Welcome to my blog. I hope to share some funny retail pharmacy stories, as well as educate the public a little bit about what pharmacists really do. I know a lot of people think that all we do is put pills in a bottle, and I will often get interrupted with questions like, "Hey, where are the shoelaces?" My first story will be the educational sort...
Your pharmacist is a safety net against erroneous or inappropriate prescribing from your doctor. I will not doctor-bash on this blog, as I have much respect for physicians, but they are human. They make mistakes. Heck, we all do. My "catch" last week was a new prescription for Levothyroxine, written as "Synthroid 0.25mg." This is a drug used to replace thyroid hormone when your body isn't making enough of it. I checked the patient's profile, as I always do with a new one, because Levothyroxine is one of those drugs that some patients prefer to be dispensed as the brand. Patients can be very sensitive to changes in manufacturers because the drug is dosed in micrograms, which are thousandths of milligrams. So any minute change in the amount absorbed into the patient's system can result in clinical changes in efficacy. Therefore, I like to check. This patient had never had this drug before. Now, when starting Levothyroxine, it is usually dosed low and adjusted up to the patient's response. We are talking 25 to 50 micrograms here. My gut instinct told me that the doctor meant 0.025mg (25 micrograms), NOT 0.25mg (250 micrograms)! Doctor verified that he intended to write for 0.025mg, and the prescription was dispensed with the correct and appropriate dose. Now let me point out here that 250 micrograms CAN BE an appropriate dose...for someone who has been on the drug and needed a higher dose for the proper response. But it would have a new patient climbing the walls. It's knowing those little nuances that make us an integral and vital part of the health care team. And I can tell you where the shoelaces are...
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