Wednesday, March 21, 2007

Requirements for being a pharmacist

1: being able to decipher illegible scrawls

I don't think I've ever recieved prescriptions as badly written as those, but some have come close.

Tuesday, March 20, 2007

Naughty nursing homes

I got a phone call today from one of the nursing homes we look after:
'Mrs X has got four tablets in her nightime slot, she should only have three?'
Oh bugger....
'Ok, I'll send my driver out with a new tray and to pick up that one so we can figure out whats happened'

So we got the tray back later on. We eventually worked out that one of the members of staff at the nursing home had been tampering with the tray. This lady used to be on hydroxyzine (a sedating antihistamine), 1 or 2 at night when needed. These were supplied as they would be to any patient: we can't put them in a tray as we don't know when she would need them. Hydroxyzine was difficult to obtain a few months ago, so this patient was switched to zopiclone, another sleeping tablet.

Once we had figured out what had happened we spoke to someone senior at the home and explained the situation. This is a totally unacceptable situation: nursing homes shouldn't tamper with pre-packed medication provided from the pharmacy. The manager said they would look into it, and I would expect disciplinary action to be taken. I'm waiting to hear what happens.

I feel like a tennis ball....

I had my mobile stolen the other day. At work. I'd taken all the stuff out of my jacket to put it in at the dry cleaners and had left my phone on top of my filling cabinet in my consulting room. And some little bastard helped himself to it. It was visible from the shop floor, so it's partly my fault, but its still bloody annoying. I just need to get some footage off the CCTV cameras. It wont actually show him taking it, (no camera in the consulting room) but may be of use to the police.

The real fun came when I tried to report it. I phoned the phone company: 'we need a crime reference or lost property number before we can do anything.'
I phoned the police: 'We need the IMEI number' (What???)
Back to the phone company to get the IMEI number
Back to the police: 'Has the phone been barred? Have any calls been made on it since its been taken? Can't give you a crime reference number until we know this.' I don't know, why didn't you ask me this when I first called???

Eventually back to the phone company. I actually get to speak to a decent person, who doesn't ask for a crime reference, sorts out a replacement handset for me, manages to keep the same number as before, and gives me all the details I need for the police. A replacement handset is either a £70 one off charge, or £30 and a 12 month subscription to their insurance policy at £6 per month (=£92). As this is the first phone I've lost in six years I think I'll take the first option.

The mobile phone company (Orange) only provide a 07 number to contact them on if you aren't calling from an orange mobile. The whole reason I'm phoning you is because I don't have my phone!!!! There were several times I called and got told there was a 20 minute wait to speak to someone. Nice little earner for them, though obviously I didn't hold the line (when do I have 20 minutes to hang on the phone at work?). When my contract is up I think I'll be moving elsewhere as I was not at all impressed by their customer service.

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!