Occasional Blog

[johnep]

1) Had pt on Clav + Amox syrup for nine days using 3 x 100ml bottles. Dispenser asked re stability and on checking PIL, said use within 7 days. So we had to give two bottles and asked her to return for third. This seems a short time to me.
2) Scripts for Nystatin suspension all say sugar free. In past I have given Lagap product, but only Nystan in stock. I ordered what I thought was Lagap product but in came a pack where sucrose listed. Anyone seen a sugar free product?
3) Methotrexate soln for child. Just 20mls and total charge was £260. Dose was 3mls at night.
johnep

[Band6]

Methotrexate at night? Every night, not weekly? 6-mercaptopurine is od, but MTX is always weekly (unless aiming for radical cure is leukaemia - esp in the brain - when pt would undergo folinic acid rescue, but that would be as an inpatient)

[johnep]

Notice recent press on perindopril arginine. Today got script for perindopril
erbumine. Presumed standard variety-- or is it.

'Phoned by irate warden of care home re non delivery of dosette box for a resident. We had no script and our records showed script rquested but not received from surgery. Warden then 'phoned back to tell me that script had gone to our competitor who had delivered it, but in standard boxes. Pt rejected as said wanted in dosette box. The pharmacy collected and when I asked them, said script now destroyed. I cannot be sure but appears they had not 'phoned us to let us know.

I phoned surgery and we will get new script tomorrow. Naturally we will give dosette boxes for free, while our independent competitor makes a charge.

In the end, after consultation with surgery, I filled dosette box and delivered to residential home as pt run out. At least the SmartNav found the home so no worries there. But I filled the box without any script-----.

The fact that the other pharmacist saw no reason to let us know he had received the script in error illustrates why pharmacists will never win. We attack each other and the DOH divides and rules.
johnep

[Zoggite]

Re. perindopril: yes, erbumine is the "standard" one, the BNF confirms this.
Re. script going to another Phcy: I hardly think it's fair blaming the other Phcy for not ringing you; After all, it's the surgery who sent it to the wrong chemist in the first place, they should sort it out. As a locum, do you know whose scripts you're supposed to do and whose you're not? If I get a Rx from a surgery for a patient I haven't got on my PMR, I just do it, I don't start 'phonong all the other Phcies in town to ask if it's one of theirs...
If you had records that the Rx had been requested but not received, then why didn't you chase it up before the irate warden's call?

[Pharmanaut]

Originally Posted by Zoggite

Re. perindopril: yes, erbumine is the "standard" one, the BNF confirms this.

When I saw the perindopril change to erbumine, my first thought was... "Not another amlodipine farce in the making". Thankfully, the standard perindopril is being changed to erbumine to distinguish it from the exciting new arginine that has been brought out to standardise international pharmaco operations, so we can all sleep at night. At least the strength of the erbumine is different from the arginine range, so at least we will be able to tell the difference on a script that doesn't quote the salt (ester or whatever 'tis).

By the way, the April 2008 Drug Tariff has got the erbumine name now. DM+D should change soon.

[johnep]

The saga continues. apparently the elderly lady concerned was confused and phoned the other pharmacy to pick up script and deliver, As to us chasing. well, On 28th March regular pharmacist left as did the junior dispenser. The senior dispenser went off sick on the folowing Monday. Last week (when I was enjoying being at home) was absolutely horrendous and lots of routine jobs such as putting away goods or even ordering them got left behind.

I have worked there the last two days with just the Saturday girl and mainly been a fire fighting exercise. Today we even stopped taking in 'waiters' as trying to get the PCS done in time for our delivery lady.

Not helped by local surgeries issuing 2 month scripts but expecting 8 weeks of dosette boxes or trays, delivered weekly.

I've now finished for the week and off on my cruise round WI on Saturday.

No work until 12th May.
johnep

[JonF]

If surgeries want weekly deliveries get weekly Rx. If you get monthly or two monthly Rx send 1 month or 2 months. Under out terms of service we have to dispense what is on Rx, we are under no obligation to send out weekly amounts on a monthly Rx.

When our local surgeries stopped doing weekly Rx's, we explained this and they were fine with it, until some patients weren't coping with 4 trays, so they then issued weeklies for those patients.

[Zoggite]

Originally Posted by johnep

well, On 28th March regular pharmacist left as did the junior dispenser. The senior dispenser went off sick on the folowing Monday.

Sounds like a full-blown case of "Lloydsitis" to me...spreads like wildfire, and very hard to eradicate!

[the old merlin]

Originally Posted by johnep

'Phoned by irate warden of care home re non delivery of dosette box for a resident. We had no script and our records showed script rquested but not received from surgery. Warden then 'phoned back to tell me that script had gone to our competitor who had delivered it, but in standard boxes. Pt rejected as said wanted in dosette box. The pharmacy collected and when I asked them, said script now destroyed. I cannot be sure but appears they had not 'phoned us to let us know.


The fact that the other pharmacist saw no reason to let us know he had received the script in error illustrates why pharmacists will never win. We attack each other and the DOH divides and rules.
johnep

We had a case where a care worker took all the Rx for one month to the "wrong" pharmacy, and they arrived at the Home out of MDS. However, My advice was that the pharmacy had done absolutely nothing wrong, although I might have expected them to check. It was our (Care Home)'s mistake and we had to sort it out.

Cannot see that the "other pharmacy" did anything wrong in this case. However Rx now destroyed????

[johnep]

Policy of pharmacy (from HO) is to offer 'trays' to all who want them on weekly scripts or not. Weekly Labels are generated when script received and kept with script (some dated from February). When use last set of labels, new script requested. With all the turmoil of last week some trays sent out with tablets owing as items not ordered. I would certainly change things if I was in charge, but just an occasional locum for a day.

A nursing home nomads due on Thursday, not even been looked at yet.

Because free delivery advertised, last week pt phoned, said unable to get up and wanted some syndol,Imodium and box of chocolates delivered. They were!

Reminds me of the story that Harrods used to deliver a loaf a bread every week to a customer who had moved from Kensington to Brighton.

When I took over as Marketing manager at Bush Boake Allen, discovered that a customer? sent in his own oils for repackaging and then got the company to deliver to his customers FOC. I soon stopped that nonsense.
johnep