September 22, 2005

• IANAD This site identifies the second drug by its more common trade name Compazine, which is indeed often prescribed as an anti-nausea drug. This site says It is not known whether prochlorperazine will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. Many drugs are not tested for effects on fetuses. Compazine is a common med. You may not get a definitive answer, but there doesn't seem to be a serious indication of any known issues.
• Doesn't your doctor have an answering service? There should be a doctor on call who would call you back right away. Good luck! Don't panic!
• My best wishes for everything to turn out well! And sue the bastard for all he's worth is there's a porblem!
• Failing that, you could call the hospital non-emergency number. Someone there should be able to calm your fears. *hug*
• Note that Compazine is considered a category C. Reglan (metaclopramide) is category B. Either might be prescribed during pregnancy. I don't think 30Mg is worth worrying about. IANAD As to what to do... hmmm.
• 1. Call your Obgyn's hotline service. 2. Try and stay calm -- most likely everthing is ok. As BrianK pointed out, while there has not been any testing on Compazine, that is usually an indicator that no major redflags have been raised for this drug. 3. Pay attention to the baby and what your wife is feeling. Have there been any major changes in frequency of kicks, etc? 4. Call the pharmacy and report this to the management. Don't go looking for vengeance, just make sure that the pharmacist learns from this mistake. 5. Give your wife a hug from the monkeys.
• Search of the medical literature brings up nothing other than 'women with hyperemesis that does not respond to [Compazine] may be given X, Y, Z'. Relax. The stress will do more than the drug. I worked in a high risk pregnancy clinic and let me tell you - that's nothing. We saw lots of people on stronger, weirder meds all the time. (IANAD, but I was raised by an OB NP, who can't go into private practise because of the cost of malpractice insurance in the OB field...)
• sugarmilktea, word freom a kinsman who works in a pharmacy: Suggestions: 1. Call your local hospital pharmacy NOW -- speak to the inpatient hospital pharmacy even though your wife/baby is not a patient at this time. You will need to tell the pharmacist there how you identified the pill, and give him the imprint number on those pills. 2. THEN, if necessary, call your lawyer. A retail pharmacist is not likely to help you much, because you have definite grounds for a suit against the retail pharmacist who made this error.
• Thanks much everyone for the fast response and helpful advice (it's been one of those crazy days, hard enough to think straight as it is). The thing that has made my wife most concerned is that she did notice that the baby was not very active last night (as has been the usual for several weeks now). I've been doing my best to relieve her worries, but for a while there she was crying from the stress/worry. I think your monkey hugs and advice have helped! My wife is from Indonesia, and is therefore is not knowledgeable with US meds. She asked me before she took the pills, "are you sure they are safe?" I assured her that the doctor wouldn't prescribe a drug harmful to her or the baby. Uggh, then this happens! We have calmed down. I'm sure everything will be ok... it's easy to get overly nervous and worried when it comes to an unborn baby :) Can't believe I've been on the internet, what, almost 12 years now, and I never knew what IANAD meant! Now I do...
• Thanks for that advice bees. I will give the hospital pharmacy a call now.
• IANAL. Make sure the baby is good. Call another doctor. Call the FDA. Call a lawyer. Even though everything appears to be (thankfully) fine, you can't just drop this. Either it was an honest mistake, or the pharmacist thought he could just substitute something else. Neither case is defensible. Make sure that someone else in your situation doesn't have to go through this.
• Bad (and possibly illegal) form for the pharmacist involved, at least if you're in the US. Any dispensed bottle should (legally) have an Rx label, even if it's just a few pills.
• I called the hospital pharmacy. The pharmacist there said that Compazine is considered an "intermediary risk" to pregnant women, "there are better choices." Since the bottle was dispensed to us with no label, and all of those pills are gone, it will probably be difficult to prove anything at this point. Well, the RiteAid pharmacist did say he would make a report of his mistake. Assuming he actually does so, there may be nothing we can do? Waiting for a word from the doctor now...
• One final thought, the RiteAid pharmacist has offered to "replace the mistaken three pills with the three correct ones." Should I go there tomorrow and collect them? Kinda bizarre the way he said it on the phone, "I'm really sorry. Well, I guess I owe you three pills!" I'm wondering if by collecting these three pills, would that help our case any if we need to prove anything? *needs a rest*
