I am afraid; terrified at the possibility of one day I might turn out to be a less-than-competent pharmacist. Prior to this, I have not worked along with a pharmacist who I considered to be a sub-par pharmacist. Legally speaking, they are fit to be a pharmacist, but do not expect them to know much about anything. Working with a pharmacist who dislikes being one all of a sudden does not seem that bad at all.
A pharmacist is an expert on drugs and a pharmacist do know more on a lot of medications as noted by Pharmacy Mike – We don’t realize how much we know. Being a student, I hate it whenever a customer knows more about a medication or a product more than me. I am the one working in a pharmacy and not them, I am supposed to be the drug expert one day, being involved in retails do imply that I have to know about a lot of other products not covered in my four years undergraduate course.
I am not giving them a chance to yell at me, “Why the hel* are you working in a pharmacy then?” I am not letting them think I am stupid, that I am not doing my job well.
A pharmacist I worked with ranted about customers expect a lot from a pharmacist, more than you would anticipate as a pharmacist, and no, the university did not prepare you for all of that, you could only hope that the customers are not going to ask you about the plumber problem or how to troubleshoot their car.
As a pharmacist, you have no escape, you can’t say the six magical words, let me get you the pharmacist and save your own ass. All men for their own but no one is going to save you. You are the pharmacist, right? Oh wait, I forget you are only a pharmacist because the law and regulation says you are fit to be one. How do you sleep well each night without worrying that someday you might just hand someone their death sentence because you are incompetence?
I regard highly a pharmacist who is willing to teach, someone I can learn from, a mentor. Unfortunately, I have seen many pharmacists, one that I would not want to be in future. I do not want to regard being pharmacist as a job, pharmacist should be a career and not having to deal with having an aversion towards being a pharmacist, I do not want to lose the respect of the pharmacy assistant I work with.
I will have to be a role model. Every mistake I make as a pharmacist could be fatal and they will have to be at minimal level at all time, no one would watch my back, double checking all my work because I am the pharmacist. Dispensing a medication with the wrong direction for use is not acceptable, especially when you are not overworked.
You are the pharmacist, not god but errors are still not allowable in your field of choice, and being lacking in ability is a choice, a poor selection.
Showing posts with label A Day In Pharmacy. Show all posts
Showing posts with label A Day In Pharmacy. Show all posts
running around too much lately?
Do you or do you not treat a non self limiting minor illness?
He came in asking for terbinafine once-only formulation. Terbinafine commonly used to treat athlete’s foot and the formulation he asked for is to be applied only once and it will leave a film which then releases terbinafine for up to 13 days. It costs more compared to the cream formulation which is to be applied once daily for up to 14 days and the public generally are not aware of the once formulation while others are skeptical towards it, most, however are put off by the cost.
I decided to spend more time with him as it was not that busy in the pharmacy. After confirming the classic symptoms of athlete’s foot with him, further questioning revealed that the most recent episode of athlete’s foot is a recurrent infection, not too surprising considering he is fairly familiar with the range of terbinafine available.
He does not resist much of my counselling so I took him through on some general points on self care before taking it a step further recommending pine tar gel to help with the inflammation and itch, to be used before applying the terbinafine. I glanced at his feet and he was wearing leather shoes. A chance to push the sales with miconazole powders I thought, might as well eradicate any possible chance of reinfection this time.
As he was getting more comfortable with me, he enquired about the amorolfine used to treat fungal infections of the nails, big toe and one small toe of his was infected. The reason he kept getting reinfected was identified at last. Amorolfine is only available as a kit and he complained about the product being pricey despite the kit should last him six to nine months depending on the severity of his nails infection. The longer he left it untreated, the more time and money he had to spend treating it in the end assuming the infection do not spread to the nail bed.
While the majority of untreated athlete’s foot proceeds to infect the nails sooner or later, this very customer keeps getting recurrent episodes of athlete’s foot because he left the nails infection untreated.
You just have to live with surprises working in a retail pharmacy, not the kind of surprises you want though.
He came in asking for terbinafine once-only formulation. Terbinafine commonly used to treat athlete’s foot and the formulation he asked for is to be applied only once and it will leave a film which then releases terbinafine for up to 13 days. It costs more compared to the cream formulation which is to be applied once daily for up to 14 days and the public generally are not aware of the once formulation while others are skeptical towards it, most, however are put off by the cost.
I decided to spend more time with him as it was not that busy in the pharmacy. After confirming the classic symptoms of athlete’s foot with him, further questioning revealed that the most recent episode of athlete’s foot is a recurrent infection, not too surprising considering he is fairly familiar with the range of terbinafine available.
He does not resist much of my counselling so I took him through on some general points on self care before taking it a step further recommending pine tar gel to help with the inflammation and itch, to be used before applying the terbinafine. I glanced at his feet and he was wearing leather shoes. A chance to push the sales with miconazole powders I thought, might as well eradicate any possible chance of reinfection this time.
As he was getting more comfortable with me, he enquired about the amorolfine used to treat fungal infections of the nails, big toe and one small toe of his was infected. The reason he kept getting reinfected was identified at last. Amorolfine is only available as a kit and he complained about the product being pricey despite the kit should last him six to nine months depending on the severity of his nails infection. The longer he left it untreated, the more time and money he had to spend treating it in the end assuming the infection do not spread to the nail bed.
While the majority of untreated athlete’s foot proceeds to infect the nails sooner or later, this very customer keeps getting recurrent episodes of athlete’s foot because he left the nails infection untreated.
You just have to live with surprises working in a retail pharmacy, not the kind of surprises you want though.
i swear to speak only the truth, yea right.
Human lies for many reasons, while some have a noble motive behind it; others are just trying to get away with something. When someone walks through the door and come to me, they could claim a lot of things and I have no means of verifying that. Sometimes, they are bad at lying but that is none of my business. I might be suspicious but no confrontation would be needed.
For instance, customers could claim that they worked in a pharmacy despite not knowing the difference between phenylephrine and pseudoephedrine. Customer could claim that they are a qualified pharmacist so that I would not have to try to elicit history from them and subsequently recommend the most suitable treatment. They could claim that their child is older than 2 years old so I am to supply some medication to relieve their child’s cold. They could claim the product is taken under the recommendation of the doctor but the truth says otherwise.
Customers get the benefit of doubt most of the time. I did get one pharmacist came in and starts throwing all the azoles drug names at me, the ketoconazole, miconazole, bifonazole, clotrimazole and the terbinafine. He is trying to treat the athlete’s foot he had and I was still quite new to the field, and only familiar with brand names. After the request of clotrimazole topical cream, I summoned the pharmacist to assist. (The incongruent about the encounter is that the pharmacist isn't aware of the azoles available over the counter)
I do get customers who claim they knew everything there is about the medication; take it with food, two to start with, maximum of six. This phenomenon is more common especially if the customer is working as a naturopath practitioner or nurses, anything that could be associated with healthcare. No matter how comfortable I am in any particular drug or group, I always stick with; I do know quite a fair bit about - head lice treatments, NSAIDs, travel sickness but never, the word everything.
