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, my teenage DD was prescribed the combined pill Rigevidon. Approximately 3 months after starting it she became very anxious and depressed. After seeing her GP she stopped taking the pill and has been feeling a lot better (she IS under pressure with exams looming).

She would like to start taking the pill again but is worried about her anxiety escalating again, do you think it would be worth trying a different pill? We have both read articles online pointing to a link between Rigevidon and depression and obviously want to avoid a decline in her mental health.

@Eviecee Brexit would have caused massive medication shortages however it is now my hope that we will have some plan in place for this before Brexit actually happens.Inwould urge you not to stockpile as that puts a further unnecessary strain and on the supply chain and could mean someone might hav to go without unnecessarily metformin and jardinance are highly common medications and we make metformin in this country so I think a real shortage is unlikely and I wouldn't stress over it .Victoza is a bit more complicated don't be tempted to stockpile it as there are stability and shelf life concerns considering it needs to be stored in the fridge an domestic fridges are not suitable for this long term.It will be more difficult to import victoza with Brexit as the cold chain cannot be Brocken so being stored at a port etc could be an issue but again I hope a strategy will be put in place soon so I would try your bet not to worry

I use phenergan to help me sleep, probably about 8-10 times a month. I have anxiety related insomnia and it really helps, never take more than 1 tablet, often half is enough- is there anything better and is this ok? Thanks

This is a hugely boring question but it's really bothering me and spotted your thread so thought I'd ask!
I've recently been prescribed epiduo for acne. Seems to be working a bit but has brought on a flare up of eczema on my eyelids-which I hadn't had in ages. I'm using e45 round my eyes but it's so stingy! Only stingy when I apply the e45.
Could the epiduo cause that? Should I persevere? I'm fed up with my face atm!!

I am very interested in all this...thank you.
My question..do you or did you do upselling in your job at the pharmacy you managed? Trying to gently persuade customers to buy an add on product. It's my pet hate and totally unethical l believe so would like to hear your opinion.
Also l absolutely hate being interogated when l request a simple OTC . I am late 50s so look sensible enough. I know you have to be careful but for goodness sake hand over the item !!! Do you find doing that questioning awkward at times?

@sillychilli Not really the only thing that possibly might help is valerian root sold as kalms the evidence is weak and is it a herbal medicine but some people do find a benefit from it. Anxiety is one of the things patients ask me most about the thing about anxiety as unfortunately, it is hard to treat. The only long term suitable treatment pharmacological options are antidepressants, antipsychotics etc. I know you have probably heard this advice but meditation mindfulness and self-help are key to managing anxiety. I understand the lure of Xanax and other benzos are enticing but it is not the answer.

@vivariumvivariumsvivaria The use of metformin in PCOS is only suitable in pateints with insulin resistance(usually defined as those who have prediabetes like levels in PCOS) and under specialist use in women who do not ovulate due to PCOS.Do you have a diagnosis of PCOS? If so you may need to see an endocrinologist as I would be very surprised if a GP would initiate metformin off-label and if I saw it would query. Metformin is not a treatment for obesity it is a treatment for diabetes that increases insulin sensitivity and decreases glucose production in the body. You need to go to your GP and ask for a HbA1c and if this is raised i.e anything in the prediabetic range I would request a referral to an endo. Metformin is not a wonder drug it has some unpleasant side effects and it alone will not cause much weight loss unless you are suffering from insulin resistance which is likely with PCOS.

How bad is it really to take antibiotics prescribed for someone else, if they ended up not needing them but then you came down with something you definitely needed antibiotics for, and theirs were the right ones?

Probably too late but for the poster whose husband has toothache, I find (and there may be no sound scientific basis for this) that lemsip works better than just plain paracetamol.

I've just had the flu and now I have a d&v bug. I feel like I'm going to die. Is there anything that will help me to feel better and get better quicker?

Very interesting thread !Thank you!
I am also a pharmacist.Very disillusioned with the profession due to the complete lack of normal working conditions.
10 hour days with no breaks, ever increasing demands for more services,more paperwork and beaurocracy ,more and more stress and less time to spend with actual patients .
Totally disillusioned with the profession and lack of professional recognition.
Have been held up in violent robberies 5 tines so far!!!
People expected me to finish their prescriptions and continue on after watching me have a gun ( turned out to be pellet gun) pointed at my head.
Would rather do practically anything else for a living!!!
Do you ever feel like this!!!
!!

