Saturday, February 27, 2010

The Men in the White Coats

It doesn't take more than a few days of working in a pharmacy to learn the perplexing phone calls one receives throughout a day. After a while, it becomes a normal step in an otherwise hectic day.

The other day was different.

Early in the morning I received a phone call from one of our elderly customers. She has always been a bit on the forgetful-side, but she is otherwise quite well. The reason she was calling was that she had been to the hospital the day before and was concerned about taking too much of her meds.

A quick check and I saw:

Cheratussin AC #120 1-2 Teaspoonfuls Every 6 Hours As Needed

and

Levaquin 500mg #14 1 Tablet Twice Daily Until Gone


Namely she was concerned about taking too much of the cough syrup as she took some in the middle of the night and couldn't quite remember when that was. We set her up on a rough time frame and called it good.

Now after lunch the phone rang again and it was her again. This time however, her tone was completely different from before.

"What um.... why do I have these meds?" was uttered on the other line.

My curiosity spiked, I inquired what she meant.

"Well you see.. I was uh.. I was just sitting on my couch when these six men came into my house. And the took me, they TOOK ME, off my couch and threw in me in an ambulance. I don't know why they came to g... do you know why they came? And they took me to the hospital to see this Doctor and the Doctor was scary and then... and then he gave me this medicine to kill me... and I don't want to take the medicine to kill me.. do I? Wait... who are you? Are you from that Doctor's office?"

Now I have talked to many people who have been out of it over the last nine years. Either they've been high on drugs (prescription or otherwise) or are generally just a little off, it is another common occurrence in a pharmacy.

This was something completely and utterly different. As I'm still comprehending what I'm hearing, her little voice says softly;

"I should hide. Do you think I should hide from that doctor? So he won't give me any more drugs to kill me?"

By that point sirens are going off in my head. This is a woman in her mid-70s who lives completely alone. If she goes hiding, in her condition, no one is going to find her.

After a few minutes of rambling discussions I convince her to stay put and that I'll call the doctor to talk to him about the 'deadly' medicine he gave her.

Upon calling the ER she went to I asked, quite plainly, if they had a next of kin on file or if they knew how she got home. Of course I received answers to neither question as I was passed from nurse to nurse to nurse.

Finally we decided to have a welfare check done. A few hours later we received a call back from the ER doc from the night before wanting to know what had transpired. The police found her at home during the check, thank God, and were forced to bring her back to the hospital.

I have not been back to that store since, nor am I likely to for quite a while, so I still have no idea what happened afterwords.

The most puzzling part is what precisely set her off so quickly. She had no history of mental illness prior to this which led our pharmacist to suggest perhaps it was a reaction to the Levaquin. He had read about a similar occurrence in the past and it was the only thing that readily made sense.

Maybe they should add something like this to an experiential section of pharmacy school.

The main lesson? Beware of the men in the white coats...

5 comments:

TiredRPh said...

BID on Levaquin? That's an overdose. Why would the rph dispense that unless he-she called the md and documented. Also she could have a urinary infection which sometimes manifets in behabioral changes with the elderly.

Frantic Pharmacist said...

I'd be more suspicious of the codeine in the Cheratussin AC. Confusion, hallucinations in the elderly -- distinct possibility.

Deputy's Wife said...

I'm no pharmacist, but it sounds like the cough syrup really did her in. Benadryl and Nyquil make me hallucinate. She probably shouldn't take any more! :) HAHA

Phathead said...

Sorry, I mistyped the dosing on the Levaquin, it was QD.

The only reason we thought the Levaquin is that she had been on the Cheratussin previously whereas the Levaquin was completely new. From what we've heard back thus far, it sounds like she never even took the Cheratussin.

Grumpy, M.D. said...

All the quinolones can do this. I've seen it in hospital patients.

A LOL who's borderline demented can easily get tipped over by a new med.