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Author: Subject: SMH - How can there be so little knowledge at pharmacies?
RogueRose
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sad.gif posted on 5-7-2016 at 18:26
SMH - How can there be so little knowledge at pharmacies?


SMH (shaking my head)...

The following stories are US based..

At a pharmacy that specializes compounding and supplying medical equipment to offices and labs I asked the head pharmacist (say ~45 years old and employed there for a good number of years - they guy who handles the controlled meds) if they had or could order potassium hydroxide I was asked "pills of what milligram?":o I didn't know what to say, I said it was usually a powder, beads or flakes, possibly a solution. I got a look like I just made a request in some alien language. After that I just said nevermind.

At another pharmacy, a large nation wide chain, I saw a bottle of castor oil behind the counter on a shelf which looked like a display and possibly not stock. I asked the head pharmacist (only person there) if it was for sale or if it was "decor/display" and pointed and described the item. She picked it up and scanned it and couldn't find a price but it had an old pricetag so it had been for sale - or still was. Since it wasn't incomputer, no-sale. She asked why I needed it - what was it for (why that matters, IDK...).

Same pharmacy as castor oil, I asked for glycerine a week later as it wasn't on the shelves where it was a year before. Asked pharmacist if they had it and all she could offer was suppositories (all a search for "glycerine" would return on their computer). I had to explain what it was - really! A thick clear liquid in a 4 or 8oz bottle. The pharmacist seemed like she had never heard of this before. I felt like I was asking for a fine botlte of wine a McDonalds.

There are many other experiences that have dealt with medications and they have at times performed similarly cluless even after referring to the almighty computer.

I can not understand how a person who is supposed to have the training required for a head pharmacist to have such little understanding of some of the most common chemicals that a high school chemistry graduate should easily know. I have heard similar stories from some people, one being a doctor, about an absolutely ALARMING lack of fundamental knowledge and often common sense by people in professions where it would seem impossible for these traits to allow for continued employment - if they can even gain employment.

This is truly scary especially when some of these people go on to work in legislation or advise on it. I am wondering if these people (or some of them) understand how ignorant they are and the damage they can cause. I have come across this all too often in the IT world where (IT) managers implement virtually no security measures or totally inadequate measures where they are of vital importance.

I don't want to say what I think about why this happens as it is too depressing but IDK what to do when I encounter it. No one likes when their ignorance is pointed out, especially by an "outsider of the industry", when they are "the authoritar" (say that in Cartman's voice)

I know this was often blamed on the "peter principle" or rising to a level about that which one is best suited, and then doing a horrible job - in other words "rising to the level of their incompetence"


On a similar note, I found out why so many bright people get fired within a 3 month period of being hired. They often excel at the position and learn it very well, possibly learning their superiors roles as well. In these cases the new-hire has become "essential" and a possible threat and the superiors see this and end up taking action - which could be harassments of types, stressful work environment, false accusations of inadequate work or out-right firing - all so the new hire doesn't become to "needed" or possibly show how poor of a job others are doing.

Does anyone else see this type of thing in society as a whole? If you see this and are from another country I'd love to hear about it and what you think about it and if there is anything that can be done.

The only time I have never run into this problem with working "too hard or to good" was when working hand in hand with the owner of the company. In those cases I always received great feedback and appreciation for work and effort provided and going above and beyond was often greatly appreciated and acknowledged..

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ziqquratu
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[*] posted on 5-7-2016 at 20:08


I'll be the first to admit that I've had issues with pharmacists before - like the time one tried to sell me a homoeopathic "remedy" for my child. I'll also freely acknowledge that there are lazy, incompetent and even outright bad operators in every profession, and also that anyone can have a bad day. That said, I think you're being a little unfair here.

Think about it - a pharmacist spends the vast majority of their time dealing with medicines, and is expected to have up-to-date knowledge of what medicines are for what purposes; common side effects and contraindications; which medicines should not be taken together; and so on. They spend their time counselling customers on the drugs they're buying or have been prescribed; packaging and checking hundreds of doses of dozens of different drugs for the residents of the local aged care facilities; communicating with the doctor who just prescribed a patient a potentially dangerous combination of medicines; tracking stock to ensure they have critical medicines and that their supplies haven't expired; and so on. And when they talk to customers, they're answering questions about diseases and medicines all day long, and probably automatically assume that any sciencey-sounding term they're not familiar with has some relevance to drugs or diseases (and would be right about that most of the time, I'd happily wager!).

