Let the Pharmacist HELP

                                                      Let the Pharmacist HELP

Me - Hello
Friend - Hello , I need help
Me - yes What Is it?
Friend - I was given an inhaler
Me - so?
Friend - How to use it?
Me - Did not your Pharmacist explain?
Friend - I was in a hurry. I Came

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Above is a part of a telephone conversation I very recently had with a friend of mine. Being a student and now a graduate I have faced similar situation a lot and It was good this was at least a phone call once I was asked about a suppository through a text message !!!!!

Use of certain Medical Devices such as Inhalers, Insulin pens and certain dosage forms such as suppositories, Pessaries, Eye drops and ear drops need practice and prior demonstrations in most of the cases. When ever you visit your Pharmacist with a prescription of a medical device he or she may try to explain you how to use it. You may be in a hurry, you may think you know, and you may even assume that you can Call your pharmacist friend and take their advice But it is very important that you listen to your pharmacist and  I am positive there is no way you can learn the proper technique of using an inhaler over the phone and not to mention the varieties of inhalers currently available.

Now what you should focus on ,

- How to use / administer
- When to use 
- Where and How to store 
- How to carry your device with you 
- How to clean your device  
- When to discard and get a new one 

Yes above may differ according to the device but is true for most of them.

Your pharmacist will explain all the above in detail and it is essential for you to remember at least what I have listed.

Why you think your pharmacist make you wait and explain all these even when you yourself don't want to hear half the stuff he explains.

 Because it

- ensure proper use of device 
- improves patient compliance
- minimizes potential adverse events
- reduces side effects
- avoids misuse and abuse 

So it is for your own good and he wastes his own time to make sure you get
   Right Drug, 
                     Dose, 
                     Time, 
                     Route  


Also one step forward your pharmacist may also provide you with leaflets, pictograms and any other material for further reference if you are in doubt.

Know your Rights 

All Pharmacists may not be ready to waste time on counselling when they have long queues waiting for them ....

- Yes you can always ask for your Pharmacist to Explain or Demonstrate the use of a medical device no matter how long the queue is
-  You may feel free to ask for a language of your preference
-  If you are not comfortable being counselled in public ask for privacy!!
- Ask for an emergency contact number if available

In an ideal set up the privacy of the patient should be regarded with greater importance by the pharmacist and should have a separate area for counselling!!
Pharmacists are bound by a code of ethic and you can always trust your pharmacists with your health problems and expect them to respect privacy.

So the next time you walk in with a prescription of a Medical Device make sure you are willing to spend few minutes to be counselled for your own good and please do note that ignoring what your pharmacist got to say and ending up with consequences will be a Bitter Pill To Swallow....... Its always good to let your pharmacist help you with your medical devices than asking your friends family or googling.



Let Him HELP!!!!!!!!!!


Piumish (B.Pharm USJP)

Social Media and Healthcare

Being the e - Generation most of us have become so dependent on internet for all most all our needs. From a song of your favorite artist to what you can cook from bread left overs, from sari designs to fashions of tribal people, from origami air crafts to rocket science and the list may go on, is just a touch away.
Google is excellent,  a total savior, a fixer, a friend in need, a mind reader, and a teacher ....

With the advancement of the technology use of Internet has become an inseparable thing in human life and it has made the most simplest daily chores easier by leaps and bounds. People use internet for Everything and this is true when they fall ill as well.

Back in the days when someone fell ill it was either self medication, visit to the doctor and sometimes we may get the help of a friend. Now this " friend" is replaced with social media and google.

Being public about private life has become a fashion in social media and this is no exception when people are sick.

A Knight in Armour for the Damsel in Distress !!!!!!!!

Social Media is of help -

- It provides access to medical assistance or advice to millions of people who complain of their ailments in different groups where medical professionals provide advice.
- There are professional forums which provides support for Mental Health to people who are either embarrassed or not in a position to obtain a direct medical advice
- It provides a platform for Public Health Education where people are made aware of diseases, prevention strategies, novel discoveries in health care sector.
- It provides patient counselling on medications, indications, side effects and proper usage
- It is an excellent place for people to develop their own interests on Healthcare Sector.
- Further Social media can  be used to establish very basic healthcare practices very effectively among both young and old.

Ex - Proper use of contraceptive methods
     -  Importance of vaccination


So the social media is of immense help for mothers with sick kids, students with stress needing medical assistance and also for people who are interested in living healthy !

But all the people who go on giving Medical advice are they all professional?

