CoVID19 ABC's and 123's

The virus, is here and there.  It has reached almost everywhere.

Do not fear; get informed.

First of all; fear does nothing for you. All the agitation much like rocking in a chair will get you nowhere.

Find reputable sources for updates. Listen  to rumours only for banter and use sound judgement to discern between the two.

Pharmers is a pharmaceutical consulting business which offers a handful of services. Sound pharmaceutical advice and preventative care services are some examples. Do not hesitate to ask your questions or send comments to: info@pharmers.co.za 

Our CoVid19 statement to our valued members and to the public  is an ABC acronym for easy remembering. It stands for:

A LWAYS wash your hands with soap,

B EFORE touching your face or eating, &

C LEAN your commonly shared surroundings, and surfaces using disinfectants, often.

Simple and effective.

Also remember these 3 things:

1) boosting your immune system (whether using herbal  or chemical remedies) is not going to prevent you catching an infection, you will still carry the pathogen.  It will only help your immune fighters to better cope with the infection and possibly render you asymptomatic in the best case scenario (but still a carrier able to infect others).

2) the best way to prevent an infection is to reduce the probability of contracting it through  physical touch - hence the heightened personal hygiene recommendations and frequent surroundings disinfection as well as reduced contact with others/isolation.

3) be compassionate.  We are facing frustrating times. Buisness as usual has changed, schools are closed, functions and events are cancelled...  Be kind and understanding. Use this time to introspect, reconnect with your reality and realise how frail we all are in the face of microscopic agents; lets remain humble and grateful for what we still have.

Two national SA Covid19 helplines operating 24h a day are: 
0800 029 999 and 0800 111 132. 

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Info@pharmers.co.za

Pharmacists: show your preventative care in 5 ways

If you're a pharmacist you might start feeling guilty as soon as you read through the checklist that follows and find that you've fallen short on your duties!

Have you in the past year:

• Initiated & monitored patient therapies
• Conducted/initiated community health talks
• Conducted/initiated health expos/ campaigns challenges or competitions
• Led/ participated professionally in health awareness days
• Led/participated professionally in health screening days
• Demonstrated pharmacological and pharmaceutical expertise in patient interactions or interventions 
• Acted in any other intentional health promotional activity

If you have done some or all; that's excellent  [insert pat on your back] but  the reality is most haven't. Did you know that this is part of your scope and uties as a professional sworn pharmacist? Without getting into the numerous reasons why many have not regardless of subfield or sector; lets try and highlight a few crucial reasons why you now should reconsider. Get involved today!

Shocker: The Global Disease Burden quickly rising with many preventable illnesses, diseases and deaths occuring on your watch. 🙈

1) don't be shortsighted, the smallest act matters:

If you dont plan to intervene on purpose, it will never happen or become effortless.

E.g. lady comes in for morning after pill. You give her the form she signs and you issue the pill.

Now If you had planned for intentional preventative care, you would inform her that as part of preventative care you'd like to add value to her purchase by enquire about her (their) past experiences/concerns if any, with STI's / STD's and offer measures on how to prevent them in the future. Having pamflets ready greatly assist with this. Offering (free where possible) HIV screening to know her status and handing out (free) condoms would also supplement the encounter. Highlighting risks can steer even one person clear. If response is favorable and you notice a trend or young students from a campus near by (school/college/university), go as far as asking for contacts to plan a sexual health talk in a relevant upcoming session/event. 

Even if youre not in retail or hospital don't think you are left out, local park runs, weekend expos and many other community events need you to volunteer. Speak to the organizers. Get a few colleagues together especially interns and students to put together a short 10mins relevant talk  before or after the event.

2) don't outsource, YOU are qualified:

Pharmacists are more than able professionally (and within scope) to conduct primary (preventive) health care. You can do most screenings, immunisations, counselling and basic diagnoses (s3: self limiting)! If not get a PCDT pharmacist who can. Add medication management and reviews and you've got yourwork cut out for an entire day/event! Don't employ additional proffessionals if you dont have to.  Nurses and physicians are great but they will never be pharmacists.  In a pharmacy  you alone have the entire holistic view of the patient's condition. Show expertise. Your call on the actions to take will be most wholesomely accurate. Plus, we are trying to shine the pharmacist light. The other professionals can campaign for themselves! 

If you must outsource, stay on top of things and in the know. Your pharmacology and pharmaceutics are your unique differentiators. Incorporate then in the care process. 
 Never let such a huge aspect of your patient's care be completely out of your hands. Follow ups will be difficult if you don't partake.

