Proposal to Change legal structure of Psi Benevolent Fund

issue 7 volume 12 july/august • 2010 www.greencrosspublishing.ie 

the THE independent INDEPENDENT monthly MONTHLY for FOR irish IRISH pharmacists 

PHARMACISTS 

Proposal to change legal structure of Psi Benevolent Fund p10 

neWs 

Doctors can object to 

pharmacist substitution p4 

IPU calls for the reinstatement 

of over the 70s fee p4 

Minister favours bigger role 

for pharmacy p4 

LTI and HEP C medical card 

holders – exempt from 50c 

charge p4 

PSI guidelines on patient 

consultation p6 

Pharmacists received 

payments of almost €17 

million p8 

IMB’s remit to be extended to 

cosmetics p8 

European Court backs limits 

on pharmacies p12 

Ombudsman critical of EMA 

p12 

sPeCial rePort 

Battle oF the laBs 

Headshops – after the ban 

June Shannon 

Q and a 

Rory O’Donnell 

Vice President IPU 

des Corrigan 

Celibate 

monks and the 

menopause 

david Jordan 

How private is 

private? 

Chronic 

obstructive 

pulmonary 

disease 

MiChelle MCdonagh 

CorMaC o’neill 

Protecting 

intellectual 

property 

Fintan Moore 

The Island of Dr R 

The clever way to fight stomach discomfort. 

PA Holder: McNeil Healthcare (Ireland) Ltd., Airton Rd, Tallaght, Dublin 24. PA Number: 823/51/1. Product not subject to a medical prescription. Full prescribing information available on request. MOA/019/01

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the independent monthly for irish pharmacists 

issue 7 volume 12 • july/august 2010 

4-11 neWs 

12 eU PharMaCy neWs 

Gary Finnegan reports from Brussels. 

14 herBal MediCine 

In his brilliant series on uses of herbal medicine Dr Corrigan 

explores the uses of Agnus castus. 

16 the CoalFaCe 

David Jordan aint that impressed with the PsIs ideas for 

consultation areas. 

18 sPeCial rePort 

Battle of the labs 

As the remaining headshops’ attempt to circumvent the law June 

shannon interviews Dr Pierce Kavanagh of TCD who is attempting 

to beat them at their own game and Dr Bobby smyth, Adolescent 

Psychiatrist who is dealing with the casualties of ‘legal highs’. 

20 Q and a 

rory o’donnell 

newly elected Vice President of the IPU answers our questions. 

22 FinanCe 

Iain Cahill 

contents 

24 the laW 

Protecting intellectual property. Cormac O’neill on the legal 

implications of patents and copyright. 

25 CliniCal revieW 

The ciagnosis and treatment of hronic obstructive pulmonary 

disease and the role of the pharmacist. 

Michelle McDonagh 

28 e-PharMaCy 

Opening of the new pharmacy laboratory at TCD 

32 ProdUCt neWs 

35 CrossWord 

your chance to win €70. 

36 oUtside edge 

Fintan ponders the ‘talents’ of one Dr James Reilly. 

Irish Pharmacist is published by GreenCross Publishing, 

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Nevertheless, no responsibility is accepted 

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Any opinions expressed by contributors are 

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Cooke and Maura Henderson. Between them Graham and Maura have over 30 years experience 

working in healthcare publishing. Their stated aim is to publish titles which are incisive, vibrant and 

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EDITOR: Maura Henderson 

DEsIGn: Barbara Vasic 

REPORTER: June shannon 

sUB-EDITOR: Tim Ilsley 

PUBlIsHER: Graham Cooke 

PUBlIsHER: Maura Henderson 

COnTRIBUTORs: Iain Cahill, Dr Des Corrigan, 

Garry Finnegan, David Jordan, Julian Judge, 

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Publishing 2010 

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4 

news 

THE IPU has called on the Minister 

for Health to reinstate the 

over 70s fee paid to pharmacists, 

as according to the union, 

pharmacists are not adequately 

rewarded for looking after this 

cohort of patients. 

As part of its submission to 

the Minister on the Review of 

the Financial Emergency Measures 

in the Public Interest (FEM- 

PI) Act, 2009, which the Minister 

was obliged to complete by the 

30th June last, the IPU stated 

that the rationale for the over 

70s fee was in recognition of the 

extra time involved in dealing 

with this patient segment. 

According to the submis- 

sion “the fee was abolished on 

the basis that there would be 

a significant reduction in the 

number of medical cards held 

by patients over 70, due to 

eligibility changes. However, the 

impact of the changes has been 

much smaller than budgeted 

for.” 

“At the end of 2009 there 

were 337,669 over-70s with a 

medical card, which represents 

a reduction of just 14,184 or 4 

per cent in the 12-month period 

following the changes. In the 

current fee structure, pharmacists 

are not being adequately 

rewarded for looking after 

patients over 70. If the Minister 

proceeds with the introduction 

of the prescription levy and 

of a reference pricing system, 

then the pharmacist will have to 

spend even more time with this 

patient cohort,” the submission 

stated. 

The IPU submission also 

pointed out that as those over 

70 are normally on a number 

of medications they will be the 

sector most affected by the 

prescription levy and that the introduction 

of a reference pricing 

system would also call for an increased 

amount of pharmacist’s 

time counselling the patient and 

making sure that they adhere to 

their medicines. 


iPU calls for the reinstatement of over the 70s fee 

As Irish Pharmacist went to 

press the Heads of Bill of 

the new legislation for the 

introduction of the 50 cent 

prescription charge were due 

to be published, however, Irish 

long Term Illness (lTI) and Hep 

C medical card holders will be 

exempt from the charge Irish 

Pharmacist has learned. 

According to the 

Department of Health “the 

Bill will provide that a person 

with full eligibility who is 

Prescribers can object to pharmacist 

generic substitution for clinical reasons 

Pre cribers will have the option 

to object to pharmacist generic 

substitution on clinical grounds 

but must include a specific exemption 

code on the prescription 

according to the recently 

published report on generic 

substitution. 

The report on a Proposed 

Model for the substitution 

of Interchangeable (Generic) 

Medicines and Reference 

Pricing stated that the inclusion 

of an exemption code on 

prescriptions would enable 

the HsE to monitor the use of 

exemptions by prescribers. 

The report noted that in 2006, 

prescribers in sweden objected 

to substitution in just 2.5 per 

cent of all cases. 

darragh o'loughlin 

lti and heP C medical card 

holders – exempt from 50c charge 

supplied by a community 

pharmacy contractor with a 

drug, medicine or surgical 

appliance on the prescription 

of a registered medical 

practitioner, registered dentist 

or nurse (who is entitled to 

prescribe) shall be charged 50 

cent per item. It is important 

to note however that the 

maximum payable by a person 

and his or her dependents in 

any month will be €10.” 

Coupled with lTI and Hep 

Under the proposed model 

for the substitution of Interchangeable 

(Generic) Medicines 

and Reference Pricing 

set out in the report, when 

prescribers prohibit substitution 

for clinical reasons patients 

do not face any additional costs 

if the prescribed product costs 

more than the reference price. 

According to the Department 

of Health government 

approval has been received 

for the drafting of Heads of a 

Bill to provide for the introduction 

of reference pricing and 

to permit generic substitution 

by pharmacists. The General 

scheme and Heads of a Bill are 

being drafted and a Regulatory 

Impact Analysis, which will 

C medical card holders other 

categories of patients who will 

be exempt from the charges 

include: children who are in 

the care of the HsE and those 

who are supplied with specific 

controlled drugs such as 

methadone. 

The Bill also permits the 

Minister for Health to make 

regulations to exempt other 

groups of patients from the 

charge subject to certain 

conditions. 

include consultation with all 

relevant stakeholders, is also 

being undertaken. 

Responding to the report 

the IPU welcomed the move by 

the Minister for Health to allow 

pharmacists offer patients the 

choice of a cheaper generic 

medicine. However, the union 

called on the Minister to take 

a cautious approach to the 

introduction of a system of 

reference pricing which could 

lead to medicine shortages. 

The IPU said that it would be 

examining the report in detail 

and will then be seeking a 

meeting with the Minister for 

Health to discuss the implications 

of today’s report for 

patients and pharmacists. 

THE Minister for Health has said 

that she would like to see the 

expansion of the role of pharmacists 

in the Irish healthcare 

system. 

speaking to Irish Pharmacist 

at the opening of a new 

teaching facility at the school 

of Pharmacy at TCD recently 

Minister Harney said that she 

was a “strong fan” of expanding 

the role of pharmacists in the 

healthcare system. 

The minister said that there 

were a great number of areas 

where she would like to see 

a greater role for pharmacy 

including asthma management 

and smoking cessation. 

“I think there is many, many 

areas, appropriate management 

of medication, informing patients, 

very often if people have 

the right information about their 

illness it is much more likely that 

they will take the appropriate 

medication and take advice 

from somebody they know well 

such as their community pharmacist. 

so I would like to see an 

enhanced role for community 

pharmacists,” the Minister said. 

However when asked if pharmacists 

would receive any extra 

funding for providing additional 

services the Minister said that 

there was a “finite sum of money 

available” and it was a question 

of using existing resources “in a 

different way to deliver better 

outcomes.” 

The new facility at TCD, the 

‘Boots Practice of Pharmacy 

Teaching and Development 

“In light of the fact that 

most over-70s patients have 

retained their medical card and 

the greater demands of this 

particular cohort of patients 

on the professional advice of 

pharmacists, the Union is calling 

on the Minister to reverse the 

decision to remove the fees in 

the forthcoming review,” the IPU 

stated. 

In its submission to the FEMPI 

Review the IPU also called on 

the Minister to eliminate the 

€3.50 fee band, which it said 

was “unsustainable” and to “establish 

a process to address the 

many challenges being faced by 

all stakeholders.” 

Minister for Health in favour 

of expanding the role of 

community pharmacy 

Unit’, includes a range of 

modern facilities designed to 

equip pharmacy students with 

the necessary skills to meet the 

challenges and opportunities of 

the future. stand-alone teaching 

stations will help students 

become familiar with the more 

traditional tasks of dispensing 

and administration, while separate 

areas have been designed 

to provide training in advanced 

pharmacy services. 

Minister Mary harney 

Commenting on its significance, 

the Minister for Health 

said: “The professional education 

and training of pharmacists 

and the conduct of pharmacy 

practice research will be of 

world class standard in this 

modern facility at Trinity 

College. Through the use of 

state-of-the-art educational and 

pharmacy technology, pharmacists 

will be trained in new 

and innovative ways, ensuring 

that patients in our healthcare 

system benefit from the highest 

standards of pharmacy care and 

practice.”

Why should your 

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When there’s a solution as simple as this. 

Diarrhoea has many causes and can strike at any time. Many people are reluctant to treat it because 

they believe it’s a natural defence mechanism to ‘flush out’ toxins or that treatments cause constipation. 

Diarrhoea is actually a symptom that the digestive system is working too fast. Imodium works with the 

body to slow the digestive rhythm to a natural pace, which prevents further fluid loss and stops diarrhoea. 

So there’s no need for anyone to suffer in silence. 

ReStoReS youR boDy’S natuRal RhythM. 

Tradename: Imodium Plus 2mg/125mg Tablets and Imodium Plus Chewable Tablets and Imodium Instants 2mg Tablets. Qualitative and Quantitative Composition: Imodium Plus: Each tablet contains loperamide hydrochloride 2 mg and 125mg simeticone. Imodium Instants: 

Loperamide hydrochloride 2 mg per tablet. Pharmaceutical form: Imodium Plus Tablet: Tablet, White, capsule-shaped tablet and Imodium Plus Chewable: White, round, flat-faced tablet with a vanilla-mint odour. Imodium Instants: Orodispersible tablet White to off-white, circular, freezedried 

tablets. Therapeutic indications: Imodium is indicated for the symptomatic treatment of acute diarrhoea in adults and adolescents over 12 years. Instants: As an adjunct in the management of diarrhoea together with fluid and electrolyte replacement. Posology and method of 

administration: Adults over 18 years: Imodium Plus: Take/Chew two tablets initially, followed by one tablet after every loose stool. Not more than 4 tablets should be taken in a day, limited to no more than 2 days. Adolescents between 12 and 18 years: Take/Chew one tablet initially, 

followed by one tablet after every loose stool. Not more than 4 tablets should be taken in a day, limited to no more than 2 days. Use in children: Should not be used in children under 12 years. Use in the elderly: No dosage adjustments. Use in renal impairment: No dosage adjustment. 

Hepatic impairment: Imodium Plus should be used with caution in such patients because of reduced first pass metabolism. Imodium Instants: Adults and children over 12 years only:The usual dose is 2 tablets initially, followed by 1 tablet after each further episode of diarrhoea up to a 

maximum of 5 in 24 hours. Elderly:No dose adjustment. Method of administration:Oral. Contraindications: Imodium should not be used in: Children less than 12 years of age. Patients with a known hypersensitivity (allergy) to any component of the product. Acute dysentery, which is 

characterised by blood in stool and high fever. Acute ulcerative colitis. Pseudomembranous colitis associated with broad spectrum antibiotics.Patients with bacterial enterocolitis caused by invasive organisms including Salmonella, Shigella and Campylobacter.In general, Imodium should not 

be used when inhibition of peristalsis is to be avoided due to the possible risk of significant sequelae including ileus, megacolon and toxic megacolon. It must be discontinued promptly if constipation, subileus and/or abdominal distension develop. The stated dose should not be exceeded. 

In addition to taking Imodium, patients should be advised to drink plenty of fluids such as water, clear soup and squash. Patients should be advised to consult their doctor if diarrhea persists for more than 24 hours. In addition Imodium Plus Chewable should also not be used in: Patients 

with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency, because the product contains sorbitol and sucrose. Special warnings and precautions for use: In patients with (severe) diarrhoea, fluid and electrolyte depletion 

may occur. It is important that attention is paid to appropriate fluid and electrolyte replacement. If clinical improvement is not observed within 48 hours, the administration of Imodium must be discontinued. Patients should be advised to consult their physician.Patients with AIDS treated with 

Imodium Plus for diarrhoea should have therapy stopped at the earliest signs of abdominal distension. There have been very rare reports of toxic megacolon in AIDS patients with infectious colitis from both viral and bacterial pathogens treated with loperamide hydrochloride. Although no 

pharmacokinetic data are available in patients with hepatic insufficiency, Imodium should be used with caution in such patients because of reduced first pass metabolism. Patients with hepatic dysfunction should be monitored closely for signs of CNS toxicity. Imodium Plus should be used 

under medical supervision in patients with severe hepatic dysfunction. Since treatment of diarrhoea with loperamide and simeticone is symptomatic, diarrhoea should be treated causally whenever such treatment is available. Interaction with other medicinal products and other forms of 

interaction. Non-clinical data have shown that loperamide is a P-glycoprotein substrate. Concomitant administration of loperamide (16 mg single dose) with quinidine, or ritonavir, which are both P-glycoprotein inhibitors, resulted in a 2 to 3-fold increase in loperamide plasma levels. The 

clinical relevance of this pharmacokinetic interaction with P-glycoprotein inhibitors, when loperamide is given at recommended dosages (2 mg, up to 8 mg maximum daily dose), is unknown. Adverse Effects Imodium Plus: Clinical trial data (common events only, reported for loperamide 

with simethicone).Gastrointestinal system disorders: Nausea. Special senses: Taste perversion.Post-marketing experience (reported with loperamide with simethicone, or loperamide alone). Skin and appendages: Very rare: skin rashes, pruritus and urticaria. Very rare (for loperamide): 

angioedema. Body as a whole, general: Very rare (for loperamide): allergic reactions and in some cases severe hypersensitivity reactions including anaphylactic shock and anaphylactoid reactions. Gastrointestinal system disorders: Very rare: abdominal pain, nausea, constipation, 

flatulence, vomiting, and dyspepsia. Very rare (for loperamide): abdominal distension, ileus and megacolon including toxic megacolon (See warnings and special precautions for use).Genitourinary: Very rare (for loperamide): urinary retention. Central and Peripheral Nervous System: 

Very rare (for loperamide): dizziness. Special senses: Very rare: taste perversion. Psychiatric: Very rare: drowsiness. Imodium Instants: In clinical trials, constipation and dizziness have been reported with greater frequency in loperamide hydrochloride treated patients than placebo treated 

patients. The following adverse events have also been reported with use of loperamide hydrochloride: Skin and Appendages Very rare: rash, urticaria and pruritus. Isolated occurrences of angioedema, and bullous eruptions including Stevens-Johnson Syndrome, erythema multiforme, 

and toxic epidermal necrolysis.Body as a whole, general Very rare: isolated occurrences of allergic reactions and in some cases severe hypersensitivity reactions including anaphylactic shock and anaphylactoid reactions. Gastrointestinal System Disorders Very rare: abdominal pain, ileus, 

abdominal distension, nausea, constipation, vomiting, megacolon including toxic megacolon, flatulence, and dyspepsia. Skin and Appendages Very rare: rash, urticaria and pruritus. Isolated occurrences of drowsiness Central and Peripheral Nervous System Very rare: dizziness A number 

of the adverse events reported during the clinical investigations and post-marketing experience with loperamide are frequent symptoms of the underlying diarrhoeal syndrome (abdominal pain/discomfort, nausea, vomiting, dry mouth, tiredness, drowsiness, dizziness, constipation, and 

flatulence). These symptoms are often difficult to distinguish from undesirable drug effects. MA Holder: McNeil Healthcare Ireland Limited, Airton Road, Tallaght, Dublin 24, Ireland. MA Number: Imodium Tablets: PA 823/60/2. Imodium Plus Chewable Tablets: PA 823/60/1. Imodium Instants: 

PA 823/56/2. Date of last revision: Imodium Plus: 11/2009, Imodium Plus Chewables: 11/2009, Imodium Instants: 06/2009.Not subject to medical prescription. Further information available upon request from Johnson & Johnson (Ireland) Ltd. Tel: 01-4665200. 

