The pharmacists role
Whenever I prescribe medicines to patients, I always tell them to buy from leading drug stores in order to avoid fake medicines. Sometimes I even specify Mercury drug as it oftentimes is more complete and medicines are always new. But lately I get irritated when I send some patients to them because do not only stick to their job of dispensing what is written on the prescription. But they also change the prescription altogether depending on what is available to them. Or, they comment on the dosage, even telling patients that there is overdosaging in the prescription.
There was one time when I prescribed mefenamic acid suspension to a six-year-old. After sending off the patient, the mother came back telling me to compute again because the lady in the drug store told her that her child will die because of overdosage. I got furious of course. I told her to tell the lady to come to my clinic and I would gladly explain to her how dosages of medicines for children are computed. The mother refused to bring her. I wrote her a letter instead explaining how the dosage of the said medication is computed. I also explained to the mother in detail how I arrived in the dosage. I just don’t know if she followed the dosage written in the prescription. Well, I cannot blame her after hearing the comment from the drug store.
Just the other day, my son Ralph got sick. I asked my house helper to buy the medicine in Mercury drug. When the lady in the drug store (the new Mercury drug in Mangaldan, Pangasinan) read the prescription, she told my maid that there is overdosage. My maid commented that the parents of the boy who is going to drink the medicine are doctors, and that she doesn’t have to worry because the parents love their son too much to cause him into trouble. To make the story short, it turned out that the medicine written in the prescription was not available to them. She was making comments of overdosage because she wants to change the prescription to another drug which is available.
The drug I am referring to which I prescribed to my son was Cefixime. It used to be computed as 1-3mg/KBW/dose. But lately, recent studies show that there is a need to increase dosage to 8mg/KBW/dose. With Ralph, I only computed 5mg/KBW/dose. How could that lady in the Mercury drug say that there is overdosage?
The problem with pharmacists or ladies manning drug stores in general is that they only know the dosaging of medicines by basing it on the age of the patient. Please be informed, you people. There are only a set of medicines on which dosages can be based on the age of the child. These are called drugs with empirical dose. And these include cough and colds preparation ONLY. The rest are computed based on weight and the number of times they are given in a day.
So, if you have two 5-year-old boys. One is overweight meaning his weight is beyond the normal range of his age. The other boy cannot be given the same dosage as this overweight boy because that would mean overdosage.
I hope these people in the drug stores would stop commenting about overdosage. Know first the range of dosage of each kind of drug (that compels a lot of memorizing!), learn how to compute, ask the weight of the child and NOT the age, then comment if there really is overdosage. Doctors certainly know more of that aspect as we regularly attend updates and conventions regarding these things. It would be best if these people just do what is expected of them and stop acting as if they know everything and as if they are better off than doctors. And PLEASE stop changing prescriptions.
Tags: Cefixime, dosaging, Mercury drug, overdosage, prescription