A doctor did prescribe himself with metformin and glipizide last week, and he presents me with the handwritten script. Handwritten scripts are definitely a pain compared to those computer generated scripts. He was first time getting his script filled at our pharmacy and thus I asked the customer to write their name and address in a readable form without adding that I could not read the doctor’s handwriting, and in this case, he is the doctor, his handwriting that I could not read. Glad that I for once, did not try to be chatty.
A customer on Thursday night asking us to quote a price on hepatitis B vaccine but upon enquiring with the pharmacist, he refused to quote a price but instead requested the customer to make an appointment with the doctor. The pharmacist on duty claimed that there are too many vaccines on the market to quote the customer every vaccine. A self-claimed doctor then showed up on Saturday asking for a quote on hepatitis B vaccine and I was regurgitating the Thursday night information before being forced (customer: I am a doctor myself) to approach the pharmacist on duty, and this another pharmacist quoted 24 dollars without any hassle.
Lesson number one - speak less and use the same time to accomplish more work, not everything is your business, at least not the part of unearthing the truth. Despite some of the words are less than convincing, they are still the truth nonetheless.
For instance, customers could claim that they worked in a pharmacy despite not knowing the difference between phenylephrine and pseudoephedrine. Customer could claim that they are a qualified pharmacist so that I would not have to try to elicit history from them and subsequently recommend the most suitable treatment. They could claim that their child is older than 2 years old so I am to supply some medication to relieve their child’s cold. They could claim the product is taken under the recommendation of the doctor but the truth says otherwise.
Customers get the benefit of doubt most of the time. I did get one pharmacist came in and starts throwing all the azoles drug names at me, the ketoconazole, miconazole, bifonazole, clotrimazole and the terbinafine. He is trying to treat the athlete’s foot he had and I was still quite new to the field, and only familiar with brand names. After the request of clotrimazole topical cream, I summoned the pharmacist to assist. (The incongruent about the encounter is that the pharmacist isn't aware of the azoles available over the counter)
I do get customers who claim they knew everything there is about the medication; take it with food, two to start with, maximum of six. This phenomenon is more common especially if the customer is working as a naturopath practitioner or nurses, anything that could be associated with healthcare. No matter how comfortable I am in any particular drug or group, I always stick with; I do know quite a fair bit about - head lice treatments, NSAIDs, travel sickness but never, the word everything.
A doctor did prescribe himself with metformin and glipizide last week, and he presents me with the handwritten script. Handwritten scripts are definitely a pain compared to those computer generated scripts. He was first time getting his script filled at our pharmacy and thus I asked the customer to write their name and address in a readable form without adding that I could not read the doctor’s handwriting, and in this case, he is the doctor, his handwriting that I could not read. Glad that I for once, did not try to be chatty.
A customer on Thursday night asking us to quote a price on hepatitis B vaccine but upon enquiring with the pharmacist, he refused to quote a price but instead requested the customer to make an appointment with the doctor. The pharmacist on duty claimed that there are too many vaccines on the market to quote the customer every vaccine. A self-claimed doctor then showed up on Saturday asking for a quote on hepatitis B vaccine and I was regurgitating the Thursday night information before being forced (customer: I am a doctor myself) to approach the pharmacist on duty, and this another pharmacist quoted 24 dollars without any hassle.
Me: He claims that he is a doctor, you know. Hehe.
Pharmacist: Oh yeah, he is Dr. XYZ right?
Me: *shocked.* So he a real doctor?Pharmacist: Yeah, we always get his scripts at the other pharmacy.
Lesson number one - speak less and use the same time to accomplish more work, not everything is your business, at least not the part of unearthing the truth. Despite some of the words are less than convincing, they are still the truth nonetheless.
do i need a script for this?
The Chinese has a saying; no one is born with the same fate as others - 同人不同命,同遮(伞)不同柄(手柄). I am definitely curious with things the public could lay their hands on without a prescription especially if it is out of Australia. They turn me on. Why not? It is interesting to have a quick look at how various authorities at different parts of the world assess the risk benefit ratio in a way that contradict each other.
What is considered safe and who gets to have their say on that matter? Why the selected few get to decide whether the rest of the majority layperson has easier access to certain medications and most importantly, how they reach that conclusion. Surely the drug being deregulated still stay the same, only we learn more about it over time.
Simvastatin is reclassified for sale without prescription in UK in 2004 whereas no statin is available OTC in Australia. Not only that, tamsulosin, an alpha1-adrenergic blocker for the treatment of functional symptoms of benign prostatic hyperplasia (BPH) is available OTC as well. Being a second year student, I do not even have the slightest idea of what BPH is. Azithromycin, a macrolide antibacterial is also available OTC for the treatment of Chlamydia, a sexually transmitted infection (STI).
Sumatriptan, a specific 5-HT type 1 receptor agonist, is available OTC in UK for the treatment of migraine. The closest thing Australian public could get for migraine is paracetomol along with antiemetic, metoclopramide or ibuprofen lysine – a preparation claimed to have greater water solubility than ibuprofen and thus, provides a more rapid onset of action. Prochlorperazine, recently commercially available OTC as a product is approved as treatment for nausea associated with migraine.
That is just a small portion of differences I discovered yesterday. On a interesting side note, my previous roommate back in Malaysia used to parade his only tablet of Viagra, kept in his wallet in front of everyone. He then will proceed to tell the same old story of people coming in (into the pharmacy) to buy Viagra the “sebiji potong empat” way, the cut that (tablet) into a quarter for me. I don't think one needs a script for that; no one goes to a community pharmacy in Malaysia with a script.
My study buddy thinks that I am a little obsessive about primary care, but I am really just interested in the efficacy, bogus or any medicinal value. Having said that, I might consider the option of co-authoring a book on primary care next time if I have the credibility.
Alan, up for some extra money, buddy?
Alan Nathan, a free-lance writer and pharmacy consultant, pharmacist by training with 25 years of experience as a community (retail) pharmacist and an expert in non-prescription (over-the-counter) medicines.
What is considered safe and who gets to have their say on that matter? Why the selected few get to decide whether the rest of the majority layperson has easier access to certain medications and most importantly, how they reach that conclusion. Surely the drug being deregulated still stay the same, only we learn more about it over time.
