Extemporaneous stuff

[bobbin]

As I have said before, the course is 'not fit for purpose'. It is related to pharmacy as it was, not now. It needs to be updated.
johnep

I agree. Having said that, I also believe that the pharmacy degree is not fit for purpose.

[johnep]

In the old days it was four years apprenticeship and nine months at a college. At the end of that most students were 21 and ready to face anything.
johnep

[sparkybw]

As most pharmacies no longer do much extemp work is it not a bit much to have to detail the process for a combining 2 creams 3 times during the NVQ? Already done for Mod 11( think it was that 1), and unit 1, now got to do again for Unit 18!
Think they're just trying to think of lots of long processes so it takes longer to finish the course!!
Maybe I'm just tired..
Ginny

Are you in the community?

If you work in hospital in the manufacturing unit you might find more use there for knowing these techniques. The course has to cover all the bases rather than simply concentrate on one side or the other. similarly if you go into industry you could be using the techniques. Just because it may not seem relevant to your particular circumstances doesn't mean that it is irrelevant.

As for the course being out of date, my course was rewritten for this year.

[Ginny]

Good point Sparkybw,
The Module 18 has been rewritten to reflect the registration changes, don't know about the others.
Good luck with yours,
Gin

[Fleegle]

I am on the same one Ginny. Does anyone have any pointers on how you would PREPARE to give a colleague a demonstration on how to extemporaneously dispense betnovate cream 1 part aqueous cream 4 parts (supply 50g). Any help gratefully received. xxx

OK..I'm not busy..here's how I would have done it..

You will need a balance, (or scales) and a set of weights, both of which which hold a current validation certificate issued by Her Majesty's weights and measures department, an ointment slab, a medium-sized spatula, a 60g ointment jar, a tube of Betnovate Cream (30g), sufficient quantity of aqueous cream, parchment, scissors, approximately 30ml Acetone, a bar of soap (or suitable liquid substitute), two clean white coats and hairnets for yourself and your colleague, and hot, not boiling water from an available tap (mains water acceptable).

Put on white coats and hairnets. Wash your hands with soap or suitable substitute. Clean down slab, spatula, scissors and balance (or scale) with a suitable quantity of acetone. No drying is needed, as evaporation should be sufficient. Using the scissors, cut one (or two) squares of parchment to appropriate (if two identical) size, just to cover the pan(s) of the balance or scale you have just cleaned. Tare your chosen machine. Place Betnovate cream, aqueous cream, 60g ointment jar and spatula within easy reach of your colleague. You are now good to go.

NB. (to any smart-arses out there) Betnovate 1 part, Aqueous cream 4 parts is not Betnovate RD 1 in 4. This preparation is a 1 in 5.

This scenario should NEVER happen. If it ever does, re-post and I'll let you know how to compound the extemp and receive payment for doing so.

Fleeg.

[johnep]

WE had a naked flame in the dispensary for use with sealing wax. Acetone would be a definite no no. Health and safety?
johnep

[Fleegle]

My pre-reg tutor smoked a pipe in the dispensary from morning till night..we still used acetone. We just got on with it.

[andrew paxton]

Just two points: 1) You don't mix Betnovate with Aqueous Cream. There is a chemical incompatibility, and the correct diluent is Cetomacrogol Cream (though I can't remember whether it's Formula A or Formula B) and 2) I would ask the prescriber whether he wouldn't rather have 1 to 3 and supply Betnovate RD. Also, it might swing things if you told him that because of (any made-up excuse) it would have to be done as a special and cost more than £100!

[Fleegle]

Just two points: 1) You don't mix Betnovate with Aqueous Cream. There is a chemical incompatibility, and the correct diluent is Cetomacrogol Cream (though I can't remember whether it's Formula A or Formula B) and 2) I would ask the prescriber whether he wouldn't rather have 1 to 3 and supply Betnovate RD. Also, it might swing things if you told him that because of (any made-up excuse) it would have to be done as a special and cost more than £100!

OK.. points taken..

1) 'You don't mix Betnovate with Aqueous Cream. There is a chemical incompatibility'
Please provide inarguable proof of this.
2) 'the correct diluent is Cetomacrogol Cream (though I can't remember whether it's Formula A or Formula B)'
Please find out which one it should be, and why.
3) 'I would ask the prescriber whether he wouldn't rather have 1 to 3 and supply Betnovate RD'
Pure laziness.
4) 'Also, it might swing things if you told him that because of (any made-up excuse) it would have to be done as a special and cost more than £100!'
Yet more laziness.

The original poster did ask for advice on how to prepare to compound the preparation..not for a daft 'easy way out'. Appreciate where you're coming from though.

Fleeg. (An Beagle le dearcadh)

[andrew paxton]

Firstly Betnovate is in a cetomacrogol-based cream, as that is chemically neutral. Betametasone Valerate is incompatible with alkalis, as it hydrolyses to Betametasone and Valeric Acid (the reason you shouldn't mix it with Coal Tar, which is also alkaline. You should use Betametasone Diproprionate for that) The Betametasone free alcohol is less active. Although I cannot remember the reason, you can't mix Cetomacrogol Creams with Aqueous Cream. I remember this from the old NPA Diluent Directory, and it specified one of the two, A or B, but I can't remember which one. Whilst yes, I agree it's laziness, the Extemp Disp fee has not gone up with inflation, and it is not worth the effort. That's why the specials manufacturers are doing so well at overcharging the NHS. The point about the original posting is valid, though. He or she may be hoping to work for one of the aforementioned specials manufacturers, and the step-by-step instructions are fine, and after going through my objections with the original prescriber, I would proceed as per that.