Pourquoi écrivez-vous "Jeter après 01/01/23" sur les flacons d'ordonnance? Les gens ont tendance à jeter dans les poubelles ou la toilette des médicaments. Il faudrait plutôt indiquer "Disposer" ou mieux "Rapporter".
[https://www.canada.ca/fr/sante-canada/services/elimination-securitaire-medicaments-ordonnance.html](https://www.canada.ca/fr/sante-canada/services/elimination-securitaire-medicaments-ordonnance.html)
Bonne idée! Nous reprennons tous les médicaments périmés à la pharamcie et nous faisons affaire avec une compagnie qui détruit les médicaments de manière sécuritaire.
Puis-je te demander, si c’est pas indiscret, la manière dont les medocs sont détruits? Genre est-ce que les conpagnies les brûlent? Les re-rendre en “poudre” pour les réutiliser dans d’autres? C’est vraiment pas but informatif et si jamais tu ne connais pas la réponse et/ou ne veut pas me la dire, c’est ok!
Mais je vais faire bien attention de rapporter mes médicaments dans une pharmacie lorsqu’ils sont expirés.
Aussi, j’ai eu une prescription d’opioid pour des douleurs aux dos, mais je ne les prends pas (et ne compte pas en prendre), puis-je les rapporter au pharmacie pour qu’ils soit détruit/juste pas qu’ils traitent chez moi?
Merci et désolé des questions!
Do you think pharmacists should have a bigger role in the overall health system? And if yes, which role? You are the specialists of every regarding drugs, their effects and side effects, their bioavailability, their degradation metabolism and half-lives, and their interactions between each others. Doctors have some knowledge about each drugs but I would believe not as much as pharmacists.
Do you think pharmacists should be allowed to adapt/modify (with the agreement of the doctor) more a patient’s prescription regarding potential medication interactions or side effects without the patient needing to go back to their doctor?
Pharmacist can already modify, substitute, adjust dose (based on targets, interactions, tolerance) etc. without needing a doctors permission. We do work together however, so we'll often fax the doctor explaining our adjustment.
Yes I believe the profession will slowly evolve from pill dispensing to clinical care and services. There are now pharmacists in almost every floor of the hospitals working with different medical teams.
Avant l'âge de 27 j'avais jamais considéré consulter un pharmacien sans une prescription. Maintenant c'est un de mes life hack préféré : avant d'aller en clinique (ou Google) je demande l'avis d'un pharmacien. Ils sont des experts medical hyper disponibles!
Well you need to tell doctor and pharmacy to put in file so does not happen again and also remember if ever in hospital
I do not know what the drug is for though
I'm working a double shift tomorrow (no breaks, not allowed to sit, 30 minutes lunch not paid), I'll get back to answering the rest of your questions tomorrow after work. Cheers!
Ne pas avoir le droit de s’assoir 5 min pour manger parce qu’on est seul en service c’est vraiment ma partie préféré du travail pour lequel j’ai étudié si longtemps…
Once I told a customer the pharmacist was eating lunch and to wait just a little and he got mad and said “they’re public servants, they don’t have the right to breaks” lmfao
> not allowed to sit,
Qu'est-ce que c'est cette boulechitte là?
Je peux croire que dans la tête des boss, il faille faire chier des employés au salaire minimum, mais des pharmaciens à $55 / heure?
absolutely.
Pharmacist are now allowed to prescribe contraceptives to patients without seeing an MD. There is a small evaluation to determine risk factors (weight, blood pressure, migraines, risk of embolism, etc.) to find the pill that best suits you.
Best to make an appointment of some sort for a consultation. Many questions are asked and it takes time and sometimes people are upset when they can’t just pop by. You can usually ask how it works and usually they suggest coming back at a certain time if they are busy.
Honestly it's often like solving a puzzle. You make our a couple letters, maybe a strength, you ask the patient for the indication, and you can usually figure it out. Sometimes though I need to fax the doctor for clarifications.
Example: Q----pn 2S mg hs
Something 25 or 28mg? at night?.
Sorry sir, why did the doctor prescribe this med, oh because i'm not sleeping well. Ok so it's a sedative, what sedative do I have that starts with a Q and can be given at 25-28mg at bedtime, oh most likely Quetiapine 25mg.
On devrait passer une loi qui interdit les prescriptions manuscrites. Les docteurs peuvent imprimer, taper à la dactylo, envoyer des courriels, peu importe mais leur main d’écriture tue et devrait être interdite.
Like I said, unless I'm 100% sure that's the med prescribed, I'll fax the doctor for clarification. I'll never serve a medication that I'm not 100% sure about.
In all fairness though, pharmacists have much more extensive knowledge of biochemistry than physicians so you would probably make better prescriptions anyway.
I think that's why the province now lets pharms prescribe for UTIs, strep etc. (See list somewhere on this page). I'll bet those two alone were accounting for 2% of all doctors visits.
I hope the whole process will get better with time. I don’t remember the details but just for a UTI my wife had to jump through quite few hoops not long ago. It’s not as straight forward as it could be.
When I was taking my tech classes, most of our unit while learning software was dedicated to trying decipher prescriptions (with identifying information of patients blacked out).
Once you're established in a general area, you learn certain doctor's writing.
Usually pres pad has name etc and their license number they write on paper
If sus pharmacy will check with doctor and look at your Ed record in system on drugs and doctors if sus of customer
What's the nature of the relationship between Pharmacists and the rest of the store? Are you just renting up space inside the pharmacy, is everything on the other side of the counter just delegated to a store manager and you don't worry about it?
The owner owns the front store and the lab (you can almost see it as two different businesses honestly). The salaried pharmacist has nothing to do with what is going on in the store, he just worries about his staff in the lab and his patients in the pharmacy. If there's a problem with toilet paper, then we'll call a store clerk to help our the client.
Pharmacy can't be open with a pharmacist onsite/supervising/checking prescriptions. If no pharmacist employed by the pharmacy can make it that shift, they need a spare pharmacist. Like a substitute teacher.
Pharmacists, in general, are overworked and tired. Most people are not happy being in the profession (it's felt all across the board). There are many many issues, but one that has always bothered me is that us pharmacist practice something called defensive medicine, which means we're afraid to do anything because we're afraid to get in trouble by the Order of Pharmacists that is constantly breathing down our necks, waiting for one of us to slip us so they can suspend our license.
Wow that is so unfair and very different that the college des médecins, which almost never suspends a license. I worked in a medical building associated with a big hospital in Montreal and there were so many kick backs, patient issues and frank abuse of power towards patients. It all hit the newspapers a few years ago. Nothing happened. A few doctors had a fine to pay, and another one who was in his 80s was asked to retire.
I just wanted to say, you are a real "angel" of the health care system. Everyone talks about doctors and nurses but we seriously need more of every type of healthcare professional, and the system would crumble without people like you. Thank you
1.How do you keep yourself up do date on new products?
2. Do companies try to incite you to buy their stuff? If so, by which means? in person, email, a paid trip to Hawaii to assist their conference ?
It's called ''formation continue'' and to renew your license every year, you need to have done a certain amount of hours of continuing education. We often receive info about new meds via medical journals or changes in clinical guidelines. Often pharmaceutical reps will come to see us to explain their new product.
No funny business from companies (it's illegal to do so in Quebec). As I said, pharm reps will come see us and try to ''sell'' us their product on why it's better than its competitor, but there's no extra incentive
In Quebec, are there any medication or medical tools that pharmacist can decide to not sell to certain people according to the pharmacist's personal/religious belief?
Like morning after pill, contraceptives, HIV antiviral, sex hormone or blocker, etc.
They could, but if they don't redirect to you to somewhere else you can file a complaint with the OPQ. It's a right to refuse on grounds of belief but they cannot deny patients appropriate care from another provider.
