At home self testing HIV kits: progressive or destructive

There are always new items being sold in the pharmacy. Products and tools to improve health, and others that prevent illness. Lately, next to the common pregnancy tests are drug tests and even HIV test kits. They are also very affordable (not aimed at any specific class of people). Pharmacists need to be increasingly aware and sufficiently warned about products hitting their shelves. When I saw these for the first time, I immediate had mixed feelings and couldn't help but wonder: is this even legal? So many questions flooded my mind. What happened to the pre and post counselling? What do the positive test result patients do after? How do they cope? Who is accountable or responsible for allowing this? Where were pharmacists? 

Health care is such a basic primary necessity. It must be accessible and available to all but are we doing the public a disservice by exposing them to a potentially dangerous territory to which they are inexperienced? What are the pros and cons of having such test kit so readily available?

In the country with the  highest prevalence of HIV/ AIDS in the world (~19% of the general population) how do we approach the matter conscientiously? Is normalization the way to go? I don't have all the answers to these many questions but my unsettling intuition is alarming.

Yes, HIV is closer to a typical "chronic"  disease in its management today than it ever was but does that mean we lower our guard and efforts of detection and management? How about its prevention? Are we over it? 

Who is the kit targeted at? Conscious couples who want to engage in sexual practises and are being cautious? Or individuals who have been exposed/ at risk and now want to confirm infection? Let's be frank, those who buy them are not on the prevention side if things. In fact this tool might have a negative impact on the prevention spectrum. 

Isn't that what clinics were for? Free testing in the presence of a health care professional? What is the advantage of secrecy? Are people known to do the right/ healthy thing when no one is there to counsel them? I think not. Especially when a new younger generation of sexually active individuals have not been part of the intense campaigns that once were efficacious in preventing STIs and HIV

Nowadays youngsters are desensitized and the illness is de-stigmatized as perpetrated. Not that stigma is positive in itself, but in a context of at least deterring some, it was useful.

Can we leave the numerous already existing testing methods alone and focus on heightening prevention methods. Prevention has always been better than cure, especially when there still is no official cure. If we start preventing more than detecting, perhaps numbers van go down and new infections can cease. What happened to: no new HIV infections by 2020? Or was that not a thing?

Can we ask psychologists on how behavioural patterns are modified when susceptibility perceptions drop? When new infections or disease stigma disappear? But why don't we? Perhaps big pharma doesn't really care. This is just another money making tool.

The number of undiagnosed and untested individuals is high, but encouraging people to test in clinics is better than leaving them to depressive disorders or dangerous behaviors in the case of positive results. 

If anything is going to be sold in a pharmacy, pharmacists should at least stand up for patients who cant defend themselves and refuse such practises. It is dangerous, irresponsible and seldom beneficial.

Shocked,  saddened and confused.

Prescribers' scribble; Dispensers' struggle

Poor handwriting is a common cause of error in 100% of dispensaries across the world. In SA, most prescribers think that money is more important than lives, therefore they hurry on scribbling things away unbeknownst to the patients who often leave the practice confused and unsatisfied. 

Upon arrival to their favourite pharmacy, they hand the mystical paper to the custodians who's bravery is understated👩‍🔬. They consult among each other, sometimes review history, or have to call the prescriber for clarification. 

This waste of time, and energy is distasteful,  disrespectful and border line unprofessional.  As part of the health care team, their role is to diagnose and prescribe in a manner that simplifies therapy initiation. They believe,  however that the art of pharmacy rhymes with wizardry.  

Technology luckily has come at a time where those who cant spell or those who've forgotten how to shape their letters can now type their script and print it. This old age (mystery-filled) (mal)practice, once considered honourable and prestigious must die a prompt and permanent death.

For a prescription to be valid, it must first be legible. How do we enforce clear or printed script from here on? Policies must change and we pharmacists need to be at the forefront. ✊

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BPharm + Post grad? But still stuck in your career?

I often ponder and reflect on my profession.  The choices I've made and those that have been made for me. Did I freely become what I am or was I coerced into it by default?

The south African pharmaceutical industry is great but it has its structural and recruitment challenges. when it comes to entry level posts, there exists a gap between industry needs and academic skills acquired. 

 Why are there virtually no junior posts that newly qualified pharmacists can apply and get into without much fuss? I'm speaking of sub sectors. Esp when it comes to regulatory; it seems many struggle to get a fair chance let alone apply for entry level posts.

 Why are posts not calibrated in a stepwise manner? Does the grading system even work? And if it does is it being used correctly?
 In industry, 90% of vacancies seek 5+years experience and are managerial positions.  So how does one get experience? 

There also seem to be a grey area when it comes to pre-qualifications. As many candidates without the five years requirement get posts by what seems like sheer luck or connections. 

Are post graduate course ever really necessary? Many have felt like it is a waste of resources as the courses are not reflected in the positions advertised nor are they remunerated consequently. 

How does one climb the ladder from junior to senior pharmacist, and when are specific courses required and not just advantageous? It's almost as if companies dictate and set the tone and standards for their personal requirements; and appoint whomever they want in any post without much explanation nor post grad qualification correlation. 

Should legislation jump in to save the echelons?! Who can change or implement new policies concerning such problems? 

Are pharmacists fast asleep and obliviously to challenges within their own profession? Where are they and why haven't they said anything about any of this? 