IMD/009/02

6 

news 

The PsI has published 

guidelines on the provision of 

consultation areas for private 

patient counselling, which 

must be in place in all retail 

pharmacies by 1st november. 

According to the PsI 

guidelines, the patient 

consultation area must be 

constructed so as to ensure a 

reasonable level of privacy for 

the patient, and the patient 

should also be provided 

with appropriate visual 

privacy, for example, for the 

demonstration of medicinal 

products and/or devices. 

“Visual and sound barriers 

can be used to ensure the 

above criteria are met. 

However, it is not necessary 

to create an enclosed room to 

achieve an appropriate level of 

THE Irish Heart 

Foundation (IHF) is 

calling on pharmacists 

to help with the 

promotion of a new 

campaign, which aims 

to raise awareness 

among women of their 

risk of cardiovascular 

disease (CVD). 

According to the 

IHF nearly 5,000 Irish 

women died from 

CVD in 2008. Research shows 

that Irish women believe that 

breast cancer is a bigger health 

risk than CVD with 60 per cent 

of those surveyed believing 

that breast cancer was the 

biggest killer among women. 

According to the IHF a total of 

731 women died from breast 

cancer in 2008 compared 

to heart disease and stroke, 

which caused nearly seven 

times more deaths in the same 

year. 

Worryingly, only 18 per cent 

of women correctly identified 

heart disease as the main 

cause of female death. 37 per 

cent of women also believed 

that heart disease was an 

exclusively ‘male disease’ even 

though just as many women 

die from it as men. 

This september the IHF with 

the support of the HsE aims to 

increase awareness of these 

issues using the international 

brand for heart disease and 

women – Go Red for Women. 

A sharp rise in the 

prevalence of CVD is expected 

across the population over 

privacy,” the guidance notes. 

The PsI document also 

recommends that patient 

consultation areas must also 

be designated areas to be 

used by the pharmacist for 

the sole purpose of patient 

consultation and counseling. 

It should not be used for other 

purposes, e.g. the storage of 

medicines or excess stock. It 

should also not be the only 

access route to other areas of 

the pharmacy. 

Each retail pharmacy should 

have a written policy and 

procedure, which encourages 

and trains staff to direct 

patients to the area and inform 

the next 10 years and of 

particular concern is the level 

of major risk factors among 

women. At present 32% of 

women are obese, 86% t have 

a cholesterol greater than or 

equal to 5 mmols and 53% 

have a blood pressure greater 

than 140/90 mmHG. By 2020, 

heart disease is expected to 

rise by 50%, stroke by 48%, 

high blood pressure by 40%, 

and diabetes (Type 1 and Type 

2) by 62%. 

That is why the Foundation’s 

Go Red for Women campaign 

will focus on specific issues 

for women including 

recognition of signs and 

symptoms of heart attack 

and stroke, healthy lifestyle 

behaviours and appropriate 

management of high BP and 

high cholesterol as well as 

the impact of menopause 

on women’s heart health. 

The charity’s national Heart 

and stroke Helpline 1890 

432 787 will be on hand to 

answer queries and further 

information will be available 

on request or at www. 

them of their entitlement 

to a private consultation. 

There must also be a sign in 

place, which informs patients 

that the facility exists and is 

available for their use. 

The guidelines approved 

by the PsI Council also cover 

issues such as accessibility and 

security. 

Encouraging the public 

to avail of their entitlement 

to a private discussion with 

a pharmacist about their 

medicines the CEO of the 

PsI Dr Ambrose Mcloughlin 

said that communicating the 

correct information to patients 

was as important as providing 

the medicine itself. 

“The World Health 

Organisation (WHO) states 

patients should be entitled to 

irishheart.ie 

In addition, there 

will be a free public 

lecture on women 

and CVD jointly 

organised by the RCPI 

and the IHF on 14 

september 6.30pm. 

A webcast link will 

also be available on 

the day which can 

be downloaded for 

later viewing. The 

month long campaign will end 

with the Foundation’s World 

Heart Day Walk on sunday 26 

september where everyone is 

invited to walk for 30 minutes 

or more to get their hearts 

pumping. 

The IHF is asking 

pharmacists to support the 

campaign by promoting 

awareness among women 

of their risk. Pharmacists are 

invitied to display Irish Heart 

Month promotional materials 

and to circulate flyers and 

information on the campaign 

as well as highlighting their 

plans for coronary health 

promotion such as blBPand 

cholesterol awareness. 

Free materials will be 

available to display in 

pharmacies from late June 

onwards. 

For more information on 

Irish Heart Month and the 

free public lecture or to get 

promotional material to 

display in your pharmacy 

contact Eimear Cotter 

on 01-6685001 or email 

heartmonth@irishheart.ie 

request to use such a facility if 

they wish to speak in private to 

a pharmacist. The requirement 

to have a consultation area 

within a pharmacy already 

exists in many countries, and 

is widely recognised as an 

essential element of good 

pharmacy practice. Patient 

consultation areas are a 

beneficial resource for patients 

and this facility will make it 

much easier for patients in 

Ireland to get the information 

and advice they need, in a 

confidential manner. Using the 

specialised knowledge and 

expertise of their pharmacist 

has huge potential to improve 

patients’ health, increasing 

patient education and 

encouraging the safe and 

rational use of medicines.” 


Psi publishes guidelines on patient consultation areas 

dr ambrose Mcloughlin 

Psi Ceo 

Pharmacists called to promote 

heart health amongst women 

Professor Paul Gallagher has 

recently been appointed as 

the new Director of the school 

of Pharmacy at the RCsI Irish 

Pharmacist has learned. 

Prof Gallagher replaces 

Professor John Kelly who 

has retired as the founding 

Director of the school. 

Paul Gallagher trained 

as a pharmacist in TCD 

and while practising as a 

pharmacist acted as tutor to 

pre-registration students. 

This experience rekindled 

his interest in academia 

and research and he took 

up a lecturing position in 

RCsI in september 2005. 

He has previously served 

as the convener of the 

RCsI Research and Ethics 

Committee and previous 

editor of the IPU review. In 

2007 he was appointed by 

Dr Mcloughlin added that 

the public should be aware 

that the term ‘patient’, as used 

by the PsI, refers to everybody 

using the professional services 

of a pharmacy or a pharmacist 

and includes people needing 

prescription and nonprescription 

medicines, as 

well as information and advice 

about their medicine use or 

other health-related issues. 

since the introduction of the 

Regulation of Retail Pharmacy 

Businesses Regulations 

in november 2008, all 

pharmacies are required to 

provide a designated area for 

patient consultation within the 

premises. A transition period 

was granted for pharmacies 

already in existence until 1 

november 2010. 

RCsI appoints new Director 

of the school of Pharmacy 

Prof Paul gallaghernovember 

2009 issue) 

the Minister for Health as the 

academic representative on 

the PsI Council on behalf of 

all three schools of Pharmacy. 

He is currently chair of the 

Professional Development and 

learning Committee of the PsI 

and Programme Director of 

the RCsI Pharmacy Internship 

Programme. 

RCsI Graduation Ceremony 

at the rCsi graduation Ceremony on the 3rd June 2010 are 

three Phd graduates from the school of Pharmacy: dr eva 

Bunk (neuroscience; jointly with department of Physiology), 

dr neeraj sivadas (Pharmaceutics), Prof. John Kelly (head of 

school) and dr tamasine grimes (Clinical Pharmacy).

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8 

news 

Pharmacists received payments 

of c1,695 million in 2009 

The HsE paid a total of c1,695 

million to pharmacists under 

its Community led schemes 

in 2009 according to the 

Executive’s latest annual report 

Published recently the HsE 

annual report for 2009 also 

revealed that the Executive 

paid for more than 67 million 

prescription items and that 

in excess of 4.9 million claims 

were made against the 

DPs, with over 13.5 million 

items paid for under this 

scheme. Almost 16.5 million 

prescriptions were filled under 

the GMs accounting for more 

than 50.9 million items. 

The report also found that 

that payments to wholesalers 

under the High Tech Drugs 

scheme totaled c315 million 

last year while c16 million 

was spent on patient care fees 

under the same scheme. 

According to the HsE the 

sustained deterioration in 

the Irish economy during 

2009, coupled with increasing 

numbers on the live Register 

and associated uptake of 

Demand led schemes, 

presented ìunprecedented 

challengesî for services during 

the year. In 2009 nearly 2.3 

million people used the 

services of 

Primary Care Contractors 

through arrangements under 

the Community schemes 

provided by the HsE, 

generating more than 72 

million transactions with an 

associated expenditure of over 

c2.9 billion. 

This expenditure also 

included costs associated with 

the Health (Amendment) Act 

1996, Methadone Treatment 

scheme, DTs prescriptions 

and Pharmacy Training 

Grants which came to 

c13 million, payments to 

dentists totaled c87 million, 

payments to optometrists/ 

ophthalmologists came to c24 

million, while payments to 

doctors totaled c500 million. 

According to the HsE 

ìdriving efficiencies continues 

to be our priority and the 

following projects were 

addressed during 2009: 

centralisation of medical cards 

and primary care schemes, 

clinical focus on all licensed 

drugs/medicines reimbursed 

and a review of all non-drug 

items reimbursed under the 

schemes. 

In total the HsE spent almost 

c2.9 billion on community 

schemes in 2009 which 

represented a 2.8 per cent 

increase on 2008 figures. 

new legislation to extend IMB’s remit 

to cosmetics due this year 

THE Department of Health 

is preparing new legislation, 

which will transfer the 

responsibility for the 

regulation of cosmetics in 

Ireland from the Department 

to the Irish Medicines Board 

(IMB). 

According to the latest IMB 

newsletter the new legislation 

is expected to be finalised 

during 2010, and once in force 

the IMB will be ìresponsible for 

the regulation of cosmetics in 

Ireland and will carry out the 

functions of the Competent 

Authority for cosmetics. 

As the Competent Authority 

for cosmetics the IMB will 

be responsible for: the 

maintenance of a notification 

database of cosmetic product 

manufacturers, importers 

and Responsible Persons; the 

establishment of a market 

surveillance system involving 

inspection, market sampling 

and analysis and review of 

product information files; 

the enforcement of the 

legislation where necessary; 

the generation of Certificates 

of Free sale; and participation 

in international activities 

including relevant EU working 

groups. 

The proposal to extend the 

IMB’s remit to cosmetics was 

first mooted in 2007 when the 

IMB initiated a project in 

conjunction with the 

Department of Health to 

assess the feasibility of the 

project. 

According to the IMB 

"this project has involved 

close interaction with the 

current Competent Authority, 

the Department of Health 

and Children and other 

stakeholders". 

Following on from the 

formal agreement with the 

Department of Health and 

Children, the IMB has begun 

the process of integrating 

the competent authority 

role for cosmetics into the 

new Healthcare Products 

Distribution section within 

the Compliance Department. 

The section also incorporates 

the areas of Controlled Drugs, 

Good Distribution Practice 

and the distribution of medical 

devices. 

a.Menarini meeting on kidney failure 

at a recent a.Menarini 

Pharmaceuticals meeting 

on Kidney Failure were 

tom holohan, a.Menarini 

Pharmaceuticals; dr helen 

Quirke, skibbereen; dr 

Fergus o'Connell, Mayfield, 

Cork; and nicola Mcnamara, 

a.Menarini Pharmaceuticals. 


support the Benevolent 

Fund and reward your 

customers 

Irish Pharmacist is producing a charity calendar for 2011 

which will directly benefit your Benevolent Fund. For 

every calendar bought by pharmacists, €1 will go to the 

Benevolent Fund. 

The 2011 Irish Pharmacist Calendar will be produced to high 

standards and will feature pictures of pharmacy instruments 

of historical interest. so reward your loyal customers with a 

gift of a beautiful calendar this Christmas and in turn support 

your colleagues who have fallen on hard times. 

The calendars may be purchased in batches of 10s and 40s 

– the more you purchase the cheaper the individual unit but 

we guarantee that the Benevolent Fund will receive €1 from 

the sale of each calendar. Batches priced as follows: 

10 calendars – €40 (€10 to the BF) 





Aoife Garland will be contacting all pharmacists over the 

coming weeks with details about the calendar. 

For more information, or to order calendars, you 

can contact Aoife directly on 01405 3590 or aoife@ 

greencrosspublishing.ie 

lady Pharmacists’ Golf results 

Results of lady Pharmacists Golf Outing held at Faithlegg 

House on saturday 29th May 2010. 

1st Barbara O Donnell (22) 38 points 

2nd Mary Condon (22) 35 points 

3rd Marie Donnellan (21) 33 points 

Category 1 Ciara Marmion (20) 29 points 

Category 2 Mary Mellet (21) 31 points 

Category 3 Veronica Treacy (36) 30 points 

Future outings are at Druid's Glen on 24th July 2010 

and Adare Manor on 21st August 2010. Please contact 

competition secretary Doreen O'Donoghue on 086 2336896 

for more information. 

lady Captain, anne nolan, presenting first prize to 

lady President, Barbara o'donnell at Faithlegg golf 

Club on saturday 29 May 2010.

THE POWER OF 

Date of preparation: April 2010 Tevirl 02/04/10 

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Doing more and better for less

10 

benevolent fund 


the Pharmaceutical society of ireland Benevolent Fund 

(Charitable Trust CHy 5467) 

Trustees: Mr. Vin Cronin, Mr. Denis Hickey and Mr. Diarmuid 

O’Donovan 

Proposal to Change legal structure of 

Psi Benevolent Fund 

Dear Friend of the Pharmaceutical society of Ireland Benevolent Fund, 

21st June 2010 

I am asking for your help with our review of the structure of the Pharmaceutical society of Ireland Benevolent Fund (BF). We, the committee 

and trustees of the BF, believe that consideration be given to changing the legal structure of the Benevolent Fund. 

While the Benevolent Fund was founded in the late 1920s, it has existed as a charitable trust only since 1982 – when the current ‘Rules 

and Regulations’ were adopted. i The BF Committee had identified some time ago that these ‘Rules and Regulations’ required significant 

updating. The 2008 AGM of the BF agreed, in principle, many changes that would improve the functioning and governance of the Fund’s 

activities. ii 

The enactment of the Pharmacy Act 2007 has led to a creation of a significantly different PsI and, as a result, there is general acceptance 

amongst those involved in the PsI and the BF of the need to formally decouple the two organisations. iii Originally, the plan was to make 

changes to the constitution of the current Trust to enable this to happen and to do this along with the other changes agreed at the 2008 

AGM. 

However, there are some problems with this plan. Rule 34 of the constitution does not permit any changes to the first three rules of the 

constitution, the first being that the name of the Trust is ‘The Pharmaceutical society of Ireland Benevolent Fund’. A change of name would 

be essential to decouple the BF from the PsI. There are further difficulties inherent in the ‘Rules and Regulations’ as constituted not least of 

which is found in Rule 6 which states that ‘ The President for the time being of the Pharmaceutical society of Ireland, if willing to act, shall 

be President of the Trust for the period of twelve months from the date of each Annual General Meeting. In the event of his being unwilling 

to act, the Council of the Pharmaceutical society of Ireland may select and invite another member of the profession to accept the office of 

President.’ It became custom and practice for the immediate past-president of the PsI to be so invited and in that context I was invited by 

the PsI council of 2004 to accept the office of President of the BF – an invitation which I considered it a privilege to accept. It is, however, 

important to emphasise that the BF has been operating entirely independently of the PsI Council since at least 2005. 

We have been advised that changes to the constitution, particularly substantive changes of this type, would not be without risk as it would 

be at the discretion of the Revenue Commissioners as to whether the amended organisation would retain its charitable status. While some 

would argue that the risk would be slight, nevertheless it has caused us to consider carefully what other options might be appropriate. 

Following consideration of recent legal advice from Dominic Dowling solicitor, retained by the BF committee to support it through the 

process of change, the proposal is that the opportunity be taken to undertake a more radical re-structuring of the BF so that the organisation 

continues to be fit for purpose in the 21st century. It is proposed that the BF be reconstituted as a company limited by guarantee without 

a share capital iv which is the most commonly used legal structure for charities in Ireland. The company would require a Board of Directors 

elected from amongst the members of the Benevolent Fund and a company secretary who can be one of the directors. The Board of 

Directors would be responsible for the running of the company and the management of its assets and in so doing would take over the roles 

of the current BF Committee and trustees respectively. Operational and governance changes, as agreed in principle at the 2008 AGM of the 

BF, could be incorporated into the new structure. The Board would be entitled to appoint whatever sub-committees it considers necessary, 

including, for example, a Case Committee and a Finance Committee. 

