Table Of Content

6A drugget PHARMACY 22 July 1995 PSNC conditionally accepts 2.5pc rise Iwo more regions gain from DoH £lm fund Courts uphold Staffs FHSA's view on Clothier MCA consults on more P to G8L moves ... Homing in on parasites home at and abroad sens A salesman's salesman Helps smokers cut down as well as give up makes his pitch ... Natural and nicotine-free Can be recommended for all smokers, LOGflDO including pregnant women Numark fulfils early Contact yourwholesaler, Chefaro representative, or order on 01223 420956 to smoking promises on rebates EXISTING RAFTING AGENTS ARE ABOUT Massive £1-7 million TV burst starts July 17th NEW Please contact your Pharmacy SupportTeam Tagamet FIGHTS representative or hearU,««<painFAST Freephone the OTC "Mrsi.witu/i'J"* CONTROLS Tagamet Information Line ocidretl„x on 0500 100 222 *J DUAL ACTION LIQUID TagametDualActionLiquid.ProductInformation: Presentation.Awhitesuspensionwithanodouroffruitandmintcontaining500mgsodiumalginateB.P.C. and200mgcimetidineper 10mldose.Use. Shorttermsymptomaticreliefofheartburn, associatedwithacidregurgitation,especiallyifprovokedbybendingoverorlyingsupine.Dosageandadministration:Adults (incl. theelderly),children16yearsandover. 10mlsuspensionwhensymptomsappear.Ifsymptomspersistformorethan 1 hourafterthefirstdose,aseconddose(10ml)maybetaken, butnomorethan2dosesinany4hoursandnomorethan4dosesinany24hours.Treatmentshouldnotbecontinuedformorethantwoweeks.Ifsymptomspersistformorethantwo weeksorrecurregularly, adoctorshouldbeconsulted.Nottobegiventochildrenunder16yearsofage.Contraindications. Hypersensitivitytocimetidineoranyoftheotherconstituents. Precautions.Notrecommendedinpatientswithimpairedrenalfunction,hepaticimpairment;takingoralanticoagulants, phenytoin,theophylline,intravenouslignocaine;middleagedorolder patientswithnew/changingdyspepticsymptoms,anypatientswithunintendedweightlossanddyspepticsymptoms,becauseofpotentialdelayindiagnosisofgastriccancer;withcompromisedbone marrow;inpregnancyandlactation. Useonlyonadoctor'sadviceinpatients:withanyotherillness,usinganymedication,undermedicalsupervisionforotherreasons,withahistoryofpeptic ulcerwhoarenowusingNSAIDSespeciallytheelderly.Contains66mgsodiumper 10mldoseandthisshouldbeincludedinthedailyallowanceofpatientsonsodiumrestricteddiets. Adversereactions. Diarrhoea,dizziness,rash,tiredness.Gynaecomastia,occasionalliverdamage,confusionalstates(usuallyintheelderlyorveryill),allreversible.Rarelythrombocytopenia, leucopenia,agranulocytosis,allreversible.Veryrarely,hepatitis, interstitialnephritis,acutepancreatitis,headache,myalgia, arthralgia,fever, sinusbradycardia,tachycardiaandheartblock, ailreversible,aplasticanaemia,pancytopeniaandanaphylaxis.Reportsofalopeciaandveryrarelyreportsofimpotencebutnocausalrelationshiphasbeenestablishedatusualprescribed therapeuticdoses.Productlicencenumber0002/0232. Retailprice(200ml)£4-99.LegalcategoryP. Dateofpreparation8June1995. SBSmithKline Beecham SmithKlineBeechamConsumerHealthcare, SBHouse,Brentford,Middlesex,TW89BD.Telephonenumber0181 5605151. 'Tagamet'isatrademark. ConsumerHealthcare ! COMMENT Pharmacists should need little encour- CHEMIST& agement to climb aboard the public- accountability bandwagon that is rolling through the professional world at large. It was set in motion by a Government that believed DRUGGIST the natural instinct ofthe professions was to look after their own interests, rather than those of the public they professed to serve. The irony is that while most other professions operate behind VOLUME244No5993 136th YEAR OF PUBLICATION ISSN 0009-3033 closed doors, community pharmacists openly practice over the counter. Hence the Society's PSNC accepts 2.5pcconditional on action onworkingcapital 104 move to introduce medicine sales protocols, and Professionalallowance thresholds fixed al 1,100 to 1,600 a training requirement for assistants that will ensure a level ofcompetence commensurate with Topical clotrimazole settojoin ibuprofen asGSL 104 the potency ofproducts available OTC. M('Aplans more Pto (iSLmoves l>y the end oftheyear The Cambridge Counterpart Pharmacy Assist- ant Development Programme is Chemist & High CourtdeniesStaffs1 GPjudicial reviewofClothier 105 Druggist's response to help pharmacists bridge Stall's' FHSA hascorrectly interpreted the regulations any gaps in staff training needs to satisfy the C&D Society's July '96 requirements. It is free to subscribers because of Whitehall Laboratories' Counterpart: the answerto assistanttraining 105 (COUNTERPART generous sponsorship. Additional assistant ' Firsl module in this weeksissue, phisdetailson modules and question papers will be available to ,.J Hi how to usethis freetrainingprogramme C&D subscribers from Whitehall's pharmacy sales force. DoH handsoutmore fromSimprojectfund 106 Counterpart is a superb way to work with BidsuccessforTrent FHSAs, Angliaand ()xford assistants to ensure that pharmacies maintain their high standards of public service, and meet German courtstorpedogovernmenthealth reforms 118 the Society's formal requirements by July '96. It Bayersuccessfully challenges fixingofdrugprices will satisfy the needs of experienced assistants who are eligible for the RPSGB's Multiple Choice Parasites-unwelcomebaggage athome and abroad 120 Question paper. And because each Counterpart Alookat infectionstravellersmight wanttoavoid overseas module is preceded by a Pharmacist's Briefing, it leads naturally to pharmacist/assistant inter- action in the pharmacy. Time is the only cost up European Courtrulingset tocause chaosoverscriptfees 127 to the point where pharmacists or assistants want Qualifyingage forfreescriptsformencould dropto60 to monitor progress via the telephone marking service. Counterpart is for you and yours. Please Asalesman'ssalesman expounds 128 pass on now! Graham Ford ofPfizerConsumerHealthcare it ... CHEMIST* EDdeiptuotryJEodhintSokrelPtaotnr,icMkRGPrhicaer,mS CChheemmiissttf DPrhuagrgmiasctyinUcpodraptoreatingRetail Numarkdeliverson own-brand rebates 129 DRUGGIST MRPharmS PublishedSaturdaysby Pharmacistspoorretailers, sayschairmanIrish ALiszsiJosnteasn,tBEAditor/BeautyEditor TMSieollvleeeiprehioFgnrnee'eWma0ay1n.73PTr2oonf3ber6si4sd4igo2en2.alKeLnttdTN91RW ContributingEditorAdriennedeMont,MRPharmS TFealxe-x0-19753123236M1I5L3F4REG Creighton'sspends£1.5mto expand in haircare market 130 NBueswisneEsdsitEodritAoilrsJaaCcokliqeuBhloounnde,llB.ScBA SOuvbesrcsreiapsti&onEsirHeo£1me55£p1er08anpenrumannum Profitsdown9percent dueto fallingexports TechnicalEditorMariaMurray,MRPharmS includingpostage ReportersMarianneMacDonald,MRPharmS £2.25percopy(postageextra). FawzFarhan,MRPharmS CSiorvceurleaitginonHaonudses,ubBsecrreipstfioornd:SRtoryeeatl, REGULARS ArtEditorTonyLamb LondonSE186BQTeh01818557777 PriceList CDoalrirnenSiLmarpksionn,(MCaornitaroLlolcekr)e dRoineslfcyurnebtdeisopnor,novucinadlneecdseslatlseptedhceisfupibucsbacllrliiysphteiro'nsswill News 104 NewsExtra 127 guaranteedwithinthetermsof DeputyAdvertisement subscriptionoffer. ManagerJuliandeBruxelles Theeditorialphotosusedarecourtesy Pen Portrait 107 BusinessNews 129 DougMytton,MartinCalder-Smith ofthesupplierswhoseproductsthey feature ProductionKatrinaAvery TopicalReflections 107 ClassifiedAdvertisements 132 PublisherRonSalmon.FRPharmS PublishingDirectorPamBarker f9y/a1*- aMCinilleldeNerws&FMredeiaepubmlicaatinon PrescriptionSpecialities 108 BusinessLink 134 ABC ©MillerFreemanpic. 1995 Counterpoints 110 AboutPeople 138 BUSINESSPRESS CHEMIST&DRUGGIST22JULY1995 103 NtWo PSNC accepts 2,5% on global sum The Pharmaceutical Services startsatS755 for 1,100itemsper willkeepthefeeperprescription ment'sattentiontotheproblems Negotiating Committee has ac- month,risingatSI.17peritemto constantatjustoverSI.34forthe of returned prescriptions bring- cepted a 2.5 percent increase in SI,340for 1,600itemsandabove. wholefinancialyear. ing contractors below the 1,100 theglobalsum,onconditionthat TheproposedS647.8mforcore The threshold changes mean threshold needed to obtain the the Department takes actinn In services includes S2.8m under- contractors dispensing 2,500 professionalallowance. alleviate the problems of work- payment. But an overpayment items per month and over will PSNC has approved a report ingcapitalandadvancepayment which started in April would receive a 3.3 per cent rise in in- producedbythediscountinquiry bythestartof1996-97. have reached Sl.lm by Septem- come year on year, while those unitand hopes to meetthe DoH The settlement comes into ber,soPSNCdecideditwouldbe between 1,000-1,099willsuffera later this month to discuss the effect on September 1 and takes moresensible mathematicallyto net reduction of 20.8 per cent offsets. Preliminaryfindingssug- the global sum to 5671.7 million spread the net underpayment year on year. Below 1,000 the gest it is unlikely that the figure for 1995-96. over fees, rather than paying a reductionwillbe 13.3percent. will change much, says PSNC The professional allowance lump sum to contractors. This PSNC has drawn the Depart- chairmanDavidSharpe. New 'No' to introduction of patient packs regulations The Pharmaceutical Services • PSNChaswrittentotheOffice • PSNC is still considering expected soon Negotiating Committee is refus- of Fair Trading detailing advice research to demonstrate phar- ingtogoalongwiththeintroduc- that it makes to LPCs and con- macists' added value. Discus- The Pharmaceutical Services tion ofpatient packs until there tractors, and advice LPCs might sions are continuing with acade- NegotiatingCommitteeisexpect- isawritten undertakingfromthe givetocontractors. TheOFThas mics and it is hoped proposals inga'raft'ofregulationstobelaid Department of Health that the suggested that adviceofanysort willbeputtoPSNCinOctoberor beforeParliamentinSeptember. problems of pharmacists being could fall within the Restrictive November. Joint funding with Chairman David Sharpe said left with dead stock will be Trade Practices Act. As PSNC's theSocietyisbeingexplored. last week: "We are confident resolvedbeforethestartdate. head office deals with over 10(1 • The DoH hasdecided to defer there will be no change in the Other issues that needed queriesaday,itishopedtheOFT discussion of a national welfare control ofentry regulations." He resolvingincludedchangesinthe will realise what an impossible milktokenscheme,butwillmon- was also hopeful that a ban on Terms of Service to inform con- situationthiscouldcreate. itor local schemes. PSNC1 sug- faxing prescriptions from non- tractors what pack size they • It appears only 42 LPCs have gestsLPCsapproachappropriate contract pharmacies would form should supply against the quan- completed local negotiations on authorities to arrange local part oftheregulations. tityprescribed. payments for giving advice to schemesinvolvingpharmacies. PSNC-hastakenlegaladviceon PSNCiswritingtotheworking nursing and residential homes, • The response to Pharmacy prescription charges under the partyimplementingpatientpacks, andoutofhoursservices,leaving Weekisto be evaluated byOcto- NHSPharmaceutical Regulations deploring the way pharmacists' 5(5whichmightnothavedoneso. ber, when the pharmacy bodies 1992 and been told that the only viewshavebeen ignored. Theproblemhasbeenbroughtto involved will decide whether to chargeacontractorcanmakefor ()thermattersdiscussedatlast theDoH'sattention. holdanotheroneinautumn1996. Prescription Only Medicines on week's PSNC meetingincluded: • Devon LPC intends to move a • PSNC' isaskingcontractorsor