Have post grad qualifications become irrelevance to most employers?  How do we begin to fix this lack of uniformity in (growth) structures and start promoting specialties (oncology, etc) and academic skills more equitably with the assurance of matched  positions and remuneration?

Moving from one sub sector in to another is also very tricky. Has the BPharm degree become inadequate and lacking specialty training? Should it be scraped off and perhaps upgraded to a more complete and respectable PharmD?! 

I'm here, thinking out loud and would love your opinions on the matter! Thanks for commenting! 

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Codeine Abuse: what are you doing?

Should codeine containing products be regulated? How do we curb the rampant concerns of abuse we face in our daily settings as pharmacists? 

Well this short article raises a few suggestions but many more questions. 

We've all seen the typical codeine suspect coming in to get yet another box of "codein" with a friendly smile and a ready-to-use excuse. 

It's for family, I forgot mine at home, I travelled... etc etc. 

We indulge them more often then not and advise them to only buy for themselves and not for other family members but is it enough? 

It's especially worrying when they directly request (by name) specific codeine syrups and combination flu tablets without allowing the dispenser to suggest anything else or even slightly deviate from their request! There's no telling what goes in their private homes.. do they drink the whole bottle and take multiple pills at once? 

We often see notes or alerts left by previous dispenser warning the next dispenser of a possible addiction or misuse; But when do we say NO and refuse to sell?

Should there be a form that they fill much like that of the morning after/ emergency contraception? 

Should the law change yo limit the number of purchases of pack size and frequency per month? 

Should health care professionals make a bigger effort to educate populations against the misuse of codeine and its dangers? 

If we have sugar tax and other bizzar regulations surely the state can be more stringent concerning its beloved citizens' health? 

If you had a say and a national impact how would you address the issue of codeine abuse and misuse. 

Codeine:

You work too well for your own good. 

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What are Consultant Pharmacists?

Have you heard of consultant pharmacists?

Do you perhaps know one?

Consultant pharmacists are a new thing in Africa! This specialty is more common abroad, however it is still growing and patients are now getting to know what it's all about.

So what is consulting pharmacy?

 In summary, it's a one-on-one specialized consulting service provided by a pharmacist to a client. It goes deeper than what you typically experience at your retail pharmacy when you go in to fill a prescription or inquire to buy some over the counter medication. Consultant pharmacists provide information, dig much deeper, and perform complex investigations to provide well rounded, complete health care analysis and assessments.

They are therefore suitable for:

Private patients: who seek private one-on-one sessions. 

Those with Co-morbidities : patients who have multiple chronic diseases or illnesses and find themselves with many regimens to follow. Eg. A diabetic, hypertensive hyperlipidemic patient with heart failure.

The elderly: apart form falling in the first described category, the elderly have fragile sensitive systems. Excretion, metabolism and other functions usually decrease with age and therefore dose monitoring and drug adjustments are frequently necessary.

The miscellaneous: anyone with unusual, uncommon or rare conditions seeking additional support, resources or health care guidance.

Consultant Pharmacist also provide drug information to patients with uncomplicated prescriptions and those seeking daily medicinal advice.

MRs (medicines review) are individualized drug reviews done in certain pertinent instances.

CMRs (Complete Medicines Reviews)  or sometimes called comprehensive medication review are done on the entire patient profile. Whether annually or quarterly, Therese thorough reviews are done to monitor and track hidden issues unperceived by patients or their carers.

MTMs (medication therapy management) are a combination of reviews and action plans set to streamline, and simplify misunderstandings and complexities.

This specialty comes as a result of therapy gaps, mistakes, and non-adherence due to mis-coordination, multiple prescribers, and patient misunderstandings exacerbated by unbearable side effect profiles.

As pharmacists we always try to encourage patients to participate in their health care and thus become empowered to improve it.

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The Morning after Pill: Did You Know?

Here's a WHO, WHAT, WHEN, WHERE, & WHY breakdown about the mighty, infamous morning after pill. If you've ever wondered about it's uses, or have been too scared to ask; here is the 411.

Who: the pill is made to work on the female reproductive system to alter female hormones (for those who are of child bearing age and fertile) and it should therefore only be purchased and ingested by them, in an "emergency" situation.

What: these POP (progesterone only pills) /emergency contraceptives are high dose progesterone pills taken orally to prevent pregnancy. They should NOT therefore be taken if pregnancy is suspected or has been established.

When: the 'emergency pill' is preferably taken within 12h of unprotected intercourse. The sooner it is taken after intercourse, the  greater the percentage chance of preventing pregnancy. Its efficacy decreases with passing time. It should NOT be taken as a regular contraceptive pill and should not be repeated frequently as it may cause severe hormonal stress and disturbances.

Where: it acts to prevent ovulation and implantation of a fertilized egg (ovum) in the uterus. Depending on the stage of menstrual cycle at which it is taken.

Why: Pops are taken to prevent pregnancy when the female is in her fertile period of her menstrual cycle. Typically during ovulation time. It should be avoided otherwise.

Many times ladies rush into the pharmacy with a panic and request the morning after pill without considering some very important points.

It is not warranted if:

-She is pregnant

-She wishes to fall pregnant

-She takes daily contraceptives or other forms of contraception ( however some antibiotics and other drugs may decrease the efficacy of contraceptives in which case a second preventative measure is needed)

-She has had her period within a week  (5 days) or is expecting it within a week.

-She has a known allergy or hypersensitivity to any component in the pill.

-She' s at high risk of arterial disease or has undiagnosed vaginal bleeding.