How often, in the life of a community pharmacist, do you expect they even need to think about simple chemicals like potassium hydroxide or glycerine, if those chemicals aren't also commonly used medicines? Sure, they have to study chemistry as part of their degree (at least, in my country they do), but by analogy, I was required to study atmospheric science, and whilst I recall the broad strokes, I can't remember the names for the different types of clouds, let alone what the differences between them are! As a more pertinent example, I can imagine that most pharmacists would recall how to deal with dilutions (since some common medicines - some antibiotics, for example - do need to be prepared as a solution or suspension for use), but would not necessarily recall what a mole is, since drugs are most commonly done by mass/volume - a pharmacist has no practical use for the mole, and so it's quite reasonable to assume that they might forget about it (or, at least, need prompting to bring it back to their mind).

Once you specialise in an area, or work in a place where certain aspects of your knowledge are called upon extremely rarely, it's easy to forget the things that are no longer commonly important in your speciality or day-to-day work - especially when you're doing something that requires you to draw from an enormous body of other knowledge on a daily basis. Ultimately, I would ask you - when it comes time for you to walk into a pharmacy with a need for advice on a medical issue, will it really matter to you if they know what potassium hydroxide is, so long as they're up-to-date on the information needed to address your medical problems? Would you rather your pharmacist spend time revising their undergraduate chemistry text, or would it be better for them to keep up with the medical literature?

As for asking why you need the castor oil - a pharmacist has a duty of care that not too many other professions share, because they're giving out medical advice and medicinal products from a position of respect and authority, and most take that responsibility seriously (most of the time - unless they've bought in to nonsense like homoeopathy, for example, although even then they're usually well-meaning and misguided, rather than stupid or malicious). They know that any medicinal product can have side effects - which can often be disastrous - and that people take all sorts of things which could be harmful for all sorts of reasons, so they usually err on the side of caution and, where there's no obvious reason that you'd need something, they ask. It's not the pharmacist being snoopy; it's usually not even them trying to cover their asses against a lawsuit. Usually it's genuine concern for the wellbeing of their customers that drives them to ask why you need something, to ensure that granny isn't trying to treat her diabetes with multivitamins, or 70 kilo Sal isn't trying to shed 40 kilos before bikini season by using a castor oil laxative.
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[*] posted on 5-7-2016 at 21:36


You needed the glycerin for the soap bubble recipe that comes with the giant bubble blowing kit-

https://www.vat19.com/item/bubble-thing-giant-bubble-maker/a...

Or at least I did, several decades ago. I did find a different type use for the rest of that 8oz. Bottle of glyceri
Pharmacists have got me castor oil, 500ml straight methyl salicylate, lovely AN cold packs...




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[*] posted on 6-7-2016 at 07:28


It's my experience that big chains are a no go for the cool stuff.

My friend's father owns 4 pharmacies in Amish country and he has all sorts of good things that aren't carried at any chain. He is an old fashioned pharmacist with a good knowledge of chemistry, and quite the impressive collection of old reagent bottles (including some various bottles of certain tinctures that they just don't make anymore, like laudanum). He's able to order through Aldrich and such.




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[*] posted on 6-7-2016 at 08:58


I know these feelings very well, however one day, I was at pharmacy looking for some oxalic acid. I was obviously prepared that the pharmacist will look at me as if she sees some extraterestrial entity, drug maker, terorist,.... (U know what I mean :D). But not this time!
This time she simply asked how many grams I want, so I just bought it and said goodbye. <---- It had made my day:):):).

[Edited on 6-7-2016 by crystal grower]




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[*] posted on 6-7-2016 at 15:12


Pharmacies are places where you buy milligrams of Drugs, not kg of chemicals.

A Pharmacist studies Pharmacology for several years, specifically the important parts, like how how certain highly complex human biochemical systems (generally) react to the introduction of an exogenic substance, such as acetylsalicylic acid (aspirin).

During the course of their intensive studies into That kind of thing, there really is not enough time to go into the details of growing copper sulphate crystals or making glacial acetic acid.

Comparing a Pharmacist to a Chemist is the same as chalk and cheese.

Would you expect an Astronaut to know how to precision-machine the sealing rings on his booster rockets, be an expert in stainless steel smelting, also an expert pilot and chemist ?

The local Farmacia/Pharmacy/Apoteke is basically a drug store, not a bulk chemical shop.

Ebay on the other hand ....




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[*] posted on 6-7-2016 at 18:46


Quote: Originally posted by aga  
Pharmacies are places where you buy milligrams of Drugs, not kg of chemicals.


