Drugstore Profile

In an age of medical specialization it is not unusual for a patient to visit within a short time a family doctor who prescribes an antibiotic for a strep throat, a psychiatrist who prescribes a tranquilizer, and a dentist who prescribes a painkiller. Some of these medications are compatible with each other and can be taken concurrently. But there are notable and alarming exceptions. For example, certain of the anticoagulant drugs used after a heart attack, in combination with aspirin, may increase the tendency toward internal bleeding. Some antihistamines, taken along with tranquilizers, may produce dangerously soporific effects.

The physician knows the dangers of drug antagonism, but is not always aware of all the medications that a patient may be taking, especially those bought without prescription. The patient knows what he is taking, but is rarely aware of the dangers. But there is someone in a position to know both the drugs being taken and the harm that wrong combinations can cause: the pharmacist. By keeping a medication profile of each steady customer and referring to it each time he fills that customer's prescriptions or sells him over-the-counter drugs, he can prevent the possibility of a harmful reaction.

Growing Risk. Some pharmacies have kept such records of prescription drugs for decades. But instruction in the use of medication profiles has only in recent years become standard in most schools of pharmacy, and the profiles are only now coming into widespread use for both prescription and proprietary drugs. In fact, some New York City pharmacists dispensing prescriptions under Medicaid are required to keep these profiles on Medicaid patients. The New Jersey board of pharmacy has issued a regulation, now under court challenge, requiring all pharmacists to keep such records. In these and many other states, a customer who hands a prescription to the pharmacist is likely to be asked: "Do we have your individual medication profile?" If not, the pharmacist may try to start one, and add to it with successive prescriptions or purchases of proprietary drugs. When he spots a potentially dangerous combination, his responsibility is clear.

Says Ronald May, pharmacist of a mid-Manhattan drugstore who has accumulated more than 3,000 individual profiles in five months: "We don't decide anything, but when we get a new prescription we advise the physician if ill effects are possible. Then he decides."

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