Simvastatin is reclassified for sale without prescription in UK in 2004 whereas no statin is available OTC in Australia. Not only that, tamsulosin, an alpha1-adrenergic blocker for the treatment of functional symptoms of benign prostatic hyperplasia (BPH) is available OTC as well. Being a second year student, I do not even have the slightest idea of what BPH is. Azithromycin, a macrolide antibacterial is also available OTC for the treatment of Chlamydia, a sexually transmitted infection (STI).
Sumatriptan, a specific 5-HT type 1 receptor agonist, is available OTC in UK for the treatment of migraine. The closest thing Australian public could get for migraine is paracetomol along with antiemetic, metoclopramide or ibuprofen lysine – a preparation claimed to have greater water solubility than ibuprofen and thus, provides a more rapid onset of action. Prochlorperazine, recently commercially available OTC as a product is approved as treatment for nausea associated with migraine.
That is just a small portion of differences I discovered yesterday. On a interesting side note, my previous roommate back in Malaysia used to parade his only tablet of Viagra, kept in his wallet in front of everyone. He then will proceed to tell the same old story of people coming in (into the pharmacy) to buy Viagra the “sebiji potong empat” way, the cut that (tablet) into a quarter for me. I don't think one needs a script for that; no one goes to a community pharmacy in Malaysia with a script.
My study buddy thinks that I am a little obsessive about primary care, but I am really just interested in the efficacy, bogus or any medicinal value. Having said that, I might consider the option of co-authoring a book on primary care next time if I have the credibility.
Alan, up for some extra money, buddy?
Alan Nathan, a free-lance writer and pharmacy consultant, pharmacist by training with 25 years of experience as a community (retail) pharmacist and an expert in non-prescription (over-the-counter) medicines.
i am asking but not listening.
Customers come and go, most of them have in mind what they want, not all of them. They did not choose to come to you; they chose to shop at your store you happened to work at. They are easy to spot; they come to you with a specific product in mind. They just need a means to get the product.
Those without an idea come to you with their symptoms and concerns. These people walk through the front door asking to speak to the expert in the store, sometimes you [pharmacy assistant/student] are the only expert they could get their hands on. They value your opinion, because you are the one with the knowledge to take their worries away, you know more than them and certainly you know the best course for them. They believe and trust in you.
Nonetheless, I am dumbfounded at times. Some of them are looking for assurance, that their decision is a good one, I get this part. Most of the time, I take away their doubts without second thought. They get the product and assurance they want. It is a win-win situation for them. They walk away happy.
I tend to err on the safe side all times. I chose my words carefully. I told them about the manufacturer’s claims about the products, the popularity among other customers if any. Some manage to get my unspoken lines, and they would proceed to ask me about the efficacy of the product.
I do believe a big part of retail pharmacy is based on placebo or sugar pills, anything of no direct medical benefit which nevertheless makes people feel better or benefit psychologically. Direct to consumer marketing is a powerful tool, on certain occasions, words written on the box is regarded as the highest authority instead of your words.
“But the box says that it will help with [insert patient’s worries].”
“I am looking for [whatever was advertising on the television].”
I am confused. Some approach you with the decision made in their mind and yet, they want you to have the same amount of confidence as they have in their decision, that you are backing their wise decision or at times, why not. And the magic line makes the second appearance in the interaction again.
“But the box says that it will help with [insert patient’s worries].”
I do not get them then. Why are you acting that you value my opinions then. If you have the money to spend, I will not stop you. It is simple; your money, your decision. Just don’t force your beliefs on me, just don’t. It annoys the crap out of me. I can’t be expected to endorse your decision when you chose to contradict me or the pharmacist’s advice.
Efficacy does not pick side and thus, has nothing to do with my support or approval. Asking to speak to me multiple times does not change a thing either.
Those without an idea come to you with their symptoms and concerns. These people walk through the front door asking to speak to the expert in the store, sometimes you [pharmacy assistant/student] are the only expert they could get their hands on. They value your opinion, because you are the one with the knowledge to take their worries away, you know more than them and certainly you know the best course for them. They believe and trust in you.
Nonetheless, I am dumbfounded at times. Some of them are looking for assurance, that their decision is a good one, I get this part. Most of the time, I take away their doubts without second thought. They get the product and assurance they want. It is a win-win situation for them. They walk away happy.
I tend to err on the safe side all times. I chose my words carefully. I told them about the manufacturer’s claims about the products, the popularity among other customers if any. Some manage to get my unspoken lines, and they would proceed to ask me about the efficacy of the product.
I do believe a big part of retail pharmacy is based on placebo or sugar pills, anything of no direct medical benefit which nevertheless makes people feel better or benefit psychologically. Direct to consumer marketing is a powerful tool, on certain occasions, words written on the box is regarded as the highest authority instead of your words.
“But the box says that it will help with [insert patient’s worries].”
“I am looking for [whatever was advertising on the television].”
I am confused. Some approach you with the decision made in their mind and yet, they want you to have the same amount of confidence as they have in their decision, that you are backing their wise decision or at times, why not. And the magic line makes the second appearance in the interaction again.
“But the box says that it will help with [insert patient’s worries].”
I do not get them then. Why are you acting that you value my opinions then. If you have the money to spend, I will not stop you. It is simple; your money, your decision. Just don’t force your beliefs on me, just don’t. It annoys the crap out of me. I can’t be expected to endorse your decision when you chose to contradict me or the pharmacist’s advice.
Efficacy does not pick side and thus, has nothing to do with my support or approval. Asking to speak to me multiple times does not change a thing either.
tight on budget and love
A colleague commented that I always get customers with weird request. Nothing is weird in a retail pharmacy.
He came to the over-the-counter section to get a paracetamol suspension (1 month up to 2 years).
Mr Stingy: Actually I need advice on another thing.
Me: Yes?
Mr Stingy: Is there any alternative for Elevit?
[Elevit is the only brand on vitamins & minerals for pregnancy & lactation scheduled behind the counter]
Me: Elevit is now on sales.
Mr Stingy: Elevit costs a bomb; I want something similar but cheaper.
[We are already selling Elevit for 33% under the recommended retail price]
Me: Okay, let me show you other brands we have then.
[I started with the pricey range, from there I move down to the cheaper ones]
Mr Stingy: All of them worked out to be more or less the same.
Few moments later, pharmacist on duty paged me back in dispensary.
I was so close to asking him, "You mean your wife no longer deserves quality products having recently gone into labour for you?" Although price does not correlate to the quality.
Elevit does not cost more than half a dollar per day.
He came to the over-the-counter section to get a paracetamol suspension (1 month up to 2 years).
Mr Stingy: Actually I need advice on another thing.
Me: Yes?
Mr Stingy: Is there any alternative for Elevit?
