  - pharmgal</p>
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		<title>By: Shalom</title>
		<link>http://justatech.blogpharm.com/2007/10/05/another-cox-2-withdrawn-from-the-canadian-market/#comment-211</link>
		<dc:creator>Shalom</dc:creator>
		<pubDate>Wed, 10 Oct 2007 20:14:51 +0000</pubDate>
		<guid isPermaLink="false">http://justatech.blogpharm.com/2007/10/05/another-cox-2-withdrawn-from-the-canadian-market/#comment-211</guid>
		<description>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)</description>
		<content:encoded><![CDATA[<p>Re: the ass you saved&#8230; One pharmacist I know got in trouble for something like this, but it wasn&#8217;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 &#8220;tab i QD PC&#8221;. He entered that into the computer, which expanded the shorthand for him. Problem is that on this particular system, &#8220;PC&#8221; expands to &#8220;after meals&#8221;. Note that last letter. The patient saw &#8220;Take one tablet every day after meals&#8221;, and misinterpreted that to mean after *every* meal. So she took three a day, and experienced adverse effects therefrom.</p>
<p>So whose fault is that? Partly the patient&#8217;s, partly the guy who programmed the computer, and partly the pharmacist&#8217;s for not catching that, although it apparently didn&#8217;t occur to him that someone would interpret the sig that way. I guess they&#8217;ll have to let the lawyers decide that one.</p>
<p>(Personally I don&#8217;t like using the shorthand, except for simple things like &#8220;1TQD&#8221; or &#8220;1DTID&#8221;, etc. I&#8217;ve seen techs scratching their heads over the documentation, trying to build a complex sig, and asking me what&#8217;s the sig code for &#8220;before breakfast&#8221; or something. Why not just write it out? Last time I tried building a sig that way, I put &#8220;I1-2PQIDPRNAS&#8221;, which I thought would get me &#8220;Inhale 1 to 2 puffs four times daily as needed for asthma&#8221;. Unfortunately &#8220;asthma&#8221; on that system was `AT&#8217;, so the sig read &#8220;&#8230; as needed in left ear.&#8221; Good thing I caught that before hitting print.)</p>
<p>You always have to assume that you&#8217;re filling a prescription for Amelia Bedelia, and make things as unambiguous as possible. Look at the sig cockeyed, saying &#8220;How (many ways) can this possibly be misinterpreted?&#8221; and then reword it so it can&#8217;t.</p>
<p>(You remember her, the maid who took everything literally. &#8220;Dust the furniture&#8221; resulted in furniture covered in dusting powder, and when they asked her about that, she said something like &#8220;Well, if you wanted me to undust the furniture, why didn&#8217;t you say so.&#8221;)</p>
<p>Shalom (it&#8217;s &#8220;AJ&#8221;, for ante jentaculum, by the way)</p>
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