NOTE:

The pill is neither a first line (condom, pessary, foam, etc) nor a second line (patch, daily pill, injection etc) pregnancy prevention mechanism. It should therefore be taken seriously and strictly in emergencies. They also do not prevent against sexually transmitted diseases. Ladies (and their partners) should be adequately informed before opting to take it.

Be in the know. Stay safe.

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Why do we eat when taking tablets

We've all been advised to take our medication with food. Since childhood, it's a common thing to hear. Although most drugs don't actually require food, here's a couple of reasons why:

1. Disguise taste : many drugs have unpleasant tastes. By taking them with food, their foul tastes can be masked and avoided altogether. 

2. Reduce side effects (nausea and vomiting): drugs that have known and pronounced nausea and vomiting side effect profiles can be improved by advising patients to take them with food in an attempt to attenuate these reactions. Penicillins can cause nausea and by taking them with food, tolerance in most patients is improved. 

3. Metabolism: in some cases, food can delay, speed up or improve the absorption of certain drugs. In the case of some oral anti fungals for example, fatty food promotes absorption of acidic drugs. 

4. Sensitivities: the gastrointestinal tract is lined with soft delicate epithelial cells and these can often become sensitive in some patients; having food with drugs ensure that no direct contact with these cells and potentially abrasive drugs occur. In this case food acts as a protective lining to reduce irritations. 

It's important to note that, needing to take your medicine with food is not a call to gluttony. I'm most cases a piece of fruit or snack is enough. No need to fill up your plates and overindulge under pretext of medicine. 

Another point to note is that certain foods like grapefruit shouldn't be taken with medicine as it may induce metabolism 

And reduce drug efficacy. 

For these reasons and more, it is a rule of thumb to take medicine with food; Unless specifically indicated to be taken on an empty stomach. 

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Pharmacist Or Superhero? The extraordinary Lengths

We can all pull a list of some of the lawful, common duties that are required to be performed by a pharmacist in a retail setting, but what about those extra miles that go unnoticed, unspoken of and unwritten?

Here's a break down of just 6:

*They are babysitters: Mostly to certain identified less than careful GPs (some interns and/or weirdos) who often let a lot of basic mistakes slide in their prescriptions. Imagine phoning for dosages, directions or dates?! The validity of a script is one thing, but some errors are more fatal than others of course... thankfully your pharmacist is their to double check those discrepancies and save your life! They have to call, email, follow up, adjusting doses and rectifying drug mistakes or drug interactions. If you ever have a treatment concern or a question your pharmacist is the first person to ask.

*They are health care "bouncers": To ensure safety for patients, pharmacists monitor use of all medication. They are often shouted for refusing to refill expired prescriptions, early refills or excessive OTC purchases, but it's for patients' own good. Codeine abuse for example can only be curved by strict one item per patient enforcing rules. Let them responsibly safeguard your drug intake.

*They are life coaches: When patients have difficulties (even personal) they usually rant and ramble at the counter. Fortunately there's a pharmacist with a listening ear ready to indulge and advise that patient as best they can (esp when time allows). Both in a professional but empathetic manner. They get stopped at the grocery store, at the bank and pretty much anywhere in their community to answer pertinent personal questions and give guidance. When you have no one else to go to, pour out your heart to your pharmacist, they really care.

*They are multipurpose jugglers: Whether its your specialist, your medical aid, your GP or your dentist, pharmacists plat a key role in co ordinations with other health care practitioners. Between phone calls, prescriptions, compounding, emails, and  counselling; their juggling game is strong. They also know about unusual things not necessarily pertaining to the pharmacy. They sometimes go the extra mile to book appointments and make sure you are on track with your next check up.

*They are your advocate & supporter: They really care for your treatment adherence and outcomes. So much so that they often break the rules to help their patients obtain medicine or treatment promptly. They borrow, lend, and outsource all sorts of medication to ensure patients have their supply. Sometimes procedure will take days to be approved, but trust your pharmacist to make miracles happen. They are also known to supporting your wallet by saving you some coins on your medicines bills. They know what's on special, which generics to substitute and how to make your Rands go further. Some have even made personal home deliveries outside of work hours.

*Some are even magicians: The most unforeseen circumstances may occur where medicine is unavailable but your trusted pharmacist will make it appear in your dispensary ready for you to take home. They will mix, extract, compound and manipulate drugs in order to achieve the desired outcome but if the drug isn't even registered in the country, they are known to pull strings, obtain favours and deliveries from suppliers at the drop of a hat. When your medical aid refuses to pay for certain medicine under certain conditions, they have a few tricks up their sleeves that could work too. Marvel at their prowess.

There's a lot more that goes on behind the counter all for the sake of PATIENTS well being and there s nothing (almost) a pharmacist wouldn't do for their patient. Appreciate all the effort because most of it is definitely out of their scope.

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The "Generic" Myth Finally Debunked!

To substitute or not to substitute! That is the question!

It's not as clear-cut as we'd like it to be. Many drugs on the market are generics to originator (branded) drugs. Do they differ? Can they be substituted? To simplify it, the answer is two fold.

Yes, because they are (bio) equivalent but no because sometimes they are metabolized differently and therefore the experience is that: they're not the "same"?!

Some pharmacists will tell you 'it's the same'! And quite rightly so, often when addressing patient fears, uncertainties and issues of treatment accuracy. It's a quick answer to calm the patient down. A generic drug contains the same active ingredient, at the same dose than it's original counterpart. Therefore in this light, they ARE the same!