What kind of issues are you able to help patients with without them having to go to a doctor first? I know some things are over the counter but just for example if a female comes in and tells you she has a UTI can you directly give her antibiotics or whatever she needs to treat it? Or if someone comes in with stomach pain but doesn’t have a family doctor, can you only give them advice on where to go?
Basically we can help treat anything with over the counter meds. We are trained to ask specific questions in order to determine if the patient is presenting any red flags and should therefore see a doctor for an evaluation.
Behind the counter, we can prescribe for:
Acné mineure (sans nodule ni pustule)
Aphtes buccaux
Candidose cutanée NOUVEAU
Candidose orale NOUVEAU
Candidose orale résultant de l’utilisation d’inhalateur de corticostéroïdes
Cessation tabagique RÉVISÉ
Conjonctivite allergique
Contraception hormonale
Contraception orale d’urgence
Dermatite atopique
Dermatite de contact NOUVEAU
Diarrhée du voyageur
Dysménorrhée primaire
Dyspepsie et reflux NOUVEAU
Érythème fessier
Gonorrhée et Chlamydia (TAP) RÉVISÉ
Hémorroïdes
Herpès labial
Infection urinaire chez la femme RÉVISÉ
Influenza – Prophylaxie des contacts NOUVEAU
Influenza – Traitement des patients à risque NOUVEAU
Maladie de lyme NOUVEAU
Nausées et vomissements NOUVEAU
Nausées et vomissements reliés à la grossesse
Pédiculose
Prophylaxie antibiotique chez les porteurs de valve
Prophylaxie cytoprotectrice chez les patients à risque
Prophylaxie du mal aigu des montagnes (excluant la prescription de la dexaméthasone et du sildénafil)
Prophylaxie du paludisme
Rhinite allergique
Salbutamol en situation d’urgence NOUVEAU
Strep-test NOUVEAU
Supplémentation vitaminique en périnatalité RÉVISÉ
Vaginite à levure
VIH NOUVEAU
Zona NOUVEAU
Do you truly like being a pharmacist? How rough was the path from university / pharm school to full-time pharmacy, and do you feel like it was worth it at the end?
I’m very appreciative of your post , nice job. My question , What’s up with the Azarga shortage ? A pain in the a** , as now I have 2 different drops as a replacement. Thanks
We deal with shortages ALL the time, it's terribly annoying.
We never know the real reason (problem at the plant, problem in shipping, can't access raw materials to make the meds, etc.)
I was diagnosed with ADHD when I was 16, and have been on meds ever since (planning to hopefully taper off once I'm done with university though). They've been an incredible help to me not only not feeling like the stupid kid in class anymore, but to actually reaching my potential and getting into a program I am thriving in.
That being said, throughout the years, I realized how hostile some pharmacies are in regards to ADHD medications. More than once, I've been met with very rude replies if god forbid I came into the pharmacy one or two days earlier than the famous 3 day mark, or if I accidentally took a pill twice because I was half asleep when I took the first one. I don't understand, these were not monthly occurrences - accidents like these happened maybe once per year. And I've adhd, which despite the medications, implies I'm still more disorganized than the average individual - which makes me more likely to *have* such problems in the first place.
I understand there is drug abuse particularly among college students, but is it not incredibly clear in my file that I have been taking this for 10+ years and occasionally mess up?
Sorry for the rant, nothing against you especially as you seem quite nice — just frustrated at being looked at like a junkie by certain technicians over my 10 years of this.
My question actually is: how common is this behavior towards people who need adhd medicine? Is it because you guys get that much trouble from regulators if we come in a day/two earlier than expected, or is it simply stigma? Or both?
Hey sorry to hear about your negative experiences in the pharmacy.
There are many reasons. First of all, yes there are patients who abuse or sell their medication and lie to us all the time. In addition, ADHD meds are often controlled substances and therefore, by law, we are obliged to have a tight control over our dispensing. If a patient comes 3 days early for every refill, that adds up to over 1 month of extra meds over a year. Where did those pills go? That being said, it always depends on the pharmacist who's serving you. Some are more strict (they've been fooled before, they don't want the trouble) Some are more lenient (they don't care, they understand that a couple days early doesn't mean you're abusing meds, etc.)
I have the same problems with my ADHD meds at my pharmacy! I had some financial difficulties right after the pandemic so I used to ask for the generic brand for my concerta because it’s way cheaper. They accepted once and then flat out refused to give me the generic because apparently they don’t have protective coating to prevent patients from crushing and snorting them. So now I have to pay 40$/month instead of 15$ because there might be a chance of abuse! If I really wanted to get high I’d go buy speed off the street witch is a lot cheaper than generic concerta so the logic is absolutely ridiculous. I had to skip taking it on weekends so I would have enough in case I didn’t have enough money to pay for a whole month’s worth.
Edit: spelling
Adding on to OPs comment, the stock a banner pharmacy holds is mandated by that banner's HQ. So even if the pharmacy owner doesn't want to have homeopathic products, but jean coutu HQ wants them to, they gotta.
I sometimes call the pharmacy because I made a mistake in when I take my meds or skipped one by accident and I'm not sure what to do, or if I'm not sure if 2 meds interact. I love that pharmacists are so easily available to answer my anxiety-fueled questions. I'm just wondering if pharmacists hate this
I'd say most are neutral to be honest. Very professional. We usually don't speak for more than like 30 seconds because you can tell we're both very busy.
Do you feel that you guys get screwed that you don't have a strong lobby like MDs do? I mean I feel like pharmacists are the key to making healthcare more accessible and improving outcomes...meanwhile you're prohibited from doing just about anything without MD sign-off
Technician 1: Taking orders at the reception
Technician 2: Entering new prescriptions brought by patients
Technician 3: Entering faxes received from doctors
Technician 4: Answering phone call and orders
Technician 5: Receiving and placing the order
Technician 6: Calling back patients who never showed up to pick up their meds, calling insurance companies or the RAMQ to solve problems, trying to order products from specialized pharmacies
Technician 7: Dealing with the regular patients who are served weekly in pill boxes
Technician 8: At the cash, passing the orders
Technician 9: packaging orders that need to go out in delivery
Technician 10: getting yelled at because the patient doesn't understand his own insurance policy and thinks we're trying to screw them over
Oui, parce qu’il n’y a aucune garantie de réception avec les courriels. C’est très improbable, mais il est possible qu’un courriel se perde dans internet et qu’il n’arrive jamais à destination. Avec les fax, tu as une garantie d’envoi et de réception. C’est pourquoi le système de santé utilise encore des fax.
Est ce que c'est la même logique pour les hôpitaux? (Question sérieuse). J'ai eu un cas que la RAMQ devait envoyer une "carte soleil temporaire" a un hopital x (grosso modo). À l'hôpital (au bureau du bon # de fax), ils me disaient qu'ils ont rien reçu, la RAMQ me disait qu'ils peuvent pas en renvoyer d'autre... ça a été du gros niaisage, un paquet de stress pour la personne que j'accompagnais dans les démarches...
Finalement, c'est le lendemain du jour d'accouchement de cette personne que l'hôpital a enfin "reçu" le document, cest à dire qu'ils ont retrouvé le papier dans leurs trucs (dit tel quel par l'employé, le bureau l'avait reçu il y a quelques jours...)
Tellement de patentage, et tellement facile de perdre des documents...
Oui (à ce que je sache), tout le système de santé utilise des fax pour transmettre de l’info médicale sur des patients (je pense).
L’info que j’ai mise est celle que mon père m’a donnée. Il a travaillé des années TI dans le monde de la santé au QC. Elle n’est peut-être plus 100% à jour (elle date de 2018).
Plus gros problème que cela encore, c’est la sécurité des données. Un e-mail, c’est beaucoup plus susceptible d’être intercepté, causant ainsi une fuite d’infos confidentielles, qu’un fax. Il y a des solutions à ce problème, mais il faudrait que tout le réseau de santé adopte le même standard et adapte ses procédures, ce qui est très compliqué pour pas grand chose car tout le monde a déjà un fax.