The biggest problem with social media is the users tend to Trust.
This applies to healthcare as well. Giving wrong advice for the wrong patient by a wrong personnel can lead to various complications, serious adverse events such as hospitalization or even death.

The Social Media has only replaced your "friend" but Not your Doctor and the Healthcare team. It is fine to get advice but people should meet the doctor as well.

One of the worst cases of Social Media is people trying for Self Medication this ranges from Home remedies to Self prescribing Antibiotics!!!!

Similarly there are millions of cosmetic products, whitening creams, weight gain products, weight loss products and many borderline products being advertised and sold through Social Media. These should be regulated to ensure the quality safety and efficacy of these products.
Not everything in social media is reliable information and every person giving medical related information may not be a Health Care Professional (HCP). This leaves a huge responsibility on Policy Makers and HCPs in using and regulating what and what not to be posted and shared in Social Media and as well as to streamline who says what!!

So next time when you seek help in social media for your ailments or regarding your medication you can always check for the reliability of information and keep in mind its always best to meet a doctor when ill and meet a pharmacists to know about all the borderline products such as Ayurveda medication and cosmetics.

Social Media Cannot  Replace the Health Care Team !!!!!!!!!!!!!! 

Piumish (B.Pharm USJP)

If I pay Why not sell?

If I Pay Why not sell? 

"Health is Wealth" yet we fall ill, some very often and some rarely and some of us may be on life time medication for chronic diseases such as diabetes or high blood pressure. As I have seen there are different types of people when think of illness..

- Type I - People who rush to the nearest doctor as soon as they feel ill .... be it real or not they end up meeting their prescriber!!! 

- Type II -  Self Medication Type  Who try home remedies be it herbal preparations, OTC products or the medication they have previously used for the same kind of illness .. 

- Type III -  Who CALL their Doctor friend and get a list of medicines. 

Now all these Three types happen to end up in the pharmacy and will be treated very differently.  

How Pharamcist may react 

A - will provide medication

B - pharmacist will Refuse 

C - will give an OTC medication single dose depending on patients condition and refer to a medical officer  

If you go to your pharmacy with a legal prescription issued by 

            - Registered Medical Practitioner (RMP)

           -  Registered Dental Practitioner 

           -  Registered Veterinary Practitioner  

pharmacist will issue the drugs without trouble. 

In  Sri Lankan set up there are several laws governing the dispensing without prescriptions as well as pharmacists are bound to adhere with Good Pharmacy Practice as well. According to the law of Sri Lanka Pharmacist cannot prescribe medication for any ailment unless the patient is in a critical condition needing immediate medical assistance. 

According to the NMRA (National Medicine Regulatory Authority) of Sri Lanka there are 3 types of drugs in the pharmacy. 

Schedule I - Drugs which can be sold without a license. 

These are available in any good store not necessarily in a pharmacy. Paracetamol, herbal preparations, some Traditional medicines used for the common ailments such as herbal balms and creams. 

Schedule II - This is subdivided as Schedule II - A and Schedule II - B 

Schedule II A - These are Non Prescription drugs or OTC ( Over The Counter) medication.  OTC medicines are available to treat an expanding range of ailments. 

Ex -  Some analgesics, dermatologic products, anti-diarrheals, laxatives, antiemetics, antacids, anti-allergics etc  

Schedule II B - Drugs which can be sold only under prescription. 

Theses include All Antibiotics, anti diabetic medication anti hypertensives, anti psychotics and so on. 

   

Shedule III - These drugs are dispensed only with a prescription from a RMP. These are addictive drugs of abuse and should only be dispensed with a prescription not exceeding 3 days. 

Ex- Morphine , Diamorphine tablets. 

Now going back to type II and type III,  

 When you ask for a self prescribed medication which cannot be dispensed ( Schedule II B , III) without a legal prescription your pharmacist has every right to refuse giving you the medication.  

The list you got from your doctor friend isn't a Legal Prescription. 

  

He just sells. If I pay Why not sell? 

This is the attitude of patients who can't take NO for an answer. 

Why the Refusal????  

- it is illegal to sell prescription only drugs without a legal prescription - Ex  antibiotics 

- patient may be in need of medical assistance rather than self medication 

- self medication for symptomatic relief is not a good practice 

- there can always be allergies, interactions with other food and drug the patient may be taking so dispensing without a history can be harmful. 

- certain medications are contraindicated for special patients groups such as pregnant women and kids.  

- when the pharmacist is unaware of quality, safety and efficacy of certain products. 

 Now when you all go to the drug store with no prescription you are asking for something illegal and unethical to be done. 

