Piriton....

[pharm112]

Feeling absolutely disappointed in my decision today. After closing the shop a sales assistant comes over and tells me there's a worried parent at the door who says that child has had an allergic reaction. I decided to go over to the door and speak to parent ( first mistake, I think if shop closed don't bother ) anyway, I let the parent in and he tells me that child has come in contact with cat and is swelling. Ask for the age and he says 4 months??? I tell him its not licensed in babies under one. He tells me that child normally suffers from allergy and they give him piriton following advise from doctor from hospital. He also says that he has spoken to paediatric doctor at hospital who said get piriton and give baby 1ml. Having already checked in BNF that dose for babies under 6months is 2.5mg, I figure that they will give baby 0.4mg. To cut long story short after deliberating with parent I sold the piriton. With hindsight I would not have sold the piriton. I should have directed parent to a&e. I was so caught up on thinking that baby would suffer a massive allergy attack if I sent them away. Now all I can think of is what if the piriton affects the baby? I just want to cry, maybe I'm just over reacting. I know had I not sold it I would be giving myself a hard time thinking why did I just not sell it to them? I don't know..I like being a pharmacist but sometimes I think I should just have become a flower selling person....

[Asterix]

If you would have recommened the product then it would be a diff case. In this instance the parent has forced you into it, i would relax, what will happen, they will somehow gve 0.4ml and take him to a and e

[pharm112]

Thanks Asterix, I will try and relax. Its my second year as a pharmacist and I'm already looking forward to retirement. Tired of this damned if you do/ damned if you don't situations...

[Asterix]

tbh would you actually be under any possible problem, dad was adamant to buy it, how is that your problem. You have made an ethical decision to help in interests of the baby. try and relax, this is the problem with this job, so many crap decisions to be made. apparently they are lobbying hard to decriminalise dispensing errors you heard?

[pharm112]

Pharmacists stop so many errors from happening. Im a newly qualified pharmacist and yet I have been on the phone with doctors countless of times to query things most of which have been amended...so you can imagine how much more experienced pharmacists have done and yet you make a mistake n all this is overlooked. Ever noticed when you call a doctor regarding a mistake they seem so cool and always say they'll send a replacement script..but when Mr.whatshisname walks into pharmacy with his open bag of medication all I want is the ground to open n swallow me..n probably all he wants is a different brand of medication...I don't think drs are as worried about making mistakes as pharmacists are.....

[hibernia]

I don't think drs are as worried about making mistakes as pharmacists are.....

Maybe they are just better at hiding it...
Doctors tend to think more 'life and death' issues. If the patient is able to walk into a pharmacy their attitude is that he can't be that bad. If a doctor writes ramipril 5mg instead of 10mg the attitude is 'sure he won't come to any harm.' If a pharmacist dispenses the wrong strength they can't sleep at night.
Pharmacists tend to focus on things like the licenced dose. Doctors think about the highest dose they can prescribe without landing the patient in A+E.

When I was fussing over my first baby (I'll bet that baby was a first child) my mother in law always told me about an earthquake in Mexico. The maternity hospital was flattened. Days later they rescued new born babies whose mothers were dead but they had survived without food or water. The moral of the story was that my precious would survive even if she didn't get feed every 4 hours on the dot. Babies survive fussing parents and neglectful parents.

You have to build up self-confidence, the kind the doctors have. You made a call. You may not have been right but you did what you thought was best at the time and you can't change that now. That baby is probably sleeping happily, so forget about it.

[bobbin]

Doctors tend to think more 'life and death' issues. If the patient is able to walk into a pharmacy their attitude is that he can't be that bad. If a doctor writes ramipril 5mg instead of 10mg the attitude is 'sure he won't come to any harm.' If a pharmacist dispenses the wrong strength they can't sleep at night.

Indeed. Pharmacists even worry about 'errors' which are essentially of no significance eg. ramipril tabs versus caps. Doctors would not even recognise this type of situation as an error because it is of no consequence.

[Asterix]

what do you lot make about the fact that a bill has been passed about decrimilanisation errors now. This a big moment...

[El-loco]

Hi pharm112

I doubt that the baby will have suffered any harm in this case so stop worrying.

But - The sale of a [P] medicine is your responsibility regardless of whatever pressure you are put under. In the event of harm occuring it would be no defence at all to imply that the decision to sell or not was not your decision entirely. You have to make a professional decision based on the facts available to you. See all of principle 2 of the GPhC's Standards of conduct, ethics and performance especially 2.1 and 2.5.

I think you made the right choice from what you have said but it would have been better if you had made a note of the transaction with the statement that, in view of all the details available to you and of your expert knowledge of the action and uses of drugs it was your professional opinion that the sale of this product was in the best interest of the patient (the baby). Unless you have done something really crazy I doubt that there is a court in the land that would challenge that.

[Asterix]

if he was taken to court though, he can argue both sides if you ask me