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Always expect the unexpected - a surprising MUR outcome...

28/5/2012

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When we do a patient service, such as a medicine use review (MUR), we expect minor issues to be raised during the consultation, but every now and again something stops you in your tracks...it happened to me the other day. 

I was doing a MUR on a gentleman and we began discussing his medication...when we got onto his pain relief medicines and reached paracetamol I though he was going to say "yes, I take them as prescribed - Two, up to Four times a day when necessary" but he didn't...He said "I often take Four tablets Four times a day when in pain - sometimes more - I know it's an overdose!" I was shocked...such a toxic overdose is potentially lethal.

 The maximum dose is on all products and labels. I had a stern conversation about overuse of paracetamol and the toxicity of it. He admitted that he obtains extra supplies from corner shops and from family members...We discussed liver toxicity and the risk of paracetamol poisoning, and death, with overdose... I've referred him to his doctor urgently.

 I hope the patient takes my advice, cuts down on the paracetamol and gets his pain control reviewed; or else I fear for the consequences... and, I guess, this just goes to show the benefit of the MUR service - even on what might be thought of as trivial medication...

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