However, when it comes to efficacy and side effect profile, generic drugs might differ. This is because formulations (processes of manufacturing the drug and excipients or other additives) can differ.
Potency may also differ, as drug concentrations, release rates and absorption into plasma rates also differ. The regulated ranges for plasma concentrations (AUC) usually fluctuate between 85-110% match. Meaning a generic drug can be less or more potent than the original drug even at the same dose. Generic drug bio-equivalence have to be the same by law, but bio-equivalence doesn't necessarily mean tolerance equivalence either.
Patients may often complain that one generic doesn't work for them, or that the generic "feels" different. Besides a strong possibility of them just being picky or playing mind games, there is a real rationale behind it. It might actually be that they metabolize the generic differently and hence experience (effect and side-effect of) the generic drug more or less than with the originator.

The other common patient phobia is with pricing. Many patients feel cheated if a drug is too cheap. They actually want to pay more as they think it will "work better". Again it often is a mind game associated with perceived value. But the truth is, big price difference are  because of research setbacks.

The originator drug took time (including clinical trials) and lots money to develop, and so once it reaches the market for the first time, it benefits from patent exclusivity in sales. Usually 15-20 years. This is to recuperate the heavy research costs incurred and make profit for that manufacturing company.
After this period, the originator drug patent expires and is then made available to other manufacturers who can simply "copy" the 'recipe' for much less monetary investment and no research time. They therefore can slash the prices radically - hence cheaper generics.

At the end of the day, a generic drug will act in the same way as an original drug in effecting it's desired pharmacological effect. It may however feel different to a patient  who experiences it differently due to a difference in overall metabolism.

Next time a patient asks you if "they're the same", what will you say?


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10 Baby Pharmacy Hacks

So here are 10  helpful baby health tips for you when it comes to easing your baby routine!

Skip the queue: most facilities will agree to let a parent with a baby receive priority assistance especially if the child is in distress or crying. Kindly ask your pharmacist for prompt assistance.

Sooth Teething : with a clean finger, apply drops of the medicated solution dose to the gums and rub gently every 1-2hours. By dividing the dose into smaller intakes, pain threshold (local) coverage is better  experienced by baby. This is a great alternative to giving a full oral dose 4-6 times daily.
You get better symptomatic relief at the site and you can apply more frequently for soothing and control.

No spill: never use a spoon to give baby their medication. Rather use a syringe. It is better calibrated hence accurate and it also doesn't spill if they knock it with their hands or heads. Always dilute medicine in a bit of milk, or juice rather than the whole feed. This helps to mask the taste. If they don't finish the feed at least the full dose is taken.

Nappy rash: you will never have a nappy rash again if you apply an oil to baby's bum after each change. Unlike water based creams, oils don't completely absorb and therefore they form a good protective (anti-rash) layer on top of baby's skin.

Home made re-hydration: if baby has lost a lot of fluids, they easily become dehydrated especially if they've been vomiting or had diarrhea. This could quickly become dangerous and send you to the ER. However with one tbsp of sugar, half a tbsp of salt and a tall glass of pure/boiled/ filtered water, electrolytes can be replenished and resolve the situation. Administer in small intervals until diaper trends return to normal.

Baby change bag: when packing for baby, the usual diapers, wipes and bottles should be included but don't forget to add a change of clothes for the parent too! If baby throws up or squirts you during a change, your clothes may be embarrassingly messing afterward.

Baby medicine:  when giving an antibiotic or other liquid medicine to baby, to keep track of administered doses, draw a chart with all required doses on the side of the bottle with a permanent marker and tick as you go along. It can get quite confusing and losing track is easy.

Nail clipping: when baby has just falling asleep, wait 20 minutes and proceed to clipping their nails. This ensures no fussing and crying during this mandatory task.

Spit up or vomit stains: whether on the couch, catpet or your clothes, use a paste made with sodium bicarbonate (baking soda) and water. Apply generous amount to stain and let dry over night. Vacuum or wash in the morning!



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Employees Before Customers!

In 2018 every employer needs to realize change, recognize trends, and readjust their strategies. Employees are no longer secondary citizens but they are in fact your primary customers!

Think of it this way; If no one wants to work for you, you won't have very many customers in any case. Additionally, if those working for you feel unappreciated and uncared for, they won't go out of their way to serve your customers who too will in turn feel uncared for. Thus unravelling the 'satisfaction' meter and ultimately dropping profitability.

Company culture is a fool proof way to check how employers value their employees.

30 years ago Richard Branson said: customers don't come first, employees come first. Look after your employees and they will look after your customers.

This is truer today than ever. Employee engagement is likely the most important thing after customer care to a profitable business. However, the best care will only be given to customers by employees who are most engaged in their work. This comes through value demonstrated, and value experienced by employees.

A study done at Harvard business school found that millennials aren't as focused on pay scales as the previous generation used to be. Although it still matters, recognition and a sense of achievement are primordial to remaining engaged.

It therefore makes all the sense to factor this in any company's culture in order to increase  competitiveness, profitability and desirability.

If you're a company owner or in senior management, let this grab your attention. Little changes in your company culture may prove to be tremendously beneficial both in the short term experience and it's overall ranking by employees.