We are also influenced by the new Charities Act 2009 – which will significantly change the landscape for charities in Ireland. Greater 

transparency and legal accountability will be required of charities, including those that exist as charitable trusts like the BF. In future, 

charities will be required to submit annual statement of accounts and activity reports to the new charities regulatory authority. It should be 

noted that the BF has for many years ensured audited accounts were prepared for presentation to the AGM (and therefore this will not be a 

new cost to the BF).


benevolent fund 

The advantages of the proposed new structure (i.e. company limited by guarantee) include: 

• Clear legal status for the Benevolent Fund. 

• A company has perpetual succession and limited liability for members. 

• BF trustees are relieved of their personal responsibility to hold assets on behalf of BF. 

• There is a strong framework for corporate governance associated with company law and common law duties of companies and 

directors. 

• There is a clear legal entitlement to enter contracts of service and, if required at any stage, contracts of employment. 

• The development of a Memorandum and Articles of Association for the new company offers the opportunity to review fundamental 

matters such as the name of the BF, the scope of the BF’s activities and who is eligible to receive assistance from the Fund. 

Disadvantages include: 

• set-up costs for new entity. In practice, these can be minimised by for example, adapting Memorandum and Articles of Association 

templates for charities provided by Revenue rather than drafting completely new documents. It is the decision of the BF committee, 

supported by the Trustees, that legal advice from Dominic Dowling solicitor be retained through the process.. 

• Additional administrative work associated with the new entity including submission of annual returns (including accounts and auditor’s 

reports) and notification of changes of directors to the CRO. This work can be minimised by using the CRO’s online submission service. 

Even if the BF continues as a trust, it will be required under the new Charities Act to submit accounts to the new charities regulatory 

authority. 

We sincerely want to engage with all those who have supported the Fund over its many years of existence, those who believe the BF has 

untapped potential or those with insight and experience of restructuring other charities in which they are involved. In this way we can be 

confident that whatever decisions are made over the coming months are genuinely likely to be in the best interests of the BF, its objectives 

and its present and future beneficiaries. . 

We would appreciate it if you would particularly consider questions such as: 

• The merits of the proposal to change the status of the BF to that of a company limited by guarantee? 

• The proposed change of name from ‘Pharmaceutical society of Ireland Benevolent Fund’ to ‘Pharmacy Benevolent Fund’? 

• The scope of the BF’s activities and those that should be eligible to receive consideration for assistance. Currently the rules state that 

‘The object of the Trust is to give financial assistance to persons in need who are or have been engaged in or associated with the 

pharmaceutical profession and to the wives, widows, children and other dependents of such persons who themselves are in need and 

also to any other persons in the state, or to any charitable institution catering in general for persons in the state who may be considered 

to be in need of financial assistance.’ To date, the BF has provided assistance to pharmacists, pharmaceutical assistants, counter 

assistants and their families and pharmacy students. Occasional one-off donations have also been made to charities such as the society 

of st Vincent de Paul but not in recent years. 

• Appropriate criteria for support being offered by the BF? 

• Whether there should be circumstances where beneficiaries might be expected to repay financial support from the BF, for example, if 

they sell an asset or if a beneficiary dies and leaves an estate? 

We would appreciate it if all such submissions, comments or observations could be forwarded to cicelyroche@eircom.net to arrive no later 

than september 15th 2010. (Electronic copies would be preferable as they facilitate more timely circulation to committee members, but hard 

copy format may also be sent to Cicely Roche, c/o Tearmann, Kilmurray, Gorey, Co. Wexford). 

The BF committee/Trustees will plan proposals for the BF AGM, planned for 8pm on Wednesday 17th november 2010 in 18 shrewsbury 

Road, based on review and consideration of any submissions made during this consultation process. 

Many thanks for your support and interest. 

In anticipation 

Cicely Roche MPsI 

President, Pharmaceutical society of Ireland Benevolent Fund. 

(endnotes) 

i Please feel free to contact cicelyroche@eircom.net for a copy of the current ‘Rules and Regulations’ of the PsI Benevolent Fund Trust. 

ii Please feel free to contact cicelyroche@eircom.net for a copy of the current ‘Rules and Regulations’ of the PsI Benevolent Fund Trust with 

amendments as proposed at the 2008 BF AGM. 

iii Please note that the management and operation of the Benevolent Fund, and its bank accounts, auditing and governance have been 

separate from the PsI for many years. 

iv A company limited by guarantee without a share capital is a company which has not been established to earn profits for its members 

but rather to carry out a specific purpose. The minimum number of members is 7. The members’ liability is only the amount they have 

undertaken to contribute to the assets of the company, being not less than €1 in the event that the company is wound up. The company 

is not required to raise funds from the members and they still retain the benefits of limited liability and a separate legal entity. This type 

of company is favoured by groups of people coming together for a common purpose and who wish to have the protection of limited 

liability, e.g. charities, residential associations, property management, educational, sports clubs, trade associations, professional bodies and 

associations. Charitable status may be applied for to the Revenue Commissioners on projects which are set up for charitable, scholastic or 

religious purposes. 

11

12 

eu news 

Gary Finnegan, 

European Correspondent and Irish 

winner of the 2009 EU Health Prize 

for Journalists 

The European Ombudsman 

has hit out at the European 

Medicines Agency over its 

refusal to release documents 

to researchers and patients, 

despite the EMA’s pledge to 

improve transparency. 

The Agency refused to grant 

Danish scientists access to 

clinical trial data on two antiobesity 

drugs saying the data 

was commercially sensitive. 

Researchers from the nordic 

Cochrane Centre claim studies 

supporting certain medicines 

are biased and would not 

stand up to independent 

scrutiny. 

The Ombudsman, P 

nikiforos Diamandouros, 

has given the EMA until the 

end of August to release 

the files or come up with a 

more compelling reason to 

keep them confidential. He 

said he has inspected the 

documents in question and 

does not believe they contain 

information that would have 


Court backs limits on pharmacies 

Europe’s highest court has 

said governments can cap 

the number of pharmacies 

operating in a particular area. 

Two pharmacists had taken 

a case to the European Court 

of Justice after a spanish 

region decided it would allow 

no more than one pharmacy 

per 2,800 people. The 

Asturian regional government 

also prevents new pharmacies 

from opening within 250 

metres of an existing 

pharmacy. 

spanish regions issue 

licenses to pharmacists 

wishing to operate in their 

jurisdictions and Asturia’s 

decision to cap the number 

of pharmacies based on 

demographics had been 

challenged on the grounds 

that it broke EU rules. 

The court agreed that the 

spanish law technically limits 

citizens’ freedom to set up a 

business but decided that it 

was justifiable provided the 

rules are tweaked to guard 

against discrimination. 

One of the criteria for issuing 

licenses to retail pharmacies in 

Asturia is that the pharmacist 

should have been trained in 

the region. This, said the court, 

is discriminatory and must be 

changed. 

spanish officials said the 

rules were designed to ensure 

that wealthy parts of the 

region do not have a higher 

concentration of pharmacies 

while poorer regions have 

limited services. 

However, the court noted 

that the demographic criteria 

would not necessarily ensure 

equitable access to community 

pharmacies. The judges 

said having one pharmacy 

per 2,800 might still mean 

that rural populations must 

travel long distances to see a 

pharmacist. 

The court added that 

densely populated areas could, 

in theory, have more than 

2,800 living inside a 250 metre 

area which would mean that 

they could not have a second 

pharmacy on account of the 

‘250 metre rule’. 

While regional authorities 

in spain might reflect on 

the precise limitations they 

online pharmacy 

fakes PgeU logo 

A Russian internet pharmacy 

has been using the logo of 

the Pharmacist Group of the 

European Union (PGEU) to 

endorse its products. The 

website also mocked up a 

certificate which includes 

a forged signature of PGEU 

president Filip Babylon. 

"All drugs sold […] are 

considered to be approved 

by the PGEU," the website 

claims on the fake cert, which 

features the Union's mission 

statement. PGEU secretary 

General John Chave said 

the website is a sham and 

highlights the ease with which 

logos can be forged. 

The pharmacy group 

became aware of the problem 

when one of their members 

received as spam email from 

the Russia-based company 

claiming to be supported by 

European pharmacists. 

The site, which has now 

been taken down, primarily 

sells erectile dysfunction drugs 

and cancer mediation and 

claims to operate in Canada. 

It falsely advertised that it 

is licensed by the College 

of Pharmacists of Ontario, 

Canada, and carries the 

logos of blue-chip delivery 

and payment companies – 

including FedEx, UPs, Visa and 

American Express. 

The European Parliament 

is preparing to vote on 

the Counterfeit Medicines 

Directive, which MEPs want 

to use to target illegal online 

pharmacies. Portuguese MEP 

Marisa Matias – who is in 

charge of steering the new 

law through parliament – has 

proposed that legitimate 

Internet pharmacies carry an 

EU certification logo. However, 

the PGEU have consistently 

expressed concern that any 

new quality mark would be 

faked as soon as it is published. 

"The idea that you can get 

around online counterfeiting 

through certification is quite 

difficult. An EU authenticity 

mark would be immediately 

faked. We would be asking 

patients to differentiate 

between genuine and forged 

logos," said John Chave, 

secretary-general of the PGEU. 

He said some bootleggers 

have become highly 

sophisticated and have proven 

capable of reproducing 

high-resolution colour copies 

of logos. The PGEU wants 

national governments to 

be free to prohibit Internet 

pharmacies if they choose to 

do so. 

apply to the licenses for retail 

pharmacies, the ruling means 

local and national legislators 

are free to apply restrictions 

in the area of community 

pharmacy. 

ombudsman critical 

of Medicines agency 

commercial implications. 

According to 

Diamandouros, the Agency is 

guilty of “maladministration” 

for repeatedly withholding the 

reports which the Cochrane 

group first requested in 2007. 

In a separate case earlier 

this year the EMA came under 

fire from the Ombudsman 

after an Irish citizen requested 

access to reports linking an 

acne medication to suicidal 

tendencies. Again, the 

Agency refused access to 

the medicine, claiming EU 

transparency guidelines do 

not apply to adverse drug 

reactions. 

The Ombudsman saw things 

differently, saying medicines 

regulators’ work has a direct 

impact on public health and 

the widest possible access to 

documents should be given 

when requested. The EMA 

has until July 31 to formally 

respond.

14 

opinion 

Celibate monks, 

the menopause and 

premenstrual syndrome 

In previous columns Dr Corrigan wrote about herbal 

alternatives to HRT, so where you might reasonably 

ask do celibate monks enter into the story? 

the answer is one you couldn’t make 

up and involves the plant Vitex agnus 

castus usually referred to pharmaceutically 

as Agnus castus. In English 

it is called Chaste Tree or Chasteberry 

because during the Middle 

Ages monks used it as a spice (Monks Pepper) in 

order to promote chastity and help them remain 

celibate. I can imagine some comments about 

that in the light of recent controversies but I am 

more interested in the use of this plant in herbal 

products for menopausal women or in products 

for premenstrual syndrome (PMs). 

evidenCe 

The use of Vitex agnus castus (VAC) for 'female 

complaints' dates back to the time of Hippocrates 

in the 4th century BC although its role in 

menopausal women is much more recent and 

appears to have arisen from clinical experience in 

Germany in the 1970s. Evidence from randomised 

clinical trials of Vitex in the menopause is lacking 

but pharmacological evidence is said to support 

a role for the berries in the reducing symptoms. 

This view is based on well recognised dopaminergic 

activity of extracts, reported binding to u 

opioid receptors and enhancement of melatonin 

secretion. It is known that endorphins decrease 

as the menopause progresses and this is associated 

with mood disorders, migraines and fluid 

retention. The dopaminergic activity is relevant 

to reductions in hot flushes and of the emotional 

symptoms associated with the menopause. The 

effect on melatonin secretion relates to the 

possible role declining melatonin production 

has in menopause-related sleep 

disturbance because Vitex can increase 

levels by up to 60%. 

PMs stUdies 

Much of the use of VAC for the menopause 

has to do with the similarities between 

the symptoms experienced during the 

perimenopause and those of PMs for 

which VAC is more widely used. There have 

been a number of trials with mono-preparations 

of VAC for PMs which show effects 

superior to placebo whereas trials in the 

menopause have tended to use complex 

formulations which make it impossible to 

draw conclusions about the effectiveness 

of any single herb in the mixture. In both 

sets of trials small numbers were involved 

and there was a very high placebo response. 

The PMs studies do show evidence 

of beneficial effects and the Herbal Medicinal 

Products Committee (HMPC) at the European 

Medicines Agency has published a draft Community 

Monograph on Agnus Castus. These 

monographs provide a harmonised approach to 

the scientific evidence base on herbal products 

within the EU. Under the Medicines Directive all 

Member states are obliged to take them into account 

when examining an application for either a 

standard Marketing Authorisation or a Certificate 

of Traditional Use Registration. In the case of Vitex 

the monograph describes the material as a “traditional 

herbal medicinal product for the relief of 

minor symptoms in the days before menstruation 

(premenstrual syndrome)". 

The fact that it is described as a traditional 

herbal medicinal product suggests that the 

learned members of the HMPC do not believe that 

the clinical trial evidence is sufficiently strong to 

justify including VAC within the “well-established 

use” provisions of the Directive, which is the 

other licensing avenue available to them. The 

basic Medicines Directive was amended in 2004 

to establish a simplified registration procedure 

(traditional use registration) for herbal medicinal 

products fulfilling certain criteria such as; that the 

indication for the product did not require medical 

supervision; that it was for oral or external use 

only; that the material had been on the market 

for a period of 30 years including 15 years within 

the EU; that a bibliographic review of safety data 

shows the product not to be harmful and that the 

pharmacological effects of the medicinal product 

All herbal 

medicinal 

products for 

sale in Ireland 

must be 

registered 

...by April 2011 

although few 

applications have 

been received by 

the IMB to date. 

Vitex agnus castus 

dr des CorrIGAN 


Dr Des Corrigan is the former 

Director of the school of Pharmacy 

at TCD, and won the lifetime 

Achievement Award at the 2009 

Pharmacist Awards. 

He is the Irish representative 

on the scientific Committee of 

the European Monitoring Centre 

for Drugs and Drug Addiction. He 

also currently chairs the national 

Advisory Committee on Drugs as 

well as the chair of the Traditional 

Herbal Medicinal Products 

subcommittee of the Advisory 

Committee on Human Medicines at 

the Irish Medicines Board. 

are plausible based on long-standing use and 

experience. While this system does not require 

manufacturers to conduct clinical trials or toxicity 

tests it does still require that full quality control 

procedures be followed and that the product be 

manufactured under GMP conditions. 

CertiFiCate oF traditional Use 

All herbal medicinal products for sale in Ireland 

must be registered under the scheme by 

April 2011 although few applications have been 

received by the IMB to date. The Certificate of Traditional 

Use registration for herbal products will 

provide both pharmacists and their patients with 

the reassurance that the product in question eg 

one containing Agnus castus has been subject to 

expert scrutiny regarding quality and safety. Furthermore 

the Community list of herbal substances, 

preparations and combinations along with the 

Community Monographs both prepared by the 

HMPC provide a major resource for hard-pressed 

pharmacists looking for information on indications, 

dosages, side effects, contraindications 

and interactions for particular herbal products. 

nearly 60 monographs have been adopted so far 

but only 11 herbs are on the list which is legally 

binding on member states and on applicant companies. 

Both the list and the monographs can be 

easily accessed through the EMEA website (www. 

ema.europa.eu/htms/human/hmpc ). 

The information on Agnus castus is typical of 

what is contained in the Monographs. Under 

Duration of Use it advises that if symptoms persist 

after continued use over three menstrual cycles 

a doctor or qualified healthcare practitioner 

should be consulted. special precautions are 

recommended for those with oestrogen-sensitive 

tumours or in patients with a history of pituitary 

disorders because VAC can mask symptoms 

of prolactin secreting tumours of the pituitary 

gland. Interactions possibly include 

dopamine agonists and antagonists, 

oestrogens and anti-oestrogens. 

Reported side effects include allergic 

reactions, rash, headache, dizziness, 

nausea, abdominal pain, acne and 

menstrual disorders but these are all 

mild and reversible. 

I know that many pharmacists have 

been uneasy in the past about recommending 

unlicensed herbal products 

but my hope is that the availability 

of products assessed by the IMB will 

remove that reluctance and that more 

members of the profession will feel 

empowered to seize the opportunity 

to use their professional skills and 

judgement to help patients who 

would benefit both from the products 

themselves but also from the objective 

advice of the only health professional 

with any semblance of knowledge 

of these widely used materials.

Prescribing Information for Nexazole 20 mg & 40 mg Gastro – resistant capsules. Qualitative and Quantitative Composition: Each 

capsule contains 20 mg or 40 mg of esomeprazole (as esomeprazole magnesium dihydrate). Pharmaceutical Form: Hard, gastro-resistant 

capsule: Slightly pink body and cap, containing white to almost white pellets. Therapeutic Indications: Treatment of erosive reflux oesophagitis. 

