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A prescription for Zopiclone 7.5 mg tablets ONCE daily comes into the pharmacy. All seems well, the dose is appropriate for the 40 year old gentleman. The pharmacist is satisfied. He accurately checked the dispensed item; all was fine.
The pharmacist asks the patient if he is taking any other medicines; ''Yes, I'm taking something to help me sleep .. erm Nitra .... ? Nitrazepam? Yes that's the one.
The pharmacist thinks 'Two sleeping tablets? Really? ' This isn't safe.
The pharmacist could have used the Patient Medication Record to check if the patient was taking other medicines. Why didnt he?
Obviously, there is no substitute for proper patient interaction; there is no greater tool during the clinical check than talking to the patient.
However, just because the Zopiclone dose was safe, this did not mean that taking the Zopiclone was safe.
Pharmacists, at present, seem to only check the PMR to see if a patient is eligible for an MUR, or a candidate for NMS. shouldn't it be standard practice for a pharmacist to clinically check first, and then pass the prescription on for labelling and dispensing.
I could not imagine being a pharmacist and not carrying out a clinical check using the PMR. Printing off an interaction label means nothing to the pharmacist. They need to be able to utilise the PMR and assess the individual patient. Without using the PMR, I feel we are taking a risk when deeming a medicine 'clinically safe'.
When I qualify as a pharmacist, I fully intend to insist that I use the PMR to carry out a full clinical check before labelling and dispensing. I could not imagine practising in any other way, and I would hope fellow future pharmacists would adopt the same attitude.
Yes, time is tight, but we could miss so many interactions: Diltiazem and Ivabradine, Beta blockers with asthma medications, thiazides in diabetes etc. The PMR is there to help us, we should not let this help go unused.