You go to the hospital and see a doctor, the doctor prescribes you some medicines. Now, you go to the pharmacy to get those medicines. You saw a person wearing a white coat who would be responsible for dispensing the medicine as per the prescription. That person responsible for giving you those medications is the pharmacist/chemist.
A pharmacist works as a connecting link between a patient and the doctor. And their work is not just restricted to dispensing medications but has other responsibilities as well.
Roles and Responsibilities of the Pharmacist
Reading the prescription properly, starting with checking name, age, and disease. Making sure that medicine is dispensed to the correct patient only.
Dispensing medications as per the prescription.
LASA (Look Alike Sound Alike) Drugs, e.g. medications like Doxofylline, Doxycycline, and Deriphyllin, may appear similar in prescriptions. In such cases, reading correctly and dispensing only the correct medication is necessary. In case of any doubt, it’s the responsibility of the pharmacist to clarify with the doctor.
Sometimes, doctors may prescribe the wrong medications in a hurry. In such cases, it is important to clarify with the doctor separately without making the patient cautious.
Maintaining the confidentiality of the patient.
Advising patients about the dose to be taken and by which route.
Advising patients about the precautions that needs to be taken during the treatment.
Knowing Drug-Interactions and advising patients about the same, e.g. when a patient is prescribed DMARDs (Disease-modifying antirheumatic drugs) like Methotrexate(MTX) and folic acid in his prescription. Due to its hepatotoxic nature, MTX is generally prescribed once a week and folic acid is taken daily. In such cases, the patient is advised not to take folic acid and MTX on the same day. Patient is advised to skip folic acid on the day he/she will be taking MTX, as folic acid blocks some actions of MTX and can cause side effects like abdominal pain, mouth sores, hair loss, liver problems, and anemia. Therefore, a pharmacist should know all the possible drug interactions properly to prevent any ADR(Adverse Drug Reactions).
Never tell the patients particularly about the use of medicine. You can tell them about the dose, and methods of administration but don’t tell them about the medication use until necessary or specified by the doctor to prevent self-administration in the future, otherwise, they will take the medicine without consulting a doctor which they might not even require, or they may even develop resistance like in the case of antibiotics.
Types of Pharmacist
There are different types of pharmacists like
Clinical Pharmacist - To make sure that the medicines given to patients contribute to the greatest potential health outcomes, clinical pharmacists work closely with doctors, other healthcare providers, and patients.
Staff Pharmacist - Supervise pharmacy operations and distribute medications as per the physician's prescription.
Retail Pharmacist - Provide the general public with prescribed pharmaceuticals, instruct patients on health promotion, illness prevention, and the proper use of medications, and market over-the-counter medications and associated products in a community pharmacy.
Community Pharmacist - Support both patients and the general public by evaluating their diseases, choosing the medications they should take, participating in medication dispensing, and giving patients advice and helpful tips for maintaining their health.
Consultant Pharmacist - Based on a patient's medical history, consultant pharmacists review their prescription regimens to assess the appropriateness, safety, advantages, disadvantages, and cost-effectiveness of their medication therapy.
Technical Pharmacist - Pharmacy technicians inspect inventories and fill prescriptions. Pharmacy assistants assist pharmacists in dispensing prescription drugs to patients or medical professionals. They primarily work in hospitals and retail pharmacies.
Challenges faced by pharmacists while dispensing medications
When pharmacists dispense medications, they have to deal with various kinds of patients from different socio-economic backgrounds. It’s not just about making them understand how to take medications but it is more than that. Different patients have different mindsets and beliefs while taking medications.
Different types of patients that a pharmacist deals with:
1) The More The Merrier: These patients believe in the philosophy that if they will get a lot of medications then they will be cured soon. They ask why the doctor has given them only a few medications. Making such patients understand that they will be cured by the given medication is a task for the pharmacist.
2) They become pharmacists: “Hello ma’am, You haven’t given this medication. I have been taking this medicine for the past two years." This is a sentence that a pharmacist hears the most. Often, the color of the packet changes, which causes confusion among patients, making them believe that perhaps they are receiving the wrong medication.
In such cases, make sure to tell them that the color of the packet has changed but the medication is same.
One such incident happened to me when a lady asked me if I had given her the wrong dose of medication. Because she mistook her thyroid medication for diclofenac sodium 50mg. Her response was, "You are wrong, and I am right because I have been taking this medication since 1 year." I then showed her both diclofenac strips and Thyroid 25 mcg strips to explain the difference. To avoid confusion, I wrapped her thyroid medications on another piece of paper as they were meant to be taken on an empty stomach. Thankfully, she understood.
3) Explaining each and everything: Many times patients tend to get themselves checked by more than one physician on one form. Afterward, they explain where each medication comes from such as this medicine comes from an orthopedist and this one from a dermatologist. Having medications prescribed by doctors that are either the same or have the same purpose in both prescriptions causes problems, such as omeprazole or ranitidine. Both medications are used to treat GERD (Gastro Esophageal Reflux Disease). In such cases, one of them will be dispensed. Then, they count and ask, you haven't given me one medicine yet, there are five in this and you have given me four. Then, explain to them that the medications are the same and that doubling the dose can harm them and can produce ADR (Adverse Drug Reaction).
4) They are always in a hurry: Despite that, the pharmacist must still verify dosage and API (Active Pharmaceutical Ingredient) before dispensing.
5) Psychological dependence: They do not require medication but they believe that they are ill and taking certain medications is something they need to survive. It’s mostly seen in old-age patients. Once I saw such a prescription and asked the doctor why there was a diagnosis of so many diseases in the prescription. He prescribed multivitamins, and then he explained to me that the old lady was completely fine. She just believes that taking medications is something that keeps her fit and fine.
Those were different kinds of patients I encountered while dispensing medications. Tell us about your experience.