Pharmacists advise on holiday essentials

68 Pages·2017·8.43 MB·English

IRELAND’S OFFICIAL PHARMACY PUBLICATION
JULY 2018
Pharmacists
advise on Review of the
holiday community
essentials pharmacy sector
PCRS: What
to expect when
they’re inspecting
EDUCATING FUTURE PHARMACISTS | JIM POWER | TWITTER
CHRISTMAS
2018
ORDER BEFORE JUNE 30TH!
Ensure to order from our exciting Christmas Range which
includes the popular everyday branded sets, plus some unique
new ranges for your pharmacy this Christmas.
Order Online at www.uniphar.ie or Contact our team [email protected]
*Please note there is no minimum order
JULY 2018
07 A Note from the Editor 26

IPU News
The latest news and events
from Butterfield House
8 Dates for your Diary
8 Pharmacy in the Media
10 Got everything you need?
Pictured at the launch of the IPU’s
Pharmacists advise on
Holiday Healthcare campaign are
holiday essentials
community pharmacist Ann-Marie
Horan with Zach and David Carroll. 12 Men’s Health Week 2018
The IPU Review is published
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pharmacists. The views expressed
by contributors are not those
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CHRISTMAS accepted for claims in articles
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14 PCRS: What to expect
Tel: [phone]
Fax: [phone]
when they’re inspecting
Email: [email protected]
Website: www.ipu.ie
ORDER BEFORE JUNE 30TH! Editor: Jack Shanahan MPSI
Editorial Associates: 18 Report of PSI Public Council
Siobhán Kane, Jim Curran
Meeting of 21 June 2018
and Ciara Browne
Advertising: Siobhán Kane
Email: [email protected]
Tel: [phone] Review of the Community
Pharmacy Sector
©2018
Ensure to order from our exciting Christmas Range which Copyright: All Rights Reserved,
Irish Pharmacy Union.
Printed by Ryson Colour Printers Ltd.
includes the popular everyday branded sets, plus some unique IPU Review is a Registered Trademark 26 Jim Power: Economic
of the Irish Pharmacy Union.
and financial update
new ranges for your pharmacy this Christmas.
30 Educating future pharmacists
– what has changed?
Order Online at www.uniphar.ie or Contact our team [email protected]
14
34 CPD: Don’t hesitate, vaccinate
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IPUREVIEW JULY 2018 3
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45
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50
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n
h ati
Nog w Atwimotrulvaatistons y o u r p a r t...
40 m for Y o u p l a y e d
i n g e t ti n g h i m h e r e
Trinomia is the 1st
polypill licensed
for secondary
prevention of
cardiovascular
events in Ireland
Trinomia 100 mg/20 mg/10 mg, 100 mg/20 mg/5 mg, 100 mg/20 mg/2.5 mg hard capsules (acetylsalicylic acid, atorvastatin (as atorvastatin calcium trihydrate) and ramipril) and Trinomia 100 mg/40
mg/10 mg, 100 mg/40 mg/5 mg, 100 mg/40 mg/2.5 mg hard capsules (acetylsalicylic acid, atorvastatin (as atorvastatin calcium trihydrate) and ramipril) Abbreviated Prescribing Information Please
consult the Summary of Product Characteristics (SmPC) for full prescribing information. Presentation: Hard capsules containing: two 50 mg acetylsalicylic film-coated tablets, two 10 mg atorvastatin film-coated
tablets and one 10 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 10 mg atorvastatin film-coated tablets and one 5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic
film-coated tablet, two 10 mg atorvastatin film-coated tablets and one 2.5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablets, two 20 mg atorvastatin film-coated tablets and one 10 mg
ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 20 mg atorvastatin film-coated tablets and one 5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 20
mg atorvastatin film-coated tablets and one 2.5 mg ramipril film-coated tablet. Uses: Secondary prevention of cardiovascular accidents as substitution therapy in adult patients adequately controlled with the
monocomponents given concomitantly at equivalent therapeutic doses Dosage: Oral administration. 1 capsule per day, preferably after a meal. Swallow with liquid. Do not chew or crush. Avoid grapefruit juice. Patients
currently controlled with equivalent therapeutic doses of acetylsalicylic acid, atorvastatin and ramipril can be directly switched. Treatment initiation should take place under medical supervision. Cardiovascular prevention,
target maintenance dose of Ramipril is 10 mg once daily. Daily dose in renal impairment based on creatinine clearance - ≥ 60 ml/min, maximum daily dose is 10 mg ramipril; 30-60 ml/min, maximum daily dose is
5 mg ramipril. Contraindicated in hemodialysis and/or with severe renal impairment (creatinine clearance <30 ml/min). Administer with caution with hepatic impairment. Perform liver function tests before initiation of
treatment and periodically thereafter. Maximum daily dose is 2.5 mg ramipril and initiate treatment under close medical supervision. Contraindicated in severe or active hepatic impairment. Start treatment in very old
and frail patients with caution. Contraindications: Hypersensitivity to any component, to other salicylates, to NSAIDs, to any other ACE inhibitors, tartrazine, soya or peanut. History of previous asthma attacks or other
allergic reactions to salicylic acid or other NSAIDs. Active, or history of recurrent peptic ulcer and/or gastric/intestinal haemorrhage, other kinds of bleeding. Haemophilia and other bleeding disorders. Severe kidney