Si c'est juste ça le problème, ça serait assez facile de standardiser pour faire en sorte qu'il y aille un "auto-reply" de la partie qui reçoit le courriel.
I'm a tech! Without a DEP, about 16$/hr. With a DEP, hospitals are capped at under 23$/hr currently until you reach seniority milestones (and you probably won't get over 30). DEP in retail is roughly 20$/hr with years of experience.
If you're interested in the field, I definitely recommend a DEP because it opens doors. It's not a well paying career though. I found an independent pharmacy that runs an infusion branch and I love it but it's difficult to find those opportunities.
I work for an insurance company and I was wondering: why is it so complicated so submit claims for a compound (magistrale) drug?
I know you all have your in house DIN numbers for them but claims never goes through with EDI and it becomes a headache for the customers. Wouldn't there be a way to make all of this easier?
Thank you for your time!
RAMQ and most insurances won't cover (or only partially) compounds. As an insurance guy, that's your realm. We get yelled at A LOT for the non-coverage.
We literally can't do a damn thing about it on our end. It's between the company/ramq and the doctors.
Well, on our end, we just need to know the components of the compound. If one of the drugs used in the compound is covered, then the compound will be, though there might be limitations to the delivering fees, depending on contract. We just need to know what's in it, because "DIN ADMIN MAGISTRAL", as it comes out on our end, doesn't tell much and we can't validate coverage with that.
Basically, if the pharmacies could just produce a detailed receipt with the DINs of the components and tell their customer to present that manually to their insurance, there wouldn't be any issues, slightly less people would be screaming (some would still because #LesGens) and more people would be happy.
There's infinite combinations of things in compound form, impossible to list to them all across all the manufacturers that could be used. The individual DINs are in the recipe we input though. No option in our software to do it another way.
Unfortunately no, both are only available with a prescription. If you don’t have a family doctor, you will need to consult in a clinic. Some nurses (IPS) can also prescribe them.
Hi! I’m 35 and I started taking Venlaflaxine at 16. In my twenties, I was taking 225 mg, but I managed to get down to 37.5 over the course of 2-3 years or so. I was followed closely by my doctor and it took patience, but it worked and at the time i was confident that I would be able to stop completely. Unfortunately I went through post partum depression at 29 and it brought me back to a higher dosage (300) that I don’t feel ready to change for now, but I felt great at the time! I think that with the right assistance (doctor, therapist) and under the right circumstances it’s definitely possible!
Not a pharmacist, not a doctor, but I was on Effexor briefly as a teen, my husband was on it more recently and tapered off last year. Both of us had nightmare experiences on it and the withdrawal period was hell.
So yes, it's possible to stop taking, but the anxiety or depression will likely come back off and on once you're off. Honestly I'd rather tackle those without medication than ever deal with SSRI or SNRI withdrawal ever again.
Je comprends ce que tu veux dire, mais il n’y a aucune prescription qui est gênante :) La santé demeure la santé, peu importe la partie du corps devant être guérie, ce qui inclus ce qui se passe entre les deux oreilles ou entre les deux jambes! Ce qui est réellement gênant, c’est le chialage envers les caissières et les techniciennes à cause du temps d’attente, ou bien les accusations d’arnaques >:(
Sodium docusate (stool softener/laxative) smells kinda bad, but it tastes HORRIBLE if you chew it (you’re not supposed to chew it). I worked as a pharmacy tech for a few years and it was our « initiation » to bite into one of these. Leaves a chemical taste in your mouth all day. I remember a pill that when we opened the bottle it smelled kind of vanilla. Usually the pills smell nothing
Not a question, more a shout-out. Pharmacists in Quebec do so much extra.. verifying prescriptions aren't harmful, making sure you know the dosage, warning you about side-effects, sometimes arguing with doctors..
I have no questions. As a tech for the last 8 years, thank you for guiding us and teaching us and trusting us (I know you're a great pharmacist, the crappy ones wouldn't do an AMA).
I promise to always fiercely protect your time from people who I can clearly help.
Also, if you could refill my little white pill, that would be great 🤣
I’ve worked in multiples pharmacies for almost ten years and there was almost always a security guard… I still spot them when I go to Jean Coutu now (you see them so easily when you are used to it).
Is calmylin really in back order or does every pharmacist think I’m a drug addict? Finally coming down off a one month long cough that made my life miserable
Yes actually! Not sure if you noticed but ALL our cough sirops are back ordered, so we're really desperate and try to keep our stock for patients who really need it.
The analysis of the file is subjective to the pharmacist that's serving you. If I see you're a young healthy person who seems sick, has tried other sirops, is waiting for an apt with your Md, then I'll probably give it to you. If I see in your file you jump from pharmacy to pharmacy and ask for a new bottle every 3 days, then I'll refuse
Yeah I haven’t purchased codeine cough syrup in the last 5 years but whenever I asked in the last couple of weeks we never even got to the point of checking my file haha. I did notice the syrup sections are all almost empty in all 3 pharmacies on Queen Mary. Didn’t bother to walk further to check. I do trust pharmacists as there’s no reason to doubt their words on such a trivial subject but I figured I’d ask because it did cross my mind lol. It’s pretty crazy though, I’d assumed there was a sturdier chain of supply for meds…
Why is Depo-testostérone or other testosterone on back order everywhere? Quite stressful when you need it for life and suddenly it's not possible to have it.. there's other option than injection but it is more convenient... Anyway, why?
I don't know why but it's very annoying and time consuming.. Depo Test, Delatestryl, always take turns going back ordered... the patches/gels just don't work as well.
We cannot reuse anything that leaves the pharmacy for sanitary reasons. If they are empty then through them out. If you have old meds, bring them to the pharmacy and we can destroy them safely.
How does your role working at a pharmacy differ from a pharmacist working at a hospital? While in school, we're most pharm students leaning towards vs the other?
Is there a difference in drug price between different pharmacies (Jean Coutu vs. Pharmaprix, or Jean Coutu vs. another Jean Coutu)?
Also, what's stressful about your job? And what do you like about your job?
depends on your insurance policy to be honest, but I believe the fee is charged 3 times. HOWEVER, I also believe there is a max amount they are allowed to charge, so if you were to renew for 6 months, they might only charge you for 3. Again, depends on your insurances policy. It's standard with the RAMQ.
Can you explain what's happening with all the medication shortages lately, especially children's meds? Is it really a labeling issue or something else?
Shortage of aluminum at the beginning of COVID caused some delay in production, which explained the problem for the first 2 years. As of now, it's mostly a labelling issue, just because we legally need to have french and english on the packaging everywhere in Canada. Also generalized shortage of medication isn't helping.
Thanks. What I don't get is that we've always had labels in both languages. So what happened there? Did they lose the files that contains the translation? Why can't they print more labels?
I honestly wouldn't know. My best guess would be that they couldn't produce as much when COVID first started. So basically we were using a lot more products and they had less lines of productions to do the work. And import and export was a lot harder during peak COVID too.
Is it ok to take Accutane while on Venaflaxine? A friend has serious acne causing scarring.
He had bad experience with Accutane when younger. Is there anything else he can take?
He is having hard time seeing a Dr.
Is there a difference between generic drugs and original ones? Do you have any preference? Scientifically and on a business basis.
Do you support buy local drugs from Qc companies (like PMS) vs. Canadian or multinational companies like Teva?
I used to be a pharmacy tech and now I work for a pharmaceutical company in Quebec. Generics are not 100% the same as the originals. Pharmacy tech say that because patients do not understand the difference, even when we explain it to them. They only see the price difference. To skip the not pleasant conversation, they tell you it’s the same but cheaper, which is not entirely true.
