obtained through a licensed doctor.
• Over-the-counter pills, liquids or
creams. Any medication available with-
out a prescription. Moffett noted some
over-the-counter medications require a
prescription.
“Even though they may be classified
as over-the-counter, these medications
may be a little more dangerous to the
public,” he said. “One of the biggest
among these are products that contain
Sudafed (pseudo ephedrine). That’s
due to them being used illegally to
manufacture methamphetamines (also
known as meth).
• Vitamins, eye drops or dietary
supplements. Can be available with a
prescription or over-the-counter.
According to Moffett, duplication is
one of the first things a pharmacist con-
siders when filling a prescription.
“You never want to duplicate thera-
py,” he said. “Common blood pressure
medications can often be duplicated.
Especially if the patient has been hos-
pitalized and the hospital discharges
them on a certain blood pressure med-
ication, and possibly they have been
taking a medication in that same class
from their primary care physician. So
we try to make sure there are no dupli-
cations in therapy because that can cre-
ate more problems, and possibly more
hospital readmissions.”
A medication’s side effects is anoth-
er consideration.
“When a patient starts a new drug
therapy, we make sure the dosages are
adjusted for certain drug interactions,”
Moffett said. “For example, there are
a lot of cholesterol medications. So
you have to look make sure the right
one is prescribed to work with a drug
the patient may be taking. Cholesterol
medications tend to have more interac-
tions on common maintenance medica-
tions (i.e. diabetic, blood pressure and
cholesterol medications).
Dosage adjustment is also con-
sidered. Appropriate dosing and
drug selection is important to ensure
patients’ safety and to avoid adverse
drug effects and unfortunate outcomes.
A pharmacist can also help with:
• Problems opening medications.
Easy-open caps are available for more
standard bottles.
• Taking medications. While medi-
cations are available in various formu-
lations — pills, liquid and dissolvable
— many times they don’t have an alter-
native for how to take them, Moffett
said. Some can be cut in half or crushed
to reduce the size, but some cannot
because it may affect the formulation.
It is best to talk to the
pharmacist first to find
out if an alternative
is available, or if
cutting or chewing
is permissible.
• The differ-
ence between
generic or
brand name.
Most generic
and brand-
name medi-
cines act the
same way
in the body.
They contain
the same active
ingredients (the
part of the med-
icine that makes it
work).
“The biggest differ-
ence between a generic
drug and a brand drug
is price,” Moffett explained.
“Brand drugs have a patent that has
not expired — patents usually expire
in 10-15 years — therefore you have a
very expensive price to pay for them.
Once the patent has expired, there is an
opportunity for other manufacturers
to produce that drug, and typically
the drug is priced down. The generic
may look different and have a different
color, shape or size, but it is chemically
equivalent to the original brand pro-
duced.”
Moffett cites patient adherence to
a medication regimen (taking medica-
tions at the proper time and on a daily
basis, as well as obtaining refills on a
monthly basis) as a big concern among
pharmacists.
“That is a huge problem in the
United States,” Moffett said. “Non-
adherence to medications causes re-ad-
mission to hospital and other problems.
And for people who are on multiple
medications, it is sometimes difficult to
keep up with what they are supposed
to be doing.”
Ways to improve to adherence in
patients include patient prescription
systems that automatically calls the
patient to remind them to take their
medications or when it is time to refill.
Multi-dose packaging and pill dispens-
ers are other alternatives.
Talking to your pharmacist also can
help encourage patient adherence.
“If you have a lot of drugs or a lot
of new drugs, that when you ask your
pharmacist to sit down with you and
go over them to make sure you under-
stand
what the
medication is
for, how it should be taken and when
to take it,” Moffett said
Ironically, reluctance to consult
a pharmacist with questions about
prescriptions and over-the-counter
drugs is common among patients and
customers. While Moffett emphasizes
the importance of the pharmacist/
patient-customer relationship, he said
some of the apprehension may be
attributed to current culture.
“Unfortunately in today’s world of
pharmacists, it is a quantity type situa-
tion; we are trying to fill as many pre-
scriptions as possible,” he explained.
“Insurance reimbursements are low, so
you want to fill as many prescriptions
as possible.”
Nonetheless, pharmacists are the
most readily available and easiest med-
ical professionals to talk to and, Moffett
said, are often sought for questions
about medications as well as health-re-
lated information.
“It’s more than drugs a lot of times.
It’s health questions the patient may
have that maybe they don’t want to call
the doctor or cannot get in touch with
the doctor for answers,” he said. “And
while we may be busy filling prescrip-
tions, that should never deter anyone
from asking questions. A pharmacist
should never be too busy to answer
any question or address any concert.
Whether it’s a minute or 10 minutes,
we’re here to help the patient or cus-
tomer manage their medications.”
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