Tuesday, March 20, 2007

Busy, busy, busy!

I just don't know where the last month and a half has gone. I've been so busy it's ridiculous and there have been so many things to comment on. I've had a contract monitoring visit (which actually went ok, considering) and I've had several pieces of coursework to do for the postgrad course I'm doing. I've got a study week coming up for this course - it'll be a nice break from the daily grind.

So, some things that have happened since my last post:
Oral contraceptive to be available over the counter? I don't think it'll happen. It will take up too much of my time and women can get it free from their GP and only need to see them once a year.

Weight loss drug Orlistat becomes available over the counter in America. A forerunner to an application in the UK? Probably. As I understand it you can get it from certain Boots pharmacies in the UK without a prescription (in a scheme called a patient group direction). Orlistat works relatively well, but patients' progress needs monitoring. Orlistat works because it stops the absorption of fat in the intestine. If you have more than about 40g of fat per day while taking orlistat the fat goes straight through you, literally.

Viagra available from Boots without a prescription. No thanks! £50 for 4 tabs (which strength?) and an hour with the pharmacist is not good business sense. I can make more than £50 per hour for the business by checking prescriptions. Erectile dysfunction needs to be investigated properly as it is often a forerunner for more serious conditions such as diabetes and angina.

Royal Pharmaceutical Society to split. Probably not of much interest to the general public, but it does bring us in line with other health professionals. Regulation will be done by a General Pharamaceutical Council (appointed by the government?), along the same lines as the NMC, GMC and GDC. Representation will presumably be done by a royal college type body, and hopefully they'll make a better fist of it than the Society does at the moment.

Pseudoephedrine to be made a prescription only medicine? The MHRA are consulting on a proposal to make pseudoephedrine a POM. This ingredient is present in many OTC cold and flu preparations and congestion preparations such as Sudafed. Pseudoephedrine is used in the manufacture of methylamphetamine ('Crystal Meth'). There is no evidence that pseudoephedrine to manufacture crystal meth is obtained from pharmacies - it would be far easier to obtain it in pure form from a manufacturer in somewhere like Mexico than from pharmacies in the UK. I am trusted to sell morphine and codeine over the counter, as well as the morning after pill and sumatriptan for migraines. Why can't I be trusted to sell pseudoephedrine?

'Banned' aditives in childrens medicines.
Amazingly, given that I work in a fairly well heeled area I've not had any questions about this. Firstly the additives are banned in foods, not medicines. Medicines are different from foods as they are taken in small quantities and infrequently (normally). Their shelf life is also longer. Medicines for children are almost always liquids. These suspensions and solutions need preservatives to prevent microbes growing and to keep them stable. They also need to be flavoured so that the children will actually take them. Its difficult enough getting medicines down children even when they look and taste nice. Paracetamol, for instance, tastes foul, even when you get a tablet on your tongue. Anyone who has taken soluble paracetamol will know what I am talking about. Good luck trying to get that down a childs throat!


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