AudibleRx; Why all the fuss about Pharmacy Counseling?

There was a time when it was normal practice for a Pharmacist to not regularly counsel patients about their medications. Regardless of the knowledge base a Pharmacist had about the medications, it was their job to fill the prescription accurately and get it to the patient per the Doctor's order. Of course, your Pharmacist was always available for questions; however, it was not mandatory that they assure you know what you are doing with your medications before you left the store.

In 1990 the Federal Government passed a law titled the Omnibus Budget Reconciliation Act of 1990. (OBRA 90). This law was passed, in part, because of a growing concern about improper medication use. The law required that all Medicaid patients receive counseling from a pharmacist with any new prescription. This isn't a situation where the patient is asked if they would like counseling, it is mandatory that the pharmacy offer counseling to each and every patient with a new prescription. The patient may deny the counseling if they choose.

It did not take long until all of the State Board of Pharmacy Legal departments took this on as standard of practice for all patients, not just Medicaid participants. So, for 22 years now, the law has stated that each and every time a patient receives a new prescription at the pharmacy they will be offered a counseling session with their Pharmacist.

These counseling sessions need to include specific information in order to be complete. The American Society of Health System Pharmacists developed a set of guidelines that includes all of the information necessary for a complete Pharmacist based patient education session. Each State Board of Pharmacy Legal department has also developed their own specific guidelines on what information needs to be discussed in a Patient counseling session about a new prescription.

It is encouraged that these counseling sessions be face to face so that the Pharmacist may evaluate directly if the patient understands what they are going to do with their medication and why they are taking it. It is difficult to overcome many of the barriers to effective counseling over the phone, however, telephone consultation is the only way a mail order prescription may be counseled.

It is my impression that this does not always happen. Like I have said before, regularly I get patients who have had their prescriptions filled through mail order pharmacies or at big store chain pharmacies, and have not had all of their questions answered for one reason or another. They happen to be walking by the Clinic Pharmacy that I work in and see that there is a Pharmacist accessible and stop in for a question.

AudibleRxTM offers Medication Specific Counseling SessionsTM in audio format. Each session covers all of the information that should normally be covered in a face to face or telephone consultation with your own Pharmacist. These sessions help you understand what you do know about your medication, and help you generate educated questions to take back to your own Pharmacist or Doctor.

AudibleRxTM developed a template from extensive reiew of all the guidelies on Pharmacist based patient education and counseling. We follow this template in the development of each Medication Specific Counseling SessionTM. Each recording is an original production; written, recorded and copyright protected by AudibleRxTM.

It is important to realize that the recordings at AudibleRxTM are meant to supplement your knowledge and understanding of your medications and are not a replacement for a counseling session with your own pharmacist. Please, talk with your Pharmacist or Doctor if you have any questions about your medication.

To become a member of AudibleRxTM, please visit the registration page and sign up. For a fee of $14.95 you will have complete access to all of the Medication Specific Counseling SessionsTM for five years. AudibleRxTM has many sessions posted, and more are added each week. Please visit the Medication page of AudibleRxTM to see which Medication Specific Counseling SessionsTM are currently available.

When patients are educated about their pharmaceuical care it is much more likely that they will be motivated to take their medications appropriately, decrease the chance for improper use, and hopefully lead to their best possible outcome!

Does Pharmacy Medication Counseling really help?  Share your answer in the comment section below!
 
Thanks
Steve
www.AudibleRx.com

Copyright 2012 AudibleRx, all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx.
I selected this post to be featured on my blog’s page at Healthcare Blogs.

The Long Road To Lyme Disease

This guest  blog is posted here at AudibleRx with approval from Joanne Drayson.

Please use the comments to tell your Lyme Disease story and share any advice you may have.

“I started suffering with arthritis in mainly my large joints especially my knees 6 years ago. The symptoms varied and I remember saying that every joint was affected except my elbows to one doctor. I was told it would be hormonal and to take the usual supplements cod liver oil or glucosamine (I would certainly recommend buying shares in the companies producing these supplements) They had no noticeable effect.