[Elevit is the only brand on vitamins & minerals for pregnancy & lactation scheduled behind the counter]
Me: Elevit is now on sales.
Mr Stingy: Elevit costs a bomb; I want something similar but cheaper.
[We are already selling Elevit for 33% under the recommended retail price]
Me: Okay, let me show you other brands we have then.
[I started with the pricey range, from there I move down to the cheaper ones]
Mr Stingy: All of them worked out to be more or less the same.
Few moments later, pharmacist on duty paged me back in dispensary.
I was so close to asking him, "You mean your wife no longer deserves quality products having recently gone into labour for you?" Although price does not correlate to the quality.
Elevit does not cost more than half a dollar per day.
a day in the pharmacy
Most of the prescription medication are subsidized by the Australia Government through PBS, the patient only have to pay a fixed small portion of the full medication cost. The tiny portion is considered patient's contribution and if the total contribution of that calendar year have reached a bigger amount, patients are entitled access to medications at a cheaper rate for the rest of the calendar year. The catch is, if the patients get a month supply of medication, they are not to ask for another supply before 20 days after the previous supply or the contribution, the tiny amount that they pay would not be added to the bigger amount.
She came in, first customer of the day, wanting another refill (another supply) for four of her medications. Two of them were early, it has not been 20 days since the last supply.
Me: It seems that you are early for the refill on XXX and YYY. Thus, your contribution will not count towards safety net threshold (the bigger amount). Do you want me to proceed?
Customer: This is bullshit. If you pull this trick again, I swear I would never come back to this pharmacy again.
Me: *Okay, I think you are nuts* But it has absolutely nothing to do with our pharmacy, it is the government who comes out with the rule. Even other pharmacy will tell you the same thing.
Customer: I don't care. *That makes two of us* It is not that I abuse the drugs or anything, I just do not have the time to keep coming back to the pharmacy. Yada..yada..yada..
Obviously she could not understand there is a price to pay for getting her medication too early. The dispensing computer did came out with a note - "speak carefully" before I was allowed to dispense her medication, a note left by the previous pharmacist. It could not be more true in this case.
I added another note after the encounter, just proceed with immediate supply if needed, she does not want to know the PBS safety net 20 days rule.
What she does not know, does not hurt her.
I am sure she is not abusing her medication, sometimes a pack of blister with 10 tablets might just end up in the bin for no good reason and sometimes it is the dog's fault and sometimes it is the rainy days.
If she starts pulling tricks on me, I swear she will not get any medication at my pharmacy. See the resemblance? Of course, I do not own the pharmacy and she is still getting her meds.
She came in, first customer of the day, wanting another refill (another supply) for four of her medications. Two of them were early, it has not been 20 days since the last supply.
Me: It seems that you are early for the refill on XXX and YYY. Thus, your contribution will not count towards safety net threshold (the bigger amount). Do you want me to proceed?
Customer: This is bullshit. If you pull this trick again, I swear I would never come back to this pharmacy again.
Me: *Okay, I think you are nuts* But it has absolutely nothing to do with our pharmacy, it is the government who comes out with the rule. Even other pharmacy will tell you the same thing.
Customer: I don't care. *That makes two of us* It is not that I abuse the drugs or anything, I just do not have the time to keep coming back to the pharmacy. Yada..yada..yada..
Obviously she could not understand there is a price to pay for getting her medication too early. The dispensing computer did came out with a note - "speak carefully" before I was allowed to dispense her medication, a note left by the previous pharmacist. It could not be more true in this case.
I added another note after the encounter, just proceed with immediate supply if needed, she does not want to know the PBS safety net 20 days rule.
What she does not know, does not hurt her.
I am sure she is not abusing her medication, sometimes a pack of blister with 10 tablets might just end up in the bin for no good reason and sometimes it is the dog's fault and sometimes it is the rainy days.
If she starts pulling tricks on me, I swear she will not get any medication at my pharmacy. See the resemblance? Of course, I do not own the pharmacy and she is still getting her meds.
if only i knew. i wanted to help but.....
Pharmacist is the most accessible first line healthcare professionals to the public; there is no appointment needed, no consultation fees charged and sometimes no respect is shown. Little appreciation is shown - most of the time pharmacists are expected to finish any dispensing at light-speed, such is the high bar of the public. There is absolutely no reason for their scripts to take such a long time to be ready.
Abusive and/or customers are a common sight in a community pharmacy, nice friendly regulars too present each day in the very same exact place. There is no way to tell the former or the latter is greater in numbers but one thing for sure, most of the customers are in between both extremes. They could be one of the one-time- customers in your pharmacy, to purchase a specific product they already have in mind. They just need a means - a pharmacy to get the medication.
Prices are generally not a concern of the locals around here, many would not mind paying a higher price, such is a phenomena I seen far too many times, the same thing at a much cheaper price available at supermarket a stone throw away and yet they chose to shop in the pharmacy. Having said that, once in a while, someone of a tighter financial background, struggle to make ends meet would walk into the pharmacy. Every penny matters for this group of community and if they need two different medications, more often than not, they could only settle for one.
She came in, looking to get something to "cure" the fever and runny nose of a child. On questioning, she gave the child paracetamol the night before and it stops the runny nose and the child shown some improvement before reverting back to the same symptoms. Well, paracetamol is not supposed to have any vasoconstriction effect. My pharmacist recommended two different products, one for the runny nose and the other for the fever.
She settled for the one to dry the nasal passage. She ran out of paracetamol the night before. I would have persuaded her to treat the fever instead.
It is really not up to us sometimes, not everyone is born with a silver spoon, how true is that. We wanted to help but.....
She came in, wanting to buy ibuprofen for a 5 years old child. Fever and diarrhea are the two major symptoms. The ibuprofen is intended to reduce the fever and she wanted something to stop the diarrhea.
The only preparation I know, loperamide 2mg is not intended for use on child under 12 of age. I tried recommending Oral Rehydration Therapy (ORT).
She has a feeling that the child would not take it and declined.
I was trying to convince her to make a switch to paracetamol as anti-pyretic for fear NSAID ibuprofen would irritate the gastrointestinal more.
She did not take my advice, apparently the child's grandma would only swear by ibuprofen.
I was trying hard to recall if my lectures did mention any treatment for child under 12 but to no avail. Bulking agents did not come hit me in the head. The other person in the pharmacy, my pharmacist is busy serving other customers and the lines behind are getting long.
Many of those who present themselves in a pharmacy with diarrhea would expect an instant cure. I have failed so many times to try to convince them to get ORT; to be honest, I have yet to succeed once.
We learn the ideal treatment during lectures but things have their own way in a real world, there are simply too many factors we could not control, such is with our life too.