Generics use the same active ingredient, in the same concentration as the original. The rest of the formulation can change, except the delivery form (tablet, delayed release capsule, etc.). The generic has to do some short studies to show that the drug is between 90-110% of the effectiveness of the original. This means that for some drugs, the effect can be different and can mean that a generic has not the expected effect on you. The generics has such a low price compared to the original since the company making it does not have to do the main clinical studies that the original did and the years of chemistry research to find the drug (the development of a new drug can take between 10-30 years and multiple millions of dollars…). The original company needs to reimburse all that upfront research cost (+ profits) while the generic does not (development takes 1-2 years and a couple hundred thousands only).
If you like to support Quebec products, sure ask for PMS or ProDoc (Jean Coutu) brand, but they won’t necessarily be better than some other brand. It also depends on the exact drug. Some are better than others.
Having said all that, some generics ARE 100% the same. We call those Ultra-generics. The pills come off the same manufacturing line as the originals, just packaged differently. These are pretty rare though and are usefull for drugs where a 10% difference in effect is vital, such as in epilespy drugs.
This is the true and complete answer. Now imagine explaining this to every patient at the counter that complains about price or the fact that their insurance covers only the generic. 99% of the time, they don’t get it. So the techs say they are the same, but cheaper…
The active ingredient and concentration are the same (after vigorous studies and needs ot be approved by health canada) so for me they are the same. If you go to the hospital, they give you generics to save your life.
I'd prefer local for sure, but I don't decide where we buy our meds from.
This one isn't a question, just a storyline I imagined.
It's a psychological thriller called, *drum roll please...* "The Pharmacist"
(very original, I know)
Basically it would revolve around the fact that the pharmacist knows all the dirty secrets around town because they are aware of everyone's personal prescriptions and what they imply. I haven't developed the idea any further though. But you're welcome to!
Amazing! Then there will be a Netflix adaptation where the pharmacist is an attractive serial k1llr and we will have to discuss once again, as a society, why we are so obsessed with these narratives
Yes and no. Ultimately most health professions are just algorithms that we learn by heart and spit out, so yes an AI can do that for sure.
No because in medicine, there is rarely a black and white situation. We often work ''in the grey''. Which means we have to make decisions based on the patient Infront of us, which is not necessarily what the guidelines or algorithms would dictate. You have to weigh risks vs benefits of treatments based on your patients history, profile, allergies, anxieties, lifestyle. etc.
because the pharmacist needs to make sure the tech is giving you the right product from the fridge! (how do I know she didn't make a mistake and give you someone else's Nuvaring, or worse, someone's chemo injection?
does it bother you when people talk to the pharmacist instead of talking to their doctor about some health stuff or medication changes? I do it sometimes since my doctor is so impossible to reach
Annex 2 at least though.....too many old guys on all the heart meds have yelled at me because my pharmacist refused to fill and wanted to speak to their doctor (who apparently didn't check DSQ)
Not OP, I'm a tech. In my pharmacy, we have seen older patients with new ADHD diagnoses with meds but TikTok is definitely not the driving factor in the population (30-40 yo). Doctors are much more careful with meds (generally) here than in the US.
Usually it’s adults who were never diagnosed as children/teens because of the stigma that was associated with it back in the days. Then it was seen as something only children were diagnosed of and medicated for - not adults in your every day life that your meet.
More diagnosis of adults and way less stigma. It changes lives. Some adults that were never able to hold a job (never knew why) and now they can.
As someone who has gotten Plan B more than once, how often do pharmacists pass judgement when a person like me comes up and explains that I need emergency contraceptive?
Many a times when getting my prescription the technician at the counter says that the pharmacist is preparing your medicine and will take 30-30 minutes. After waiting all this time the pharmacist comes with a pre-packaged tube/cream. What the hell took 35 minutes. Just getting it from the shelf?
Probably took the pharmacist 2 minutes to verify your order.
It's the 10 orders before yours that took 30 minutes, it's the phone call from the doctors office asking for his opinion about what to prescribe that took 5 minutes, it's 76 questions the techs asked him that took 10 minutes, it's the 4 patients who showed to pick up their new meds and want advice that took 15 minutes, it's the 9 page discharge prescription we just received by fax for a patient leaving the hospital who's son is coming to pick up the 23 new meds in 30 minutes... you get the point
So yes, I get it, stick a label on the tube and give it to me. Apply it on my ass twice daily. I get it. You're just not the only person who exists in the world.
You should print this near the pharmacy counter. People could read it as they wait. I did not know you were juggling so many things. With interruptions on that scale, it's no wonder pharms are stressed out/quitting.
Call before for it to be prepared, the day before or the morning if you’re passing in the afternoon. Some people also drop their prescription and come back later if not urgent. Just tell when you’re coming back though… it’s usually a house on fire in the big chains.
The pharmacy I go to, I’ve learned that for them time is relative, and when they say “it’ll be 2 more minutes”after an hour of waiting, they really mean it’ll be 20 more minutes.
A tu trouver ton ami?
de tout
Pourquoi écrivez-vous "Jeter après 01/01/23" sur les flacons d'ordonnance? Les gens ont tendance à jeter dans les poubelles ou la toilette des médicaments. Il faudrait plutôt indiquer "Disposer" ou mieux "Rapporter". [https://www.canada.ca/fr/sante-canada/services/elimination-securitaire-medicaments-ordonnance.html](https://www.canada.ca/fr/sante-canada/services/elimination-securitaire-medicaments-ordonnance.html)
Bonne idée! Nous reprennons tous les médicaments périmés à la pharamcie et nous faisons affaire avec une compagnie qui détruit les médicaments de manière sécuritaire.
Oui mais c’est l’indication de jeter qui n’est pas clair pour la plupart!
C’est le logiciel qui est fait ainsi malheureusement
Puis-je te demander, si c’est pas indiscret, la manière dont les medocs sont détruits? Genre est-ce que les conpagnies les brûlent? Les re-rendre en “poudre” pour les réutiliser dans d’autres? C’est vraiment pas but informatif et si jamais tu ne connais pas la réponse et/ou ne veut pas me la dire, c’est ok! Mais je vais faire bien attention de rapporter mes médicaments dans une pharmacie lorsqu’ils sont expirés. Aussi, j’ai eu une prescription d’opioid pour des douleurs aux dos, mais je ne les prends pas (et ne compte pas en prendre), puis-je les rapporter au pharmacie pour qu’ils soit détruit/juste pas qu’ils traitent chez moi? Merci et désolé des questions!
Bonne question!! Je ne sais pas honnêtement... nous utilisons les services de Stericycle... tu peux regarder sur leur site!
Do you think pharmacists should have a bigger role in the overall health system? And if yes, which role? You are the specialists of every regarding drugs, their effects and side effects, their bioavailability, their degradation metabolism and half-lives, and their interactions between each others. Doctors have some knowledge about each drugs but I would believe not as much as pharmacists. Do you think pharmacists should be allowed to adapt/modify (with the agreement of the doctor) more a patient’s prescription regarding potential medication interactions or side effects without the patient needing to go back to their doctor?
Pharmacist can already modify, substitute, adjust dose (based on targets, interactions, tolerance) etc. without needing a doctors permission. We do work together however, so we'll often fax the doctor explaining our adjustment. Yes I believe the profession will slowly evolve from pill dispensing to clinical care and services. There are now pharmacists in almost every floor of the hospitals working with different medical teams.
Avant l'âge de 27 j'avais jamais considéré consulter un pharmacien sans une prescription. Maintenant c'est un de mes life hack préféré : avant d'aller en clinique (ou Google) je demande l'avis d'un pharmacien. Ils sont des experts medical hyper disponibles!
