interview - Green Cross Publishing

issue 2 volume 13 FeBRuARY • 2011 www.greencrosspublishing.ie
news
Pharmacy sales dive as
codeine restrictions hit
home p4
HSE plans needs based
rationalisation of
reimbursed drugs p4
Pharmacists await
findings following
FEMPI consultation p4
Political parties’ (some!)
pharmacy policies p6
Changes to psychiatric
scheme delays patient
access to medicines p6
OTC emergency
contraception p8
Positive response to call
for pharmacy experts p15
The THE independenT INDEPENDENT monThlY MONTHLY FoR FOR iRish IRISH phARmAcisTs
PHARMACISTS
interview
Vincent Cronin
– visionary pharmacist,
on the past, present
and future of pharmacy
Fintan Moore
Tablets of
the devil
terry Maguire
Swallow
the fat tax
DaviD JorDan
Tears for
Harney
Dr Des Corrigan
Herbs that
come from
a land down under
CliniCal review
Influenza
letters page
National drugs budget
announcement
CKA/092/00 *Based on combined annual fi gures - IMS Health & AC Nielsen - November 2010
Product name: Calpol 120mg/5ml Infant Sugar Free Oral Suspension, Calpol Six Plus 250mg/5ml sugar/colour free oral suspension. PA Holder: McNeil Healthcare Ireland Limited, Airton Road, Tallaght, Dublin 24, Ireland. PA number: 823/10/5, 823/10/4. Further information is available upon request. This product is not subject to medicinal prescription.

The independenT monThlY FoR iRish phARmAcisTs
issue 2 volume 13 • FeBRuARY 2011
4-15 news
16 eu news
18 news
19-21 interview
Masters of Pharmacy
visionary pharmacist,
vincent Cronin
on the past , present
and future of Irish pharmacy
Irish Pharmacist is published by
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DESIGN: Barbara Vasic
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PUBlISHER: Graham Cooke
PUBlISHER: Maura Henderson
CoNTRIBUToRS: Iain Cahill, Dr Des Corrigan,
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or 0872222221
22 Des Corrigan
Herbs from the land
down under
24 DaviD JorDan
Tears for Harney
26 terry Maguire
Fat tax?
28 FinanCe
iain Cahill
conTenTs
30-32 CliniCal review
Influenza
34-35 e-pHarMaCy
36-38 proDuCt news
39 CrossworD
40 outsiDe eDge
Putting Boots on the MAP
Fintan Moore

4
news
The HSE has set a target of
the last quarter of this year by
which it aims to carry out a
needs based “rationalisation” of
all licensed drugs reimbursed
under the GMS schemes Irish
Pharmacist reports.
In its National Service
Plan for 2011 the HSE lists
among its main priorities
to have “a clinical focus
applied to all licensed drugs/
medicines reimbursed for
their appropriateness” by the
third quarter of 2011. It also
aims to have carried out a
“rationalisation of all licensed
drugs/medicines reimbursed
Pharmacists across the
country are currently
waiting for a report from the
Minister for Health following
the completion of the recent
FEMPI review consultation
process.
The Health Minister
had called on health
professionals and interested
parties to engage in
consultation and make
submissions under the
Financial Emergency
Measures in the Public
Interest (FEMPI) Act 2009 up
until January 2011.
According to information
obtained by Irish
based on need” as well as
“continuing the review of all
non drug items reimbursed
under the Schemes for their
appropriateness,” by the fourth
quarter of 2011.
Coupled with finding €424
million in cost savings in
schemes under the Primary
Care Reimbursement Service
(PCRS) – which represents
nearly half of the overall
annual cost savings for the
HSE – the Executive has also
identified “the timely provision
of medical cards and primary
care schemes through the
centralisation of the medical
Pharmacist, at the end of the
consultation period, a total
of eight submissions were
received by the Department
of Health as part of this
consultation.
Four of these submissions
came directly from
pharmacists while further
submissions were made
by the Irish Pharmacy
Union, the Pharmaceutical
Distributors Federation, one
member of the public and
one accountant.
Speaking to Irish
Pharmacist, a spokesperson
for the Irish Pharmaceutical
Union (IPU) said that the
card services as another of its
main priorities in the PCRS area
for 2011.
According to the NSP 2011
as of 31st December 2011, the
total number of people with a
medical cards was estimated
to be 1,779,585, representing
almost 40 per cent of the total
population and a growth of 9.5
per cent population coverage
since December 2008.
The NSP stated that this
was a 31.6 per cent increase in
numbers in receipt of medical
cards since 2008 and a 46
per cent increase since 2006.
There are also estimated to be
body had submitted a
comprehensive report to
the Department of Health as
part of the review and was
eager to receive a decision
on this submission. “Having
made a submission to the
Department regarding
the review of pharmacy
payments and, having made
presentations to officials
within the Department of
Health and the HSE, we are
now awaiting a decision on
the consultation process
and expect to hear from
the Department over
the coming weeks,” the
spokesperson said.
138,816 GP Visit Cards issued by
the end of 2011, an increase of
62 per cent since 2008.
“In 2011, our key aim is to
modernise the community
schemes administered by
the HSE. We will continue to
extract efficiencies out of the
system, standardise process
and decision-making and
achieve economies of scale.
The continuing contraction of
state revenue stream coupled
with increasing numbers on the
live Register and consummate
uptake of Schemes, presents an
unprecedented challenge for
services in the future.”
issue 2 volume 13 • FeBRuARY 2011
pharmacy sales take a dive as
codeine restrictions hit home
New figures have revealed that
pharmacy sales were down
almost five per cent in the final
quarter of 2010.
According to the new
statistics from Retail Excellence
Ireland’s (REI) Irish Retail
Industry Performance Review
Q4 2010, total pharmacy sales
dropped by 4.74 per cent in
the fourth quarter of the year
when compared with the same
period last year.
over the counter sales were
hit the hardest during this
period and witnessed a 5.52
per cent decrease on the same
period last year while retail
sales were down 4.88 per cent
and dispensary sales were
down 3.58 per cent.
october was by far
the worst month for Irish
pharmacists with sales
tumbling down by 6.49 per
cent on the same month in
2010. In fact, over the counter
sales for october dropped by
a whopping 11.12 per cent,
primarily, as a result of the
implementation of the new
restrictions relating to the
sale of codeine. Retail sales
also took a significant hit in
october with pharmacies
reporting an 8.7 per cent
decrease in these sales when
compared to october 2009
while dispensary sales were
needs based rationalisation of all
reimbursed drugs planned by Hse
pharmacists await Minister’s findings
following FeMpi consultation
down 4.89 per cent.
While sales improved
slightly for pharmacists in
November and December,
figures were still down on 2009
with November sales down 3.7
per cent on the same month
last year and December sales
down 2.95 per cent.
Commenting on the figures,
REI Chief Executive officer,
David Fitzsimons, said,
“As the measures contained
in Budget 2011 work their
way into real and anticipated
incomes, the disposable
income consumers have to
spend has been reduced.
Together with the current
political uncertainty and
prospect of a general election,
this is likely to hamper any
prospects of an immediate
return to growth and more
probably could contribute to
accelerated market decline.”
“During the year, the cost
savings of €424m in schemes
will deliver nearly half of the
overall annual cost savings for
the HSE. There are considerable
challenges to the delivery of
this level of cost reduction
and we recognise that the
targets are aggressive. Should
any shortfall arise, further
action will be taken to deliver
savings at the required level.
The HSE is dependent on
actions of the DoHC in regard
to early implementation of
key decisions to achieve these
savings.” The Service Plan
added.
TCD School of Pharmacy prize giving
Trinity College
Dublin undergraduate
students,
Frank Moriarty,
Maeve McCarthy,
Mary lennon and
Catherine Byrne,
celebrate at the
annual School
of Pharmacy
prize giving after
receiving awards
sponsored by
leading pharmaceutical companies.
Frank Moriarty took the GlaxoSmithKline prize in Pharmacognosy.
Maeve McCarthy won the leo Pharma price in Pharmaceutics.
Mary lennon won the best final year performance in the practice
of Pharmacy prize sponsored by McNeil Healthcare Ireland ltd, and
Catherine Byrne won the Paul Higgins Memorial prize sponsored by
Cahill May Roberts for Pharmaceutical Chemistry.
Trinity College’s School of Pharmacy was established in 1977 and
is the oldest academic pharmaceutical institution in Ireland.

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6
news
Medical card patients, with
mental health difficulties, are
being hugely inconvenienced
and in danger of not filling
their prescriptions on time
under changes unilaterally
enforced by the HSE to the
psychiatric scheme in the
greater Dublin area Irish
Pharmacist reports.
Although not a statutory
scheme, up until late last year
a system was in place whereby
medical card patients who
attended a psychiatric clinic in
the old ERHA area could take
their prescription from the
clinic directly to a pharmacist
and collect their medicines
for free.
However, since the
introduction of the 50-cent
prescription charge in october
last year, patients must now
take their prescription from
the psychiatric clinic to their
GP to be transcribed onto a
medical card prescription,
which they can then take to
the pharmacist for dispensing.
The IPU raised concerns
about this issue when it first
occurred last year. Speaking to
Irish Pharmacist IPU President
Mr Darragh o loughlin said,
“the difficulty that arises for
patients is there is a delay.
obviously they used to be
able to go from the clinic to
the pharmacy and get their
medications for free now
there is a delay while they go
to the GP’s surgery to have
it transcribed. There is a fear
among pharmacists that the
more transcription you have
of prescriptions between the
specialist and the dispensing
the more chance there is of
errors creeping in.”
Mr o’ loughlin added that
the IPU feared that some
patients who did not get
their prescription dispensed
immediately may not get it
dispensed at all, as that extra
step of going to the GP may
prove too much of a burden.
“It does put an extra
administrative burden on the
medical card holding patient
because they have this extra
step to undergo, this extra
hoop to jump through before
they can get their medicines,”
he said.
This issue was raised in
a Parliamentary Question
(PQ) recently by Mr Terence
Flanagan TD who asked if the
Psychiatric Scheme could be
left in place.
In raising the PQ Deputy
Flanagan said, “some
pharmacists have stated that
it can take up to 48 hours
for medication to be given
once a script is left in which
could cause a lot of trouble
for patients having to wait
this long for medication. They
have also stated that this isn’t
going to cost the HSE any
less but will just cause a lot of
hassle.”
In a written response the
HSE said, “in line with our
stated policy to standardise
and streamline arrangements
under the State Drug
Schemes, to improve equity
for service users and increase
efficiency, local services have
been advised to direct Medical
Card holders requiring
psychiatric medicines to
attend their local General
Practitioner with effect from 1
october 2010.”
According to the HSE,
“this approach will align
the arrangements for
the dispensing of drugs/
medicines to persons on
medication for a mental health
condition, who reside in the
greater Dublin area, with the
arrangements that pertain in
the case of persons living in
all other parts of the country.
This is also consistent with the
arrangements for dispensing
issue 2 volume 13 • FeBRuARY 2011
political parties set out pharmacy policies
(but not every party responded...)
At what is undoubtedly one
of the most challenging
times for pharmacists
operating in Ireland, there is
no doubt that many people
will have lots of questions
for the countless politicians
that will be canvassing and
knocking on their doors in the
coming weeks. Ahead of the
elections, Irish Pharmacist,
asked all of Ireland’s political
parties how their current and
future policies would impact
on pharmacists if they were
elected. At the time of going
to print, Fianna Fáil, the Green
Party and Sinn Féin had
responded to the request.
Fianna Fáil
over at Fianna Fáil HQ,
their plan going forward
is to continue with the
implementation of the
National Recovery Plan and
the savings which they have
outlined will be required from
the health service.
A spokesperson for the
party says the party also
plans to tackle the costs
of drugs by, “introducing
clinical guidelines to improve
prescribing behaviours in
order to generate savings in
drug costs, where appropriate
and reduce other treatment
costs by providing more
effective drug treatment.”
The party acknowledged
that measures already
introduced to reduce the
cost of drugs to the state
and the consumer has
impacted on pharmacists, but
added, “unfortunately, this
is necessary as every saving
achieved by the HSE will
reduce pressure on funding
for front-line services.”
The spokesperson added,
“Fianna Fáil recognises
the important role that
pharmacists play in their
communities and that is why
in 2007 we modernised the
Pharmacy Act. This was a very
significant step in putting
standards of pharmacy
practice on a comprehensive
legal footing. It ensures
the highest standards for
pharmacists and safeguards
the delivery of services to all
citizens of the state.”
Concluding the
spokesperson added, “Fianna
Fáil believes honestly that no
person, group or sector can
be absolved from making
a fair contribution to the
resolution of our economic
difficulties. The measures
in the 4 year plan are
proportionate and we must
all accept our share of the
burden in order to resolve our
current economic challenges.“
the green party
At a time when pharmacists
across the country are urging
government to realise their
ability to contribute to
community health services,
it makes sense that amongst
the Green Party’s key
pharmacy policies going
forward is that the role of
community pharmacist is
extended. Speaking to Irish
Pharmacist, a spokesperson
for the Green Party said they
are intent that, “as single
tier universal Primary Health
Care is extended, community
pharmacy services should
become an integral part of
Primary Care Teams.”
The Green party is also
eager to bring down the
costs of drugs and as part of
its policy it believes that, “to
control costs, prescription
and dispensing in Primary
Care should be confined to
an established list of essential
drugs subject to regional or
national procurement.”
sinn Féin
Sinn Féin is putting forward
a number of new measures
regarding the pharmacy
sector which it believes are
necessary to create a renewed
and revitalised health service.
Speaking to Irish Pharmacist,
Sinn Féin’s spokesperson for
Health and Children, Deputy
Caoimhghín Ó Caoláin said
that it is his party’s belief that
pharmacists need to have a
central role as primary care
providers. “Medicine use
review should be central to
the expansion of that role.
It would help to ensure that
Caoimhghín Ó Caoláin
patients get optimum benefit
from medication and that
waste is reduced. A Minor
Ailment Scheme would
be a logical and sensible
extension of the role of the
pharmacist. It would help to
relieve pressure on our overextended
GP system, due to
the current shortage of GPs.”
Another area of concern
is the current prescription
charges and Deputy
Ó Caoláin said that he
believes the prescription
charge for medical card
patients must be abolished.
Instead, he said, “the cost
of medicine to the health
system should be addressed
through targeting excessive
profiteering by producers
and distributors and through
more efficient use of generic
medicines.”
The Sinn Féin TD said
that he believes that health
promotion in pharmacies
should be encouraged and
the new Minister for Health
should work with pharmacies
in this regard and on the
whole range of primary
care issues that concern
pharmacists.
Changes to psychiatric scheme delays timely
access to medicines for patients
drugs/medicines across the
full spectrum of medical
conditions and is consistent
with the policy of normalising
and de-stigmatising this
aspect of our healthcare
service.
“This initiative will ensure
that general practitioners
have a full involvement in their
clients’ medications, including
their psychiatric drugs.
“The process will also
ensure that pharmacists, who
will continue to provide this
medication to eligible persons
under the various scheme
arrangements, can claim
reimbursement in respect of
these drugs with their other
monthly submissions.
“This change will not
disadvantage medical card
holders and it will reduce the
administration associated with
these arrangements and free
up resources for other patient
services,” the HSE added.

