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?

Lady, I have sinusitis. I’ve had amoxicillin, and then doxycycline, which has cleared up the infection, but I’ve still got inflammation. I also have Avamys. Is there anything else which will work for the residual inflammation, and help me breath freely again? Thanks in advance!

If someone asks for e.g. Nurofen do you explain that generic ibuprofen is the same drug and lots cheaper?

@florence11 I would actually say that hospital pharmacy roles are quite sought after especially with young pharmacists.They have a very large scope of practice and really do great work.I did a brief stint in one a few years ago when I wanted to leave the store I was working at.....and I really disliked it.I had a ward of 16 patients that I would round in daily they were very acutely ill there was constantly medication issues side effects and toxicities and as soon as I fixed one thing another thing would go wrong.I felt I wasn't helping them merely keeping them alive and that was all .I also had to release a lot of chemo which I really didn't like it was stressful and monotonous at the same time and all and all I packed it in but those are just my reasons.Hospital pharmacy is great for career progression and the hours are very sociable but it wasn't for me.Community is much more long term and less acute and I get to build relationships with my patients,overall for me it has more job satisfaction.

When you give quick advice to patients over the pharmacy counter do you make any record? Do patients ever formally complain later?

My cousin is a pharmacist and omg the stories I hear!!! I think many people don’t realise the point you made OP about there only being one of you and you have to personally check everything - there is often a lot of staff visible and so people get frustrated thinking someone else can hand over/OK their prescription.

lady if the GP prescribes something but when the pharmacist tries to get it its out of stock or there are manufacturing problems so there's a shortage, who's job is it to recommend an alternative medication, would you have to go back to the GP or could the pharmacist prescribe?

Lady I always worry I give my son too much Calpol. He has sore eczema and has also been teething pretty much continuously for the past few months. I seem to have been giving him Calpol in the night a few nights a week for what feels like months! Do you think people are generally too quick to give painkillers to babies and toddlers and we should be only giving it when they are screaming in pain (this is what my mum reckons!)

lady if the GP prescribes something but when the pharmacist tries to get it its out of stock or there are manufacturing problems so there's a shortage, who's job is it to recommend an alternative medication, would you have to go back to the GP or could the pharmacist prescribe?

sorry for the double post 🙈

Is Brexit going to cause problems with stocks of medicines? I take slow release metformin, jardiance and victoza injections. I was seriously worried and would have liked to stockpile. Am i wrong to worry?

Is there an OTC item that actually works temporarily for anxiety? I’ve tried various thing but nothing’s really works. Thanks

Do you think that metformin helps symptoms of PCOS - specifically, obesity? And if so, how do I get my GP to prescribe something that's off license? desperate

@cockadoodledooooo I feel as though my opinions in prescription charges will be slightly controversial but you did ask.I feel as though the vast majority of us in this country underpay for medications.The NHS is in its knees and this away we could relieve a huge financial burden.I do not think it is unreasonable to make people contribute towards their own medications.I have no problem with except drugs and believe these should stay as is and perhaps be expanded to include some more vulnerable groups.This is the point at which I admit I am originally Irish I believe there medications payment system is very effective (just that no saying their system is perfect )people under certain income thresholds and those will complex medical needs pay a small levy on each item to a maximum of 20euro (couple )then people over that threshold pay a maximum of 124 euro a month per household.I feel this is fair as everyone contributes towards their medication and even that small levy really makes people think whether they need it or not.I believe this would stop medication wastage and lessen the NHS burden.Also something that frustrates me endlessly is that people are happy to spend on drinking holidays and clothes but very unhappy to contribute towards their health.

@HopelesslydevotedtoGu yes I would love to see pharmacists providing more services to pregnant women the reason that right now this is limited is too fold.OTC products are licensed for specific conditions and groups and it is risky to break this license as you are then responsible for adverse effects.Secondly clotrimazole and other azole aren't recommended in pregnancy because they are associated with risks when taken orally.But the reality of the situation is no GP will refuse a pregnant women treatment as she will be in discomfort and this also causes greater risk to the baby.I will admit I have sole canestan to pregnant women before as they were in need.I really feel like some guidance needs to come out that allows pharmacists to provide these services as the reality is the licensing won't change due to the ethics of testing a product in pregnant women.This is something the NHS need to take the initiative on

@kissmelittleass ohh esophageal candidiasis what a nasty dose .It is true that fluconazole can cause raised liver enzymes and sometimes for longer courses such as a prophylactic course a doctor would run Liver function tests to make sure everything is okay.That course is standard and presuming your are otherwise healthy should not have had any long term effect on you.I can assure this is the best course of treatment as the other treatment options if the fluconazole has failed are at a much higher risk of causing liver damage.

What's the most common thing you give out on prescription?

@Miss1973HulaHoopChampion Medicines are always going in and out of stock but yes as the moment things are particularly bad.Lots of companies are having manufacturing issues but the threat of Brexit has meant its harder for us to get stock in.Its quite complex but essentially if we crash out of the EU close our borders it will be much harder for people to import medicines lots o our medicines come from cheap countries like Greece where they are cheaper and are sold here.But with brexit lots of these importers had to seek alternative markets for their drugs so that if it did happen they would lose money so it was hard to source things for a few weeks.Also has been quite a bit of stock piling going on which has put a strain on resources a few other factors relating to brexit but some of the reasons even I don't understand

@helzapoppin2 the best thing for inflammation in your sinuses is the avamys as it is a steroid keep using is daily two actuations in each nostril and continue to use it even after symptoms have gone for atleast a few weeks to prevent it coming back.Not really that much else you can do but would recommend steaming yourself over a bowl of hot water maybe with some Vick's in it to try and encourage your sinuses to clear out.Feel better soon

@SayPleasePlease yes I will always ask if they want nurofen or the generic and say they are the same thing .Most of the time I get barked at saying they asked for nurofen

Thanks Lady

@HopelesslydevotedtoGu again it depends all my patients have electronic records on the computer where I can make notes.If a patient tells me something like they have x disease and it wasn't something I was aware of or is something unusual I will make a note .If a patient tells me something personal about themselves that I feel is relevant to their healthcare I make a note.If I notice a patient buying too much codeine containing products or sedating antihistamines I will also make a note and monitor this .Its not being nosey but i feel I have a responsibility to do this and all the information is confidential.I have had complaints made against me nothing major and have always been in the right.People can get very frustrated when they don't get what they want and can become malicious.l once had a women complain that she "didn't want a school girl handing out her medicine and wanted to see the chemist "

@guiltynetter I would say it is the pharmacists job as most pharmacists are not prescribers they would need to contact the GP.I would never send a patient back to the doctor as that is a waste of time and resources .I would ring the prescriber explain the situation and recommended and available alternative and then either edit the prescription I have or get them to send me another one.In very unusual cases where there is no alternative available they may have to go back up for a pre medication work up if different treatment was needed but that would be unusual

Why is it so hard now to buy drops for conjunctivitis? I hate the ointment, drops are much easier, but recently both DD’s have had to use the ointment.

(Both are over 8 so don’t need a prescription and I will always try to buy OTC if I can avoid making a doctors appointment)