Of course it wasn't always that way. The old apothecaries were chock full of chemicals. The first real chemical I bought was in the late 1980s at the old Rexall Drug in Vienna, VA...the real old one, across the street from Magruder's, not the newer Rexall next to it. I was probably about 13 and had seen my 7th grade science teacher do the glycerin+KMnO4 reaction. Believe it or not...nope this wasn't Oliver Sacks as a kid in the 1940s...this really happened in the late 1980s. I was very young looking and small for my age. I just asked the old pharmacist if he had any potassium permanganate and he produced a professionally labeled amber bottle and sold it to me! I still can remember some of it vividly because I was so nervous! I do think he said something like "you know you have to be careful with that, kid"? And I'm sure I answered "yes, sir." It was a fair amount, probably 1 pound. A 8 oz. amber glass wide mouth bottle about 2/3 filled. There were a few instructions for making 5000:1 dilutions for use as some kind of topical anti-infective. I so wish I'd kept the bottle afterwards, notably old looking,* I think it was made by one of those New Jersey based pharmacy supply companies. Nowadays, a kid asking for that would probably be temporarily incarcerated, get a visit from the bomb squad and EPA to their house, and their parents brought up on charges.

* - anyone remember the bottles that "Zephiran" was sold in? I always thought those were so cool looking, but I remember them being out of my budget. You could also buy them at those sort of old-time pharmacies. The old Alkalol was good too, but it's been modernized.
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[*] posted on 6-7-2016 at 18:58


Well, you can still buy pounds of KMnO4 OTC today, it's just going to be disguised as "Pot Perm Plus" or something like that. I found a two pound bottle at a Habitat for Humanity store for half price once. They had received a lot of surplus from a local Home Depot. In the same place, I found a big, high quality black lab bench top that they said came out of an old air force base lab for only $70. They clearly had no idea of its true value. Now that made my day...



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[*] posted on 6-7-2016 at 19:31


Yep, I knew you could buy it for recharging greensand filters, but I was addressing how pharmacies have changed. I wonder if some historian of commerce has written a dissertation on how pharmaceuticals separated from chemicals, but prior to the 20th century, people more or less thought of them as the same thing.
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[*] posted on 7-7-2016 at 09:09


As ALWAYS, the wet blanket's (aga) explination is full of holes and reeks like poo. I bought all the college books of a pharmacist who was selling them and talked to him about what he studied (HAD to study). I've never met a pharmicist that hasn't had less than a few classes in chemistry and I know a couple who were chemistry majors then did a pharmacy degree.

As I said, the store I went into probably makes more $$ from medical equipment and chem supply to labs than it does in pharm's. Also, compounding pharms often use chems and they have to know chemistry. They have tons of 4oz - 32oz bottles of various chems on the back shelf that have nothing to do with dispensing pills.

I can't think of any excuse that someone could give that a pharmacist shouldn't know one of the most common bases used in chemistry and the pharmaceutical industry for manufacturing.
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[*] posted on 7-7-2016 at 09:17


Quote: Originally posted by RogueRose  
As ALWAYS, the wet blanket's (aga) explination is full of holes and reeks like poo.

Confuscious say :-

When reading book,
then smelling poo,
check all pages for source of smell.
If none found, smell came from own fingers.




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[*] posted on 7-7-2016 at 09:23


Around here you normally get meds and drugs from the doctors surgery, the chemists in the town are pretty much condom and cough syrup type shops! loads of different aftershaves and millions of remedies for sore throats but little else.

my doctors surgery will also give you a couple of syringes if you ask nicely (without the needles).
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[*] posted on 7-7-2016 at 10:43


I would really be surprised if my local pharmacists didn't know what glycerine (or glycerol) was. When taking organic chemistry in college the pharmacy students were some of the brightest in the class. But perhaps after 30-40 years of worrying about drug interactions and government regulations and never having to use glycerine they may have forgot.

I graduated decades ago in chemical engineering. If not for my hobby and this forum I would have forgotten nearly all of what I learned.

I saw a bottle of glycerine behind the counter and asked about this. The pharmacist said that the only reason it was there was that there were few requests for it.




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[*] posted on 7-7-2016 at 13:43


No idea what the pharmacist does or dosnt know around here, i havnt spoken to them. I would be surprised if a fully qualified pharmacist didnt know their stuff.
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[*] posted on 10-7-2016 at 01:17


I highly doubt that a pharmacist wouldn't know about glycerine. For one nitroglycerin is a very common heart medication so they know part of the word from that not to mention normal glycerine it's a skin moisturizer and you can drink it so that overdue and over developed log doesn't have as much friction upon exit.

If I had to guess they are playing dumb because they assume you're an idiot. When I bought HCl I got at least twenty questions and I gave the worst and most smart ass answers and they still sold it. I specifically said I wanted it for the reasons they are supposed to deny sales.