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8
news
THE IPU is currently developing a protocol by which all
independent pharmacists in Ireland will have the option
to provide emergency contraception without a prescription.
The move follows an initiative by Boots Ireland last
month, which saw emergency contraception services
available in all its pharmacies throughout the country.
Speaking to Irish Pharmacist, the President of the IPU,
Mr Darragh o’ loughlin said the union was currently
writing a protocol, developing training programmes and
working on the specific Patient Group Direction
(PGD) which will allow independent pharmacists to
provide an emergency contraception service. He said
that it was hoped that all the necessary structures would
be in place before the middle of this year.
Exputex “Writing the 145x210 protocol and 16/10/2008 putting together 10:51 the train- Page 1
ing and the patient group direction for independent
pharmacists who can all then apply it themselves is a lot
more complex than producing one for a single organisation
such as Boots or any other large chain, that is why
it is taking us a bit longer than it took Boots. They have
innovated on it but we are following a similar path,” he
said.
Emergency hormonal contraception is available
throughout pharmacies in many other European countries.
The provision of emergency contraception has
been licensed for use in Ireland since late 2001; however
until now those who sought the service required a doctor’s
prescription.
The new service provided by Boots Ireland is offered
under a PGD,
which allows Boots pharmacists to provide a range
of clinical services, including medical treatments. All
services are conducted under strict guidelines laid down
issue 2 volume 13 • FeBRuARY 2011
all pharmacists will have the option to provide
emergency contraception without prescription
Good News
for chesty coughs
Exputex
Carbocisteine mucolytic syrup
COMPLETE WITH
CHILD RESISTANT
TAMPER EVIDENT
CAP
SUGAR FREE
✓ Non drowsy
✓ Mentholated
✓ 300ml - the lowest cost
sugar free carbocisteine
mucolytic syrup (on a ml
per ml basis 250mg/5ml) 1
Prescribing Information
(Please refer to full Summary of Product Characteristics [SmPC])
Exputex 250mg/5ml Oral Solution
Presentation: Carbocisteine provided as 250mg/5ml oral solution. Uses: As
a mucolytic adjunct for respiratory tract disorders characterised by excessive
or viscous mucous. Dosage and administration: Oral. Adults/Elderly:
Three 5ml spoonfuls three times daily initially. Reduce to two 5ml spoonfuls
three times daily when a satisfactory response has been obtained. Children:
6-12 years: 5ml spoonful (250mg) two to three times daily. 2-5 years: Half a
5ml spoonful (125mg) two to three times daily. Under 2 years: Not recommended.
Contraindications: Hypersensitivity, patients with known active
peptic ulceration. Special Warnings and Precautions: Patients with a history
of peptic ulceration, avoid in patients with active ulceration, patients on a
controlled sodium diet. Contains parahydroxybenzoates (E215, E217 and
E219), sunset yellow FCF (E110) and ethanol. Interactions: None listed.
Pregnancy and Lactation: Not recommended. Undesirable Effects:
Nausea, headache, gastrointestinal upset and skin rash. Overdose: No
experience. Serious effects not expected. Legal category: S1B(E) Product
Authorisation number: PA 488/14/1. Product Authorisation holder:
Monmouth Pharmaceuticals Limited, Hampshire International Business Park,
Chineham, Basingstoke, Hampshire, RG24 8EP, UK. Distributed by: Cahill
May Roberts, Pharmapark, Chapelizod, Dublin 20. Further information is
available from: Shire Pharmaceuticals Limited, Hampshire International
Business Park, Chineham, Basingstoke, Hampshire, RG24 8EP, UK. Tel: +44
1256 894000. Date of revision: June 2008. Exputex is a registered trademark
of Shire US Inc. in Ireland.
Adverse events should be reported to the Pharmacovigilance Unit
at the Irish Medicines Board (IMB) (imbpharmacovigilance@imb.ie).
Information about adverse event reporting can be found on the IMB
website (www.imb.ie). Adverse events may also be reported to
Shire Pharmaceuticals Ltd on +44 1256 894000.
MONMOUTH
P H A R M A C E U T I C A L S
Monmouth Pharmaceuticals Ltd,
Hampshire International Business
Park, Chineham, Basingstoke, Hants
RG24 8EP
1 MIMS May 2008 Date of preparation: October 2008 IRE/EXP/08/0001
by the Boots Ireland Medical Director. The emergency
contraception service is the second PGD service to be
rolled out by Boots Ireland, following the recent successful
introduction of a flu vaccination service, and others
will follow in the months ahead.
“This emergency contraception service has been introduced
as part of Boots’ objective to provide responsible,
accessible and affordable healthcare to its customers,”
said Mary Rose Burke, Chief Pharmacist, Boots Ireland.
Mr o’ loughlin added that the IPU was also considering
developing further PGDs to allow pharmacies offer
additional services that could be suitably provided in a
pharmacy such as certain vaccinations.
“The whole idea behind them is to try and provide
pharmacy services to patients at a time and location
that suits them making it as convenient as possible for
patients,” he said.
Effectiveness of childproof
containers examined
by young scientists
Students of Rosses Community School, Dungloe, Co.
Donegal were awarded the Irish Medicines Board
(IMB) Special Award at this year’s young Scientist
& Technology Exhibition. Eilish Bonner and Aideen
Meehan received the award for their project entitled
“How child-proof are child-proof containers?” in the
category of Social and Behavioural Sciences.
Speaking following the presentation of awards
last week, Pat o’Mahony, chief executive of the IMB,
commended the girls on their project. “The IMB
Award is granted to a project that best assists an
increase in understanding by people of the safe use
of, or access to, medicines and/or medical devices.
Eilish and Aideen investigated the effectiveness of
child-proof containers amongst young children. Their
findings reinforce our message on the importance
of storing medicines safely in the home and the
critical role of parents and older siblings in protecting
children from access to any medicines and other
items. We congratulate the girls and their teacher Ms
Anne Moy on such a well executed project”.

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10
news
Cork Medical Centre
recruiting pharmacy team
A major recruitment drive is
underway at a new hospital
in Cork.
Ahead of its opening this
March, the newly built Cork
Medical Centre is involved in
efforts to recruit a number of
medical positions including a
new pharmacy team for the
new facility.
Amongst the positions
it will be recruiting for
are clinical pharmacist,
new poisons helpline launched
A new, public helpline, which
will give advice about how to
deal with accidents involving
poison, has just been
launched.
The service, which was set
up by the National Poisons
Information Centre at Dublin’s
Beaumont Hospital, will
be available from 9am to
5pm, Monday to Friday.
The launch of the new
helpline comes at a time that
more and more members
of the public are contacting
the NPIC with concerns
about poisoning. In fact, calls
senior pharmaceutical
technician and a basic grade
pharmaceutical technician.
Pharmacy Manager at
the new facility, Muireann
Ryan, said that recruitment
for these positions is now
ongoing and that any
interested candidates should
send their details to hr@
corkmedicalcentre.com.
The new Cork Medical
Centre is the first new hospital
from members of the public
account for about a quarter
of the 10,000 it receives each
year.
Commenting on the
launch, NPIC Director Dr Edel
Duggan said that she was
hopeful that the new service
could improve the medical
outcomes of those who
have ingested poisons and
could reduce the number of
unnecessary visits to hospital
emergency departments,
especially by children.
“our aim in launching
this service in Ireland is to
Drug may reduce
lung cancer deaths
A commonly used breast cancer
drug may also help to tackle
lung cancer.
According to a new study
published in the journal Cancer,
the drug Tamoxifen may be
able to help reduce the risk of
death from lung cancers thanks
to its oestrogen blockers.
The study, which was
undertaken at Switzerland’s
Geneva Cancer Registry, was
based on research which shows
women undergoing hormone
replacement therapy showed
an increased risk of dying from
lung cancers.
As a result of this research,
the team at the Geneva Cancer
Registry decided to examine
the hypothesis that blocking
oestrogen might also cut lung
cancer death risk.
As part of their study, the
researchers examined data
from 6,655 women diagnosed
with breast cancer between
1980 and 2003 in Switzerland’s
Geneva Cancer Registry.
Close to half of those women,
3,066 (46%) were given antioestrogen
drugs.
The women’s progress was
followed until 2007 at which
stage, researchers found that
there were 87 per cent fewer
deaths from lung cancer when
compared to the general
population.
7 steps to Building a High profit Business
and Becoming wealthy
This is a once-in-a-lifetime opportunity to learn, from a true expert, how to build the
business and the life of your dreams, using a concrete, proven system for success:
“For one Day only I Will Train you In The Secrets of Building a High Profit Business and
Becoming a Millionaire” Brian Tracy, The World’s Number one Business Expert
Date: sunday 27th February 2011
venue: the D4 Ballsbridge inn, Dublin 4
time: 9.30am to 5.30pm (Full Day interactive seminar)
Brian tracy– the world’s number one Business expert
Internationally recognised and specialised in the training and development of individuals and
organisations, Brian Tracy will lead with his extensive expertise in sales and growth. He has
consulted with more than 1000 companies, including Pepsi, HSBC, Nissan, Toyota, Mobil, Johnson&
Johnson…
It is Brian’s passion to help as many entrepreneurs as possible to achieve the kind of success he
has, and that’s why, during this one day event, he’s going to teach you:
• 10 Requirements for Business Success – if you’re missing any
of these, you’re not going to experience the success you
deserve.
• The oNE reason behind 90% of business failures – and
why more than 70% of business failures could have been
prevented.
To book tickets log on to www.briantracydublin.com
to be developed in Cork in 30
years and has been designed
to promote faster healing in
21st century surroundings.
Developed and operated
by Sheehan Medical, the €90
million facility will house the
latest medical technology
from Siemens Healthcare,
making it the most
technologically advanced
hospital ever developed in
Ireland.
ensure that in the event of
an accident or suspected accident
involving a poisonous
substance the best possible
advice is available at the
earliest opportunity.
“Two things are vitally
important – doing the right
thing to stop the situation
getting worse and speed of
response,” Dr Duggan says.
“Members of the public
should always remember
that when it comes to poison
minutes matter.”
The NPIC’s new public helpline
is 01 809 2166.
• 7 Steps to building a high profit business.
• Why your imagination is a crucial tool when it comes to
building a million – or multi-million euro business – and how
to use it.
• one thing your product or service MUST do.
• And much more!
issue 2 volume 13 • FeBRuARY 2011
IN BRIEF
FDa approve opioid
analgesics for cancer
patients
The US Food and Drug
Administration has
approved a new opioid
analgesic for cancer patients
to help them to manage
their plain.
The drug, Abstral
(fentanyl) transmucosal
tablets, will manage
breakthrough pain for
adults with cancer and will
be administered on the soft
surfaces of the mouth, the
nasal passages or throat
where they dissolve and are
absorbed.
The new drug will only be
available in the US through
the country’s Risk Evaluation
and Mitigation Strategy
(REMS) programme to
minimise the risk of misuse,
abuse, addiction and
overdose.
Under this programme,
pharmacies who prescribe
to outpatients are required
to enrol in the program to
prescribe, dispense and
distribute this product
uK pharmacists ask
for acknowledgement
of their role
Pharmacy voice, the
body which represents
community pharmacy
owners in the UK, has urged
the Department of Health
to acknowledge the role of
pharmacists in helping to
manage their patients’ long
term illnesses and self-care.
Rob Darracott, Chief
Executive of Pharmacy
Voice, said that pharmacists
know from recent research
that public awareness
has not kept pace with
the range of professional
services introduced in
community pharmacies and
he says it is necessary to
ensure that the UK public
are aware of the services on
offer so that they can make
informed and responsible
choices about their health.
Mr Darracott’s comments
came in response to a
new consultation process
being undertaken by the
Department of Health in the
UK entitled ‘Greater Choice
and Control’.

ABBREVIATED PRESCRIBING INFORMATION. Please refer to the Summary of Product Characteristics before dispensing: Buplex 200 mg Film-coated Tablets.
Indications: Mild to moderate pain, such as headache including migraine headache, dental pain. Primary dysmenorrhoea. Fever. Dosage: Short-term use only, not
longer than 7 days. Dose depends on the patient’s age and body weight. Tablet should be swallowed with a glass of water during or after a meal. Mild to moderate pain
and fever: Adults and adolescents older than 12 years (≥40 kg): 200-400 mg as a single dose or 3-4 times a day every 4 to 6 hours. In migraine, 400 mg as a single dose, if
necessary 400 mg every 4-6 hours. Maximum daily dose: 1200 mg. Children 6-9 years (20-29 kg): 200 mg 1-3 times a day every 4 to 6 hours as required. Maximum daily
dose: 600 mg. Children 10-12 years (30-40 kg): 200 mg 1-4 times a day every 4 to 6 hours as required. Maximum daily dose: 800 mg. Primary dysmenorrhoea: Adults and
adolescents over 12 years of age: 200-400 mg 1-3 times a day, every 4-6 hours, as required. Maximum daily dose: 1200 mg. Contraindications: Hypersensitivity, Last
trimester of pregnancy, History of gastrointestinal bleeding or perforation related to previous NSAID therapy, Active or recurrent peptic ulcer/haemorrhage, Severe
hepatic or renal insu� ciency, Severe heart failure or coronary heart disease, Signi� cant dehydration, Cerebrovascular or other active bleeding, Dishaematopoiesis of
unknown origin, Children younger than 6 years of age. Warnings and Precautions: Use the lowest e� ective dose for the shortest duration necessary. Symptoms of
an infection may be masked. Avoid concomitant use with other NSAIDs, including COX-2 inhibitors. GI bleeding, ulceration and perforation may occur with or without
warning symptoms or previous history of GI events. Consider combination therapy with protective agents (e.g. misoprostol or proton pump inhibitors) for at risk
patients. NSAIDS should be used with caution in patients with a history of peptic ulcer, GI bleeding, intestinal in� ammation, hepatic, renal or cardiac insu� ciency,
hypertension, congestive heart failure, disturbed haematopoiesis, blood coagulation defects, respiratory disorders and immediately after surgical intervention. All
patients, particularly the elderly and patients with impaired hepatic and renal function, on long term NSAID treatment should be kept under regular surveillance with
monitoring of renal, cardiac and hepatic function and of haematological parameters. High dose and long term use may be associated with a small increased risk of
arterial thrombotic events. Careful consideration before long term use in patients with cardiovascular disease or risk factors. Discontinue at � rst sign of skin rash,
mucosal lesion or other sign of hypersensitivity. May impair female fertility. Strict consideration should be given to the bene� t-risk ratio in the following conditions: SLE
or other autoimmune diseases, Congenital disturbance of porphyrin metabolism, First and second trimesters of pregnancy and Lactation. Interactions: Other NSAIDs;
Anticoagulants; Ticlopidine; Methotrexate; Moclobemide; Phenytoin; Lithium; Cardiac glycosides; Diuretics and antihypertensives; Captopril; Aminoglycosides; SSRIs;
Ciclosporin; Cholestyramine; Tacrolimus; Zidovudine; Ritonavir; Mifepristone; Probenecid; Sul� npyrazone; Quinolone antibiotics; Sulphonylureas; Corticosteroids; Antiplatelet
aggregation agents; Alcohol; Bisphosphonates; Oxpentifylline; Baclofen. Pregnancy and Lactation: Pregnancy - During the � rst and second trimester of pregnancy
Buplex should not be given unless clearly necessary. Buplex is contraindicated during the third trimester of pregnancy. Lactation - With therapeutic doses during
short term treatment the risk for infant seems unlikely. If longer treatment is prescribed, early weaning should be considered. Side E� ects: Headache, somnolence,
vertigo, fatigue, agitation, dizziness, insomnia, irritability, heartburn, nausea, vomiting, diarrhoea, � atulence, constipation, dyspepsia, abdominal pain, gastrointestinal
ulcers, sometimes with bleeding and perforation, occult blood loss which may lead to anaemia, melaena, heamatemesis, ulcerative stomatitis, colitis, exacerbation of
in� ammatory bowel disease and Crohn’s disease, complications of colonic diverticula. Shelf Life: 2 years. Pack Sizes: Blister: 12, 24 & 50 � lm-coated tablets. Marketing
Authorisation Holder: Actavis Group PTC ehf, Reykjavikurvegi 76-78, 220 Hafnar� ordur, Iceland. Marketing Authorisation Number: PA 1380/87/1. Legal Category:
Product not subject to medical prescription. Retail sale through pharmacies only. Further information including the SPC is available on request from Actavis Ireland
Limited, Euro House, Little Island, Co. Cork or email: contact@actavis.ie. Information about adverse event reporting can be found on the IMB website (www.imb.ie) or by
contacting Actavis Ireland Limited. Date of Generation of API: November 2010.
Date of Preparation: November 2010. FADHCP-002-01.
AVAILABLE IN
P H A R M A C Y O N LY
SUPPORTED BY UPCOMING CONSUMER ADVERTISING CAMPAIGN AND IN-STORE PROMOTIONAL MATERIAL
INDICATED FOR MILD TO MODERATE PAIN RELIEF
Effective Pain Relief including:
Headache Migraine Headache Dental Pain Period Pain Fever

