Pharmacists Greatest Nightmares
Bruce E. Onofrey, OD, RPh, FAAO
Lovelace Medical Center
Albuquerque, New Mexico
 Pharmacists HATE 2 things
Sloppy RX’s
Drug Interactions
 The Smoking Gun
 RX is a legal document
 PHARMACEUTICAL WEIGHTS AND MEASURES
METRIC
APOTHECARY
HOUSEHOLD
 WHEN COUNSELING PATIENTS BE SPECIFIC
 RX Samples
 CLINICAL PEARLS
Suspensions are excellent alternative for people that can’t take pills
Must know concentration
Note that a suspension must be shaken
Must give enough to cover 10 days dose
Note 10 day limit on acute vs chronic meds
No refills on acute meds
 CLINICAL PEARLS
LIST DOSAGE FORM-SUSPENTION
ENOUGH MEDICINE FOR 10 DAYS8 HOUR DOSE INTERVAL
PO = BY MOUTH
PUT TX DURATION IN INSTRUCTIONS-10 DAYS
NO REFILLS OF ACUTE MEDS
 OTC VS LEGEND DRUGS-WHICH ONES ARE MORE DANGEROUS
Document patient counseled on drug side-effects and contraindications and given
proper directions for a specific reason (DX)
Do not prescribe OTC in RX dose if not in your privileges-illegal/invalidates
malpractice insurance
 Name 4 potentially fatal Beta-blocker Adverse Effects
Adverse Effects
1. Asthma
2. Coronary insufficiency
3. Heart block
4. Depression
5. Impotence
Mechanism
 The Drug
Insulin
Epinephrine
Ca++ channel blockers
The Interaction
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What Does Chloramphenicol Have in Common with Diamox?
The answer will just kill you
Adverse effect
Mechanism
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What Dirty Little Secret does Sulfacetamide share with HCTZ, Diabenese,
Acetazolamide and Celebrex??
 Acetaminophen + alcohol
The Adverse effect?
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Never give a pregnant woman:
Never Give a Diabetic:
Which eyedrop can produce flashes and floaters?
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If You Prescribe Narcotics, let your patient know NOT TO:
Never Give an Oral Steroid to:
How to add insult to injury to your dry eye patients with allergies
If your patients has high blood pressure, don’t give them anything that ends
in D
Honest Officer, I didn’t Know that Keflex could kill a person
If You’re allergic to ASA never take:
If your patient has an angle closure glaucoma attack and has diabetes don’t
give them:
So Your patient says his heart medication is making his vision fuzzy-Just
change his glasses or, maybe save their life
Viagra-The Good
Viagra-The Bad
The 3-A’s of Adverse Effects
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