Prevention of relapse of healed oesophagitis in long-term management of patients. Symptomatic treatment of gastroesophageal reflux disease 

(GERD). Eradication of H. pylori concurrently given with appropriate antibiotic therapy for treatment of H.pylori-associated ulcers. Treatment of 

NSAID-associated gastric and duodenal ulcers in patients requiring continued NSAID-treatment. Prophylaxis of NSAID-associated gastric ulcers 

and duodenal ulcers in patients at risk requiring continued therapy. Prolonged treatment after i.v. induced prevention of rebleeding of peptic ulcers. 

Treatment of Zollinger Ellison Syndrome. Dosage and Method of Administration: Capsules should be swallowed whole with liquid. The capsules 

can be opened and the pellets mixed in half a glass of non-carbonated water or if desired this solution administered through a gastric – tube in 

patients with swallowing difficulties. The capsules and / or contents should not be chewed or crushed. Treatment of erosive reflux oesophagitis: 

40 mg once daily for 4 weeks. Long-term management of patients with healed oesophagitis to prevent relapse: 20 mg once daily. Symptomatic 

treatment of gastroesophageal reflux disease: 20 mg once daily. Eradication of H. pylori for treatment of H.pylori-associated ulcers: 20 mg with 1 

g amoxicillin + 500 mg clarithromycin, all twice daily for 7 days. NSAID associated gastric & duodenal ulcers: 20 mg once daily for 4 – 8 weeks. 

Prophylaxis treatment: 20 mg once daily. Prolonged treatment after i.v induced prevention of rebleeding of peptic ulcers: 40 mg once daily for 4 

weeks. Zollinger Ellison Syndrome: Initial dose is 40 mg once daily. Dosage should be individually adjusted. Daily doses up to 160 mg have been 

used. If the required daily dose exceeds 80 mg, it should be divided and given twice daily. Severe liver impairment: Patients should not exceed a 

max. dose of 20 mg. Contraindications: Hypersensitivity to esomeprazole or to any of the excipients. Esomeprazole should not be administered 

with atazanavir. Pregnancy and breast-feeding due to insufficient data. Children under 12 years. Special warnings and precautions for use: The 

possibility of a malignant gastric tumour should be excluded as Nexazole may alleviate symptoms and delay diagnosis. Regularly monitor patients 

on long-term treatment. Patients on on-demand treatment should contact their physician if symptoms change in character. If esomeprazole is 

used in combination with antibiotics, then the instructions for the use of these antibiotics should also be followed. Treatment with esomeprazole 

may lead to slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter. Contains sucrose – Patients with rare 

hereditary problems of fructose intolerance, glucose – galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. 

Drug Interactions: Esomeprazole can affect the absorption of ketoconazole and itracanazole. Dose reduction may be required when administered 

with drugs metabolised by CYP2C19 as esomeprazole may increase their plasma concentration. Monitor patients when given in combination with 

warfarin or other coumarine derivatives. Undesirable effects: Common: Headache, abdominal pain, constipation, diarrhoea, flatulence, nausea/ 

vomiting. Shelf Life: 2 years. Marketing Authorisation Holder: Pinewood Laboratories Ltd., Ballymacarbry, Clonmel, Co. Tipperary. Marketing 

Authorisation Holder Numbers(s): PA 281/146/1-2. This medicine is a prescription only product. Further prescribing information is available on 

request. Date of revision of text: June 2010. 

Nexazole 

�� 

�� 

Ireland’s No. 1 Generic Healthcare Specialists

16 

opinion 

the CoAlfACe 

How private is 

private? 

The ins and outs of consultation rooms 

When I started to write this 

article the PsI's guidelines 

for consultation areas had 

not been published. now 

that they have been I looked 

at this again and found that I 

had to change very little. 

The PsI recently called for consultations 

on the draft guidelines for consultation areas. 

Along with many others I sent a submission in. 

It remains to be seen if the PsI pay much heed 

to our submissions when the final version of the 

guidelines come out. And having looked at the 

guidelines it would appear that they have not. 

One of the issues that I raised was that of 

timing. It would be unreasonable to expect all 

pharmacies to have to change their consultation 

areas overnight. It would only be fair to allow 

changes to be made at the next re-fit. I had a 

minor re-fit forced on me late last year due to a 

burst pipe. I took the opportunity to enlarge and 

re-shape our consultation area. I tried to imagine 

what the final guidelines would be as I designed 

the new consultation area. Unfortunately I did 

not have the luxury of time to wait for the PsI to 

have their deliberations. I would hate to have to 

pull out our newly painted and carpeted shop 

front just to keep the mandarins in shrewsbury 

Road happy, never mind the expense. 

landlord Consent 

Another issue which arose was that of landlord 

consent. Depending on the terms of individual 

leases it is necessary to obtain consent from the 

landlord for any changes to the fabric or layout 

of the pharmacy building. This begs the question 

as to what happens if a landlord for whatever 

reasons decides to withhold his consent to 

changes which would be necessary to meet 

the PsI's new guidelines. Will the PsI back up 

the pharmacist in his/her negotiations with the 

landlord or will they use it as another stick with 

which to attack the poor pharmacist? 

All of this assumes that you have the space to 

play around with in your pharmacy. 

ConsUltation rooM liFe-CyCle 

Recently I had a discussion with another 

pharmacist about consultation areas. We both 

had a major advantage over the PsI in this 

matter. We both had experience of practising 

in pharmacies with many different types of 

consultation areas. And our experiences were 

very similar. Most of the consultation areas go 

through about four different phases. Initially they 

are used eagerly by all staff in the pharmacy, not 

just the pharmacist at every suitable opportunity. 

next they become unused as pharmacists 

discover the drawbacks and patients shy away 

from them. More of this anon. Then they start 

being used as extra storage and lastly they return 

to general retail use. 

When I had a truly private consultation area I 

quickly discovered that patients did not like it. 

It wasn't too hard to discover why this was so. 

Even when there was no physical door or barrier 

to the entrance, patients felt trapped. Either the 

pharmacist stood partially or totally between 

them and the exit or they stood with their backs 

to the exit. It was very difficult to arrange the 

consultation in such a way so that they did not 

feel trapped. 

CoUnter BaCK-UP 

However from a pharmacists point of view 

the privacy gave rise to the biggest problem. 

In one particular consultation area that I used 

there was total visual privacy. so while in the 

area we could not be seen from the pharmacy, 

but neither could we see what was happening 

outside of the area. It was possible for a third 

party to stand just outside the area unseen and 

overhear any conservation inside. It follows that 

while in the consultation area I had no view or 

oversight of the pharmacy or OTC counter. If the 

PsI's interpretation of supervision is correct then 

all dispensing activity and all OTC sales would 

have to stop while the pharmacist was advising 

a patient except that they have slipped in a 

phrase “The pharmacy owner, superintendent and 

supervising pharmacists must ensure the availability 

of adequate pharmacist personnel to fulfill (sic) 

all requirements outlined in the legislation.” (This 

would also apply to when a pharmacist is taking 

dAvId jordAN 


David Jordan has worked 

in community pharmacy 

since 1979, qualifying as 

a pharmacist in 1983. He 

was chairperson of the 

Community Employee 

Committee of the IPU from 

1990 to 1998 and treasurer 

from 1994 to 1996. His 

main stress relief is riding 

his motorbike with his 

friends from 

www.irishbikerforum.com 

a toilet break but that's a whole different article.) 

If the PsI's desire for a truly private area comes to 

fruition then it would seem that every pharmacy 

would need to have a second pharmacist on 

duty at all times as there would be no predicting 

when the pharmacist would need to leave the 

pharmacy unsupervised so that he/she can carry 

out a patient consultation. This extra expense 

would place an intolerable burden on the smaller 

pharmacies. 

hse strategy 

This plays into HsE's stated desire to see about 

600 pharmacies close. Drown them with extra 

expense and paperwork. Twist the knife one time 

in the backs of independent pharmacies. Clear 

the field for the chains, Irish, British, German, 

Dutch and whatever you're having yourself. 

Why do the PsI feel that they have to re-invent 

the wheel or fix what ain't broke. It would seem 

that they have too much money (mine and yours) 

and too much time on their hands. To listen to 

the PsI you would think that pharmacists have 

not been having private consultations and 

conversations for years in consultation areas. 

They may not have called it a consultation area 

but every pharmacy had a space where advice 

could be given discreetly and with confidentiality. 

Maybe it's time for the PsI to get up off their 

backsides and spend some time in the real world 

of community pharmacy. When was the last time 

that any of the staff of the PsI actually dispensed 

a prescription, gave advice to a patient or even 

stood behind a dispensary counter. If patients do 

not like the set up in any pharmacy they can vote

Support 

your 

Benevolent Fund 

and 

Reward your Customers 

this 

later this year, 

Irish Pharmacist will 

produce a 2011 calendar 

celebrating the history 

of Irish pharmacy, 

which will benefit the 


For every calendar bought 

by you to distribute to your 

customers Irish Pharmacist 

will donate 1 euro to the 


Produced to the highest 

standard, the flip-over wire 

bound calendar will make 

an ideal gift for you to give 

to loyal customers while also 

supporting a good cause. 

Christmas 

The calendars will be sold 

in batches of 10. 

10 Calendars — €40 



Contact aoife garland on: 01 4053590 

or by email: aoife@greencrosspublishing.ie 

To order your copies just 

send a cheque or money 

order to: 

GreenCross Publishing, 

7 Adelaide Court, Adelaide 

Court, Dublin 2 or phone 

01 4053590.

18 

special report 

despite the recent government ban imposed on a number of 

so called legal highs, newer compounds are already emerging 

as manufacturers invent new ‘legal’ compounds in an 

attempt to circumvent the ban. Worryingly these newer 

products are not only more complex than their now illegal 

counterparts but they may also contain a range of recently 

invented chemical compounds, the side effects of which are completely 

unknown. 

On the 11th May the Minister for Health announced that a number of the 

substances being sold in headshop were to be controlled drugs under the 

Misuse of Drugs Act 1977, with immediate effect. 

This ban on a wide range of products meant that their possession and 

supply were now illegal and subject to criminal sanction of up to 7 years 

imprisonment and/or a fine for unlawful possession, and, on indictment, up 

to a maximum period of life imprisonment for unlawful supply. 

The list of the recently banned substances includes: synthetic cannabinoids 

(contained in sPICE products), benzylpiperazine (BZP) and piperazine 

derivatives, mephedrone, methylone, methedrone, butylone, flephedrone, 

and MDPV. 

Next geNeratioN compouNds 

Experts are now concerned that products containing next Generation 

Compounds (nGCs) or active ingredients that are not covered by the ban 

will begin to appear in products in the near future. Indeed some of these 

newer compounds went on sale in headshops within weeks of the ban. 

Apart from not knowing what some of these nGCs contain there is also a 

fear that potencies may be lower so doses will be higher and secondary 

effects such as toxicity may become a major problem. There is also a real 

concern that in attempting to treat patients suffering from the side effects 

of these products, doctors are essentially working in the dark, as they have 

no idea what some of these newer compounds contain. 

Dr Pierce Kavanagh is the Chief Technical Officer at the Department of 

Pharmacology and Therapeutics, TCD. Together with a team of researchers 

Dr Kavanagh has been working to try to identify the active ingredients in 

these newer products. This work is proving to be an invaluable tool for clinicians 

in the treatment of patients admitted EDs. 

most popular 

Dr Kavanagh and his team were awarded the best poster prize at the 32nd 

All Ireland Joint schools of Pharmacy Research seminar recently for their 

work on characterizing some of the most popular ‘legal highs’ available in a 

Dublin headshop before the ban. 

These products were found to contain the cathinone derivatives mephedrone, 

methylone, flephedrone, butylone and MDPV. The stimulant caffeine, 

and local anaesthetics benzocaine and lignocaine, were also found in a 

number of samples. Mephedrone was present in just over one quarter of the 

samples analysed. According to Dr Kavanagh this was of major concern as 


Battle of the labs 

– identifying the latest legal highs 

A war of the laboratories is currently 

being waged between chemists 

intent on creating new legal highs to 

circumvent the recent government ban, 

and those working to identify the active 

ingredients of these newer compounds, 

in an effort to help doctors deal with 

the casualties. June Shannon reports. 

Head Shop ‘Legal Highs’ Active Constituents 

Identification Chart (June 2010, post-ban) 

•Dimethocaine* 

•Fluorotropacocaine* 

•Caffeine 

•Caffeine 

•Lignocaine 

Note: LCMS revealed an unidentified compound with 

a suspected t d molecular l l mass 364 th thatt was nott 

detectable by GCMS. 

•Fluorotropacocaine* 

•Caffeine 

Note: Slightly different packaging. Both products also contain 

a trace of lignocaine. 



Note: Before the ban this product 

contained methylone. 


Note: Purchased after DOHC statement on 

dimethocaine issued on June 02. 

Machine gun g logo g on bag. g 

•Dimethylamylamine (DMAA) 

•Caffeine 

Note: This product is targetted at the 

female market. 

Outer pack 


•Caffeine 

•Caffeine 

•Ethcathinone 


•2-Phenylethylamine (2-PEA) 

•Caffeine 

Note: GCMS revealed an unidentified 

compound which is still under investigation. 

Inner pack 

•Glaucine* 

(Note: This product is sold 

as a ‘relaxant’) 

•Ethcathinone 

•‘iso-Ethcathinone’* 


•Caffeine 

•Caffeine 



• Hordenine 

•Caffeine 

•Naphyrone 

•Caffeine 

•Lignocaine 

(Note: offered for sale as 

a ‘herbal snuff’) 



•Caffeine 


•Caffeine 

•Caffeine •Caffeine •Dimethylamylamine (DMAA) •Dimethylamylamine (DMAA) 

Note: Sold as ’Powerful Herbal 

•Caffeine 


Note: ‘Gel Strip’ formulation 

•Caffeine 

party Snuff’ 

Powder Capsule Tablet 

Pierce Kavanagh1 , Jayant Sharma1 , Sinead McNamara2 , Daniel Angelov1 , Sean McDermott1 , Daniel Mullan1 and Sheila Ryder3 Powder Capsule Tablet 

* Tentatively identified from its mass spectrum as no standard was available 

These are the active constituents identified to date. It appears that an active ingredient in a number of the tablet formulations is dimethylamylamine (DMAA). 

If you have any questions please contact us - id.lab.team@gmail.com 

1 Department of Pharmacology and Therapeutics, School of Medicine, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin 8. 

2 Drug Treatment Centre Board, Pearse Street, Dublin 2. 

3 School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin 2. 

media reports have linked this cathinone to several deaths. 

With a background in organic chemistry, organic synthesis and analysis Dr 

Kavanagh and his team developed a pictorial chart of the packaging of these 

products. The idea is that patients who may not know the active chemicals 

contained in the drug they ingested may find it easier to recognise the pack and 

point it out to an emergency clinician or Garda. 

Having successfully identified the active ingredients in the most popular ‘legal 

highs’ available before the ban, Dr Kavanagh and his team are currently working 

on characterizing the products that are now available post ban with some 

alarming results. The team has produced a new poster containing the post ban 

products and their active ingredients, which they circulate to interested parties. 

In order to gather the products for analysis the TCD researchers pose as customers. 

“We just used our discretion we went in as customers. It was a perfectly legal 

activity. you go in and ask them ‘what’s the best buzz?’ ‘Any new bath salts?’ 

Primarily the bath salts were of interest to us because they were the ones that 

people were snorting,” Dr Kavanagh explained. 

A lot of the work on the pre ban poster was done between March and May 

and as soon as the headshops opened following the ban the team developed a 

poster of the newer products. They also used a colour-coded system to make it 

easier to identify powders, capsules and tablets. 

Dr Kavanagh explained that a number of products that previously contained 

banned substances were simply reinvented to circumvent the ban. For example 

a drug called Mint Mania, which contained methylone before the ban has


reappeared with a new active ingredient, which 

the TCD team has tentatively identified as dimethocaine. 

Frustratingly perhaps for Dr Kavanagh and his 

team the fact that these new ‘legal highs’ are only 

recently emerging means that there is no authentic 

standard to compare them with. Therefore the 

TCD team can only tentatively identify the active 

ingredients in these post ban products. 

“The problem we are finding now is that …we 

can look at the data we obtain and say yes it [a 

certain chemical] is there. But we don’t have an 

authentic standard to compare it with. All of chemistry 

comes down to this, you analyse something 

and you get a result. you have a known sample 

that has been characterized by an accredited 

laboratory somewhere, it is certified, you buy it, 

and you compare the two. That is how forensic 

science works. That is the level you have to go to 

for ultimate conclusive proof. We don’t have that 

luxury anymore. It was like shooting fish in a barrel 

before the ban because we had the standards for 

most of the cathinodes, we don’t any more. We are 

turning up things like flurotropacocaine, products 

like Raz which contains caffeine, lignocaine and an 

unidentified compound,” Dr Kavanagh explained. 

The newer post ban products that have been 

analysed include capsules called EnERGy that 

contain Dimethylamylamine (DMAA) and caffeine. 

However he explained that while DMAA was well 

known and contained in a lot of tablets and capsules, 

what was of most concern were the newer 

products that were emerging and in particular 

those in powder form. 

