Saturday, June 16, 2007

Tiny Pill Tales - Part 2

Gentian Violet (crystal violet, Methyl Violet 10B, hexamethyl pararosaniline chloride) is an antifungal agent, the primary agent used in the Gram stain test, perhaps the single most important bacterial identification test in use today, and it is also used by hospitals for the treatment of serious heat burns and other injuries to the skin and gums. Typically prepared as a weak (e.g. 1%) solution in water, it is painted on skin or gums to treat or prevent fungal infections.

I should be doing something a bit more useful than this blogging, such as ironing, or taking some boxes out to the recycle bin. But this is more fun - writing tales of pharmaceutical compounding misadventure.

Ill Do It!!

I was working, this particular day, with Pharm and the stores other technician, T. Between the two of them, they had about forty years experience in pharmacy. Myself, I was just out of college with a whopping six months under my belt; so very much keen to try it all.

A woman, with her little baby, came into the pharmacy. She had a prescription for the little one. It was for us to dispense a solution of 1% gentian violet.

T: This will take about half an hour to fill because we have to compound it. Do you want to wait, or will you come back?

Lady: I have some other shopping to do. Ill come back in about an hour.

T: Thanks.

A few minutes later

T: Hey Pharm, do you want to make this?

Pharm: (chuckling) No way! Why dont you do it, T?

T: No way! I told you the story about the accident when I was doing my practicum as a student?

Pharm: (still chuckling) Riiiight.

Then the two of them looked at me and the KEENER, KEENER, KEENER banner running across my forehead

Me: (going through my head: OH!, OH!, Pick Me! Pick Me!) Ill do it!!!

Now the problem with working with gentian violet is that it can easily become a very messy process. Even if you are only a little bit sloppy, your hands can end up becoming a lovely shade of purple that doesnt wash off very easily, or you may permanently stain some equipment or your lab coat (or clothes).

I knew this, but they didnt know I knew. So they were hoping to get a good laugh over my surprise. Myself, I was out to disappointment them and get the last laugh.

So as I started making the preparation, T told me about her accident. I wondered if she was trying to spook me.

One day, during her practicum, she accidentally knocked a bottle of gentian violet powder off the shelf. The bottle shattered sending powder all over. Needless to say, it was quite the mess to have to clean up. The funny bit was that even two years later, when housekeeping was doing a major clean of the pharmacy; they were finding traces of the powder in the ceiling air vents and on the tops of shelves, all the way at the other end of the pharmacy department.

And its true, as I learned with experience. The powder is so fine that no matter how careful you are when moving it to and from the balance, air currents easily waft particles and distribute them in surprisingly distant locations. You know that powder has landed on any one surface only after you wipe the surface down with a damp cloth and see the tell-tale purple. So it was always a good practice, after compounding with gentian violet, to do a thorough wet wipe down of your work and surrounding areas to prevent others from accidentally staining their clothes.

Me: Tadaahhhhh ! (after pouring the solution into the applicator bottle) See, I didnt even spill a drop. No mess.

Pharm & T: (standing around) Were impressed. Good work!

Then all three of us looked at the bottle. There was going to be a problem. I had poured so much solution into the bottle that you could see that surface tension thing happening. Its that phenomenon that happens when you fill a drinking glass so full with water , that adding just one more drop will cause the water to overflow down the sides, but you havent added the one more drop yet.

Me: Oh,oh. I havent put the applicator in the bottle yet. Here it goes.

Needless to say, purple hands.

So later, when I handed the filled prescription to the mother, showing her my hands I warned her:

Be careful, because this product will stain.


Anonymous said...

Thats taking patient education a bit far, love (k) (k) (k)

MedStudentWife said...

*lol*. I had to make sure thatI got the message across. *lol*
kisses to you too, anonymous :D

DeathSweep said...

I swear I can still remember the taste and smell of the stuff from when I was a kid. If I remember this part right I think it was used in my mouth on a sore. As a child I would get these little white sores from time to time. The parents called them "cankers" and the fix was this small bottle of purple stuff that never managed to stay just in my mouth and had a taste all it's own; and it wasn't grape!


MedStudentWife said...

DS, It probably was - this is based on what they were putting it on; I never
tasted it myself.

*lol*... I've got this image of purple drool... eeewwwww :0

MedStudentWife said...

DS, It probably was - this is based on what they were putting it on; I never
tasted it myself.

*lol*... I've got this image of purple drool... eeewwwww :0