All my symptoms deteriorated significantly over a few weeks, 4 years ago. Hips shoulders and knees being the worst and I started with muscle weakness in upper arms and upper legs. I had difficulty standing and walking across a room. I was unable to walk upstairs and my husband was making plans to convert to a downstairs bedroom. I had seen 5 doctors and 3 Rheumatologists and put on steroids for Poly Myalgia Rheumatica diagnosis. I had been diagnosed with Fibromyalgia and ME/CFS.

I have X rays and scans showing signs of osteoarthritis and Rheumatoid arthritis. I have been retired early from the Civil Service having lost my job not to mention my earning potential. My illness seemed to progress through my body not affecting the same joints left to right at the same time. I had bursitis in left hip, right hip, and left elbow. I had synovial thickening in both wrists. At that time I could not lift and hold a magazine so lifting a kettle I could only do if a third full and with two hands. Each joint in my hands fingers feet and toes were affected. I had swallowing difficulties and many other symptoms.

None of this describes the endless and awful pain whenever I moved or the tiredness but inability to get quality sleep.

Two years ago my GP gave me Amoxicillin for a sinus/throat/chest infection. All my arthritis symptoms improved. The course ended the symptoms deteriorated I started a second course the symptoms improved.

The improvement was more significant than when I had started taking steroids. This led my GP to suspect Lyme Disease. I laughed because we do not travel abroad but she said they had had other cases in the surgery in the early stages of tick bite and Erythema Migrans rash. She said but you have not had a bite. I said oh yes I have I had two on my ankles with rashes, March 05 this was confirmed on her computer when I had seen a locum doctor. My worst symptoms were waking up feeling rigid and having to painfully flex every joint in my body before struggling to get up. The only other time I had experienced this was in May 2003 during flu like illness like no other I had ever experienced. At that time I had a bite and similar rash on my right foot which lasted like the other rashes about four weeks. I had also consulted the surgery and it was dismissed as a virus. I walked our dog daily in the woods adjacent to our house where the deer roam, prime tick area. Thus started my very lengthy search about Lyme Disease leading me through Lyme Disease Action to a doctor who specializes in this illness. He confirmed my GP’s suspicions. I never had a positive blood test but then they are antigen tests and there is much research that shows they are unreliable. In my case the year of steroids and many weeks’ antibiotics could have affected the results.

So with a clinical diagnosis and following ILADS International Lyme and Associated Disease Society guidelines I continued on antibiotics for two years. Both my doctors continued to treat me despite of Health Protection Agency advising against long term antibiotics. I am now nearly 100% recovered I have no pain or muscle weakness. I can walk upstairs something I could not do for three and a half years. I can garden do house work and live a normal life. I still need to pace myself and with only a few months to 60 will not be looking to return to work. Life is such a joy. Sadly there is much controversy about Lyme Disease and doctors in UK are taught that it is so rare. Well where I live in Guildford I have been in contact with a dozen other people with it so perhaps not so rare as HPA would like us to believe.

I am in touch with nearly 2000 other patients through a chat line Eurolyme most had been misdiagnosed with several other illnesses. Look at UK charity Lyme Disease Action if you want to read more about this illness. There are many MP’s taking an interest in the problems surrounding diagnosis and treatment see above charity links into a recent meeting at the House of Commons.

Thank goodness there are some thinking doctors around who have courageously treated me against opposition and I have made such a miraculous recovery albeit rather a lengthy one. One day there will be many more people who are helped with their chronic illnesses when IDSA starts taking note of what our courageous LLMD’s are doing following ILADS Guidelines.