NHSscriptsistheS5.25fee. # PSNC officials are to discuss resolution at the next LPC con- LPCstoinvitelocalMPstospend PSNC would comment no fur- withtheDoHapossiblecompen- ference that two-thirds of all time with them. Four lunchtime theron the case ofa Welsh phar- sation scheme forsmallpharma- LPCsmustagreebeforeaspecial briefings for MPs will be held in macistfightingto dispense drugs ciesand reportback. LP< i (inference iscalled November/December. writtenon NHSscriptsprivately. Topical clotrimazole to join ihprofen on 6SL trail? The Medicines Control Agency should be a GSL medicine, pro- maximum strength of 1 percent The licence was granted last hassent out an official consulta- vided its use is limited to adults inpacksofnomorethan500mg. December. tion letter on whether ibuprofen andchildrenover12fortherelief Similar changes are proposed Finally, the letter proposes should be reclassified as a GSL ofrheumatic and muscularpain, for folic acid, which is currently that the following be added to medicine. backache, neuralgia, migraine, a GSL medicine when in a maxi- the GSL Order: benzoin tincture The letter, dated July 11, headache, dental pain, dysmen- mumdailydoseof200mcg,anda compound (0.75 per cent pas- comes after the MCAs contro- orrhoea, feverishness and symp- P medicine when the maximum tilles), capsicum tincture, cho- versial decision to grant Gal- tomsofcoldsandinfluenza. The daily dose is 500mcg. The MCA line bitartrate, equisetum, glu- pharm International a GSL maximum dose would be 400mg proposesmakingitGSLindoses cose, magnesium alginate, mag- licence to market ibuprofen and the maximum daily dose upto500mcg,andkeepingitPre- nesium carbonate, rhubarb and tablets in packs of 12. The l,200ing. Pack sizes would be scription Only for higher daily squill,and-forexternaluseonly licencewasgrantedforalimited limitedto 12tabletsof200mg. doses. -capsicum oleoresin. Medicines period under the Medicines Topical ibuprofen would also Some folic acid preparations containing these substances (Pharmacy and General Sale become GSL, again for adults already have GSL licences, have already been licensed as Exemption)Order 1980, pending and children over 12, for the although the daily doses are GSL under the 1980 Order by theMCAsconsultation. reliefofrheumaticpainandmus- 400mcg. AspokespersonforG R meansofaprovisionin,orvaria- Pharmacists have criticised cularaches, painsand swellings, Lanetold C&D that Preconceive tionto,theproductlicence. thedecisionnottoconsulthealth such as strains, sprains and was launched as an unlicensed Comments on the proposals - professionals first. The Royal sports injuries. The maximum supplement, then the company includingtheimpactonbusiness Pharmaceutical Society issued a strengthwouldbe5percentand applied for a GSL licence, sub- costs- should be sent to Dugan press release on the matter and there should be no more than mitting evidence based on the Cummings, Room 1219, MCA, tIhoesSeoeckieatny'surCgoeunntcimleehtaisnaggrweietdh 2.5Tghpeerlecttoenrtaailnseor.proposes mak- cmheinedfatmieodnictahlatoaffidcaeirl'ys droesceomo-f MLaanrek,etLoTnowdeorns,SW18Ni5nNeQ,Elmbsy theMCA(C&DJuly 15,p89). ing clotrimazole a GSLmedicine 400mcgoffolicacidduringpreg- August28. The consultation letter, MLX- when used externally for the nancywasnecessaryforthepre- The MCA plans to implement 218,proposesthatoralibuprofen treatment of athlete's foot, at a vention of neural tube defects. thechangesbyDecember29. 104 CHEMIST&DRUGGIST22JULY1995 I GPs denied Clothier review A High Court judge has backed Staffordshire Family Health Ser- vices Authority's interpretation of the Clothier regulations and denied a local GP leave forjudi- cialreview. The GP, Dr John Worthington (C&D July 15, p76), feared thai under the FIISA's interpretation pharmacistswould heallowed to setupbusinesswithout localdoc- tors being given any right to object, even if the viability of localsurgerieswasunderthreat. Butthejudgesaidhecouldfind no fault in Staffordshire FHSAs interpretation of Department of Health pharmacy rules, even though it had an "arguably sur- prising" result. Sympathising witli the CP's plight,MrJusticeBuxtonsaidthe regulations as they stood were Whyyou should pass on the How assistants self-test markingservice. unambiguousandthecourtcould Counterparttraining Eachmoduleisdesignedtobeusedby Use Ihe coupon below to write to notgobehindtheirclearwording. four assistants - there are spaces al Chemist & Druggist, enclosing a A law expert gave evidence documents in this issue the foot ofeach column for assistant cheque foi the number of staff you that the National Health Service Last week. Chemist & Druggist initialstodenote'section read' wish to participate, and your assis- (Pharmaceutical Services) Regu- launched its Cambridge Counterpart Eachstaffmemberhasatest sheet, tants will receive an individual PIN lations 1992 must havecontained Pharmacy Assistant Development with its primary practice section to iumilm] b\ return. Theywillneedthis a'draftingerror'. Programme with your Pharmacist's endorse the CP/pharmacist customer to access the markingservice and to ButMrJusticeBuxtonsaidthat Briefing (pp87/88), designed to keep referral link. Twenty questions based ensure i onfidentialit,\ and sei uritj in the wording of the regulations youonestepaheadofstaffinquiries. on SummerHealth (Module 1)willbe holdingtheirassessment wasclear, andthat the FHSAhad This week, courtesy ofco-sponsor foundonthereverse, withtick boxes After each module has been construed them in Ilie only way Whitehall Laboratories, each sub- foreachassistanttofillinforpharma- absorbed and your staff have com- possible. scribingpharmacygetsthe firstof13 cistmarking. pleted theirtest sheets, acall to Whether or not there was a FREEtrainingmodulesforassistants, Allofthisisat nocost tothephar- 274422willallowinteractivemarking. 'draftingerror', the courtssimply eachcontainingfourmarkingpapers. macist or the assistant, other than Staff have the option of verifying did not have the power to go Ifyourstaffneedhelptosatisfythe time well spent. Should your staff answersbeforeconfirmingthem, and behindtheunambiguouswording Royal Pharmaceutical Society's July wish to be marked interactively over will have asecond chance to answer oftherules, hesaid. 1996 requirements for medicine thetelephone, orifyouwant them to themodule,ifneeded counterstaff,thenthis isyourcourse. havethisoption,thenreadon. Eachmemberknowstheirfinaltest Lothian GPs welcome Experienced staff- defined by the Yourstaffneedtousethismethodif resultassoonastheyleavethephone, Society as having worked for more Counterpart is accredited, and the and should log their result. A six- than16hoursaweekonthemedicines C&D/Whitehallcourseisselected. month results' summary will be pharmacists' visits countei t'oi threeofthelastfiveyears mailedtogetherwith ayear-end posi- -willneedtotake,andpass,theSoci- Interactive marking tionandcoursecertificate. Lothian GPs are in favour of ety'sMultiple Choice Question Paper For a registration fee of S12.50 per Successful completion of each of receivingregularvisitsfromcom- beforeJuly I, 1996. Staffwilltakethe assistant, staffcan gain access to the the 13 modules allows independent munitypharmacists. paperunderyoursupervisioninyour Counterpart computerised telephone markingat lessthanSI amodule. A survey of Hi GP practices pharmacyononeofthreedatesyetto involved in a GP prescribe!' heset bytheSociety(lastweek.p76). adviseraccreditationprogramme ThelastCounterpartmodulewillbe Helephone marking - PIN application form for pharmacists, run by Lothian sentoutnextJune,sostaffwillheable Namesofassistants Health Board, found over 70 per to use the delivered modules to | centwantedthepharmacists'vis- refreshandrevise,withyourhelp.The its to continue. The scheme Assistant Module and four marking I::::::::::::::::::::::::: involved eight community phar- papers will be inserted in the fourth i, i macists making three visits to issueofeachmonth;thePharmacist's two local GP practices over a Briefingwillbeinthepreviousissue. seven-month period (C&D Staffwhohavepassedanapproved Novembers, 1994, p734). course-theNPApharmacyassistants Theaccreditedpharmacistsare manualoi theBoots'healthcareassis- I ^ bkeeienpguopffetrheedltihaiesoonp,posratyusniDtaywtno tbaenttwseceonuJrasneua-rya,n1d99w2e,raendceJrutlyi,fic1a9t9e4d, | 1 encloseacheque for xS12.-ri() =£ Sykes, one ofthe Health Board's willnotneedtositafurtherexam.Nei- Pharmacyaddress twopharmacistfacilitators. therwillstaffwhocompletetheNPA's Three practices are being cho- MCAcourse. * Telephonenumber * sen to assess the pharmacists' However, other staff will need to impact on prescribing. Results take a courseaccredited bythe body | Supervisingpharmacist | areexpectedintheearlyautumn. appointedbytheSociety.TheSociety The Health Board is to run a wantsthe College ofPharmacyPrac- | Registration number | similartrainingscheme for a fur- tleetodothe |ob lull it has vet tosa\ Sendto: Cambridge Counterpart. <Inn/is/ cV Drm/i/isi. Miller ther ten pharmacists, starting at 'yes'. C&Dwillputforwarditscourse. ^Freeman House, Sovereign Way. Tonbridge, Kent TN9 IRW. thebeginningofOctober. CHEMIST&DRUGGIST22JULY1995 105 NEWS No datesyetforMCQs The Royal Pharmaceutical Societyislikelyto run its multiple choicequestion paper forassistantsonedaythis autumnandtwodatesnextspring Three Trent Region FHSAs have nity pharmacists' cost-effective- then be scheduled six months (see C&Dlastweek,p76). Roger between them secured 5135,000 ness, the project will examine later to assess outcomes. Phar- Odd,head ofthe Society's from the Department ofHealth's hospital/community pharmacist macistsarepaidS25perhour. practicedivision,saysthat,while SI millionprescribingfund. communication, links with GPs Oneaimoftheprojectistoini- nodateshave beenset,the Rotherham FHSA has landed and how cost-effectively phar- tiatecloserliaisonwithinthepri- mooted periodsare "likely". £50,000 to fund a year-long pro- macists liaise with each other mary care team and identify ject examining prescribing over locum cover, says Rother- areas of greatest pharmacist Shrewton applicationlost acadrveicientaetrftahcee.secondary/primary hadavmisei FMHSAtie Ppathealrm"aIcfewueticcaanl icemuptaiccta,lsaadyvsiseLre,icJeostaenrn'espChhaarrlmeas.