Such a pleasurable day at work
Posted by mei | Posted in Life as a pharmacist, Motivational, On a serious note, Pharmacy queries | Posted on 04-08-2010
Tagged Under : Pharmacy over the counter queries
So today I was working near the harbour, where most tour busses stop. Because of its location, there were so many queries, especially from the visitors. The good thing is we were so quiet with prescriptions, we did only 52 items. It is the least I have ever seen so far. But that was really good, it gave me time to sort out all the queries Over the counter.
I think I covered almost all conditions on the counter today! You name it. Lol.. Another very happy day for me.. Let me tell you what I’ve seen today, Im so proud! Iv never seen so many conditions in a day!
- Ring worm – I sold canestan 1% cream
- Atheletes foot – I didnt think it was atheletes foot, so I didnt sell the anti-fungal cream, just sold E-45 cream instead
- Injured palm/wrist – I measured her wrist, sold Tubigrip , and ask her to take paracetamol
- Coldsore/sore mouth – Only a tiny blister near the mouth, didn’t think it was coldsore, I sold blistex instead of zovirax, because it has been there for 3 days, zovirax wont help much.
- Migraine – Sold co-codamol effervescent tablets (I regretted this, because apparently codeine can slow down the movement in the gut, so may slow down absorption of the drug, I would sell soluble aspirin or soluble paracetamol the next time, I sold it to them because I knew Yellow Migraleve contains paracetamol + codeine, but now I think its not a good choice)
- Corns – Put on corn plasters for several customers
- Travel sickness tablets for a lady on baclofen and dihydrocodeine – sold boots hyoscine hydrobromide, mentioned about constipation to her
- Contact dermatitis due to new washing powder – sold hydrocortisone 1% cream, advised him to apply thinly once or twice daily, no longer than 7 days.
- Head lice for asthmatic and high blood pressure – sold malathion – Derbac-M
- Had several queries on wasp stings, bites etc..
- Had a lady coming in with a deep cut on her finger, that hasnt stop bleeding since 5 hours ago!!! Blood was still gushing out, and dripping everywhere, had to sit her down, got the 1st aid kit, bandage it up for her, and referred her to the nearest surgery. The cut was so DEEP! And I am scared of blood! Omg. And I remembered not to touch the blood!
My proud moment today – one of the corn ladies came back and told the counter staff, ‘I am ever so grateful, never experienced such great customer service from a pharmacy in the past’ Please say thank you to the pharmacist.. Wooohooo. That really made my day!
well done!
Things I might do differently from you:
I feel alright of giving co-codamol for migraine, they do slow gut motility a bit but not significant enough (I think) to NOT recommend it really. No right or wrong of course. I usually ask them if they have stiff neck, coz some preps (eg Syndol/Migraleve) contain a muscle relaxant which might help. If patient can take ibuprofen, Nurofen Migraine is one of my choice.
Soluble paracetamol on its own wouldn’t touch it really. Migraines are usually nasty.
Athelete’s Foot is a difficult one. I used to have dermatitis between my toes, once I thought it was AF and applied antifungal. Didn’t do anything. Quite difficult to tell really.
And of course well done on the first aid bit. I am still not very competent with dressing wound/dealing with cuts really…
btw what did you use to bandage a deep fingertip cut!? I can’t think of anything of right size and can fit the place properly!
Hey derek! Thanks again for leaving comments. Heh.. Im really not that experience with migraine treatments. Nurofen Migraine, is not soluble right? I tend to stick to soluble ones only. but the stiff neck point is good.. Atheletes foot, the boy’s mom describe it as dry, when i look at it, it didnt look like atheletes foot, i thought its suppose to be soggy, and white-ish. but apparently it can be drry as well. so im not sure! btw the cut was nasty……. my collegue said, customer wants to speak to pharmacist, then she said, blood everywhere though! lol
Sometimes I am a bit skeptical about codeine at that strength over plain paracetamol 1g qds as there isnt much additional analgesic benefit and may cause addiction. short term is ok (3 days), but for a long term treatment, its back to the dr. anyway i think co-codamol is ok
also
http://www.medicine.ox.ac.uk/bandolier/booth/painpag/acutrev/analgesics/leagtab.html
btw, the bleeding was so bad, i had no time to think. i took the 1st aid kit, find the thickest dressing/bandage we had in there. but before that, i gave the lady plenty of tissue, asked her to press it on the wound, then i applied the dressings. but there is one thing for cuts u can use, they call it the butterfly plaster or something like that. its good when there is a slit or cut that is deep, but that wasnt in the 1st aid box, unless i couldnt see it. but that lady, needed urgent referral. but i still had to bandage it for her before refer. coz it was drippin everywhere. can you believe she started bleeding from 11.30am, she came in at 4pm??? after i wrapped her finger, literally in a min or 2, i can see blood sipping through… nasty nasty. i think if possible, after putting a dressing, better use those elastic bandage, wrap and pull it tight, to apply pressure and stop bleeding.
Toby, its definately short term. coz most migraine is just one off treatment. if regular, they would probably be on prophylaxis ie amitriptyline or propranolol etc. and if severe, on triptan. so i guess the short term thing for codeine is not much of an issue. but i still think the importnt thing is the drug has to be absorbed effectively, coz when u have a migrain, the gut slows down, then absrptn also affected. so i would still stick to soluble stuff. whenever possible.
oh one more thing, having said that about soluble stuff, i think if they can sense a migraine coming, they can quickly take the pink migraleve, eventhough not soluble, i guess before onset u take it its fine.
i like that table toby. funny how my pre-reg store got loads of Rx for Etoricoxib.
and i always like how when ppl come in asking for migraine stuff they always say “i can feel it’s coming… it’s coming!!’ dun know that feeling unfortunately, otherwise i might act more interested rather than recommending someone i HOPE will work and lol at heart. (<- sounds bloody terrible lol)
something, not someone…
yeah that would sound like a genuine migraine attack, while in my area, ppl come to us and say, cocodamol, when questioned, its more like tension/cluster headache, plus a family of daughters and son coming to buy neurofen plus and cocodamol every 2-3 days, they would hang around from a distance, waiting for a new face assistant to serve them – they are totally banned lol
a hospital locum recognised that she’s a technician at the hospital, and CoE says that we should report any concerns about one’s competence at work. not sure if he did report
It’s been a long time since I was faced with any queries like that. Even when I was attached to the Outpatient Counselling unit here, we spent most of our time teaching patients how to use inhalers and insulin devices… or answering really random questions.
And when I was in the hospital’s “retail pharmacy”, it was a mad rush at the counter & patients always needed a prescription before anything could be sold. All my responding to symptoms knowledge is getting terribly rusty huhu…