The team found the chemical ethcathinone in a 

product called White Columbia. When they bought 

it initially it was supplied in micro centrifuge tubes 

suggesting the speed at which these companies 

are determined to supply newer post ban ‘legal 

highs’. 

Another later batch of the 

“ 

same product Dr Kavanagh 

explained was supplied in a 

plastic bag with the same outer 

packaging however the team 

identified a chemical in this 

batch, which it suspected to be 

iso-Ethcathinone. 

“Again we suspect this because 

we are in territory where 

it would take us months to go 

and make this and compare it. 

you can’t buy it as a reference 

standard from a chemical company,” 

he stated. 

“not only are we finding it 

difficult to identify…we also 

can’t comment on its properties because we don’t 

know …it is a new chemical in the sense that they 

managed to incorporate it during the manufacturing 

process.” 

Another new legal high, which has recently 

reemerged, is a product called PURE nRG. The TCD 

team has categorized the product as containing 

naphyrone (a minor modification of the banned 

MDPV molecule and one for which there is a standard 

available) caffeine and lignocaine. PURE nRG 

is currently being offered for sale as ‘herbal snuff’ 

and again the manufacturers have circumvented 

the ban by modifying the banned MDPV molecule 

to produce naphyrone which is not banned. Others 

include products called AMPlIFIED and MInT 

MAnIA both of which the team has tentatively 

categorized as containing dimethocaine. Before 

the ban the MInT MAnIA product contained 

methylone. 

piNkys for ‘ladies’ 

Dimethylamylamine (DMAA), which replaced BZP 

in new Zealand when it was banned now seems 

to be contained in a number of the capsules and 

tablet formulations available such as Bliss Bomb, 

Dr Feelgood, and Pinkys – which are aimed at the 

female market. 

One new substance that is currently causing a 

lot of concern is WHACK. Dr Kavanagh said that 

although his team has yet to obtain 

samples of the product, he has 

heard anecdotal reports that indicate 

that it may contain naphyrone. 

Recently the HsE published 

a warning in relation to severe 

adverse reactions attributed to 

WHACK. The statement read that reports 

were received by the national 

Poisons Information Centre regarding 

persons suffering severe adverse 

reactions attributed to using the 

product. 

The majority of these individuals 

were young males in their 20s 

who suffered a range of symptoms 

including increased heart and 

breathing rates and raised blood 

pressure. Doctors described the 

majority as suffering from differing 

levels of anxiety with at least seven 

cases experiencing psychotic episodes. 

This psychosis is severe and is 

proving difficult to treat. 

In addition to the recent controls on legal highs 

introduced by the Minister for Health, the Minister 

for Justice is bringing forward the Criminal Justice 

(Psychoactive substances) Bill 2010 which aims to 

ensure that the sale or supply of substances which 

may not be specifically proscribed under the Misuse 

of Drugs Act, but which have psychoactive effects, 

will be a criminal offence. 

Most 

professionals 

who have worked in 

the area of addiction 

for years are feeling 

“very deskilled” 

around the issue of 

headshop products. 

One clinician who has 

witnessed at first hand the 

frightening effects of headshop 

products and who benefits 

from Dr Kavanagh’s work 

is Dr Bobby smith, Consultant 

Adolescent Psychiatrist with 

the Drug Treatment Centre 

Board in Dublin. 

“It certainly a fabulous 

help. It gives us a reasonable 

idea what is in the 

compounds because all the 

general public who purchase 

the product know is the 

brand name. Obviously there 

is no hint on the packaging as to what the product 

actually contains,” Dr smyth stated. 

“One of the challenges for us as clinicians is that 

what Pierce has come up with is a list of chemicals 

most of us as clinicians have never heard of before 

…it’s certainly is a bit daunting,”he added. 

professioNally “deskilled” 

Dr smyth together with Irish Pharmacist columnist 

and expert in the area Dr Desmond Corrigan, have 

conducted a number of workshops around the 

country. According to Dr smyth the level of demand 

for information has been “unprecedented”. 

Dr smyth said that most professionals who have 

worked in the area of addiction for years are feeling 

“very deskilled” around the issue of headshop 

products. They don’t know what questions to ask 

and are not sure how to assess people who have run 

into difficulties around the use of these products, he 

special report 

dr Pierce Kavanagh, 

Chief technical officer 

at the department of 

Pharmacology and 

therapeutics at tCd 

explained. 

However he said that although these products 

had a greater propensity than most drugs to cause 

mental health symptoms, the mental health problems 

that professionals were seeing were not new. 

For example he explained that drugs that 

have been around for a long time such as amphetamines 

and cocaine can cause the same brief 

psychotic episodes as seen with some headshop 

drugs. 

He also said that the sympathomimetic 

effects seen by these new 

products could also be caused by 

amphetamines, cocaine and cannabis. 

“In other words the psychological 

problems we are seeing 

are greater in number than would 

appear with older traditional drugs 

but they aren’t actually that different 

in terms of quality. Even though 

there could be a new chemical 

every week, the sort of problems 

they are presenting with are the 

sort of things that certainly used to 

crop up occasionally with all the old 

drugs.” 

While the duration of the psychotic 

episodes induced by legal 

highs depend on the drug used, 

Dr smyth said that people using 

WHACK were presenting to EDs 

in “phenomenally distressed states.” He also said 

that the psychotic episodes associated with this 

product were lasting much longer (up to 5 days in 

some cases) than those associated with some of 

the other headshop products (which seemed to 

settle down within six or twelve hours). 

It would appear WHACK is flourotetracocaine and 

another as yet to be defined compound. 

While patients can be monitored for the physical 

side effects such as a risk of stroke or dissection of 

the aorta, Dr smyth said that little could be done to 

alleviate the psychiatric problems apart from sedating 

those who are acutely distressed. 

“It really seems to be the psychiatric or mental 

health symptoms that are causing the greatest difficulty.” 

Dr smyth said he was convinced that in time coroner 

reports would begin to emerge linking deaths to 

the use of some headshop products. 

Both Dr smyth and Dr Kavanagh agree that as 

more products are banned the companies that 

make these legal highs will simply produce newer 

and more complex ‘legal’ compounds. One of the 

biggest worries is that as companies produced their 

best products before the ban, what they are now 

producing post ban, may contain second grade 

compounds, which Dr smyth said, seem to be “really 

nasty drugs with very serious side effects.” 

“My guess it that they are going to get such a 

bad name that users will stop using them …drugs 

go in and out of fashion and drug users talk to one 

another. The word will get out that these drugs are 

just too unpredictable with nasty side effects. 

I do think what will happen as well is that the newer 

drugs will be added to the misuse of drugs act 

and we will then have a third wave of probably even 

more toxic chemicals…I don’t think there is any 

alternative to banning them…trying to regulate this 

market would be the biggest regulatory challenge 

Ireland has ever faced,” Dr smyth said. 

“If anything this is a battle that is being fought in 

laboratories, the guys making it and the guys testing 

it. That is what it comes down to,” Dr Kavanagh 

concluded. 

19

20 

Questions & answers 

rory o’doNNell 

What other career might you have chosen? 

none. I have wanted to be a pharmacist since I was able to 

pronounce the word! 

Which figures in irish life (living or dead) do you admire 

and why? 

My parents, Paddy and Evelyn, who sacrificed everything 

for me. And my science teacher, seamus Gallagher, for his 

dedication and encouragement. 

What is the one thing you would suggest to improve 

the irish health service? 

A better spirit of co-operation at all levels. 

What is your earliest memory? 

First day at school. The teacher was my aunt. I couldn't get 

used to having to call her "a mhaistreas" instead of Aunty 

Kitty! 

What is your greatest fear? 

nothing I can think of. 

When and where were you happiest? 

I have had a great deal of happiness in my life, it would be 

impossible to single out any one particular event. 

What would your super power be? 

Multilocation. 

John Mcgoey, John Cullen and richard Brophy, 

Cahill May roberts team 2, with 83 points (on 

the back nine from haydons), came second. 


What is the worst job you have ever done? 

I can honestly say that I have gained something from every 

job I have ever done. 

What is your best trait? 

Dogged persistence. 

What is your most unappealing habit? 

I could be better at switching off sometimes. 

What trait do you most dislike in others? 

Dishonesty. 

do you use alternative medicines? What kind? 

no. 

Cat or dog? 

Both. 

What keeps you awake at night? 

nothing. 

What makes you laugh? 

Quite a lot actually: real life humour, friends, family, 

colleagues. 

how do you relax? 

I love playing various musical instruments, motorcycling, 

skiing, having friends around, spending time with my family. 

What word or phrase do you overuse? 

Accordingly… 

Favourite TV/Radio programme? 

History Channel. 

Favourite film and book? 

Shawshank Redemption, Band of Brothers (the book) 

What is your motto? 

If you think you can and you think you can't, you're right! 

Henry Ford 

how would you like to be remembered? 

Having made a positive difference. 

Psi Benevolent Fund Pharmacy golf Classic 

The Pharmaceutical society Benevolent Fund Golf 

Classic took place on Thursday 10th June 2010, 

newlands Golf Club, Co Dublin. The organizers 

would like to thank all those who took part and 

would also like to thank the sponsors for their 

support. 

Winners 

First: Brian Mangan, Pat Mangan and Ollie Kelly, 

Cahill May Roberts team 1, with 84 points. 

second: John McGoey, John Cullen and Richard 

Brophy, Cahill May Roberts team 2, with 83 points 

(on the back nine from Haydons). 

third: Hilary Haydon, Jason Bradshaw and Paddy 

sherry, Haydon's Accountants Team, with 83 points. 

Fourth: Jeffrey Walsh, Peadar Flynn and Ciaran 

Clarke, Pinewood Team. 

Fifth: playing at the crack-of-dawn, the IPU Team, 

seamus Feeley, Darren Kelly and William Kelly. 

nearest the Pin 

4th: linus Russell, Ocuco Team. 

9th: Dermot Moral, Blackhall Team. 

12th: Aaron Walsh, Ocuco Team. 

16th: Ciaran Clarke, Pinewood Team. 

longest drive gents: Ciaran Clarke, Pinewood 

Team. 

longest drive ladies: Tracey Eakin, stewart Eakin 

Team. 

raffle first prize (fourball at newlands donated by 

newlands Golf Club): Val Harte. 

Rory O'Donnell is a native of Dungloe, Co. Donegal, where 

his family owned a pharmacy. He was educated at the 

Rosses Community school, Trinity College Dublin and the 

Robert Gordon University Aberdeen. 

Rory owns pharmacies in Gweedore and 

letterkenny, Co. Donegal. He lives with his wife 

Aisling and stepsons Christopher and Ruaidhrí in 

letterkenny. 

He has served on many committees of the IPU 

over the years and has been involved in Pharmacy 

Technician education in the past. He was elected Vice 

President of the IPU in April of this year. 

Brian Mangan, Pat 

Mangan and ollie 

Kelly of Cahill May 

roberts, overall 

winners with 84 were 

presented with their 

prize by Cicely roche. 

third place was taken by hilary haydon, 

Jason Bradshaw and Paddy sherry, haydon's 

accountants team, with 83 points.

LUMIGAN® 

(Bimatoprost Ophthalmic Solution) 0.01% 

Abbreviated Prescribing Information 

Presentation: Eye drop solution, one ml contains 0.1mg 

bimatoprost. 

Indications: Reduction of elevated intraocular pressure (IOP) in 

chronic open-angle glaucoma and ocular hypertension in adults (as 

monotherapy or as adjunctive therapy to beta-blockers). 

Dosage and Administration: Please refer to the Summary of 

Product Characteristics before prescribing. Recommended dose 

is one drop in the affected eye(s) once daily, administered in the 

evening. More frequent administration may lessen the IOP lowering 

effect. If more than one topical ophthalmic medicinal product is 

being used, each should be administered at least 5 minutes apart. 

Not recommended in children or adolescents (under the age of 18). 

Use with caution in renal or hepatic impairment. 

Contraindications: Hypersensitivity to bimatoprost or any of the 

excipients. Patients who have had a suspected previous adverse 

reaction to benzalkonium chloride that has led to discontinuation. 

Warnings/Precautions: Prior to treatment patients should be 

informed of the possibility of eyelash growth, darkening of the eyelid 

skin and increased iris pigmentation. Some of these changes may be 

permanent and may lead to differences in appearance between the 

eyes when only one eye is treated. The change in iris pigmentation 

occurs slowly and may not be noticeable for several months or 

years. At 12 months there was one report of iris hyperpigmentation 

(incidence of 0.5%). Periorbital tissue pigmentation has been 

reported to be reversible in some patients. Contains the preservative 

benzalkonium chloride (0.2mg/ml) which may cause eye irritation 

and may be absorbed by and discolour soft contact lenses. Lenses 

should be removed before Lumigan instillation and may be 

reinserted 15 minutes after administration. Use with caution in 

dry eye patients, those where cornea may be compromised and 

in patients taking multiple BAK-containing drops. Monitoring 

required with prolonged use in such patients. Use with caution in 

patients with compromised respiratory function, those predisposed 

to low heart rate or low blood pressure or prior history of significant 

ocular viral infections or uveitis/iritis. Lumigan has not been 

studied in patients with heart block more severe than first degree 

or in uncontrolled congestive heart failure; inflammatory ocular 

conditions, neovascular, inflammatory, angle-closure glaucoma, 

congenital glaucoma or narrow-angle glaucoma. Cystoid macular 

Allergan Ltd, Marlow International, The Parkway, Marlow, Bucks, SL7 1YL Tel: +44 (0)1628 494026 

www.allergan.co.uk IR/0013/2010f Date of preparation: May 2010. 

New Formulation (0.01%) 

For Your 

Newly Diagnosed 

Glaucoma Patients 

Name: LUMIGAN® eye drop solution 0.01% 

Strength: 0.1mg/ml 

Size: 3ML 

Movianto code: 0916377 

GMS code: 77432 

oedema has been uncommonly reported (≥1/1000 to

22 

finance 

Our new reality 

“My best guess is that we'll have a continued recovery, but 

it won't feel terrific. Even though technically we'll be in 

recovery and the economy will be growing, unemployment 

will still be high for a while and that means that a lot of 

people will be under financial stress." 

Benjamin Bernanke, Chairman of the Federal Reserve in 

a Q&A at the Woodrow Wilson International Centre for scholars. 

some of you may have heard 

about the concept of the 'muddle 

through economy', where the 

economy in statistical terms is 

growing, but sure doesn’t feel 

like that. It is more susceptible 

to recession, burdened with the 

heavy baggage of old problems while facing 

the strong headwinds of new challenges. This 

is a description written after the .com bust 

by John Mauldin, a guy whose newsletter I 

frequently read. Interestingly it is a description 

of the world that has a lot of credence today. 

For me and indeed for anyone trying to 

rebuild wealth or make strategic decisions on 

investment trends, there is real learning in what 

has happened to date and, just as importantly, 

can possibly happen in the near future. 

two fuNdameNtal iNvestmeNt 

chaNges 

There are two large structural changes that have 

been slowly but steadily happening. Given that 

money and investment is now more than ever 

dependent on the global economy, we need to 

deal with higher volatility and lower economic 

growth. 

higher volatility 

The period of low volatility of GDP, industrial 

production, and initial unemployment claims 

is now over. For a period of over twenty years, 

excluding the brief 2001-02 recession, volatility 

of real economic data was extremely low. 

Certainly if what the economic gurus tell is 

in true, you would have to consider that going 

forward higher economic 

volatility, combined with 

much lower economic growth, 

will create more frequent 

recessions. 

lower treNd growth 

What the graph on the right 

is designed to do is indicate 

that, in essence, we have seen 

a continued decline in the 

growth of personal income, 

industrial production, and 

employment. 

There are those who believe that a 

combination of lower trend growth and higher 

volatility means more frequent recessions 

iNvestmeNt implicatioNs of the 

'muddle through ecoNomy' 

Personally I believe this has very important implications 

for how we invest in stocks and shares 

and bonds or fixed income. Indeed, the last three 

economic expansions lasted almost ten years, but 

in previous decades they averaged four or five 

years. From now on we will likely see recessions 

every three to five years. Therefore an investment 

strategy whereby owning any investment has been 

about buying it, holding it for a long time and praying 

it continues to go up in value is a very dangerous 

game. While the stock market rallied over 70% 

since the fall in 2008, the stocks are still down on 

their previous highs and therefore we have witnessed 

real losses as a result of not actively working 

within the markets. For longer-term investors this 

change of paradigm means achieving consistent returns 

is even more difficult. However, investors with 

a shorter-term, more tactical 

outlook may find these new 

more volatile conditions a 

source of great opportunity. 

It is not all doom and gloom. 

This type of economy does 

mean that businesses and 

entrepreneurs adjust to 

new and different ways of 

growing their companies 

and making a profit. The 

good news is that for most 

of us, we have taken the 

'adjusting;' and I feel we are 

capable of doing it better 

than people in almost any 

country in the world. 