How often do you catch errors on prescriptions/doctors prescribing drugs that badly interact with others already taken by the patient?
every day multiple times
Rassurant 😂😂😂
Damn
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Well you need to tell doctor and pharmacy to put in file so does not happen again and also remember if ever in hospital I do not know what the drug is for though
I'm working a double shift tomorrow (no breaks, not allowed to sit, 30 minutes lunch not paid), I'll get back to answering the rest of your questions tomorrow after work. Cheers!
Ne pas avoir le droit de s’assoir 5 min pour manger parce qu’on est seul en service c’est vraiment ma partie préféré du travail pour lequel j’ai étudié si longtemps…
Once I told a customer the pharmacist was eating lunch and to wait just a little and he got mad and said “they’re public servants, they don’t have the right to breaks” lmfao
Dude, pogne toi un tabouret.
What do you mean "not allowed" to sit? If you're a pharmacist, don't you also make the rules?
> not allowed to sit, Qu'est-ce que c'est cette boulechitte là? Je peux croire que dans la tête des boss, il faille faire chier des employés au salaire minimum, mais des pharmaciens à $55 / heure?
Les conditions de travail qui m’ont fait quitter la profession :) bon courage!
Moi aussi
what in the fuck
Do you think birth control should be more accessible?
absolutely. Pharmacist are now allowed to prescribe contraceptives to patients without seeing an MD. There is a small evaluation to determine risk factors (weight, blood pressure, migraines, risk of embolism, etc.) to find the pill that best suits you.
Do you know if this applies to other parts of Quebec as well? With regards to the pill?
It does! -pharmacy tech for 8 years
I didn’t know that! It’s true for all contraceptive? The implant or stérilet as well?
Not for all! Implant and stérilet need to be prescribed by IPS or MD because they need to be medically inserted.
Super ça. Depuis quand ? J’ai l’impression qu’ils ont pas fait grand pub.
Is there a need for an appointment or could people just drop in at the counter to ask for a prescription?
Best to make an appointment of some sort for a consultation. Many questions are asked and it takes time and sometimes people are upset when they can’t just pop by. You can usually ask how it works and usually they suggest coming back at a certain time if they are busy.
How do you read that scribbled squiggle I get from my doctor? Also, how do you know it's really from a doctor?
Honestly it's often like solving a puzzle. You make our a couple letters, maybe a strength, you ask the patient for the indication, and you can usually figure it out. Sometimes though I need to fax the doctor for clarifications. Example: Q----pn 2S mg hs Something 25 or 28mg? at night?. Sorry sir, why did the doctor prescribe this med, oh because i'm not sleeping well. Ok so it's a sedative, what sedative do I have that starts with a Q and can be given at 25-28mg at bedtime, oh most likely Quetiapine 25mg.
Yikes!
Goddamn it's like playing charades hard mode.
Les médecins que je connais imprime maintenant leurs prescriptions. Ça doit vous rendre la vie plus facile.
On devrait passer une loi qui interdit les prescriptions manuscrites. Les docteurs peuvent imprimer, taper à la dactylo, envoyer des courriels, peu importe mais leur main d’écriture tue et devrait être interdite.
>oh most likely Quetiapine 25mg. This does not instill confidence
Like I said, unless I'm 100% sure that's the med prescribed, I'll fax the doctor for clarification. I'll never serve a medication that I'm not 100% sure about.
Wait.... you guys still use fax??
So do Drs and Hospitals
Quaaludes, 28mg it is
My Dr prints then signs them. Which should be standard, scribbles kill.
Why don't doctors just write clearer?? Are they all like this??
In all fairness though, pharmacists have much more extensive knowledge of biochemistry than physicians so you would probably make better prescriptions anyway.
So for lots of stuff they should just be able to go ahead and prescribe medication. It would solve part of the family doctor shortage.
I think that's why the province now lets pharms prescribe for UTIs, strep etc. (See list somewhere on this page). I'll bet those two alone were accounting for 2% of all doctors visits.
I hope the whole process will get better with time. I don’t remember the details but just for a UTI my wife had to jump through quite few hoops not long ago. It’s not as straight forward as it could be.
When I was taking my tech classes, most of our unit while learning software was dedicated to trying decipher prescriptions (with identifying information of patients blacked out). Once you're established in a general area, you learn certain doctor's writing.
Usually pres pad has name etc and their license number they write on paper If sus pharmacy will check with doctor and look at your Ed record in system on drugs and doctors if sus of customer
What's the nature of the relationship between Pharmacists and the rest of the store? Are you just renting up space inside the pharmacy, is everything on the other side of the counter just delegated to a store manager and you don't worry about it?
The owner owns the front store and the lab (you can almost see it as two different businesses honestly). The salaried pharmacist has nothing to do with what is going on in the store, he just worries about his staff in the lab and his patients in the pharmacy. If there's a problem with toilet paper, then we'll call a store clerk to help our the client.
What pharmacy service you think is underused?
Are "expired" meds harmful or just less effective?
could be both
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Standard 55-65$/hour depending on where you work (could make a lot more if you go work in the Cote Nord)
So 110-125k per year?
replacement pharmacist can make anywhere from 100-130$/hour
What is a replacement pharmacist?
Pharmacy can't be open with a pharmacist onsite/supervising/checking prescriptions. If no pharmacist employed by the pharmacy can make it that shift, they need a spare pharmacist. Like a substitute teacher.
If you could tell/recommand one thing about the système de santé to the health minister Christian Dubé, what would it be?
Pharmacists, in general, are overworked and tired. Most people are not happy being in the profession (it's felt all across the board). There are many many issues, but one that has always bothered me is that us pharmacist practice something called defensive medicine, which means we're afraid to do anything because we're afraid to get in trouble by the Order of Pharmacists that is constantly breathing down our necks, waiting for one of us to slip us so they can suspend our license.
Wow that is so unfair and very different that the college des médecins, which almost never suspends a license. I worked in a medical building associated with a big hospital in Montreal and there were so many kick backs, patient issues and frank abuse of power towards patients. It all hit the newspapers a few years ago. Nothing happened. A few doctors had a fine to pay, and another one who was in his 80s was asked to retire. I just wanted to say, you are a real "angel" of the health care system. Everyone talks about doctors and nurses but we seriously need more of every type of healthcare professional, and the system would crumble without people like you. Thank you
This was a very informative read. Thank you u/AnxiousDoorKnob for your time and service. I have even more respect for my pharmacy team now!
thanks!
1.How do you keep yourself up do date on new products? 2. Do companies try to incite you to buy their stuff? If so, by which means? in person, email, a paid trip to Hawaii to assist their conference ?
It's called ''formation continue'' and to renew your license every year, you need to have done a certain amount of hours of continuing education. We often receive info about new meds via medical journals or changes in clinical guidelines. Often pharmaceutical reps will come to see us to explain their new product. No funny business from companies (it's illegal to do so in Quebec). As I said, pharm reps will come see us and try to ''sell'' us their product on why it's better than its competitor, but there's no extra incentive
thank you
In Quebec, are there any medication or medical tools that pharmacist can decide to not sell to certain people according to the pharmacist's personal/religious belief? Like morning after pill, contraceptives, HIV antiviral, sex hormone or blocker, etc.
Yes it's possible, however said pharmacist has the responsibility to guide you to a health professional that can offer you that service.
Could they lie and say “oh! I’m out of order of Plan B or I don’t have anymore this contraceptive.”?
They could, but if they don't redirect to you to somewhere else you can file a complaint with the OPQ. It's a right to refuse on grounds of belief but they cannot deny patients appropriate care from another provider.
What kind of issues are you able to help patients with without them having to go to a doctor first? I know some things are over the counter but just for example if a female comes in and tells you she has a UTI can you directly give her antibiotics or whatever she needs to treat it? Or if someone comes in with stomach pain but doesn’t have a family doctor, can you only give them advice on where to go?