Clinical management of acute diarrhea - here - World Health Organization and UNICEF recommend the usage of 20 mg of zinc daily to reduce the severity and duration of acute diarrhea.
Abusive and/or customers are a common sight in a community pharmacy, nice friendly regulars too present each day in the very same exact place. There is no way to tell the former or the latter is greater in numbers but one thing for sure, most of the customers are in between both extremes. They could be one of the one-time- customers in your pharmacy, to purchase a specific product they already have in mind. They just need a means - a pharmacy to get the medication.
Prices are generally not a concern of the locals around here, many would not mind paying a higher price, such is a phenomena I seen far too many times, the same thing at a much cheaper price available at supermarket a stone throw away and yet they chose to shop in the pharmacy. Having said that, once in a while, someone of a tighter financial background, struggle to make ends meet would walk into the pharmacy. Every penny matters for this group of community and if they need two different medications, more often than not, they could only settle for one.
She came in, looking to get something to "cure" the fever and runny nose of a child. On questioning, she gave the child paracetamol the night before and it stops the runny nose and the child shown some improvement before reverting back to the same symptoms. Well, paracetamol is not supposed to have any vasoconstriction effect. My pharmacist recommended two different products, one for the runny nose and the other for the fever.
She settled for the one to dry the nasal passage. She ran out of paracetamol the night before. I would have persuaded her to treat the fever instead.
It is really not up to us sometimes, not everyone is born with a silver spoon, how true is that. We wanted to help but.....
She came in, wanting to buy ibuprofen for a 5 years old child. Fever and diarrhea are the two major symptoms. The ibuprofen is intended to reduce the fever and she wanted something to stop the diarrhea.
The only preparation I know, loperamide 2mg is not intended for use on child under 12 of age. I tried recommending Oral Rehydration Therapy (ORT).
She has a feeling that the child would not take it and declined.
I was trying to convince her to make a switch to paracetamol as anti-pyretic for fear NSAID ibuprofen would irritate the gastrointestinal more.
She did not take my advice, apparently the child's grandma would only swear by ibuprofen.
I was trying hard to recall if my lectures did mention any treatment for child under 12 but to no avail. Bulking agents did not come hit me in the head. The other person in the pharmacy, my pharmacist is busy serving other customers and the lines behind are getting long.
Many of those who present themselves in a pharmacy with diarrhea would expect an instant cure. I have failed so many times to try to convince them to get ORT; to be honest, I have yet to succeed once.
We learn the ideal treatment during lectures but things have their own way in a real world, there are simply too many factors we could not control, such is with our life too.
Clinical management of acute diarrhea - here - World Health Organization and UNICEF recommend the usage of 20 mg of zinc daily to reduce the severity and duration of acute diarrhea.
If only I knew. I wanted to help but.....
the asian boy & the kangaroo land
Eight months ago, he was offered a position as a pharmacist assistant at a pharmacy. Forty minutes driving from his place and an hour to get there by public transport. He never expects to be offered a position because the interview lasted less than five minutes, whereas he took around two hours to get there the first time.
Three weeks later, the manager rang, the Asian boy who normally fell out of favor compared to the locals was asked to join the pharmacy. The job hunting had finally ended for him, a new exciting journey were in his sight that day. At last, he could claim that he is part of the community pharmacy.
The new boy showed up for his first day, eager and enthusiastic only to realize the cold hard reality slapped him in his face. He was like a toddler learning how to walk, being in the way of everyone in the pharmacy. The only part he was good at - taking money from the customers and giving them back their changes, if any.
The job proved overwhelming to him. He knew nothing about medication. There was only three things in the store he was familiar with, the universally known Panadol, Bonjela his mother bought for his ulcer and the antacid his father constantly on, Eno. He knew nothing about any other products, or counseling, or any active ingredients, or scripts or which aisle customer could get their product request. Furthermore, he could not comprehend the locals, the way they speak, they joke or the request for recommendations.
He was being more and more fearful turning up for work. He was not of a great help at the pharmacy but still being paid. He was being paid but he did a bad job. No one had time to teach him anything, everyone was constantly busy except him. He needed to learn but has no means to do so, he did not knew where to start.
A month past, he stumbled upon his faithful companion on the bus and train since then, his primary care bible. He began devoured pages after pages since then, amazed and excited at the same time at the facts lay naked in front of him, a structured way of making more sense of his pharmacy at last.
His knowledge and learning curve shot up, he was contributing more to the pharmacy. He had a value, a justification, a reason of being paid. He was getting more and more comfortable being in a pharmacy. He found his niche, his comfort spot.
The fortunate boy is in fact I myself.
The first thing the part time pharmacist told me, the pharmacy (I work at) was sold to our competitor. The pharmacists seem to be affected the most, lost their job while others, are safe. If things are going to stay as planned, but I am already expecting pay cut on my high salary.
I was quite upset. Humans fear changes, and I am only human, and an Asian.
My manager gave me the valuable chance, and he did his 500 hours at the very exact pharmacy he was promoted to be my manager. He started out as an occupational therapist but he wanted more in his life. He chose pharmacy, started at the clinical side after he graduated and subsequently joined the community pharmacy after years of battling the red-tapes.
He was different, he was willing to teach, and it has been a joy to work alongside with him. He expects nothing from me; he just let me grow at my own pace.
He entrusts the Asian boy with his car and the banking of store's money after three months, even when the Asian boy has not been driving for a good eleven months. He protects the Asian boy from the abusive customers, he teaches the Asian boy pharmacology of certain drugs, he let the Asian boy did his first webster pack, he invited the Asian boy to trash at his house so that the Asian boy would not miss the Christmas party, he teaches the Asian boy the retail side of a community pharmacy, he takes it easy on the Asian boy.
He is different. I like him.
Three weeks later, the manager rang, the Asian boy who normally fell out of favor compared to the locals was asked to join the pharmacy. The job hunting had finally ended for him, a new exciting journey were in his sight that day. At last, he could claim that he is part of the community pharmacy.
The new boy showed up for his first day, eager and enthusiastic only to realize the cold hard reality slapped him in his face. He was like a toddler learning how to walk, being in the way of everyone in the pharmacy. The only part he was good at - taking money from the customers and giving them back their changes, if any.
The job proved overwhelming to him. He knew nothing about medication. There was only three things in the store he was familiar with, the universally known Panadol, Bonjela his mother bought for his ulcer and the antacid his father constantly on, Eno. He knew nothing about any other products, or counseling, or any active ingredients, or scripts or which aisle customer could get their product request. Furthermore, he could not comprehend the locals, the way they speak, they joke or the request for recommendations.