12
leTTeRs To The ediToR
issue 2 volume 13 • FeBRuARY 2011
National drugs budget announcement – immoral
Madam,
In the recent budget, savings of the order of €200
million were announced in the national drugs
budget. Part of these savings were to be realised
by the reduction of prices paid by the government
for drugs prescribed. Everyone is agreed that this
is a good thing. It provides savings for the HSE and
the Department of Health, not to mention reducing
the drugs costs for private patients and others
ineligible for medical cards.
However, the budget was announced on Tuesday
7th December and the official notice by the
HSE of which drugs were to be reduced in price,
and by how much, was only received by pharmacists
by email at 4pm on the 29th December (via
the IPU), with the price reductions effective on 1st
January. If the average reduction in price is say 10%
(it will differ depending on the variety of medicines
held by a particular pharmacy and could be closer
to 20% in a lot of cases) this will result in a massive
capital loss for a small business.
Given the fact that it is imperative for any pharmacy
to stock these medicines at any given time,
and that this stock is essentially a private investment
by individual pharmacists and their families
in these businesses, I believe the lack of notice and
hence opportunity to reduce stock levels of these
medicines is actually an immoral act by this government.
Even in Greece, a country we are led to
believe to be in more dire straits than Ireland, pharmacists
were given two months notice of these
reductions in their stock value. Unfortunately, I feel
most observers will not be surprised by this lack of
consideration and certainly not moved in any way
to effect change in a more acceptable manner.
yours sincerely,
Barry Brennan, Mpsi
Brennan’s pharmacy,
summerhill,
tramore,
Co. waterford
Coming in spring issue of
assistant
pharmacy assistants – win E500
and learn about omega 3
In the spring edition of Pharmacy Assistant,
we will feature the first of a four-part series
on omega 3 fish oils. These articles will be
provided by Public Health Nutritionist, Gaye
Godkin and form part of an education grant
from Shield Health. This series is designed to
provide educational material to pharmacy
assistants to increase their scientific knowledge
of the health conferring benefits which
omega 3 plays in the body.
According to the World Health
organisation and the Irish Medical
organisation, chronic Illness now accounts
for 70 per cent of GP and hospital visits.
Dietary modifications are a simple and
effective way to tackle many of these
illnesses. Nutrition epidemiology is emerging
as a valuable resource which has been totally
under-used in the Irish healthcare context.
Nutraceuticals are also an emerging and
growing market used widely to support
nutritional intervention and promote
preventive healthcare. There is strong
evidence that supplementing the diet with
omega 3 fish oils can and does alter ones
lipid profile and positively impacts on many
chronic illnesses.
• Part 1 will give an overview of the various
different fats in the diet and their role in
the body, including the health benefits of
essential fats.
• The second article will concentrate on
the modulating effect omega 3 can exert
on many inflammatory conditions such
as rheumatoid arthritis, heart disease,
depression, osteoporosis and behavioural
issues.
• The focus in part 3 will be the role of
omega 3 in sport and performance. A more
in depth look at the exact mechanism of
how omega 3 supports heart health and
reduces inflammation will be covered.
• Part 4 aims to unravel the secret as to how
omega 3 taken during pregnancy and
lactation confers benefits to both mum
and baby.
At the end of each article there will be five
questions to be answered. These answers
should be torn out and returned to the
editor. The persons with the most correct
answers will enter a draw for a holiday
voucher worth €500.00. Runner up prizes
will also be given. This is a worthwhile
educational opportunity for pharmacy
assistants to win a great prize and increase
their nutritional knowledge at the same time.
letters to
the editor:
email: maura@
greencrosspublishing.ie
post: the editor
irish pharmacist
lr ground Floor
5 Harrington street
Dublin 8
Fax: 01 4789764
sixth annual teddy bear hospital
The 6th annual Teddy Bear Hospital, the largest ever in Ireland,
will take place at NUI Galway from 27 to 28 January. organised
by the Sláinte Society, the NUI Galway branch of the
International Federation of Medical Students Associations,
the event will see over 1,200 sick teddy bears admitted to
the hospital, accompanied by their owners, 1,200 primary
school children between the ages of three and seven.
Up to 200 students from NUI Galway will volunteer to diagnose
and treat the teddy bears. In the process, they hope
to help the children feel more comfortable around doctors
and hospitals.
Event organiser, Bryan Reidy, a second year medical
student at NUI Galway and a member of Sláinte Society,
said: “This year 1,300 ill teddies and their concerned owners
will visit the Teddy Bear Hospital over two days. We hope
to build on the successes of previous years and show that
going to the doctor isn’t so scary after all.”
A Teddy Pharmacy will also feature, stocked with healthy
fruit from Total Produce along with medical supplies from
Boots to help Teddy recover.
second year Medical student and event organiser
Bryan reidy checks out 6-year-old sophie lloyd’s
teddy ‘Calvin’ and 6-year-old robert Mcnulty’s
teddy ‘little ted’ ahead of the 6th annual teddy Bear
Hospital at nui galway. Both are students of scoil
Íde, salthill, galway.

THE POWER OF
Date of preparation: April 2010 Tevirl 02/04/10
CONNECTION
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Ph: 042 9395892
Fax: 042 9395898
www.teva.ie
* Global IMS MAT May 2010
TEVA PHARMACEUTICALS IRELAND
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As the Number 1 branded generic supplier in Ireland, we are
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of their branded counterparts. In doing so, we are working with
you to help your patients benefit from quality, cost-effective
medication.
With over 30 years manufacturing healthcare products in Ireland,
Pinewood Healthcare is one of the largest generic employers
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issue 2 volume 13 • FeBRuARY 2011
IN BRIEF
australian pharmacists
support flood
devastated colleagues
Pharmacists across Australia
have joined forces to bring
aid to their colleagues who
were affected by the recent
unprecedented floods in
Queensland and northern New
Wales.
Following calls for support
for pharmacists affected by
the devastating floods, the
Pharmaceutical Society of
Australia (PSA) has set up a
register where pharmacists
can actually suggest what
assistance they need to help
get them back on their feet.
The PSA has also contacted
all its members asking for
those who can provide any
assistance to contact PSA
so that their offers can be
matched against the needs of
affected pharmacists.
National President of the
PSA, Warwick Plunkett, said
the register would help
to ensure that assistance
provided went where it was
needed most and where
it could provide the most
benefit.
“We have had numerous
inquiries from Members
wanting to help their
colleagues in the floodaffected
areas and the register
is our way of coordinating the
efforts
so that the help provided is
effectual and timely.
Concerns over
continued Canadian
drug shortages
CoNCERNS are being voiced
throughout Canada over the
continued shortages of drugs
in the country.
over the past number of
months, pharmacists have
repeatedly highlighted the
difficulty they are experiencing
in sourcing drugs and the
impact this is having on their
ability to provide the highest
standards of care to their
patients.
Figures from the Canadian
Pharmacists Association
(CPhA), which were released in
December, reveal that in their
last shift, 81% of pharmacists
indicated having trouble
locating a medication and
93% of respondents indicated
having trouble finding
medication over the past
week.
news
positive response to psi's call for
pharmacy experts in chronic diseases
The PSI has received a positive
response from both hospital
and community pharmacists
willing to participate in a panel
of pharmacists who will work
with the HSE’s National Quality
and Clinical Care Directorate
in the management of chronic
diseases.
last month the PSI called for
expressions of interest from
pharmacists with an interest
or expertise in chronic disease
management to participate in
initiatives to improve patient
care and to work with the
recently established National
Pharmacy Reference Group.
Successful applicants will
work through the Reference
Group with the HSE Quality
and Clinical Care Directorate
to support initiatives
around the development
of evidence-based and
integrated care in chronic and
acute disease management
as well as contributing to
the implementation of the
Calls received by the Support
and Information Service at St.
Patrick’s University Hospital has
almost doubled in one year.
Figures show a significant
increase in calls received
in 2009 (766) compared to
numbers for 2010 (1400).
Tom Maher, Director of
Clinical Services at St. Patrick’s
says “Since January 2009 we
have noticed an increase
in patients with new onset
depression who had symptoms
directly related to the economic
decline. However, in general
we feel that more people are
starting to talk about their
mental health and numbers to
our helpline reflect that.”
Staffed by experienced
mental health nurses, the
pharmacy elements of these
initiatives.
The PSI Registrar and CEo,
Dr Ambrose Mcloughlin,
said that the initial focus of
this work would be on heart
failure, stroke, diabetes, chronic
cardiovascular disease, chronic
obstructive pulmonary disease
(CoPD)/asthma, care of the
elderly and mental health.
“The aim is to form a panel
of pharmacists for each
Support and Information
service provides accessible
professional advice, guidance
and support for the public,
healthcare professionals and
mental healthcare service
users. In 2010 the support
line received 1093 calls from
the general public, 111 calls
from healthcare professionals
and 177 calls from St. Patrick’s
service users.
Paul Gilligan, CEo of St.
Patrick’s says “It is clear that this
service is needed now more
than ever. It has at times provided
a lifeline for some callers
in sincere mental health distress
and we expect the demand to
increase greatly in 2011.”
launched as part of St.
Patrick’s Mental Health Strategy,
specific chronic disease area
to participate in the work
programme of the Directorate’s
committees in these areas. In
the future, pharmacists will be
required to contribute to other
clinical areas and programmes.
The overall objective is to
continue to progress the
development of pharmacy
practice in Ireland, in line with
international evidence and best
practice, to deliver improved
patient care in keeping with
the Pharmacy Ireland 2020
vision. In Ireland we now
have a robust regulatory
framework to ensure patient
safety and in particular with
the ongoing developments
in pharmacy education and
training, this means that
pharmacists in Ireland can
now begin to make a more
significant contribution to the
care of patients, in line with
the international evidence, to
improve the quality and safety
of care, particularly when it
Mental Health Matters, this
support service follows the
recovery model of care,
fostering positive coping and
management skills to enhance
the quality of life of those
suffering from mental illness.
comes to the use of medicines,
as well as improvements
in the accessibility and
cost-effectiveness of care
and treatment. With the
establishment of the new
Reference Group and the soonto-be
established Institute
of Pharmacy, and working in
partnership with the HSE and
other healthcare professionals,
patients and the health service
generally could gain real
benefits in the very near future”
The successful candidates
will be registered pharmacists,
preferably with a minimum of
three years’ post-registration
experience and with a
postgraduate qualification
desirable. Practice experience
in one or more of the chronic
disease areas listed, a capacity
to work constructively in
multidisciplinary teams and
a passionate interest in the
pursuit of excellence in patient
care and pharmacy practice are
essential.
Calls to mental health phoneline double
Road safety, obesity, health
promotion and public
information campaigns are just
some of the issues that will be
addressed at a major global
health conference to be held in
Dublin in the Spring.
Sponsored by Wilson
Hartnell Public Relations, part
of ogilvy Public Relations
ambrose Mcloughlin
Worldwide, the 2nd World
Non-Profit and Social
Marketing Conference, will
be held in the Citywest Hotel
on the 11th and 12th of April.
This two-day event will be
addressed by a number of
international health promotion
experts who will advise on the
best way to engage with the
Mental health query relating to:
The Support and Information
service is available Monday to
Friday with a voicemail and callback
facility outside hours.
For further information
Tel: (01) 2493333 Email: info@
stpatsmail.com
2009 2010
anxiety 106 148
adolescent 41 73
addictions 89 191
Bipolar disorder 19 38
eating disorder 32 30
Depression 125 215
support calls 110 140
other 244 401
Conference to promote the benefits of social
marketing in improving health promotion
public in an effort to change
behavioural attitudes and
promote positive lifestyle
changes, all of which are key
to improving public health.
The benefits of applying
social marketing techniques
to addressing vital social
and health issues will also be
addressed.
This conference will
be of interest to anyone
in the public and private
sector who works in health
promotion, public health,
community engagement,
strategic communication and
advocacy.
For more information please
visit www.wsmconference.com
15

16
eu news
issue 2 volume 13 • FeBRuARY 2011
eu crackdown on ‘health claims’
Up to 80% of health foods
subjected to the EU’s new rules
on health claims have been
rejected, according to industry
sources in Brussels.
As part of a crackdown,
which could have major
implications for retail
pharmacies and health food
shops, the European Food
Safety Authority is threatening
to pull products from the
shelves if they make health
claims which are not backed
by rigorous scientific evidence.
generic drugs row stalls
eu-india trade pact
A new EU-India free trade
agreement, which has
faced repeated delays due
to a dispute over generic
medicines, could be signed
by the spring.
officials say a
breakthrough in the longrunning
medicines row
will change how European
officials deal with generic
drugs being transported
through the EU, but health
activists fear the deal could
hamper access to cheap
medicines for the world’s
poorest people.
India and Brazil
complained to the World
Trade organisation (WTo)
in 2009, accusing European
authorities of illegally seizing
shipments of generic drugs in
transit through EU territories.
However, the Indian
Trade and Industry Minister
Anand Sharma and EU Trade
Commissioner Karel De Gucht
say the dispute has now been
resolved. “This is a great
breakthrough which will of
course lead to a suspension
of WTo proceedings, so the
dispute is over,” Mr Sharma
told reporters. Mr De Gucht
said generic drug shipments
en route to non-EU markets
will no longer be stopped
and inspected, “except for
counterfeiting”.
This breakthrough has
done little to assuage the
fears of medical charity
Medecins Sans Frontieres
(MSF) which says the future
of cheap Indian generic drugs
for HIV/AIDS is at risk.
Indian manufacturers are
the largest producers of
cheap generic drugs sold
in the developing world
and MSF is concerned that
these factories will be more
heavily regulated under
the Free Trade Agreement.
Critics claim that European
companies want the Indian
government to tighten
its grip on local factories
which have eaten into the
market share of researchoriented
firms which produce
patented medicines.
MSF spokesperson
Jean-Marc Jacobs said
campaigners are worried
that governments will agree
to extend exclusive patents
for European companies, at
the expense of Indian firms
producing affordable generic
versions.
The UN HIV/AIDS
programme also warned
politicians against signing
off on “trade agreements
that place additional burdens
on the manufacture, import
or export of lifesaving
medicines”.
It stressed that Indian
manufacturers accounted for
more than 80% of generic
antiretroviral medicines, and
supplied most developing
countries. EU officials insist
the FTA will not limit India’s
right to produce generic
drugs and dismissed such
concerns as scare-mongering.
Foods claiming to be “good
for your heart”, “low in fat” or
“a good source of calcium” will
no longer be able to promote
themselves as a healthy option
if the EFSA gets its way.
The Authority is expected
to publish a list of permitted
health claims by the end of the
year, but will give companies
time to adjust to the new
regime. Companies will have
six months to remove the
product from the market,
reformulate its composition
or change their marketing
material.
The move comes amid
concerns among public health
experts that the growing use
of health features in marketing
campaigns is leading to some
spurious claims.
Regulators want to rein
in misleading advertising
and may prevent companies
The European Medicines Agency
(EMA) says it expects the number
of medicines approved this year
to hold steady at around 97,
compared to 95 in 2010.
The EMA has seen its workload
grow rapidly over the past
decade, but looks set for a more
stable period as the number of
new drugs tapers off.
A recruitment freeze means
no new staff will be appointed
this year, with the exception of a
new executive director to replace
Thomas lönngren who stepped
down at the end of December. A
dispute between the European
Commission and the EMA over
the salary for lönngren’s replacement
has left the regulator without
a director until the summer.
In the absence of a new executive
director, the Agency’s board,
from promoting their foods
as “low fat” or “high fibre”
if the product is deemed to
contain too much salt or sugar.
Health foods must fit Europe’s
definition of a balanced diet
if they are to pass themselves
off as a healthy option, officials
say.
Analysts say many of the
products which have met
with a negative opinion from
the EFSA are innovative new
foods which are not yet on
the market. The industry has
focused much of its research
efforts on developing foods
which can be sold on the basis
of improving health.
Big-name brands which
promise to boost the immune
system, aid digestion or
promote “inner harmony” are
likely to come under close
scrutiny as part of the new
regime.
Gary Finnegan,
European
Correspondent and
Irish winner of 2009
and 2010 EU Health
Prize for Journalists
eMa expects stable
number of new medicines
headed up by Irish Medicines
Board (IMB) chief Pat o’Mahony,
published a new Road Map
to 2015 in which it pledges to
expand the EMA’s role in public
health, facilitating access to medicines,
and optimising the safe use
of medicines.
Meanwhile, the EMA and
European Centre for Disease Prevention
and Control (ECDC) have
agreed to step up cooperation on
vaccines, antimicrobial resistance
and antiviral medicines. The two
EU bodies will also work more
closely on the use of human tissue
and cells in medicines.
The two organisations have
worked side by side since the
outbreak of the H1N1 influenza
pandemic in 2009 and will now
improve their systems for sharing
information.