ME/CFS, Fibromyalgia, Poly Myalgia Rheumatica, Arthritis, Bell’s Palsy, MS,MN, ALS, Parkinson’s, Alzheimer’s, Heart Block, Stroke, Psychiatric, gastric problems the list is endless. Not all suffering from Lyme Borrelia but how many are even properly assessed for it.
An excellent video from an expert in ME/CFS and Lyme Disease can be found on my blog post http://lookingatlyme.blogspot.co.uk/2012/05/samuel-shor-presentation-on-lyme.html

 
Thanks
Steve

Copyright 2012 AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

My Head Is Killing Me

Migraine headaches are a huge issue and affect many people. Everyone knows someone who suffers from migraine headaches; however, few people understand what makes up a migraine headache.

Migraines are most commonly broken up into four distinct sections. Everyone who has a migraine experiences all four distinct sections, however, the duration and intensity of each section can vary greatly between individuals and migraine episodes.

The prodromal syndrome (sometimes called the pre-headache) is the warning time that a migraine is lurking on the horizon. This phase is usually experienced a couple hours to even days prior to the onset of the migraine pain. When someone has experienced migraines over the years, they come to recognize the specific symptoms of the prodromal phase of their migraine. These symptoms can be quite variable and may include significant mood changes, cravings, fatigue and a host of other symptoms. When someone recognizes these pre-headache symptoms, quite often they are able to take measures that will help avert or lessen the migraine pain.

The aura phase follows the prodromal symptoms and usually lasts somewhere between 30-120 minutes. During this time frame the migraine sufferer will usually have some level of sensitivity to light, smell or taste. Usually, the aura phase is much more familiar to people than the prodromal phase, and quite often the two phases blend together so quickly the terms are used interchangeably. A migraine sufferer realizes that at this phase of their headache, the pain is most likely eminent. If someone is aware and awake at this time, it is reasonable to take their migraine medication before the pain of the headache sets in. This may help shorten the intensity or the duration of the painful phase of the migraine.

The painful phase of a migraine headache may be so debilitating that it is difficult to comprehend for those who have not experienced it. This pain quite often affects the entire body and is not just limited to the head. The intense pain usually lasts about 1-3 hours; however, quite often it may last up to 3 days. This pain may be accompanied by a host of other uncomfortable symptoms involving the entire body.

The final phase of a migraine is the postdromal (post-headache) time. After the pain is gone, the migraine lingers on for a couple hours to a few days. During this time the migraine sufferer is in a recovery phase where they might feel hung over or dazed.

I am fortunate that I am not a migraine sufferer; however, I am very close to someone who does suffer from migraine headaches. I have a relative understanding of how significantly a migraine headache can disrupt someones day to day activities.

To listen to the Medication Specific Counseling Sessions for the medication alternatives used to treat and prevent migraine headaches, please follow this link to AudibleRx. Once there, register as a Member of AudibleRxand have full access to all of the Medication Specific Counseling sessions for the life of your membership.

You may also be interested in reading my blog about the following:
     *nerve pain
     *muscle spasms


Thanks,
Steve
www.AudibleRx.com

Copyright  AudibleRx, all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx.

Generics; The Untold Story


Rarely do I come across a pharmacy topic that stirs as much emotion as does the discussion of generic medications.  This is a subject that both patients and physicians are passionate about.   Quite often, firm opinions are based on anecdotal, rather than proven data.    When a medication has been approved by the FDA for generic substitution, it has met rigorous standards with regards to bioequivalence, strength, quality, potency, identity and purity. 

See this great page from the FDA about frequently asked questions regarding generic medications.
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/QuestionsAnswers/ucm100100.htm

There is a common miss-conception that a generic medication may be anywhere from 25% more potent to 20% less potent than its brand name equivalent.  This miss-conception comes from an interpretation of the methods of how medications are studied for FDA approval. 

The FDA states that a generic drug is considered bioequivalent to its associated brand name medication if the 90% confidence interval of the average or mean of the area under the curve vs. concentration curve and the maximum concentration of the generic product is within 80% to 125% of the brand product. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm070244.pdf

OK...so what the heck does that mean?  What happens is that someone will read that statement and the only piece of information they see is the 80% to 125% and from that tiny piece of information they falsely conclude that there is the potential for a 45% variance in generic medications. Confidence interval testing is a form of statistical analysis that demands a superior knowledge of advanced statistics. 