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Top 5 Medical Aids In SA 2018

Like many other things in life, the more options you have the more confusing it becomes to choose.
In SA, the five most popular medical aids are as follows:

1.Discovery
2.Bonitas
3.Medihelp
4.Momentum
5.Gems

According to the SAcsi (South African consumer satisfaction index), these top 5 providers have an above average quota for patient satisfaction.

However, many still complain about low value for money, unexpected high co-payments, increasing premiums far above inflation rates, complex rules and exclusions.

Medical aids are reluctantly paid as the most costly monthly expenses in many homes.

So how does one choose a medical aid?

Discovery has 15 different plans to chose from ranging from R792 for a main member in Keycare core earning from R0-R8550 and R4,398 per main member in the classic deltas comprehensive plan.

Bonitas has 4 plans ranging from R1604 for BonEssential plan to R3265 for Standard plan per main member monthly contribution.

Medihelp has 4 plans ranging from dimension prime 1 with a monthly main member contribution of R1725 to dimension prime 3 with a R2940 contribution.

Momentum has 7 plans, with options ranging from R759 per main member earning between R0-R6,300 in the Network Ingwe Option plan to
R5113 per month per main member in the Extender option 2 plan.

Gems has 6 plans with the lowest Sapphire plan of R383.50 monthly contribution per main member and the Onyx plan of R 6450 per main member per month.

Most medical aids will cover the standard 27 chronic illness list and some will add a few other conditions depending on your chosen plan.
M
The choice remains yours but to help you a little bit more here are a few comparative sites:

http://www.medicalaidcomparisons.co.za and
 https://www.hippo.co.za/medical-aid-quote/

that can tailor your need and match them to a suitable provider.


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10 Things Outstanding Pharmacists Do Differently

Here are ten ways (in no particular order) to identify someone who does an outstanding job and provides the best possible service to patients:

1. They do their homework: Continuous education is key in keeping up to date with treatment guidelines and procedures. An excellent pharmacist reads up and stays afloat on the newest trends ideas and regimens. They read up and are clued up. "I don't know" is rarely on their tongues.

2. They ask insightful questions: this requires deeper understanding of the problems patients can pose and it is strategically set out to reach an optimal desirable therapeutic end. Patient history to gain basic insight is crucial for diagnosis and treatment selection (basics) but building patient trust with thought provoking, meaningful specifics & information (deeper) is essential to adherence and ultimately therapy outcomes. Insightful questions reveal experience, knowledge and flexibility in tailoring treatments.

3. They are empathetic: They put themselves in the patients shoes to understand challenges arising. When you tell a patient to take medication six times a day, practically what does it entail? Have they tried it for themselves? Having to wake up at night to take a dose? An excellent pharmacist would add tips on how to achieve the task at hand. Setting alarms on your phone, asking a relative to remind you, and keeping a small pill container in your purse or pocket are a few examples.

4. They are open to dialogue: this might seem obvious, however when routine kicks in and pharmacists develop a comfortable road map to executing a counselling task for example, the dialogue tends to go one way and is more of a lecture to the patient. However to include them in treatment regimen, dialogue must flow in both directions. Questions and answers from both parties reveal a mutual, cooperative partnership and intentionally engages commitment To achieve therapy goals.

5. They know their value: most pharmacists add tremendous value to their patients therapies and health care in general. However an outstanding pharmacist will let it transpire. A lot goes unnoticed behind the counter and an unsuspecting patient won't know half of it. With effective communication (verbal and nonverbal) an outstanding pharmacist will demonstrate the value they add. This may be in the form of gestures/ postures and mannerisms, or statements, suggestions and questions, confirming and reassuring patients; all wrapped up into a pleasant, & superior experience.

6. They follow up: after a while working at a pharmacy, pharmacist will recognize patients on a name basis.  They develop a relationship and know more and more about their patients. Outstanding pharmacists follow up on even the non prescription items they had suggested or opted for their patients' ailments not long ago. This contributes to building patient confidence and trust as they feel valued and of importance. They are noticing the intentional care and appreciate the follow ups. Outstanding pharmacists give a phone call or write an email response.

7. They are confident: they do not need anyone to validate their skill. They are not out to please or be liked but to do an excellent job. Sometimes that requires saying no and being firm. Patients, practitioners, or nurses who push their luck and abuse favours will be reprimanded and kindly turned down by outstanding pharmacists who hold their ground. They know their scope, limits and boundaries for better and for worse. They aren't afraid to keep them.

8. They are team conscious: working in health care is NOT an individualistic or selfish job destination. You must and will form part of various teams. Outstanding pharmacists are inclusive. They know to include nurses, specialists and GPs on their wagons and do not self-limit their processes. If a patient requires additional assistance, they refer, call, ask and inquire from their team. Taking decisions alone can be detrimental to patient therapy and they know it.

9. They are resourceful: being part of a team is one thing but being in contact and having the correct resources to refer or inquire about anything is crucial to outstanding pharmacists. Poison control, emergency numbers, specialist practises and the promotional discounts/ cost cutting strategies are things that an outstanding pharmacist should know!

10. They love their job: passion is inextinguishable. When they do what they love and love what they do, it shows. It's appreciated and the positivity of it all is communicable and transferable To others. Patients will feel the energy, see the love and experience superior service emanating from passion. Outstanding pharmacists intuitively bring a 'come back to me' feeling to their patients every time.

There it is. Ten of the things that make this special breed seldom utter the phrase: "I don't know". 

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Sore Throat? Stop it Quickly!

At the first sign of a sore throat especially during the cold and flu season, this should be your first and hopefully only step if done correctly & on time!