Nexazole: for the treatment of erosive reflux oesophagitis
Prescribing Information for Nexazole 20 mg & 40 mg gastro – resistant capsules, hard. 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 Number(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: July 2010.
Nexazole
20 mg & 40 mg gastro-resistant capsules, hard
Esomeprazole
Ireland’s No. 1 Generic Healthcare Specialists

18
news
issue 2 volume 13 • FeBRuARY 2011
stop making excuses – eD ad campaign
A ground-breaking new health awareness TV advert
is encouraging Irish men to make a New year’s
resolution with a difference.
Sponsored by Eli lilly and Company Ireland, the
objective of the ‘No More Excuses’ awareness TV
commercial is to help men with erectile dysfunction
(ED) overcome any embarrassment they may
associate with their condition and seek help from
their doctor. ED is a common medical condition that
can be treated successfully.
Supporting the new TV awareness initiative, Dublinbased
GP, Dr. Justin Smyth, stated: “In my experience,
public health awareness campaigns similar to the new
lilly TV advert, can prove very successful in removing
the difficulty associated with discussing what can be
Maintain a
healthy life...
The only Effervescent drink with
the power of 20 sun ripened oranges
and Glucose in every tablet
Talk to your local Pharmacist today and ask
how RUBEX can help to defend your immune
system from colds and fl u
seen as an embarrassing topic for many.”
The ‘No More Excuse’s advert features a character
dwelling on the possible causes of his ED symptoms
– the spicy food that he ate that night, the poor state
of the economy or even the horror movie that he
watched earlier. However, these are just excuses he
– and many other Irish men like him – may make to
avoid dealing with their condition. The advertisement
is currently airing on RTE, TV3, 3e and Setanta Sports
A recent survey also suggests that men are also very
reluctant to speak to each other about the condition.
The adverts urge those affected to visit www.
manmatters.ie for advice, encouragement and even
pointers on how to start a conversation about erectile
dysfunction with their family doctor.
...with
Rubex is used for the prophylaxis and
treatment of ascorbic acid defi ciency.
Irish travellers urged to take
precautions against malaria
Irish travellers are being urged to take the necessary
precautions against illness before travelling and, in
particular, to ensure they are protected against malaria.
The call comes as Hollywood actor George Clooney
is recovering from the potentially life-threatening
disease.
Dr Graham Fry, Medical Director of the Tropical
Medical Bureau, said it is important to stress how
important it is for people to be prepared before
travelling and for them to be aware of any illnesses to
begin to experience when they return home.
“The malaria tablets we have nowadays are excellent
but they still do not provide 100% cover against this
serious disease. All travellers returning from an at-risk
region of the world should be aware that any flu-like
symptoms in the weeks or months following their trip
should be investigated for possible malaria.
“The main protection against malaria rests on using
good effective mosquito avoidance techniques though
prophylaxis with tablets should always be used in
regions of the world where this disease is common, “he
said.
Boots may provide
chemotherapy services in UK
Boots pharmacies in the UK may soon be providing
treatment to cancer patients under a major reform of
the UK’s National Health Service (NHS).
According to media reports, hospital bosses in the
UK have been in talks with the chemist chain about
the possibility of providing cancer patients with
chemotherapy at their local Boots branch.
It is understood that the UK chemist is discussing
the feasibility of providing a number of other NHS
services in store in addition to cancer treatments.
The news comes at a time when pharmacists in
Ireland are continuing to call for their role to be
expanded.
In recent weeks, the IPU has re-stated its strong
support for an expanded role for pharmacists in
delivering primary healthcare to Irish patients saying,
“the IPU, as a representative organisation, has stated
that it has been to the fore in advocating an enhanced
role for pharmacists. The IPU is working hard to
ensure that pharmacists generally are in a position to
provide a wider range of services to patients.”

issue 2 volume 13 • FeBRuARY 2011
Masters of Pharmacy
Vincent Cronin
From 1 st November
2010, all
pharmacies
were obliged
to have patient
consultation areas
in place for private patient
counselling.
While the requirement to
have a consultation area was
a welcome development
and widely recognised as an
essential element of good
pharmacy practice by the
World Health organisation
(WHo), it was nowhere near
new or revolutionary. In fact, decades ago a
number of visionary Irish pharmacists were
already providing such services to their patients.
Mr Vincent Cronin was one such visionary.
Coupled with providing private consultation
rooms and BP monitoring services in his north
Dublin pharmacy back in the 1970s, Mr Cronin
was also the first Irish pharmacist to develop
Patient Medication Records (PMRs) for pharmacy.
As a member of the PSI Council he was also
instrumental in revolutionising the pre-reg year.
He has served on a number of organisations
and bodies including the National Therapeutics
Advisory Committee and the Management
Committee of the Irish Centre for Continuing
Pharmaceutical Education (ICCPE).
Born in Wexford, the third in a sib ship of eight,
as a youngster
Vincent Cronin says he didn’t believe his father,
a hard working civil servant, when he told him
“books were his best friends”.
A keen sportsman, he said that if he had any
career ambition it would have been in physical
education. However, at that stage there were
just two places to study the specialty in the UK
and finances prevented him from pursuing that
particular goal.
However, the UK’s loss was Ireland’s gain
when Vincent chose instead to work in one
of just “three jobs in Wexford town, which at
the time promised career progression.” These
were pharmacy, of which there were two posts
available one in each of two pharmacies, or a
position with the county council.
The old apprenTice sysTem
In 1961 Vincent began work under the old
apprentice system in Hassett’s Pharmacy in
Wexford, which at the time was run by Mr
Tom Hassett. Vincent was the young Tom
Hassett’s first ever apprentice however, his
father before him, Mr Ned Hassett, who
at the time was semi-retired, had taken
numerous young pharmacists under his
wing over the years.
Mr Cronin remembers that even back
then Mr Ned Hassett had a patient
consultation room, which dated “back
through the 40s and 50s” and although
semi-retired, there was always a “steady
stream of people” calling for a private
consultation with the senior pharmacist.
He also recalled that patients would write to
Mr Hassett Senior with details of their various
symptoms with some thoughtfully including
samples of the various worms or parasites that
afflicted them.
“Ned Hassett was a great character held in very
high esteem as was his son. Tom Hasssett was
very optimistic about the future of pharmacy.
Although the old dispensary system was still in
full swing there we used to do a lot of scripts as
Wexford was a big farming hinterland,” Mr Cronin
explained.
“There was a lot of compounding, lots of
cough bottles, stomach mixtures, loads of
different creams and ointments, it was very good
experience: we made all from scratch.”
While he may not have considered pharmacy
as a career before this, the practical side of the
profession really appealed to the young Wexford
boy. He quickly “got stuck into “ with relish the
calculations, dosages, reading of prescriptions
and the presentation and packaging of liquid
medicines complete with corks and sealing wax.
Although he was there for just six short months
before his father’s job necessitated a family
move to Dublin, the experience at Hassett’s had
a strong influence on Mr Cronin. And perhaps
unbeknownst to him at the time, Ned Hassett’s
commitment to patient care was to shape Mr
Cronin’s own philosophy in his own work as a
community pharmacist years later.
“I was lucky with the people I worked for
because basically my philosophy was that you
inTeRview
A true visionary of his generation, Vincent Cronin, is a man who is held in
the highest esteem by his peers and patients, not least for his contribution
to community pharmacy as well as the development of the PMR system.
June shannon met with Mr Cronin to discuss his experiences as well as the
past, present and future of pharmacy in Ireland.
vINCeNt CroNIN
service a local community and you look after the
problems whether they are good or bad.”
on moving to Dublin Mr Cronin took up
a position with HP Corrigan, a pharmacist in
Fairview. Interestingly, he noted that Mr HP
Corrigan’s son owen was later to become
professor of pharmaceutics at TCD.
“Hugh Corrigan told me I was doing the wrong
course as the previous year the UCD degree
course had started and that was the course he
said I should be doing,” Mr Cronin recalled.
Before enrolling on the new pharmacy degree
course at UCD Mr Cronin first had to make some
money so he went to work in the UK for 12
months to raise the course fees.
It was through Mr HP Corrigan’s contact in the
UK (a pharmacist called Paddy Flood aka Fingers
Flood – so called because he was also a magician)
that Vincent got a job with a very progressive
pharmacist in Camberwell, South london called
David Davis. Mr Davis had recently extended
his pharmacy and was doing a great deal of
compounding, so the experience Vincent had
gained in Hassett’s pharmacy in Wexford served
the aspiring pharmacist well.
Training aT Ucd
In 1963 he returned to Dublin and registered for
the degree course in pharmacy at UCD.
It was during his time at UCD that Vincent got
involved in the Irish Pharmaceutical Students
Association – an organisation that was to take
up much of his time, which he freely admitted
should have been spent studying. In 1965 he
was involved in bringing the annual conference
of the International Pharmaceutical Students
Federation (IPSF) to Ireland where it was held
in Bray. He had taken time out from his studies
and was about to become President of the IPSF
in 1967 at its congress in Madrid when his future
wife Mary – a young pharmacist – asked him if he
had ever thought about returning to college to
finish his degree.
“I thought about it for a day or so. The IPSF
weren’t pleased when I said I wasn’t taking up the
job but I don’t think I would ever have qualified if
I took it up,” he stated.
As was evident in Madrid, Vincent’s wife Mary
Cronin (nee Power) was to become a hugely
important supportive and loving force in his
19

20
inTeRview
life. She registered with the PSI in 1966 four
years before her husband finally got around to
it in 1970. “She applied herself to her studies,”
Mr Cronin noted. She also later qualified as a
homoeopath.Vincent and Mary were married
in 1970 and he worked for a number of years as
a medical, pharmaceutical and veterinary rep
with companies such as Warner lambert and
Wellcome.
The Wellcome days
After working for a number of years as a rep with
Wellcome he was later promoted to work inhouse
training reps in product knowledge and he
also set up and provided a medical information
service for the company.
Mr Cronin was also charged with organising
continuing education meetings for the Irish
Medical organisation (IMo), which, he explained,
at the time were supported by Wellcome.
This was a part of his brief that Mr Cronin really
enjoyed as he also got to attend many of the CME
meetings and listen to the various talks about
recent innovations in medicine and healthcare,
all of which satwell with his interest in clinical
pharmacy and commitment to life long learning.
The pmr
In 1974 Mr Cronin and his wife purchased a
community pharmacy in Balbriggan, Co Dublin,
which he said was always their ambition.
An astute mind, Mr Cronin has introduced a
number of innovations in pharmacy practice
in Ireland most famously perhaps is the Patient
Medical Record or (PMR).
“All scripts were recorded in big bound books
and from the point of view of looking after
patients’ interests and preventing interaction
problems they were virtually useless because
all the entries were date orientated. ok you had
an index in the back but you had to be referring
back. you would have to either remember in
your head that a person got one drug and now
another may not be desirable.
My view was that we needed a more user
friendly patient medication record.”
Frustrated with having to look up patients
details in prescription books to check for
medication history or potential interactions, Mr
Cronin developed a simple carded system where
patients’ details were recorded on a 6x4 inch
card. There was a separate card for each patient
which could be colour coded. Each card had
5 different columns and contained a patient’s
full medication history viewed at a glance.
Although relatively simple it was to revolutionise
pharmacy practice and cut down on the amount
of time busy pharmacists spent trawling through
large bound prescription books for patient
information.
According to Mr Cronin, the idea to produce
user friendly patient medication records was
inspired by reading about similar systems that
had been introduced in the UK and Australia at
the time.
Mr Cronin wrote an article about his new PMR
system in a pharmacy newsletter. The work
was well received by many of his colleagues
who expressed an interest in setting up similar
schemes in their pharmacies. The PSI however
was not best pleased.
While he went ahead and introduced the
system into his pharmacy in Balbriggan, the PSI
told Mr Cronin that his card system was deemed
not to meet the requirements of the legislation
in relation to the safe storage of patient records.
The PSI pointed out that not being bound; these
cards could have been easily displaced. There
was also an issue in relation to part one poisons
which pharmacists were obliged to record in a
bound book.
“I started my patient medication records from
day one and built them up as I went along. The
Council were on my back ringing Mary and saying
‘will you not get around him he can’t use these
things’. Eventually I compromised with them by
recording the limited number of part one poisons
in a hard back notebook”
a changing indUsTry
Commenting on the various changes he has seen
over the last four decades in Irish pharmacy, Mr
Cronin pointed to the introduction of the GMS in
1972 and Ireland’s entry to the EU (then the EEC)
a year later, as two very positive developments
for Irish pharmacy.
He particularly pointed to the contribution of
those pharmacists charged with negotiating the
terms of the new GMS scheme on behalf of all
pharmacists; people like louis Cashman, John
Burke, Joe Power and Tom Miller, who Mr Cronin
described as ‘absolute visionaries’.
“Joe Power and John Burke were the Irish
reps to the pharmacy group of the European
Union and they were coming back telling us we
should be separating the professional from the
commercial. I always felt that it was a big mistake
that people didn’t take their advice.”
The expansion of front of shop sales such a
cosmetics and jewellery
in pharmacies is something which never sat
well with Mr Cronin.
Although retired, he said that he still cringes
today when he sees pharmacies referred to as
stores, the abuse of restricted titles, referring to
patients as clients or customers, using loyalty
cards and promoting linked sales. All of these he
feels are “totally incompatible” with a health care
facility.
“We sort of slavishly followed all the worst
facets of the American system. All these big
“
Pharmacists
need to develop
their roles in medicines
management rather than
screening, anybody can
do the latter. Patients will
benefit if pharmaceutical
knowledge and expertise
are developed so that
they are enabled to
manage their medicines
better.”
issue 2 volume 13 • FeBRuARY 2011
drug stores. you go into some pharmacies now
particularly the chain ones, and you are battling
your way through between what Tom Miller used
to call ‘Hooplas, Hurdy Gurdys’ and hula hoops’
before you get to the actual dispensing area. The
whole philosophy doesn’t match up. I just can’t
marry up a commercial retail philosophy with a
professional one.”
Between 1976 and the mid 80s Mr Cronin
served as a member of the PSI Council under six
presidents. During that time among the things
he tacked was the pre-reg year, which at the time
lacked any formal structure or guidelines and so
left it open to abuse by pharmacists and students
alike.
Mr Cronin was charged with putting a formal
structure in place for the pre-reg year for the
very first time. This involved a great body of work
including the development of a core curriculum,
an oTC manual and guidelines for students, as
well as putting a formal training scheme in place
for pharmacy tutors.
Throughout his long and successful career Mr
Cronin served on a number of different bodies
including the National Therapeutics Advisory
Committee (NTAC) which was established in the
early 1990s by the then Minister for Health, Dr
Rory o’ Hanlon.
Mr Cronin explained that the NTAC was asked
to examine prescribing and advise on and
encourage appropriate safe effective and cost
efficient prescribing. It was also asked to establish
protocols of care for certain long term illnesses
or chronic conditions which, ironically is being
looked at again today by the HSE’s Quality and
Clinical Care Directorate.
The NTAC produced a report in the early
90s, which recommended the introduction of
generic prescribing with some exceptions. The
committee agreed that generic prescribing was
both safe and cost effective. Almost 20 years later
it is yet to be introduced.
Mr Cronin said he enjoyed his time on the
NTAC. The group made recommendations
regarding the overall delivery of healthcare
including the development of community
groups where healthcare professionals
working in a local area could come together
and discuss various health issues and agree a
multi-disciplinary team approach in dealing
with them. The reintroduction of the National
Medicines Information Centre (NMIC) was also
recommended. “I like to think that it influenced
for the good future Department of Health and

issue 2 volume 13 • FeBRuARY 2011
pharmacy initiatives,” Mr Cronin stated.
Throughout his career Mr Cronin developed
and nurtured a keen interest in clinical pharmacy.
He joined the United Kingdom Clinical Pharmacy
Association (UKCPA) and to this day continues to
have an active interest in the area.
pharmacy services
While the expanded role of the pharmacist in
the health service today in areas like healthcare
monitoring is hugely welcome, what some of us
tend to forget is that visionary pharmacists like
Mr Vincent Cronin have been quietly doing this
for decades.
“I did BP monitoring services for about 25
years. Whether I was influenced by Ned Hassett
or not I always had a private consulting area and
since 1993 I had both a private and semi-private
one.
“Pharmacists need to develop their roles in
medicines management rather than screening,
anybody can do the later. Patients will benefit
if pharmaceutical knowledge and expertise are
developed so that they are enabled to manage
their medicines better,” Mr Cronin stated.
“There isn’t any other person who has such
a broad range of insights into drugs right
from their synthesis, trials, formulations, their
pharmacology and pharmacokinetics and this
should be exploited,” he added.
Mr Cronin retired in 2005 however remains
busy and very active. After he retired, with a view
Win
1 of 4
iPhones
For entry forms, contact
Seven Seas on 1850 681 012
to a career change, he studied for a diploma
in therapeutics in the University of Wales and
graduated with distinction.
Coupled with his interest in sports he is also a
keen cyclist and regularly cycles 50 miles a day
with ease.
no fUTUre in The pasT
Asked what one piece of advice he would give
to young pharmacists today he said it would be
to develop their clinical skills and to get some
hospital pharmacy experience.
“An insight into all the facets of drug
development is unique to pharmacy and a
greater use of pharmacokinetic calculations to
tailor doses to patients should be used. People
think that drugs have doses but it is actually
patients who have doses.”
on the future of the profession he said his
main worry was for the environment in which
pharmacists have to practise.
“Have the cuts and the impending cuts
gone too deep? Is the service viable? It is sort
of getting to that stage. I don’t think the PD
philosophy of competition in all things works
in the health environment. I think competition
should be standards based rather than on
commercial criteria.”
on retirement he said he loved spending
time with his three grandchildren, and his four
children, all of whom he is incredibly proud of.
Mr Cronin told Irish Pharmacist he believed
inTeRview
there was no future in the past. However he said
it was a terrible pity that the 1996 GMS contract
predated the 2007 Pharmacy Act.
While he may feel there is no future in this past
what is true is that without the huge contribution
to Irish pharmacy made by visionary pharmacists
like Vincent Cronin in the past, the future for
countless generations of pharmacists to come
would be a much poorer place indeed.
“
I was lucky with
the people I
worked for because
basically my philosophy
was that you service
a local community
and you look after the
problems whether they
are good or bad.”
Back in
Stock
Don’t get left out in
the cold this winter,
recommend ilvico ®
21