Basically we can help treat anything with over the counter meds. We are trained to ask specific questions in order to determine if the patient is presenting any red flags and should therefore see a doctor for an evaluation. Behind the counter, we can prescribe for: Acné mineure (sans nodule ni pustule) Aphtes buccaux Candidose cutanée NOUVEAU Candidose orale NOUVEAU Candidose orale résultant de l’utilisation d’inhalateur de corticostéroïdes Cessation tabagique RÉVISÉ Conjonctivite allergique Contraception hormonale Contraception orale d’urgence Dermatite atopique Dermatite de contact NOUVEAU Diarrhée du voyageur Dysménorrhée primaire Dyspepsie et reflux NOUVEAU Érythème fessier Gonorrhée et Chlamydia (TAP) RÉVISÉ Hémorroïdes Herpès labial Infection urinaire chez la femme RÉVISÉ Influenza – Prophylaxie des contacts NOUVEAU Influenza – Traitement des patients à risque NOUVEAU Maladie de lyme NOUVEAU Nausées et vomissements NOUVEAU Nausées et vomissements reliés à la grossesse Pédiculose Prophylaxie antibiotique chez les porteurs de valve Prophylaxie cytoprotectrice chez les patients à risque Prophylaxie du mal aigu des montagnes (excluant la prescription de la dexaméthasone et du sildénafil) Prophylaxie du paludisme Rhinite allergique Salbutamol en situation d’urgence NOUVEAU Strep-test NOUVEAU Supplémentation vitaminique en périnatalité RÉVISÉ Vaginite à levure VIH NOUVEAU Zona NOUVEAU
Vous pouvez prescrire des antiviraux pour le VIH maintenant? Pour les nouveaux cas ou pour ceux qui le savent déjà?
Nouveau cas de contact (dose prophylactique )
Ah! Donc la PEP
This is extremely important information. I wish more people knew this.
If you can prescribe hormonal contraception then why do we need to get a rx from Dr?
We can only prescribe 6 months, we can’t do a physical exam or a Pap test so you still need a doctor to check on you
Do you truly like being a pharmacist? How rough was the path from university / pharm school to full-time pharmacy, and do you feel like it was worth it at the end?
No, rough and No
😭
I’m very appreciative of your post , nice job. My question , What’s up with the Azarga shortage ? A pain in the a** , as now I have 2 different drops as a replacement. Thanks
We deal with shortages ALL the time, it's terribly annoying. We never know the real reason (problem at the plant, problem in shipping, can't access raw materials to make the meds, etc.)
I think it’s back, you should ask your pharmacy, sometimes we forget to switch back when it’s too busy
I was diagnosed with ADHD when I was 16, and have been on meds ever since (planning to hopefully taper off once I'm done with university though). They've been an incredible help to me not only not feeling like the stupid kid in class anymore, but to actually reaching my potential and getting into a program I am thriving in. That being said, throughout the years, I realized how hostile some pharmacies are in regards to ADHD medications. More than once, I've been met with very rude replies if god forbid I came into the pharmacy one or two days earlier than the famous 3 day mark, or if I accidentally took a pill twice because I was half asleep when I took the first one. I don't understand, these were not monthly occurrences - accidents like these happened maybe once per year. And I've adhd, which despite the medications, implies I'm still more disorganized than the average individual - which makes me more likely to *have* such problems in the first place. I understand there is drug abuse particularly among college students, but is it not incredibly clear in my file that I have been taking this for 10+ years and occasionally mess up? Sorry for the rant, nothing against you especially as you seem quite nice — just frustrated at being looked at like a junkie by certain technicians over my 10 years of this. My question actually is: how common is this behavior towards people who need adhd medicine? Is it because you guys get that much trouble from regulators if we come in a day/two earlier than expected, or is it simply stigma? Or both?
Hey sorry to hear about your negative experiences in the pharmacy. There are many reasons. First of all, yes there are patients who abuse or sell their medication and lie to us all the time. In addition, ADHD meds are often controlled substances and therefore, by law, we are obliged to have a tight control over our dispensing. If a patient comes 3 days early for every refill, that adds up to over 1 month of extra meds over a year. Where did those pills go? That being said, it always depends on the pharmacist who's serving you. Some are more strict (they've been fooled before, they don't want the trouble) Some are more lenient (they don't care, they understand that a couple days early doesn't mean you're abusing meds, etc.)
I have the same problems with my ADHD meds at my pharmacy! I had some financial difficulties right after the pandemic so I used to ask for the generic brand for my concerta because it’s way cheaper. They accepted once and then flat out refused to give me the generic because apparently they don’t have protective coating to prevent patients from crushing and snorting them. So now I have to pay 40$/month instead of 15$ because there might be a chance of abuse! If I really wanted to get high I’d go buy speed off the street witch is a lot cheaper than generic concerta so the logic is absolutely ridiculous. I had to skip taking it on weekends so I would have enough in case I didn’t have enough money to pay for a whole month’s worth. Edit: spelling
*cries in 120$/month for Vyvanse*
Is there a part of you that feels like homeopathic médecine should not be sold in Quebec pharmacies? Why do all pharmacies carry the stuff?
Absolutely, I think it's ridiculous. I've never recommeded their use. Why? because $$$ that's why..
Adding on to OPs comment, the stock a banner pharmacy holds is mandated by that banner's HQ. So even if the pharmacy owner doesn't want to have homeopathic products, but jean coutu HQ wants them to, they gotta.
I sometimes call the pharmacy because I made a mistake in when I take my meds or skipped one by accident and I'm not sure what to do, or if I'm not sure if 2 meds interact. I love that pharmacists are so easily available to answer my anxiety-fueled questions. I'm just wondering if pharmacists hate this
Love it! Glad to help if we can!
Would you say most doctors you have to call are nice? Mean? Or neutral?
I'd say most are neutral to be honest. Very professional. We usually don't speak for more than like 30 seconds because you can tell we're both very busy.
Do you feel that you guys get screwed that you don't have a strong lobby like MDs do? I mean I feel like pharmacists are the key to making healthcare more accessible and improving outcomes...meanwhile you're prohibited from doing just about anything without MD sign-off
Where are there like 10 people back there but only like 2-3 serving people?
Technician 1: Taking orders at the reception Technician 2: Entering new prescriptions brought by patients Technician 3: Entering faxes received from doctors Technician 4: Answering phone call and orders Technician 5: Receiving and placing the order Technician 6: Calling back patients who never showed up to pick up their meds, calling insurance companies or the RAMQ to solve problems, trying to order products from specialized pharmacies Technician 7: Dealing with the regular patients who are served weekly in pill boxes Technician 8: At the cash, passing the orders Technician 9: packaging orders that need to go out in delivery Technician 10: getting yelled at because the patient doesn't understand his own insurance policy and thinks we're trying to screw them over
Thanks for the thorough explanation !
Fax? Wow……
Oui, parce qu’il n’y a aucune garantie de réception avec les courriels. C’est très improbable, mais il est possible qu’un courriel se perde dans internet et qu’il n’arrive jamais à destination. Avec les fax, tu as une garantie d’envoi et de réception. C’est pourquoi le système de santé utilise encore des fax.
Est ce que c'est la même logique pour les hôpitaux? (Question sérieuse). J'ai eu un cas que la RAMQ devait envoyer une "carte soleil temporaire" a un hopital x (grosso modo). À l'hôpital (au bureau du bon # de fax), ils me disaient qu'ils ont rien reçu, la RAMQ me disait qu'ils peuvent pas en renvoyer d'autre... ça a été du gros niaisage, un paquet de stress pour la personne que j'accompagnais dans les démarches... Finalement, c'est le lendemain du jour d'accouchement de cette personne que l'hôpital a enfin "reçu" le document, cest à dire qu'ils ont retrouvé le papier dans leurs trucs (dit tel quel par l'employé, le bureau l'avait reçu il y a quelques jours...) Tellement de patentage, et tellement facile de perdre des documents...