and liver impairment. Hemodialysis. Severe heart failure. Concomitant treatment with methotrexate at a dosage of 15 mg or more per week. Concomitant use with aliskiren-containing products with diabetes mellitus
or renal impairment. Nasal polyps associated with ashma induced or exacerbated by acetylsalicylic acid. Active liver disease or unexplained persistent elevations of serum transaminases. Pregnancy, lactation and in
women of child-bearing potential not using appropriate contraceptive measures. Concomitant treatment with tipranavir, ritonavir, ciclosporin. History of angioedema. Extracorporeal treatments leading to contact of
blood with negatively charged surfaces. Significant bilateral renal artery stenosis or renal artery stenosis in a single functioning kidney. Hypotensive or haemodynamically unstable states. Children and adolescents
below 18 years of age. Warnings and Precautions: Only for use as a substitution therapy in patients adequately controlled with the monocomponents given concomitantly at equivalent therapeutic doses. Special
populations requiring particularly careful medical supervision: Hypersensitivity to other analgesics/antiinflammatory/antipyretic/antirheumatics or other allergens. Other known allergies, bronchial asthma, hay fever,
swollen nasal mucous membranes and other chronic respiratory diseases. History of gastric or enteric ulcers, or of gastrointestinal bleeding. Reduced liver and/or renal function. Particular risk of hypotension: strongly
activated renin-angiotensin-aldosterone system, transient or persistent heart failure post MI, risk of cardiac or cerebral ischemia, in case of acute hypotension medical supervision including blood pressure monitoring
is necessary. Deterioration of cardiovascular circulation. Glucose 6 phosphate dehydrogenase deficiency. Risk of elevated levels of uric acid. Consumption of substantial quantities of alcohol and/or have a history of
liver disease. Diagnosed pregnancy, stop treatment immediately, and, if appropriate, start alternative therapy. ACE inhibitors cause higher rate of angioedema in black patients than in non-black patients. The blood
pressure lowering effect of ACE inhibitors is somewhat less in black patients than non-black patients. Monitoring during treatment is required for: Concomitant treatment with NSAIDs, corticosteroids, SSRIs, antiplatelet
drugs, anticoagulants,ibuprofen. Signs or symptoms suggestive of liver injury. Stop treatment temporarily prior to elective major surgery and when any major medical or surgical condition occurs. Particularly careful
monitoring is required in patients with renal impairment, risk of impairment of renal function, particularly with congestive heart failure or after a renal transplant. Risk of development of hyperkalaemia – regular
monitoring of serum potassium recommended. Specific side-effects: Perform liver function tests before use and monitor periodically and with liver injury or increased transaminase levels. Use with caution with
substantial alcohol use or history of liver disease. Potential risk of hemorrhagic stroke. May affect the skeletal muscle and cause myalgia, myositis, and myopathy that may progress to rhabdomyolysis, ask patients to
promptly report skeletal muscle effects (muscle pains, cramps or weakness) especially if accompanied by malasie or fever and measure CK levels, stop treatment if significantly elevated or if severe muscular symptoms
occur. Prescribe with caution in patients with pre-disposing factors for rhabdomyolysis. Benefit/risk of treatment should be considered and clinical monitoring recommended. Do not measure CK following strenuous
exercise or in presence of plausible alternative cause of CK increase. If CK levels significantly elevated at baseline, re-measure levels 5 to 7 days later to confirm the results. Risk of rhabdomyolsis with use of potent
CYP3A4 inhibitors, transport proteins or HIV protease inhibitors. Consider alternative treatments if risk of myopathy. Consider lower starting or maximum dose and appropriate clinical monitoring with potent CYP3A4
inhibitors and medicinal products that increase the plasma concentration of atorvastatin respectively. Do not co-administer with systemic fusidic acid or within 7 days of stopping fusidic acid. Where use of systemic
fusidic acid considered essential, discontinue statin treatment during fusidic acid treatment. Reports of rhabdomyolysis in patients receiving fusidic acid and statins in combination. Where prolonged systemic fusidic
acid needed, consider need for co-administration of Trinomia and fusidic acid on case by case basis with close medical supervision. Discontinue statin treatment if interstitial lung disease occurs. Monitor patients at
risk of diabetes mellitus. Discontinue treatment if angioedema occurs and initiate emergency treatment promptly. Concomitant use of ACE-inhibitors and angiotensin II receptor blockers or aliskiren is not recommended
and should not be used in patients with diabetic nephropathy. Anaphylactic reactions during desensitization, consider temporary discontinuation of Trinomia during desensitization. Monitor white blood cells for
neutropenia/agranulocytosis and more regularly in the initial phase of treatment, impaired renal function, concomitant collagen disease and other mediciens that can change the blood picture. Cough. Contains lactose.
Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Interactions: Acetylsalicylic acid: other platelet aggregation
inhibitors, other NSAIDs,and antirheumatics, systemic glucocorticoids, diuretics, alcohol, SSRIs, uricosuric agents, anticoagulant and thrombolytic therapy, digoxin, antidiabetic agents including insulin, methotrexate,
valproic acid, antacids, ACE inhibitors, ciclosporin, vancomycin, interferon ∝, lithium, barbiturates, zidovudine, phenytoin, laboratory tests. Atorvastatin: CYP3A4 inhibitors, CYP3A4 inducers, transport protein inhibitors,
gemfibrozil/fibric acid derivatives, ezetimibe, colestipol, fusidic acid, colchicine, digoxin, oral contraceptives, warfarin. Ramipril: potassium salts, heparin, potassium-retaining diuretics and other plasma potassium
increasing active substances, antihypertensive agents and other substances that may decrease blood pressure, vasopressor sympathomimetics and other substances, allopurinol, immunosuppressants, corticosteroids,
procainamide, cytostatics and other substances that may change the blood cell count, lithium salts, antidiabetic agents including insulin. Monitor as appropriate. Consider lower maximum dose of atorvastatin with
potent CYP3A4 inhibitors. Pregnancy and Lactation: Contraindicated in pregnancy and breast-feeding. Women of child-bearing potential should use effective contraception during treatment. Side Effects: Ramipril:
Common (≥ 1/100, <1/10): dyspepsia, nausea, diarrhoea, vomiting, digestive disturbances, abdominal discomfort, gastrointestinal inflammation, non-productive tickling cough, bronchitis, sinusitis, dyspnoea, headache,
dizziness, rash in particular maculo-papular, blood potassium increased, myalgia, muscle spasms, chest pain, fatigue, hypotension, orthostatic blood pressure decreased, syncope. Atorvastatin: Common: dyspepsia,
nausea, diarrhoea, constipation, flatulence, pharyngolaryngeal pain, epistaxis, nasopharyngitis, headache, allergic reactions, hyperglycaemia, myalgia, muscle spasms, pain in extremity, joint swelling, back pain,
arthralgia, liver function test abnormal, blood creatine kinase increased. ASA: Very Common (≥ 1/10): Gastrointestinal complaints such as heartburn, nausea, vomiting, stomach ache and diarrhea, minor blood loss
from the gastrointestinal tract (micro-bleeding). Common: Paroxysmal bronchospasm, serious dyspnoea, rhinitis, nasal congestion. For less frequent side effects see SmPC. Pack Sizes: Blister containing 28 hard
capsules. Legal Category: POM. Product Authorisation Numbers: PA 1744/002/001-006 Product Authorisation Holder: Ferrer Internacional, S.A., Gran Vía Carlos III, 94, 08028 Barcelona, Spain. Marketed by: A.
Menarini Pharmaceuticals Ireland Ltd. Further information is available on request from A. Menarini Pharmaceuticals Ireland Ltd, 2nd Floor, Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin A96 T924
or may be found in the SmPC. Date of Preparation: April 2018
Date of Item: May 2018 IR-TRI-06-2018
n
h ati
Nog w Atwimotrulvaatistons y o u r p a r t... A NOTE FROM THE EDITOR Jack Shanahan MPSI
40 m for Y o u p l a y e d Are eprescriptions the
i n g e t ti n g h i m h e r e answer to all problems?
Are pharmacists robots? Do pharmacists have autonomy?
Are pharmacists subservient? In a response eerily reminiscent
of Margaret Thatcher: no, no, no. Rhetorical questions are not
meant to be answered, yet there are moments when I wonder.
