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  • 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

  • #2
    Re: clinical knowledge

    Originally posted by uurrehma View Post
    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

    Comment


    • #3
      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
      Kemzo the pharmacist forumly known as kemzero

      Comment


      • #4
        Re: clinical knowledge

        Originally posted by uurrehma View Post
        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!
        Kemzo the pharmacist forumly known as kemzero

        Comment


        • #5
          Re: clinical knowledge

          Originally posted by kemzero View Post
          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.
          47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
          2018 AD : Modern Man : I shopped, I clicked, I collected.
          How times change.

          If you find you have read something that has upset or offended you an anyway please unread it at once.

          Comment


          • #6
            Re: clinical knowledge

            Originally posted by Pharmanaut View Post
            Its off to the doctors for the carbimazole if the sore throat to be on the safe side.
            and carbamazepine as well.

            Comment


            • #7
              Re: clinical knowledge

              thnx for the info

              Comment


              • #8
                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

                Comment


                • #9
                  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.

                  Comment


                  • #10
                    Re: clinical knowledge

                    Originally posted by johnep View Post
                    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.
                    Linnear MRPharmS

                    Foetal Alcohol Spectrum Disorder: The biggest cause of brain damage and 100% preventable.

                    In pregnancy: 1 fag is not safe, 1 x-ray is not safe and 1 drink is not safe.



                    For handy pharmacy links try
                    pharmacistance.co.uk

                    If you like my posts or letters in the journal try my books!
                    eloquent-e-tales

                    Comment


                    • #11
                      Re: clinical knowledge

                      Originally posted by johnep View Post
                      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.

                      Comment


                      • #12
                        Re: clinical knowledge

                        Originally posted by Steve G View Post
                        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.
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                        • #13
                          Re: clinical knowledge

                          Originally posted by admin View Post
                          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.

                          Comment


                          • #14
                            Re: clinical knowledge

                            Originally posted by Steve G View Post
                            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.
                            47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                            2018 AD : Modern Man : I shopped, I clicked, I collected.
                            How times change.

                            If you find you have read something that has upset or offended you an anyway please unread it at once.

                            Comment


                            • #15
                              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.

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