The FDA studied 12 years of generic confidence interval testing data, from 1996 to 2007.  They found that, on average, there was no more than 3.5% difference between the brand name medication and the generic medication.  This difference of 3.5% would be the same whether it was one batch of brand name tested against another batch of the same brand name, or tested against the approved generic equivalent.   http://www.ncbi.nlm.nih.gov/pubmed/19776300

It is interesting to note that many "generic" medications are actually made by the exact same company that makes the brand name medication.  It is easy for them to do this because they do not need to do any bioequivalence testing before they package the medication; it is the same medication.  The only difference is that they package the medication in a generic container and sell the medication for a significantly reduced price. 

Please realize, cheaper cost does not equate to cheaper quality.  Generic companies can sell their medication for less money because they do not need to advertise or go through the process or repeating the costly clinical trials that the brand name drug manufacturer needed to do. 

Please do not get me wrong, I believe that the company that produces the brand name medication has the right to make a profit from all of the expenses and resources they put into testing and bringing to market their product; however, after the patent has expired, generic is the way to go.  In 2010 alone, generic medications saved over $158 BILLION dollars.  When it comes to cutting health care costs, there are very few reasons why a patient would need a brand name product when there is a FDA approved generic equivalent product available.
http://www.gphaonline.org/media/press-releases/2011/new-study-finds-use-generic-prescription-drugs-saved-consumers-and-us-heal

We have talked extensively about the fact that generic drugs are equivalent to their brand name counterparts.  Physicians and patients still raise the question as to whether generic medications are clinically inferior to their brand name counterparts.  An evaluation of 38 clinical trials showed clearly that there was no difference in clinical outcome between the generic and brand name medications. 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713758/

To help answer any more questions about generic medications, please review this page discussing facts about generic drugs.  http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingGenericDrugs/ucm167991.htm

Thanks
Steve
www.AudibleRx.com

You may also be interested in reading my blogs about:

                Mail Order Pharmacy

                Canadian Internet Pharmacy

Copyright AudibleRx (TM), all rights reserved.

Will The Fog Ever Lift?

Over my 25 years working in pharmacy I have seen many individuals come to the pharmacy counter to pick up an antidepressant medication for the first time.  We have a discussion about the medication, hopefully understanding that the depression may not go away by tomorrow.  This is a process.  The body needs to adjust and acclimate to the medication.  Quite often, not all the time, but really quite frequently, I talk with the person the next month when they come in to get their refill of their medication....and the fog has lifted, the sun has come out, and they are seeing the world in a completely different light!

Depression is real. When your neurotransmitters (the message carrying chemicals in your brain) become low for some reason, your body may receive mixed signals about emotion, behavior, body temperature, and many other functions we take for granted. This process of decreased and mixed signals about how we feel may sometimes be diagnosed as depression.

These neurotransmitters may be decreased for any number or reasons, however, most commonly it is from a prolonged stressful (emotional or physical) situation. Our body is made to handle short bouts of intense stress, however, if someone needs to carry an emotional or physically stressful situation for an extended period of time, the neurotransmitters will actually diminish and lead to a decreased ability to send and receive the important messages of daily function. I say short vs. long in relative terms. The time frame will be different for each individual.

Other common reasons for a decrease in neurotransmitter message sending ability include aging, not sleeping well, hormonal imbalance, genetics and significantly limiting your food intake for an extended period of time. Based on all the reasons for neurotransmitter deficiency, it is quite likely that anyone reading this blog will experience some amount of depression at some point in their life.

Many non-medication therapies have shown benefit in increasing neurotransmitter levels including yoga, acupuncture, massage, hypnosis and meditation. If we have the time and resources, taking our self out of the daily grind for six months and living in a warm cabin in a meadow, meditating for 8 hours a day, would most likely allow our body to recharge and rebalance our neurotransmitters. Unfortunately, we usually do not have the time to take ourselves out of the daily grind, and quite often we end up at our Doctors office discussing the medical alternatives.