Trinomia is the 1st Maybe the better question is, ‘discuss’?
polypill licensed
for secondary
am drawn to these parchment and quill. If I see point is that the vast majority care. On both sides of the
prevention of I
matters because, finally, once again that electronic of modern prescriptions, prescription journey there is
cardiovascular it looks like eprescribing prescriptions will reduce error generated on computers, are an obligation to look after the
is gaining real traction. due to poor handwriting, I will crystal clear. Sometimes they best interests of the patient.
events in Ireland
Much of the discussion have a conniption. There is a just happen to be wrong. Assuming you accept
around implementation common misconception that This segues neatly into the this simple paradigm,
risks placing pharmacists pharmacists spend a large most pervasive myth about then everything else flows
in a functional, rather than portion of their day, peering eprescriptions: the contention from this. You enable all
professional, role. The beauty over their half-moon glasses, that they somehow, magically, professionals with the best,
of introducing a new system is squinting at picassoesque make prescriptions more most reliable information
its potential. It could enhance squiggles, intermittently accurate or simply safer. This that is currently available.
patient safety, and care, by having an ‘ah ha’ moment. is simply untrue. Assertion Eventually prescribers will
fully utilising the pharmacist’s To most of us working in is not evidence. One country have systems that that can
professional expertise. Or it community pharmacy, the claimed that eprescribing genuinely leverage current
could simply replace a working era of handwriting is drawing reduced prescription errors by best practice. Systems that
system with an electronic to a dignified close. It is rare up to 15% (Sweden), on scant will actually look at the
replica, with no extra benefits. to see a fully handwritten evidence. Other countries patient and, using an ‘expert
Before I continue, I should prescription. The integrated reckon that there was no system’, make actual drug
put my cards on the table. discharge system in many change as, while some error and dosage recommendations,
I have been a member of a public hospitals has seen the types disappeared, new classes based on both history and
HIQA consultative body, the dawn of printed prescriptions of errors took their place. current biomedical values.
electronic standards advisory for inpatients on their ePrescriptions, as currently These AI systems are a long
Trinomia 100 mg/20 mg/10 mg, 100 mg/20 mg/5 mg, 100 mg/20 mg/2.5 mg hard capsules (acetylsalicylic acid, atorvastatin (as atorvastatin calcium trihydrate) and ramipril) and Trinomia 100 mg/40 group (eSAG), for several years. way home. Much of this is envisioned, simply mean that way from being market ready.
mg/10 mg, 100 mg/40 mg/5 mg, 100 mg/40 mg/2.5 mg hard capsules (acetylsalicylic acid, atorvastatin (as atorvastatin calcium trihydrate) and ramipril) Abbreviated Prescribing Information Please Our remit, as a varied group process driven, facilitated poorly written prescriptions The best diagnostician is a
consult the Summary of Product Characteristics (SmPC) for full prescribing information. Presentation: Hard capsules containing: two 50 mg acetylsalicylic film-coated tablets, two 10 mg atorvastatin film-coated
tablets and one 10 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 10 mg atorvastatin film-coated tablets and one 5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic of health professionals, is to by computerised practice will get distributed more doctor. The best medicines
film-coated tablet, two 10 mg atorvastatin film-coated tablets and one 2.5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablets, two 20 mg atorvastatin film-coated tablets and one 10 mg
ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 20 mg atorvastatin film-coated tablets and one 5 mg ramipril film-coated tablet; or two 50 mg acetylsalicylic film-coated tablet, two 20 advise on various standards management systems. Many speedily. At a fundamental expert is a pharmacist. The
mg atorvastatin film-coated tablets and one 2.5 mg ramipril film-coated tablet. Uses: Secondary prevention of cardiovascular accidents as substitution therapy in adult patients adequately controlled with the in the electronic storage GMS prescriptions are printed level, it means that if a eprescription system that
monocomponents given concomitantly at equivalent therapeutic doses Dosage: Oral administration. 1 capsule per day, preferably after a meal. Swallow with liquid. Do not chew or crush. Avoid grapefruit juice. Patients
currently controlled with equivalent therapeutic doses of acetylsalicylic acid, atorvastatin and ramipril can be directly switched. Treatment initiation should take place under medical supervision. Cardiovascular prevention, and transmission of health repeats that are generated prescriber mistakenly writes recognises, and facilitates,
target maintenance dose of Ramipril is 10 mg once daily. Daily dose in renal impairment based on creatinine clearance - ≥ 60 ml/min, maximum daily dose is 10 mg ramipril; 30-60 ml/min, maximum daily dose is and related information. by the practice secretaries. azathioprine rather than this will be world class.
