As we continue to live in a society that is promotional towards medication use, standing behind the pharmacy counter is becoming more challenging. The nature of questions pharmacists are asked continues to evolve. Most patients used to come to the pharmacy and ask for a recommendation---but now many come looking for a product they saw on TV or they found on the internet. I find myself trying to discourage patients from using products they might not need on a frequent basis. At times I feel frustrated because most of the customers have already made up their mind to use a particular product no matter what you tell them. The most common example is cough and cold medications for children under 6 years of age. Most of the products you will find state that a doctor should be consulted for children less than 6 years of age. Many parents come to the pharmacy and want the pharmacist to recommend an over the counter (OTC) product for infants-- sometimes as young as a few months that have cough or cold symptoms. Most pharmacists will tell you that cough and cold products have no proven efficacy or dosing guidelines for children less than 6 years of age. If symptoms are severe, a visit to the doctor's office would be a good choice. This is the approach I typically use for such customers but I also understand that when a mother has a crying child at home, they will do whatever it takes to help the child feel better. I also don't expect every parent to take their infants to the doctor's office each time they get a cough or cold---especially in these tough economic times. As a pharmacist my job is to provide the best advice I can—but to my frustration I sometimes see the patient walk to the cough and cold isle in the pharmacy following our discussion and pick out a product.
"Which of these two products is better?" is another question that you will frequently hear at the pharmacy. Some customers no longer share what they are trying to treat. I usually conduct a quick work-up to deduce the intended use of the product and a few times the products presented are not indicated for the desired treatment. There thousands of situations that you could point out to demonstrate the misuse of prescription and OTC products. One can only imagine what goes on at the doctor's office. Have you ever paused to think about the hundreds and thousands of prescriptions filled and OTC products purchased daily at each and every pharmacy on almost every other block? The pill has become the solution to every problem. As pharmacists, it is imperative that we act as the last line of defense. The internet and media outlets can be a good resource for patients to learn about their medications—which could reduce the number of calls coming into the pharmacy asking what that 'little blue pill' is used to treat. However, we have to take the time and explain to customers about the potential dangers of falling in the trap of drug- marketing by pharmaceutical companies.
It is saddening when you can clearly see the intent by drug companies to confuse potential customers. The new OTC eye drops marketed under the popular anti-histamine brands Claritin Eye and Zyrtec itchy eye drops surprisingly don't contain loratadine or cetirizine respectively as the brand name on the box suggests, but instead contain ketotifen—a different antihistamine already found in OTC eye drops Alaway and Zaditor. Explaining this discrepancy to a customer is a slippery slope— I sounded like a fool recently at the pharmacy trying to explain to a customer over the phone that "Mum, I know it says Zyrtec on the box, but there is actually no Zyrtec in the product." Imagine being pulled over for speeding by a police officer--- "Sir, I know the sign on the road says the speed limit is 70 miles per hour, but you are actually driving in a 35 mile per hour speed limit zone—it is written on the back of the sign. You were driving 30 miles over the limit so, I have no choice but to issue a speeding ticket" Since we can't issue any 'drug-misuse or abuse' tickets in the pharmacy to the patients, it is our duty to professionally 'pull them over to the side' and counsel!
© Kawuma
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