And how come, when the pharmacist filled the prescription, it didn't just hit him between the eyes that this was a massive dose of nasal spray?

I once had a prescription for an antibiotic. I am supposedly allergic to pennicilin. My mother always told me I was so what the heck, I believed her and never took pennicilin. I had some kind of infection, this was years ago and my doctor at that time told me, "moms made a lot of mistakes in those days, so we really can't be sure you are allergic to pennicilin and gave me a prescription for some kind of ILLIN thing.

Well, the pharmacist put it in the system, it was red flagged, he looked at me strangely and said to me "why on earth is this doctor giving you this antibiotic when you have an allergy to pennicilin?" I told him "Well, she thinks my mother may have made a mistake 40 or so years ago".

He said "oh really??, what's the doctor's number?" He called her up, he got me a different antibiotic.

Way to go, Biwise Pharmacy in Brooklyn. They are still my pharmacy.

Bet ya Dr. Fred would have never done that?????

mel

The meds are compounded and mailed by Sinucare, also called Home Care Solutions. The bottle clearly says 1.0mg/ml, and what was currently prescribed was 0.25mg/ml. I'm not even sure what happened in March--did the doctor really prescribe 1.0mg/ml, or did he prescribe 0.1mg/ml, and they dispensed something 10 times stronger.

So, I've developed total adrenal suppression, with resultant pituitary suppression, twice during the past year of supposed healing from the surgery.

And now, as I pack for vacation, I know why I'm tired, but damn, I am ******.

I'm thinking the pharmacist, when seeing the 1.0mg/ml dose in March, refilled each month, should have called the ENT to confirm this was what was wanted.

Mrs D-Can you find the usual dosages of this particular steroid advised for use in nasal sprays?

It IS a long trip....
 

but at least it will be WARM and there will be such beauty in those tropics!

It sounds as if you will be beyond super-busy before you go, but I'm more than hoping that you really will have some time to relax and smell some georgous flowers!

Safe travel with a bit of fun and laughter thrown in! - j

Mrs D
 

I just went to the website of the pharmacy, and this is their PDF for prescriptions: http://sinucare.com/quikscript.pdf


It doesn't specify the dose of the dexamethasone.

not good news...
 

Decadron Turbinaire was taken of the market here in USA due to
problems:
from http://allergy.peds.arizona.edu/sout...0inhalers.html

I am having problems finding the concentration of the European dexamethasone product called Dexacort.
...finally found an amount:
This would be about 14 milligrams/container. The rest is water/saline etc.

So, Liza, you have to do the math yourself to compare your compounded
to this commercial formula. Typically the commercial inhalers are designed
to deliver specific amounts accurately. If yours is a squeeze type that is extremely
variable in delivery. You can guesstimate how long your inhaler lasted, and work backwards to how much you were getting per day --in 8 sprays.
The total grams of the inhaler will include the weight of the fluid.

I distantly recall the Decadron Turbinaire here. It was made by Merck. It has
been off the market here for ages...and the newer more potent steroids,
replaced it's use many years later.

It looks like you have some questions for your doctor (who is bypassing FDA regs by using this old formulation)..as well as verifying the correct dosage.
Compounding pharmacies see alot of unusual things, they may or may not
verify a dosage like this. If the Rx was typically sloppily written, the period might have been hard to read. Also I have seen faxed RXs come thru very poorly and hard to read. If this product were compounded WITH the antifungal, perhaps dexamethasone was chosen, because the other steroids are not commonly available in raw state. Triamcinolone IS available in a powder and it could have been chosen. Nasacort brand has triamcinolone. But the type of delivery systems in commercial products cannot be opened or tampered with..they are sealed highly engineered delivery systems.

okay, I've got the bottle. It says it contains 30ml. and 1mg/ml. The directions on the bottle are 2 puffs each nostril twice a day. It's a metered spray.

So, they figured 8 puffs a day dispense 30ml in 30 days. Right? So, each day they were giving me 1 ml of fluid, which would contain one milligram of dexamethasone, or decadron.

Does that help?

In actuality, I took it at that dose from March through May, by which time I had Cushings Syndrome and saw an endocrinologist, who said I was being overdosed on this medicine.

Also, I found this: equivalents:

Prednisolone, 5
Prednisone, 5
Dexamethasone, 0.75
Methylprednisolone, 4

LizaJane,

I'm new to posting but have been lurking here for many months so I feel like know you all. Can't help on the nasal spray issue..but perhaps the pillow issue...

You might want to try a Boppy. It is a "U" shaped pillow made specifically for nursing a baby (you wrap it around your waist), but it could serve very well as something to sit on too. I've used my boppy for many things besides breastfreeding. You can get them everywhere....try any baby supply store...Also, I have been to Belize, but on Ambergris Caye (an island off the coast of Belize City) and it was beautiful. Take some bug spray too and definately the boppy for you bottom....relax and have fun.....

Ann

http://www.boppy.com/

Hi Liza Jane
 

Sorry to hear about the nasal spray problem. That is alarming that a mistake of that proportion could be made.

About the malaria, You may or may not recall that hubby leads tours every summer into the jungles and bush in various countries around the world. For probably 25 years now, he has been taking 100 mg. Doxycyline 2 days before leaving and continuing it upon return-I believe it is supposed to be daily for 4 weeks afterwards. Neither he nor any of the 30-40 people who go with him have ever had an issue with malaria or some of the GI problems people get when going into other countries. (I don't know if this is co-incidental or not, but I don't think so.)

If you are going to take an anti-malarial, you might want to consider this. I know photosensitivity can be a side effect from this, but they are mainly wearing light-weight long sleeves and long pants and there are practically no mosquitoes biting if they wear Deet... I am not keen on Deet, since I don't know what it would do to PN, but it is effective for healthy people. Then again, you may not be out in the jungles like he is.

Cathie

Liza Jane...I KNOW you are beyond
 

super diligent about your meds...But, isn't the whole THING scary? As in beyond scary?

For now tho....Just go and be one of those GIRLS HAVING FUN? after you get there, of course! Recharge in the world's beauty, yep, such places are beyond AMAZING and then later go and kick rear-ends! I have faith.

Really, IF I thought I could get 'snuck in' as your pet cat, I'd try....but, having lived in the tropics...my only observed s/e of cats [who eat the lizards/chameleons/bugs] have been a less desirable form of 'hairballs' and growth spurts...into really BIG cats as opposed to cats.

So, I guess, some remote cat 'pusha-pushas' are the best I can do.
GO HAVE SOME HECK OF A BUNCH OF FUN! - j

PICS? Heaps of pics? Pleeaasee?

Ok, I'm off
 

This is not an auspicious beginning for a trip, but it's a beginning of its own.

My son has a new canker sore and his gums hurt; I have a fever of 100 and my sinuses hurt; I've got pillows packed up the wazoo and a magnet on my butt and a suitcase full of pills, water pik, and something for every contingency I could imagine.

We're off!

See ya guys later!