- AWiltshire pharmacisthas lost In Ilie initiative, 200 patients show some positive benefits, Finally, DerbyshireFHSAwins hisfightto opena pharmacyin admitted to hospital dueto com- theremaybesomelocalmoney." £50,000 for its repeat prescrip- thevillageofShrewton. Sultan pliance problems will be issued Leicester FHSA, which gets tion review project, which aims Dajani, pharmacymanagerof with pharmacy care plans. Upon £35,000 for its GP and commu- toseeabout25communityphar- Edwards Pharmacy inthe nearby discharge, the care plan will be nity pharmacist repeat prescrib- macists liaise with 50-plus GP villageofDurrington, losthis forwarded to the patient's com- ing project, is to review, over a practices. It pays pharmacists appeal againstWiltshire FHSA's munitypharmacywhichwillpro- six-month period, the regimens around S25 an hour to become decision onthegroundsthat videuptosixhomevisitsayear. of 25 patients receiving six or additional advisers at practice granting a contractwould Themajorityoffundswillgoto moreitems. andpatientlevel. prejudicemedical services. remunerate the 34 (out of 43) Twenty-five GP and pharma- Commenting on the bid, Jeff participating pharmacies; pay- cist'pairings'havebeenset upin Worrall, Derbyshire FHSAdirec- Suicideverdict ment isat£25perhomevisitand innercity, markettownandrural tor of primary healthcare, says: £100 for two evening training locations. GPs will identify "Thereisstrongevidencenation- Averdictofsuicidewasrecorded sessions. patients for the pharmacist to ally that management of repeat on 42-year-old hospital As well as assessing commu- review; a follow-up meeting will prescribingisvariable." pharmacistAlastairGibson,who died onJune20following an HEA overdoseofanalgesics.The and Anglia and Oxford get to launch folic ... inquestheard hewasbeing treatedforclinical depression. acid campaign MrGibson, ofOvingdean, DoHHm Brighton,wasthetechnical £91,000 from fund The Health Education Authority servicesprincipal pharmacistfor isto launch thebiggest-everfolic Brighton HealthcareTrust. He acid education campaign later joined Brighton General Hospital Anglia & Oxford Region has tohelpGPstorecognisepharma- thisyear. in 1982afteraspell atGlasgow's made two successful bids to cistsasaresource". The £2.3 million Government- Southern General Hospital. secure up to 591,000 of the NorthWestAngliaHealthCom- funded project aims to raise Department of Health's SI mil- mission has secured up to awareness of the importance of Cregiau delay lionprescribingfund. £67,000 to run a pilot which will increasing folic acid intake Northamptonshire FJJSA has assess the effect ofpatient input before conception, and for the Adecisiononwhethera won £24,000 to fund a pilot into onoutcomes. first 12 weeks of pregnancy to pharmacyshould beallowedto community pharmacist-led pre- The pilot comprisestwoparts. reduce the risk of neural tube open inthe Mid-Glamorgan scribing audits. The project will In the first, GPs identify elderly defects. Previous campaigns village ofCreigiau hasbeen see 12 pharmacists looking at patients on multiple repeat med- have not raised awareness as deferred until September.The threeareasofprescribingatindi- ication;thepharmacistauditsthe highlyashoped. applicationfromW Davies& vidualGPpracticelevel. regimen, medication indications The new scheme will also pro- Sonsfacesfierce oppositionfrom Areas of interest include and frequency of review; an motethefortificationmessageto villagers,whoenlistedthehelp diuretic prescribing, oxygen and action plan is then drawn up, foodmanufacturersinanattempt ofthe local LabourParty intheir nebulisertreatmentandrational- withathree-monthfollow-up. to boost the range offoods con- battle(C&DJuly 1,p5>. Mid- ising prescribing in practices In the second part, a domicil- taining folic acid. In thepast, the Glamorgan FHSAhasdeferred its with a high nursing home case- iaryvisitisbuiltintotheprotocol Department of Health has decisionwhile itseeksformal load. Participants are being paid todiscussside-effectandcompli- opposed the blanket fortification adviceonthe interpretation ofthe S200 per day, based on a seven ance problems with the patient. offoodstuffs,suchasflour. Clothierregulations.The dayperpersonworkload. Outcomesofbothtrialswillthen Thecampaignwill belaunched applicantmaybenefitfromthe Janet Corbett, FHSA prescrib- be compared to assessthe effect to health professionals later in so-called Clothier loophole'. ingadviser,saystheprojectaims of patient involvement. The 17 September or October this year, to strengthen inter-professional participants are paid S15 per and to the public early next Swanseadispute links, "enablingcommunityphar- hour spent on the project, but spring, with consumer leaflets macists to see patients as a bonus incentive payments and television or press advertis- TheWelsh Office hasfinally wholeratherthanonascriptand shouldalsobecomeavailable. ing, whichwillrunfortwoyears. announced itsdecision ontwo appealsheld on March 17 concerning premisesatthe M Welsh primary care scheme extended O'Kane&Partnersmedical centre in Swansea.Kieft Chemistsand Howard& Palmer The Mid-Glamorgan primary apy. They will be employed to Education. The scheme starts in had bothappealedagainsteach carepharmacists'schemeisnow work within their own area for Septemberandwillrequirephar- other'sapplicationto relocateto beingrolledout tootherareas. oneyear,paidforbytheWPSP maciststoattendonedayaweek the medical centre. On Monday, TheWelshPrescribingSupport In aseparateventure, upto20 for eight weeks. It is hoped that KieftownerHenry Barnessaid Projectis offering fourplacesto places are being made available fundingwillbeobtainedtocover both appealshad been decided in pharmacists,oneeachfromWest for pharmacists wishing to par- locumexpenses. hisfavour.The medical centre and South Glamorgan, Gwent ticipate in the training scheme. Interested pharmacists should hasbeen open 18months. Mr and Dyffed. Pharmacists will be This is being funded by the contact Dr David Temple at the Barneshasalreadytaken upthe trained to liaise with GP prac- WPSP, with training being run in Welsh Centre for Post-graduate lease,fitted outand registered tices on developing an inter-dis- conjunctionwith the Welsh Cen- Pharmacy Education, tel: 01222 thepharmacy. ciplinary approach to drug ther- tre for Post-graduate Pharmacy 874784. CHEMIST&DRUGGIST22JULY1995 XRAYSER PHARMACISTPENPORTRAIT New a John Wheater 'not tea,. medicine' category It seemsthere is a new Reflections category of product on the market, courtesy of Britannia Health Products, called a 'not a medicine' (Letters, C&DJuly 15). This apparently exhibits all the characteristics ofthe which to encourage the re- genuine article, with full establishment of natural sleep scientific justification for its patterns, ratherthan demand- existence, pharmaceutical led products which encourage licences in othercountries and dependency by 'strength' an advertising profile almost marketing. • Qualified in 1974 altergradu- indistinguishable from the real ating from Sunderland School of thing. However, in orderto Pharmacy and completing pie- avoid consumer misunder- Hope springs registration with Dodds Chemist standing, it is to be labelled in Royton. Lancashire. 'XXXX is not a medicine'! • CareerStarted inpharmacyat This is certainly a novel the age of ten, spending school concept, but if it is a genuine eternal holidays helping out al J Roy attemptto inform the Diysdale\ Sihi in Rochdale, Lan- consumer, I cannot I was interested in the project cashire. After qualifying, spent a understand the reasoning. A funded by West Sussex Family yearat Failman's('hemistinSun- product is either a medicine, Health ServicesAuthority, derland. Returned to Dodds with a product licence and which allowed the employ- Chemist in 1975, where he was therapeutic profile, or it is not. ment of part-time pharmacists joint proprietor with Harvey I suspectthe reason forthis within dispensing doctors' 1lodd until 1992, when the busi- verbal smokescreen lies more surgeries [C&DJuly 15, p78). ness was sold lo Tinted Norwest with the time and cost of ob- This was an attempt to Healthcare. taining the licence than with reconcile the entrenched John then worked as a locum clarifying confusing legalities. positions of both professions interspersed withworldtravel. In But, in orderto clear up any in the rural battle and appears 1994,heboughtPendlePharmacy misunderstandings, this is my to have had some success. in Brieifield uilh his pharmacist unequivocal opinion: "Any Few have ever denied the wife, Karin. lie has also been product which makes claims disturbance, so cannot desirability of a compre- I 'on/off superintendent pharma- of, or implies, medicinal understand the necessity for a hensive pharmaceutical cistofJRoyIhysdale&Sonsince efficacy should require a higher-strength alternative. service, but achieving that has 1980. medicinal licence". Nytol, in common with most always eluded our nego- • Committees Secretary of If Britannia Health feels that single-ingredient sedating tiators. However, in the report- Rochdale Local Pharmaceutical a change in the licensing antihistamines, is open to ed success ofthis project, Committee since 1978 and Old- regulations is necessary to excessive use and cocktail- wherethe advantages of hamLPCsince 1992(chairmanof restrict the use ofthe title taking by abusers; it also pharmaceutical input into Oldham. 1982-85); secretary of 'medicine', while providing for produces dependency in doctor dispensing has appar- Rochdale National Pharmaceuti- a new, less onerous, category legitimate users. ently been accepted by the calAssociationbranch and mem- of licensed 'alternatives', then am now adept at identify- participating medical prac- I berofOldham FamilyHealthSer- the company will have my ing the abusers and refuse tices, may lie hope. vicesAuthoritysince 1977. Chair- support, butthe marketing of them Nytol, but sleep-induc- This principle could, man ofBury Royal Pharmaceuti- 'not medicines' only arouses ing dependency is a more perhaps, now be extended to calSocietybranch 1978-82. my deepest suspicions. difficult problem, which all dispensing doctors by • Hobbies Genealogy - special- affects the respectable middle- being included in all FHSA isingin own surname worldwide, aged or elderly, and with medical and pharmaceutical music, driving and 'the local', 'Strength' no whom my counselling skills strategies: that, where whichJohn refers to as the "uni- are fully stretched ifany dispensing occursfor rural versityoflife". intervention is to be of help patients, this should ideally • Pharmacy philosophy "Com- ratherthan to offend. only be undertaken underthe munity pharmacy is currently cure for It is to this lattergroupthat supervision ofa pharmacist. submitting to a pay and condi- 50mg Nytol is being targeted. Itcould be leftto each tions' revolution which is putting They are alsothe most practiceto decide howto best pharmacists, in both theindepen- susceptible to long-term implementthis. However, dentand multiplesections, under insomnia dependency, and the given encouragement from alotofpressme. introduction ofthis higher FHSA advisers, most rural "The future, much like the Stafford-Miller hasjust strength can only aggravate dispensing practices would no weather, isunpredictable,butthe launched a higher, 50mg, the problem by restricting the doubt soon incorporate a forecast is good. Acceptance as strength of Nytol on the back ability to adjust to a minimum pharmacist into theirteam full members of the primary of its successful original 25mg dosage. The problems of and extend the limited healthcare team, improvements formulation. However, the insomnia are as complicated recommendation to include in standards of both staff and instructionsforthe original asthey are real, and would the advantages of a fully- I premises, and continued exten- are one or two at night forthe preferto have available a integrated pharmaceutical sion ofthe POM to P list will all temporary relief of sleep range ofalternatives with service. enhance.jobsatisfaction." CHEMIST&DRUGGIST22JULY1995 107 RIPTspecials Adenoscan Clomiphene SanofiWinthrop hasintroduced Glaxo Wellcome gets Adenoscan(adenosine),a coronaryvasodilatorfor cancer intravenous infusion,tobeused in conjunctionwithradionuclide myocardial perfusion imaging in concern patientswho cannot, orshould Hpybri go-ahead not,exercise. Each 10mlvial contains30mgadenosine ina Doctors are being advised to salinesolution.Apackofsix avoid the long-term prescribing vialshasanNHSpriceof£80. of the ovnlation-inducing drug SanofiWinthrop Ltd.Tel:01483 Glaxo Wellcome has received benigngastriculcers. clomiphene. 