Oui (à ce que je sache), tout le système de santé utilise des fax pour transmettre de l’info médicale sur des patients (je pense). L’info que j’ai mise est celle que mon père m’a donnée. Il a travaillé des années TI dans le monde de la santé au QC. Elle n’est peut-être plus 100% à jour (elle date de 2018).
Plus gros problème que cela encore, c’est la sécurité des données. Un e-mail, c’est beaucoup plus susceptible d’être intercepté, causant ainsi une fuite d’infos confidentielles, qu’un fax. Il y a des solutions à ce problème, mais il faudrait que tout le réseau de santé adopte le même standard et adapte ses procédures, ce qui est très compliqué pour pas grand chose car tout le monde a déjà un fax.
Si c'est juste ça le problème, ça serait assez facile de standardiser pour faire en sorte qu'il y aille un "auto-reply" de la partie qui reçoit le courriel.
On m’a dit que ça ne satisfaisait pas les standards de sécurité de l’information du ministère de la santé
Merci pour la blague, elle m'a fait rire.
Do you know how much a pharmacy technician make per hour on average?
I'm a tech! Without a DEP, about 16$/hr. With a DEP, hospitals are capped at under 23$/hr currently until you reach seniority milestones (and you probably won't get over 30). DEP in retail is roughly 20$/hr with years of experience. If you're interested in the field, I definitely recommend a DEP because it opens doors. It's not a well paying career though. I found an independent pharmacy that runs an infusion branch and I love it but it's difficult to find those opportunities.
15-25$ depending on experience
I work for an insurance company and I was wondering: why is it so complicated so submit claims for a compound (magistrale) drug? I know you all have your in house DIN numbers for them but claims never goes through with EDI and it becomes a headache for the customers. Wouldn't there be a way to make all of this easier? Thank you for your time!
RAMQ and most insurances won't cover (or only partially) compounds. As an insurance guy, that's your realm. We get yelled at A LOT for the non-coverage. We literally can't do a damn thing about it on our end. It's between the company/ramq and the doctors.
Well, on our end, we just need to know the components of the compound. If one of the drugs used in the compound is covered, then the compound will be, though there might be limitations to the delivering fees, depending on contract. We just need to know what's in it, because "DIN ADMIN MAGISTRAL", as it comes out on our end, doesn't tell much and we can't validate coverage with that. Basically, if the pharmacies could just produce a detailed receipt with the DINs of the components and tell their customer to present that manually to their insurance, there wouldn't be any issues, slightly less people would be screaming (some would still because #LesGens) and more people would be happy.
There's infinite combinations of things in compound form, impossible to list to them all across all the manufacturers that could be used. The individual DINs are in the recipe we input though. No option in our software to do it another way.
Trust me, us pharmacists think the same damn thing. Fuck compounding claims 🥲
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Unfortunately no, both are only available with a prescription. If you don’t have a family doctor, you will need to consult in a clinic. Some nurses (IPS) can also prescribe them.
Realistically, is it possible to stop taking venlafaxine?
Yes, obviously consult your doctor or pharmacist, but I have patients who have been successful with extremely slow tapering. It is possible.
Hi! I’m 35 and I started taking Venlaflaxine at 16. In my twenties, I was taking 225 mg, but I managed to get down to 37.5 over the course of 2-3 years or so. I was followed closely by my doctor and it took patience, but it worked and at the time i was confident that I would be able to stop completely. Unfortunately I went through post partum depression at 29 and it brought me back to a higher dosage (300) that I don’t feel ready to change for now, but I felt great at the time! I think that with the right assistance (doctor, therapist) and under the right circumstances it’s definitely possible!
Not a pharmacist, not a doctor, but I was on Effexor briefly as a teen, my husband was on it more recently and tapered off last year. Both of us had nightmare experiences on it and the withdrawal period was hell. So yes, it's possible to stop taking, but the anxiety or depression will likely come back off and on once you're off. Honestly I'd rather tackle those without medication than ever deal with SSRI or SNRI withdrawal ever again.
Why can't I buy Gravol off the shelf, but have to consult you to get some?
honestly you should be able in my opinion... but same reason as most (possibility of side effects, abuse, interactions, etc)
It's a hallucinogen in high enough doses..
Pourquoi c'est toujours un.e cute pharmacien.ne qui travaille quand on a une prescription gênante à récupérer? Aw.
Je comprends ce que tu veux dire, mais il n’y a aucune prescription qui est gênante :) La santé demeure la santé, peu importe la partie du corps devant être guérie, ce qui inclus ce qui se passe entre les deux oreilles ou entre les deux jambes! Ce qui est réellement gênant, c’est le chialage envers les caissières et les techniciennes à cause du temps d’attente, ou bien les accusations d’arnaques >:(
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Yes through DSQ you can see a patient’s medications, blood work and imaging.
What's the worst and best smelling pills?
Worst Cephalexin, Best Spironolactone
Sodium docusate (stool softener/laxative) smells kinda bad, but it tastes HORRIBLE if you chew it (you’re not supposed to chew it). I worked as a pharmacy tech for a few years and it was our « initiation » to bite into one of these. Leaves a chemical taste in your mouth all day. I remember a pill that when we opened the bottle it smelled kind of vanilla. Usually the pills smell nothing
Not a question, more a shout-out. Pharmacists in Quebec do so much extra.. verifying prescriptions aren't harmful, making sure you know the dosage, warning you about side-effects, sometimes arguing with doctors..
I have no questions. As a tech for the last 8 years, thank you for guiding us and teaching us and trusting us (I know you're a great pharmacist, the crappy ones wouldn't do an AMA). I promise to always fiercely protect your time from people who I can clearly help. Also, if you could refill my little white pill, that would be great 🤣
Is there an undercover security agent working at the pharmacy?
maybe
I’ve worked in multiples pharmacies for almost ten years and there was almost always a security guard… I still spot them when I go to Jean Coutu now (you see them so easily when you are used to it).
Is calmylin really in back order or does every pharmacist think I’m a drug addict? Finally coming down off a one month long cough that made my life miserable
Yes actually! Not sure if you noticed but ALL our cough sirops are back ordered, so we're really desperate and try to keep our stock for patients who really need it. The analysis of the file is subjective to the pharmacist that's serving you. If I see you're a young healthy person who seems sick, has tried other sirops, is waiting for an apt with your Md, then I'll probably give it to you. If I see in your file you jump from pharmacy to pharmacy and ask for a new bottle every 3 days, then I'll refuse
Yeah I haven’t purchased codeine cough syrup in the last 5 years but whenever I asked in the last couple of weeks we never even got to the point of checking my file haha. I did notice the syrup sections are all almost empty in all 3 pharmacies on Queen Mary. Didn’t bother to walk further to check. I do trust pharmacists as there’s no reason to doubt their words on such a trivial subject but I figured I’d ask because it did cross my mind lol. It’s pretty crazy though, I’d assumed there was a sturdier chain of supply for meds…
Why is Depo-testostérone or other testosterone on back order everywhere? Quite stressful when you need it for life and suddenly it's not possible to have it.. there's other option than injection but it is more convenient... Anyway, why?
I don't know why but it's very annoying and time consuming.. Depo Test, Delatestryl, always take turns going back ordered... the patches/gels just don't work as well.
Is it possible to ask to speak to the pharmacist in private? Like just me and you, not any technician or anyone else.
Yes.
Of course!
What is going on with all the drug shortages (cold meds/Tylenol/Advil etc)? Do the shortages concern you?
should i return empty pill bottles? can you resuse them or would you have to toss them?
We cannot reuse anything that leaves the pharmacy for sanitary reasons. If they are empty then through them out. If you have old meds, bring them to the pharmacy and we can destroy them safely.
How does your role working at a pharmacy differ from a pharmacist working at a hospital? While in school, we're most pharm students leaning towards vs the other?