5 mg ramipril. Contraindicated in hemodialysis and/or with severe renal impairment (creatinine clearance <30 ml/min). Administer with caution with hepatic impairment. Perform liver function tests before initiation of
treatment and periodically thereafter. Maximum daily dose is 2.5 mg ramipril and initiate treatment under close medical supervision. Contraindicated in severe or active hepatic impairment. Start treatment in very old The development and This works by the prescriber azithromycin, it is unlikely
aanlledr gfriaci lr peaactiteionntss wtoit hsa cliacuytliioc na. cCido notrr oatihnedri cNaStiAoIDnss:. HAycptievres,e onrs hitiivsittoyr yto o af nrye ccuormrepnot npeenptt, icto u olctheer ra snadli/coyrl agtaesst,r itco/ iNnSteAsItDinsa, lt oh aaenmy ootrhrhear gAeC, Eo tinhheirb kitionrdss, toafr tbrlaezeindein, gs.o Hyaa eomr poepahniliuat .a nHdis otothrye ro fb plereedviionugs d aissothrdmears a. tStaecvkesre o kr iodtnheeyr implementation of standards flagging medicines as routine, that any prescribing system
and liver impairment. Hemodialysis. Severe heart failure. Concomitant treatment with methotrexate at a dosage of 15 mg or more per week. Concomitant use with aliskiren-containing products with diabetes mellitus should, over time, create which is code for repeatable. will pick this up. An alert
or renal impairment. Nasal polyps associated with ashma induced or exacerbated by acetylsalicylic acid. Active liver disease or unexplained persistent elevations of serum transaminases. Pregnancy, lactation and in
women of child-bearing potential not using appropriate contraceptive measures. Concomitant treatment with tipranavir, ritonavir, ciclosporin. History of angioedema. Extracorporeal treatments leading to contact of a stable environment for These defined medicines are pharmacist will.
blood with negatively charged surfaces. Significant bilateral renal artery stenosis or renal artery stenosis in a single functioning kidney. Hypotensive or haemodynamically unstable states. Children and adolescents interoperability. The net printed onto prescription This really gets to the core
below 18 years of age. Warnings and Precautions: Only for use as a substitution therapy in patients adequately controlled with the monocomponents given concomitantly at equivalent therapeutic doses. Special
populations requiring particularly careful medical supervision: Hypersensitivity to other analgesics/antiinflammatory/antipyretic/antirheumatics or other allergens. Other known allergies, bronchial asthma, hay fever, result would be improved forms, for review and of what prescriptions are all
swollen nasal mucous membranes and other chronic respiratory diseases. History of gastric or enteric ulcers, or of gastrointestinal bleeding. Reduced liver and/or renal function. Particular risk of hypotension: strongly health outcomes. signature by the prescriber. about. Some people think that
activated renin-angiotensin-aldosterone system, transient or persistent heart failure post MI, risk of cardiac or cerebral ischemia, in case of acute hypotension medical supervision including blood pressure monitoring
is necessary. Deterioration of cardiovascular circulation. Glucose 6 phosphate dehydrogenase deficiency. Risk of elevated levels of uric acid. Consumption of substantial quantities of alcohol and/or have a history of Perhaps I am a simple Often this is in response to the they are orders. Some think
liver disease. Diagnosed pregnancy, stop treatment immediately, and, if appropriate, start alternative therapy. ACE inhibitors cause higher rate of angioedema in black patients than in non-black patients. The blood
pressure lowering effect of ACE inhibitors is somewhat less in black patients than non-black patients. Monitoring during treatment is required for: Concomitant treatment with NSAIDs, corticosteroids, SSRIs, antiplatelet contrarian, but what patient filling in a ‘prescription that they are permissions
drugs, anticoagulants,ibuprofen. Signs or symptoms suggestive of liver injury. Stop treatment temporarily prior to elective major surgery and when any major medical or surgical condition occurs. Particularly careful particularly got my gander request form’. This is akin to supply. Yet the former is
monitoring is required in patients with renal impairment, risk of impairment of renal function, particularly with congestive heart failure or after a renal transplant. Risk of development of hyperkalaemia – regular
monitoring of serum potassium recommended. Specific side-effects: Perform liver function tests before use and monitor periodically and with liver injury or increased transaminase levels. Use with caution with up has been the repetition to a medicines shopping list, plainly wrong and the latter
substantial alcohol use or history of liver disease. Potential risk of hemorrhagic stroke. May affect the skeletal muscle and cause myalgia, myositis, and myopathy that may progress to rhabdomyolysis, ask patients to of the so-called advantages replete with checkboxes, which is only a part of the picture.
promptly report skeletal muscle effects (muscle pains, cramps or weakness) especially if accompanied by malasie or fever and measure CK levels, stop treatment if significantly elevated or if severe muscular symptoms
occur. Prescribe with caution in patients with pre-disposing factors for rhabdomyolysis. Benefit/risk of treatment should be considered and clinical monitoring recommended. Do not measure CK following strenuous of electronic prescriptions. A is provided to the patient by Prescriptions are clinical
eCxYePr3cAis4e ionrh iinb itporress, etnracnes opfo prtl apursoitbelien sa loter rHnIaVt ipvreo cteaaussee ionfh CibKit oinrsc.r eCaosnes. idIfe Cr Ka llteevrenlast isvieg ntrifiecaatmntelyn tesl eifv aritsekd oaft mbaysoeplainthey, .r Ce-omnseiadseur rleo wleevre lsst a5r ttion g7 odra mysa lxaimteur mto dcoosnefi ramn dth aep rpersouplrtisa.t eR icslkin oicf arlh mabodnoitmoryionlgs iws iwthit hp outseen to Cf YpPo3teAn4t specific sentence, “eprescribing the prescribing practice. The care documents. They are
inhibitors and medicinal products that increase the plasma concentration of atorvastatin respectively. Do not co-administer with systemic fusidic acid or within 7 days of stopping fusidic acid. Where use of systemic can improve patient safety system isn’t perfect. It is quite produced by professionals,
fusidic acid considered essential, discontinue statin treatment during fusidic acid treatment. Reports of rhabdomyolysis in patients receiving fusidic acid and statins in combination. Where prolonged systemic fusidic
acid needed, consider need for co-administration of Trinomia and fusidic acid on case by case basis with close medical supervision. Discontinue statin treatment if interstitial lung disease occurs. Monitor patients at considerably by reducing common to have written who exercise their expertise
risk of diabetes mellitus. Discontinue treatment if angioedema occurs and initiate emergency treatment promptly. Concomitant use of ACE-inhibitors and angiotensin II receptor blockers or aliskiren is not recommended errors in mistaken identity, additions or alterations on and judgement to decide what
and should not be used in patients with diabetic nephropathy. Anaphylactic reactions during desensitization, consider temporary discontinuation of Trinomia during desensitization. Monitor white blood cells for
neutropenia/agranulocytosis and more regularly in the initial phase of treatment, impaired renal function, concomitant collagen disease and other mediciens that can change the blood picture. Cough. Contains lactose. incorrect dosage, incorrect computer generated forms. is best for the subject of care.
Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Interactions: Acetylsalicylic acid: other platelet aggregation medication, adverse drug It is not unusual to discover They are received by other
inhibitors, other NSAIDs,and antirheumatics, systemic glucocorticoids, diuretics, alcohol, SSRIs, uricosuric agents, anticoagulant and thrombolytic therapy, digoxin, antidiabetic agents including insulin, methotrexate,
valproic acid, antacids, ACE inhibitors, ciclosporin, vancomycin, interferon ∝, lithium, barbiturates, zidovudine, phenytoin, laboratory tests. Atorvastatin: CYP3A4 inhibitors, CYP3A4 inducers, transport protein inhibitors, reactions and so on”. Really? that these additions are not professionals, who take the
ignecmrefiabsrionzgi la/ficbtirviec saucbids tdaenrcievas,t iavnetsih, yepzeetritmenibseiv,e c aogleesnttips oaln, dfu ostihdeicr saucbids,t acnoclcehsi ctihnaet, mdiagyo dxienc, roeraasle c bolnotorda cperpetsisvuesre, ,w vaasrfoaprirne.s Rsoarm siypmrilp: aptohtoamssimiuemti cssa latsn,d h oetphaerri nsu, bpsottaanscseiusm, a-lrleotpauinriinnogl , dimiumreutincos saunpdp roetshsearn ptsla, scmorati cpoosttaesrsoiiudms, Many of these presuppose recorded on the prescriber’s document and ensure that
procainamide, cytostatics and other substances that may change the blood cell count, lithium salts, antidiabetic agents including insulin. Monitor as appropriate. Consider lower maximum dose of atorvastatin with that we still live in an era of system. Nevertheless, the the patient gets the optimal
potent CYP3A4 inhibitors. Pregnancy and Lactation: Contraindicated in pregnancy and breast-feeding. Women of child-bearing potential should use effective contraception during treatment. Side Effects: Ramipril:
Common (≥ 1/100, <1/10): dyspepsia, nausea, diarrhoea, vomiting, digestive disturbances, abdominal discomfort, gastrointestinal inflammation, non-productive tickling cough, bronchitis, sinusitis, dyspnoea, headache,
dizziness, rash in particular maculo-papular, blood potassium increased, myalgia, muscle spasms, chest pain, fatigue, hypotension, orthostatic blood pressure decreased, syncope. Atorvastatin: Common: dyspepsia,
nausea, diarrhoea, constipation, flatulence, pharyngolaryngeal pain, epistaxis, nasopharyngitis, headache, allergic reactions, hyperglycaemia, myalgia, muscle spasms, pain in extremity, joint swelling, back pain, If you have any comments, queries or issues to raise, send
arthralgia, liver function test abnormal, blood creatine kinase increased. ASA: Very Common (≥ 1/10): Gastrointestinal complaints such as heartburn, nausea, vomiting, stomach ache and diarrhea, minor blood loss
from the gastrointestinal tract (micro-bleeding). Common: Paroxysmal bronchospasm, serious dyspnoea, rhinitis, nasal congestion. For less frequent side effects see SmPC. Pack Sizes: Blister containing 28 hard your “Letters to the Editor” by email to [email protected].
capsules. Legal Category: POM. Product Authorisation Numbers: PA 1744/002/001-006 Product Authorisation Holder: Ferrer Internacional, S.A., Gran Vía Carlos III, 94, 08028 Barcelona, Spain. Marketed by: A.
Menarini Pharmaceuticals Ireland Ltd. Further information is available on request from A. Menarini Pharmaceuticals Ireland Ltd, 2nd Floor, Castlecourt, Monkstown Farm, Monkstown, Glenageary, Co. Dublin A96 T924
or may be found in the SmPC. Date of Preparation: April 2018
IPUREVIEW JULY 2018 7
Date of Item: May 2018 IR-TRI-06-2018
NEW
Pharmacy in
the Media
THEY’RE COMING...
Ahead of World No Tobacco Day, the IPU issued a press
release calling on the Minister for Health to make
Nicotine Replacement Therapy (NRT) available to
medical card holders. IPU Executive Committee member
Caitriona O’Riordan was interviewed on KFM, Limerick’s
Live 95 FM and Highland Radio, and there was also
media coverage in the Irish Sun and in TheJournal.ie.
A press release was also issued to advise students and
parents on how to deal with exam stress. IPU Executive
Committee member Elaine Clarke said, “While it is
normal for everyone to feel a little nervous before these
big exams, it is important to prevent stress taking hold.”
There was coverage in the Irish Daily Mirror.
We also issued a press release promoting our Going
on Holiday... Think Pharmacy campaign, advising people
of the holiday essentials they need before going on
holidays. There was coverage on Joe.ie, RSVPlive.ie and
in the Southern Star. IPU Executive Committee member
Dates for ALinvne 9M5aFrMie. Horan was also interviewed on Limerick’s
your Diar y thDe aIrrirsahg Ihn dOe’pLeonudgehnlti, nw whiacsh q audodtreeds sine da nG Pasr thicalvei ning a
conscientious objection to providing medical abortions,
but being ethically obliged to refer the woman to a
doctor who will provide the service. Darragh called for
J2U8 JLuYly 2018 Wwworwld.w Hoerpldahtietpisa Dtiatiys, pttohh adatri smspuaeccnhis spitnrsog tv oai sbaiolosrnotis oh bnae vp eei xlalts ec anondndes dcsi aetiond ta, i“lolIu th sies oa ebltsjhseeccnatirtoeina l TOGETHER
day.org professionals, including pharmacists, and not only to
medical practitioners in order to ensure that individual
practitioners would not be compelled to participate in
AUGUST 2018 a procedure to which they have fundamental religious
1 – 7 August WWoerelkd, Bwrweaws.twfeoerdldin g opre re tthhiec acol dobe joefc tcioonnds”u. cHt,e i na lssuoc whe cnirtc ounm tsot asnayc etsh,a tth, ea s
breastfeedingweek.org patient would then be directed to a pharmacist who will
provide the service. This piece was also covered in the
27 August ITPeUc hPnhiacrimana Ccyo urse HeIrPaUld P nreewsidspeanpt eDr.aragh Connolly was quoted in the Irish
Year 1 begins, Daily Mail for an article, which highlighted the overuse
www.ipu.ie of antibiotics.
We issued a press release to promote Men’s Health
Week (11 June – 17 June) and advised men to start
addressing their health issues. There was national media
coverage in the Irish Examiner, Irish Daily Mirror and the
Athlone Advertiser. Daragh Connolly was also interviewed
on Newstalk’s The Hard Shoulder with Ivan Yates.
IN YOUR PHARMACY SOON
Date prepared: March 2018. 2018/ADV/EAS/007
8 IPUREVIEW JULY 2018
Teaser advert HR.indd 1 11/06/2018 16:36
NEW
THEY’RE COMING...
TOGETHER
IN YOUR PHARMACY SOON
Date prepared: March 2018. 2018/ADV/EAS/007
Teaser advert HR.indd 1 11/06/2018 16:36
IPU NEWS
Got everything you need?
Pharmacists advise on
Now easier Improved
than ever to search
holiday essentials
order functionality
Access to Stock
latest stock Indicators
It’s easy to get caught up in the flurry of holiday packing and n Mixing alcohol and the sun: Be careful when drinking
to forget the important things; so the IPU launched a public alcohol in hot weather as it can cause dehydration. information
campaign with a checklist of holiday essentials to remind Avoid swimming or engaging in sporting activities
holiday-makers that their local community pharmacist can if you have taken alcohol.
provide the checklist, the products, and the advice they need for
n Stomach upsets: If barbequing or eating foods you are Up-to-date Notifi cations
a worry-free summer holiday.
Speaking about preparing for trips abroad, Ann-Marie Horan, not used to, make sure the food is fully cooked all the way news
through and always keep cooked food separate from raw
a pharmacist and member of the IPU Executive committee said,
food. This will help avoid food poisoning. If you do suffer
“The days before departing for a holiday can be very hectic.
diarrhoea, drink plenty of water to avoid dehydration.
That is why we have published this handy checklist so nothing
Ask your pharmacist for advice on which non-prescription
important gets left behind.”
medicines you can bring with you on holidays so you can
Ms Horan said the most important thing to remember is your
treat the condition immediately.
essential medicines: “You should bring at least enough for the
duration of your trip, and always bring a copy of your prescription n Insect bites: Bring insect repellent to protect from insect
in case you need something while away. Be aware of the storage bites. If you get bitten, wash the area with soap and water,
Our new and improved
conditions of your medications, some will need to be refrigerated. and apply a cool compress or calamine lotion to help cool
Discuss this with your pharmacist who will advise you how best down the affected area. Finally, apply some antiseptic
to transport and store these medications.” cream to avoid infection. If you suffer a severe allergic
Ms Horan provided the following tips for a safe and enjoyable reaction to a bite, seek medical assistance immediately.
UDW Website, now with
holiday:
n Medication: Make sure to bring an adequate supply of
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delayed or goes missing.
n Sun: In warmer climates, stay
out of the sun between 11.00am
and 3.00pm. Protect yourself
with a high sun protection factor
(SPF) with UVA protection, along
n wAceShsupiptinplhedlb cyrauie a arhnl nlca ya:ot n,Iam fsdf yutp eronlereug ats lepgwa epssitlsmu yesn smuf r bnaeilnbnqougduc.r ketn n-ts,o thsl yti,ar ty. G o t feovre ryyotuhri nhgo lyi doauy n?e e d
out of the sun for a few days until
the sunburn dies down. Drink
plenty of water. Ask your pharmacist q Rehydration salts
about appropriate creams and
pbraiinngk idlloewrsn t ao treemliepveer saytumrpe.t oSmevse raen d q Sunscreen (body/face/lips) q Medicine for constipation To access the UDW website select You can now access and move within
cbausrens corfe asumn baunrdn b murany drreeqsusiirneg ssp. Aecsika l q Aftersun q Medicine for indigestion register now on www.udw.ie UwDithW o, neele sminegnltes ,s iogsnto omny and PLC sites
yhoauver psehvaerrme ascuinstb fuorrn a wdvitihc eh. eIfa ydoauch es, q Sunglasses q Plasters and antiseptic
nausea, vomiting or dizziness, see a GP.
q Insect repellent q Hand sanitiser
q Insect bite treatment q Cleansing wipes
q Pain relief medicine q Flight socks
q Antihistamines q Travel size toiletries For further information please contact
q Travel sickness medicine q Travel plugs [email protected]
10 q Medicine for diarrhoea IPUREVIEW JULY 2018
If yyoouu ttoa kceo vperre sycoruiprt hioonli dmyaeoyRdu. irIEct pa MmrteioaIsNnyc ,rb DimpeEt auioRksnee fstuoulor te.o y hoauv be rain pgh eontooucogphy w oitfh 15943 UD New Website Press ad_A4.indd 2 18/05/2018 14:06