505515. Medicines Control Agency ap- Therecommendeddoseforthe Thelatest CommitteeofSafety proval foritsHelicobacterpylori formeris400mg twice daily plus on Medicines/Medicines Control Cicatrin slashed treatment, Pylorid. clarithromycin 1-1.5g a day or Agency's 'Current Problems in The product, ranitidine bis- amoxycillin 2g a day, for two Pharmacovigilance' recommends Following discussionswiththe muth citrate, has been approved weeks. For the latter: 400mg thedrugshould"notnormally"be DepartmentofHealth,the for the eradication of H pylori twice daily for four weeks for used for more than six cycles, Wellcome Foundation has and the prevention ofrelapse of duodenal ulcer and for up to becauseofasmallincreaseinthe substantiallyreducedtheprices duodenal ulcer when given in eight weeksforgastriculcers. absolute risk of ovarian cancer in itsCicatrinrange: 15g creamis conjunction with either amoxy- Pylorid is expected to hit the whenusedformorethan 12men- now£0.90(was£4.52),30g cream cillin or clarithromycin; and the UK market within the next few strual cycles. "However, there is £1.80(£8.22),15g powder£0.90 treatment of both duodenal and months. no evidence that clomiphene (£4.87)and50g powder£3.00 used forthe recommended dura- (£12.31). tion of treatment (three to six TheWellcomeFoundation Ltd. Carace approved post-MI months) increases the risk of Tel:0161 4359000. ovariancancer,"addsthereport, ClomipheneisavailableasMar- TheACEinhibitorCarace(lisino- tion with other post-MI treat- ion Merrell Dow's Clomid and Stiefel loss pril)hasbeenapprovedforusein ments, such as thrombolytics, Serono Laboratories' Serophene. AcneAid SoapfromStiefel acute myocardial infarction, aspirinandbeta-blockers. Neitherproduct isrecommended Laboratorieshasbeen whengivenwithin24hoursofMI The dose is 5mg for the first for use for longer than six discontinuedfromJuly10. symptoms'onset. two days, rising to lOmgafter48 months, with Clomid only Stiefel Laboratories(UK)Ltd.Tel. According to the GISSI-3 hours, for a further six weeks. advisedforuseinthreecycles. 01628810021. study, the product reduces over- Treatment, should be continued "We fully support the report," all mortality and the combined in patients who develop conges- says Serono's medical director, Initard cancelled outcome measure of mortality tiveheartfailure. Mercia Page. "Treatment should and severe ventricular dysfunc- Du PontPharmaceuticalsLtd. be reviewed if a patient has not Following onfrom Novo Nordisk's tion. It can be given in conjunc- Tel:01462482648. ovulatedwithinsixmonths." discontinuationofHuman Initard, thecompanypointsoutthatthe MEDICAL MATTERS Wellcome Foundation isnot holdinganyfurtherstocksand is Immunisation changes Doctors urged to take the sugar-free option cancelling all remainingorders forthe product. Novo NordiskPharmaceuticals in the offing Doctorsare beingencouraged to west of England was greeted Ltd.Tel:01293613555. take the lead inthe dental decay with enthusiasm from pharma- The Department of Health is battle by prescribing sugar-free cists, but doctors rarely pre- expectedtointroducenewimmu- medicines. scribedthesugar-freevariant. Italian style nisationpolicies. In an editorial in the British Not only were pharmacists Nutricia DietaryProductshas Some changes are anticipated MedicalJournal,DrIainMackie, prevented from switching to the added morepastavariantstoits inthenewGPs'guidetoimmuni- seniorlectureratthedepartment sugar-freevarietybycurrentreg- gluten-free Glutafinand low- sation policy, in particular a of oral health and development ulations but "the actofprescrib- protein Loprofin ranges. Glutafin revamped approach to measles, at the University of Manchester ing medicines with sugar was nowincludesLasagneand where "several options are being Dental Hospital, revealed that a seen as endorsing their use", Tagliatelle(basic NHSprice£2.56 considered",saysaspokesperson sugar-free campaign in the north writesDrMackie. for250g);Loprofin hasbeen fortheDoH. relaunchedand includesSpirals, A report in GP magazine sug- Macaroni Penne,newLong gests these may include vaccina- Resistance the biggest issue Spaghetti (all 500g.£2.56)and tion campaigns repeated every Vermicelli (250g,£2.56).All four to six years; and a pre- productsareprescribable. school/school-age MMR or MR Doctors and pharmacists are Staphylococcus aureus was Nutricia DietaryProductsLtd.Tel: booster. In addition, changes to becoming increasingly concern- cited as the most commonly- 01225771801. Haemophilus influenzae type b ed about the threat ofantibiotic encountered pathogen in the vaccine supply are likely, once a resistance,iftheresultsofanew Bayer-supported survey, con- TB boost studyexaminingtheinterchange- studyareanythingtogoby. ducted after a series of work- ability of the two available vac- Asurveyof92hospitaldoctors shops on current aspectsofhos- The BritishLung Foundationhas cine brands is concluded; and and pharmacistsrevealed 90 per pital infection. Survey respon- beenawarded£90,000to improve alterations to the tuberculosis cent rated antibiotic resistance dentssaidtheyfrequentlyturned tuberculosisdiagnosis,the vaccinationprogramme. veryimportantintheselectionof to quinolones when first choice monitoringofresistantstrains Thechangeswillbeannounced an antibiotic, compared to only antibiotics, which were usually andthespreadofthedisease in in the new Immunisation Ag- 38 per cent whose primary con- betalactams or cephalosporins, the UK. ainstInfectiousDiseases. cernwascost. failed. 108 CHEMIST&DRUGGIST22JULY1995 Presenting Double Agent Eurax He. Mission: To locate and eliminate itching and inflammation caused by mild to moderate eczema, contact dermatitis and insect bites Weapons: Crotamiton to relieve itching, Hydrocortisone to reduce inflammation. Duration ofMission: Up to 10 hours. Status: The only combination steroidal product available OTC for eczema. Eurax He. Licence to Quell. ltn»HtlLlHUHf S PAM Of THS (IBtGROUP ACTIVE INGREDIENTS: Eurax HecontainsCrotamiton BP 10%and Hydrocortisone BP 25% Indications Reliefof inflammation and pruritusassociatedwith irritant contactdermatitis, allergiccontactdermatitis, insectbite reactions and mild to moderate eczema. DOSAGE AND ADMINISTRATION: Adults and children over 10 years: Apply sparingly over a small area twice a day for a maximum period of I week. Occlusive dressings should not be used Not recommended for children under 10 years Contra Indications Hypersensitivity to any component ofthe formulation. Bacterial, viral orfungal infectionsofthe skin Acute exudative dermatoses Application to ulcerated areas. Use on the eyes/face, ano-genital region, broken or infected skin includingcold sores,acne andathletesfoot Side-effects:Occasionallyatthesiteofapplication signsofirritation suchasaburningsensation, itching,contactdermatitis/contactallergymayoccur. Use in pregnancy andlactation: Useinpregnancyorlactationshould only beatthedoctorsdiscretion. LEGALCATEGORY P PRODUCT LICENCE NUMBER 0001/SOIOR DISTRIBUTOR Zyma Healthcare, Holmwood. RH54NU DATE Of PREPARATION April 1995 PRICE U59 COUNTERooints Cow & Gate enters non-foods You can counter on Nurofen CrookesHealthcareis introducinganew pharmacycounterunit. market with Breast Pad It featuresboth 12-and 24-packsofNurofenand NurofenPlusand Cow&Gatemarksits incorporatesanew debutinthebabycare, consumerleaflet, 'The non-foodsectorwiththe NurofenGuideto launchofBreast Pads ChoosingtheRight (30,£2.99). Painkiller',which Fortheretailer,the answersthemost brandoffersan commonquestionsposed approximate21percent onanalgesicselection Crookes HealthcareLtd. PORandeasymerchan- andpainmanagement. Tel:01159507431. dising;packscanbe shotraiczkoendtavlelrtyiocarlloyn,end. Selfcare fertility management Thelaunchshouldalso encourageearlyloyalty Selfcareisanewrangeof whichdeterminesthe totheC&Gbrand,the fertilitymanagement fertileperiodvia companysays. productsfrom Royce temperaturereadings Thebreastpads grabbing20percentof bya£2.69introductory Laboratories. (£114.95) market,currentlyworth salesafter 18months, priceoffer, Emma'sgift Thesix-strong •FloraClear,a £5millionatrsp,is withgroceryincreasing packsamplingand portfoliocomprises: screeningtestfor expectedtocontinueits its9.4percentsliceby leafletwithcoupon • FirstSignal bacterialvaginosis 15-pluspercentyearon poachingfromBoots. drop. pregnancytestkit,which (£8.95). yeargrowth. Cow& BreastPads'August 1 Cow&GateNutricia Ltd. givesareadingonthe Promotionaland Gateanticipates launchwillbesupported Tel:01225768381. firstdayofamissed educationalmaterialis period. Itisavailablein available, withback-up threeformats: atest fromacustomercare More impact First aid for offthe beaten track cassette,wheremineis helpline(9.00am-5.00pm, droppedintothesample MondaystoFridays). well(retail£6.95); and Allproductshavea for Senokot Anewfirstaidkitisnow packofsuturematerial, stick,whichiskept minimumPORof30per availablefortravellers one dripneedle,five undertheurineflow(one cent, andRoyce venturing offthebeaten steristrips,threemelolin test£7.95,two£10.45) Laboratoriesisoffering track. non-stickdressings,four •YourTimeovulation introductoryfreestock. TheTravel Mate(£8.84) injectionswabsand one predictorkit. Urineis Theproductswillbe fromSweeneycontainsa labelforblood notation. droppedintothetest availabledirectfrom widerange ofmedical SweeneyFirstAid cassettetodetermine Royceandwholesalers equipment:three Supplies.Tel:01926 whetherovulationwill fromSeptember.A syringes,tenneedles, one 426621. occurwithin24hours.A nationaladvertising five-testkitcosts£17.95 campaigncoincideswith Dramamine charity bonus offer • Bioself,amicro- thelaunch. computerconnectedtoa Royce LaboratoriesLtd. Reckitt&Colmanhas precisionthermometer, Tel:01427891911. repackageditsstimulant Anewdisplayouterfor NSPCCHappyTraveller laxAavtaiivlea,bSleenionktoatb.lets, aDvraailmaabmlienienapascpekcsiaisln1o4w AppTehael.bonuspackisonly J&J is spot on Wisdom's smile granulesandsyrup,the for12offer. availableduringthe updateincorporatesa Thepackisdesigned summerperiodand Johnson&Johnson is grows wider newlogoandstronger tobemoreconsumer- Searleisgivinga boosting itsClean&Clear coloursformoreon-shelf friendlyandgraphically donationtotheNSPCC rangewiththeadditionof Wisdomisspending£1.6 presence. communicatesthe foreverypacksold. three newproducts. milliononadvertisingthis Reckitt&Colman benefitsoftheproduct G D Searle&CoLtd.Tel: Invisible BlemishGel summer, includingaTV ProductsLtd.Tel:01482 whilesupportingthe 01494521124. (£3.29,20ml),available in campaignbackedupwith 326151. maximumstrengthand nationwideposterson sensitiveskinvariants, is four-and48-sheetsites. aspottreatment,while The30-andten-second DeepActionCleansing commercialsareonair SwissCleanhaslaunched Wash(£3.29,150ml)hasa nowandrununtiltheend an'Anti-germtravelkit' 'whipped cream'formula ofOctober. Itcomprisesfour fordeepcleansing. Theyfocuson products: adisinfectant Clean&Clearis Wisdom'slatesttooth- spray,wipes,soapand currentlybeingsupported brush, Contour,withthe watertablets. Itretailsat bya£1 million regionalTV theme, 'Wisdomwortha £19.95. campaignanda high- millionsmiles'andgiveit Displaymaterialis profilesupportpackage in an upbeatimage. available. theteenagepress. WisdomToothbrushes, Perma-JeuneLtd.Tel: Johnson&Johnson Ltd. DivisionofAddisLtd.Tel: 0171 5806900. Tel:01628822222. 01440714800. 110 CHEMIST&DRUGGIST22JULY1995