22
heRBAl medicine
Herbs that come from
a land Down Under
From eucalyptus to tea tree – the aborigines
know a thing or two about healing.
a
recent trip to Australia to spend
Christmas with our son, daughterin-law
and new granddaughter
prompts me to write about two
quintessentially Australian plants
and the oils they produce. Since
envy is such a destructive emotion, I will spare
you descriptions of blue skies, 30º temperatures,
swims in the Indian ocean and ‘barbies’ washed
down with a thimbleful or two of Margaret River
Cab Sauv. Suffice it to say, a traditional Irish
Christmas it wasn’t.
euCalyptus
Those of you who have been to Australia and
who managed to travel beyond Bondi Beach,
Coogee and Surfers Paradise can’t but have
noticed that the continent has an amazing variety
of trees, shrubs and wildflowers. Bottle brushes
(banksias) and wattles (acacias) are everywhere
but none are as characteristic or as widespread
as the huge number of gum or eucalyptus
trees. Australia is home to 691 of the estimated
700 species of eucalyptus, the leaves of which
produce different essential oils. The commercial
oil is mainly produced from E.globulus, but 70
percent of the world’s supply comes from China
and, ironically, it is prepared from a camphor oil
fraction or from eucalyptus plantations in Spain
or Portugal.
According to the ESCoP monograph, the
cineole-rich oil is used internally as an adjuvant
in chronic obstructive respiratory complaints
such as bronchitis and to relieve the symptoms
of colds and catarrh. Externally it is used for colds
and for rheumatic complaints. However, it is
important that it is not used externally on babies
or small children as it; like peppermint oil (with
which it is sometimes mixed) can cause bronchial
spasms. There have been few clinical studies with
the oil itself as most have involved cineole which
constitutes 70 to 90 percent of the oil. These
studies show some positive effects when the
cineole is given in conjunction with other asthma
“
Eucalyptus oil also
has antibacterial
properties but is less
effective than Melaleuca
alternifolia or tea tree oil.
or bronchitis medication.
Most people probably
resort to eucalyptus
products for their
perceived decongestant
properties and one study
found that while objectively
the oil had no effect on measured
resistance to airflow the majority of
subjects reported a cold sensation in the nose
together with a feeling of improved airflow.
Swallowing pure eucalyptus oil can be fatal
especially in children and patients buying the oil
for aromatherapy use must be advised about safe
storage in order to avoid problems. Eucalyptus
oil also has antibacterial properties but is less
effective than the oil from another characteristic
Australian plant, namely Melaleuca alternifolia or
tea tree.
tea tree
For centuries Aborigines have used tea tree by
inhalation for coughs, colds and wounds and
as an infusion or tea for sore throats. The plant
supposedly gets its English name from the
story that the early English settlers used the
leaves to make tea because they had exhausted
their supply of ‘normal’ tea leaves. The official
Australian name is Melaleuca oil but since the
name tea tree oil (TTo) is now so well known I
can’t see it being called anything else on this side
of the world. It is now widely available as oil, in
creams, gels and a variety of cosmetic products.
Scientific investigations soon established
that the distilled oil had antibacterial activity
11 times greater than phenol. It has been found
to be effective against a range of pathogenic
micro-organisms including E. coli, Streptococcus,
Staph. aureus, including methicillin-resistant
strains (MRSA), Candida and Trichophyton
species to name but a few. This led to its use
in a variety of bacterial and fungal infections
including boils (furunculosis), athlete’s foot (tinea
pedis) due to trichophyton and other fungi,
onychomycosis (fungal infections of the toe
nails), dandruff, vaginal infections due to candida
and trichomonas and to MRSA eradication in
hospital settings. It was also found to be an
effective pesticide against head lice. In the case
of athlete’s foot, two RCTs showed that the oil
was effective. In a six month RCT in patients with
onychomycosis TTo was as effective as Canestan.
Two trials (one single blind) investigated the
effect of TTo in acne. The first study was a
comparison with benzoyl peroxide. The latter
was adjudged more effective due to the slower
onset of action of the TTo even though both
treatments were similar in their effect on the
issue 2 volume 13 • FeBRuARY 2011
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.
dr des CorrIGAN
number
of lesions. The
second trial showed that the oil
was 5.75 times more effective in reducing an acne
severity index compared to placebo. Positive
results have also been reported from studies
in cases of dandruff, boils, gingivitis, vaginal
infections and candidiasis in AIDS patients.
MRSA is now a major issue in hospitals
everywhere and based on the laboratory results
showing that TTo is effective against MRSA,
two clinical trials have been conducted and
the results reviewed in the British Journal of
Community Nursing. The reviewers noted that
while the clinical studies supported the potential
of TTo products in MRSA patients, there was
no evidence that they were superior to existing
eradication regimes. TTo might be considered
as second line treatment especially in patients
without nasal colonisation with MRSA.
Caution
The major safety concern with tea tree relates to
the allergic reactions it can cause in susceptible
individuals and when used undiluted on skin.
It is now clear that oil which has aged or been
exposed to air and light is a more potent
allergen than the fresh oil. you can help your
patients who purchase TTo products minimise
adverse reactions by advising them to avoid
oral ingestion; use only diluted oil on the skin
and use oil which has not been exposed to light
and/or air. It is interesting to note that Australian
legislation requires that 100 percent tea tree
oil products be sold in containers with a childresistant
cap and the labelling must state ‘Keep
out of the reach of children’ and ‘Not to be
taken internally’. While no human deaths after
ingesting the oil have been recorded, cases of
drowsiness, disorientation and ataxia in children
who swallowed small amounts of the neat oil
have occurred. Two simple products but yet
again your professional care and attention is vital
to avoid casualties.

Communication is important 1-3
If only I could
fi nd the
words
Abbreviated Prescribing Information:
For full prescribing information refer to the Summary of Product Characteristics. Name: Ebixa Active Substance: Memantine Hydrochloride.
Indication: Treatment of patients with moderate to severe Alzheimer’s disease. Dosage & Administration: Treatment
should be initiated and supervised by a physician experienced in the diagnosis and treatment of Alzheimer’s dementia. Therapy
should only be started if a caregiver is available who will regularly monitor the intake of the medicinal product by the patient. Treatment
is orally either as tablets (10 mg) or solution (10 mg/g) taken with or without food at the same time every day. The solution
should only be dosed onto a spoon or into a glass of water using the pump. Maintenance dose is 20mg/day, (two tablets or 2ml
solution [4 downward strokes] once daily). Treatment starts with 5mg/day (half a tablet or 0.5 ml solution [1 downward stroke]
once daily) for the fi rst week; the 2nd week 10mg/day (one tablet or 1 ml solution [2 downward strokes] once daily); the 3rd week
15mg/day (one and a half tablets or 1.5ml solution [3 downward strokes] once daily) and the 4th week 20mg/day (two tablets or
2ml solution [4 downward strokes] once daily). Moderate renal impairment 10mg/day (one tablet or 1 ml solution [2 downward
strokes] once daily), if well tolerated after 7 days the dose can be titrated up to 20mg/day (two tablets or 2 ml solution [4 downward
strokes] once daily). Severe renal impairment- dose is 10 mg/day (one tablet or 1 ml solution [2 downward strokes] once daily).
Mild-moderate hepatic impairment- no dose adjustment. Severe hepatic impairment- no data available. Children & Adolescents:
Not recommended. Contraindications: Hypersensitivity to the active substance or any of the excipients. Pregnancy and Lactation:
Pregnancy: Memantine should not be used in pregnant women unless clearly necessary. Lactation: Memantine should not
be used in women who are breastfeeding. Special Warnings and Precautions for use: Caution is recommended in patients with
epilepsy. Caution is advised in patients with raised urine pH as this may elevate plasma levels. Clinical trial data are limited on patients
with recent myocardial infarction, uncompensated congestive heart failure and uncontrolled hypertension and patients with
these conditions should be closely supervised. Avoid concomitant use of NMDA antagonists (see also interactions). Patients with
sugar intolerance should not take Ebixa. Patients should be warned to take special care if driving and using machines as Ebixa has
minor to moderate infl uence on these tasks. Interactions: Effects of L-Dopa, dopaminergic agonists and anticholinergics may be
enhanced. Effects of barbiturates and neuroleptics may be reduced. Concomitant administration of Ebixa with antispasmodic agents
Ebixa
Approved from the moderate stage
of Alzheimer’s Disease onwards 5
e.g. dantrolene and baclofen can modify their effects, dose adjustments may be necessary. Plasma levels of cimetidine, ranitidine,
procainamide, quinidine, quinine and nicotine may be increased. Co-administration with hydrochlorothiazide (HCT) may lead to a
reduced serum level of HCT. Concomitant use of NMDA antagonist- amantadine, ketamine, dextromethorphan or phenytoin should
be avoided. Close monitoring of prothrombin time or INR is advisable for patients treated concomitantly with oral anticoagulants.
Adverse reactions: Common (≥1/100 to

24
opinion
By the time that this is published the
general election may have been
called. If not then it is not far away.
And this got me to thinking. How
should I treat the budding TDs and
their sycophantic election workers
when they call to my door?
My mind went back to shortly after I bought
my first motorbike many years ago. Funds were
tight so I carried out many of the servicing and
repair myself. An election had been called and
aware that I wanted to question budding TDs,
my mother called me when Gay Mitchell called
to our door. Not wanting to miss the opportunity
I hurriedly headed to the door straight from my
bike. I was oblivious to the fact that I was barechested,
covered in oil and grime and carrying
a massive wrench. I will never forget the look
on Gay’s face as I reached the door. All I can say
is that I doubt that he would need a laxative for
some time after.
So after ruling out all the illegal and violent
acts I found myself at a loss and instead I set
about putting together some questions that I
could ask them and some statements of opinions
that I felt they should hear.
the CoAlfACe
what to do with
politicians?
David Jordan muses on the impending election and asks
how he should treat the budding TDs seeking his vote.
relation to community pharmacy, how they see
community pharmacy developing, what sort of
new services they see being offered to the public
by pharmacists and how these might be paid for.
At the time of writing I have not had any replies.
So how this article ends will depend on how
quickly they can cook up something. At the time
of writing only the labour Party had replied to
say that they were passing my query on to their
health spokesperson.
Now this may seem a bit unfair, but it is based
on a further piece of research. While getting
contact details for the parties I carried out a
search of each of their websites for the word
“Pharmacy” and “Pharmacist”. The results were
not awe inspiring. Most of the results were from
2007/8 when the dispute with the HSE was at its
height. The bulk was TDs jumping up with “the
Government should do something about this”
type of comment. It would seem that for most
of our mainstream political parties, community
pharmacy doesn’t really exist. We are like the
postal workers or road sweepers, we’re there, we
provide a service, but beyond getting the service
as cheap as possible they don’t want to know. At
times I just feel like getting them and slapping
them across the face and yelling at them that
pharmacists can do so many things better and
cheaper and why don’t they just listen. Then I go
and sit in a darkened room, with soft music and
thoughts of pink fluffy bunny rabbits and cuddly
kittens.
tears For Harney
one thing I will miss about the outgoing
Government will be SWMBo Harney. Now that
may seem strange to those who know me, but
that woman has provided me with so much
material for my articles and blog that I will
genuinely miss her.
As she is unlikely to stand again (even she
wouldn’t be that thick headed) I decided to
do a review of her time as health minister. one
compliment I will give her is that she is one hell
of negotiator. She managed to achieve a seat in
cabinet for her one Dáil vote. Either that or she
has a great set of negatives. Just visualise the
scene now. Bertie, Mary and Brian in a menage-
dAvId jordAN
issue 2 volume 13 • FeBRuARY 2011
gay Mitchell met an oiled up, bare chested,
wrench wielding David Jordan
a-trois. Even the Star or the Sun would be hard
pressed to print that one.
As I considered her performance as health
one thing I will
Bunny raBBits anD CuDDly Kittens
minister it occurred to me that there was very
Being a pro-active type of person I decided to little in her actions to suggest health at all. Her
check out the various party websites, but I could actions were more akin to Minister with nominal
not find any specific policy which mentioned responsibility but no accountability for the HSE.
pharmacy on any of their sites. As the next step According to Mary everything that happened in
I emailed the different press and policy officers health was the responsibility of the HSE. But who
to ask them what was their party’s policy in was responsible for the HSE?
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
There did not seem to be any communication
lines between Dr Steevens Hospital and
leinster House. They seem to operate in parallel
universes. So nothing new there.
outside of the direct health service I judged
some of her other actions and it occurred to
me that she was instrumental in destroying
Irish jobs. Her last deal with IPHA is a case in
point. This is a deal which favours the big brand
name multinationals over the mainly Irish based
generic companies and saw her strengthen the
position of foreign based companies, with just
an office in Dublin, over generic companies
putting real money into the Irish economy and
generating exports. The deal will also be seen as
a blow for the PI companies who are extracting
value from the multinational brands, giving
some to pharmacists and paying Irish based staff
putting real money into the Irish economy. So
now we will have the multinationals taking more
profit out of Ireland and Irish based companies
having to cut back.
And I haven’t even started to count the cost of
jobs lost in the community pharmacy sector. We
have already had pharmacy closures and some
high profile receiverships, but to politicians like
Harney these are just like buses. There will be
another one along in a minute.
It saddens me that she will in all likelihood
“retire” from the Dáil when the dissolution comes
and we won’t have the comfort of being able to
say that at least the voters of Clondalkin kicked
her out. After sitting in Government for all of
the economic bubble she would probably claim
it was all the international bankers fault. And
what then? Well she won’t be stuck for a schilling
or two. It’s a pity that there is no performance
element to TDs and ministerial pensions. If there
was, how many of the current Dáil and former
TDs would get anything at all? What a money
saver! I’m sure after a respectable period she will
take up a number of directorships on the boards
of the various foreign multinationals that she
helped in their desire for world domination. Now
I need to find another darkened room.
“
miss about the
outgoing Government
will be SWMBo Harney.

