I am a pharmacist-AMA

[Ladyofthenuvarings]

First off I have NC for this as with my other posts it's very identifying
I am a community pharmacist and independent prescriber working in a primary care center.I really feel there is a huge misconception out there that all pharmacists do is count out tablets and try to rip people off with over priced suncream.But it really is much much more than that.Like any profession there is good and bad and I've met plenty of both variety,but the majority of us are perhaps more knowledgeable and helpful than the public realize.Just trying to clear up any misconceptions really.....so AMA?

How long did you train for before you qualified? Do you need a degree?

Why does medication have zero effect on me?

Both DH and I had broken different parts of our body at the same time (joint accident) and both had the same meds. His knocked him out, mine did nothing at all. Same goes for paracetamol, ibuprofen etc.

I did a four year bachelors degree then I did a masters which is essentially a year long internship in order to be able to register as a pharmacist.Then I did a one year post graduate certificate course to become in independent prescriber.I am also hopefully going to begin a PhD in September 2020

Are you aware of the proposals for pharmacist apprenticeships? If so what is your view on them and did you respond to the IATA consultation?

I am so happy people do this job.

I would be a wreck. I would have to check, then check, then check again that I had given the correct medication out.

Do you ever take the job home, or worry about it?

@Pengrin really interesting question actually since we are all genetically different there could be lots of difference reasons for this.Mots likely though it's due to how our bodies metabolize drugs.For example a common pain medication is codeine and it is metabolized by a liver enzyme called CYP2D6 to morphine about 10% of Europeans have lots of this enzyme and therefore can metabolize more codeine into morphine so they get drowsy and sleepy more than the general population.Conversely some people have very low levels of this enzyme and and don't metabolize it well and so it has very little effect in them.In terms of ibuprofen and paracetamol however a disparity like this would be unlikely and there might be other factors at play

If 180mg fexofenadine isn't working what else can I take? More fexofenadine? A cetirizine? (I don't take any other medication but I have been using an avamys nasal spray as per my prescription this year)

I do all the stuff you're supposed to do, air clothes and bedding indoors, shower the pollen off, vaseline to stop pollen getting up my nose yada yada but it's not working so well this year and it has been my saviour until now.... Help!

What do you do if you are sure a doctor has made a mistake? Eg prescribed something unsuitable.

Since pharamacists need years of training in the effects of drugs, I often wonder how doctors can be expected to know which one to prescribe, since they are body/symptoms experts but you are the one who understands drugs?

What's the most cfery request you've ever had from a customer?

What is the strongest painkiller you can buy over the counter?
DH has raging toothache and no dentist until tomorrow

Wow thank you Lady. Very interesting indeed. Trust DH to be one of the 10% easily knocked out by codeine when he really doesn’t need any help in the snoozing department!

@ImADadButThatsOKIsntIt
I am aware of this proposal and am completely against it.Pharmacists are health care professionals our overarching responsibility is the safe and effective use of medications in order to do this you have to study every aspect of medication use.This is not something you learn on the jobs,you need a university setting with exams and standards.I also feel as though this would make the public lose respect for pharmacists.To me this idea is bizarre is equivalent to saying that doctors should do apprenticeships.I did respond to the consultation and voiced similar concerns

@DonPablo - this happened to me last year and the doctor gave me Montelukast, which has been a game changer.

I wish pharmacists could prescribe in the UK - I've lived abroad a lot, in places where you go and speak to the pharmacist when you are ill, and they have been brilliant. At one stage, I suffered horrendous cold sores, that nothing would touch, and Zovirax was about £20 a tube (and not that useful). The pharmacist recommended me an antibiotic eye ointment that was pennies and worked in hours - but tbf, it's no doubt not licensed for coldsores, so I expect even if chemists could prescribe more, this wouldn't have happened! Do you get frustrated that you can't do more, OP?

And have you ever had a prescription to fill that you have spotted is not right - whether because of drug interaction or dosage or whatever?

I always ask the pharmacist about what OTC remedies DF can use for colds, hay-fever and pain - his GP tends not know, and just shrugs (lots of heart meds). I have huge respect for pharmacists - they do an amazing job.

If someone was rude and then came back a few days later to apologise, do you believe they are sorry? I had a panic when I was out of medication and didn't yet understand how prescriptions worked. I didn't shout but was clearly cross. I went back a few days later to say sorry but I still feel guilty every time I see her.

Who funded your IP qualification and Do you currently prescribe in your community pharmacy role for NHS patients?

Do you have a cat?

This is not something you learn on the jobs,you need a university setting with exams and standards

The pharmacist apprenticeship WILL include a university setting with exams and standards - it's a Masters level apprenticeship proposal. Just saying...

@Sparklingbrook It can be very stressful.I have made mistakes every pharmacist has but I have caught and remedied then in time .I do take the worry home with me when I first qualified I would wake up the middle of the night thinking about medication and whether the box was purple or blue and was it the right one even though I knew it was.I have to give everything my 100 percent attention and do not bring any stress form my life into work.I am always fearful of making a mistake but do my best to eliminate any risk of that happening of course

Sorry this is very specific - few years back had joint replacement surgery. Was previously allergic to codeine, told them. After op was on Tramadol, Naproxen?, aspirin, ibuprofen and paracetamol. All OK for a few days then GP said I could double the dose of Tramadol as I was not sleeping. Did so and was rushed to A&E with anaphylaxis. Came home, happened again, then again till they kept me in for a few days. They seemed to think it was doubling the Tramadol that caused it. I had to stop all meds and was given epipen. I was told that anything could now cause a reaction as I was 'sensitised'. Have not taken anything since, but will have surgery again soon and worried about what I can have for pain relief...

Is it possible to get rid of acne scars with drugs/ creams? Or is surgery the only way?

That's what I thought Lady, it is a very stressful job, trying to concentrate and be on the ball the whole time. Must be tiring as well.

I have seen some of the pharmacists in my local chemists get terrible abuse too.

I notice at the hospital pharmacy some of the staff wear hi viz jackets with warnings on the back that they can't be disturbed. V good idea.

If you work for a chain like Boots do you have to manage the store as well as the pharmacy? It seems like a lot.

How do you keep up with the constant changes in drug information and availability?

@DonPablo not a pharmacist but I was on fexo and cetirizine at the same time
I take 4 cetirizine a day at the moment as the fexo didn't work