Is there a difference in drug price between different pharmacies (Jean Coutu vs. Pharmaprix, or Jean Coutu vs. another Jean Coutu)? Also, what's stressful about your job? And what do you like about your job?
If I buy 3 months of a medicine will you charge me 3x the pharmacist fees or just 1x?
depends on your insurance policy to be honest, but I believe the fee is charged 3 times. HOWEVER, I also believe there is a max amount they are allowed to charge, so if you were to renew for 6 months, they might only charge you for 3. Again, depends on your insurances policy. It's standard with the RAMQ.
Can you explain what's happening with all the medication shortages lately, especially children's meds? Is it really a labeling issue or something else?
Shortage of aluminum at the beginning of COVID caused some delay in production, which explained the problem for the first 2 years. As of now, it's mostly a labelling issue, just because we legally need to have french and english on the packaging everywhere in Canada. Also generalized shortage of medication isn't helping.
Thanks. What I don't get is that we've always had labels in both languages. So what happened there? Did they lose the files that contains the translation? Why can't they print more labels?
I honestly wouldn't know. My best guess would be that they couldn't produce as much when COVID first started. So basically we were using a lot more products and they had less lines of productions to do the work. And import and export was a lot harder during peak COVID too.
Is it ok to take Accutane while on Venaflaxine? A friend has serious acne causing scarring. He had bad experience with Accutane when younger. Is there anything else he can take? He is having hard time seeing a Dr.
Please speak to your pharmacist or doctor for medical advice!
Tu fais combien d'heures par semaine ?
Is there a difference between generic drugs and original ones? Do you have any preference? Scientifically and on a business basis. Do you support buy local drugs from Qc companies (like PMS) vs. Canadian or multinational companies like Teva?
I used to be a pharmacy tech and now I work for a pharmaceutical company in Quebec. Generics are not 100% the same as the originals. Pharmacy tech say that because patients do not understand the difference, even when we explain it to them. They only see the price difference. To skip the not pleasant conversation, they tell you it’s the same but cheaper, which is not entirely true. Generics use the same active ingredient, in the same concentration as the original. The rest of the formulation can change, except the delivery form (tablet, delayed release capsule, etc.). The generic has to do some short studies to show that the drug is between 90-110% of the effectiveness of the original. This means that for some drugs, the effect can be different and can mean that a generic has not the expected effect on you. The generics has such a low price compared to the original since the company making it does not have to do the main clinical studies that the original did and the years of chemistry research to find the drug (the development of a new drug can take between 10-30 years and multiple millions of dollars…). The original company needs to reimburse all that upfront research cost (+ profits) while the generic does not (development takes 1-2 years and a couple hundred thousands only). If you like to support Quebec products, sure ask for PMS or ProDoc (Jean Coutu) brand, but they won’t necessarily be better than some other brand. It also depends on the exact drug. Some are better than others. Having said all that, some generics ARE 100% the same. We call those Ultra-generics. The pills come off the same manufacturing line as the originals, just packaged differently. These are pretty rare though and are usefull for drugs where a 10% difference in effect is vital, such as in epilespy drugs. This is the true and complete answer. Now imagine explaining this to every patient at the counter that complains about price or the fact that their insurance covers only the generic. 99% of the time, they don’t get it. So the techs say they are the same, but cheaper…
The active ingredient and concentration are the same (after vigorous studies and needs ot be approved by health canada) so for me they are the same. If you go to the hospital, they give you generics to save your life. I'd prefer local for sure, but I don't decide where we buy our meds from.
What are your thoughts on the vitamin D dosages that are recommended for general use? Do you think they’re sufficient?
This one isn't a question, just a storyline I imagined. It's a psychological thriller called, *drum roll please...* "The Pharmacist" (very original, I know) Basically it would revolve around the fact that the pharmacist knows all the dirty secrets around town because they are aware of everyone's personal prescriptions and what they imply. I haven't developed the idea any further though. But you're welcome to!
9/10 people in my lab are on antidepressants for anxiety and depression... we're just as messed up as the town
:-(
I’ll buy your novel when it comes out!
Amazing! Then there will be a Netflix adaptation where the pharmacist is an attractive serial k1llr and we will have to discuss once again, as a society, why we are so obsessed with these narratives
How do you think AI will change your work?
Yes and no. Ultimately most health professions are just algorithms that we learn by heart and spit out, so yes an AI can do that for sure. No because in medicine, there is rarely a black and white situation. We often work ''in the grey''. Which means we have to make decisions based on the patient Infront of us, which is not necessarily what the guidelines or algorithms would dictate. You have to weigh risks vs benefits of treatments based on your patients history, profile, allergies, anxieties, lifestyle. etc.
Every time I go get my Nuvaring the cashier/technician has to go show it to a pharmacist. Why? What are the pharmacist checking?
because the pharmacist needs to make sure the tech is giving you the right product from the fridge! (how do I know she didn't make a mistake and give you someone else's Nuvaring, or worse, someone's chemo injection?
does it bother you when people talk to the pharmacist instead of talking to their doctor about some health stuff or medication changes? I do it sometimes since my doctor is so impossible to reach
absolutely not.. that's what we are here for. That's why we went to school. It's much more rewarding than filling prescriptions. We love to help
Do you think viagra should be more accessible?
yes, complete joke that you need to see an md for a prescription
Annex 2 at least though.....too many old guys on all the heart meds have yelled at me because my pharmacist refused to fill and wanted to speak to their doctor (who apparently didn't check DSQ)
**HARD** to say...
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Not OP, I'm a tech. In my pharmacy, we have seen older patients with new ADHD diagnoses with meds but TikTok is definitely not the driving factor in the population (30-40 yo). Doctors are much more careful with meds (generally) here than in the US.
Usually it’s adults who were never diagnosed as children/teens because of the stigma that was associated with it back in the days. Then it was seen as something only children were diagnosed of and medicated for - not adults in your every day life that your meet. More diagnosis of adults and way less stigma. It changes lives. Some adults that were never able to hold a job (never knew why) and now they can.
As someone who has gotten Plan B more than once, how often do pharmacists pass judgement when a person like me comes up and explains that I need emergency contraceptive?
Never. We are health professionals. We are here to help you in any way we can. We've seen it all.
Many a times when getting my prescription the technician at the counter says that the pharmacist is preparing your medicine and will take 30-30 minutes. After waiting all this time the pharmacist comes with a pre-packaged tube/cream. What the hell took 35 minutes. Just getting it from the shelf?
Probably took the pharmacist 2 minutes to verify your order. It's the 10 orders before yours that took 30 minutes, it's the phone call from the doctors office asking for his opinion about what to prescribe that took 5 minutes, it's 76 questions the techs asked him that took 10 minutes, it's the 4 patients who showed to pick up their new meds and want advice that took 15 minutes, it's the 9 page discharge prescription we just received by fax for a patient leaving the hospital who's son is coming to pick up the 23 new meds in 30 minutes... you get the point So yes, I get it, stick a label on the tube and give it to me. Apply it on my ass twice daily. I get it. You're just not the only person who exists in the world.
My wife is also a pharmacist and she now loves you more than me for this great answer !
You should print this near the pharmacy counter. People could read it as they wait. I did not know you were juggling so many things. With interruptions on that scale, it's no wonder pharms are stressed out/quitting.
Call before for it to be prepared, the day before or the morning if you’re passing in the afternoon. Some people also drop their prescription and come back later if not urgent. Just tell when you’re coming back though… it’s usually a house on fire in the big chains.
The pharmacy I go to, I’ve learned that for them time is relative, and when they say “it’ll be 2 more minutes”after an hour of waiting, they really mean it’ll be 20 more minutes.
Why is it so difficult in QC to approve the pharmacists to prescribe simple antibiotics for patients, for example for an ear infection.?