Titration is important 1,2
Titration is important 1,2
If only I could
fi nd the
words
Abbreviated Prescribing Information: For full prescribing information refer to the Summary of Product Characteristics. Name:
Ebixa Active Substance: Memantine Hydrochloride. Indication: Treatment of patients with moderate to severe Alzheimer’s
disease. Dosage & Administration: Treatment should be initiated and supervised by a physician experienced in the diagnosis
and treatment of Alzheimer’s dementia. Therapy should only be started if a caregiver is available who will regularly monitor the
intake of the medicinal product by the patient. Treatment is orally either as tablets (10 mg) or solution (5mg/pump) taken with
or without food at the same time every day. The solution should only be dosed onto a spoon or into a glass of water using the
pump. Maintenance dose is 20mg/day, (two tablets or 2ml solution [4 downward pumps] once daily). Treatment starts with
5mg/day (half a tablet or 0.5 ml solution [1 downward pump] once daily) for the fi rst week; the 2nd week 10mg/day (one tablet
or 1 ml solution [2 downward pumps] once daily); the 3rd week 15mg/day (one and a half tablets or 1.5ml solution [3 downward
pumps] once daily) and the 4th week 20mg/day (two tablets or 2ml solution [4 downward pumps] once daily). Moderate renal
impairment 10mg/day (one tablet or 1 ml solution [2 downward pumps] once daily), if well tolerated after 7 days the dose can
be titrated up to 20mg/day (two tablets or 2 ml solution [4 downward pumps] once daily). Severe renal impairment- dose is 10
mg/day (one tablet or 1 ml solution [2 downward pumps] once daily). Mild-moderate hepatic impairment- no dose adjustment.
Severe hepatic impairment- no data available. Children & Adolescents: Not recommended. Contraindications: Hypersensitivity
to the active substance or any of the excipients. Pregnancy and Lactation: Pregnancy: Memantine should not be used in
pregnant women unless clearly necessary. Lactation: Memantine should not be used in women who are breastfeeding. Special
Warnings and Precautions for use: Caution is recommended in patients with epilepsy. Caution is advised in patients with
raised urine pH as this may elevate plasma levels. Clinical trial data are limited on patients with recent myocardial infarction,
uncompensated congestive heart failure and uncontrolled hypertension and patients with these conditions should be closely
supervised. Avoid concomitant use of NMDA antagonists (see also interactions). Oral solution only: Patients with rare hereditary
problems of fructose intolerance should not take Ebixa 5mg/pump oral solution as it contains sorbitol. Tablets are lactose free.
Patients should be warned to take special care if driving and using machines as Ebixa has minor to moderate infl uence on these
tasks. Interactions: Effects of L-Dopa, dopaminergic agonists and anticholinergics may be enhanced. Effects of barbiturates and
neuroleptics may be reduced. Concomitant administration of Ebixa with antispasmodic agents e.g. dantrolene and baclofen
kk 11
eekk 22
5mg week 1
week 3
10 mg week 2
15 mg week 3
3
For patients to enjoy
the benefi ts 4-8 of
Ebixa*
the recommended
dose is
20mg
once daily 3
can modify their effects, dose adjustments may be necessary. Increased plasma levels could occur with concomitant use of
cimetidine, ranitidine, procainamide, quinidine, quinine and nicotine. Co-administration with hydrochlorothiazide (HCT) may
lead to a reduced serum level of HCT. Concomitant use of NMDA antagonist- amantadine, ketamine, dextromethorphan or
phenytoin should be avoided. Close monitoring of prothrombin time or INR is advisable for patients treated concomitantly
with oral anticoagulants. Adverse reactions: Common (≥1/100 to

26
PINIoN
opinion vIew from Above
a fat lot of good
If the politicians could swallow a fat tax we might
have a fighting chance of tackling obesity, but until
then Terry is introducing his new No Bullsh** Diet.
if the politicians could swallow a fat tax we
might have a fighting chance of tackling
obesity, but until then Terry is introducing his
new No Bullsh** Diet
I’m introducing a new service for the New
year; the N.B. Diet Programme. It’s a weight
management service that will be even better and
more successful than my Darwin Diet of a few years
back. It is so effective that I will be able to charge
€500 per customer. It will be advertised widely and
indeed this will be a key and only investment for
my pharmacy. When someone signs up for the N.B.
(No Bullsh**) Diet Programme they will be brought
into the pharmacy counselling room, they will be
weighed and their body mass index calculated.
Following this they will get the critical advice that
is central to the diet programme’s success, no
gimmicks, no bullsh** as in the Darwin Diet, just
sound, practical, helpful advice.
My focus on diet and weight has been motivated
by the draft N. Ireland obesity Prevention
Framework 2011-2021; A Fitter Future for All. This
strategy outlines what N. Ireland will do about the
fact that most of our population is getting fatter year
after year.
overall the proposed framework is helpful,
properly researched and well presented in that it has
identified the myriad factors that have conspired to
create our current public health obesity problem. It
also sets out in general terms how the Department
of Health intends to address the problem; “by small
steps, over time and involving many agencies”.
Indeed this is the only way that primary disease
prevention is effective irrespective of the behaviours
that cause chronic disease development.
Sadly the scope of the obesity strategy is much
too limited. The focus on primary prevention is
welcomed, but the greatest and more immediate
threat to the population and to health service
resources comes from those individuals who have
already eaten too much and have been much too
lazy over recent years. As a result they are currently
obese and even when they are asymptomatic it will
not be too long until they will be developing type
2 diabetes and CHD if they fail to lose weight. our
obesity strategy does not consider them. Weight
loss interventions must be commissioned and there
exists a growing body of evidence for effective
primary-care based weight-control interventions.
We all need help
It is ironic that at a time when national governments
across the developed world are addressing health
problems associated with obese populations, the
commercial weight-loss business is booming. In the
UK this is estimated to be worth £11 billion a year, yet
in N. Ireland we are saying it is not worth addressing
obesity once it appears. This paradox I feel expresses
public desire to change and to be healthy, but
underpins the inability of individuals, families
and communities (particularly socially deprived
communities) to do so in a poorly regulated
‘obesogenic environment’.
The current obesity epidemic has its origins in
the 1980s and has multi-factorial causes. However,
the NI obesity strategy, as it is presented, allows
manufactures of processed food, supermarkets
and fast food outlets to avoid their responsibility in
creating and worsening the current problem. It is
the market place which has created the obesogenic
environment and unless the market place is taken to
task then there will be no resolution of the obesity
problem.
Failure to implement robust regulatory action
against certain groups, those that are making us
fatter and doing it because it makes them a profit,
will merely assure the continuation of the problem
and its progression to that predicted in the UK
Foresight Report. This report suggests that in 20
years time 50% of the population will be obese
and 80% will be overweight. Now that will be a big
problem.
“
Action must
be taken with
international beefburger,
pizza and fried-chicken
take-away franchises as
well as Chinese takeaways.
processed food
In Britain four supermarkets dominate the supply
of foods and ultimately consumer choice and this
is increasingly becoming the case in N. Ireland.
It is in the context of these deep-rooted and
long-term trends in the UK agriculture, food and
retail industries that our modern pattern of food
consumption and health must be understood
as it has set the basis for the current obesity
epidemic. It is therefore insufficient to only
address this matter when referring to N.
Ireland food manufactures only.
Food labelling is an important element
in helping consumers shop and eat
more healthily. More robust regulation
must be assured here to say the least.
Food labelling, or rather the lack of
good food labelling makes me
angry. Food labels should
provide easily accessible and
understandable information,
which can be rapidly
assimilated by a busy shopper
who only has a few seconds
available to choose any one
terry m AGuIre
issue 2 volume 13 • FeBRuARY 2011
Terry Maguire owns two
pharmacies in Belfast.
He is an honorary
senior lecturer at the
School of Pharmacy,
the Queen’s University
of Belfast. His research
interests include
the contribution of
community pharmacy
to improving public
health.
particular brand. A product containing a massive
15% fat should not be misleadingly labelled 85% fatfree,
and a low fat product containing high levels of
sugar should not be able to masquerade as a healthy
product.
Accurate and informative food labelling will only
succeed as a weapon in the fight against obesity
if the information is properly targeted towards
consumers, in order for them to understand the
complicated facts and figures involved in making
the healthy choice.
I addressed this in an earlier column The
Conservatives make me sick (Irish Pharmacist
September 2010). This year in the European
Parliament, following extensive lobbying by the
food manufacturing industry, the GDA scheme
was chosen over TlS. This will have serious
consequences for our population in the coming
years and will be a main driver towards a more
obese population. The N. Ireland obesity strategy
says nothing about food labelling.
fasT food indUsTry
The fast food industry’s success is based on a
commitment to business principles; quality,
efficiency, uniformity and marketing. It has also been
successful in making us fat. Action must be taken
with international beef-burger, pizza and friedchicken
take-away franchises as well as Chinese takeaways.
Greater consideration should be given in the
obesity strategy to the introduction of a fat-tax and
a salt-tax on fast-food outlets. To ignore the need
for more robust regulation is to fail to appreciate the
scale of the public health crisis we are dealing with.
So, government policy in N. Ireland on obesity
seems to be so indifferent that as a population
we have at best a fat chance of staying slim and
no chance of achieving normal weight once our
weight has exploded. So my new service, the N. B.
Diet Programme, is committed to the government
line on weight control. My service will be a totally
counselling based
service that will go
something like this “Eat
less, move more. Now
that will be €500”.

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email: alchemy@cmrg.ie

28
FinAnce
Is this the beginning
of a new decade?
(not a frivolous question)
Iain Cahill shares his secrets for success
for the year ahead.
i
thought I would share with you how we
have approached 2011 within our own
business. By doing so, I would hope that
for some of you, I may be able to help
to provide you with some planning and
thoughts for your own business. Having
spent 4th January in a strategy day, we decided
that as a business, a real gap exists in Ireland
in helping business owners and people create,
not just wealth, but the opportunity to combine
wealth with personal fulfilment in what they do.
dealing WiTh The debT issUe
In 2010, I focused a lot of time working with
clients who have accumulated significant
debt. If there is a lesson to be learnt about a
pure consulting business, it is that you simply
cannot work with enough people at any given
time. Therefore over the Christmas, we built a
'mastering your debt workshop' which is aimed
at educating people in how to handle debt
and negotiate with their banks. Despite writing
the book (www.survivingtowin.com) I am
still amazed that not enough is being done to
educate people on the debt issue. Unfortunately,
as long as people are not informed, the banks
can continue to take charge of the situation.
We formally launched the programme in early
January. During the course of the year, I will
share some of the learning from the courses as
we continue to run these on a monthly basis. I
am personally looking forward to the inaugural
course as, not only will it focus on the financial
numbers, but it will also deal with all of the legal
and technical aspects of debt. If you need to
understand your own situation, please do not
hesitate to contact me.
“
for those with
investible
cash, investing in Irish
property in 2011 could
prove to a shrewd move.
looking To The horizon
The second area that we have looked to focus
on for 2011 is in the need for greater education
of both ourselves and in how we can run our
businesses better. I am not one to stand still even
in times of perceived adversity, so in conjunction
with some business partners, we have teamed up
with a company called Horizon Speakers so that
we can look to bring key international speakers
into Ireland who can help all of us to learn. our
first event at the end of the month (27th of
February) sees Brian Tracy come to Ireland in
an event titled “7 Steps to Building a High Profit
Business and Becoming Wealthy.” I had the
pleasure of hearing Brian speak a conference
in 2002 and I still listen to and read his advice
several years on. We will look to bring a number
of speakers during the year, so please do keep an
eye on these events as we are looking to create
real added value for business owners.
climbing oUT of The recession
The third area that I believe we need to focus on
in 2011, is (for some) reappraising our financial
goals. I am privileged in that I am either involved
in a number of great businesses or consult to a
number of great businesses and I see significant
opportunities that will present themselves
during the year. In the area of stocks and shares,
I have spent some time in conversations with a
company in the UK who have been delivering
an average of 15% return to their clients year on
year without significant risk. They share similar
thoughts to my own with regard to ensuring
that, not only can investors get good returns in
investment, but also ensure that they remain in
absolute control of their monies. I am excited at
the prospects of introducing their methodology
into Ireland in the coming months and again
sharing some of the learning and education over
the year. In another guise I write regular articles
on investing in shares and how you can do so
yourself once you learn how to do so. I will look
into linking some of these articles because I do
believe that as the rest of the world begins to
climb out of this recessionary period, we must
find ways to grow or rebuild our wealth out of
the opportunities that will present themselves
to investors. I also believe that for those with
IAIN CAhIll
issue 2 volume 13 • FeBRuARY 2011
iain Cahill aCCa MBa QFa
Director
art of wealth ltd.
Dunlair House
old athlumney
navan
Co. Meath
Mob: 087 2411371
tel: 046 9072824
investible cash, investing in Irish property in 2011
could prove to a shrewd move as the country
continues to untangle the property bubble of the
noughties.
an early spring-clean
Finally, as I spend time over January and February
working with clients on their businesses, our
focus in these meetings will initially focus on
thoroughly tidying up accounts, setting up
limited companies if still operating as sole traders
(there is a corporation tax exemption for new
companies) and writing off any bad debts that
are unlikely to be collected to reduce taxable
profits on income they’re not likely to receive.
once the housekeeping has been done, then it
is about focusing on each strand of the business
and consider individually, what strategy each
business is likely to undertake to grow each
of these strands. As you can see from my own
business, we have identified three key strands
to our business, debt negotiation, business and
personal education and wealth creation. Each of
these areas requires a business plan, focus and
delivery. While it will mean that we are in for a
busy year (hopefully), behind all of these stands
is our need to ensure that we get great business
processes in place.
As I wrap it up, there is one piece of trivia that
maybe you can help me with. Is 2011 the start of
a new decade or did the decade start in 2010? For
me I hope it is the former as I do truly believe that
this next decade will provide us all with a great
adventure if we can embrace this real period of
change. Until next month happy, wealthy and
safe planning and so come and see Brian Tracy....

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30
clinicAl Review
mIChelle mCdoNAGh
Escaping
the grip of influenza
The current high level of concern among the public about the swine flu
pandemic has reinforced the vital role of the community pharmacist as a
frontline healthcare professional who consumers turn to for advice.
in the first week of 2011, influenza-like illness
(IlI) rates reached the highest recorded
levels since surveillance began in Ireland in
2000/2001 with some 9,000 cases reported.
Influenza A (H1N1 2009) is the predominant
influenza virus circulating in Ireland this
winter accounting for around 60 per cent of all
influenza positive specimens this season.
According to the latest figures, while influenza
levels continued to increase at the start of the
influenza season, all indicators of influenza
activity decreased in week three of 2011 across
Ireland and the HSPC say that it appears that
influenza activity has peaked for the 2010/2011
influenza season and is now decreasing.
The highest cumulative age specific rate for
influenza confirmed hospitalised cases for the
2010/2011 influenza season to-date is currently
in the 0 to 4 year age group (45.7 per 100,000
population), followed by the 55 to 64 year age
group (21.6 per 100,000 population)
“
Evidence has
emerged that
there is a significant risk
of death for pregnant
women from influenza B.
Influenza rates have increased significantly
in younger age groups (0 to 4 and 5 to 14 year
olds) in Ireland since the start of the New year,
according to the HSPC. Detections of influenza
B viruses have also been increasing in recent
weeks.
Twelve people have died from flu so far this
season-10 of these were as a result of influenza A
(H1N1 2009) and two of influenza B. one death
was in a patient in the 0 to 4 year age group,
seven patients were in the 15 to 64 year age
group and four patients were aged 65 years
and older. Eleven deaths occurred in patients
with underlying medical conditions. one death
occurred in week 52 2010, one in week 1 2011,
four in week 2, five in week 3 and one in week 4.
To-date, (26th January, 2011), 749 confirmed
influenza patients have been hospitalised with 98
cases admitted to ICU.
Ten influenza/IlI outbreaks have been
reported to HPSC to date this season, three of
these in week two of 2011.
In Northern Ireland, 23 people suffering from
the effects of the H1N1 virus have now died.
Twenty of these patients were also suffering
from an underlying medical condition, according
to the Northern Ireland Public Health Agency.
However the level of new cases in new patients is
decreasing in the North.
WhaT is seasonal flU (inflUenza)?
Seasonal flu is a highly infectious viral illness of
the respiratory tract that can be life threatening.
The flu virus changes each year and this is why a
new vaccine is needed each year. Flu is a serious
issue 2 volume 13 • FeBRuARY 2011
illness with most deaths from seasonal flu
occurring in people aged 65 years and over.
Commonly known as swine flu, influenza A
(H1N1 2009) is a new influenza virus that first
emerged in April 2009. As most people did not
have any immunity against this virus it spread
rapidly worldwide and infected a large number
of people.
signs and sympToms of inflUenza
Symptoms of the flu include fever, chills,
headache, aches and pains, and sometimes a sore
throat and dry cough. The flu is also characterised
by a very sudden onset of symptoms. A cold is
a much less severe illness than flu that usually
starts gradually with a sore throat and a blocked
or runny nose. Symptoms of a cold are generally
mild compared to flu.
signs and sympToms of sWine flU
The symptoms of influenza A (H1N1 2009) are
similar to those of regular seasonal flu, but the
onset will probably be sudden and may be more
severe. They include high temperature (over
38 o C/100.4 o F), dry cough, sore throat, runny nose,
headache, aching muscles and joints, weakness
and fatigue, vomiting and diarrhoea (in some
cases).
proTecTion from The inflUenza
virUs
The best protection from the influenza virus is
the flu vaccine. Seasonal flu vaccines have been
given for more than 60 years to millions of people
across the world. The most common side effects