3) Do anticipate trends, timely and tailored: 

If the majority of your patients are diabetic, conduct diabetes awareness days, talks, management series etc.  Serve the specific needs of your patients while preventing many more from developing the disease, complications or  deteriorations. Metabolic diseases are majorly lifestyle disease, show the correlations, and tie them up together to demonstrate "cause and effect". Mental health is still very entwined yet ignored, stats will shock and awaken your crowds. Have no sugar days (and I dont mean substitute real sugar for the fake toxic carcinogenic stuff); do biggest loser competitions too and include kids and teen! Both reap tremendous health benefits in the long run. 

4) Do offer prevention products & services:

Preventative vaccines such as those for Influenza or HPV have been demonstrated to greatly reduce disease burden. Especially in the risk groups.

Health isles with preventative medicines such as supplements, boosters, aids etc may also offer great support to patients but still require your expert advice (even if just on cost, effectiveness, combinations or comorbid risks). Couple these with screening services and run monthly competitions for the ultimate "Preventative Care" packages. 
Keep them interested. 
You may already offer these services indivudually but renaming and regrouping them can have a unique flair and appeal.

Encourage healthy weight by measuring patient BMIs to stay within ranges and offer to assist those who fall outside of margins with nutritional supplements or referrals to nutritionists/ dieticians as needed.

5) Do support your patients:

Perspective is everything. If you refer to them as clients or customers, you lose the care aspect to when they are patients. The power dynamics shift and power struggles result. 

Show your patients you care by putting their health needs first.
Smoking cessation is another big topic to tackle, offer close monitoring, otc gums or patches and if needed referals but ultimately patients want to feel heard and understood.  Acknowledge their struggle. Often  the smoker only needs your professional push and assistance to quit/start the quitting journey. Have that chat with them highlighting positive effects and avail yourself. Establish channels and create quick/easily accessible directories/ contact lists. Imparted confidence is what every patient needs to succeed.

There is a lot of work to be done and patients need to see this happening.  Pharmacy is not just pills. Phamacy is you and your added value to therapies.

If you're not a pharmacist atleast now you know all the services you should be able to benefit from; go ahead and request them.

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Upcoming Festive Overindulgence? Try These 4 Tips to Overcome

If you're a part of the majority, you've already set off on the overindulgence 'ke Decemba' train. The month of December is inherently filled with weddings, birthdays, funerals, holidays which all equate to food, food and more food!

There's no need to panic, here are four tips to avoid bloating,  weight gain (water retention), tummy upsets and toxins buildup which can trigger joint pain and other inflammatory conditions.

All suggested medicine are available OTC from your local pharmacy and do not require a prescription. Ask your pharmacist for advice if in doubt or taking other medication concurently. 

 Firstly, liver support - whether you plan to drink or eat more than usual, substantiate your levels of essential phospholipids  with supplements  to assist your liver in its metabolic functions. 1 or 2 tablets up to three time (8hly) a day with food will do. 

Secondly, consider a hydration supplement.  In the heat of the summer, we tend to sweat  (salts are lost) and lose water a lot more than in winter. Increasing our water (fluid) intake is great but a step further is replenishing our electrolytes along with it. This keeps the "thirsty" feeling away and curves more subsequent cravings by maintaining feelings of satiety. One sachet dissolved in a liter of water as required on very hot days will do.

Next, lets consider excess acid levels. PH levels are critical to healthy body tissue states. Alkaline states help your system to better prevent cellular inflammation and  tissue injury/disease. Take an alkaline powder (7.5g) once or twice a day with a glass of water for a good week or so before and during the festivities to curb over acidity in the entire body. 

Lastly, its a good idea to add fiber to your diet. By sprinkling some on your food or in your drink, you ensure your gut remains regular and eliminates waste timeously.  Constipation often results from overindulgence of high sugar, high fat and low fruits/veg diets typical of party foods. Try soluble fibres to avoid this.

Whatever you decide to eat and indulge in, always keep moderation at the back of your mind. Portion sizes matter. Start with the salads and the greens before heading for the meats and the desserts.  Drink water before you leave the house as a prep to redu8ce your overall appetite, while conditioning your digestive enzymes for incoming food. 

Prevention is always better than cure. 

Enjoy your holidays, have a merry Christmas and a happy new Year 2020. 

Stay safe. 

Pharmers 

www.pharmers.co.za 

Pharmacy - Cornerstone of Health Care!

Whatever disease, illness or condition you may come across (go ahead and think of at least 3), part or the entire treatment protocol will require medicines. And who says medicine says: PHARMACY!

Who's in charge and running (around in) the pharmacy? Pharmacists of course! With the help of their assistants. 

But that's overly simplified you might think. Medicines being sold in a pharmacy don't quite illustrate the entire health care scenery does it? So why is pharmacy cornerstone?