He was being more and more fearful turning up for work. He was not of a great help at the pharmacy but still being paid. He was being paid but he did a bad job. No one had time to teach him anything, everyone was constantly busy except him. He needed to learn but has no means to do so, he did not knew where to start.
A month past, he stumbled upon his faithful companion on the bus and train since then, his primary care bible. He began devoured pages after pages since then, amazed and excited at the same time at the facts lay naked in front of him, a structured way of making more sense of his pharmacy at last.
His knowledge and learning curve shot up, he was contributing more to the pharmacy. He had a value, a justification, a reason of being paid. He was getting more and more comfortable being in a pharmacy. He found his niche, his comfort spot.
The fortunate boy is in fact I myself.
The first thing the part time pharmacist told me, the pharmacy (I work at) was sold to our competitor. The pharmacists seem to be affected the most, lost their job while others, are safe. If things are going to stay as planned, but I am already expecting pay cut on my high salary.
I was quite upset. Humans fear changes, and I am only human, and an Asian.
My manager gave me the valuable chance, and he did his 500 hours at the very exact pharmacy he was promoted to be my manager. He started out as an occupational therapist but he wanted more in his life. He chose pharmacy, started at the clinical side after he graduated and subsequently joined the community pharmacy after years of battling the red-tapes.
He was different, he was willing to teach, and it has been a joy to work alongside with him. He expects nothing from me; he just let me grow at my own pace.
He entrusts the Asian boy with his car and the banking of store's money after three months, even when the Asian boy has not been driving for a good eleven months. He protects the Asian boy from the abusive customers, he teaches the Asian boy pharmacology of certain drugs, he let the Asian boy did his first webster pack, he invited the Asian boy to trash at his house so that the Asian boy would not miss the Christmas party, he teaches the Asian boy the retail side of a community pharmacy, he takes it easy on the Asian boy.
He is different. I like him.
you bitch!
That was on my mind.
I do not have any problem with customers but sometimes they do with me, when I do not comprehend them. Language still is an on-going issue for me, although not that frequent. It is that simple.
She came in two weeks ago, old, grumpy and with his son always by her side.I could tell her son could not take her either. She wanted paracetamol, ibuprofen, bisacodyl suppository, diclofenac sodium gel and few others things. She is old, I know, but she is demanding. I am demanding too at times, I am fine with that.
The problem is, she has difficulty swallowing large tablets, something I perfectly could understand, because she is old. Your body just have to remind you about your age, how you are not as fit, your health is deteriorating, you getting less sleep, fatigue kicks in even before you complete a simple task. Everyone will age, I understand.
The thing is, she does not know that being the most famous brand does not mean that they have the smallest dosage form available, and I am talking about the size of tablets. I was merely exploring the options of generic, not that I did not get her.
She has one sole purpose, to locate the smallest tablets and she would be very happy. So there I was, tampering with the packaging so that she could have a look at the size of the tablets herself and decide whether she would be able to get those tablets down her throat. It was not a single pack I messed with, I opened a few boxes knowing that I should not have, the thing is - she is old. Tamper evident packaging will have to come after her old age. She is old, she is old, she is old.
She was losing her patience when I showed her the size of Nurofen tablets, not that I am involved in any way of coming out with those insanely huge tablets she could choked on. She settled for liquid capsules at the end of the day and I did not told her that the capsules are likely more difficult to swallow. I just want to cease the interaction. She was getting on my nerve although she is old.
The blister pack is creamy in color thus, size of tablets or capsules is not visible unless I popped one out.
She had a script to be filled. It is not my fault that Ducolax ran out of stock, it has been a few weeks. I told her that and offered her alternative. She settled for my choice and being a nice old lady, she told her son in front of me that I do not get her. She must be happy because she managed to get all the stuff she wanted except Dulcolax because I was certainly not.
Some people just need to work on their mannerism, you do not talk bad about strangers in front of them. No excuse even when you are old. Being old does not mean you arepathetic superior. I should probably have mentioned that the combination product for cold, flu and cough your son bought is only to be used on dry cough but I could not be bothered. I just want to cease the interaction.
I was not sure why was I angry but I just need to get it out now.
The bottom line is, when I do go extra miles for someone, they should be a little nicer - reciprocal favor. I was trying to be nice over there. Of course there are many nice customers out there, but bad experiences do carry more weights and customers are going to lose out on valuable counseling points.
If your attitude defines who you are, then by definition I hate you. You were a bit** that day, you accused me.
I do not have any problem with customers but sometimes they do with me, when I do not comprehend them. Language still is an on-going issue for me, although not that frequent. It is that simple.
She came in two weeks ago, old, grumpy and with his son always by her side.
The problem is, she has difficulty swallowing large tablets, something I perfectly could understand, because she is old. Your body just have to remind you about your age, how you are not as fit, your health is deteriorating, you getting less sleep, fatigue kicks in even before you complete a simple task. Everyone will age, I understand.
The thing is, she does not know that being the most famous brand does not mean that they have the smallest dosage form available, and I am talking about the size of tablets. I was merely exploring the options of generic, not that I did not get her.
She has one sole purpose, to locate the smallest tablets and she would be very happy. So there I was, tampering with the packaging so that she could have a look at the size of the tablets herself and decide whether she would be able to get those tablets down her throat. It was not a single pack I messed with, I opened a few boxes knowing that I should not have, the thing is - she is old. Tamper evident packaging will have to come after her old age. She is old, she is old, she is old.
She was losing her patience when I showed her the size of Nurofen tablets, not that I am involved in any way of coming out with those insanely huge tablets she could choked on. She settled for liquid capsules at the end of the day and I did not told her that the capsules are likely more difficult to swallow. I just want to cease the interaction. She was getting on my nerve although she is old.
The blister pack is creamy in color thus, size of tablets or capsules is not visible unless I popped one out.
She had a script to be filled. It is not my fault that Ducolax ran out of stock, it has been a few weeks. I told her that and offered her alternative. She settled for my choice and being a nice old lady, she told her son in front of me that I do not get her. She must be happy because she managed to get all the stuff she wanted except Dulcolax because I was certainly not.
Some people just need to work on their mannerism, you do not talk bad about strangers in front of them. No excuse even when you are old. Being old does not mean you are
I was not sure why was I angry but I just need to get it out now.
The bottom line is, when I do go extra miles for someone, they should be a little nicer - reciprocal favor. I was trying to be nice over there. Of course there are many nice customers out there, but bad experiences do carry more weights and customers are going to lose out on valuable counseling points.
If your attitude defines who you are, then by definition I hate you. You were a bit** that day, you accused me.
post number 301
He was the last customer of the day; Caucasian, came in, chatted with me a little and started speaking words of Bahasa Malaysia; not that I have a problem with that until….
