Wednesday, August 19, 2009

Side by Side Effects

I have actually had people pick up prescriptions and say, "Now, this doesn't have any side effects, right?" Where the heck would someone get that idea? Obviously, anything one puts down the gullet has the potential for side effects, I tell them, although I try not to be too harsh about it because they were so bright-eyed and hopeful......

People often ask about side effects from their prescriptions. Usually they call on the phone when we are extremely busy and want to to launch into a fairly long description/ timeline of what they're having and when they have it. To me, it doesn't matter if the side effect shows up anywhere in the fine print of the package insert, Micromedex, or anywhere else --- my rule of thumb is 'proximity'.

So if someone calls and says, "I just started atenolol 4 days ago. Today I feel like the end of my nose is burning and my toenails are all of a sudden growing really fast. Is that a side effect of atenolol?" My response pretty much has to be, "Well, if there have been no other changes in your medications, diet, lifestyle, laundry detergent or general environment, I guess we can't rule it out."

And really we can't, even though I could never produce a shred of documentation to support it. It goes under "anecdotal."

I think about this as we're asked to make sure the latest FDA warning goes on all our prescriptions, either on the bottle or in the patient leaflet:

"Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088."

Boy, they may want to re-think that. Or hire some more FDA operators darn quick.


Anonymous said...

Yous should be happy, with the insane number of calls about possible side effects, especially from the life story patients, they might have too much time to make up and enforce daft rules to make your life harder

Grumpy, M.D. said...

Holy shit, they're gonna need a LOT of operators. And they'll need to be good at keeping a straight face.

Lipstick said...

Something else that I think is particularly funny is when ppl *freak out* about the number of milligrams they are taking as if every single drug in the world is in a 1:1 ratio with one another.

Phathead said...

Has anyone called these operators? I bet ya twenty bucks they've outsourced them to India