I would challenge all of 

us to consider adjusting to 

this new investment and 


IAIN CAhIll 

iain Cahill aCCa MBa QFa 

director 

art of Wealth ltd. 

dunlair house 

old athlumney 

navan 

Co. Meath 

Mob: 087 2411371 

tel: 046 9072824 

economic reality. Many would have us believe that 

reducing debt is the only key way to adjust and yet 

as a bank manager said to me recently, now is the 

time for 100% mortgages...stable doors accepted. 

Another is to reduce the time that we intend to 

hold investments for and be prepared not to abdicate 

our own responsibility for making investment 

decisions and become less reliant on supposed 

professionals to take the management headache 

away. An example of this is a newsletter I received 

from a global fund manager which has the stated 

aim of beating the world stock market index by 

15%. sounds great until you see that for the second 

quarter of 2010 their performance is a -2.8% return 

on the fund. It neglected to make protecting investors 

as an aim of the fund I suspect. 

good respoNse 

In essence we must as investors become more 

nimble. Change is something we have lived with 

all our lives. Responding to change and new 

opportunities is how family businesses will survive 

and thrive. Finally I mentioned in my last article 

that we are looking for people who are interested 

in taking part in a process that is about changing 

“ 

The good news 

is that for most of 

us, we have taken the 

'adjusting;' and I feel we 

are capable of doing it 

better than people in 

almost any country in 

the world. 

 

AZILECT ® once-daily 1 

Abbreviated Prescribing Information. For full prescribing information refer to the Summary of Product 

Characteristics. Name: Azilect® 1mg tablets. Active Substance: Rasagiline mesilate. Indication: Treatment of 

idiopathic Parkinson’s disease (PD) as monotherapy (without levodopa) or as adjunct therapy (with levodopa) 

in patients with end of dose fluctuations. Dosage: 1 mg tablet orally once-daily with or without levodopa. It 

may be taken with or without food. Elderly: No change in dose is required for elderly patients. Children and 

adolescents(< 18yrs): Not recommended due to lack of data on safety and efficacy. Contraindications: 

Hypersensitivity to the active substance or to any of the excipients. Concomitant treatment with other 

monoamine oxidase (MAO) inhibitors, including medicinal and natural products without prescription (e.g. St. 

John’s Wort) or pethidine. At least 14 days must elapse between discontinuation of rasagiline and initiation of 

treatment with MAO inhibitors or pethidine. Rasagiline is contraindicated in patients with severe hepatic 

impairment. Special warnings and precautions: The concomitant use of rasagiline and fluoxetine or 

fluvoxamine should be avoided. At least five weeks should elapse between discontinuation of fluoxetine and 

initiation of treatment with rasagiline.At least 14 days should elapse between discontinuation of rasagiline and 

initiation of treatment with fluoxetine or fluvoxamine. The concomitant use of rasagiline and 

dextromethorphan or sympathomimetics such as those present in nasal and oral decongestants or cold 

medications containing ephedrine or pseudoephedrine is not recommended. Caution should be used when 

initiating treatment with rasagiline in patients with mild hepatic impairment. Rasagiline use in patients with 

moderate hepatic impairment should be avoided. Parkinson’s disease is associated with a higher risk of skin 

cancer, any suspicious skin lesion should be evaluated by a specialist. Interactions: In view of the MAO 

inhibitory activity of rasagiline, antidepressants should be administered with caution. Co-administration of 

rasagiline and ciprofloxacin (or other potent inhibitors of CYP1A2) is cautioned. There is a risk that the plasma 

levels of rasagiline in smoking patients could be decreased. See also interactions listed in the contraindications 

and special warning sections. Pregnancy and lactation: Caution should be exercised when prescribing to 

Azilect is the first 

Parkinson's Disease 

treatment to offer the dual 

benefits of symptomatic 

efficacy and disease 

modification potential 2 

1, 2 

pregnant women. Caution should be exercised when rasagiline is administered to a breast-feeding mother. 

Driving: Patients should be cautioned about operating hazardous machines, including motor vehicles until 

reasonably certain Azilect does not affect them adversely. Adverse reactions: only very common (≥1/10) and 

common (≥1/100 to

24 

law 

lAW 

Intellectual property 

Intellectual property is the group of legal rights in 

things people create or invent. Intellectual property 

rights typically include patent, copyright, trademark 

and trade secret rights. 

Basis of capitalism 

Most people are surprised to discover that 

intellectual property rights along with all of 

our other property rights originate in our 

Constitution. We need to protect and indeed 

further develop our intellectual property law 

in Ireland going forward if we are going to 

create the best legal environment for research 

and development into medicines and drug 

treatments. Intellectual property law has the 

power “to promote the Progress of science 

and useful Arts, by securing ownership for 

limited times to authors, inventors, doctors 

and pharmacists the exclusive Right to their 

respective Writings and Discoveries.” 

The right to exclusive ownership and use of 

one’s inventions, plus the monetary rewards from 

giving others permission to use them, are integral 

to the functioning of capitalism. Pharmaceutical 

companies are required to balance the need to 

invest cash in research and development of new 

or improved medicines with the requirement to 

pay a dividend to their shareholders. Without the 

protections which intellectual property law offers 

no company would invest a cent in research 

because they could not be sure of enjoying the 

associated monetary benefits from their new 

discoveries. 

BalaNce of rights 

The heart of intellectual property law is the 

balancing of (a) financially rewarding creation 

through granting of exclusive rights to the 

inventor and (b) promoting the free flow of 

ideas to facilitate more creation. Therefore there 

is a tension between the free flow of ideas and 

the right of the inventor to enjoy the profits 

“ 

If a third party 

who was 

not the inventor 

obtains the necessary 

information and they 

register the patent 

before the inventor 

the patent will belong 

to the third party and 

not the inventor. 

associated with his or her idea. Bearing in mind 

that no research funding would be available 

unless intellectual property law guaranteed a 

reasonable return on the original investment 

(should there be an eventual market) the law 

solves the tension by restricting the time period 

to which the inventor can have sole access to all 

of the profits. Eventually the invention becomes 

the property of everyone and nobody at the same 

time and this will eventually allow new entrants 

into the market to copy the invention and sell 

it without breaking the law. This always has 

the effect of drastically lowering the cost of the 

medicine or invention to the eventual customer. 

pateNt law 

Patents are enormously valuable intangible 

assets, however I believe that their value is little 

understood in Ireland. Patents are a very old legal 

concept, indeed the first one was taken out in the 

England in the fifteenth century. Without a patent 

the inventor does not own his or her invention 

and cannot benefit from it financially. Therefore 

anyone who discovers a medical treatment either 

as a result of research and development or simply 


Corm AC o’NeIll 

Cormac O’neill is a barrister 

practising on the Dublin 

and south Western circuits. 

He is also a chartered 

management accountant 

with considerable 

experience in industry 

and banking. In addition, 

Cormac lectures on 

Business and law in the 

Institute of Technology 

in Tralee and can be 

contacted on 087 657 1124. 

as a result of a happy accident should apply for 

a patent to ensure that they receive any financial 

wealth created for the discovery. Medical and 

pharmacological patents are hugely valuable. 

The difficulty with patents is that the first person 

to register them owns them. Therefore, if a 

third party who was not the inventor obtains 

the necessary information and they register the 

patent before the inventor the patent will belong 

to the third party and not the inventor. 

securiNg a pateNt 

After inventing a work the inventor must apply 

for and obtain a patent from the Patent Office. In 

order to patent something you should have an 

intellectual property lawyer assist you with the 

application. Upon receipt of your application, 

the Patent Office will examine the application to 

determine if it meets the legal requirements for 

obtaining a patent. The invention must be novel: 

this means it must not be known or used by 

others in this country, or patented or described in 

a printed publication here or abroad, or in public 

use or on sale in this country more than one year 

prior to the application for patent. It must be 

non-obvious: this means it must not be obvious 

to a person having ordinary skill in the pertinent 

art or science as it existed when the invention 

was made, it must be something new. It is also 

required to be useful: this means it must have 

current, significant, beneficial use as process, 

machine, manufacture, composition of matter, or 

improvements to one of these. 

If the patent is granted, you receive a 20 year 

monopoly on selling, using, making or importing 

the invention along with the right to stop all 

others from doing the same. 

risks 

Pharmacists interested in research and 

development should be aware of two risks. 

Firstly, obtaining a patent can be expensive. you 

should consult your intellectual property lawyer 

and perhaps an accountant to get a specific 

estimate, but the application and granting 

process can take years and require substantial 

legal work. secondly, be aware that in exchange 

for your patent rights, your patent (i.e. how the 

invention works), becomes public information 

so that others may learn from your ideas and 

create further. Due to the disclosure result, many 

often opt not to seek patent rights so that they 

can keep their invention and ideas secret. Given 

the current political interest in generic drugs 

in Ireland which are medicines manufactured 

outside of the patent term, intellectual property 

law is very likely to interest pharmacists in the 

near future.


Chronic 

obstuctive 

Pulmonary 

disease 

mIChelle mCdoNAGh 

Despite rapidly increasing illness 

and death rates due to chronic 

obstructive pulmonary disease 

(COPD), awareness of the condition 

– which is now the fourth leading 

cause of death in the world – among 

the general public remains low. 

the true burden of COPD is 

underestimated because early 

symptoms are not recognised 

or clinically apparent until it is in 

moderately advanced stage. Due to 

the largely irreversible nature of this 

disease, it is important to focus on prevention 

and rapid control to halt further deterioration. 

Pharmacists, who are at the forefront of patient 

care, are well positioned to play an integral 

role in the management of COPD. It has been 

well documented that patients with chronic 

long standing diseases, or their carers, see their 

community pharmacist more often than their GP, 

whether it be to simply collect a prescription or 

to seek advice. 

risk factors 

Identifying patients with early stages of COPD, 

reducing the risk factors for developing COPD, 

such as smoking cessation, and managing the 

disease are key roles for the pharmacist in the 

pharmaceutical care of the COPD patient. As 

our understanding of COPD changes, there are 

opportunities for collaboration between those 

caring for patients with the disease. It might, for 

instance, mean that the pharmacist is involved 

more formally in diagnosis, inhaler device 

selection and technique teaching and long-term 

monitoring of lung function. 

clinical review 

Patients with COPD must be regularly assessed 

to determine whether they are benefiting from 

their treatment and if there is no benefit, therapy 

needs to be modified. Pharmacists should pay 

attention to their patients' use of over-thecounter 

(OTC) products such as cough medicines 

and prescription medications (e.g. antibiotics), 

and regularly review their inhaler administration 

technique. 

Pharmacists should advise patients about 

the importance of regular exercise to maintain 

cardiovascular health, smoking cessation 

attempts, and compliance to medication 

regimens. A referral to the physician is 

recommended when there are any signs of 

worsening COPD, including increased cough, 

phlegm, and breathlessness, and increased use of 

inhalers or OTC cough medications. 

stopping smoking is the most important factor 

in reducing lung function decline and the single 

most important way of affecting outcome of all 

stages of COPD. The pharmacist is often the first 

port of call for those wishing to stop smoking 

and has a key role in providing advice as well as 

providing replacement therapy. 

defiNitioN 

COPD is an umbrella term for chronic bronchitis 

and emphysema, a pair of commonly co-existing 

diseases of the lungs in which the airways 

become narrowed. This leads to a limitation of 

the flow of air to and from the lungs causing 

shortness of breath. In contrast to asthma, the 

limitation of airflow is poorly reversible and 

usually gets progressively worse over time. 

COPD is caused by noxious particles or gas, 

most commonly from tobacco smoking, which 

triggers an abnormal inflammatory response in 

the lung. The inflammatory response in the larger 

airways is known as chronic bronchitis, which is 

“ 

COPD death 

rates for 

women have risen 

steadily and today, 

more women than 

men die of the 

disease each year. 

25

26 

clinical review 

diagnosed clinically when people regularly cough 

up sputum. In the alveoli, the inflammatory 

response causes destruction of the tissues of the 

lung, a process known as emphysema. 

Most people who have COPD are at least 40 

years old when symptoms begin. Although it 

isn't common, people younger than 40 can have 

COPD. For example, this may happen if a person 

has alpha-1 antitrypsin deficiency, a genetic 

condition. 

The natural course of COPD is characterised by 

occasional sudden worsening of symptoms called 

acute exacerbations, most of which are caused by 

infections or air pollution. This debilitating lung 

illness affects over 110,000 Irish people and is 

the second largest cause of respiratory deaths in 

Ireland. Worldwide, COPD death rates for women 

have risen steadily and today, more women than 

men die of the disease each year. 

sigNs aNd symptoms 

COPD can cause coughing that produces large 

amounts of mucus (often called “smoker’s 

cough”), wheezing, shortness of breath especially 

with physical activity, chest tightness, and other 

symptoms. These symptoms often occur years 

before the flow of air into and out of the lungs 

declines. However, not everyone who has these 

symptoms has COPD. likewise, not everyone who 

has COPD has these symptoms. 

COPD symptoms usually slowly worsen over 

time. At first, if symptoms are mild, a patient may 

not notice them, or they may adjust their lifestyle 

to make breathing easier, for example, by taking 

the lift instead of the stairs. 

diagNosis 

A diagnosis of COPD should be considered 

if a person has symptoms of cough, mucus 

production and shortness of breath on exertion. 

A diagnosis will be made based on the patient’s 

signs and symptoms, medical and family histories 

and test results. 

lung function tests can measure how much air 

a patient breathes in and out and how well their 

lungs are delivering oxygen to the blood. The 

diagnosis of COPD is confirmed by spirometry, 

a test that measures breathing. Doctors can use 

the results from this test to find out how severe a 

patient’s COPD is and to help set their treatment 

goals. Other tests that may be recommended 

include a chest x-ray, CT scan and arterial blood 

gas test. 

treatmeNt 

There is currently no cure for COPD, however, it 

is both a preventable and treatable disease. A 

wide range of treatments are now available to 

improve the quality and length of life for COPD 

patients, including vaccination against influenza, 

inhaled bronchodilator drugs, pulmonary 

rehabilitation, oxygen therapy, and surgical 

interventions. Glucocorticoids and antibiotics 

are regularly used to treat acute exacerbations 

of COPD. 

Any effective treatment programme for COPD 

includes four components of care: assessment 

and monitoring of disease; reduction of risk 

factors; management of stable COPD by 

medical and non-medical interventions and 

management of acute exacerbations of disease. 

smoking cessation is the single most 

effective treatment for COPD and can slow its 

progression. Even at a late stage of the disease, 

smoking cessation can significantly reduce the 

rate of deterioration in lung function and delay 

the onset of disability and death. 

Measures can be taken to reduce the 

likelihood that workers in at-risk industries 

such as coal mining will develop COPD. some 

examples of these measures are: education 

of workers and management about the risks, 

promoting smoking cessation, surveillance 

of workers for early signs of COPD, the use of 

personal dust monitors, the use of respirators 

and dust control. 

Bronchodilators can reduce the symptoms 

of shortness of breath, wheeze and exercise 

limitation, resulting in an improved quality of 

life for people with COPD, but they do not slow 

down the rate of progression of the underlying 

disease. Corticosteroids are used in tablet 

or inhaled form to treat and prevent acute 

exacerbations of COPD. 

Influenza can cause serious problems for 

people who have COPD so a yearly flu vaccine 

is recommended. People with COPD are also at 

higher risk for pneumonia so should consider 

getting the pneumococcal vaccine. 

supplemental oxygen can be given to people 


“ 

stopping 

smoking 

is the most 

important factor 

in reducing lung 

function decline 

and the single most 

important way of 

affecting outcome of 

all stages of COPD. 

with COPD who have low oxygen levels in the 

body. It does not greatly improve shortness of 

breath but can allow people with COPD and 

low oxygen levels to do more exercise and 

household activity. long-term oxygen therapy 

for at least 16 hours a day can improve the 

quality of life and survival for people with COPD 

and arterial hypoxemia or with complications of 

hypoxemia such as pulmonary hypertension, cor 

pulmonale, or secondary erythrocytosis. 

Pulmonary rehabilitation has been shown 

to improve shortness of breath and exercise 

capacity. It has also been shown to improve the 

sense of control a patient has over their disease 

as well as their emotions. 

Being either underweight or overweight can 

affect the symptoms, degree of disability and 

prognosis of COPD. People with COPD who 

are underweight can improve their breathing 

muscle strength by increasing their calorie 

intake. When combined with regular exercise or 

a pulmonary rehabilitation programme, this can 

lead to improvements in COPD symptoms. 

In rare cases, surgery may benefit some 

people who have COPD but this is usually a last 

resort for people who have severe symptoms 

that have not improved from taking medicines. 

surgery for COPD patients includes bullectomy 

and lung volume reduction surgery (lVRs). A 

lung transplant may be required in cases of very 

severe COPD. 

New research 

While other major causes of death have been 

decreasing, COPD mortality has continued 

to rise. Although researchers continue to 

investigate the role of proteases in COPD, new 

findings suggest strong inflammatory and 

immune components to COPD. This insight 

has led to a variety of new ideas about COPD 

treatment and has stimulated a surge in research 

activity. 

It is now recognised that 10-20% of COPD 

patients have never smoked. Furthermore, only 

a fraction of smokers develop COPD, suggesting 

that genetic and environmental factors influence 

the risk of developing COPD. Investigators 

are beginning to explore genetic factors, air 

pollution, and occupational exposures as 

possible causes of COPD.