There are quite a few newer antidepressant medications that work to help increase our level of neurotransmitters. This increase in message sending ability then helps us process thoughts easier and gain a better outlook on life so that we may manage daily living a little easier.

It is important to realize that psychotherapy goes hand in hand with antidepressant medication treatment. This is crucial for two reasons; first, your therapist will help you see and understand what it was that triggered the decrease in neurotransmitters and led to the depression, and second, it is a good idea to have a non-biased third party that you can discuss with how the medication is working. They will help you define where you need to get to and help you know when you are there.

To learn about the different medications available to treat depresson, please visit AudibleRx and register to become a member.  You will then have full access to all of the Medication Specific Counseling Sessions for all fo the anti-depressant medications, as well as all of the other currently available medications.

You may also be interested in reading the blog:  Anxiety vs. Stress

Thanks
Steve
www.audiblerx.com

Copyright AudibleRx, all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx.

Attention Deficit Hyperactivity Disorder; medication treatment options


Attention Deficit Hyperactivity Disorder (ADHD) is associated with inattentiveness, over-activity, impulsivity or some combination of all three.  I am not going to attempt to describe the causes and symptoms of ADHD, an excellent description of this can be found at the U.S. National Library of Medicine.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002518/

My goal here is to help educate about the medications available for treatment. 

Medications for ADHD treatment are used in combination with psychological, educational and social counseling as part of a complete treatment plan.  These medications may help an individuals ability to stay focused on specific tasks and activities while also helping behavioral issues.  Treatment with this medication may also help an individual organize their tasks and improve their ability to listen. 

To listen to a Medication Specific CounselingSessionTM on any of the following medications, please visit AudibleRxTM and register to become a member.  You will then have full access to all of the counseling sessions.


  • Amphetamine Salts (Adderall-tm)
  • Amphetamine Salts Extended Release (Adderall XR-tm)
  • Lisdexamphetamine (Vyvanse-tm)
  • Methylphenidate (Ritalin-tm)
  • Methylphenidate Long-Acting Capsule (Ritalin LA-tm)
  • Methylphenidate Controlled-Release Tablet (Ritalin SR-tm)
  • Methylphenidate Sustained-Action Osmotic (Concerta-tm)
  • Methylphenidate Transdermal Patch (Daytrana-tm)
Other AudibleRxTM Blogs you may be interested in:

Full Description of a Medication Specific Counseling SessionTM

Safe Storage of Controlled Substances at Home


Thanks
Steve
www.AudibleRx.com

Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

hCG: Weight Loss vs. Starvation

Just so we are clear, there are no FDA approved hCG weight loss products on the market and both the Federal Drug Administration (FDA) and the Federal Trade Commission (FTC) are focusing on companies marketing hCG products promoted for weight loss.  Companies that sell products that have not been approved and market these product with unsupported claims are in violation of federal law.

The FDA is cracking down specifically on products promoted as homeopathic hCG weight loss supplements.

The concept is that hCG hormone will suppress hunger and stimulate your body to use your own fat for fuel while you are consuming not more than 500 calories per day of unprocessed, organic food..  There is no scientific evidence the claims for hCG are accurate; however, unprocessed, organic food is a great idea!

The issue is, you will lose weight.  If you eat only 500 calories per day you are starving yourself.  Minimum calorie levels are close to 1200-1500 per day in order to satisfy basic hunger, provide nutrients for daily living and energy for daily function.  When so few calories are consumed, your body not only burns fat but also burns muscle mass for daily fuel.  Muscle mass is what keeps your metabolism at its best.  Just sitting still, the more muscle you have, the more calories you will burn.

