Urgent but out of date

Had a mum in first thing today who handed in a script for domperidone suspension from the local urgent care centre.

It wasn’t until we looked at it closely that we noticed it was out of date (you don’t often see this from ‘urgent care’ scripts).

Mum explained that her toddler had been sick during the night and so she had just dug this script out since she knew it was for nausea and vomiting.

I counselled her and off she went with the appropriate advice and some dioralyte under the Care at the Chemist scheme.

Inhaler checks

Had an interesting one today with a girl asking for an emergency supply of her salbutamol inhaler.

Now we always check that patients are also using their preventer inhalers, and when they last had a supply of the salbutamol inhaler just to check for signs of overuse or over-reliance on the reliever.

When we checked this one, she had been dispensed two MDIs two days earlier. When I questioned her she told me she had lost them, so what do you do, particularly when you know her asthmatic boyfriend was refused a similar supply the day before because of a definite over-reliance on his reliever?

Well I told her that I would make the supply this time in good faith but that in future she would need to sort this out with the practice.

I also made a call to the practice’s asthma nurse to let her know what was going on and hopefully they will be called in for a review.

Ironic

I had a great week last week for querying and stopping potential overdoses of drugs, and they all seemed to come together in the space of two days. Here are some of them:

* The patient taking perindopril 8mg and 2mg tablets. On querying this, the 2mg tablet was stopped.

* Tramadol MR 200mg being prescribed QDS. Got this one changed to the BD dosage.

* Co-danthrusate being prescribed on repeat at a dose of 2 TDS. This should have just been docusate at this dosage.

I found making all these important interventions quite ironic so soon after the MHRA decided to allow us to continue to sell pseudoephedrine!

Switch info

The PCT pharmacists have been in again today to let us know about three switches they are planning to do at one of the local practices.

They are atorvastatin to simvastatin, risedronate to alendronate, and gaviscon advance to peptac.

They are asking the practice to send out letters to patients about the switches, and we have already started to adjust our stocks.

What we then thought about was the issue of not consuming grapefruit when dosette box patients are swapped from atorvastatin to simvastatin because you can't get that amount of detailed information on the back of the dosette boxes.

So we have written our own letter for these patients to tell them about not consuming grapefruit when they are swapped to simvastatin.

Hydrocortisone problem

Had one of those annoying situations today where a lady came in asking for hydrocortisone cream 1% to buy for use on her face.

She understandably got rather frustrated with me when I told her that I couldn’t sell it for use on the face since this wasn’t covered by the OTC license.

I remember getting this situation a lot 10 years ago when OTC hydrocortisone was fairly new to the market and I’m surprised that this is still happening.