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6A drugget PHARMACY 22 July 1995 PSNC conditionally accepts 2.5pc rise Iwo more regions gain from DoH £lm fund Courts uphold Staffs FHSA's view on Clothier MCA consults on more P to G8L moves ... Homing in on parasites home at and abroad sens A salesman's salesman Helps smokers cut down as well as give up makes his pitch ... Natural and nicotine-free Can be recommended for all smokers, LOGflDO including pregnant women Numark fulfils early Contact yourwholesaler, Chefaro representative, or order on 01223 420956 to smoking promises on rebates EXISTING RAFTING AGENTS ARE ABOUT Massive £1-7 million TV burst starts July 17th NEW Please contact your Pharmacy SupportTeam Tagamet FIGHTS representative or hearU,««<painFAST Freephone the OTC "Mrsi.witu/i'J"* CONTROLS Tagamet Information Line ocidretl„x on 0500 100 222 *J DUAL ACTION LIQUID TagametDualActionLiquid.ProductInformation: Presentation.Awhitesuspensionwithanodouroffruitandmintcontaining500mgsodiumalginateB.P.C. and200mgcimetidineper 10mldose.Use. Shorttermsymptomaticreliefofheartburn, associatedwithacidregurgitation,especiallyifprovokedbybendingoverorlyingsupine.Dosageandadministration:Adults (incl. theelderly),children16yearsandover. 10mlsuspensionwhensymptomsappear.Ifsymptomspersistformorethan 1 hourafterthefirstdose,aseconddose(10ml)maybetaken, butnomorethan2dosesinany4hoursandnomorethan4dosesinany24hours.Treatmentshouldnotbecontinuedformorethantwoweeks.Ifsymptomspersistformorethantwo weeksorrecurregularly, adoctorshouldbeconsulted.Nottobegiventochildrenunder16yearsofage.Contraindications. Hypersensitivitytocimetidineoranyoftheotherconstituents. Precautions.Notrecommendedinpatientswithimpairedrenalfunction,hepaticimpairment;takingoralanticoagulants, phenytoin,theophylline,intravenouslignocaine;middleagedorolder patientswithnew/changingdyspepticsymptoms,anypatientswithunintendedweightlossanddyspepticsymptoms,becauseofpotentialdelayindiagnosisofgastriccancer;withcompromisedbone marrow;inpregnancyandlactation. Useonlyonadoctor'sadviceinpatients:withanyotherillness,usinganymedication,undermedicalsupervisionforotherreasons,withahistoryofpeptic ulcerwhoarenowusingNSAIDSespeciallytheelderly.Contains66mgsodiumper 10mldoseandthisshouldbeincludedinthedailyallowanceofpatientsonsodiumrestricteddiets. Adversereactions. Diarrhoea,dizziness,rash,tiredness.Gynaecomastia,occasionalliverdamage,confusionalstates(usuallyintheelderlyorveryill),allreversible.Rarelythrombocytopenia, leucopenia,agranulocytosis,allreversible.Veryrarely,hepatitis, interstitialnephritis,acutepancreatitis,headache,myalgia, arthralgia,fever, sinusbradycardia,tachycardiaandheartblock, ailreversible,aplasticanaemia,pancytopeniaandanaphylaxis.Reportsofalopeciaandveryrarelyreportsofimpotencebutnocausalrelationshiphasbeenestablishedatusualprescribed therapeuticdoses.Productlicencenumber0002/0232. Retailprice(200ml)£4-99.LegalcategoryP. Dateofpreparation8June1995. SBSmithKline Beecham SmithKlineBeechamConsumerHealthcare, SBHouse,Brentford,Middlesex,TW89BD.Telephonenumber0181 5605151. 'Tagamet'isatrademark. ConsumerHealthcare ! COMMENT Pharmacists should need little encour- CHEMIST& agement to climb aboard the public- accountability bandwagon that is rolling through the professional world at large. It was set in motion by a Government that believed DRUGGIST the natural instinct ofthe professions was to look after their own interests, rather than those of the public they professed to serve. The irony is that while most other professions operate behind VOLUME244No5993 136th YEAR OF PUBLICATION ISSN 0009-3033 closed doors, community pharmacists openly practice over the counter. Hence the Society's PSNC accepts 2.5pcconditional on action onworkingcapital 104 move to introduce medicine sales protocols, and Professionalallowance thresholds fixed al 1,100 to 1,600 a training requirement for assistants that will ensure a level ofcompetence commensurate with Topical clotrimazole settojoin ibuprofen asGSL 104 the potency ofproducts available OTC. M('Aplans more Pto (iSLmoves l>y the end oftheyear The Cambridge Counterpart Pharmacy Assist- ant Development Programme is Chemist & High CourtdeniesStaffs1 GPjudicial reviewofClothier 105 Druggist's response to help pharmacists bridge Stall's' FHSA hascorrectly interpreted the regulations any gaps in staff training needs to satisfy the C&D Society's July '96 requirements. It is free to subscribers because of Whitehall Laboratories' Counterpart: the answerto assistanttraining 105 (COUNTERPART generous sponsorship. Additional assistant ' Firsl module in this weeksissue, phisdetailson modules and question papers will be available to ,.J Hi how to usethis freetrainingprogramme C&D subscribers from Whitehall's pharmacy sales force. DoH handsoutmore fromSimprojectfund 106 Counterpart is a superb way to work with BidsuccessforTrent FHSAs, Angliaand ()xford assistants to ensure that pharmacies maintain their high standards of public service, and meet German courtstorpedogovernmenthealth reforms 118 the Society's formal requirements by July '96. It Bayersuccessfully challenges fixingofdrugprices will satisfy the needs of experienced assistants who are eligible for the RPSGB's Multiple Choice Parasites-unwelcomebaggage athome and abroad 120 Question paper. And because each Counterpart Alookat infectionstravellersmight wanttoavoid overseas module is preceded by a Pharmacist's Briefing, it leads naturally to pharmacist/assistant inter- action in the pharmacy. Time is the only cost up European Courtrulingset tocause chaosoverscriptfees 127 to the point where pharmacists or assistants want Qualifyingage forfreescriptsformencould dropto60 to monitor progress via the telephone marking service. Counterpart is for you and yours. Please Asalesman'ssalesman expounds 128 pass on now! Graham Ford ofPfizerConsumerHealthcare it ... CHEMIST* EDdeiptuotryJEodhintSokrelPtaotnr,icMkRGPrhicaer,mS CChheemmiissttf DPrhuagrgmiasctyinUcpodraptoreatingRetail Numarkdeliverson own-brand rebates 129 DRUGGIST MRPharmS PublishedSaturdaysby Pharmacistspoorretailers, sayschairmanIrish ALiszsiJosnteasn,tBEAditor/BeautyEditor TMSieollvleeeiprehioFgnrnee'eWma0ay1n.73PTr2oonf3ber6si4sd4igo2en2.alKeLnttdTN91RW ContributingEditorAdriennedeMont,MRPharmS TFealxe-x0-19753123236M1I5L3F4REG Creighton'sspends£1.5mto expand in haircare market 130 NBueswisneEsdsitEodritAoilrsJaaCcokliqeuBhloounnde,llB.ScBA SOuvbesrcsreiapsti&onEsirHeo£1me55£p1er08anpenrumannum Profitsdown9percent dueto fallingexports TechnicalEditorMariaMurray,MRPharmS includingpostage ReportersMarianneMacDonald,MRPharmS £2.25percopy(postageextra). FawzFarhan,MRPharmS CSiorvceurleaitginonHaonudses,ubBsecrreipstfioornd:SRtoryeeatl, REGULARS ArtEditorTonyLamb LondonSE186BQTeh01818557777 PriceList CDoalrirnenSiLmarpksionn,(MCaornitaroLlolcekr)e dRoineslfcyurnebtdeisopnor,novucinadlneecdseslatlseptedhceisfupibucsbacllrliiysphteiro'nsswill News 104 NewsExtra 127 guaranteedwithinthetermsof DeputyAdvertisement subscriptionoffer. ManagerJuliandeBruxelles Theeditorialphotosusedarecourtesy Pen Portrait 107 BusinessNews 129 DougMytton,MartinCalder-Smith ofthesupplierswhoseproductsthey feature ProductionKatrinaAvery TopicalReflections 107 ClassifiedAdvertisements 132 PublisherRonSalmon.FRPharmS PublishingDirectorPamBarker f9y/a1*- aMCinilleldeNerws&FMredeiaepubmlicaatinon PrescriptionSpecialities 108 BusinessLink 134 ABC ©MillerFreemanpic. 1995 Counterpoints 110 AboutPeople 138 BUSINESSPRESS CHEMIST&DRUGGIST22JULY1995 103 NtWo PSNC accepts 2,5% on global sum The Pharmaceutical Services startsatS755 for 1,100itemsper willkeepthefeeperprescription ment'sattentiontotheproblems Negotiating Committee has ac- month,risingatSI.17peritemto constantatjustoverSI.34forthe of returned prescriptions bring- cepted a 2.5 percent increase in SI,340for 1,600itemsandabove. wholefinancialyear. ing contractors below the 1,100 theglobalsum,onconditionthat TheproposedS647.8mforcore The threshold changes mean threshold needed to obtain the the Department takes actinn In services includes S2.8m under- contractors dispensing 2,500 professionalallowance. alleviate the problems of work- payment. But an overpayment items per month and over will PSNC has approved a report ingcapitalandadvancepayment which started in April would receive a 3.3 per cent rise in in- producedbythediscountinquiry bythestartof1996-97. have reached Sl.lm by Septem- come year on year, while those unitand hopes to meetthe DoH The settlement comes into ber,soPSNCdecideditwouldbe between 1,000-1,099willsuffera later this month to discuss the effect on September 1 and takes moresensible mathematicallyto net reduction of 20.8 per cent offsets. Preliminaryfindingssug- the global sum to 5671.7 million spread the net underpayment year on year. Below 1,000 the gest it is unlikely that the figure for 1995-96. over fees, rather than paying a reductionwillbe 13.3percent. will change much, says PSNC The professional allowance lump sum to contractors. This PSNC has drawn the Depart- chairmanDavidSharpe. New 'No' to introduction of patient packs regulations The Pharmaceutical Services • PSNChaswrittentotheOffice • PSNC is still considering expected soon Negotiating Committee is refus- of Fair Trading detailing advice research to demonstrate phar- ingtogoalongwiththeintroduc- that it makes to LPCs and con- macists' added value. Discus- The Pharmaceutical Services tion ofpatient packs until there tractors, and advice LPCs might sions are continuing with acade- NegotiatingCommitteeisexpect- isawritten undertakingfromthe givetocontractors. TheOFThas mics and it is hoped proposals inga'raft'ofregulationstobelaid Department of Health that the suggested that adviceofanysort willbeputtoPSNCinOctoberor beforeParliamentinSeptember. problems of pharmacists being could fall within the Restrictive November. Joint funding with Chairman David Sharpe said left with dead stock will be Trade Practices Act. As PSNC's theSocietyisbeingexplored. last week: "We are confident resolvedbeforethestartdate. head office deals with over 10(1 • The DoH hasdecided to defer there will be no change in the Other issues that needed queriesaday,itishopedtheOFT discussion of a national welfare control ofentry regulations." He resolvingincludedchangesinthe will realise what an impossible milktokenscheme,butwillmon- was also hopeful that a ban on Terms of Service to inform con- situationthiscouldcreate. itor local schemes. PSNC1 sug- faxing prescriptions from non- tractors what pack size they • It appears only 42 LPCs have gestsLPCsapproachappropriate contract pharmacies would form should supply against the quan- completed local negotiations on authorities to arrange local part oftheregulations. tityprescribed. payments for giving advice to schemesinvolvingpharmacies. PSNC-hastakenlegaladviceon PSNCiswritingtotheworking nursing and residential homes, • The response to Pharmacy prescription charges under the partyimplementingpatientpacks, andoutofhoursservices,leaving Weekisto be evaluated byOcto- NHSPharmaceutical Regulations deploring the way pharmacists' 5(5whichmightnothavedoneso. ber, when the pharmacy bodies 1992 and been told that the only viewshavebeen ignored. Theproblemhasbeenbroughtto involved will decide whether to chargeacontractorcanmakefor ()thermattersdiscussedatlast theDoH'sattention. holdanotheroneinautumn1996. Prescription Only Medicines on week's PSNC meetingincluded: • Devon LPC intends to move a • PSNC' isaskingcontractorsor