Monthly Archives: May 2012

GPS and Pharmacists working in partnership? Guest blog by Stephen Riley @pharmaste

The recent GMC study has shown that 5% of prescriptions contain prescribing errors and the DoH backed PINCER study found that Pharmacist-led interventions can substantially reduce common medication errors and are cost-effective. These studies support my own experiences in working with CCGs and GP Practices. I work as an independent provider of medicines management and optimisation services to CCGs and GP practices. One of my key roles is as Lead Pharmacist providing the complete medicines management service to a CCG in the North West who decided to contract out of the PCT in 2010 and commission their own service.

It has provided a great way to build a rapport with GP Practices and staff at all levels (Clinicians, Practice Nurses, Management and reception staff) and has also allowed us to develop partnership working with the GPs. As we are commissioned by the CCG directly we are not bound solely by the PCT agenda and purely cost cutting. Cost-effective prescribing is a factor, but we have also worked with practices to optimise therapies, reduce wasteful prescribing, increase prescribing of licensed therapies, reduce prescribing of unnecessary unlicensed specials, conduct safety audits and conduct face to face medication reviews.

I sit on the executive committee for the PDA union and worked on their Road Map project for Pharmacy. The essence is develop enhance clinical roles for Pharmacists, such as running clinics managing long term conditions (e.g. respiratory, hypertension, etc) or near patient testing (e.g. anticoagulation). These could be delivered via the Community Pharmacy network, by Community Pharmacists. A practice based Pharmacist role could be ideal for Primary Care Pharmacists to move into and work in a complimentary fashion to the essential role of Community Pharmacists.

I am standing for for the EPB in this year’s RPS elections and have joined with some other like minded candidates to work to provide a Bright Future for Pharmacy. Partnership working with GPs and other health professionals is essential If Pharmacy is to have a significant role, high profile impact in the new NHS structure and be effective and properly rewarded as part of the healthcare team. I would urge all RPS members to vote before noon on 01/06/12 and anyone to have a look at our face book group https://www.facebook.com/groups/353602354689304/, we plan to use it as a forum post elections. Together we can work towards a Bright Future for our profession.

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Je Nes Comprende Pas

Many drugs have unusual names and are hard to pronounce. Every day, we hear strange pronunciations and they always bring a smile to our faces. It’s normally done by patients but also by pharmacy staff and even pharmacists.

The Electronic Medicines Compednium have produced Medcines guides for patients. These also include the correct way to pronounce the drug. http://www.medicines.org.uk/guides

For example, Bendroh-flu-meth-eye-ahzide and Dye-peer-rid-ah-mole.

Co-codamol

@Jonesy147: my grandmother used to say ‘co-dominal’ rather than co-codamol

@Clareylang: Codramol,

Bendroflumethiazide

@SowTomorrow: Try keeping a straight face at an old lady who says “it’s those tablets that sound like ‘Bend Me OverTheFireside’!”

@impure3 I think bendro-whatsit is the most common 🙂

Clopidogrel

@arleniebeanie: clopiDOGrel!

@jonathanmason: “cloppy dog rell”

@SusieMinney: Cloppy-dog-rel

@mrdispenser Sloppydogrel

Paracetamol

@alkemist1912 I’m sure one of my older patients asks for -barry-shit-em-alls

@kevfrost: honourable mention forparacetamoxybendrofruseneomyocin?

Ibuprofen

@SusieMinney Ibooprofen (from a fellow pharm tech)

@HelenRoot izobuzafen

@pillmanuk eye-boo-pho-fen

Omeprazole

@Clareylang: Codramol, Ompazol,

Louise Isobel Henry: Omi prazolly

Miscellaneous

@googlybear84: Diposlack Ointment (Diprosalic) , Primigone(Piriton) & Calvaline Cream (Calamine)

@PatelSuk: Staff dispense Naftidoodidaties (naftidrofuryl)

@EmmTurner: woman on phone asking if we had something in stock ‘sexisenadine’ (fexofenadine).