Pharmacy is no ordinary store with business goals only. Pharmacists are bound with a code of ethic and laws from which they are restricted to sell anything and everything as and when they want and patients request.

"No " doesn't make him a bad, non supportive person with lack of customer care. It is natural to feel irritated and angry about your pharmacist in a situation as such when you happen to go to the drug store amidst the busy schedule only to be told that you cant get your medicines. Being human most of you will make a mental note to "avoid" the particular drug store for the rest of your lives owing to the refusal since you all don't have the slightest idea that the  pharmacist had been doing the righteous thing and had been concerned about your health more than a pharmacist who runs a business for profit motive only. 

Yes there are Pharmacists who will "Sell" anything and everything no matter what. 

Not All People are Ethical.....   

So next time when the pharmacist say NO just keep in mind he must be having a Good enough reason for that. 

Nobody will lose a Customer with No Good Reason !!!!!!!!!!!!!!!!!!!  

And instead of avoiding the "NO Pharmacy" avoid "Sell Pharmacy" for your own good. 

Generic Vs Brands

                                                             
                                           


 Generics Vs Brands  

We all might have visited the drug store at least once in our life time and ever wondered what are the  Brands and Generic of Drugs and did we even know such types of drugs exist? 

It is simple as this we all know Biscuits lets say Chocolate Biscuits!!! 
Well when you buy Chocolate biscuits from the store its exactly same to your Generics in the drug store. One more step forward you try buying X - Chocolate biscuits ( Given - X any brand of Biscuits you prefer). Now this is more or less your brands in medicines. Now what are the differences of the two types of biscuits? May be the Packing, Labeling, Quality as you feel it But most importantly the content and the taste will be the same. This is common to medicines as well but in contrast both generics and any type of brand of a particular medicine should comply with similar quality standards. 

Now to be very specific  

Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. 

The most simplest example 

Paracetamol - Generic 
Panadol - Brand name 

The main advantage of using Generics over Brands is their comparatively low cost. Most patients are having in a wrong belief that generics are of low quality due to the lower prices but it is NOT...  and they also wonder if the quality and effectiveness have been compromised to make the less expensive products. 

High cost doesn't always imply High Quality!!!! 

Actually, generic drugs are only cheaper because the manufacturers have not had the expenses of developing and marketing a new drug. When a company brings a new drug onto the market, the firm has already spent substantial money on research, development, marketing and promotion of the drug. A patent is granted that gives the company that developed the drug an exclusive right to sell the drug as long as the patent is in effect. 

Also the packing and labeling in Generics and Brands vary and most probably the appearance of the tablet or the capsule. 

Another common disbelief is that generic drugs take longer to work. Both Generics and Brands should be manufactured under exact conditions and should be manufactures as per the regulations and are being tested for quality, safety and efficacy with no discrimination. So being less effective is not likely to happen if the quality control is done as per the guidelines. 

For the same drug there can be several brands and generics available in the pharmacy with a huge price deviation according to the manufacturer. 



So next time you go to your Pharmacist you have every right to ask for either Paracetamol or Panadol!!!!!!!!!!!! 


Reference - https://www.fda.gov/home

“When religion was strong and science weak, men mistook magic for medicine; now,when science is strong and religion weak, men mistake medicine for magic.” 

Industrial Pharmacists

Pharmacists - The drug designers

 Tablets, capsules, syrups, vaccines and all the dosage forms and drug delivery methods are not god made!!!

Each and every medicine both you and I have been using ever since we were born is the hard work and years of lab studies and clinical trials conducted by the healthcare professionals throughout the world.

Today the pharmaceutical industry has become one of the largest industries in the world.

Yes we all fall sick and even the kings need medicine!!

Also it is the second largest mafia in the world !!!!!!!!

  

Role of Pharmacist in pharmaceutical industry... 

• Research and development 

A drug reaching the pharmacy is a long and lengthy process which involves years and years of hard work and hours spent in laboratories and clinical trials.

From the process of finding an active pharmaceutical ingredients pharmacists are involved.

They may use the knowledge in pharmacology,toxicology, pharmaceutics, chemistry, physiology and even bio pharmaceutics in developing a sustainable dosage form. There are no miracles in this industry ....  

• Manufacture and quality assurance 

once the clinical trials are done with and drug is good go with production it is the pharmacists who see to the process. 

Drugs are being manufactured as per the pharmacopoeia standards (BP,USP, JP, IP ) and from the manufacturing to the quality control and quality assurance pharmacists are involved.

As of all industries this is also profit oriented and pharmacists face a huge challenge in meeting the best pharmaceutical standards with an affordable cost to the patients with best safety and quality.  

