clinical knowledge

[uurrehma]

hello,

I've just finished my 3rd year, and got a summer placement with Boots. I thought i'd register here to see what you guys think to pharmacy, and im seriously starting to get worried! I have just got a few questions, that i was hopiong that you could please answer for me.

When does all the clinical knowledge come during community pharmacy? Most people that i have spoken to say it practically none existant, confirmed by some of these threads. The reason im worried is because im at uni, and my clinical knowledge at the moment is also practically none existant, i only know a few things and thats it.

Also, when you finish your pre reg, are you expected to know everything, i've never felt so depressed!

thanx

[Jeff]

Re: clinical knowledge

When does all the clinical knowledge come during community pharmacy?

Saturday morning - customer complains of a sore throat - and is currently taking
1. carbamazepine
or
2. carbimazole

What do you recommend in each scenario?

Most people that i have spoken to say it practically none existant, confirmed by some of these threads.

Most of the time what most people do require few skills that haven't become second nature.

The reason im worried is because im at uni, and my clinical knowledge at the moment is also practically none existant, i only know a few things and thats it.

And the more you learn the more you'll become aware of how much more that you don't know.

Also, when you finish your pre reg, are you expected to know everything,

No

i've never felt so depressed!

CBT at Living Life to the Full Website

Jeff

[kemzero]

Re: clinical knowledge

Interesting stuff Jeff....what's the best OTC med for sore throat if on carbimazole or carbamazepine..should one just play safe with honey and lemon

[kemzero]

Re: clinical knowledge

hello,

I've just finished my 3rd year, and got a summer placement with Boots. I thought i'd register here to see what you guys think to pharmacy, and im seriously starting to get worried! I have just got a few questions, that i was hopiong that you could please answer for me.

When does all the clinical knowledge come during community pharmacy? Most people that i have spoken to say it practically none existant, confirmed by some of these threads. The reason im worried is because im at uni, and my clinical knowledge at the moment is also practically none existant, i only know a few things and thats it.

Also, when you finish your pre reg, are you expected to know everything, i've never felt so depressed!

thanx

As Jeff mentioned ...there would be loads of clinical interventions ,esp now tha most POMs are being declassified....one even has to be careful with certain GSL sales such as K/Na citrate in patients taking ACe inhibitors
Clinical Pharmacy in community is what you make it....but beware of the mystery shopper....could be someone from Which? years ago quite a few pharmacists were told off for selling ibuprofen to patients on methotrexate!

[Pharmanaut]

Re: clinical knowledge

Interesting stuff Jeff....what's the best OTC med for sore throat if on carbimazole or carbamazepine..should one just play safe with honey and lemon

Its off to the doctors for the carbimazole if the sore throat to be on the safe side.

This should start you off...

Start reading the BNF, not the monographs the general bits.
Get hold of the pocket clinical guides - titles to follow.
Learn what drugs are metabolised by what enzymes
In the pharmacy start looking at a patient history and see if you can work out the rationale and any problems that a patient might report.

[Steve G]

Re: clinical knowledge

Its off to the doctors for the carbimazole if the sore throat to be on the safe side.

and carbamazepine as well.

[uurrehma]

Re: clinical knowledge

thnx for the info

[johnep]

Re: clinical knowledge

Someone here queried ibuprofen and methotrexate. NSAIDs plua methotrexate commonplace. BNF says 'increases toxicity' I always check pt having regular liver function tests and most have been on for years. What would you suggest?
johnep

[alex]

Re: clinical knowledge

Hi, I have pre-reg exam 2 weeks today so i've been trying to swot up on as many areas as possible :S
Knowledge comes with experience from when you graduate. After seeing things that you are taught in theory in practice it really drums it into you in various scenarios. When you're not having various bits of interesting but useless information forced into you, you're more able to absorb the bits whihc are applicable to practice.
ie. One of the main modules i did last year was "production and characterisation of comericaaly important drugs". I haven't seen a single UV/IV spectra since then and haven't had to interpret a mass spectra either

Try not to worry about it and learn as much from your experiences as you can, people won't expect you to know it all already.

[Linnear]

Re: clinical knowledge

Someone here queried ibuprofen and methotrexate. NSAIDs plua methotrexate commonplace. BNF says 'increases toxicity' I always check pt having regular liver function tests and most have been on for years. What would you suggest?
johnep

We had a CPD evening on Benefit/Risk assessment and relaying that to the patient without scaring the shit out of them.

We had a talk by a Rheumatologist (My wife's rheumatologist actually) who firstly told us to always say Benefit/Risk rather than Risk/Benefit but that's just an aside.

When asked about Methotrexate interactions he said that he believed that at doses for Arthritis etc. MTX held no serious interaction problems.

It was only when you got up to serious Cytotoxic doses for cancer etc., which you're unlikely to see in community anyway, that the interactions became a real problem.

I'm always wary of MTX interactions but after hearing that I lose a lot less sleep over them.

[Steve G]

Re: clinical knowledge

Someone here queried ibuprofen and methotrexate. NSAIDs plua methotrexate commonplace. BNF says 'increases toxicity' I always check pt having regular liver function tests and most have been on for years. What would you suggest?
johnep

BNF is not always particularly helpful - Stockley is far more useful.

[admin]

Re: clinical knowledge

BNF is not always particularly helpful - Stockley is far more useful.

It's a bit bulky to carry around though isn't it? Do you use it regularly? I agree it's a much better book then the BNF section is, but it's just too big to take around with me.

[Steve G]

Re: clinical knowledge

It's a bit bulky to carry around though isn't it? Do you use it regularly? I agree it's a much better book then the BNF section is, but it's just too big to take around with me.

I do use it quite regularly, but I only work in one branch so have it to hand. A bit more difficult if you locum I suppose.

[Pharmanaut]

Re: clinical knowledge

I do use it quite regularly, but I only work in one branch so have it to hand. A bit more difficult if you locum I suppose.

I usually carry the textbook around in my briefcase. Usually needed at least once a day to clear up what the PMR system is saying to me. Unless using Cegedim Pharmacy Manager which licences the Stockley interactions.
There's a pocket Companion to Stockley - which is quite useful.

[mm45]

Re: clinical knowledge

Hi. I've just finished my second year of pharmacy and spent alot of my holidays working at Boots. To start with I had very little clinical knowledge, just finishing first year, but working in the dispensary with good pharmacists changed this. I feel my clinical knowledge is alot greater then most of my friends. Take the placement as a learning experience you wont be expected to know everything but when you get a spare minute just read bits and pieces in the BNF and remember the important things.

Hope all goes well and let me know how you get on.