• Once you're through the medical aspects of this, your most immediate concern, you may want to sit down and document everything. You've made a good start with your posting here, so add anything else you can remember and be sure and record the times when things happened as best you remember them. Keep the pill bottle, perhaps the residue is testable. This keeps your options open should, knock wood, you need to sue. It also gives you a basis for a complaint to the pharmacist's professional organization, something you may want to whether you take legal action or not.
• whoa, just an offer of hugs to you and your wife! as upsetting as this is, try to take a few deep breaths and stay calm. it'll help your wife calm down and be better for the baby. you have a monkey army behind you!
• I don't advocate betting anybody's life on Wikipedia, but in this case I doubt you'd have to. Links follow. Reglan (metoclopramide), Compazine (prochlorperazine), and what they gave my dad for 25 years (but not for nausea), Thorazine (chlorpromazine). I'm not a doctor either, but from Dad's experience and a bit of reading I'd say long term everyday use of any of these drugs will really fuck you over (see the list of possible side-effects in the Thorazine article, and the article on tardive dyskinesia), though an occasional dose for nausea probably won't do major damage (and might even help). And it does seem to me that Reglan and Compazine are pretty much interchangeable, like Librium and Valium among "minor tranquilizers" or like aspirin and ibupropen among OTC pain medications. (Not that you might not have a lawsuit; I'm not a lawyer either.) My non-medical hunch though is that the doctor prescribed them because they might help, the pharmacist substituted one drug for another in the same class thinking he was doing y'all a favor that was better than nothing, and that your stressing out isn't helping you or your pregnant wife. Whatever y'all do decide to do you might try to relax a bit. (I'm not criticizing you though: I spent most of Monday afternoon worrying if my new puppy was eating enough and if I should bake the dude some chicken and/or scramble him an egg in case he didn't like the pricey bagged kibble, so I emailed my SO at work for her opinion, in depth, twice, as if a puppy who's happily bouncing around the room, and pooping on the floor because I'm too distracted by my VERY URGENT typing, could starve to death in the 2 hours till she got off work and came home.) I do recommend trying to get the doctor to prescribe another kind of anti-nausea drug though, if there is anything better available; my non-medical gut feeling is that any of these drugs should be last-resort items especially for pregnant women. I'm never going to be pregnant and I regard the Compazine I was prescribed when my migraines got so bad I was nauseated and puking as a last-resort. But then I'm admittedly prejudiced against these chemicals, so take my opinion with a barrel of salt. (Incidentally, when I was a teenager I was put on Mellaril [the Wikipedia article goes by its generic name] for a year or so, and when my turning 30 seemed to involve a CIA-Satanist plot against me I spent about 18 months on Loxitane; I don't think either of those drugs did a damn thing for nausea however.)
• This won't help at the moment. Many, many drugs are given to women at various levels of pregnancy due to emergency. 99% likely that your wife + the baby are fine. Drugs like this have been around long enough that they've been used accidentally at one time or another. The levels were so low...and she's now off of them......that any real damage was primarily psychological. Yes, talk to your GP, the rite aid, etc...but relax a bit.
• Many thanks everyone for the kind words. Thanks for the links as well Big Davey, I didn't even think to look to the wiki (*slaps forehead*). We have relaxed... And yes, it does help at the moment to hear such words!
• SMT, if you and your wife have concerns about taking meds for her nausea, might I suggest Chinese medicine (acupuncture/herbalism)? As TCM student, and the spouse of someone who used it during pregnancy, I can vouch for its efficacy and safety. Send me a private email if you have questions. Address is in the profile.
• I initially read the thread title as 'Perception Mistake'. /offtopic
• if you and your wife have concerns about taking meds for her nausea, might I suggest Chinese medicine (acupuncture/herbalism) Herbs are not an alternative to drugs. Herbal remedies are drugs. Ingesting a traditional herb is just as much taking a drug as eating pot brownies is, or as taking Taxol is, or as taking Digoxin is -- all are plants or plant extracts. The main difference between herbal medicine and normal medicine in the US is that herbal remedies are largely unregulated, so the only assurance that you're getting what you paid for and not a higher dose, or lower dose, or a different substance altogether is that the manufacturer says so. No doubt many herbal remedies are efficacious and safe -- that is because those are safe and efficacious drugs. But pretending that herbs are an alternative to drugs, as if they were some other thing altogether, is simply foolish on its face.
• ·Prochlorperazine