@jonathanmason: I had a patient who referred to her “niffy dip ins”

@jonathanmason: my old gran referred to Movelat as move-it gel

@HelenRoot: And the obvious anus-ol

@tonyrob77: also like Cacit pronounced as ‘Kackit’ andFybogel pronounced as ‘Fi-boh-gull’

@darkvignette Once got asked for some Robin Cousins cough medicine (Robitussin)

@tonyrob77 always remember an old lady asking me for ‘Methadone Tonic’ (she meant Metatone of course)

@SowTomorrow Ferocious sulphate.

@Suepharm Had elderly gent asking for Neck. Finally turned out to be Head and Shoulders.

@EmilyJaneBond82 discojesus (distalgesic) and CandyStatton (candesartan) my two favs

@Lauraberrycakes: Lansarope (as in sounds like the placeLansarote) for lansoprazole!

@frandavi99: i-prat-opium

@cathrynjbrown: hali-bori-orange as well 🙂

@mraparmar: I’ve got a pt who’s adamant her blood pressure meds are called “Rap-ri-mil”…I don’t have the heart to tell her she’s wrong.

@arleniebeanie: also had dippymole instead of dipyridamoleonce!

@Mumgonecrazy: flufloxacillin

@Planet_Jackie: One guy asked for his ‘sillyarse’ tablets……he meant Cialis LOL

@MaryP58: slimvastatin – so close. The marketing team missed a trick there.

@pillmanuk: a-rato-va-stan

@alkemist1912: Lactu-loose!!!

Selinahuihoong: Celebrate instead of Celebrex

@Cathrynjbrown: I always enjoy monkeylast 🙂

@Planet_Jackie: An old lady handed me a note, she’d written down her med to be repeated it said ‘Lovethyroxine’

@Clareylang: Parrot (Pariet)

Wendy Finney: carbellomarzipan !

Rebecca Ross: My dispenser called pregabalin ‘preg balling’

@TheCynicalRPh Here’s a story for you. Day shift pharmacist says we have a patient with cocksucky virus. He meant this –http://en.wikipedia.org/wiki/Coxsackievirus

Have a look at this great video:

 

 

 

 

 

 

 

 

Pharmacy in the Future

Its 2030 and Mr Dispenser is about to retire. He’s chatting to a newly qualified pharmacist.

“Pharmacists these days, you don’t know you’re born. All we had to pass the time during the day was Twitter. We used to have to manage with twice daily deliveries only. Only doctors were able to prescribe. Look at your face! You don’t remember, do you? It was hilarious. We were always saving their asses.

Only rich pharmacies had a robot, not like now. Silly people used to open 100 hour pharmacies. We never had original pack dispensing. We used to have to count tablets and cut strips by hand. By hand! There used to be some nonsense called Category M. That was before the revolution in 2013 when PSNC were overthrown and we negotiated our own contract. You don’t know you’re born”

CPD: Continual Pain in the Derriere

You can run but you can not hide. Your CPD will get called up eventually. Mine has not been called up yet. I have seen my colleagues and tweeps stress about it. 
 
The feedback that I have got from them is that they all got over 90% and that you just have to fill in every box to get a good mark. How is this making me a better pharmacist?
 
While it is here to stay, here are some useful links: 

 
CPD website: http://www.uptodate.org.uk/home/welcome.shtml
 
I would prefer a pre-reg style exam with OSCE every five years to ensure that we are keeping up to date.
 
Thoughts?

What would you do part 3? Guest post by @MrRx

Patient puts in repeat for Durogesic patches 25 – 2 boxes (and other meds)

Comes back in 3 days later with a new Rx asking for them now and also wanting to collect others. New Rx is for MST 30mg 120 tabs.

Check with patient no longer needs patches. Patches not yet handed over to patient as still in CD cubpoard in bag waiting to be handed over.

Dispense MST 30mg.