NHSscriptsistheS5.25fee. # PSNC officials are to discuss resolution at the next LPC con- LPCstoinvitelocalMPstospend PSNC would comment no fur- withtheDoHapossiblecompen- ference that two-thirds of all time with them. Four lunchtime theron the case ofa Welsh phar- sation scheme forsmallpharma- LPCsmustagreebeforeaspecial briefings for MPs will be held in macistfightingto dispense drugs ciesand reportback. LP< i (inference iscalled November/December. writtenon NHSscriptsprivately. Topical clotrimazole to join ihprofen on 6SL trail? The Medicines Control Agency should be a GSL medicine, pro- maximum strength of 1 percent The licence was granted last hassent out an official consulta- vided its use is limited to adults inpacksofnomorethan500mg. December. tion letter on whether ibuprofen andchildrenover12fortherelief Similar changes are proposed Finally, the letter proposes should be reclassified as a GSL ofrheumatic and muscularpain, for folic acid, which is currently that the following be added to medicine. backache, neuralgia, migraine, a GSL medicine when in a maxi- the GSL Order: benzoin tincture The letter, dated July 11, headache, dental pain, dysmen- mumdailydoseof200mcg,anda compound (0.75 per cent pas- comes after the MCAs contro- orrhoea, feverishness and symp- P medicine when the maximum tilles), capsicum tincture, cho- versial decision to grant Gal- tomsofcoldsandinfluenza. The daily dose is 500mcg. The MCA line bitartrate, equisetum, glu- pharm International a GSL maximum dose would be 400mg proposesmakingitGSLindoses cose, magnesium alginate, mag- licence to market ibuprofen and the maximum daily dose upto500mcg,andkeepingitPre- nesium carbonate, rhubarb and tablets in packs of 12. The l,200ing. Pack sizes would be scription Only for higher daily squill,and-forexternaluseonly licencewasgrantedforalimited limitedto 12tabletsof200mg. doses. -capsicum oleoresin. Medicines period under the Medicines Topical ibuprofen would also Some folic acid preparations containing these substances (Pharmacy and General Sale become GSL, again for adults already have GSL licences, have already been licensed as Exemption)Order 1980, pending and children over 12, for the although the daily doses are GSL under the 1980 Order by theMCAsconsultation. reliefofrheumaticpainandmus- 400mcg. AspokespersonforG R meansofaprovisionin,orvaria- Pharmacists have criticised cularaches, painsand swellings, Lanetold C&D that Preconceive tionto,theproductlicence. thedecisionnottoconsulthealth such as strains, sprains and was launched as an unlicensed Comments on the proposals - professionals first. The Royal sports injuries. The maximum supplement, then the company includingtheimpactonbusiness Pharmaceutical Society issued a strengthwouldbe5percentand applied for a GSL licence, sub- costs- should be sent to Dugan press release on the matter and there should be no more than mitting evidence based on the Cummings, Room 1219, MCA, tIhoesSeoeckieatny'surCgoeunntcimleehtaisnaggrweietdh 2.5Tghpeerlecttoenrtaailnseor.proposes mak- cmheinedfatmieodnictahlatoaffidcaeirl'ys droesceomo-f MLaanrek,etLoTnowdeorns,SW18Ni5nNeQ,Elmbsy theMCA(C&DJuly 15,p89). ing clotrimazole a GSLmedicine 400mcgoffolicacidduringpreg- August28. The consultation letter, MLX- when used externally for the nancywasnecessaryforthepre- The MCA plans to implement 218,proposesthatoralibuprofen treatment of athlete's foot, at a vention of neural tube defects. thechangesbyDecember29. 104 CHEMIST&DRUGGIST22JULY1995 I GPs denied Clothier review A High Court judge has backed Staffordshire Family Health Ser- vices Authority's interpretation of the Clothier regulations and denied a local GP leave forjudi- cialreview. The GP, Dr John Worthington (C&D July 15, p76), feared thai under the FIISA's interpretation pharmacistswould heallowed to setupbusinesswithout localdoc- tors being given any right to object, even if the viability of localsurgerieswasunderthreat. Butthejudgesaidhecouldfind no fault in Staffordshire FHSAs interpretation of Department of Health pharmacy rules, even though it had an "arguably sur- prising" result. Sympathising witli the CP's plight,MrJusticeBuxtonsaidthe regulations as they stood were Whyyou should pass on the How assistants self-test markingservice. unambiguousandthecourtcould Counterparttraining Eachmoduleisdesignedtobeusedby Use Ihe coupon below to write to notgobehindtheirclearwording. four assistants - there are spaces al Chemist & Druggist, enclosing a A law expert gave evidence documents in this issue the foot ofeach column for assistant cheque foi the number of staff you that the National Health Service Last week. Chemist & Druggist initialstodenote'section read' wish to participate, and your assis- (Pharmaceutical Services) Regu- launched its Cambridge Counterpart Eachstaffmemberhasatest sheet, tants will receive an individual PIN lations 1992 must havecontained Pharmacy Assistant Development with its primary practice section to iumilm] b\ return. Theywillneedthis a'draftingerror'. Programme with your Pharmacist's endorse the CP/pharmacist customer to access the markingservice and to ButMrJusticeBuxtonsaidthat Briefing (pp87/88), designed to keep referral link. Twenty questions based ensure i onfidentialit,\ and sei uritj in the wording of the regulations youonestepaheadofstaffinquiries. on SummerHealth (Module 1)willbe holdingtheirassessment wasclear, andthat the FHSAhad This week, courtesy ofco-sponsor foundonthereverse, withtick boxes After each module has been construed them in Ilie only way Whitehall Laboratories, each sub- foreachassistanttofillinforpharma- absorbed and your staff have com- possible. scribingpharmacygetsthe firstof13 cistmarking. pleted theirtest sheets, acall to Whether or not there was a FREEtrainingmodulesforassistants, Allofthisisat nocost tothephar- 274422willallowinteractivemarking. 'draftingerror', the courtssimply eachcontainingfourmarkingpapers. macist or the assistant, other than Staff have the option of verifying did not have the power to go Ifyourstaffneedhelptosatisfythe time well spent. Should your staff answersbeforeconfirmingthem, and behindtheunambiguouswording Royal Pharmaceutical Society's July wish to be marked interactively over will have asecond chance to answer oftherules, hesaid. 1996 requirements for medicine thetelephone, orifyouwant them to themodule,ifneeded counterstaff,thenthis isyourcourse. havethisoption,thenreadon. Eachmemberknowstheirfinaltest Lothian GPs welcome Experienced staff- defined by the Yourstaffneedtousethismethodif resultassoonastheyleavethephone, Society as having worked for more Counterpart is accredited, and the and should log their result. A six- than16hoursaweekonthemedicines C&D/Whitehallcourseisselected. month results' summary will be pharmacists' visits countei t'oi threeofthelastfiveyears mailedtogetherwith ayear-end posi- -willneedtotake,andpass,theSoci- Interactive marking tionandcoursecertificate. Lothian GPs are in favour of ety'sMultiple Choice Question Paper For a registration fee of S12.50 per Successful completion of each of receivingregularvisitsfromcom- beforeJuly I, 1996. Staffwilltakethe assistant, staffcan gain access to the the 13 modules allows independent munitypharmacists. paperunderyoursupervisioninyour Counterpart computerised telephone markingat lessthanSI amodule. A survey of Hi GP practices pharmacyononeofthreedatesyetto involved in a GP prescribe!' heset bytheSociety(lastweek.p76). adviseraccreditationprogramme ThelastCounterpartmodulewillbe Helephone marking - PIN application form for pharmacists, run by Lothian sentoutnextJune,sostaffwillheable Namesofassistants Health Board, found over 70 per to use the delivered modules to | centwantedthepharmacists'vis- refreshandrevise,withyourhelp.The its to continue. The scheme Assistant Module and four marking I::::::::::::::::::::::::: involved eight community phar- papers will be inserted in the fourth i, i macists making three visits to issueofeachmonth;thePharmacist's two local GP practices over a Briefingwillbeinthepreviousissue. seven-month period (C&D Staffwhohavepassedanapproved Novembers, 1994, p734). course-theNPApharmacyassistants Theaccreditedpharmacistsare manualoi theBoots'healthcareassis- I ^ bkeeienpguopffetrheedltihaiesoonp,posratyusniDtaywtno tbaenttwseceonuJrasneua-rya,n1d99w2e,raendceJrutlyi,fic1a9t9e4d, | 1 encloseacheque for xS12.-ri() =£ Sykes, one ofthe Health Board's willnotneedtositafurtherexam.Nei- Pharmacyaddress twopharmacistfacilitators. therwillstaffwhocompletetheNPA's Three practices are being cho- MCAcourse. * Telephonenumber * sen to assess the pharmacists' However, other staff will need to impact on prescribing. Results take a courseaccredited bythe body | Supervisingpharmacist | areexpectedintheearlyautumn. appointedbytheSociety.TheSociety The Health Board is to run a wantsthe College ofPharmacyPrac- | Registration number | similartrainingscheme for a fur- tleetodothe |ob lull it has vet tosa\ Sendto: Cambridge Counterpart. <Inn/is/ cV Drm/i/isi. Miller ther ten pharmacists, starting at 'yes'. C&Dwillputforwarditscourse. ^Freeman House, Sovereign Way. Tonbridge, Kent TN9 IRW. thebeginningofOctober. CHEMIST&DRUGGIST22JULY1995 105 NEWS No datesyetforMCQs The Royal Pharmaceutical Societyislikelyto run its multiple choicequestion paper forassistantsonedaythis autumnandtwodatesnextspring Three Trent Region FHSAs have nity pharmacists' cost-effective- then be scheduled six months (see C&Dlastweek,p76). Roger between them secured 5135,000 ness, the project will examine later to assess outcomes. Phar- Odd,head ofthe Society's from the Department ofHealth's hospital/community pharmacist macistsarepaidS25perhour. practicedivision,saysthat,while SI millionprescribingfund. communication, links with GPs Oneaimoftheprojectistoini- nodateshave beenset,the Rotherham FHSA has landed and how cost-effectively phar- tiatecloserliaisonwithinthepri- mooted periodsare "likely". £50,000 to fund a year-long pro- macists liaise with each other mary care team and identify ject examining prescribing over locum cover, says Rother- areas of greatest pharmacist Shrewton applicationlost acadrveicientaetrftahcee.secondary/primary hadavmisei FMHSAtie Ppathealrm"aIcfewueticcaanl icemuptaiccta,lsaadyvsiseLre,icJeostaenrn'espChhaarrlmeas.