Thursday, June 4, 2009

Swish and swallow

Another example of why e-prescribing will not take over the world...

Nystatin sus 100,000 units/ml
swish and swallow 4-6 ml four times daily
disp: 60ml

Congratulations, you can read the prescribing information for this drug!  At this point you're as skilled as a monkey (you know, the one that fills all of your prescriptions overnight, allowing you to call in an rx at 2 in the AM and expect it to be ready when the gates are opened).

Now, let's see if your degree can help you apply this knowledge...

4-6 ml.... Yeah, that's the recommended adult dose, but did you LOOK at the population you're prescribing this to?  If I write this on the bottle the patient will be back with an empty bottle in three days because they thought that a ml is a teaspoon, or worse, tablespoon. (And for laypeople out there, 1 teaspoon=5ml.)  Just write one teaspoonful!

But it gets better, because since you only wrote for 60 ml, they WILL be back in three days.  I really hope you don't think it will a day for this to clear up, but sadly I know you wrote 60 ml because, oh, in the prescribing information this is available as a 60ml bottle (for infants!).  What? you actually wanted your patient to be on this for one week?  Well it's a good thing I called to cover your ass.

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