The only thing running through my mind is selamat sejahtera and it is not what he wants. I could only let out a polite smile.
He proceeds to make his way out. I was offended, I do not consider bahasa as my first language and while I am here in Australia, my mandarin and malay are basically non-functional. Before he managed to get out of the pharmacy, I uttered selamat tengah hari. Nonetheless, he was not convinced.
Then, there was this teenage boy who sat in the middle of the bus lane with a meditating pose, trying to be cool because his friends are around. A Transperth patrol car arrived with two officers. He stood up and ran away. Good on ya mate! Hope you have a nice weekends!
There has been lack of updates here. Time has been rough for me. My marks have hit the new low and what-not, everything is at low. Baby are you down down down down down.... I am unfortunately.
Caucasian: Good morning is selamat pagi and late evening is selamat petang, right?
Me: I am impressed.
Caucasian: So how do you say good afternoon? Mid-day?
Me: Errr…*blank, still blank, still blank...*The only thing running through my mind is selamat sejahtera and it is not what he wants. I could only let out a polite smile.
Caucasian: How embarrassing!
He proceeds to make his way out. I was offended, I do not consider bahasa as my first language and while I am here in Australia, my mandarin and malay are basically non-functional. Before he managed to get out of the pharmacy, I uttered selamat tengah hari. Nonetheless, he was not convinced.
Then, there was this teenage boy who sat in the middle of the bus lane with a meditating pose, trying to be cool because his friends are around. A Transperth patrol car arrived with two officers. He stood up and ran away. Good on ya mate! Hope you have a nice weekends!
There has been lack of updates here. Time has been rough for me. My marks have hit the new low and what-not, everything is at low. Baby are you down down down down down.... I am unfortunately.
underworld elixir, toilet trips, throat slap
She came in complaining of a chesty cough, green phlegms and sore throat. She then asked for my recommendation before requesting an ammonia and senega mixture. I did not even have the chance to finish my Q on nasal congestion.
Now, the tricky part. Do I say
A. "oh hey, that is good shit yea, it works like magic cure."
or
B. "I don't know much about that, happy to assist if you are considering other products."
I am still not in favor of the efficacy of the product, not I am being bitchy but just practicing evidence based approach. If you have a product in mind, go ahead and request it, that makes two happy person instead of me doing futile effort trying to identify a suitable product for you.
She came in complaining of a tight chest with little to no phlegm. I grabbed an mucolytic and suppressant combination.
He came in asking for Stingose -treatment for insects bite; active ingredient - aluminium sulfate.
He still bought Stingose after much consideration. Grrrrrrrrr..........
He came in asking for diarrhea treatment.
I think I could have done better with advice of letting the diarrhea continues, you do not want to treat a diarrhea unnecessary.
She came in looking for cheapest paracetamol.
He came in with a bad one-week sore throat (RED FLAG), complained about difficulty in swallowing (RED FLAG), pain, loss of voice, Strepsils not helping, took some pain killers etc.
I grab Strepsils with local anesthetic and Betadine sore throat gargle.
Assistant 1 later commented that someone asked her before if taking a shot of vodka would help to kill the germs.
A day in a pharmacy.
Now, the tricky part. Do I say
A. "oh hey, that is good shit yea, it works like magic cure."
or
B. "I don't know much about that, happy to assist if you are considering other products."
I am still not in favor of the efficacy of the product, not I am being bitchy but just practicing evidence based approach. If you have a product in mind, go ahead and request it, that makes two happy person instead of me doing futile effort trying to identify a suitable product for you.
She came in complaining of a tight chest with little to no phlegm. I grabbed an mucolytic and suppressant combination.
"I would definitely recommend this, pholcodeine to suppress the constant urge of coughing and bromhexine to loosen the sputum making them easier to cough out."
"Is it suitable for asthmatic?"
*RED FLAG - suppressant and asthmatic*
Before I could say anything, she reads my face and insists that she will take it."Is your asthma well under control?"
She ignored my Q and proceed to grab her purse."Make sure you monitor your asthma condition."
He came in asking for Stingose -treatment for insects bite; active ingredient - aluminium sulfate.
"Well, we have spray, gel, big bottles, small tubes."
"All the same?"
"Same stuff in it. Is it for insect bites? I would suggest you go for Paraderm Plus instead - with the antiseptic, local anesthetic to numb to pain and an anti-inflammatory to help with inflammatory, it is way better than Stingose as Stingose needed to be applied to affected area as soon as possible for it to work, preferably within 20 minutes."
He still bought Stingose after much consideration. Grrrrrrrrr..........
He came in asking for diarrhea treatment.
"Is it for you?"
"Yes."
"How long has it been?"
"A week or so."
*My eyes were wide opened*"Traveled anywhere recently?"
"Not for the past three weeks."
"I have GastroStop for you and it is basically Imodium with a much cheaper price."
*Both contains loperamide*"I just want it to stop, price doesn't matter.So, which of them work better?"
"Same stuff in it. Take two immediately and they should stop your diarrhea, if not take another one for each subsequent loose motion"
"How many can I take a day?"
*Shocked by his Q*"Normally you won't need more than 3 or 4."
"I will see a doctor on Monday if it doesn't helps."
I think I could have done better with advice of letting the diarrhea continues, you do not want to treat a diarrhea unnecessary.
She came in looking for cheapest paracetamol.
"100 of them for 5.95, definitely a deal."
"What? You can get 100 tablets over here? We can only get a pack of 36 back home. What are people using them for? This is insane!"
"Remember not to exceed 8 tablets per day."
"Yes yes. I knew about that."
He came in with a bad one-week sore throat (RED FLAG), complained about difficulty in swallowing (RED FLAG), pain, loss of voice, Strepsils not helping, took some pain killers etc.
I grab Strepsils with local anesthetic and Betadine sore throat gargle.
"This will helps with the pain and this will helps to get rid of the sore throat."
"Don't you think your sore throat is serious?"
"Yea, but I have been drinking as well."
"Okay, you must not exceed 8 lozenges per day and make sure you are extra careful with hot beverages. The lozenges will numb your whole mouth so you won't feel anything until the beverages is down your throat burning it."
Assistant 1 later commented that someone asked her before if taking a shot of vodka would help to kill the germs.
"Why he doesn't think his sore throat is serious?"
"Guys just drag along basically?"
A day in a pharmacy.
a day in a pharmacy
Things could get quite repetitive in a pharmacy especially the not so busy ones, like mine.
Deez! Deez! Deez!
Customers with a sense of humor are gems - hard to come by but never fail to put a smile on your face.
I was at the dispensary, my pharmacist was behind the counter.
He approaches.
"Hi, do you need any help at all?", asked my pharmacist.
