A male in his 70’s is scheduled with the physician with whom I am working. The patient’s chief complaint is hallucinations. He is on 13 routine medications
RPh: Would you like me to go in and talk to him before you go in.
MD: Okay, sure. Why?
RPh: He is here for hallucinations and is on a lot of medicine.
Pharmacist sees the patient. He states hasn’t taken his medicines for a week because he had very vivid hallucinations of snakes. He was so scared that he went to stay with his daughter. The hallucinations went away when he stopped taking the medications.
I present to the MD.
RPh: I think it’s his medicine.
MD: You would say that. You are a pharmacist. (Said in a fun-loving spirit). He had hallucinations in the past. He was in the hospital. He was worked up, sent to neurology.
MD: They didn’t find anything physically/neurologically wrong. He had a urine drug screen and it was positive for amphetamines.
RPh: That is a drug.
MD: (shaking his head in jest) Why, yes it is.
Patient was examined, urine drug screen ordered, also urinalysis to rule out infection. Two medications known to cause hallucinations were discontinued. Now he is on 11. His medications come in a package. He brought in one. I was able to show him which medications to remove, called his pharmacy with the update. The patient seemed grateful.