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?

@BrightonBB rosacea is not something I know loads about but the first line is topical antibiotics and possibly oral if these fail. As a previous poster has said ivermectin is useful but not exactly new and a GP would be able to prescribe this for you. Newer treatments are retinoids such as isotretinoin which when used in a low dose can be successful only under specialist use through so would need to see a derm and not suitable for everyone. Sorry I can't be of more help

When asked for fluconazole, have you ever said really (really) loudly “have you got discharge?” when the 2 people directly behind in the queue were male?

He got the most withering look I could muster up...

I'm 58 and saw GP recently as believed I had tinnitus. Have always been quite sensitive to noise but after a couple of incidents of being very close to people shouting very loudly I developed occasional crackling in one ear - tends to be if I hear kettle boiling or tap running; that type of noise, but have the crackling many times each day.

GP suggested it may not be tinnitus as not ringing. Prescribed Beclometasone Dipropionate nasal spray and steaming. I use menthol crystals. After a month I'm not noticing any improvement. Is there anything else I could try?

I’m not trying to be mean. I love pharmacists, just not that one.

@Ladyofthenuvarings thank you so much. I've made a note of those pills and will suggest she discusses them with her GP. It's for contraception.

How are you affected by Brexit?

Can I ask a question about "special" orders please. DD's psychiatrist recommended she take an addl 5mg of fluoxetine daily when she had a bad patch. Already on 20mg. 5mg only available in liquid form and tasted like "vomit". Made a huge differènce quickly (despite nice guidelines) but dd couldn't face it beyond three weeks. We compromised on a 10mg capsule every other day. The high street chemists (mainly Boots) continually said they couldn't access the capsules from their suppliers. GP reissued script to say capsules or tablets (but golly made a fuss about an extra £17.50pcm). But what a performance. Funnily enough tje independent chemist in next town has no problem getting capsules and says they are perfectly routine.

Secondly I have hypothyroidism. I get ALL prescriptions free. My income is high. It seems absurd. Whereas my student daughter who needs three items every two months has to pay for each prescription. Well I pay for her of course, but not all parents would.

Hmmm.Well where I live, if you have a lot of community retail experience and no hospital or industry experience its very difficult to change really.
Have been looking to change course for some time but its very much same old thing and the insidious rise of the chains just seems to make things worse.
Great thread you sound like a credit to the profession!!
Ps I know its an in joke but had to laugh at your name change!!

Name changed for this because it’s terrible but I would love an answer.
I’ve been taking over the counter sleep aids for over 10 years. Every night, double the dose now as it doesn’t work as well as it uses to. My question is addiction aside, would you be concerned for what the medication are doing to my body? I know everyone says it’s just an antihistamine but I withdraw if I stop for even a day :(
Thanks

Can I ask about interactions please? I'm on 300mg of pregabalin morning and night, also 90mg etoricoxib & 50mg amitriptyline at bedtime. Have also been given duoloxetine to try in the morning (haven't started yet) and take 30/500 cocodamol probably twice a day. I've also been prescribed 100mg tramadol for when I need it but haven't used them yet as I'm a bit scared of the possible side effects. Everything I've read suggests an interaction which can cause serotonin syndrome but consultant says this is only theoretical and I should stop if I start to feel twitchy. What are your thoughts please?

is there an over the counter version of that drug that makes you react really badly to alcohol? Can I buy it and give it to my x bf and say it's vitamins? (flippant but also kind of wondering)

Hi, I take MST 10 mg for chronic arthritis of the knees and a back problem. My doctor has told me that I can double up the dose on really painful days but when I do it makes me itch. Antihistamines don't work 😐

How much prescribing do you do? I'm currently doing my non medical prescribing course, I am a nurse practitioner in UCC. Do you prescribe from your pharmacy & are you then able to dispense your own prescriptions?

Hi all,
As MN doesn't check the bona fides of our AMAers, we're not comfortable with medical advice being given out on an AMA topic and have done a bit of pruning on the thread. That said, do feel free to continue to ask more general questions, it's just the specific advice we felt it appropriate to remove.

If you give medication that can affect sleep to new parents, do you talk about safe sleep guidelines?

I take a certain tablet (not saying which because I don't want you to be 'accused' of giving advice).

There are 3 standard brands available. 1 hardly anyone struggles with, and it's the most expensive. The second one some struggle with and it's moderately expensive and I'm fine with it. The third and last one, the cheapest, a large percentage of people can't take because of the side effects. I'm one of those, inevitably. I had it this month and thought someone had poisoned me ;)

I asked my (amazing, helpful and lovely) pharmacist) and she said she can't guarantee the brand, it depends on the supplier. I haven't taken my meds this month, I can't tolerate them.

Is there a way to guarantee the brand, a private prescription etc? I'm seeing my rheumatologist soon and will enquire, but it seems ludicrous not to be able to specify when the toleration levels are well documented.

Thank you xx

Is there something which is hardly ever prescribed and you’re like oooooooooo when someone hands over a script for it?!

I’ve got 2 if you don’t mind?
Do you do the NMP course the same a nurses or is it different?
Also I work in a CMHT and am baffled as to why mirtazipine makes you sleepy in small doses but not when you go above 15 mg, Do you know why this is?

@SciFiScream I will do my best to answer your question in light of what MNHQ have said. Omeprazole has been around for over 20 years it is prescribed to millions of patients in this country and worldwide and as such there have been many long term safety studies on it. It is highly highly likely unlikely that your MIL use of omeprazole had any influence on her cancer. There is no proven link between omeprazole and cancer some studies have suggested a higher incidence in that cohort but there is no concrete evidence proving a causative effect. Excess stomach acid actually is a risk factor for some stomach tumours.GORD in children is more complicated as children have immature sphincters but mots do grow out of it. In terms of your DH best thing to do is watch for triggers keep a diary what triggers an attack alcohol food, smoking, coffee whatever and try an avoid these.

@Ivegotthree I won't answer this as I'm not much a rule breaker . But give your local pharmacist a ring and they will look into it for you or better still look up the scopoderm Summary of product characteristics on medicines.org.uk

@ColdNeverBotheredMeAnyway you have answered your own question those are the only options for fungal nail infection unfortunately. If you have been advised against the terbinafine then you may have to persevere with the Loceryl

@LikeDolphinsCanSwim No, I haven't haha I have had my fair share of awkward consultations and now anytime anybody asks me about anything intimate/embarrassing/taboo I always bring them away from the counter. Something that irks me is when I am speaking to a patient and jimmy-big ears sidles up behind them and listens to our consultation. I have learned to just exclaim quite loudly "take a seat, Jimmy, I will be with you in a moment' in my most condescending tone

@Ladyofthenuvarings erm I've had no less than three different doctors all tell me that I'm no longer to use ompram or similar every day and need to control my GERD with diet if possible as it's widely accepted that they cause cancer and Alzheimer's now.

Although GERD can cause throat cancer so...

Do doctors still prescribe placebos?
I had another question as well but can't remember it now...grrr