We 

■ are a one-stop service for exempt sourced medicinal products 1 

■ supply manufactured specials/extemporaneous products within 24-48hrs 

■ have experienced support staff to manage the intricacies associated with handling exempt sourced 

medicinal products in an ethical and professional manner from the initial request, through to the 

supply of the medicine 

■ source, import and supply irregular and once off products 

■ no extra delivery charges using customers current delivery arrangements 

■ provide a first class cold chain service 

If you are a hospital or community pharmacist, doctor, dentist or a veterinarian and you have a product 

enquiry or order, contact your local CMR telesales office or the Alchemy specialist team and we will then 

source, price and oversee the delivery of your order making sure you get what you need quickly and 

cost-effectively. Working with Alchemy and CMR provides you with instant access to a multitude of 

international possibilities to fulfil your exempt sourced medicinal products requests. 

CMR & Alchemy operates in line with Irish Medicines Board (IMB) guidelines. 

1 S.I. No. 538 of 2007: MEDICINAL PRODUCTS (CONTROL OF WHOLESALE DISTRIBUTION) REGULATIONS 2007, (SEC 2 (17)). 

Dublin 

Cahill May Roberts 

Tel: + 353 1 630 5432 

Fax: + 353 1 626 8164 

email: alchemy@cmrg.ie 

Sligo 

Cahill May Roberts 

Tel: +353 71 9161801 

Fax: +353 71 9161977 

email: alchemy@cmrg.ie

28 

e-pharmacy 

juNe shANNoN 


helix health Ceo, howard Beggs, Boots ireland Chief Pharmacist, Mary rose Burke, Minister for health and Children, Mary harney, head of 

the school of Pharmacy and Pharmaceutical sciences, Prof Marek radomski and tCd Provost, dr John hegarty. 

students to benefit from top of 

the range pharmacy technology 

The recent opening of the pharmacy laboratory at TCD means that for once the 

term state-of-the-art is not redundant. 

the new facility, the 

‘Boots Practice of 

Pharmacy Teaching and 

Development Unit’, is a 

collaborative initiative 

between TCD, Boots and Helix 

Health. 

The unit contains a range 

of facilities designed to equip 

students with the necessary skills 

for a future career in pharmacy. 

These include 40 stand-alone 

teaching stations, a model 

pharmacy with an adjacent 

communications suite and three 

separate patient consultation areas. 

The 40 teaching stations are 

designed to will help students 

perfect the more traditional 

pharmacy tasks of dispensing and 

administration. They also come 

equipped with the very latest 

pharmacy IT systems donated 

by Helix Health which will allow 

students to become familiar with 

up to date community pharmacy 

and hospital dispensing software. 

The software will also enable 

them to learn about dispensing, 

drug interactions and pharmacy 

management using the best 

available technology. Helix Health 

has committed to updating and 

maintaining the systems for the 

next three years, ensuring that they 

reflect market changes and provide 

information on the very latest 

drug information, updates and 

interactions. 

pharmacy robot 

Helix has also committed to provide 

an automated Pharmacy Robot 

(Consis A2) to the school. This will 

give students the opportunity to 

gain valuable experience using 

the most advanced automated 

pharmacy installations. The robot 

and the latest hospital dispensing 

software will also be supplied to 

the laboratory within six months, 

bringing Helix Health’s complete 

investment to almost €2 million.

Protect the future of your pharmacy 

Join the growing number of pharmacists turning to robotic solutions 

to di�erentiate and safeguard their business 

Increase revenue and customer base 

Free up time for value added services 

Improve stock control 

Increase competitive advantage 

Enhance patient safety 

Reduce dispensing errors 

Dispense easily to care homes 

Achieve optimal sta�ng levels 

Save space and enhance your work environment 

Call us now on 01 4633000- we have the robotic solution for you 

Calendar Pack Dispensing 

Helix Health robotics fully integrate 

with all pharmacy systems in Ireland 

GOLD CERTIFIED 

Partner 

ISV/Software Solutions 

The only Irish Healthcare ICT Microsoft Gold Certi�ed Partner 

Helix Health Limited 52 Broomhill Road, Tallaght, Dublin 24, Ireland. 

T: 01 463 3000 F: 01 463 3011 E: sales@helixhealth.com 

W: www.helixhealth.com 

The Helix Team really helped in 

making our pharmacy work�ow more 

e�cient. Our Consis solution manages 

dispensing stock in a fast, accurate, 

timely and safe manner 

Morgan Power, Powers Pharmacy, 

Ballybricken, Waterford 

MDS Care Home Dispensing 

.

Are you listed? 

Find a Pharmacist 

new search option on 

www.yourmedicines.ie 

The self-care website www.yourmedicines.ie 

Find a Pharmacist is a natural add-on for a site solely devoted to self-care and to 

has now added a new search option designed 

encouraging the public public to take more advantage of the knowledge provided FREE 

to by by encourage their local pharmacist. the public to visit their local 

pharmacy fi rst. 

When you log onto the site you should see a listing for for your pharmacy.* 

We intend to to list every pharmacy pharmacy in the country for for free but we are also offering — 

the more enterprising among you — the chance to enhance your your listing by adding 

extra information about your your pharmacy. By availing of this service your pharmacy 

will be listed and highlighted highlighted above your less enterprising competitors. You will 

also be given the chance chance to list your services. 

When the general general public public log log onto our site looking for a product to to cure a minor 

ailment they they will at the stroke of of a key be be able able to find the the nearest pharmacist who 

provides that product. 

For those among you who want to encourage the public to visit your particular 

pharmacy we offer you the chance to enhance your own listing for an an annual fee of 

€39. This is an introductory offer which which is only available until the the end of October. 

Find a Pharmacy 

Looking for a Pharmacy in your area? What service are you looking for? 

So So log onto www.yourmedicines.ie www.yourmedicines.ie and SAVE 50% off off annual fee by by registering 

before the end end of October 

*If for some reason you are not listed, please contact us through the site and we will 

add your pharmacy pharmacy details. 

What service are you lookin 

Search


“ 

The project 

highlights 

the importance 

of universityindustry 

relationships 

for the benefit 

of third level 

education and 

research in 

Ireland.” 

speaking at the opening Mr 

Howard Beggs, CEO, Helix Health 

said, “Every industry is looking to 

adopt new technologies that enable 

better productivity and service, and 

pharmacy is no different. specialist 

IT systems and robots are enabling 

today’s pharmacists to better cater 

for their patients and manage their 

centres so if we can provide future 

pharmacists with the skills and 

knowledge that will better serve 

them and their clients in the future, 

than we have created a winning 

formula”. 

“We are delighted to support 

Trinity College Dublin and Boots in 

what we believe to be the future of 

pharmacy” he added. 

model pharmacy 

The new unit also features a Boots 

model pharmacy, which allows 

students to experience real life 

pharmacy situations at first hand 

and provides a realistic setting for 

the teaching of pharmacist-patient 

communication. 

The model pharmacy can be 

observed both directly and through 

video technology from an adjacent 

communication skills training 

suite. The unit will also incorporate 

technology and facilities to support 

both on-site interactive training and 

distance e-learning. The use of video 

playback allows students to observe 

and receive constructive feedback to 

perfect their patient counseling and 

communication skills both of which 

are vital for a career in pharmacy. 

Three separate areas or service 

bays are attached to the lab and 

have been designed to provide 

training in advanced pharmacy 

services. This will allow students to 

become familiar with the expanded 

role of community pharmacy and 

to perfect their clinical skills in a 

wide range of areas including blood 

pressure, cholesterol and diabetic 

screening, inhaler technique for 

asthmatic patients and smoking 

cessation. 

Professor Marek Radomski, Head 

of the school of Pharmacy and 

Pharmaceutical sciences at TCD 

explained: “The facility is intended 

to be the most advanced in Ireland 

and allows Trinity to provide the 

highest standard of professional and 

research training to pharmacists of 

the future. Over the past years our 

school has greatly benefited from a 

strong partnership with Boots and 

we are very pleased to now also have 

Helix Health as one of our strategic 

partners. The project highlights the 

importance of university-industry 

relationships for the benefit of third 

level education and research in 

Ireland.” 

Commenting on its significance, 

the Minister for Health Ms Mary 

Harney, T.D. said: “The professional 

tCd Pharmacy intern, helen duffy, demonstrates a smokealyser 

used in pharmacies that measures the level of carbon monoxide in 

lungs, on fellow intern, Padraig Corbett to the Minister for health 

and Children, Mary harney 

e-pharmacy 

tCd Pharmacy intern, Frank Moriarty, role plays as the ‘pharmacist’ 

with tCd postgraduate in pharmacy, elaine Breen, the ‘customer’ for 

the Minister for health and Children, Mary harney 

education and training of 

pharmacists and the conduct 

of pharmacy practice research 

will be of world class standard 

in this modern facility at Trinity 

College. Through the use of 

state-of-the-art educational and 

pharmacy technology, pharmacists 

will be trained in new and innovative 

ways, ensuring that patients in our 

healthcare system benefit from the 

highest standards of pharmacy care 

and practice.” 

seed capital 

As a long standing partner of the 

TCD school of Pharmacy Boots 

provided the seed capital to enable 

the refurbishment of the laboratory 

along with funding for the audio 

visual technology to enhance the 

students’ learning environment 

valued at €200,000. In addition, 

Boots has funded a teacher 

practitioner at the school since 

2001. Other significant contributions 

have included the provision of 

placements for undergraduate 

students as well as collaborating 

on and facilitating practice-based 

research. 

speaking at the official opening 

of the Unit, Ms Mary Rose Burke, 

Chief Pharmacist with Boots, said: 

“This is an extremely significant 

investment for Boots and reflects 

our firm commitment to our role in 

ensuring that the pharmacists of the 

future are equipped with the skills to 

fully embrace all the opportunities 

to better deliver on primary care. 

We are delighted to partner with 

Trinity on such a progressive and 

modern facility and wish all current 

and future students success in their 

training.” 

tcd ethos 

The ethos of the TCD school of 

Pharmacy is firmly based in teaching 

through research and this new 

facility will also benefit postgraduate 

and research activity. 

speaking to Irish Pharmacist at the 

opening Professor Radomski said 

that the new facility meant that the 

Trinity school of Pharmacy could 

offer its undergraduate students the 

very best education in the practice 

of pharmacy. He added that the 

new laboratory would also be of 

benefit to postgraduate and research 

students alike as well as all those 

involved in the practice of pharmacy. 

Prof Radomski added that he was 

particularly pleased that the school 

could open the new facility given 

the “very challenging” economic 

environment of the past two years 

and he thanked both Boots and Helix 

Health for their generosity. 

“ 

The 40 

teaching 

stations are 

designed to will 

help students 

perfect the 

more traditional 

pharmacy tasks 

of dispensing and 

administration. 

31

32 

product news 


Two-year data show patients taking Januvia experienced less hypoglycemia and 

weight gain 

Results from two-years of treatment in a study comparing Januvia 

(sitagliptin) with glipizide (a commonly used sulfonylurea) were recently 

published by the International Journal of Clinical Practice. This study 

showed that the addition of Januvia to ongoing metformin therapy 

improved blood sugar control over two years similar to adding glipizide. 

Treatment with glipizide was associated with a 14-fold higher number of 

hypoglycemic episodes over the two years compared with treatment with 

Januvia, a DPP-4 inhibitor. Moreover, Januvia was associated with weight 

loss whereas glipizide was associated with weight gain. 

The aim of the study was to evaluate the two-year safety and efficacy of 

adding sitagliptin or glipizide to ongoing metformin therapy in patients 

with type 2 diabetes. After metformin, sulfonylureas are the most 

commonly prescribed therapy worldwide. The previously reported primary 

analysis at one year was continued as a randomized, double-blind, activecontrolled 

study for an additional year. 

“Both clinicians and patients are interested in therapies which 

are effective in A1C lowering, are associated with fewer episodes of 

hypoglycemia and weight loss rather than weight gain". Commented 

Dr Alistair McBride, Medical services Manager, MsD. “These study 

findings support the use of a DPP-4 inhibitor, such as Januvia, instead of a 

sulfonylurea for appropriate patients with type 2 diabetes.” 

As a glucose-dependent DPP-4 inhibitor, Januvia works when 

Pinewood Healthcare launches 

nexazole 20 mg and 40 mg 

Pinewood Healthcare have launched Esomeprazole under the brand 

nEXAZOlE 20 mg and 40 mg. 

nEXAZOlE 20 mg and 40 mg gastro-resistant capsules are GMs 

reimbursable and offers savings of 33% compared to the brand leader*. 

“This is a significant development for Pinewood Healthcare” said Fergal 

Murphy, Company Director, Pinewood Healthcare. “We are delighted to 

have nexazole in our stable of quality pharmaceuticals. nexazole offers 

real cost savings for customers, patients and the HsE”. 

Pinewood Healthcare is a wholly owned subsidiary of Wockhardt 

limited and is the leading branded generic pharmaceutical company 

in Ireland. With a state of art manufacturing facility in Ballymacarbry, 

Clonmel, Pinewood is one of the largest employers among the generic 

companies in Ireland employing over 350 people. Pinewood Healthcare 

markets a wide range of products in Ireland and continually strives to 

provide the Healthcare Industry with new, cost-saving products. 

For further information relating to nexazole 20 mg and 40 mg or any 

other product from the Pinewood Healthcare range, please contact 1850 

207 207 or email info@pinewood.ie. 

* Ref IPU list June 2010. 

blood sugar is elevated to address pancreatic insulin deficiency and 

overproduction of glucose by the liver. Glipizide is a sulfonylurea that 

lowers blood sugar by stimulating the pancreatic beta cells to release 

insulin regardless of glucose levels a mechanism that may contribute to the 

increased risk of hypoglycemia. 

study Design 

Patients who were on a stable dose of metformin (≥1500 mg/day) for at 

least eight weeks were randomized in a double-blind manner to receive 

either sitagliptin 100 mg once daily (n=588) or glipizide 5 mg/day (uptitrated 

up to 20 mg/day based upon pre-specified criteria) (n=584). The 

efficacy analysis assessed the change in A1C * from baseline using the perprotocol 

population. 

In this study, 519 of the 1,172 randomized patients (44 percent) 

completed the two-year treatment period, of which 504 were included in 

the per-protocol analysis (Januvia, n= 248; glipizide, n=256). 

The proportion of patients with an A1C of less than 7.0 percent at the end 

of the second year was similar between the Januvia (63 percent) and the 

glipizide (59 percent) groups. nearly three-quarters (73 percent) of patients 

taking Januvia in the two-year per-protocol cohort with an A1C of less than 

7.0 percent at week 52 also had an A1C of less than 7.0 percent at week 104; 

similarly, 69 percent of patients in the glipizide group achieved this result. 

levitra Price Reduction 

Bayer schering Pharma have announced that from the 1 st July 2010, 

prices for levitra (Vardenafil HCI), indicated for the treatment of erectile 

dysfunction, will be reduced across all dose ranges. levitra 20mg will be 

reduced by 6%; the medium and maintenance dose of levitra 10mg will 

be reduced by 40%; while the lower dose of levitra 5mg will be reduced 

by 75%. The updated MsP price list will be as follows: 

levitra 20mg €27.84 per pack 

levitra 10mg €14.64 per pack 

levitra 5 mg €7.40 per pack 

should you have any further queries in relation to levitra, please 

contact Bayer schering Pharma Ireland on 01 – 2999313. 

www.medicali


The launch of Irish Cancer society’s 

look Good...Feel Better Programme 

lisa Cannon joined forces Helen Grimes and Georgina Davies who 

recently participated in the Irish Cancer society’s look Good... 

Feel Better Programme, to help promote the launch of a new 

partnership between Elave skincare and the Irish Cancer society’s 

look Good...Feel Better Programme. 

The look Good...Feel Better programme helps cancer patients’ 

deal with the appearance-related side effects of their treatment 

by holding free skincare and make-up workshops. The programme 

aims to help individuals with cancer look good, improve their selfesteem, 

and manage their treatment and recovery with greater 

confidence. 

The Irish Cancer society’s partnership with Elave means that the 

Irish skincare company will donate €1 from every Elave Intensive 

Cream 500ml pump pack sold this summer with the proceeds 

going to the look Good Feel Better Programme. The limited 

edition pump packs will be available in all major pharmacy outlets 

including major chains and independent pharmacies. The Elave 

Intensive Cream 500ml for Face and Body is priced at €14.50. 

Breast cancer survivors Helen Grimes and Georgina Davis have 

recently taken part in the look Good Feel Better workshops in 

Dublin. Helen commented, “The lGFB workshop was fantastic. 

They really helped me regain a sense of control and normality at 

a time when my diagnosis and treatment seemed overwhelming. 

There was a lot of fun and laughter in our session and I left with 

renewed sense of confidence and improved self esteem. I’m 

delighted that more money is being raised for these workshops 

through the partnership with Elave.” 