Well they give you the final products. The end valuable result of the complex pharmacy machine! That's not all! You see,  health care in essence is the organized provision of medical care to individuals or communities. As each component of care giving requires either consumables, medicines or tools; pharmacists are the only licensed, sworn in, and responsible authorities for safely providing these to everyone else.  

To provide quality health care, rigorous investigations must be done. Diseases, their cause and progression, their treatment or management etc is studied with the aim of curing or at least controlling the condition. Pharmacists do that. Any agent which causes a desired physiological response can be deemed a drug, how it works and should be administered to treat and cure diseases is the pharmacists' prerogative! If you're still not convinced,  consider the following concluding points.

5 ways pharmacists are the cornerstones of health care: 

○They manufacture ALL available drugs; no pharmacist, no medication. 

○They understand both sides of diseases: etiologies vs therapies; no pharmacist, no prescription, disease & drug gate keeping. 

○They have basic and advanced knowledge regarding Primary, Emergency and Secondary/ Tertiary health care; no pharmacists, no adequate intermediate resources connecting all treatment levels. 

○They ensure quality treatments from obtaining raw materials, to maintaining quality through storage, manufacturing, packaging, distribution, prescribed indications and patient use. No pharmacist, no quality treatment. 

○they are the ultimate health care multitaskers: making the actual medications, ordering and controlling supply, supervising staff, consulting & counselling patients, intervening in patient therapies, mediating between prescribers and insurance providers, referring or initiating care, teaching and educating communities, while running profitable businesses among many others! No pharmacist, no cross-disciplinary, functional health care system!

You just can't beat them.

Pharmacists remain the undefeated,  unprecedented but ultimately undermined,  health care professionals!

Love and respect your pharmacist. Be patient while your community pharmacist helps you. They are there to optimize your treatment (outcomes) and improve your quality of life but if you rush them and they make a mistake it could really harm you.




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Pharmacy Blog 

Flu Virus - to vaccinate or not?

So you know by now every year when flu season is about to start,  (roughly a 13 weeks duration spanning from March to July) the influenza vaccine gets promoted through advertisement everywhere! So is this a sales gimmick or is there some real benefit to it?

Well it depends! Who's asking?

Young children (from 12months), pregnant mothers up to 2 weeks post partum, the elderly or the immuno-compromised ( esp HIV/TB), lung/chronic disease and co morbid patients, certainly will benefit from it. The advantage isn't as directly observable as one would think (not catching any virus/not getting sick for the entire season etc). It is more of a "lessening of risk" , or aversion of exacerbation from a viral infection, which is key! After vaccination, the special groups (those mentioned above) patient drastically reduces their risk of landing up in hospital due to severe infection and secondary complications (cardiovascular, pulmonary, etc). The burden of the influenza related hospitalizations depends on the transmission and virulence of the strain each year.

Let's mention the three strains which cause illness. Influenza A - most usual cause of epidemics or yearly outbreaks, Influenza B - less severe outbreaks and illness, mostly burdensome on children and the immuno-compromised individuals. Lastly, Influenza C - which caused minor respiratory illnesses.

However the influenza virus (including all infectious strains) is not the only flu-like virus in the air.
Rhinoviruses which cause the common cold are another huge culprit; the adenovirus, coronavirus and other viruses all thrive during the colder months as indoor ventilation decreases and human clusters (viral harbouring and sharing) increase. So you may still get a cold, or another viral infection or even allergies, which all involve sneezing, rhinorea and sinus congestion among others. NB: the flu has a sudden onset of symptoms, includes fever and body aches, git disturbances in children, sore throat, and running nose as differential.

The question remains, do you vaccinate or not?

Considering the above information. If you fall within this special group, the safe advise to receive is: vaccinate.

If you live or work (especially health care workers) with this special group including newborns/infants, avoid becoming a source of infection to them: vaccinate

If you fall outside of this group, are a healthy individual and have no additional risk: you can skip the vaccine

The trivalent vaccine (TIV) in itself is not a live attenuated strain (it contains three dead/inactivated strains of 2 different A strains & 1 B strain) , therefore the rumors of it causing the flu or other diseases are unfounded/unrelated. However, after vaccination, a mild localized irritation might occur which clears quickly.

Lastly, it is worth mentioning that since the flu vaccine is not long lasting (6 months longevity), it should be re-administered annually at the start of flu season (in SA it's March/April). This also means that if you've had the flu at the beginning of the season, you may still get it again towards the end even if you vaccinate.

Look at this table which shows reduction in severity of disease and morbidity in those who vaccinate vs not:

Heads up, Now you know.

ALWAYS ask your pharmacist for sound pharmacy related advise.

Happy flu aversion

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 "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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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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