Thursday, December 22, 2011

Let's Talk Meds

We are told that generic drugs are no different from the brand name ones.  I guess this is true, but in at least one instance, this is not--and doctors and pharmacists agree.  When someone has hypothyroidism, the drug of choice--or the name brand drug of choice--is Synthroid.  Over the years, the patent on Synthroid has expired and we now have quite a few different meds to take care of this condition/disease.  After being diagnosed with hypothyroidism, I was put on one of the meds to control my condition and over the course of time, things got better.  I was relieved when we got to the dose I needed and everything was stabilized--and it all came to pass with the drug Levoxyl, a generic thyroid supplement.  All was going along fine until the day I went in to pick up a refill of my meds and the pills looked MUCH different from what I was used to.  Levoxyl looks like this:

And I was given pills that looked like this:

Same color, VERY different shape.  But, I was told both pills/meds are equivalent.  And I was okay with that until I had my next blood work done--and my blood levels were unstable, again.  It took me another round of blood work a few months later before I realized that my new problem was tied to the change in my meds--and I was correct.  After discussing this with my MD, he prescribed Levoxyl, no substitutions, and my levels have been stable ever since.  Another lesson learned.


A few months back, K saw his doctor and pointed out a bit of a rash/dry skin that he had behind his knees. It was diagnosed as a kind of dermatitis and a prescription for a lotion was written.  K filled the prescription and his rash was taken care of in good time.  The other day, he brought the bottle to me and asked if I would order a refill for him.  The name of the medication--mometasone--seemed familiar to me, so I had to look it up.  As it turned out, K's lotion for his rash is the same medication that I use as a nasal spray for my sinuses, Nasonex.  Same drug, different forms, for two quite different problems.  Interesting.


A while back, I wrote about a friend of mine who was diagnosed with acute myelogenous leukemia.  He ultimately decided to have a bone marrow transplant and has had some set-backs and side-effects from it.  He wasn't tolerating a medication called tacrolimus--which is given as an immunosuppresant agent for those having transplants--very well and the doctors were needing to do some adjustments.  The name of the drug sounded very familiar to me, but I put the thought out of my mind.  After all, I knew of no one else that had received a transplant of any kind, so I shouldn't be familiar with the drug.  And then one day, I reached for one of my many lotions/potions/ointments that I use for the psoriasis I still have and there was a tube of Protopic, which is the ointment form of tacrolimus!  I guess I shouldn't be so surprised, as psoriasis is an auto-immune disease and the immune system needs suppressing in order for the skin to heal, but it stunned me, nevertheless.  It's hard to wrap your mind around two such different uses for the same drug. 

With these three examples alone, I can't imagine what it takes for doctors to 'get things right.'  And 'get things right' is what they do more times than not.  While their mistakes can, and often do, have life-ending consequences, it still is a wonder that more mistakes aren't made.  Whenever I think about it, I have a new respect for doctors and all that they know.


Anonymous said...

I guess that's why they go to school for so long and make the big bucks! I really admire them, they have to have all this stuff crammed into their heads ready to be pulled out at a moment's notice. It sometimes seems like doctors are overpaid, and I think sometimes some are, but as far as the ones in the trenches, they're underappreciated.

cmk said...

I don't think most people appreciate what doctors do/know as much as they should. I think that is why I miss the really good doctors I have had over the years who have gone on to retirement or new areas of their profession. I was lucky to have two long-time doctors who cared about their patients and kept up with the newest things happening in the world of medicine--and I hope the new generation of doctors have mentors that teach them to be this way.