For more information about the look Good...Feel Better 

Programme, call the Irish Cancer society’s national Cancer 

Helpline on Freefone helpline 1800 200 700, or visit www.lgfb.ie. 

see also www.elaveskincare.com 

tv3 presenter lisa Cannon (centre), pictured on grafton street 

with breast cancer survivors helen grimes and georgina davis 

as they joined forces to raise awareness of irish Cancer society’s 

look good...Feel Better Programme and its partnership with the 

irish skincare Brand elave for sensitive skin to raise vital funds 

for the charity through sales of elave skincare from all major 

pharmacy outlets. 

product news 

sensiTest” – sensitive skin Diagnostic 

Pharmacy Promotion 

la Roche-Posay has worked with dermatologists to develop the scientific 

sensiTest diagnosis and easy to follow skin analysis questionnaire which also 

gives insights and tips on how to prevent and contain sensitivity. Pharmacy 

advisors nationwide have been trained by la Roche-Posay to help diagnose 

each individual consumer’s skin type and choose the correct product for 

their skin using the sensiTest. Furthermore, if your customers purchase one 

product from the promotional ranges, theywill receive a complimentary 

Essential Travel Kit worth €11 while stocks last. 

Complimentary “essential travel Kit” gift worth €11. 

Following the sensiTest diagnosis, the consumer can avail of the sensitest 

Promotional gift worth €11, perfect for travel, which is complimentary 

with any one purchase from the ranges included in the sensitest Promotion 

- Toleriane, Hydreane, Rosaliac, nutritic, nEW Hydraphase Intense and 

Physiological Cleansers (while stocks last). 

The “Essential Travel Kit” contains the following mini-products which are 

ideal for travelling: 

• Physiological Miscellar solution 50ml 

• la Roche-Posay spring water 50ml 

• 1 x Anthelios sun Protection 5ml 

la Roche-Posay have skincare products formulated and manufactured 

to the high standards of the pharmaceutical industry which are suitable for 

each type of sensitive skin whether intolerant, reactive, prone to redness, 

dehydrated or dry. 

Choose from the following la Roche-Posay ranges for sensitive skin: 

1. Very sensitive - TOlERIAnE – soothing Intolerant, allergic, reactive skin, 

high-tolerance formula limited ingredients 

2. sensitive - ROsAlIAC – Prone to redness, reactive skin 

3. sensitive - HyDREAnE – sensitive skin, tightness, discomfort triggered 

by external factors & reduces skin sensitivity 

4. Barely/not sensitive – new HyDRAPHAsE Intense – Dehydrated skin, 

dry patches, fine lines for intense hydration 

5. Barely/not sensitive - nUTRITIC – Dry to very dry skin, rough patches: 

tightness, fragility, rigidity and roughness. 

6. Each type/degree of sensitivity – PHysIOlOGICAl RAnGE OF ClEAnsER 

ndependent.ie 

  

33

34 

product news 

Aloclair – the only non-stinging 

treatment for mouth ulcers 

Many people suffer the problem of mouth ulcers either on occasion or as 

a persistent problem, often finding stinging treatments painful. Aloclair, is 

the only non 

–stinging treament for mouth ulcers that is fast acting, long lasting and 

comes in a number of forms to suit all age groups from children to adults 

– an Aloclair spray, Aloclair mouthwash and the newest Aloclair addition – 

an easy to apply gel. Aloclair contains aloe vera extract which is renowned 

for its calming and soothing properties. 

Aloclair forms a strong, invisible barrier/film over the ulcer which 

protects the nerve endings giving fast pain relief thus stopping the pain. 

It also prevents bacteria from infecting the ulcers which helps to promote 

fast healing in the area, important for those who suffer from re-occuring 

ulcers. 

Aloclair is available without prescription from pharmacies nationwide. 

The new Aloclair gel comes in an 8ml tube and is great for using ‘on the go’ 

as it has a long reach applicator nozzle which ensures easy application. The 

Aloclair spray is 15ml and has an innovative applicator nozzle which allows 

for economical use and can treat ulcers at the back of the mouth with ease, 

while it’s also handy for treating kids. The Aloclair Mouthwash comes in 

two sizes, a 60ml bottle and a 120ml. This can be used for treating multiple 

ulcers quickly and effectively. The mouthwash is also particularly suitable 

for individuals wearing orthodontic braces. All Aloclair presentations are 

suitable for use by adults, children and babies. 

Ativan (lorazepam) 4mg/ml solution 

for injection (PA 22/1/3) 

Pfizer Healthcare Ireland advises that Ativan (lorazepam) 4mg/ml solution 

for injection will be out of stock shortly and is expected to become 

available again before the end of August. This estimate is based on current 

information and may be subject to change. 

For more information contact the Medical Department 01 4493500.. 


Could white kidney beans hold the 

weight loss key for ‘Carb-aholic’ 

Ireland? 

In a national first, a natural product is now on sale to consumers in the 

Republic of Ireland that has been shown in clinical studies to stop the 

body absorbing up to two thirds (66 per cent) of dietary carbohydrates 

from a meal. 

DEcarb is a highly concentrated glycoprotein complex harvested from 

white kidney beans. The product has been shown to lower calorie intake 

by blocking the production of the digestive enzyme that breaks down 

starchy carbohydrates (e.g. bread, pasta, and potatoes). This significantly 

reduces the carbohydrates absorbed from these foods, which then pass 

through the body naturally instead of being metabolised. 

DEcarb is the latest product to launch in the Republic of Ireland from 

sHAPE·sMART which offers a range of natural products tailored to 

individual needs and requirements to help people lose weight and keep it 

off for good. 

Research from the sHAPE.sMART ‘Weight of the nation’ report surveyed 

800 Irish adults found that a third admit they feel physically addicted 

to carbohydrate laden foods. Half (49 per cent) of the typical Irish diet 

is made up of starchy carbohydrates such as white bread, pasta and 

potatoes and typically people eat three portions of chips a week alone. 

Mary strugar, nutritionist and obesity behavioural therapist said: 

“Carbohydrate dependency is a big problem, with many people relying 

on starchy and processed carbohydrates such as white bread, chips 

and pasta to make up the bulk of their diet. Excess calories from surplus 

carbohydrate consumption not used are quickly stored by the body as fat, 

and will contribute to weight gain if not burnt off”. 

The research also found that 77 per cent of adults in Ireland have 

admitted to fad dieting in the past, yet only 18 per cent have managed to 

lose weight and keep it off. 

A free online assessment tool is now available from sHAPE·sMART that 

offers people the opportunity to identify their own individual eating 

habits and preferences and find out what product could help them – 

www.eatertypes.com. The EATERtypes assessment has been developed 

by leading experts and was trialled by 1,000 overweight adults with nine 

out of ten people describing the result as accurate to their perceived eater 

personality. 

DEcarb costs €29.95 for a pack of 60 tablets. 

www.yourmedicines.ie


dates For yoUr diary 

17th July 

Walsh research institute dublin 

outreach Conference 2010 

Walsh Research Institute Dublin 

Outreach Conference 2010 

on ‘nutrient therapy protocols 

for mental and behavioural 

disorders’, at the J.M. synge 

Theatre, Trinity College Conference 

Centre, Dublin. 

The main presenter will be 

Bill Walsh PhD, Walsh Research 

Institute, Us, and the topics 

to be discussed will include: 

biochemical imbalances in 

mental health populations; 

epigenetics and mental health; 

schizophrenia; depression; 

autistic spectrum disorders; 

behavioural disorders and 

ADHD. 

Organised by: BUnU Health 

limited, the conference has 

been approved by the ICGP for 

CME. Visit http://sites.google. 

com/site/bunuhealth or 

contact 087-1529861. 

name: 

Address: 

E-mail: 

ip Crossword no.177 

1 2 3 4 5 6 

7 

8 

10 11 12 13 

9 

14 

15 16 17 18 

20 

20 Jul 2010 to 24 Jul 32nd international 

school Psychology 

association (isPa) conference 

The Psychological society 

of Ireland will co-host the 

32nd International school 

Psychology Association (IsPA) 

conference with the northern 

Ireland British Psychological 

society in TCD. 

For more information please 

see www.ispaweb.org 

28 August – 2 September 

70th FiP World Congress of 

Pharmacy 

70th FIP World Congress of 

Pharmacy/Pharmaceutical sciences, 

lisboa Congress Centre 

From Molecule to Medicines 

to Maximising Patient Outcomes 

network and connect 

with pharmacists and 

pharmaceutical scientists at 

the 70th FIP Congress. 

The FIP Congress is the 

leading international event 

offering diverse learning 

19 

21 

opportunities for those active 

within all areas of pharmacy. 

The latest trends highlighting 

innovative and interesting 

topics will be discussed 

under the main theme of 

From Molecule to Medicine 

to Maximising Outcomes 

– Pharmacy's Exploratory 

Journey. Participants will be 

engaged in such issues as the 

current and future status of 

pharmacy practice; science 

and practice throughout the 

supply chain and collaborative 

approaches to care. 

lisboa Congress 

Centre Praça das Indústrias 

1300-307 lisboa – Portugal Tel: 

+ 351 213601400 Fax: + 351 

213601499 lisboacc@aip.pt 

www.lisboacc.pt 

17-18 September 

scientific Conference: Faculty 

of sports and exercise Medicine, 

rCPi & rCsi 

The conference will focus on 

classifieds/crossword 

issues related to posterior 

thigh pain, including hamstring 

pathology and lumbar 

sacral spine pathology, a 

team-physician update, as well 

as original research and case 

presentations. 

Panel of national and 

international speakers invited. 

Closing date for Abstracts 

for scientific Papers – Friday 

18 June 2010 to opuirseil@ 

rcsi.ie. CME/CAs will 

apply. Programme and early 

registration at www.rcsi.ie/ 

fsem. 

www.rcsi.ie/fsem 

diary/ClassiFieds serviCe 

at irish PharMaCist 

Please email your ad to 


across 

1 Absorbs food in condensed books? (7) 

4 Respiratory problem found in micro upsurge (5) 

7 ...or flame of the femur (7) 

8 Wild-west show in Bustrode, Oregan (5) 

9 A neat hospital attendant? (7) 

10 Confused in siam, like apes (6) 

12 French farewells! (6) 

15 Try nuke to reform warder (7) 

17 I dove into a TV recorder (5) 

19 A handy fortune teller? (7) 

20 This spasm is a pain in the neck! (5) 

21 skipper – Bird’s-eye, perhaps (7) 

down 

1 Put off or freed in confusion (5) 

2 Orca sam could show a tumour (7) 

3 Confused models rarely encountered (6) 

4 love-god that takes a bow! (5) 

5 Watch out for verbose shenanigans (7) 

6 It’s so near the larynx it rhymes with it! (7) 

10 Rushdie’s devilish verses (7) 

11 Cocktail I mixed in Antrim (7) 

13 Grow into a more mature state - photographically perhaps! (7) 

14 It would be short-sighted of one to be like this! (6) 

16 Rap for site of Horan International Airport (5) 

18 Frequently the opposite of 3 down (5) 

lady Pharmacists’ 

golf 2010 outings 

All lady pharmacists who 

hold a golf handicap are most 

welcome to join our friendly 

society. We are always happy 

to welcome new members and 

it is an ideal way to catch up 

with old friends. 

Barbara O’Connell is this 

year’s President, Anne nolan is 

the Captain and Marie Walsh is 

Treasurer. 

dates and venues 

Saturday 24 July 

Druid’s Glen 

Saturday 21 August 

Adare 

Pre-booking is essential to 

reserve a place at any of this 

year’s outings. 

Contact: Competition 

secretary, Doreen 

O’Donoghue 086 233 6896 or 

Hon secretary, Ann O’Connor 

087 232 6483. 

lAsT MOnTH’s 

CROssWORD AnsWERs 

Congratulations to the winner of last month’s crossword: 

Michelle Quinn, The Burren Pharmacy, Main st, lisdoonvarna, Co Clare. 

For a chance to win €70, please send completed entries to: 

the Editor, Irish Pharmacist, GreenCross Publishing, 

7 Adelaide Court, Adelaide Rd, Dublin 2 or 

fax to (01) 478 9779 by 20 August 2010. 

Please note the winner's cheque will be issued 45 days after publication. 

1 

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I Z A B 

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A R 

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C R S E U E 

7 

A R C H A I C D M L 

L I A A B I 

8 

P R O W L P 

9 

U L S A T E 

L E G V 

10 

O 

11 

F F S E T 

12 13 

I G N O R E 

B A R 

14 

R 

15 

E N T 

16 

I T L E E 

17 

T H E R 

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I G P E 

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L A T I O N 

T U I A D G 

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Y I E L D 

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L E E C H E S 

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36 

opinion 

outsIde edGe 

The Island of docTor r. 

at time of writing the dust is still 

settling after the leadership scrap in 

Fine Gael during which Enda Kenny’s 

praetorian guard of Phil Hogan and 

Dr James Reilly wiped the floor with 

Richard Bruton’s mutineers. Enda is 

still pondering the make-up of his front bench and is 

expected to offer a few olive branches to the Bruton 

camp, but I think we can assume that Dr Reilly will 

stay in the health portfolio. A lot has been made of 

Kenny’s charisma deficit with the public, being an 

impediment to Fine Gael, but is the real issue not the 

fact that it’s a sad indictment of the Irish electorate 

that we want charisma so badly? I can remember 

back to the 1980s when the choice was between 

Paralink 

SIX PLUS 

PARACETAMOL 250mg/5ml 

ORAL SOLUTION 

NEW 

Theres a new kid on the block! 

The only solution for childhood pain and fever 

Now available in six plus strength. 

Made in Ireland 

JOB NO 2017 COLOURS USED 

Garret FitzGerald and Charlie Haughey, and people 

preferred the ‘roguishness’ of Haughey, who was 

rotten to the core, a bully and a thief. Haughey’s own 

bad lieutenant, Bertie Ahern, was seen as one of us, a 

decent skin who liked an oul pint. yet, as we’ve come 

to realise, if treason was still a crime then Ahern’s 

head would be on a spike at Dublin Castle. let’s face it 

– we’ve a small country with a limited pool of political 

talent – we’re not going to produce an Obama 

anytime soon, so let’s forget about charisma, and 

start by getting leaders in every party who are honest 

and competent. 

Given that Dr James Reilly is the most likely next 

Minister for Health, it is hard to know what that 

could mean for pharmacists. He will have a better 

Irish Pharmacist. The dimensions for that are 340 x 245, 3mm bleed. 

2 

Reasons to choose 

Paralink Six Plus 

Pleasant taste. No bitter 

aftertaste, No Gloop, 

No Colouring. 

Significantly cheaper than 

the market leader 

SIGN OFF 

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Sugar & Colour Free 

Reduces Temperature 

Manufactured & Licenced in Ireland by 

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Always read instructions carefully. 

Do not exceed the stated dose. 


fINtAN moore 

feel for healthcare than Mary Harney, but there was 

an interesting Dáil exchange recently in which Reilly 

asked Harney if the DPs regarded a month as being 

28 days, requiring patients to pay for their medication 

13 times a year instead of 12. Harney replied that 

only 12 payments in a full year should be made for 

medication. There are a few remarkable things about 

this, one being that Harney was actually present in 

the Dáil; and another being that she got a basic fact 

relating to pharmacy correct – three cheers for the 

backroom staff. The other is that Dr Reilly, who is a GP, 

and who has been Fine Gael’s health spokesman for 

years, needed to ask the question in the first place. It 

seems that the nitty gritty bits of our everyday life still 

remain a mystery to those who would decide our fate. 

BoxIng clever 

I’ve been studying possible designs for the new 

consultation area to try and comply with the 

guidelines issued by the pharmacy regulator. The 

front-running idea at the moment would involve 

ripping out a corner of shelves near the counter and 

building a large wooden box containing two chairs 

and a table. This would allow me to sit down and talk 

to a patient while still being close to the OTC counter 

and dispensary. I reckon that the number of times 

this would be used in a year could be counted on the 

fingers of one hand. The question has been crossing 

my mind in idle moments as to what else the room 

could be used for. 

It could be perfect for those times when you’d like 

to lie down in a darkened room and play chill-out 

music, maybe with a couple of scented candles. If 

all of the surfaces were padded with nice soft foam, 

then it could be a handy place to go for a few minutes 

to de-stress by hopping off the walls – after which 

you can go and try yet again to get through to the 

hospital doctor that you’ve been chasing for the last 

two days. Or you could use it to contain hyperactive 

children fuelled up on Mars bars and Fanta to stop 

them wrecking your shop, but they’d probably chew 

the foam thinking it was candyfloss. The room could 

be used like a telephone box to change into your 

superhero costume before you go to fight crime. 

It could be painted like a Tardis and rented to Dr 

Who enthusiasts to watch old episodes on laptop. 

Or it could be used as a scumbag trap – put a sign 

on the door saying ‘Diazepam store’, put your pet 

Dobermann in there to sleep and when the balaclava 

bandits arrive they can wake the doggie. 

Or maybe I should go back to the drawing-board 

and design something that could be useful as well as 

legal. 

MonosyllaBIc Messenger 

I had a kid come into my pharmacy today who came 

up to the counter and said ‘Can I have a Ventolin 

inhaler?’ 

‘Who’s it for?’ 

‘My brother.’ 

‘And your brother is...?’ 

‘Asthmatic.’ 

Maybe he was the eighth dwarf.

Proposal to Change legal structure of Psi Benevolent Fund

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