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32
clinicAl Review
will be mild and may include soreness, redness
or swelling where the injection was given.
Headache, fever, aches and tiredness may occur.
The seasonal flu vaccine helps the person’s
immune system to produce antibodies to
the flu virus. When someone who has been
vaccinated comes into contact with the virus,
these antibodies attack the virus. The flu vaccine
reduces infection and associated illnesses and
hospitalisation, especially for those people for
whom flu can become a serious illness. It starts to
work within two weeks.
This year’s seasonal flu vaccine contains strains
of flu viruses as recommended by the World
Health organisation (WHo). The three strains are:
• A/California/7/2009 (H1N1)-like virus (the
pandemic H1N1 2009 virus)
• an A/Perth/16/2009 (H3N2)-like virus;
• a B/Brisbane/60/2008-like virus
last year, 98 per cent of the flu virus in
circulation in Ireland was H1N1. This year, a large
number of people in Ireland will be immune
to the H1N1 virus, either because they had the
virus last year or because they received the
vaccine during the HSE’s Swine Flu vaccination
programme that ran from November 2009
to March 2010. In particular, the groups most
affected by H1N1 were widely vaccinated.
However, the HSE has appealed to all those
in at-risk groups who have not already been
vaccinated to make an appointment to get the
flu vaccine. The National Immunisation Advisory
Committee has recommended that the following
groups of at-risk people need to be vaccinated
for seasonal influenza: everyone aged 65 and
older; children and adults with long-term
illnesses such as asthma, heart problems etc;
people who attend schools or day centres for
people with disabilities; health care staff and
carers and pregnant women.
Pregnant women who have received the swine
flu vaccine are also being urged to return to their
doctors for the full flu vaccine, after evidence
emerged that there is a significant risk of death
for pregnant women from influenza B.
TreaTmenT of inflUenza
Most people who get the flu are able to self
medicate and be looked after at home, with rest.
Plenty of fluids, paracetamol or ibuprofen and
rest will ensure that most people recover within
a week. However, as had been anticipated, this
winter some people have been hospitalised as a
result of their illness.
The IPU’s Ask your Pharmacist about Pandemic
(H1N1) 2009 leaflet provides the following advice
for people who think they may have symptoms:
• Stay at home for up to seven days or until you
fully recover (whichever is longer)
• Don’t have visitors to the house
• Take medicines such as paracetamol to
relieve symptoms – ask your pharmacist for
advice on how to treat symptoms.
• Drink plenty of fluids
• In most cases, the infection will be relatively
mild and will not need treatment with antiviral
medication
Patients suffering from certain medical
conditions, those under five and over 65, and
pregnant women may require additional
treatment or monitoring.
only people with severe symptoms or existing
health conditions should need medical care
“
This year, a
large number of
people in Ireland will
be immune to the H1N1
virus, either because
they had the virus last
year or because they
received the vaccine
during the HSE’s
Swine Flu vaccination
programme that ran
from November 2009 to
March 2010.
or advice from their GP, which might include
prescription of anti-viral medicine. Prescriptions
for oseltamivir (Tamiflu) should be prescribed
and dispensed in accordance with the current
treatment algorithms. Treatment with oseltamivir
should commence as soon as possible after onset
of symptoms and preferably within 48 hours.
Customers should be advised of common side
effects, which include nausea and headache in
adults and children over 12 years, and nausea and
vomiting in children under 12, including infants.
Pharmacists should be familiar with the SPC
for oseltamivir and the recently published Irish
Medicines Board drug safety newsletter on antivirals.
Suspected ADRs should be reported to the
IMB, preferably online via the IMB website.
pharmacisTs have viTal role in
providing advice
Pharmacists are being inundated with inquiries
from consumers about swine flu and surveys
show that more than 80 per cent of these queries
are for general advice and information. S urvey
findings highlight the accessibility of community
pharmacists for consumers seeking information,
guidance and advice. The vast majority (94 per
cent) of respondents reported they had been
able to provide information which met the
consumers’ needs.
Patients should be encouraged to contact their
pharmacist for information and advice at any
time. Pharmacists should urge their customers,
particularly the elderly and other at-risk groups,
to ensure they get the flu vaccine to protect
themselves and also prevent spread of this very
infectious virus. If a customer is over 65 or has a
long-term medical condition, they should also be
advised about the pneumococcal vaccine which
protects against pneumonia.
The pharmacist can provide vital advice to
customers on preventing the spread of swine
flu, which is outlined clearly in the IPU leaflet,
and caring for people who have the flu. Advice
issue 2 volume 13 • FeBRuARY 2011
should also be given on medicines to relieve the
symptoms of flu e.g. paracetamol and ibuprofen
as well as decongestants, throat lozenges or
spray, medicines to relieve diarrhoea and nausea,
rehydration salts and cough mixtures.
There is now a wide variety of therapies
available over-the-counter to treat symptoms
such as sore throat, fever, pain and congestion
and the pharmacist can advise the patient on
which products will best treat his/her symptoms.
The HSE has requested that information and
guidance on the management of A (H1N1) 2009
be circulated to pharmacists. Any further updates
from the HSE will be circulated by the PSI to
pharmacists and information will also be made
available on www.thepsi.ie.
references
1. www.hpsc.ie/hpsc/A-Z/Respiratory/Influenza/
SeasonalInfluenza/Surveillance/InfluenzaSurv
eillanceReports/20102011Season/File,4859,en.
pdf
2. www.hpsc.ie/hpsc/A-Z/Respiratory/Influenza/
SeasonalInfluenza/Surveillance/InfluenzaSurv
eillanceReports/20102011Season/File,5692,en.
pdf
3. www.hse.ie/eng/swineflu/
4. www.immunisation.ie/en/
HealthcareProfessionals/Influenza/
5. Swine flu reinforces role of community
pharmacists; survey by the ACT Branches of
the Pharmaceutical Society of Australia and
the Pharmacy Guild of Australia (www.psa.org.
au/site.php?id=4160)

34
e-phARmAcY
juNe shANNoN
Depression –
we have to talk/type about it
sometimes it’s easier to
type than to talk. This
was the central message
from mental health
organisation, Aware last
month as it launched a
new online support group service for
people suffering from depression.
It is estimated that more than
400,000 people in Ireland experience
depression at any one time and that
the condition can affect anyone at
any point in their life.
According to the World Health
organisation (WHo), an estimated
one in four people globally will
experience a mental health
condition in their lifetime. Mental
health conditions are responsible
for a great deal of mortality and
disability. Furthermore the WHo
predicts that depression will be the
second highest cause of disease
burden in middle-income countries
and the third highest in low-income
countries by 2030.
As we are all acutely aware,
Ireland is currently in the grips of
one of the worst recessions ever
experienced in the history of the
state and worryingly in a recession,
levels of stress and anxiety increase.
Furthermore where there are other
risk factors for depression, it can lead
to a depressive episode.
According to Aware mental health
is “a particularly important issue
given the continuing economic
climate, especially in light of the
large increase in the number of
suicides in Ireland in 2009.
“levels of stress and anxiety do
increase in a recession, and where
other risk factors are present this can
lead to a depressive episode: the risk
of suicide also increases.”
Aware estimate that up to 80
per cent of suicides can be traced
back to unrecognised or untreated
depression, although depression is
actually a very treatable illness.
In 2009, a total of 527 people died
by suicide, this was an increase of
24 per cent on the 2008 figures. The
vast majority, or 80 per cent, of those
that took their own lives in 2009
were male. While most age groups
reported an increase in suicides,
tragically the largest increase was
witnessed in young men between
the ages 30 and 44.
There was a 40 per cent increase in
the figure for males aged 30-34 (52
per cent, up from 37per cent); a 100
per cent increase for males aged 35-
39 (52 per cent, up from 26 per cent);
and a 62 per cent increase for males
aged 40-44 (44 per cent, up from 27
per cent).
Speaking at the launch of the
new online service, Mr Kevin Smyth,
issue 2 volume 13 • FeBRuARY 2011
AT a time when blogs, forums and social networks are beginning to play a big
part in our health, Ireland’s mental health organisation Aware has launched a
new online support group. June Shannon takes a look at the new service.
“
We know that there are a
number of barriers, which
prevent some people from seeking
help via more traditional methods:
these include fear of face-to-face
communication; difficulty expressing
oneself vocally; distance from services.
People can now benefit from peer
support and learn coping skills for
managing depression from the safety
and comfort of their own home.”
Mr Kevin smyth and aware supporter Ms samantha long, Miss un ireland and europe, photographed at the
launch of aware’s new online support service.

issue 2 volume 13 • FeBRuARY 2011
“
The online
support
groups work in
the same way as
Aware’s support
groups throughout
the country. They
give attendees a
safe space where
they can talk
through their
specific concerns
and learn coping
skills from others.”
Aware’s Chief Executive said, “We are
very ambitious for this new online
support group service. We know that
there are a number of barriers, which
prevent some people from seeking
help via more traditional methods:
these include fear of face-to-face
communication; difficulty expressing
oneself vocally; distance from
services. People can now benefit
from peer support and learn coping
skills for managing depression from
the safety and comfort of their own
home.”
Available on www.aware.ie,
the online support groups are
completely confidential. They offer
a safe and supportive environment
where people with depression, or
relatives, can talk through their
particular concerns and explore the
options available to them.
e-phARmAcY
Mr Kevin smyth, Chief executive, aware, Ms agnes rowley, aware volunteer and Mr David Carton,
Chairman pictured at the launch of aware’s new online support service.
The online support groups work
in the same way as Aware’s support
groups throughout the country.
They give attendees a safe space
where they can talk through their
specific concerns and learn coping
skills from others. Each session lasts
approximately 90 minutes, opens
at a specified time, is facilitated by
a trained Aware facilitator and is
attended by up to ten users of the
aware ambassador and leinster captain Mr leo Cullen with Mr Kevin smyth, Chief executive of aware
pictured at the launch of aware’s new online support service.
service at any one time.
on signing up a user chooses
their own username to be used in all
communications meaning that none
of the other participants will ever be
able to link the username with an
email address.
Signing up is easy. Simply log
onto www.aware.ie , follow the link
to register for the online depression
support group service, enter your
details and follow the on-screen
instructions. you will have to confirm
your email address by clicking on
a link that will be sent to you in a
separate email.
Both users and facilitators can find
answers to their questions in the
online help section. If your question
is not answered there, service users
are encouraged to contact Aware for
more information.
Aware also offers face-to-face
depression support groups all over
Ireland, as well as an email support
service and an online discussion
board. Aware also offers a number
of support services for individuals
and families affected by depression
including their loCall helpline (1890
303 302), which is open 365 days a
year.
35

36
pRoducT news
EasySoP – stress free SoPs for Irish
pharmacies
Since the introduction of the Pharmacy Act 2007, all Irish pharmacies must
have a standard operating procedure (SoP) in place to meet legislative
requirements.
The comprehensive SoP writing service offered by EasySoP provides clear,
tailor-made, detailed and easy to follow standard operating procedures for
Irish pharmacies, ensuring each pharmacy meets its SoP obligations. The
service provided by EasySoP includes the following:
SoP Pack: this contains the SoPs necessary to be legally compliant and
to keep up with the highest standards of best practice. Each set of SoPs
provided by EasySoP is unique to each pharmacy and drafts are submitted
to the supervising pharmacist for approval.
Pharmacy Records Pack: this contains training records for each member
of the pharmacy staff. It also contains all the forms and documents needed
to support current legislative requirements (date checking records,
temperature/humidity records, near miss/error logs etc).
over the last year EasySoP has provided its quality service to pharmacies
all over Ireland ranging in size from single independent pharmacies to large
pharmacy groups.
“Trying to find the time to write SoPs as required by the PSI was a major
problem until I discovered EasySoP. All the hassle was taken away at a price
that was great value. I would recommend EasySoP to all” according to Seán
Meade, Meade’s Medical Hall, Carrick-on-Súir.
For more information, please visit us at www.easysop.com or contact us at
0871707817 or team@easysop.com
New from Clonmel
Zithromel (azithromycin) 250mg tablets
Zycron Mr (gliclazide) 30mg tablets
temozolomide Clonmel 5mg, 20mg, 100mg, 140mg, 180mg, 250mg
Capsules Hard
amidex (anastrozole) 1mg film-coated tablets
Clonmel Healthcare have announced the launch of Zithromel (Azithromycin)
250mg Tablets,, Zycron MR (Gliclazide) 30mg Tablets, Temozolomide
Clonmel 5mg, 20mg, 100mg, 140mg, 180mg, 250mg Capsules Hard and
Amidex (Anastrozole) 1mg film-coated Tablets.
These products will join our other medicine product listings within the
Ethical Prescription Division of Clonmel Healthcare.
Zithromel is an antibiotic belonging to a group called macrolides. It
stops the growth of bacteria which cause infections, by preventing the
manufacture of protein in the bacteria. Zithromel (Azithromycin) 250mg
Tablets are 42% cheaper than the brand leader.
Zycron MR is a medicine which reduces blood sugar levels (oral
antidiabetic medicine belonging to the sulfonylurea group). Zycron MR
30mg is used in Type 2 Diabetes Mellitus in adults when diet, exercise and
weight loss alone do not have an adequate effect on keeping blood sugar
at the correct level. Zycron MR 30mg Tablets are 8% cheaper than the brand
leader.
Temozolomide Clonmel is indicated for the treatment of newly-diagnosed
glioblastoma multiforme concomitantly with radiotherapy and subsequently
as monotherapy. Temozolomide Clonmel capsules hard are 34% cheaper
than the brand leader.
Amidex is indicated for the treatment of advanced breast cancer in post
menopausal women. Amidex 1mg Film-coated tablets are 64% cheaper than
the brand leader.
Full prescribing information for all these products is available on
request or go to www.clonmel-health.ie . All Products listed are subject to
prescription. Zithromel, Zycron MR & Amidex are GMS reimbursable from
1st February 2011. Temozolomide Clonmel is available on the Hi-Tech Drug
scheme.
Please contact Clonmel Healthcare on 01-6204000 if you require any
additional information on any of these new product launches.
First iPhone App for psoriasis
issue 2 volume 13 • FeBRuARY 2011
Rosaliac – skin perfecting moisturiser
la Roche-Posay Rosaliac is a skin perfecting moisturiser
that offsets and neutralises redness in reactive sensitive
skin. Rosaliac is also available with UV protection,
Rosaliac UV and Rosaliac UV Riche, which has SPF15 –
UVA7 & SPF15 – UVA8 respectively, to protect the skin
from UV rays which can further damage the skin. UV
rays are considered by dermatologists as a worsening
factor of redness as exposure further weakens the blood
vessels.
Rosaliac uses two vitamins with complementary
action to diffuse the onset of redness. With Vitamin B3,
natural defences are stimulated to protect skin and calm
redness. Vitamin CG strengthens fragile or weakened
blood vessels and diminishes their reactivity. Rosaliac
neutralises redness at the source, hydrates and fortifies
the skin.
Rosaliac by la Roche-Posay soothes sensations of
discomfort. The core ingredient of Rosaliac is la Roche-
Posay Thermal Spring Water which supplies anti-free
radical, soothing and decongesting properties. The
Rosaliac formula, rich in glycerine, has been specially
developed to supply long-lasting hydration. Rosaliac has
a fine, green tinted, smooth texture which naturally offsets
redness, contains no perfume and provides an excellent make-up base.
Day after day the skin is transformed, has a more luminous and unified
complexion with long-lasting comfort.
To help people reach their goal of managing their psoriasis, the first
dedicated iPhone app for people with psoriasis was launched today. The
new resource is designed to help improve understanding of the disease and
to make it easier for people to adhere to treatment.
The Irish-developed MyPsoriasis app and accompanying website (www.
mypsoriasis.ie were developed following research2 which revealed that one
in two patients with psoriasis struggle to use treatments as directed by the
doctor.
The MyPsoriasis app has been designed to help improve understanding of
psoriasis and make it easier for people to manage their treatment regimen.
The Irish-developed resource is complemented by a website – www.
mypsoriasis.ie.
Dr Brian Kirby, Consultant Dermatology at st vincent’s Hospital and
Michelle o’loughlin, sales representative with leo pharma at the
launch of the first dedicated iphone app to help patients manage
their psoriasis and a complimentary website, www.mypsoriasis.ie
www.medicali