Gargle with salt water!

Sounds simple enough, but shockingly this inexpensive, efficacious, easy to make & use home remedy often gets overlooked and undervalued when it should be the first line.

This capitalistic world pushes adverts that teach us to run to the pharmacy for everything (sprays, lozenges and syrups) but actually you don't have to.

Save yourself a trip. Be wise, a sore throat is usually a sign that the bacteria balance in your throat is offset. Streptococci are the common culprits. Sugar at this point is your worse enemy but salt is your best friend.

To bust these intruders, do not wait. Grab a tablespoon of salt and a cup of water. Stir together and gargle as frequently through out the day as possible. Even up to 10x.
Remember, bacteria grow quickly so if you gargle once in the morning (@ 8h), by lunch time (@ 13h)  it's already too late. Especially if you've eaten or had sugar in between, make sure to set your phone on a 2 hourly or 3 hourly frequency to gargle through out. The first day is most critical. By the next, it either will have subsided and resolved or fully developed and proliferated into a full blown throat infection.

The convenient thing to do is to prepare a salt water bottle to take with you for the day. Whether at work or at school, take a 2 mins gargle trip to the bathroom every 2-3 hours.

It's safe for everyone,  But Do not swallow. Gargle and spit. If you swallow, your ingesting an unhealthy amount of salt and bacteria dislodged from your throat are able to continue their trouble in your gut.


That's the good pharmacists

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Pharmacy Hacks Everyone Should Know!

Here are ten genius tricks for every one to know; once you've read them share to your friends so they can also make use of them.

1. Swallowing tablets: did you know that to easily swallow a tablet you need take a generous sip of water, insert the tablet in your mouth and tilt head backward.  This prevents bitter taste from settling in your tongue if you place the tablet first before taking water. For capsules, tilt head forward. This allows the capsule to float to the back and helps your process.

2. cutting tablets: Sometimes scored tablets are difficult to break. You may need to half your painkiller dose or just need a smaller strength then what you have; for this if you don't have a 'fancy' pill cutter at home you can clean and sterilize a nail clipper with alcohol /swabs or ask at the pharmacy for them to cut some tablets fir you in advance.

3. Paying less for tablets: Buying chronic medication can become very expensive in the long run. If your prescription drugs are available in a double strength, ask your pharmacist to dispense the double strength in half doses. That way you pay up to half the price of X 20mg for 15tablets instead of full priced X10mg for 30 tablets.

4. Ensuring quick & accurate services: before rushing into a pharmacy and becoming furious with impatience at the long lines you may find, phone your pharmacy before hand and let them prepare what you need. Many services are now available such as pre-ordering and are easily done through phoning or using apps. If your prescription is long or has particularly rare items on it, phoning ahead of time ensures that it it prepared, checked and that any outstanding item is ordered and delivered before you get there. If there are any co payments you can also prepare your payment before coming in to pick up. Ask that they phone you back to confirm pick up or if delivery services are possible. This saves time and reduces stress for both parties.

5. Never lose your info: walking in the pharmacy to grab something and suddenly realize you left your discount or loyalty cards at home? Worse your new medical aid card details? Well switch to digital! Email yourself a copy of all you pharmacy profile information so you'll have it anywhere!
Send a picture to yourself on social media and use that instead. Usually the serial / membership number is sufficient to store even as a contact.

6. Never forget a refill date: if you're forgetful or too busy to remember your life priorities, set a reminder on your phone! Nowadays everyone has a calendar on their phone. Set it to ring a day or two before you medication is due for a refill. Leaving it to the last day is risky if the pharmacy runs out or if a delivery gets delayed. There are also refill subscription services which send out automatic messages to members informing them of such important dates.

7. Be strategic: know your pharmacy and their various day to day operations such that you determine the best time to come in. Some pharmacies are swamped on a Wednesday morning after a staff meeting and have the longest lines then. Usually there is a first thing in the morning rush and an after work/ after school rush so knowing the busy times helps you come in when it's quieter. Also at lunch time there may be less staff as they relieve each other for lunch. The best time could be around 10-11am and 2-3pm. Ask your pharmacist when is the best time to be served in peace and quiet.

8.  Stay informed: your doctor is supposed to tell you what your diagnosis is and what the treatment entails. If they don't, ASK. Then quickly write it at the back of your script to make your pharmacist and your life simpler. This prevents misunderstandings, phoning to double check and hard to read scribbles that can delay dispensing time.

9. Be proactive: at the beginning of each year medical aid schemes usually modify their policies. The onus is on patients to make sure they understand these changes and are ready. Don't let your savings account surprise you half way through the year when you though it would cover you right through. Understand what you can and cannot buy and the frequency of these.

10. Be kind and friendly: usually behaviour is reciprocated. If you come in with attitude or anger, that energy is likely to be dished right back at you. Pharmacies are help centres where staff will go over and beyond the call of duty to attend to and help a friendly patient. Sometimes even breaking rules just to assist.  A polite request reasoned with a smile ( even when in pain or sick) can make a big difference to the counselling and outcome you may get form your prescription.

At the end of the day everyone is dealing with a lot. Use these 10 simple hacks during your next visit to the pharmacy and see if they help!

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Scarce Posts For Scarce Skills?!

Isn't it upsetting that so many scarce skilled jobs are equally scarce to come by? While populations sit on degrees, diplomas and certificates at home or resort to doing other forms of work from their actual qualifications, this situation is increasingly absurd and has to change.