So, at the end of 6 weeks, when you have lost however many pounds, chances are quite a bit of that will be from muscle loss.  Most likely you will gain the weight back because it was not a lifestyle change, it was just a six week starvation.  It is probable that the weight loss will return, and because you are not exercising, it will all return as fat, not as muscle.

Bottom line, don't do it!  Talk with your pharmacist or doctor or nutritionest or trainer or some other health care provider.  Healthy and maintainable weight loss comes from a change in lifestyle.  Llifestyles that includes healthy portions of real food and regular exercise are ones that leads to  slow and steady manageable weight loss.

If you haven't done so yet, please visit our facebook page and give us a like!

Thanks
Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

Who's Responsible for My Medications Anyway?

My goal, as a pharmacist, pharmacy blogger, and Owner/President of AudibleRxTM is to educate and motivate patients to participate in their own pharmaceutical care.  So then, the question is, who's responsibility is it to make sure that patients refill their prescriptions on time and continue to be compliant with their therapy?

This, my friends, is an ongoing issue, one that regularly surfaces, and one that requires diligence on the part of the patient, caregiver, pharmacist and doctor. 

Some pharmacies offer an auto refill program.  This is a situation where the medication is filled automatically about 5 days before the refill is due.  Perhaps then, some sort of automated phone call is sent to the patients phone directing them that a prescription is ready to be picked up.  This does quite a bit to increase the number of prescriptions that a pharmacy is filling; however, quite often the prescriptions are reversed within 7 -10 days because they were not picked up. 

The problem here is that the patient may have spoken with the doctor and possibly changed the dose of the medication or changed to a completely different medication.  Another problem with this is if a care giver comes in to the pharmacy and picks up and pays for a prescription that the doctor had told the patent to stop taking.  The patient may end up receiving a medication that their doctor does not want them to take.

Another situation arises when patients slowly become unable to monitor and take care of their own prescriptions.  Over a course of a few months different family members, friends or other assorted care givers become involved.  Without one person taking charge and educating all of the others, it is likely that there will be doses and refills missed and possibly a prescription that has been discontinued may accidentally be picked up through an auto refill program.

So, when an individual is mentally able, they are the ones responsible for following their pharmacy regimen.   I encourage everyone and anyone who take prescription medications to create a list.  This list includes the name and directions of your medications, your pharmacy phone number, your doctor phone number and your medication allergies. 

Each and every time you go to your doctor or pharmacy, have them verify that they all have the same exact information.

Here is a simple two step process:
                1.  Today, create your list of medications, complete with dose and directions, pharmacy  phone number,  doctor phone number, and medication allergies.

                 2.  Have a discussion with a family member or friend who you trust to initially manage your medications for you when (not if) the situation arises that someone else needs to step in and take care of your medications.

This is a very simple exercise that may save your life!

Please comment about how you remember to take your medications at the right time every day and what you do to remember to refill your prescriptions on time.

You may also be interested in reading these prescription/pharmacy blogs:

                Prescription Labels
                My Pills Look Different
                What to do with Expired Medications
                Mail Order Pharmacy
                Prescriptions from Canada
                Safe Narcotic Storage at Home

Thanks
Steve
www.AudibleRx.com

Copyright  AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

What's In Your Urine?


What the heck is creatinine, and more importantly, why do we care?

Medications, once they act on the body, are metabolized and broken down.  Quite often they change form or get stored in fat cells, or any number of other biochemical reactions; however, eventually the waste, or un-metabolized medication, needs to be eliminated from your body.  Some medications are metabolized by your kidney, others by your liver, most by a combination of both your kidney and your liver.

Today, we are discussing the fate of medications whose main route of elimination is through your kidneys.  If a metabolized medication is eliminated from the body through the kidneys, then we better make sure that your kidneys are working as they should.  If the kidneys have a decreased function, then the medication may back up to potentially toxic levels. 

I like to use the analogy of a freeway on ramp.  If the traffic is flowing, then there is no problem merging onto the freeway.  If the traffic slows, then the on ramp gets backed up and cars come to a stop.  It gets very crowded really quick.  At this point, we need to either stop sending cars down the on ramp or open up some more lanes on the freeway before we have a problem. 

