Who is at fault here?

[Angelcake]

Going to try to make this as short as possible.

I take FLUOXETINE and a doctor said that he gave me bromfed DM(that dm part is what i can not take because of fluox google it)

First off I told the nurse about it, a few minutes later the doctor comes in and tells me my symptoms(cough,congestion) So he prescribed me bromfed DM

I went to the pharmacist and gave them my prescription, I know they have a system that would catch stuff like this but I never heard a word from them. Take your prescription and go(no counseling btw)

So i went home and google searched it and it said that the DM part of the medicine(it was a 3 part medicine all in one) would affect me and could possibly give me seretonin syndrome(again google it) or other bad symptoms.

 

My question is who do you think its at fault here?

Did the nurse not tell the doctor?

Did the pharmacy did not check the computer for any contradictons?

[Bobsplosion]

Ask the doctor or consult with a medical malpractice lawyer if you believe you have damages.

[Deku]

Ask the doctor or consult with a medical malpractice lawyer if you believe you have damages.

She hasn't taken anything yet as it's too risky but I agree that talking to the doctor would be best. Always best to start at the top of the chain of command.

[HarryG]

Definitely you. I don't believe they are required to provide that information (guarantee it's in the fine print of a contract I also guarantee you didn't read (even if that doesn't ring true, see next point)). Especially given you did your research AFTERWARDS that's on you. So easy to do proper research beforehand (even if it's not correct always, see WebMD, you can consult your physician based on what you found).

 

Source: Whole family in the medicine industry.

[Angelcake]

Definitely you. I don't believe they are required to provide that information (guarantee it's in the fine print of a contract I also guarantee you didn't read (even if that doesn't ring true, see next point)). Especially given you did your research AFTERWARDS that's on you. So easy to do proper research beforehand (even if it's not correct always, see WebMD, you can consult your physician based on what you found).

 

Source: Whole family in the medicine industry.

http://medical-dictionary.thefreedictionary.com/negligence

I could of been hurt if i didnt do research at all. What if i didnt research and just drank it? Am I suppose to know everything about medicine before I go to the doctor? Read the following article about negligence and what could have happened if i didnt do research

[♠Derpeh♤]

Think you underestimate how many people go to the hospital and how hard nurses are worked, chances are the nurse forgot and the doctor didnt know. You should have asked the doctor directly i.e. doc I take XXX would it be okay for me to ...etc. It's stupid I know but you shouldn't rely on nurses and should have played it safe and clarified with the doctor directly.

 

Imo Nurse is to blame and you're at fault for not clarifying properly with the doctor when he prescribed you the meds especially if you had doubts in the first place.

[Hyperqube]

Doesn't either medicine contain a strip of paper with a lot of text on it? (dunno the english term). That thing that usualy says "Don't tkae this when you're pregnant. At most tkae X. Side effect may be X Y Z. ..." ?

 

 

From a moral point of view - I don't think anyone's at fault (as I don't think there's bad intent on anyone's part). sh*t happens.

 

From a legal point of view - I'm afraid the mecidal sector covers it's *ss quite good, making you the one at fault if you take two medicines that work together in a bad way

 

 

 

Edit: I dunno about your country - but if you've gotten a drug that you're not allowed to use, and you haven't used it yet - it's possible you can bring it back to the pharmacy for a refund.

[HarryG]

http://medical-dictionary.thefreedictionary.com/negligence

I could of been hurt if i didnt do research at all. What if i didnt research and just drank it? Am I suppose to know everything about medicine before I go to the doctor? Read the following article about negligence and what could have happened if i didnt do research

You should know everything about something you're putting into your body, yeah. Again, who's fault do you think it is if you didn't do research (hint: the answer's in there)

[Angelcake]

Think you underestimate how many people go to the hospital and how hard nurses are worked, chances are the nurse forgot and the doctor didnt know. You should have asked the doctor directly i.e. doc I take XXX would it be okay for me to ...etc. It's stupid I know but you shouldn't rely on nurses and should have played it safe and clarified with the doctor directly.