1. Was chemistry your best subject at school? How hard was the chemistry as an undergraduate?
2. How’s the pay for a pharmacist who doesn’t own their own business? Is anyone an independent pharmacist anymore or does everyone work for a chain?

One more question- what’s the female:male ratio for pharmacists nowadays ?

Rosacea - any new products lately? Suffered acne since a teenager, cleared up massively after pregnancy (in 40s) but now replaced with rosacea!! Red nose and little pustules around nose when it flares up (no idea of trigger). Any suggestions appreciated. Thank you.

I'm no pharmacist @BrightonBB but I do have rosacea and ill tell you what works: Soolantra. I had to get a dermatologist to prescribe it initially and now get it online via pharmacy2u (sorry OP!) and it's magic stuff.

My MIL, DH and DD (8) all suffer badly from reflux. DD has GORD. We managed to get her off all the medicines as soon as we could and now only give relief when she has the hot, burny tummy/hiccups (thank goodness she can tell me now) she takes a Rennie.

My MIL has been on omeprazole (sp? With an l) for many years. It says in the leaflet that is might cause cancer? She has cancer of the stomach, lungs, lymph nodes and oesophagus which was originally skin cancer (eye)
Has her reflux medicine made this worse?
My DH takes it daily - what else should he take?

What other things can be done for reflux/GORD? I don't want the medicine to contribute to other illnesses for my DH and DD.

Thanks for the very useful AMA.

Great thread OP btw. And I have a question about Scopaderm patches - my SEN DD has been prescribed them to help with her dribbling.

The instructions say stick the patch behind the ear but she notices it's on and tried to rip it off.

So my question is - can I stick it elsewhere eg between shoulder blades where she can't reach? Will it still be effective?

Sorry for niche question!

@junebirthdaygirl I do not upsell currently as I don't really agree with it but in the shop, I managed the staff were encouraged to buy head office, not a decision I was comfortable with but wasn't up to me. I do think there is an element of this in every business, there are times when it is not appropriate but other times when I do not see any issues, customers can make their own decisions. The interrogation thing is an interesting one. If I am making an OTC sale generally I don't ask too many questions I usually know the patients and if not can make my own judgement. There are some questions I have to ask as the one patients I don't ask is the patient where something goes wrong and that is completely my responsibility . I do not make every OTC sale my staff do and they ask the questions to safeguard the sale. The questions allow them to identify any issues and bring them up with me. It's about safety not being nosey so please do not take offence at this

MooPointCowsOpinion please do not do this . My question to you is how do you know these are the right ones ?? The answer is you don't you even know whether the infection is viral or bacterial. Thing is the doctor doesn't know either what bacteria it is but they make an educated guess based on symptoms and usually given something sort of broad-spectrum anyway. Chances are you could take them and be fine but there are so many factors at play with medication use I just couldn't condone this. If you do choose to do this please get some advice off your pharmacist to make sure they are safe for you and in date and at an appropriate dose etc

@Moviestar I have felt like this and completely understand. Just after I graduated I became completely disillusioned with the whole thing. Was held up with a syringe one night locking up and suffered from terrible PTSD after this. I couldn't see a way out so I changed direction slightly and now really enjoy my job . But I still have all the bureaucracy and paperwork, unfortunately. There are so many opportunities for pharmacists these days do not feel trapped you can find a new avenue

@Doubleaxel yes chemistry was my first real love if you don't love it pharmacy isn't for you. The chemistry is difficult at undergrad not impossible but very different from the kind you did in school. I make just under 80k I could make more in the private sector and will make more once I change directions after I complete my PhD but for now I'm happy with this. My sister qualified two years ago and is now on 85K in Ireland so i would say the pay there is higher and rising all the time.
I would say 60:40 women to men but not really sure

Are there ANY topical treatments that genuinely kill fungal nail infection, or is a tablet the only way?

I've got awful fungal nails. I've tried the expensive paint on stuff, I've tried tea tree which seems to have a similar effect - but all of them just suppress the fungal growth rather than outright kill it. So you need to keep applying it for months and months until the entire nail grows out.. and I've never been able to keep it up.

The tablet, I believe, is effective but I've been told not to take it while trying to conceive. So I'm stumped... what can I do to cure my hideous gargoyle feet?