- AWiltshire pharmacisthas lost In Ilie initiative, 200 patients show some positive benefits, Finally, DerbyshireFHSAwins hisfightto opena pharmacyin admitted to hospital dueto com- theremaybesomelocalmoney." £50,000 for its repeat prescrip- thevillageofShrewton. Sultan pliance problems will be issued Leicester FHSA, which gets tion review project, which aims Dajani, pharmacymanagerof with pharmacy care plans. Upon £35,000 for its GP and commu- toseeabout25communityphar- Edwards Pharmacy inthe nearby discharge, the care plan will be nity pharmacist repeat prescrib- macists liaise with 50-plus GP villageofDurrington, losthis forwarded to the patient's com- ing project, is to review, over a practices. It pays pharmacists appeal againstWiltshire FHSA's munitypharmacywhichwillpro- six-month period, the regimens around S25 an hour to become decision onthegroundsthat videuptosixhomevisitsayear. of 25 patients receiving six or additional advisers at practice granting a contractwould Themajorityoffundswillgoto moreitems. andpatientlevel. prejudicemedical services. remunerate the 34 (out of 43) Twenty-five GP and pharma- Commenting on the bid, Jeff participating pharmacies; pay- cist'pairings'havebeenset upin Worrall, Derbyshire FHSAdirec- Suicideverdict ment isat£25perhomevisitand innercity, markettownandrural tor of primary healthcare, says: £100 for two evening training locations. GPs will identify "Thereisstrongevidencenation- Averdictofsuicidewasrecorded sessions. patients for the pharmacist to ally that management of repeat on 42-year-old hospital As well as assessing commu- review; a follow-up meeting will prescribingisvariable." pharmacistAlastairGibson,who died onJune20following an HEA overdoseofanalgesics.The and Anglia and Oxford get to launch folic ... inquestheard hewasbeing treatedforclinical depression. acid campaign MrGibson, ofOvingdean, DoHHm Brighton,wasthetechnical £91,000 from fund The Health Education Authority servicesprincipal pharmacistfor isto launch thebiggest-everfolic Brighton HealthcareTrust. He acid education campaign later joined Brighton General Hospital Anglia & Oxford Region has tohelpGPstorecognisepharma- thisyear. in 1982afteraspell atGlasgow's made two successful bids to cistsasaresource". The £2.3 million Government- Southern General Hospital. secure up to 591,000 of the NorthWestAngliaHealthCom- funded project aims to raise Department of Health's SI mil- mission has secured up to awareness of the importance of Cregiau delay lionprescribingfund. £67,000 to run a pilot which will increasing folic acid intake Northamptonshire FJJSA has assess the effect ofpatient input before conception, and for the Adecisiononwhethera won £24,000 to fund a pilot into onoutcomes. first 12 weeks of pregnancy to pharmacyshould beallowedto community pharmacist-led pre- The pilot comprisestwoparts. reduce the risk of neural tube open inthe Mid-Glamorgan scribing audits. The project will In the first, GPs identify elderly defects. Previous campaigns village ofCreigiau hasbeen see 12 pharmacists looking at patients on multiple repeat med- have not raised awareness as deferred until September.The threeareasofprescribingatindi- ication;thepharmacistauditsthe highlyashoped. applicationfromW Davies& vidualGPpracticelevel. regimen, medication indications The new scheme will also pro- Sonsfacesfierce oppositionfrom Areas of interest include and frequency of review; an motethefortificationmessageto villagers,whoenlistedthehelp diuretic prescribing, oxygen and action plan is then drawn up, foodmanufacturersinanattempt ofthe local LabourParty intheir nebulisertreatmentandrational- withathree-monthfollow-up. to boost the range offoods con- battle(C&DJuly 1,p5>. Mid- ising prescribing in practices In the second part, a domicil- taining folic acid. In thepast, the Glamorgan FHSAhasdeferred its with a high nursing home case- iaryvisitisbuiltintotheprotocol Department of Health has decisionwhile itseeksformal load. Participants are being paid todiscussside-effectandcompli- opposed the blanket fortification adviceonthe interpretation ofthe S200 per day, based on a seven ance problems with the patient. offoodstuffs,suchasflour. Clothierregulations.The dayperpersonworkload. Outcomesofbothtrialswillthen Thecampaignwill belaunched applicantmaybenefitfromthe Janet Corbett, FHSA prescrib- be compared to assessthe effect to health professionals later in so-called Clothier loophole'. ingadviser,saystheprojectaims of patient involvement. The 17 September or October this year, to strengthen inter-professional participants are paid S15 per and to the public early next Swanseadispute links, "enablingcommunityphar- hour spent on the project, but spring, with consumer leaflets macists to see patients as a bonus incentive payments and television or press advertis- TheWelsh Office hasfinally wholeratherthanonascriptand shouldalsobecomeavailable. ing, whichwillrunfortwoyears. announced itsdecision ontwo appealsheld on March 17 concerning premisesatthe M Welsh primary care scheme extended O'Kane&Partnersmedical centre in Swansea.Kieft Chemistsand Howard& Palmer The Mid-Glamorgan primary apy. They will be employed to Education. The scheme starts in had bothappealedagainsteach carepharmacists'schemeisnow work within their own area for Septemberandwillrequirephar- other'sapplicationto relocateto beingrolledout tootherareas. oneyear,paidforbytheWPSP maciststoattendonedayaweek the medical centre. On Monday, TheWelshPrescribingSupport In aseparateventure, upto20 for eight weeks. It is hoped that KieftownerHenry Barnessaid Projectis offering fourplacesto places are being made available fundingwillbeobtainedtocover both appealshad been decided in pharmacists,oneeachfromWest for pharmacists wishing to par- locumexpenses. hisfavour.The medical centre and South Glamorgan, Gwent ticipate in the training scheme. Interested pharmacists should hasbeen open 18months. Mr and Dyffed. Pharmacists will be This is being funded by the contact Dr David Temple at the Barneshasalreadytaken upthe trained to liaise with GP prac- WPSP, with training being run in Welsh Centre for Post-graduate lease,fitted outand registered tices on developing an inter-dis- conjunctionwith the Welsh Cen- Pharmacy Education, tel: 01222 thepharmacy. ciplinary approach to drug ther- tre for Post-graduate Pharmacy 874784. CHEMIST&DRUGGIST22JULY1995 XRAYSER PHARMACISTPENPORTRAIT New a John Wheater 'not tea,. medicine' category It seemsthere is a new Reflections category of product on the market, courtesy of Britannia Health Products, called a 'not a medicine' (Letters, C&DJuly 15). This apparently exhibits all the characteristics ofthe which to encourage the re- genuine article, with full establishment of natural sleep scientific justification for its patterns, ratherthan demand- existence, pharmaceutical led products which encourage licences in othercountries and dependency by 'strength' an advertising profile almost marketing. • Qualified in 1974 altergradu- indistinguishable from the real ating from Sunderland School of thing. However, in orderto Pharmacy and completing pie- avoid consumer misunder- Hope springs registration with Dodds Chemist standing, it is to be labelled in Royton. Lancashire. 'XXXX is not a medicine'! • CareerStarted inpharmacyat This is certainly a novel the age of ten, spending school concept, but if it is a genuine eternal holidays helping out al J Roy attemptto inform the Diysdale\ Sihi in Rochdale, Lan- consumer, I cannot I was interested in the project cashire. After qualifying, spent a understand the reasoning. A funded by West Sussex Family yearat Failman's('hemistinSun- product is either a medicine, Health ServicesAuthority, derland. Returned to Dodds with a product licence and which allowed the employ- Chemist in 1975, where he was therapeutic profile, or it is not. ment of part-time pharmacists joint proprietor with Harvey I suspectthe reason forthis within dispensing doctors' 1lodd until 1992, when the busi- verbal smokescreen lies more surgeries [C&DJuly 15, p78). ness was sold lo Tinted Norwest with the time and cost of ob- This was an attempt to Healthcare. taining the licence than with reconcile the entrenched John then worked as a locum clarifying confusing legalities. positions of both professions interspersed withworldtravel. In But, in orderto clear up any in the rural battle and appears 1994,heboughtPendlePharmacy misunderstandings, this is my to have had some success. in Brieifield uilh his pharmacist unequivocal opinion: "Any Few have ever denied the wife, Karin. lie has also been product which makes claims disturbance, so cannot desirability of a compre- I 'on/off superintendent pharma- of, or implies, medicinal understand the necessity for a hensive pharmaceutical cistofJRoyIhysdale&Sonsince efficacy should require a higher-strength alternative. service, but achieving that has 1980. medicinal licence". Nytol, in common with most always eluded our nego- • Committees Secretary of If Britannia Health feels that single-ingredient sedating tiators. However, in the report- Rochdale Local Pharmaceutical a change in the licensing antihistamines, is open to ed success ofthis project, Committee since 1978 and Old- regulations is necessary to excessive use and cocktail- wherethe advantages of hamLPCsince 1992(chairmanof restrict the use ofthe title taking by abusers; it also pharmaceutical input into Oldham. 1982-85); secretary of 'medicine', while providing for produces dependency in doctor dispensing has appar- Rochdale National Pharmaceuti- a new, less onerous, category legitimate users. ently been accepted by the calAssociationbranch and mem- of licensed 'alternatives', then am now adept at identify- participating medical prac- I berofOldham FamilyHealthSer- the company will have my ing the abusers and refuse tices, may lie hope. vicesAuthoritysince 1977. Chair- support, butthe marketing of them Nytol, but sleep-induc- This principle could, man ofBury Royal Pharmaceuti- 'not medicines' only arouses ing dependency is a more perhaps, now be extended to calSocietybranch 1978-82. my deepest suspicions. difficult problem, which all dispensing doctors by • Hobbies Genealogy - special- affects the respectable middle- being included in all FHSA isingin own surname worldwide, aged or elderly, and with medical and pharmaceutical music, driving and 'the local', 'Strength' no whom my counselling skills strategies: that, where whichJohn refers to as the "uni- are fully stretched ifany dispensing occursfor rural versityoflife". intervention is to be of help patients, this should ideally • Pharmacy philosophy "Com- ratherthan to offend. only be undertaken underthe munity pharmacy is currently cure for It is to this lattergroupthat supervision ofa pharmacist. submitting to a pay and condi- 50mg Nytol is being targeted. Itcould be leftto each tions' revolution which is putting They are alsothe most practiceto decide howto best pharmacists, in both theindepen- susceptible to long-term implementthis. However, dentand multiplesections, under insomnia dependency, and the given encouragement from alotofpressme. introduction ofthis higher FHSA advisers, most rural "The future, much like the Stafford-Miller hasjust strength can only aggravate dispensing practices would no weather, isunpredictable,butthe launched a higher, 50mg, the problem by restricting the doubt soon incorporate a forecast is good. Acceptance as strength of Nytol on the back ability to adjust to a minimum pharmacist into theirteam full members of the primary of its successful original 25mg dosage. The problems of and extend the limited healthcare team, improvements formulation. However, the insomnia are as complicated recommendation to include in standards of both staff and instructionsforthe original asthey are real, and would the advantages of a fully- I premises, and continued exten- are one or two at night forthe preferto have available a integrated pharmaceutical sion ofthe POM to P list will all temporary relief of sleep range ofalternatives with service. enhance.jobsatisfaction." CHEMIST&DRUGGIST22JULY1995 107 RIPTspecials Adenoscan Clomiphene SanofiWinthrop hasintroduced Glaxo Wellcome gets Adenoscan(adenosine),a coronaryvasodilatorfor cancer intravenous infusion,tobeused in conjunctionwithradionuclide myocardial perfusion imaging in concern patientswho cannot, orshould Hpybri go-ahead not,exercise. Each 10mlvial contains30mgadenosine ina Doctors are being advised to salinesolution.Apackofsix avoid the long-term prescribing vialshasanNHSpriceof£80. of the ovnlation-inducing drug SanofiWinthrop Ltd.Tel:01483 Glaxo Wellcome has received benigngastriculcers. clomiphene. 