• Clinical trials and post-marketing surveillance

The pharmacist has the knowledge of drugs and health care provision required to facilitate collaboration between companies, health professionals and governments in relation to clinical trials and surveillance.

Drugs are under constant monitoring once introduced to the market and all side effects, adverse events, quality complaints and customer feedback are collected around the globe and pharmacist work day and night to deliver best dosage forms to the patients. 

• Sales and marketing

The pharmacist, whose professional ethics demand a concern for the interest of patients, can make a contribution to proper marketing practices related to health care and to the provision of appropriate information to health professionals and the public .

so the medicines you get from your druggist is not Gods work its the effort of millions of pharmacists and Health care professionals working across the globe to supply you with an appealing dosage form you prefer to swallow when you are really sick!

Cheers the Heroes Behind The Scene !!!!!!!!!!!!!!! 

Piumishh - Bpharm (USJ)

Community , Hospital Pharmacist

Pharmacist in community pharmacy

These are privately owned pharmacies or SPC outlets such as Rajya Osusal 

They are responsible in  

• prescription reviewing - yes your doctor can make mistakes they are human after all!! 

• filling the precription 
  

• providing patient counselling - this may or may not be practiced in community set up as well as in hospitals owing to the long queues in hospitals but its a very important thing that should be performed by the pharmacist to ensure the proper use of drugs by the patient. otherwise most patients will end up swallowing suppositories!!! 

and as patients you have a right to be counselled and ask all your questions and clear your doubts at the pharmacy

• providing OTC medicines - OTC medicines are your non prescription drugs such as paracetamol, Vitamins. you can always go to your pharmacists and get their assistance in OTC products. Specially in a country like Sri Lanka where Ayurveda medicines and herbal medicines are still being used for minor ailments pharmacists have a responsibility in providing information on these multitude of products. Green concepts are healthy still herbal preparations also may have interactions with food and your other medicines so please consult your pharmacist as and when necessary!!!! 

• Extemporaneous preparations - Pharmacists everywhere continue to prepare medicines in the pharmacy. This enables them to adapt the formulation of a medicine to the needs of an individual patient. New developments in drugs and delivery systems may well extend the need for individually adapted medicines and thus increase the pharmacist’s need to continue with pharmacy formulation. In some countries, developed and developing, pharmacists engage in the small-scale manufacture of medicines, which must accord with good manufacturing and distribution practice guidelines.

Hospital Pharmacists 

Hospital pharmacists are of diverse nature but the patients come in contact with the pharmacists who dispense. Other than that its your pharmacists who manages drug records, inventory control, proper storage of all your medicines, maintaining ward pharmacies along with the nursing staff and now in some leading hospitals in private sector " B.Pharm graduates work as Clinical Pharmacists"... 

hospital or institutional pharmacist:

• has more opportunity to interact closely with the prescriber and, therefore, to promote the rational prescribing and use of medicine - this ensue the patient safety.. 

• having access to medical records, is in a position to influence the selection of drugs and dosage regimens, to monitor patient compliance and therapeutic response to drugs, and to recognize and report adverse drug reactions- this is the role of a clinical pharmacists .. they may spend hours of ward round and review the BHT and medical records to make sure the patient recieves the best and most affordable health care. 

• serves as a member of policy-making committees, including those concerned with drug selection, the use of antibiotics, and hospital infections (Drug and Therapeutics Committee) and thereby influences the preparation and composition of an essential-drug list or formulary;

• is in a better position to educate other health professionals about the rational use of drugs;

• takes part in the planning and implementation of clinical trials. 

What does a pharmacist do???

Well your pharmacist is the one who fills your prescription, assists you with your OTC medication and provide medication in an emergency when its unable to access the medical care. Basically pharmacist is your "guy" in the drug store!!!!

Pharmacy is the art and science of manufacturing and dispensing drugs and biological to cure and prevent diseases to preserve health of humanity..... 

The role of a pharmacist in ensuring safety quality and efficacy of medicines is much wider and important. pharmacist play a huge role in providing quality health care for patients around the globe. 

Coming to  Sri Lankan set up where the pharmacists are believed to be mere vendors of drugs it is timely to discuss the role of a pharmacist as a health care professional. 

• pharmacist in community pharmacies
• pharmacists in hospitals
• pharmacists in regulatory affairs 
• pharmacists in industry and manufacturing
• pharmacists in RnD 

these are the most basic roles played by pharmacists in Sri Lankan set up but in global aspect the role is more broader and diverse catering the patient safety and better health care.....