 

Imo Nurse is to blame and you're at fault for not clarifying properly with the doctor when he prescribed you the meds especially if you had doubts in the first place.

Yeah could of been more cautious when she was checking me. Oh well I will be more careful next time. Thanks

[Teeny Tiny Cat]

Speaking generally, anyone who sees you should be taking a medical history and finding out what medications you're currently on. They should also be aware of contraindications and if they aren't knowledgeable about the drug they are prescribing or dispensing, they should be looking it up to be sure. Your doctor, your nurse, and your pharmacist should all be catching contraindicated drugs. Not sure if harry g is talking out of his ass or if america just has shitty standards compared to the UK, but this is how it works here. As a nurse, if I give a patient medication which could interact with something they are already taking and there are negative consequences, I could lose my license. 

 

I will note that there's nothing necessarily wrong with taking those meds together, but I guess they should have made you aware of potential side effects so you'd know when you needed to seek help if you did have a reaction.

[Zcrab]

Definitely you. I don't believe they are required to provide that information (guarantee it's in the fine print of a contract I also guarantee you didn't read (even if that doesn't ring true, see next point)). Especially given you did your research AFTERWARDS that's on you. So easy to do proper research beforehand (even if it's not correct always, see WebMD, you can consult your physician based on what you found).

 

Source: Whole family in the medicine industry.

You should know everything about something you're putting into your body, yeah. Again, who's fault do you think it is if you didn't do research (hint: the answer's in there)

 

I know it is off topic, but is it not the doctor's job to make sure they don't give you anything that could be dangrous?

 

By your logic a doctor could put me on sleeping pills and tell me to take a deadly amount of it, and if I didn't check if it was too much, and I died; it'd all be my fault for not researching.

[HarryG]

I know it is off topic, but is it not the doctor's job to make sure they don't give you anything that could be dangrous?

 

By your logic a doctor could put me on sleeping pills and tell to take a deadly amount of it, and if I didn't check if it was too much, and I died; it'd all be my fault for not researching. 

I know I personally wouldn't take anything without at least double checking. Physicians aren't infallible, and I wouldn't completely trust anybody anyways when it comes to stuff like that. Gotta learn to be somewhat independent and do some things for yourself.

[Zcrab]

I know I personally wouldn't take anything without at least double checking. Physicians aren't infallible, and I wouldn't completely trust anybody anyways when it comes to stuff like that. Gotta learn to be somewhat independent and do some things for yourself.

 

But what you're saying is that doctors are not responsible if they give you anything dangerous. If the medicine you give a person kills that person, you certinely must lose your authority to give anyone any kind of medication. I go to my doctor to get my health problems fixed, just like I visit my mechanic to have my car's problems fixed. They are both experts in their fields, they may make mistakes but if so, it is their fault not mine.

[Bodomi #Ms. Lady]

Selling Surgeries.

 

*mistakes not refundable.

[Hyperqube]

Question though. Fluoxetine doesn't seem to mention DM or vice versa? The only thing I can find is

 

 

Floexetine: https://www.medicines.org.uk/emc/medicine/18083

 

Do not take Fluoxetine capsules if you: are taking, or have taken within the last two weeks any monoamine oxidase inhibitors (MAOIs). MAOIs include phenelzine, tranylcypromine, isocarboxazide and iproniazid.

DM (https://en.wikipedia.org/wiki/Dextromethorphan)

 

Dextromethorphan should not be taken with monoamine oxidase inhibitors[14] due to the potential for serotonin syndrome

and (https://www.drugs.com/pro/bromfed-dm.html#C)

 

Do not use dextromethorphan in patients receiving monoamine oxidase (MAOI) inhibitors (see PRECAUTIONS - Drug Interactions).

While neither claims to be a MAOI. You sure they interact?

[Angelcake]

Question though. Fluoxetine doesn't seem to mention DM or vice versa? The only thing I can find is

 

 

Floexetine: https://www.medicines.org.uk/emc/medicine/18083

 

Do not take Fluoxetine capsules if you: are taking, or have taken within the last two weeks any monoamine oxidase inhibitors (MAOIs). MAOIs include phenelzine, tranylcypromine, isocarboxazide and iproniazid.

