The Pharmaceutical Journal Vol 267 No 7170 p545-548
20 October 2001

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Prescribing

Pharmacists should start with prescribing Epipen

From Mr E. Muammar, MRPharmS

I was interested in the reported October Council meeting (PJ, 13 October, p531) concerning the arguments for pharmacist prescribing of nicotine replacement therapy (NRT). To put this in perspective, I would draw reader’s attention to the situation regarding the precribing status of Epipen adrenaline injection.

Earlier, I read in the Good Health section of the Daily Mail (9 October, p46) about a 39-year-old anaphylatic shock victim who died as a result of allergy to hair dye. I could imagine the tragic scenario of the victim gasping for breath at a high street salon, staff rushing to the nearest pharmacy for help, the reply: “sorry, you need a prescription.”

About two years ago, I recall watching a documentary on television about the treatment of anaphylatic shock. It favoured the self-administration of injectable adrenaline (Epipen) and gave the reassurance that if adrenaline is not needed the body will eliminate it since it is a natural body hormone.

Because community pharmacists are easily accessible to most people, crucial time could be saved if the pharmacist was allowed to prescribe Epipen (from the patient medication records). This would allow pharmacist prescribing to spearhead into a serious, life-saving therapy area, which would have more impact than starting with NRT or dressings — they could follow later.

I am afraid this might not be a viable proposition unless the pharmacist was adequately reimbursed because:

• It concerns a high priced, infrequently used item which must be on the shelf all year round.
• Consequently, it involves freezing outlay on a slow moving item.
• It would incur losses due to injections running out of date.
• It would require training, paperwork, etc.

Elias Muammar
Chandlers Ford,
Hampshire

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