  What side effects can this medication cause? Although side effects from prochlorperazine are not common, they can occur. Tell your doctor if this symptom is severe or does not go away: ·drowsiness If you experience any of the following symptoms, call your doctor immediately: ·jaw, neck, and back muscle spasms ·fine worm-like tongue movements ·rhythmic face, mouth, or jaw movements ·slow or difficult speech ·difficulty swallowing ·restlessness and pacing ·tremors ·shuffling walk ·skin rash ·yellowing of the skin or eyes

  ·http://skepdic.com/acupunc.html

  ...Acupuncture may be harmful to the fetus in early pregnancy since it may stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin, which affect labor. [...] And some patients will suffer simply because they avoided a known effective treatment of modern medicine.

  IOW, YMMV.
• Xeny, I did not intend to suggest otherwise. Yes they are drugs, hence it being called traditional medicine. I also do not want anyone to think that I recommend self-treatment. For the very reasons Xeny points out, one should always seek treatment from a licensed practitioner (LAc). Wedge, once again, go to a licensed practitioner. From day one in TCM school, you are taught the contraindications for treatment during pregnancy.
• Reglan and Compazine are interchangable, the only big difference here is the amount of research done on taking them during pregnancy, which of course is important. I'd be more concerned about the stress than the medications (as somebody already mentioned). Keep in mind too, before there was all this research people used to drink, smoke, eat swordfish, soft cheese and raw fish, etc, and their kids turned out ok. In some parts of the world, we do things while pregnant that would horrify them. For example, I believe it's the japanese that says you shouldn't eat anything cold (temperature-wise) while pregnant at all. I panicked quite a bit when I found out I was pregnant and it clicked that the bad headaches and migraines I was taking lots of meds (NyQuil and all sorts of prescriptions that weren't working) for were from being pregnant. They sent us to a specialist (I don't even remember what kind anymore)just to be on the safe side, and your doctor may recommend that for you if your insurance covers it and she likes to err waaay on the side of caution. Everything turned out fine for my son. Please try to reassure your wife that everything will be ok, it was just a short exposure to the medication, and panicking/her emotional state will probably have more of an impact than the medication. If possible, for her sake, downplay your concern and speak with the OB privately about your conern for the time being. The baby has done a lot of the gross developing, and it was a short exposure. And please be sure to let us know what the doctor says too! Of course, the standard disclaimer of IANAD applies here, too.
• Regarding the advice to call a lawyer, unless you can prove harm has been done, you have no case for a malpractice lawsuit. Doctors and other health professionals are allowed to make mistakes. It only becomes malpractice when it is detrimental to the patients health. Of course, just by bringing the suit, you have a good chance at getting a settlement because most insurance companies can settle cheaper than they can litigate, but it is those kind of frivalous law suits that raise malpractice insurance rates to ridiculous amounts making it harder for proper care to be had.
• Following from that, speak to a lawyer anyway, if only to hear it from them. And when I say speak to a lawyer, I mean speak to a lawyer your know and trust, not some malpractice guy whose phone number you saw on a fridge magnet. Even a lawyer who is outside of the field will know the basics to give you some rough advice, and can direct you to a more appropriate solicitor. But all that comes AFTER checking things out with the doctor. In the meantime, document, document, document. Don't forget to breathe! Good luck!
• I have nothing more to offer than support and hugs, but here you go! *hugs*
• Wow, this has the be the scariest thing for you so far. Good luck!
• Sorry, zanshin, I ought not have jumped on you. That's one of those things that sends up the red mist and gets me going without stopping to think about what I'm writing.
• Again, thanks to everyone for all of the great (and very helpful!) feedback. The doctor has said that it should be absolutely fine, "good that it was a few pills rather than an entire bottle." Still, it was enough to give us a good scare. *take a deep breath* I've never been the type of person to jump at the chance to file suit against someone. While I was understandably upset with the pharmacist in question, I would find it hard to pursue any type of legal action (unless something harmful had in fact occurred). I will most likely report the incident to the appropriate parties, and hope that he is a bit more cautious from now on. The baby seemed to be back to normal last night. I felt a few kicks myself as I placed my cheek to my wife's belly. Now, just another 18 weeks or so to go! And then perhaps I will have little time for MoFi for a couple of months...
• It's all been said before but absolutely complain to the head pharmacist there, if not to some sort of Medical Quality Assurance Commission (depends on your state what the equivalent is called) to report this. Pills should never be handed over in an unmarked bottle--a first year pharmacy student knows that much! Very poor practice and potentially fatal.
• Hope the next 18 weeks go smoothly. And no slacking off MoFi, or we take both kids away.
• or we take both kids away For a few days?? Please, please!! Ok, ok... I'll try my best
• Hurray, smt! Glad things are not as bad as they first appeared. Don't be long away - and thanks for not being a suer. :-)
• smt, what a scary moment for you two. A word of warning to you.....it just gets worse from here on out. Just wait until they learn to walk and go down their first set of stairs. Or climb a tree. Or run in to the street after a stupid ball. Yep. It just gets worse. This is all part of your training. Get used to it. ;> I'm a mom, I know.
• Darshon speaks the truth. I loved the kicking, but #2 would always get the tiniest bit freaked out by the big rolling movements across my stomach later in pregnancy. Understandably, because so did I. I'm glad everything is okay.
• Glad everything's alright, SMT and Mrs. SMT. And then perhaps I will have little time for MoFi for a couple of months... HAR har HAR HAR HAR snicker snort HaH! In 18 weeks, kiss your life and sanity goodbye for the next 19-25 years.
• In 18 weeks, kiss your life and sanity goodbye for the next 19-25 years Now you know why I'm here on MoFi ;) (after the first one was born, no time for much of anything else really... and thank god for MoFi, at least it keeps me from losing the last bits of my sanity!) Hell, I gotta laugh with you GranMa. When I re-read that comment, your wisdom shines through!
• Monkeyfilter: big rolling movements across my stomach
• Wait 'till SMT finds out that the hair on the top of the toddler's head is a last second handle to keep them from darting out into traffic.
• That's why my toddler wears hoodies.
• *takes out notepad* Hoodies... aha! Great, as if I wasn't freaked out enough by the heavy traffic outside our doorstep, a.k.a. Boulevard of Death!
• My brother used to have to wear a harness because of that. Man, I wish I had pictures.
• Drug Reactions Send 700,000 Yearly to ER