No other patient on Durogesic patches, ordered specially in.

Why did she put in repeat request if not getting long with them.

ULTIMATE problem – what do you do with Rx. Strictly speaking not handed across to patient. yet specially ordered in.

1) Do you class as not dispensed and tear up Rx, keep and see if ever needed again

2) You ordered in good faith, they were “dispensed” submit Rx for payment, enter out of CD reg and then enter into pt return CD book and destroy immediately

McPharmacy

Pharmacy has a lot in common with fast food chains.

Here are five reasons:

1) Both have long waiting times. “Why is my burger/Simvastatin taking so long?”

2) Generally you cant see cant see the staff working in the kitchen/dispensary, but you can hear them talking.

3) Both (unfortunately) have drive throughs available.

4) Both run out of products and having no ice-cream/Temazepam brings out different but strong emotions in people.

5) Both have 16 year old clueless Saturday assistants on the counter.

Pharmacy Films part 2

51] @sarayummymummy: Puss in Boots

52] @kevfrost: MHRA Class 1: Total Recall

53] @Cleverestcookie: Four errors and a funeral

54] @googlybear84: Sleepless in Cialis

55] @vento: Lyclear and Present Danger

56] @vento EPS I love you

57] @vento To Kill Amoxil Bird

58] @vento A Hard Day’s Nitrate

59] @ShabnamMirza: Scary Movicol

60] @vento: Dianette Another Day

61] @s9njay: Risedronate of the planet of the Apes

62] @vento: NMS of the State

63] @alkemist1912: Galaxy Questran

64] @vento: Who Framed Roger Rabipur?

65] @alkemist: The Spy who came in with a cold

66] @iPothecary: Dr No (I won’t let you join the CCG)

67] @vento: Ali Baba and The Fortisip Thieves

68] @MrDispenser: Lorenzo’s Oilatum

69] @vento: I Know What You Did Last Sumatriptan

70] @pgimmo: Live and Let Direct Supply

71] @vento: The Maxtrex

72] @kevfrost: On Her Majest’s Prescription Delivery Service

73] @pgimmo: Never Say Teva Again

74] @kevfrost: The Man with The Cold Sores Gum

75] @pill_O_Saurus_: Durogesic Park

76] @ciaraMK: Gladiatorvastatin

77] @impure3: Ace Ventolin: Pet Detective

78] @vento: The Manchurian Candida

79] @ciaraMK: BraveHAART

80] @impure3: Bridget Jones Diazepam

81] @jasonpeet: Harry Potter and the Order from Phoenix

82] @pgimmo: You Only live NICE

83] @ciaraMK: The Devil Wears Pradaxa

84] @dropboy: Never Say Diet

85] @jasonpreett: Mary Pill Poppins

86] @vento: Bugsy Malarone

87] @lil_rea_rea: 2fast 2Fybogel

88] @vento: Bill and Ted’s Ex-Lax Adventure

89] @s9njay: Anusol This

90] @vento: Brokenbulk Mountain

91] @JonnyB_at_RMP: Captain Corelli’s Melonin

92] @MrDispenser: Avengers Asasantin

93] @vento: You’ve got Male (Pattern Baldness)

94] @vento: The Silence of the Lambeth

95] @Eimbot: Napoleon Dyazide

96] @vento: Tamiflu Over The Cuckoo’s Nest

97] @kieranrichards: Aliens vs Pred Forte

98] @googlybear84: The Bourne Indometaci

99] @sugarandlife: Paranormal Activase

100] @pgimmo: A View to a Pill

The End

Pharmacy Films Part 1

These are not in any order! This was started by @CandDChris. Special thanks to @pillmanuk for assisting in the compilation.