DM (https://en.wikipedia.org/wiki/Dextromethorphan)

 

Dextromethorphan should not be taken with monoamine oxidase inhibitors[14] due to the potential for serotonin syndrome

and (https://www.drugs.com/pro/bromfed-dm.html#C)

 

Do not use dextromethorphan in patients receiving monoamine oxidase (MAOI) inhibitors (see PRECAUTIONS - Drug Interactions).

While neither claims to be a MAOI. You sure they interact?

 

http://www.webmd.com/drugs/2/drug-91515/mucinex-dm-oral/details/list-interaction-details/dmid-2474/dmtitle-dextromethorphan-fluoxetine-paroxetine/intrtype-drug

 

source:whole ancenstors in medical industry

[HarryG]

http://www.webmd.com/drugs/2/drug-91515/mucinex-dm-oral/details/list-interaction-details/dmid-2474/dmtitle-dextromethorphan-fluoxetine-paroxetine/intrtype-drug

 

source:whole ancenstors in medical industry

Isn't WebMD notorious for horrid information? My parents are both docs and despise people that think they know better than docs because they looked something up on WebMD, just saying. Lot of other docs do the same.

[Hyperqube]

Oh, think I found something: (https://en.wikipedia.org/wiki/Fluoxetine)

 

Fluoxetine [...]is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class

and (https://en.wikipedia.org/wiki/Dextromethorphan)

 

Dextromethorphan can also cause serotonin syndrome when used with SSRI medicines,

Though I don't seem to find this on 'professional' sites. (wikipedia notes itself "The link between therapeutic dosages of dextromethorphan and serotonin syndrome has been suggested to be less conclusive." )

[Teeny Tiny Cat]

Yeah tbh it's not even a noted contraindication in the BNF, there's no particular reason not to take it. If medical professionals listed every hyper-rare potential interaction every time they prescribed you something, nobody would ever take their meds.

[Deku]

Yeah tbh it's not even a noted contraindication in the BNF, there's no particular reason not to take it. If medical professionals listed every hyper-rare potential interaction every time they prescribed you something, nobody would ever take their meds.

She's mainly concerned about the serotonin syndrome

[Teeny Tiny Cat]

She's mainly concerned about the serotonin syndrome

 

What's your point?

[polar]

"The combination of dextromethorphan with potent CYP450 2D6 inhibitors [like fluoxetine] should be generally avoided. Some manufacturers consider the concomitant use of dextromethorphan and selective serotonin reuptake inhibitors contraindicated. If use is considered necessary, the patient should be monitored for signs of dextromethorphan adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome, and advised to notify their health care professional if these adverse effects develop or worsen."

 

The two are actually often prescribed together for treatment of pseudobulbar affect, so it's not like prescribing them together is a huge no-no and puts the doctor liable for neglect. If the doctor did not follow up with the patient (like any doctor who prescribes fluoxetine is supposed to anyways), then there's a problem. If the person taking the two together started developing any one of those symptoms and ignored it, then there's a problem. Just simply prescribing the two together with proper follow-up is not really a problem.

[Angelcake]

"The combination of dextromethorphan with potent CYP450 2D6 inhibitors [like fluoxetine] should be generally avoided. Some manufacturers consider the concomitant use of dextromethorphan and selective serotonin reuptake inhibitors contraindicated. If use is considered necessary, the patient should be monitored for signs of dextromethorphan adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome, and advised to notify their health care professional if these adverse effects develop or worsen."

 

The two are actually often prescribed together for treatment of pseudobulbar affect, so it's not like prescribing them together is a huge no-no and puts the doctor liable for neglect. If the doctor did not follow up with the patient (like any doctor who prescribes fluoxetine is supposed to anyways), then there's a problem. If the person taking the two together started developing any one of those symptoms and ignored it, then there's a problem. Just simply prescribing the two together with proper follow-up is not really a problem.

polars and teenys responses really helped me in this problem, thanks everyone! now i will be closing dis :3