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[*] posted on 10-7-2016 at 01:44


Quote: Originally posted by Arg0nAddict  
I highly doubt that a pharmacist wouldn't know about glycerine. For one nitroglycerin is a very common heart medication so they know part of the word from that not to mention normal glycerine it's a skin moisturizer and you can drink it so that overdue and over developed log doesn't have as much friction upon exit.

If I had to guess they are playing dumb because they assume you're an idiot. When I bought HCl I got at least twenty questions and I gave the worst and most smart ass answers and they still sold it. I specifically said I wanted it for the reasons they are supposed to deny sales.


Why didnt you just tell them the glycerine hadnt shifted the log :D, and you wanted the HCl for a proper delogging
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[*] posted on 10-7-2016 at 02:08


Quote: Originally posted by NEMO-Chemistry  
Quote: Originally posted by Arg0nAddict  
I highly doubt that a pharmacist wouldn't know about glycerine. For one nitroglycerin is a very common heart medication so they know part of the word from that not to mention normal glycerine it's a skin moisturizer and you can drink it so that overdue and over developed log doesn't have as much friction upon exit.

If I had to guess they are playing dumb because they assume you're an idiot. When I bought HCl I got at least twenty questions and I gave the worst and most smart ass answers and they still sold it. I specifically said I wanted it for the reasons they are supposed to deny sales.


Why didnt you just tell them the glycerine hadnt shifted the log :D, and you wanted the HCl for a proper delogging


Let me clarify a bit, it was 32.45% Muriatic Acid that was industrial grade for concrete cleaning. It was cheaper than I've ever seen it $10/gal and I always wanted to try and reach its 37% maximum dissolved HCl in water solution and remove the yellowish impurity. I've never had a problem using 32 but having a saturated solution and no color would be nice as I just got a 1/5oz of 0.9999 gold coins that are damaged from drilling. I got quite the deal and I verified the metal myself.... Oh yeah anyway HCl enema no thank you. Anus chloride is not a substance to be trifled with. Plus filtering the intestinal hydroxide can ruin your assware it eats right through it like hydrogen fluoride on glass

Ok. I'm done. Its late and I'm saturated in ethanol. I'm probably rated a 3 right now for flammability. And yes of course it's 200 proof well 198 but I think the cheap China hydrometer is off a bit or I mixed up the sieeve labels




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[*] posted on 12-7-2016 at 16:55


Most of the chain stores in the us only have one pharmacist, all the rest are pharmacy technicians.
Often the pharmacist is shared between multiple locations. So if you see such a person it is a rare
occurence. In some places they are no longer even required to have a real pharmacist. And the
requirements have changed. As some have pointed out, compounding is now a specialty.
Even the real pharmacist seldom use chemistry now. I find glycerine in health and nature
stores as a skin treatment and laxative. Potassium hydroxude is practically non-existent outside
soap and biodiesel suppliers.
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[*] posted on 15-7-2016 at 09:31


Quote: Originally posted by Arg0nAddict  
Quote: Originally posted by NEMO-Chemistry  
Quote: Originally posted by Arg0nAddict  
I highly doubt that a pharmacist wouldn't know about glycerine. For one nitroglycerin is a very common heart medication so they know part of the word from that not to mention normal glycerine it's a skin moisturizer and you can drink it so that overdue and over developed log doesn't have as much friction upon exit.

If I had to guess they are playing dumb because they assume you're an idiot. When I bought HCl I got at least twenty questions and I gave the worst and most smart ass answers and they still sold it. I specifically said I wanted it for the reasons they are supposed to deny sales.


Why didnt you just tell them the glycerine hadnt shifted the log :D, and you wanted the HCl for a proper delogging


Let me clarify a bit, it was 32.45% Muriatic Acid that was industrial grade for concrete cleaning. It was cheaper than I've ever seen it $10/gal and I always wanted to try and reach its 37% maximum dissolved HCl in water solution and remove the yellowish impurity. I've never had a problem using 32 but having a saturated solution and no color would be nice as I just got a 1/5oz of 0.9999 gold coins that are damaged from drilling. I got quite the deal and I verified the metal myself.... Oh yeah anyway HCl enema no thank you. Anus chloride is not a substance to be trifled with. Plus filtering the intestinal hydroxide can ruin your assware it eats right through it like hydrogen fluoride on glass

Ok. I'm done. Its late and I'm saturated in ethanol. I'm probably rated a 3 right now for flammability. And yes of course it's 200 proof well 198 but I think the cheap China hydrometer is off a bit or I mixed up the sieeve labels


Not to be too pedantic but.....isnt it Anal Chloride and not Anus Chloride?
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