So, back to the beginning, what the heck is creatinine?  Creatinine is a chemical waste product in the blood that passes through the kidneys to be filtered and eliminated in the urine.  The chemical waste is a by-product of normal muscle contractions.  Creatinine is made from creatine, a supplier of energy to the muscle.

In general, your creatinine blood levels will remain relatively constant on a day to day basis.  There are a few situations where it may be slightly elevated or lowered based on your gender, age, exercise level or what you are eating; however, rapid fluctuations are usually not the norm. 

An individual with relatively healthy kidneys will filter out creatinine at a regular rate and maintain a relatively constant level of creatinine in their blood serum.  If the kidneys are not functioning so well, then the creatinine may back up and the blood serum levels will increase.  This process allows for a reasonably simple way of monitoring how well the kidneys are functioning. 

If your blood serum level shows a rising level of creatinine, then the doctor may look into what is going on to cause the kidneys to not filter as well.  At this point, your pharmacist gets excited about making sure that the doses of any of your medications that are excreted via the kidneys are decreased so that you don't end up with toxic levels of the medication in your system which may cause some significant/unwanted side effects.

If you take any medications on a regular basis, here is your homework:


                1.  Next time you visit your doctor, ask them how your kidney function is.  If they ask you why you want to know, let them know that you are just concerned about your own health and want to make sure your medications are dosed appropriately for your current kidney function.
                2.  Next time you visit your community pharmacist, ask them which of your medications are eliminated primarily through your kidneys.  If they ask you why, tell them the same thing you told your doctor in #1.

Thanks
Steve
www.AudibleRx.com

Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

Just Another Customer


So, there I was, just standing there.  I had walked in to the store, there was one person ahead of me and the attendant at the counter was helping them.  The attendant stepped away from the counter because they were, well, I don't know, I guess helping the person at the counter figure something out.  A couple minutes went by......

There were three other workers behind the counter.  All of them looked relatively busy, however, the phone would ring and they would answer it.  As a matter of fact, this happened 2 or 3 times, the phone would ring and they would answer it and deal with whatever.  All the while, the attendant came and left the counter twice trying to help the person in front of me take care of something. 

I noticed that two of the other people behind the counter were having a conversation of some kind, one of them was actually laughing at something the other had said.  So, it has been about five minutes now and the attendant is still helping the person in front of me at the counter.  The other three workers look busy; however, what the heck.  Maybe someone could at least notice that I am here. 

Oh, look at this, someone just came and is now in line behind me.  Now maybe someone else will come out and help us.  I hear the gentleman behind me say something to one of the workers, evidently they know each other and they have a short verbal exchange about some vacation something or other.   The worker reaches behind the counter, picks up a bag of some kind, then hands it to the gentleman and they say thanks and bye. 

Again, what the heck!  The worker gentleman looks my way and says someone will be with me in just a moment.  Just a moment!  Here it has been almost 10 minutes now, the person in front of me is taking the time of two of the other worker people, this guy just had a conversation with the person that came in behind me, and the first acknowledgment I get is from someone who says someone will be with me shortly. 

I don't think so.  I know, I think I will go out into the parking lot and call them on my phone, then maybe they will be able to give me some service.

OK, so maybe this scenario may be a bit exaggerated, however, I know that everyone, at one time or another, has felt this way.  This doesn't necessarily need to be a pharmacy counter, it could be any type of business; however, when I was writing this I was definitely picturing a busy pharmacy. 

In my opinion, if you need to wait in line in your community pharmacy for an extended period of time with zero acknowledgment, you need to find a new community pharmacy.  Do not get me wrong, there may be times when you need to wait in line for an extended period of time, however, simple acknowledgment can go a long way to helping a customer feel like they are being taken care of.

Thanks
Steve
www.AudibleRx.com

Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).