Great Catch by CRBH's Leslie King RPh!

CRBH would like to recognize Leslie King, RPh for her recent Great Catch.  While reconciling a patient's medications, she noticed that there was a drug interaction between Pradaxa and Amiodarone.  This interaction increases the chances of an AKI along with a significant chance of bleeding.  Leslie also noticed that the patient reported to our ED nurse that he had been taking his prescribed dose of amiodarone twice a day (actually took it three times on day of admission), when it was only supposed to be taken once a day.  Leslie took the initiative and called the patient's cardiologist at UVA to verify that indeed the patient was only supposed to be taking this medication once a day as prescribed.  The patient presented with kidney issues and hematuria.  After ensuring that this change was made, the patient was rehydrated, his AKI improved, his hematuria resolved and the patient was discharged in stable condition.  Great Catch, Leslie and thank you for your attention to detail and for your commitment to patient safety!  Great work!