"Yes, I would like to have a word with him.", referring to me.
"She is the pharmacist.", I replied with a broad smile.
Another reason I prefer to be at the dispensary putting through scripts.
Deez! Deez! Deez!
"It is $27.45."
"Savings, thanks." Hands over her debit card. "Would you like a bag?"
"Nah, I have enough bags with me already. I have bags everywhere, even here." *points to her eye bags and she just done her shopping at Coles. Customers with a sense of humor are gems - hard to come by but never fail to put a smile on your face.
I was at the dispensary, my pharmacist was behind the counter.
He approaches.
"Hi, do you need any help at all?", asked my pharmacist.
"Yes, I would like to have a word with him.", referring to me.
"She is the pharmacist.", I replied with a broad smile.
Another reason I prefer to be at the dispensary putting through scripts.
DOESN'T MATTER, I WRITTEN MY WILL
He came in.
Man: I am looking for Benadine.
Me: You mean Betadine? or Benadryl?
Man: I don't quite remember the name.
Me: So what is it used for?
Man: Allergy, cold, runny nose etc etc.
Me: Must be an antihistamine.
Brings him over to the antihistamine section.
Me: Fexotabs, Telfast, Zyrtec, Claratyne...
Man: *still thinking hard..*
Me: Maybe it is Polaramine? *points to Polaramine*
Man: Oh yes yes, it is Polaramine.
Me: So do you normally go for 2mg or 6mg ones?
Man: Erm, I think it is Phenergan.
Me: Phenergan? You sure?
Man: Yea.
Me: So the 10mg or the 20mg ones?
Man: Just the blue ones.
Me: So you taking any other medications?
Man: Doesn't matter.
The first thought in my mind. "I HOPE YOU DON'T DIE TAKING THOSE". First, you aren't sure what you are looking for, then you wouldn't let me get more information from you. Doesn't matter, what does that supposed to mean.
Sometimes I do feel bad for not wanting to check for interactions but sometimes I think I should not care that much either.
LETS TALK SEX TODAY
Legend has it that one Japanese died at the age of 147. She was still a virgin at that time and her name was mati-mati-tak-mau-kasi. lol.
Enough of virgins, let us talk about sex.
Today some Asian couple came in for morning after pills. They looked like students.
According to her, they had sex three hours ago. It was not a common time slot to be indulged in such activity but as long as I am not involved, I could not be bothered.
I was reading a book few days ago and the author touched on the role of oxytocin during process of love-making. Women tend to get more attached to the guy, the bond of her towards him becomes stronger but because of the testosterone, the effect of oxytocin is not prominent and was neutralized in males. The so called male species has a major problem; God gave them a brain and a penis but only enough blood supply to fill one of them at one time.
Back to the incident, the other pharmacy assistant mentioned that her how-fast-did-one-get-to-the-pharmacy-after-having-unprotected-sex is 20 minutes. My pharmacist however highlighted one of her colleagues encountered one particular couple where their moment is five minutes ago.
Location of the pharmacy - middle of the city. They soon postulated the action took place in some random back alley.
I always wanted to believe that Asians are more conservative.
The other day I was talking to my friend and one of them mentioned that teens back in school are sexually active at the age of 15. Most of my friend agreed that we should go back to study instead of continue to grow in length.
FUNNY YOU ARE
Woman: I want a pack of Osteo Panadol.
Assistant 1 grabs a pack of Panadol Osteo.
Woman: No, not this. Osteo Panadol, not Panadol Osteo.
I COULD HELP, SERIOUSLY
A man wondering up and down the aisles.
Me: Do you need any help?
Man: No, just browsing.
Me: *Fine. Condoms are behind that aisle though.*
He makes one more trip before stopping at that aisle.
Me: *Evil laughs.*
Checked on the sale later. Personal lubricant. Sweet.
NO PILLS BUT I'LL TAKE 100 OF THEM THIS TIME
Asian, mid 30s came in with her mother.
Chick: I want some antihistamines. *she keeps gesturing with her hands*
Me: Non-drowsy one?
Chick: No, I don't want any tablets. *rubbing her left hand on right this time*
Me summons the pharmacist. *thinking the customer might be happy with nasal spray*
She wanted a antihistamine cream to help with the skin rash (her mother).
After the lengthy counseling, she ended up buying 100 tablets of Claratyne. No one know why she insisted no tablets in the first place.
Chick's mother: Do you think we should try a small pack first? (in Cantonese)
Chick: Look, the tablets won't make your leg disappear or mutate your hands. Take one when you have the rash. (in Cantonese)
CASE REVIEW
Patient: adult.
Symptoms: unproductive cough.
Duration: > 2 weeks.
A woman came in on behalf of her husband.
“How long the cough has been present?”
She gestured me with her head, thinking hard. I turned around and grab a bottle of Duro Tuss Dry Cough (pholcodeine), still no reply.
“Maybe a few days?”
“Two weeks..”
I wanted to sell her nothing at that point other than try to convince her that probably her husband should consult a doctor. My pharmacist did not interfere. Proceeded with the sale and persuaded her to consult a doctor if the symptom does not improve after he finishes the pholcodeine.
Things I could have done different:
a) Refuse the sale and appeared unhelpful.
b) Sold her Duro Tuss Dry Cough Forte instead. It is three times stronger.
c) Sold her a small bottle of Rikodeine. The strongest cough suppressant one may get OTC, contains dihydrocodeine tartrate and sorbitol)
d) Sold her a combination of cough suppressant and antihistamine to help her husband sleep - Benadryl range.
X doze off while you have your noodle...
"Can I have a pack of noo-doz?"
*Huh? noodle? instant noodle?*
"Can you repeat that again?"
"Noo-doz?"
Assistant 1: "Yea, it is just right behind you."
Assistant 2 walks over and grab a pack No-Doz Plus.
No-Doz Plus is a caffeine tablet that contains 100 mg of caffeine plus Vitamin B1 (10mg thiamine hydrochloride) and Vitamin B3 (nicotinic acid) in a base containing glucose.
I just love the way they pronounce that, Noooo-Doz. Coles supermarket 20 steps away is selling the same thing with a much cheaper price.
*Huh? noodle? instant noodle?*
"Can you repeat that again?"
"Noo-doz?"
Assistant 1: "Yea, it is just right behind you."
Assistant 2 walks over and grab a pack No-Doz Plus.
No-Doz Plus is a caffeine tablet that contains 100 mg of caffeine plus Vitamin B1 (10mg thiamine hydrochloride) and Vitamin B3 (nicotinic acid) in a base containing glucose.
I just love the way they pronounce that, Noooo-Doz. Coles supermarket 20 steps away is selling the same thing with a much cheaper price.
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