But How???

Algorithms are not so hard to figure out and put together. Surely if we can forecast the number of posts for a particular profession every year, (government should have that information) then we could match up the number of available posts to those skilled & seeking them, and at least saturate the market to a reasonable point.

Another idea could be to provide incentives  for individuals to create private posts for these types of skills; or rather yet import post-creating internationals and multinationals to increase skilled jobs and get the quota right.

Perhaps these skills shouldn't be termed scarce if demand doesn't exceed the need. Institutions that provide them should maybe redirect students before they register and warn them of the scarcity of jobs in that field afterward? If that can deter some students and redirect them into more "job abundant" fields then employment rates could grow.

One way or another the problem is there and has to be solved. Pharmacy (pharmacists) in South Africa is an example of one of those scarce skilled fields. However, we all know nothing is ever simple in practice as it is in theory!

Have you experienced this problem? How would you solve this problem?

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Pharmacist Salaries in South Africa!

According to a recent 2018 review done on pharmaceutical jobs from the Indeed recruitment and the pay scale websites,  pharmacists in South Africa earn anywhere from an entry level approximate of R20 000 a month to an experienced million Rands a year!

So why does this four year bachelor degree fluctuate so much in remuneration?
Well it depends on the sector and the years experience that one has. In the private sector, international pharmaceutical companies such as Pfizer Inc, are well able to pay even international rates hence an RA (regulatory affairs) pharmacist with at least 5 years experience can earn up to R100 000 monthly salary!

You may need to top up your degree with a post graduate course at some point along the way when you figure out which path you want to follow, but adding a managerial or business degree can give you the edge you require. Pharmacovigilence and quality assurance/ control related course also seem to be in demand.

Source: pay scale 2018 pharmacist in SA.


An intern earning R20 000 may choose to pursue a masters degree in business administration or entrepreneurship with the hope of developing a company in the future and work for themselves. However if regular (retail, hospital) employment in either the public or private sector is the aim, this route may not be necessary. Rather people skills & mamagenent or public health / and drug utilization courses are better suited and more profitable.

PhDs are very challenging and can equally become highly profitable if carefully thought through. It's mainly achieved by those willing to stay in academia or research or again those aiming for self-determining business or international careers. In academia, a senior lecturer or professor with a PhD may earn R45-R55 000 a month depending on The specific institution and experience.

The average pharmacist (64% female and 36% male) however earns about R34 000, and depending on the city or town they live in, this will also vary slightly.

There is much to gain in this wonderful profession, and career satisfaction is inevitable provided you love what you do while making strategic decisions.

Happy pharming!


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3 things to prevent a cold or flu this winter!

Colder winter days are upon us and the common cold (milder) and flu (more severe/intense) season as well! You may know that both these similar conditions are caused by viruses ( rhinoviruses and influenza viruses) meaning they are self limiting. Once you get a cold or flu expect 7-10 days of symptoms including a sore throat, fever, runny nose and a dry cough (persistent).

Note: you do not need a doctor to treat an episode as most over the counter medication will suffice. However if an underlying or pre existing condition exist such that your symptoms are exacerbated, do not hesitate. Antibiotics are usually seldom required and unnecessary as they only treat bacterial infections and not viral ones. So to steer clear of these viral bugs here are 3 things you can do:

1. The obvious one is keep warm! "Catching cold" can actually trigger sickness if you have a sensitivity or predisposition. Hypothermia will cause illness. The mucus membrabe in your nose and mouth can dryup or crack therefore compromising the protective layer and inviting the common cold or flu virus in. Also asthma can become exacerbated or flare up leading to dry or productive coughs. Smokers can also further irritate their bronchi with prolonged cold weather exposures.

2. Intentional supplemental intakes. During the colder winter days be proactive to ward of getting sick. Maximise your water intake, this helps flush out parasites and viruses from your system before they cause harm. Eat more citrus fruits packed with vitamin c to boost your immune system.  You can also take a daily vitamin c & zinc supplement. You should also eat balanced meals that give you essential amino acids and minerals to build a stronger body... and don't forget to exercise!

3. Prevention is better than cure. You've surely heard that saying many times before and it couldn't be truer regarding colds and flu. Avoid crowd, and busy enclosures. Since the weather is cold, people tend to stay indoor more and thus recycle each other's air, airborne germs and viruses. If someone coughs or sneezes openly, those particles travel to everyone else. Same with shaking hands with someone who just sneezed, coughed or held a used tissue. Wash hands more regularly throughout the day to prevent direct contamination. Lastly, check with your pharmacist if you qualify and get a flu injection.

Also note that through the hundreds of various "colds & flu" preparations that promise to cure you, many have similar active ingredients which can cause serious harm when taken concurrently. Especially with anti pain/inflammation substances like paracetamol / codeine / ibuprofen.

Always check with your pharmacist the total daily allowed dose for any particular active ingredients to avoid overdose, contraindications and side effects.

Happy Winter!

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What is Pharmacy? Who is a Pharmacist?

Over the years most professions change and pharmacy is no exception.

It is still represented by a mortar and pestle as that once was the major function of crushing and mixing leaves, seeds, and various strange things. But today the profession has stretched out far and wide...

The age of scientific evidence has demystified and surely transformed the perceptions of this noble career. Pharmacists are not wizards who compound nauseating concoctions for you to mystically cure you anymore. Now they are (for the most part) highly scientific, professionally trained drug dealers!

