hay fever

[Ray]

hey guys, okay i guess i did some medicine sale which i am not allowed to do today. the pharmacist was at lunch and someone came asking for anything for hay fever. i am aware the sale of P medicine should be under the pharmacist supervision, but i simply asked if she have had anything before for it " managed to get she used some tablets one daily of the 8 pounds somthing price " then i used the WWHAM system and supplied Zirtek tablets.

now i think i should have waited for the pharmacist to come from his break " tho i am 3rd year pharmacy student but well.... rules are just rules".

i noticed sodium cromog....... eye drops, loratadine and citiryzine hydrochloride" zirtek" can be used for hay fever allergy. when it comes to make a recommendation of a product i do not feel i can handle it well any advices for this case?

[johannes]

Hi,
Ok she is female. Than it is the question if she is pregnant.
If so Loratadine wouldn't be suitable and Cetirizine not within the first 3 month and whilst breast feeding, SPC says.
But it was Cetirizine HCL

[johnep]

Rule generally is, stock outside healthcare, then GSL and can be sold if GSL area not registered as pharmacy, eg supermarket.

Stock on shelves behind counter, then P and should be sold under supervision.

Rediculous situation at present is that pharmacist not required for GSL sales in garage etc, but supposed to be present if gsl sold from registered pharmacy premises. One reason why multiples have deregistered rest of sales area away from healthcare.
johnep

[johannes]

Well,
I actually do not unterstand what is behind this regulation?

[Ray]

i am confused from your post

[johannes]

Originally Posted by Ray

i am confused from your post

How confusing this regulation might be for a customer?

[Ray]

gotta be bloody confusing to them, specially when u try to explain things that u might not even be convinced with i.e 10 ml sodium cromog--- for hay fever is available as P medicine while 13.5 is POM, we cant supply the 13.5ml hence, we are indirectly telling the customer to go to another pharmacy and get another 10 ml sodium cromog eye drops!
what do u think?

oh btw i have been checking the BNF after your post, anti-histamine"non sedative" like loratadine and citirizine HCL are CI in pregnancy + breast feeding. might also product anti-muscirinc blockage, risk of drowsness hence councel about driving. this is what i learnt from checking few pages few mins ago and i think its most imp bits from this chapter.

again thank you

[johnep]

Modern hay fever products are CI in pregnancy simply because no trials in pregnant women. Rule is that any suggested indication has to be backed by approved clinical trials. Hence all modern drugs not suggested for children or pregnant women. Older drugs have been used for 50 years or more so trials were by experience. Thus, amoxycillin for infections, paracetamol for headaches etc, gaviscon for indigestion. Most common problem is a pregnant lady with heavy cold wanting sudafed etc. I would suggest nose drops.
johnep

[Ray]

ok thanks johnep
ok its friday, busy day, and we have those 2 pescription collected from the surgery for the same patient, with exactly same quantity and dose.....etc one issue 9 and one of the 10 of june.
1- should we dispense both? call the GP to double check? dispense the most up to dated Rx?
remmember the 2 Rx are the same and for the same drugs.
cheers

[johnep]

Seems obvious duplication except that sometimes PCT has rule of only scripts for one month and if pt going on holiday, then sgy often issues second set of scripts.
Check with pt first. You can always hold one script for upto six months.
johnep