Sunday nite. Was busy dispensing when I received TDM blood samples for Gentamicin. Called up the Doctor in-charged to confirm some details.
Pharmacist (P): Good evening Dr. This is from pharmacy. I just received a Gentamicin TDM sample of patient XXX from you. May I know the date when Gentamicin was started, the dose, and the dosing interval? They are not written in the form.
Doctor (D): Har? I dun remember lar.. Hehe.. Yesterday got one pharmacist asked me to repeat TDM so I just repeat lor...
P: Ah? Which pharmacist was that?
D: Erm.. I dun remember lar.. Hmm.. Wait, I think the patient started Gentamicin 4 days ago.
P: 4 days ago?? Gentamicin treatment period is usually for 5 days only, right? That means the patient would be off Genta tomorrow. Why would u wanna repeat TDM? Moreover, now that our TDM machine has broken down, we have to send the samples to JB. By the time we receive the result, patient might be off Genta already...
D: I dunno lar.. Pharmacist asked me to repeat so I just repeat lor..
P: Hmm.. Or is there any reason that u might wanna prolong the treatment period? How's the patient's condition?
D: Actually the patient was already discharged this morning lah...
P: !!!!! Har??!
D: Yeah.. Cause he was initially diagnosed with Endocarditis, but upon reviewing his ECHO, we thought it was unlikely Endocarditis. Most probably just viral fever so we off the Genta and discharged him this morning..
P: Then why did u send his blood samples for TDM since he was already discharged??!
D: I dunno!! Pharmacist asked to repeat one mah!!
P: Dr, next time if patient is already discharged, DON'T send samples for TDM anymore, ok?! There's no point!
D: Ok ok...
(-__________-"') Don't just follow instructions, use ur brain to think lah... Dots...
14 comments:
Hahaha... zha dao... since whn dr listen to pharmacist so much...
ooooh garang pharmacist!
i laike!
~ming
haha must be a HO... :p
LOL @ xinhui's comment... but can't agree more XD
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hi ...jus a question.if the patient hss endocarditis..isnt treatment iv genta for six weeks?not five days.secondly..if pharmacist ask to repeat tdm,its usually due to tdm high level or error in sampling rite?so y didnt u read it n inform the ward if tdm is high?y does it matter if patient is discharged?its lifetreatening if pt is disicharged n tdm high
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