The South African Pharmaceutical Council, responsible body for controlling and  registering all pharmacies and their personnel;  states that pharmacy is the science of dealing with collection, preparation, standardization, dispensing and storage of drugs.
Did you know that pharmacy has over 8 specialty fields ?
From laboratory, research, academia, retail, hospital/clinical, industrial/production, to regulatory/ quality control, warehousing/distribution, consultant/specialist, and a few others! There are a lot of options to explore throughout ones career as a pharmacist! With all these sub sectors come just as many diversified services they offer!

Think of it this way, when you're sick, a general practitioner could diagnose you with a condition X. But if it weren't for all those pharmacists who research the medicine in the labs, those who manufacture the medicine in industry, those who package it and make sure it is safe, and the one who hands it over at the counter or in the hospital wards; you couldn't get treatment!

If you know a pharmacist in your friends or family circles, ask them what they do at work! You may be surprised.

Never think again of Pharmacy only as a shop where you can buy medicine. That's only the last carriage on the pharmacy-types train!


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Pharmacist, Take Charge!

How many of us really fight against antibiotic abuse. Stewardship is OUR duty. I'm lenient with young children and the elderly but when anyone else comes with an "Amoxicillin + clavulanic acid/ similar" script for a "cold" I start frowning. SA has one of the worst stats in microbial resistance and we keep daily dispensing as if to ignore those numbers. We pharmacist must be FIRM. Double check, phone the doctor and ask if they've performed culture tests and advise patient to wait/defer before starting antibiotic course.

It's a real problem and it's only getting worse.
Don't turn a blind eye, take an extra minute to ask the right questions.

Of course this comes with knowledgeability and confidence. Therefore revise your antibiotic classes and coverage,  re-educate and refresh your triage skills. Develop easy-to-use algorithms for your co-workers and yourself to use in the pharmacy. 

Changing the face of pharmacy will start with each and every script we scrutinize and the value we add through discussions with patient and health care providers!

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Don't Make This Common Health Mistake!

Patients are increasingly clued up about various medical and pharmaceutical developments and their treatments or requests thereof are subsequently getting more and more demanding.

While the internet and social media have done tremendous good with knowledge sharing and increased wide-spread communication, patients are advised to take what they browse through, with a pinch of salt.

From rumours, to gimmicks to facts and experiences; it can get quite tricky to filter through the relevant information you acquire from the net. Without a health care background one can easy move from a headache to a brain tumour in just one click.

These unnecessary self scaring diagnoses are harmful to the lay person and frankly, time and energy wasters.

You know how your body usually feels and if one day you feel "different" observe, for a bit, then consult if it persists.
At the pharmacy you can quickly get a free symptom check from your pharmacist and some good sound advice on how to proceed.
Always let them know if you are taking any new, old, chronic or acute medication and be ready with the correct name so they can check contraindications and side effect profiles.

Give a call or book an online appointment to your trusted pharmacist at Pharmers.co.za. They will help you navigate the

Do not self diagnose;
Especially from the Internet!

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What Your Pharmacist Wishes You Knew!

Every Pharmacist's Wish

Here's a quick run down of the top 5 things your pharmacist secretly wishes you knew:

1. That you can trust them. They went to school for several years and are not just tellers or cashiers. They actually studied pharmaceutical sciences including pharmacology and kinda know what they're doing. Whether for over-the-counter products or prescription items they are in a better position to give you accurate sound professional advice. Trust them.

2. They are more than pill counters. Of course counting pills is part of dispensing your medication but that's really the last steps towards issuing your treatment. From the minute your prescription is handed in, pharmacists begin the art of multitasking. They do a quick but thorough scan through first of all to"assess" the correctness of the prescription including if it's valid by law and secondly look at the correctness of the treatment prescribed vs the condition being treated.
All this happens under your unsuspecting nose and so just because they don't mention what they're doing doesn't mean it's not happening.

3. That you can speed up the process and cut down your waiting time by being ready with all relevant cards, prescriptions and information required (by law) before hand. (Also, don't take phone calls while next in line. They need your full attention and must ask important questions.) Its no use staring at the pharmacist while standing in line just to get to the counter and start shuffling through your bag or briefcase. Either way they usually do their best with regards to time. They're not standing there being slow on purpose or delaying the line for fun. Each patient needs is different and waiting times will fluctuate.
Be ready and patient.

4. The pharmacy is not a fast food store. Pharmacists don't appreciate your impatience. In general its rude to rush someone doing their job. When a service is rendered for your benefit, you must realize that it's to your advantage that all the safety precautions are taken to ensure a quality. Don't come in expecting to be out in 5mins. Make allowance for prescription mistakes to be caught and changed Which may involve phone calls to your prescriber or even medical aid provider. Again, it's medicine not pizza. An allergy, a wrong dosage or label could send you to the ER or worse.

5. They are there to help you. Pharmacists are the last member of your health care team. The last professionals you interact with before commencing treatment. Don't rush in to grab something for a runny nose without asking your pharmacist if it will interfere with any other medicine your taking. Advice from family and friends are well meaning but sometimes misguided. There's nothing worse to a pharmacist than giving you advice on a pain pill and you dismissing it because so and so suggested you take something else instead. They are professionals. Trained to help you. Ask them about the correct approach to relieving all your ailments.

There are a lot more things on their list apparently, but if you start with these 5, you'll be sure to get much appreciation from your pharmacist next time you visit the pharmacy.

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