505515. Medicines Control Agency ap- Therecommendeddoseforthe Thelatest CommitteeofSafety proval foritsHelicobacterpylori formeris400mg twice daily plus on Medicines/Medicines Control Cicatrin slashed treatment, Pylorid. clarithromycin 1-1.5g a day or Agency's 'Current Problems in The product, ranitidine bis- amoxycillin 2g a day, for two Pharmacovigilance' recommends Following discussionswiththe muth citrate, has been approved weeks. For the latter: 400mg thedrugshould"notnormally"be DepartmentofHealth,the for the eradication of H pylori twice daily for four weeks for used for more than six cycles, Wellcome Foundation has and the prevention ofrelapse of duodenal ulcer and for up to becauseofasmallincreaseinthe substantiallyreducedtheprices duodenal ulcer when given in eight weeksforgastriculcers. absolute risk of ovarian cancer in itsCicatrinrange: 15g creamis conjunction with either amoxy- Pylorid is expected to hit the whenusedformorethan 12men- now£0.90(was£4.52),30g cream cillin or clarithromycin; and the UK market within the next few strual cycles. "However, there is £1.80(£8.22),15g powder£0.90 treatment of both duodenal and months. no evidence that clomiphene (£4.87)and50g powder£3.00 used forthe recommended dura- (£12.31). tion of treatment (three to six TheWellcomeFoundation Ltd. Carace approved post-MI months) increases the risk of Tel:0161 4359000. ovariancancer,"addsthereport, ClomipheneisavailableasMar- TheACEinhibitorCarace(lisino- tion with other post-MI treat- ion Merrell Dow's Clomid and Stiefel loss pril)hasbeenapprovedforusein ments, such as thrombolytics, Serono Laboratories' Serophene. AcneAid SoapfromStiefel acute myocardial infarction, aspirinandbeta-blockers. Neitherproduct isrecommended Laboratorieshasbeen whengivenwithin24hoursofMI The dose is 5mg for the first for use for longer than six discontinuedfromJuly10. symptoms'onset. two days, rising to lOmgafter48 months, with Clomid only Stiefel Laboratories(UK)Ltd.Tel. According to the GISSI-3 hours, for a further six weeks. advisedforuseinthreecycles. 01628810021. study, the product reduces over- Treatment, should be continued "We fully support the report," all mortality and the combined in patients who develop conges- says Serono's medical director, Initard cancelled outcome measure of mortality tiveheartfailure. Mercia Page. "Treatment should and severe ventricular dysfunc- Du PontPharmaceuticalsLtd. be reviewed if a patient has not Following onfrom Novo Nordisk's tion. It can be given in conjunc- Tel:01462482648. ovulatedwithinsixmonths." discontinuationofHuman Initard, thecompanypointsoutthatthe MEDICAL MATTERS Wellcome Foundation isnot holdinganyfurtherstocksand is Immunisation changes Doctors urged to take the sugar-free option cancelling all remainingorders forthe product. Novo NordiskPharmaceuticals in the offing Doctorsare beingencouraged to west of England was greeted Ltd.Tel:01293613555. take the lead inthe dental decay with enthusiasm from pharma- The Department of Health is battle by prescribing sugar-free cists, but doctors rarely pre- expectedtointroducenewimmu- medicines. scribedthesugar-freevariant. Italian style nisationpolicies. In an editorial in the British Not only were pharmacists Nutricia DietaryProductshas Some changes are anticipated MedicalJournal,DrIainMackie, prevented from switching to the added morepastavariantstoits inthenewGPs'guidetoimmuni- seniorlectureratthedepartment sugar-freevarietybycurrentreg- gluten-free Glutafinand low- sation policy, in particular a of oral health and development ulations but "the actofprescrib- protein Loprofin ranges. Glutafin revamped approach to measles, at the University of Manchester ing medicines with sugar was nowincludesLasagneand where "several options are being Dental Hospital, revealed that a seen as endorsing their use", Tagliatelle(basic NHSprice£2.56 considered",saysaspokesperson sugar-free campaign in the north writesDrMackie. for250g);Loprofin hasbeen fortheDoH. relaunchedand includesSpirals, A report in GP magazine sug- Macaroni Penne,newLong gests these may include vaccina- Resistance the biggest issue Spaghetti (all 500g.£2.56)and tion campaigns repeated every Vermicelli (250g,£2.56).All four to six years; and a pre- productsareprescribable. school/school-age MMR or MR Doctors and pharmacists are Staphylococcus aureus was Nutricia DietaryProductsLtd.Tel: booster. In addition, changes to becoming increasingly concern- cited as the most commonly- 01225771801. Haemophilus influenzae type b ed about the threat ofantibiotic encountered pathogen in the vaccine supply are likely, once a resistance,iftheresultsofanew Bayer-supported survey, con- TB boost studyexaminingtheinterchange- studyareanythingtogoby. ducted after a series of work- ability of the two available vac- Asurveyof92hospitaldoctors shops on current aspectsofhos- The BritishLung Foundationhas cine brands is concluded; and and pharmacistsrevealed 90 per pital infection. Survey respon- beenawarded£90,000to improve alterations to the tuberculosis cent rated antibiotic resistance dentssaidtheyfrequentlyturned tuberculosisdiagnosis,the vaccinationprogramme. veryimportantintheselectionof to quinolones when first choice monitoringofresistantstrains Thechangeswillbeannounced an antibiotic, compared to only antibiotics, which were usually andthespreadofthedisease in in the new Immunisation Ag- 38 per cent whose primary con- betalactams or cephalosporins, the UK. ainstInfectiousDiseases. cernwascost. failed. 108 CHEMIST&DRUGGIST22JULY1995 Presenting Double Agent Eurax He. Mission: To locate and eliminate itching and inflammation caused by mild to moderate eczema, contact dermatitis and insect bites Weapons: Crotamiton to relieve itching, Hydrocortisone to reduce inflammation. Duration ofMission: Up to 10 hours. Status: The only combination steroidal product available OTC for eczema. Eurax He. Licence to Quell. ltn»HtlLlHUHf S PAM Of THS (IBtGROUP ACTIVE INGREDIENTS: Eurax HecontainsCrotamiton BP 10%and Hydrocortisone BP 25% Indications Reliefof inflammation and pruritusassociatedwith irritant contactdermatitis, allergiccontactdermatitis, insectbite reactions and mild to moderate eczema. DOSAGE AND ADMINISTRATION: Adults and children over 10 years: Apply sparingly over a small area twice a day for a maximum period of I week. Occlusive dressings should not be used Not recommended for children under 10 years Contra Indications Hypersensitivity to any component ofthe formulation. Bacterial, viral orfungal infectionsofthe skin Acute exudative dermatoses Application to ulcerated areas. Use on the eyes/face, ano-genital region, broken or infected skin includingcold sores,acne andathletesfoot Side-effects:Occasionallyatthesiteofapplication signsofirritation suchasaburningsensation, itching,contactdermatitis/contactallergymayoccur. Use in pregnancy andlactation: Useinpregnancyorlactationshould only beatthedoctorsdiscretion. LEGALCATEGORY P PRODUCT LICENCE NUMBER 0001/SOIOR DISTRIBUTOR Zyma Healthcare, Holmwood. RH54NU DATE Of PREPARATION April 1995 PRICE U59 COUNTERooints Cow & Gate enters non-foods You can counter on Nurofen CrookesHealthcareis introducinganew pharmacycounterunit. market with Breast Pad It featuresboth 12-and 24-packsofNurofenand NurofenPlusand Cow&Gatemarksits incorporatesanew debutinthebabycare, consumerleaflet, 'The non-foodsectorwiththe NurofenGuideto launchofBreast Pads ChoosingtheRight (30,£2.99). Painkiller',which Fortheretailer,the answersthemost brandoffersan commonquestionsposed approximate21percent onanalgesicselection Crookes HealthcareLtd. PORandeasymerchan- andpainmanagement. Tel:01159507431. dising;packscanbe shotraiczkoendtavlelrtyiocarlloyn,end. Selfcare fertility management Thelaunchshouldalso encourageearlyloyalty Selfcareisanewrangeof whichdeterminesthe totheC&Gbrand,the fertilitymanagement fertileperiodvia companysays. productsfrom Royce temperaturereadings Thebreastpads grabbing20percentof bya£2.69introductory Laboratories. (£114.95) market,currentlyworth salesafter 18months, priceoffer, Emma'sgift Thesix-strong •FloraClear,a £5millionatrsp,is withgroceryincreasing packsamplingand portfoliocomprises: screeningtestfor expectedtocontinueits its9.4percentsliceby leafletwithcoupon • FirstSignal bacterialvaginosis 15-pluspercentyearon poachingfromBoots. drop. pregnancytestkit,which (£8.95). yeargrowth. Cow& BreastPads'August 1 Cow&GateNutricia Ltd. givesareadingonthe Promotionaland Gateanticipates launchwillbesupported Tel:01225768381. firstdayofamissed educationalmaterialis period. Itisavailablein available, withback-up threeformats: atest fromacustomercare More impact First aid for offthe beaten track cassette,wheremineis helpline(9.00am-5.00pm, droppedintothesample MondaystoFridays). well(retail£6.95); and Allproductshavea for Senokot Anewfirstaidkitisnow packofsuturematerial, stick,whichiskept minimumPORof30per availablefortravellers one dripneedle,five undertheurineflow(one cent, andRoyce venturing offthebeaten steristrips,threemelolin test£7.95,two£10.45) Laboratoriesisoffering track. non-stickdressings,four •YourTimeovulation introductoryfreestock. TheTravel Mate(£8.84) injectionswabsand one predictorkit. Urineis Theproductswillbe fromSweeneycontainsa labelforblood notation. droppedintothetest availabledirectfrom widerange ofmedical SweeneyFirstAid cassettetodetermine Royceandwholesalers equipment:three Supplies.Tel:01926 whetherovulationwill fromSeptember.A syringes,tenneedles, one 426621. occurwithin24hours.A nationaladvertising five-testkitcosts£17.95 campaigncoincideswith Dramamine charity bonus offer • Bioself,amicro- thelaunch. computerconnectedtoa Royce LaboratoriesLtd. Reckitt&Colmanhas precisionthermometer, Tel:01427891911. repackageditsstimulant Anewdisplayouterfor NSPCCHappyTraveller laxAavtaiivlea,bSleenionktoatb.lets, aDvraailmaabmlienienapascpekcsiaisln1o4w AppTehael.bonuspackisonly J&J is spot on Wisdom's smile granulesandsyrup,the for12offer. availableduringthe updateincorporatesa Thepackisdesigned summerperiodand Johnson&Johnson is grows wider newlogoandstronger tobemoreconsumer- Searleisgivinga boosting itsClean&Clear coloursformoreon-shelf friendlyandgraphically donationtotheNSPCC rangewiththeadditionof Wisdomisspending£1.6 presence. communicatesthe foreverypacksold. three newproducts. milliononadvertisingthis Reckitt&Colman benefitsoftheproduct G D Searle&CoLtd.Tel: Invisible BlemishGel summer, includingaTV ProductsLtd.Tel:01482 whilesupportingthe 01494521124. (£3.29,20ml),available in campaignbackedupwith 326151. maximumstrengthand nationwideposterson sensitiveskinvariants, is four-and48-sheetsites. aspottreatment,while The30-andten-second DeepActionCleansing commercialsareonair SwissCleanhaslaunched Wash(£3.29,150ml)hasa nowandrununtiltheend an'Anti-germtravelkit' 'whipped cream'formula ofOctober. Itcomprisesfour fordeepcleansing. Theyfocuson products: adisinfectant Clean&Clearis Wisdom'slatesttooth- spray,wipes,soapand currentlybeingsupported brush, Contour,withthe watertablets. Itretailsat bya£1 million regionalTV theme, 'Wisdomwortha £19.95. campaignanda high- millionsmiles'andgiveit Displaymaterialis profilesupportpackage in an upbeatimage. available. theteenagepress. WisdomToothbrushes, Perma-JeuneLtd.Tel: Johnson&Johnson Ltd. DivisionofAddisLtd.Tel: 0171 5806900. Tel:01628822222. 01440714800. 110 CHEMIST&DRUGGIST22JULY1995

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