1] @CPPEGFlavell: Gone with the Windeze

2] @EPSPharmacist: The Rx Files

3] @RSDave: The 39 steps to re-accreditation

4] @RSDave: Debbie does Diazepam

5] @dracox: Apothecary now

6] @RSDave: Senna

7] @josephbush: Mission Impossible V: Procuring Orlistat

8] @Xrayser: Bridge Over The River Kwai garlic

9] @kevfrost: Se7en day scripts for Dosettes

10] @impure3: The Fast and the Furosemide

11] @lil_rea_rea: The Dark Nytol

12] @MCPharmS: Goldeneye Drops

13] @abitina: MUR on the orient express

14] @mrdispenser: Die hard with a Viagra

15] @jasonpeett: ACEi Ventura Pet detective

16] @MCPharmS: Star Wars: Revenge of the Cyst

17] @SowTomorrow: Fargocalciferol

18] @aisha_adnan: Joan of Arcoxia

19] @pill_O_saurus: The Good, The Bad and The Urgotul

20] @ChaChaChandni: Harry Potter and the Chamber of Controlled Drugs

21] @jasonpeett: Star Trek 3: The Search for Stock

22] @jasonpeett: Independents Day

23] @manolo_ko: 28 Days Later (Repeat Prescription)

24] @RSDave: No Flomax for Old Men

25] @tobyhiggins: Kill Pill

26] @mumegonecrazy: Dirty Dispensing

27] @mrdispenser: Ferrous Sulphates Day Off

28] @tonyrob77: Catch Me If You Canesten

29] @EmilyJaneBond82: Twin Peak Flow Meters

30] @katie7h: Avatarginact

31] @mrdispenser: Saving Ryan’s Private Prescription

32] @kevfrost: Dude, where’s my Carbamazepine?

33] @KrishOza: How to lose a Rx in 10 days

34] @EPSPharmacist: American History Rx

35] @mrdispenser: Dial M for MUR

36] @GwavaSalim: Get MURs or die tryin

37] @amyotway: MUR Due Date

38] @tonyrob77: Lord of the Ring Pessaries

39] @PatelSuk: Live and Let Dyazide

40] @NeelmSaini: Home Asilone

41] @ChrisALangley: On the Trusses

42] @CandDChris: The Great Escitalopram

43] @amyotway: Lock, Stock and Two CD cabinets

44] @tonyrob77: Wall-E45

45] @tonyrob77: Escape to Victoza

46] @EPSPharmacist: The Incredible Broken Bulk

47] @googlybear84: Kick Aspirin

48] @kevfrost: The Phenytoin Menace

49] @JonnyB _at_RMP: Sister Actos

50] @s9njay: Good Pill Hunting

Which is your favourite?

Part 2 is coming soon. The response to pharmacy films from twitter was immense!

Gadgets in pharmacy

[Inspired by Stephen Fry]

 

TV: Very few pharmacies have them. Good for promoting services and key messages. Also lets patients watch Jeremy Kyle whilst waiting for their prescription.

 

Laptop: Used for methameasure and viewing restriced websites.

 

Landline: Best way to get stonewalled by a GP receptionist.

 

Pen: Losing one of these can increase waiting times.

 

Microwave: Essential for warming up last night left overs.

 

Smartphone: used for sneaky tweeting whilst the boss is not looking.

 

Digital camera: passport photos

 

Desktop computer: Can you imagine typing labels on a typewriter?

 

Electric Kettle: Most valuable gadget in pharmacy.

 

Fax: Used for receiving illegal CD prescriptions.

 

Retractable tape measure: measuring for hoisery

 

Stapler: Normally empty but invaluable

 

Calculator: used all the time after qualification.

 

Bathroom scales: weighing customers before going on Lipotrim and for the weekly staff weigh-in.

 

Burglar Alarm: keeps addicts out.

 

Vacuum Cleaner: cleaning up mess left by naughty kids.

 

Answerphone: We have not got one but some customers insist that they left us on a message on it.

 

Fan: used for two days of the year when it’s hot at work.

 

Shredder: Destroying confidential waste.

 

Scissors: used when dispensing split quantity of Stugeron.

 

Tablet counting machine: For those who cant operate a triangle