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· Methadone dispensing
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Letters to the Editor
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CD prescribing
No confusion
From Mr T. P. House, MRPharmS
I was interested in the letter from Nicholas
Aling (PJ, 2 December,
p665) in which he was explaining his problems with a prescriber who insisted
on prescribing methadone mixture in milligrams instead of millilitres.
I have had experience of similar situations with other Controlled Drugs,
and have even been almost accused of headbutting a surgeon over a quantity
of another CD.
We all know that the prescriber has to specify the quantity, and the
law states precisely (and the BNF includes this) that it is the quantity
of the preparation. So if 490mg of methadone mixture 1mg/1ml is prescribed,
it legally means 490mg of the mixture, so you take your smallest bottle
and weigh into it 490mg of liquid. There is no mention anywhere of being
allowed to prescribe in terms of active ingredient.
There can be no confusion either over the strength of methadone mixture
to be dispensed; the BNF states that the title of the DTF formula (which
is the only preparation that could possibly not have a strength specified)
includes 1mg/ml in the title.
Tim House
Haverhill, Suffolk
Unnecessary box-ticking undermines the profession
From Mr J. E. Turnbull, MRPharmS
Why do we waste our time pandering to unwarranted bureaucracy? I was angered
by the letter from Nicholas
Aling (PJ, 2 December, p665) asking for clarification
on whether prescriptions for Controlled Drugs in liquid form should be
written in milligrams or millilitres. I was not angered by the letter itself
but by the fact the question had to be asked in the first place.
The doctor, who had written that prescription for 490mg of methadone mixture
1mg/ml (sugar free), had his reasons for writing it in mg. Most pharmacists
would surely agree that the prescription contained a complete lack of ambiguity,
and no person of any pharmaceutical knowledge would be in any doubt as
what to dispense and how much.
Given that, why should the doctor need to be contacted and have his or
her time wasted? All that is achieved by that is the fury of the medical
profession, annoyed by the futile nature of some pharmacists’ requests.
Why, again, should the patient be forced to suffer a delay in procurement
of the medicine? And, finally, why does the pharmacist have to waste his
or her own time? Does this type of restriction give meaning to the job?
I wonder how long it took to sort out this “problem” when time
would perhaps have been better spent doing something productive.
This sort of unnecessary box ticking is undermining the profession and
serves no purpose other than to discredit pharmacists. Pharmacy is such
a worthwhile profession, ruined by aspects exactly like this.
James Turnbull
Sheffield |
The
Pharmaceutical Journal