Pandora's Box o' Drug Problems

So yeah, I did quite a few “patient assessments” solely based on the patient’s profile today and got into a mess that I really wasn’t sure how to fix. We had a single patient who received 23 medications in a single fill, so I knew that it was going to be fairly challenging. Actually, fairly challenging would be an understatement; I knew I was basically opening “Pandora’s Box o’ Drug Problems.” What I ended up with was a patient taking: (a balls-kicking BID dose of) insulin + two antihyperglycemics for NIDDM, 2 anticoagulants, 3 different drugs with actions on leukotrienes, 3 different drugs for anxiety, 2 diuretics (one loop and one thiazide-ish), 2 antihypertensives, and potassium to correct the electrolytic-emias associated with these diuretics + a mishmash of a few other drugs. So I’m legitimately wondering why we haven’t been asked to conduct a MTM on this patient as its fairly obvious that doing so could probably halve her medication’s cost-burden on Medicare. Seriously, if the government wants to talk about saving medicare some sizable coin it should lower the cost requirements for MTM or set the requirement that if a pharmacist can lower the annual cost of a patient’s regimen by X%, that the pharmacist takes so much of that cut (which probably wouldn’t work in practice for obvious gaming-the-system reasons).


In a case of “way to miss the point, dumbass,” Donald Trump and Carrie Prejean (who’s name sounds “like a fucking mustard”) held a press conference yesterday to absolve her of any wrongdoing for her breach of contract. It also turned into a big cryfest over having freedom of speech, which is one of the dumbest talking points I’ve ever heard of. Sure, some people legitimately criticized her for her opinion on same-sex marriage, but guess what? That’s their freedom of speech as well. Also, I get that a lot of people believe/feel this way (and I very much disagree with each and every one of you, you bastards), and that’s fine. The more troubling offense was that she lacked the basic communication skills to convey her opinion. Heterosexual marriage is now called “opposite marriage,” apparently. Not even opposite-gendered marriage, but “opposite marriage.” As a matter of fact if hetero sexual marriage is “opposite” then does that make homosexual marriage “normal?” Yeah, opposite could mean anything right? Tall men and short women, skinny dudes and fat dudes -- just “opposites.” After watching her whole response to the question, I must confess that I did not in fact have enough mental breadcrumbs to get home – i.e. it took some effort to know what the hell she was saying, and who knows what prevented her from communicating like she knew English. There are no excuses when my trusty decoder ring can’t tell what you’re saying. Sorry to interject my bias here, but eloquence can go a long way towards carrying your retarded opinion to the realm of validity.

Also: I had a House MD moment today when looking at the above patient’s med profile (over 4 years), but haven’t you folks really had enough of me for the day? Here’s your awesome content: