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Sunday, June 21, 2015

Pharmacy Community Posting (3/6)

Continuation for Week 3 Community Posting in Pharmacy Shop

        Activities for this week are calling the customers, continuing stock check,  reading prescription and help dispensing, learn about setting the price for the product, presence of halal certificate for the bovine capsule, doing blood glucose test to the customer, and lastly learning about computerized system.

        Initially at the beginning of the pharmacy, they only use manual system to store the information, for example the amount of product. The drawbacks of manual system are we cannot know the actual progress of selling the product, the exact quantity of products, and if there is any missing item because of pilferage. After some time, the pharmacy manage to have the computerized system. The system is able to manage the stock and data which is more efficient, effective, and easy. Together with the system, there are also maintenance fee required to be paid every year, but if the pharmacy do not pay, they will be charged at a higher rate each time if call for a help.

        Setting a product price have many ways to do. Usually if the products have the recommended selling price (RSP), the pharmacy will just follow the RSP. For the imported product which are usually more expensive, the mark-up margin is usually only around 5%. For normal product (other than imported product and RSP product), the margin price usually mark-up around 10-20%. Mark up price is important especially when the customers requested for a discount. The poison item usually don’t have RSP. According to the pharmacist, previously the price war doesn’t feel the impact so much. There are customers who come and compare the price of the product in the pharmacy with the other shop and even ask why the price is high compared to certain shop.

        Regarding my activity this week, I’m required to call the customers to remind about the blood test this weekend. Even though a bit nervous, but I know that I just don’t need to think too much and just prepare what I should talk. It is very simple which only require me to begin with an introduction that I’m from the ABC pharmacy and is it Mr/Ms ABC. Then proceed to remind them about the blood test this Saturday, and don’t forget to fast  before coming and only allowed to drink plain water only. From what I notice, when I speak at a faster speed, they couldn’t listen properly and this required me to repeat again. So after that, I talk at more slower speed. Some of the customer prefer to talk in English and then I reply in English. There are some of the customer which I need to repeat around 2-3 times because she keeps asking whether can she eat this and that. Around 10 calls has been made which can makes me overcome nervousness if I need to call anybody after this.

        Another activity done this week is continuing stock check until finished. From my opinion, this activity is a very good way to recognize, memorize the name, nature, and the location of the item since I need think/guess first what is actually the product looks-like, what is the possible indication/uses in order to be able to find the location of the item (since the arrangement of product in the pharmacy is according to indication/uses). When the process of searching begin and I found the product, it will stick into my mind longer and stronger.

        Next activity is reading prescription. An India female customer present with a government prescription. First I wonder why she choose to buy medication and not taking from the government pharmacy. Then the pharmacist told me that it is a new policy that the foreigner cannot take medication for free if it exceed more than 1 week supply. So, the foreigner need to buy the medication by themselves. According to the prescription, she is diagnosed having upper respiratory tract infection (URTI) and hyperactive airway disease and was prescribed 30mg prednisolone. The highest dose available at the pharmacy is only 5mg/tab. So again, I’m bit surprised about the dose because I think it is too high. But when I ask the pharmacist, she explained that there are patient who requires such high dose whereby the patient require to take 6 tablet at one time. The prescription is then return back to the customer since the customer want to keep it. However, since the pharmacist is not available at that time, the sales assistant only give 1 strip to the customer which I think the customer may not have enough dose to manage her disease.

        Other activity done is doing a blood glucose test to the customer. This is my first time doing to the customer. So I’m bit slow and nervous of course. When I want to prick the finger of the patient, I forgot to pressed the patient’s finger first. Then the patient pressed it by himself and then I do the pricking and the rest until finished. Doing blood glucose test is more easier rather than cholesterol/lipid test because we require more blood and so require to press the finger more.

        There are one patient coming with wound at the upper limb and told that he just having motorcycle accident. The customer requested to buy for dressing his wound which are gauze, cotton ball, iodine solution, and self-adhesive bandage. Actually there are many types of plasters and bandages available which can be choose according to the customer’s preference. Dressing can also be sterile or non-sterile type. Bandage also have the self-adhesive or non-adhesive type.

        New information this week is about the label “Available through Doctors Only” at the Gaviscon Advance bottle. However, the Gaviscon company also sell those items to the retail pharmacy. The pharmacist also told that there are also some other product which are being sold in special type of package for pharmacy and special type for doctor. There are also more bonuses given to the doctor than for the pharmacy when buying products from certain company. For example, if the doctor buy 50 boxes, they will get free 50 boxes. However, if the pharmacist buy the product, they will only get free 20 boxes. This practice is actually not good since the pharmacist is the one expert and responsible about the drug.

        Another thing is about Progynova which is having estrogen as its pharmaceutical ingredients, used for hormone replacement therapy (HRT) and usually given for menopausal women. However, if estrogen is combine with progesterone, it is categorized as oral contraceptive pills (OCP). The price different between the government OCP with the other OCP is very large which is around the range of RM30. Type of OCP available are mini-pills (progesterone only pill) and combination of pills (combination progesterone and estrogen).

        Regarding the Halal certificate, there are customer who want to buy Ginsana but the product cover do not have any Halal logo. So, the customer has asked whether the product can be eaten by Muslim. From my knowledge, any herbal preparation/drinks are consider Halal and only porcine capsule that is not Halal. Since the pharmacist also not sure about that, she called the sales rep of the Ginsana to ask about the Halal certificate of the product. From this observation of this situation, I just realized that Halal certificate is also required for the bovine capsule. Below is the example of Halal certificate.

        Last thing is story observation about the customers. There are customer who want medication for his child daughter, age around 5+ years old because of rash present with seeds (biji-biji) & (kudis). So the pharmacist give Vizomet which contain Mometasone which is more safer to the child. Another customer requested for oral medication for itchiness, Cetirizine will be dispensed. Rasitol is dispensed for people request to remove excess fluid in the body by increase urination while Domper (domperidone) is being dispensed to customer who request medication to remove air from the body. One customer requested for statin drug but then he complaint that her mother having muscle weakness. The side effect of the statin drug  is muscle weakness. So the pharmacist has recommended the customer to inform the doctor about those symptom.

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