issue 2 volume 13 • FeBRuARY 2011
launch of new aloclair educational
campaign for pharmacy...
ocean Healthcare -
distributor of Aloclair,
is running an exciting
competition over the next
three months with two
super prizes to be won; an
iPAD or an iPhone.
To enter the
competition all you have
to do is read the NEW
Aloclair Training Guide
for Pharmacy, answer the
questions on the Aloclair
questionnaire , which
will be presented by the
ocean Healthcare Territory
Manager , and return the
forms by 25th March 2011
to ocean Healthcare.
Aloclair provides Instant Pain Relief from Mouth Ulcers and provides Triple
Action Treatment ..... Fast Acting / long lasting and Non Stinging.
For further information on how to enter the competition log on to www.
oceanhealthcare.ie or www.aloclair.co.uk
Hedrin oNCE television campaign
NEW Hedrin oNCE will be advertised
throughout the year on national television –
commencing 24th January and into March 2011.
Hedrin oNCE is all it takes to treat head lice.
Hedrin oNCE is 100% effective – it kills head lice
and eggs in oNE 15 minute application.
Ask your ClonMedica representative for more
details on Hedrin oNCE.
pRoducT news
Janssen receives marketing rights for
cancer medication – Caelyx
Janssen recently announced, that it has assumed marketing rights for the
cancer medicine CAElyX (pegylated liposomal doxorubicin hydrochloride)
in Ireland.
The marketing and other product rights were transferred to Janssen as
part of a 1996 distribution agreement between the product’s originator,
which is an affiliate of Janssen, and an affiliate of MSD. In addition to Ireland,
Janssen has assumed marketing responsibilities in Europe and associated
countries, Canada, latin America, the Middle East and Asia-Pacific (excluding
Japan). Prior to 1 January, 2011, Janssen affiliates already marketed the
product in the United States, Japan and Israel, under the trade name DoXIl.
Combined, CAElyX and DoXIl are marketed in more than 80 countries.
Adrian Fenlon, Business Unit Manager at Janssen, comments, “It is
satisfying that CAElyX is now a core part of the Janssen portfolio. We are
very excited to begin discussing CAElyX with clinicians and it is a great
addition to our growing oncology portfolio that also includes VElCADE and
EPREX.”
MSD and its affiliates have worked with Janssen and its affiliates in Ireland
to implement a smooth transtion and to ensure that there is no interruption
to supply of treatment for patients.
The medication will continue to be sold as CAElyX in markets outside the
United States, Japan and Israel, where it will continue to be sold as DoXIl.
CAElyX branding and packaging will be refreshed in early 2011.
CAElyX is a long-circulating pegylated liposomal formulation of
doxorubicin hydrochloride, a widely used cytotoxic agent.
A novel approach for a natural solution
to vaginal yeast problems
Newly released to the Irish market, Multi-Gyn FloraPlus is a novel approach
for a natural treatment of vaginal yeast problems and prevents recurrence.
Research proves that a well balanced vaginal flora represents the most
important protection of the vaginal mucosa against harmful bacteria or
yeast infections. The dual action of Multi-Gyn FloraPlus optimises and
maintains the vaginal Ph balance by suppressing harmful pathogenic
bacteria and nourishing the good lactobacilli flora.
Multi-Gyn Flora Plus is a natural product, based on the patented bio-active
2QR complex in combination with pre-biotic components. The unique 2QR
complex effectively inhibits pathogenic bacteria without interfering with the
lactobacilli. This is a natural substance derived from plants and consists of
bio-active polysaccharides. The 2QR-complex has the unique ability to block
adhesion of harmful bacteria on vaginal tissue and in this way it neutralises
these bacteria in an effective and natural way.
Combined with the 2QR complex, pre-biotics are the nutritive
components in Multi-Gyn FloraPlus that stimulate and support the growth
of the good lactobacilli. Pre-biotics in the formula of Flora-Plus are a
unique combination of vitamins, amino acids and monosaccharides. This
novel approach creates a balanced and natural vaginal flora that prevents
overgrowth of unwanted micro-organisms such as Candida (thrush).
Dr Annelize Goedbloed, Medical Biologist and co-founder of BioClin BV
announced: New approaches are explored in the battle against harmful
bacteria, to curb their overgrowth and to re-balance the natural flora. A
non-invasive and effective method is simply to prevent these from “sticking”
to our tissues, by interfering with the attachment mechanism of the bacteria
itself. This innovative, patented approach is the basis of the Multi-Gyn
product line.”
The unique Multi-Gyn FloraPlus formula supports the vaginal flora to
treat and prevent these symptoms from reoccurring providing a sustainable
solution, rather than just a short-term fix.
Multi-Gyn FloraPlus is distributed by Shield Health Ltd based in Co. Kildare. For
further information on this product please call: 045 – 892267.
ndependent.ie
37

38
pRoducT news
EQUASyM IR Tablets (methylphenidate
hydrochloride) discontinued
Shire Ireland wishes to announce the discontinuation of Equasym IR
(methylphenidate hydrochloride immediate release) tablets from the Irish
market effective from the 28th February 2011.
All strengths of Equasym IR tablets will be available until current stocks are
exhausted.
The extended release formulation, Equasym Xl 10mg, 20mg and 30mg
capsules remain unaffected by this change.
Shire sincerely regrets any inconvenience caused to pharmacies,
physicians and patients as a result of this discontinuation. Please be assured
that the decision to cease marketing Equasym IR Tablets is based solely upon
commercial considerations and is not due to any safety or quality issue.
If you have any questions please do not hesitate to telephone the Shire Medical
Information Call Centre on 1800 818 016, Shire Ireland on 01 4297700 or email
medinfoglobal@shire.com.
New NormaDerm Micellar Solution
launching as Gift with Purchase in March 2011 (FREE
with the purchase of 2 Normaderm products, one to be
Tri-Activ*)
Available to purchase in pharmacies nationwide from
April 2011
Vichy laboratoires launch NEW NormaDerm Micellar
Solution to gently cleanse sensitive imperfection-prone
skin without rinsing. NormaDerm Micellar Solution
has been created with a specific formula for maximum
efficacy on both face & eyes to not only remove makeup
but cleanse impurities and excess sebum while at
the same time soothe sensitive skin. Used with a cotton
pad, NormaDerm Micellar Solution offers the pleasure
of cleansing without water and leaves the skin purified
& feeling fresh, soft and comfortable. It has an ultralight,
fresh water texture and a non-sticky finish. It has
an alcohol, soap, colorant and paraben-free formula and it has been tested
on sensitive skin & eyes under dermatological & ophthalmological control.
New launch – Risontel (Risedronic Acid)
35 mg once a Week Film-coated Tablets
Clonmel Healthcare is have announced the launch of Risontel (Risedronic
Acid) 35 mg once a Week Film-coated Tablets. This product will join our
other medicine product listings within the Ethical Prescription Division of
Clonmel Healthcare.
Risontel is for the treatment of postmenopausal osteoporosis, to reduce
the risk of vertebral fractures and hip fractures. It is also used to treat
osteoporosis in men at high risk of fractures.
Risontel (Risedronic Acid) 35 mg once a Week Film-coated Tablets are 28%
cheaper than the brand leader.
Risontel 35mg once a Week Film-coated tablets are available on the GMS
from 1st January 2011.
The GMS code for Risontel 35mg once a Week Film-coated Tablets is –
50703:
Full prescribing information is available on request or go to www.clonmelhealth.ie
.
Product is subject to prescription.
Please contact Clonmel Healthcare on 01-6204000 if you require any
additional information on Risontel (Risedronic Acid) 35 mg Once a Week Filmcoated
Tablets.
issue 2 volume 13 • FeBRuARY 2011
Actavis introduces new and improved
Morhulin ointment packaging
As a part of Actavis’ continued commitment to develop and strengthen its
product portfolio, the company is not only looking ahead with continuous
new product launches but is also focused on strengthening the existing
product range wherever possible. This strategy brings the introduction of
Morhulin ointment with new look packaging, which has been developed to
assist both Healthcare professionals and consumers.
Morhulin ointment promotes the healing of nappy rash, protects irritated
skin and soothes minor skin irritations and superficial trauma.
Morhulin ointment is a dual action cream which contains both Cod liver
oil & Zinc oxide. Cod liver oil contains a natural source of vitamin A and
glyceryl ethers which promotes the healing of wounds. Whilst Zinc oxide
helps remove dead skin tissue from wounds and has an established value in
the treatment of minor skin wounds.
Actavis is delighted to present the new improved Morhulin ointment
packaging to the market which is further evidence of our commitment to
delivering greater variety and value on our growing portfolio of over the
counter medications.
Morhulin ointment is distributed through all wholesalers on behalf of
Actavis and the new packaging will be introduced on a phased basis as
existing product depletes.
Should you require any further information regarding Morhulin Ointment
please do not hesitate to contact Actavis on LoCall: 1890 33 32 31 or Email:
contact@actavis.ie
New launch – Miramel (Pramipexole)
0.088mg, 0.18mg & 0.70mg tablets
Clonmel Healthcare have announced the launch of Miramel (Pramipexole)
0.088mg, 0.18mg & 0.70mg tablets. This product will join our other
medicine product listings within the Ethical Prescription Division of Clonmel
Healthcare.
Miramel is indicated for the treatment of the signs and symptoms of
idiopathic Parkinson’s disease, alone (without levodopa) or in combination
with levodopa, i.e. over the course of the disease through to the late stages.
Miramel is indicated for the symptomatic treatment of moderate to severe
idiopathic Restless legs Syndrome in dosages up to 0.54mg of base (0.75mg
of salt).
Miramel 0.088mg, 0.18mg & 0.70mg tablets are 41% cheaper than the
brand leader.
Miramel 0.088mg, 0.18mg & 0.70mg tablets are available on the GMS from
1st January 2011.
GMS codes for Miramel tablets are:
Miramel 0.088mg – 33636
Miramel 0.18mg – 33637
Miramel 0.70mg – 33638
Full prescribing information is available on request or go to www.clonmelhealth.ie
.
Product is subject to prescription.
Please contact Clonmel Healthcare on 01-6204000 if you require any
additional information on Miramel (Pramipexole) 0.088mg, 0.18mg & 0.70mg
tablets.
www.yourmedicines.ie

issue 2 volume 13 • FeBRuARY 2011
Dates For your Diary
FeBruary
Tuesday, 7th February
5th all ireland pharmacy
Conference, Dundalk, Co louth
This upcoming conference is
aimed at pharmacists, technicians
and pharmaceutical assistants.
At the conference, delegates will
be encouraged to share good
practice in pharmaceutical care
across the primary and secondary
care sector and to exchange
ideas for pharmaceutical service
development.
The Conference will take place
at Ballymascanlon House. For
Name:
Address:
E-mail:
ip Crossword no.183
1 2 3 4 5
6 7
9 10
14
11 12 13
15 16
18 19 20
21
22 23
further information log onto
www.iccpe.ie.
Wednesday, 23rd February
rCsi Mini-Med open lecture
school, Dublin
As part of the Royal College of
Surgeon’s Ireland Mini-Med
School open lecture Series,
Professor Mary Cannon of the
Department of Psychiatry,
Beaumont Hospital, and RCSI will
present a lecture entitled ‘youth
Mental Health’’. The lecture
will take place at RCSI, 123 St.
Stephen’s Green.
The RCSI Mini-Med open
lecture Series is free of charge,
19-21 October 2011
esCp 40th international
symposium on Clinical pharmacy
Clinical Pharmacy Connecting Care and outcomes,
Dublin Ireland, 19-21 october 2011.
venue: The Burlington
registration open: 1 April 2011
early Bird deadline: 31 July 2011
abstract submission open: 1 May 2011
abstract submission deadline: 1 July 2011
register through www.escpweb.org
8
Diary/ClassiFieDs serviCe
at irisH pHarMaCist
Please email your ad to
maura@greencrosspublishing.ie
17
however, pre-registration is
necessary.
For information about the
event or to register log on to
www.rcsi.ie.
MarCH
Friday and Saturday, 4th and
5th of March
national Conference for Cancer
survivorship, Dublin Castle
The National Conference for
Cancer Survivorship, formerly
known as the National
Conference of Cancer Support
Groups, takes place this March at
Dublin Castle.
The conference will see a high
profile speaker panel comprising
25 speakers from the oncology
and wider psycho-oncology
arena come together to tackle
a wide variety of issues. This
year’s keynote speaker is the
internationally acclaimed speaker
and poet David Whyte. The
purpose of the conference is to
bring people together to provide
an opportunity to network, learn
new skills and receive support.
This event will be free of
charge and open to all. To register
see www.cancer.ie.
clAssiFieds/cRosswoRd
Saturday, 12th of March
pharmacy technician
Conference, athlone
The Irish Association of
Community Pharmacy
Technicians will host the
Pharmacy Technician
Conference at the Athlone
Institute of Technology this
March, Details of the event,
booking information and
guest speakers is available
from their website
www.iacpt.ie.
Thursday, 24th March
7th national Healthcare
Conference, Dublin
The 7th National Healthcare
Conference, run in conjunction
with Ireland’s Independent
Hospital organisation (IHAI),
the HSE and a panel of industry
advisors, takes place at the
Burlington Hotel, Dublin on
March 24.
Amongst the key speakers
at this year’s event are Dr Frank
Dolphin of the HSE, Dr. Tom
o’Callaghan, Founder and
Clinical Director, livinghealth
Clinic and Pat o’Byrne, CEo of
the National Treatment Purchase
Fund. For further information log
on to www.nationalhealthcare.ie.
across
6 All in on oily wool extract (7)
7 Dance between Heaven and Hell? (5)
9 one gets a sound return from it! (4)
10 Crop slut posing for statue-maker (8)
11 Military display of skin-art? (6)
13 Meat, we hear, to encounter (4)
15 Hee-Haw Town in Wicklow? (4)
16 Don’t accept this rubbish! (6)
18 Connecting or popping the question? (8)
21 A kind of ache for everyone (4)
22 Stiff Egyptian mother? (5)
23 They are down in the mouth due to slots in disarray
(7)
Down
1 Play it, strike it or marry! (5)
2 Muddle or cry on a type of hearty artery (8)
3 Don’t hit her! (4)
4 Thpeak like thith with thith? (4)
5 Bond me a different stomach! (7)
8 Amputate or isolate (3,3)
12 large root vegetable, Pi perhaps? (6)
13 Her job is to rub people up the right way! (8)
14 Mica urn surprisingly found under 17 Down (7)
17 Claps stupidly on one’s head (5)
19 Mary manouvered soldiers (4)
20 olga wiggled for the prison (4)
Saturday, 26th of March
national association of
Hospital pharmacy technicians
conference, Dublin
The National Association of
Hospital Pharmacy Technicians
(NAHPT) will host their annual
conference at the Clarion Hotel,
Dublin Airport on the 26th of
March. Further details on the
conference are available from
www.pharmtech.ie.
lady pharmacists golf
society, leinster
The lady Pharmacists Golf
Society will hold a number of
outings this summer.
The first of these will take
place on Saturday, 28th of
May at Glasson Golf Club. on
Saturday, 23rd of July, the
society will meet at Druid’s
Glen Golf Club. Another
outing will take place at
Mount Wolseley Golf Club on
Saturday, 20th of August.
For further information
contact Doreen O’Donoghue,
Competition Secretary on 086
623 6896 or Ann O’Connor Hon.
Sec. 087 232 6483.
ANSWERS To lAST MoNTH’S
CRoSSWoRD
across: 6 Kildare, 7 Aorta, 9 lean, 10
Spectrum, 11 Bikini, 13 Cock, 15 Thus,
16 Tom cat, 18 Immunity, 21 Iron, 22
Psalm, 23 Antenna.
Down: 1 Dimes, 2 Adenoids, 3 Iris, 4
Hoot, 5 Staunch, 8 Medium, 12 In trim,
13 Clarinet, 14 Chemist, 17 Mount, 19
Ugly, 20 yank
Congratulations to the winner of last month’s crossword:
Declan Coyle, Kelly's Pharmacy, Athenry, Co Galway.
For a chance to win €70, please send completed entries by 25 th February to:
the Editor, Irish Pharmacist, GreenCross Publishing,
7 Adelaide Court, Adelaide Rd, Dublin 2 or
fax to (01) 478 9449 by 22nd December 2010.
Please note the winner's cheque will be issued 45 days after publication.
1
D
suMMer 2011
2
A
3
I
4
H
5
S
6
K I L D A R E A
7
O R T A
M E I M
8
O A
9
L E A N S
10
P E C T R U M
S O D N
1
B I
12
K I N I C
13
O C K
14
C D N U L H
15
T H U S
16
T O M C A T
E R R M
17
18
I M M U
19
N I T Y
20 21
I R O N
I G M A N U
2
P S A L M A
23
N T E N N A
T Y K T T
39

40
opinion
Putting Boots
on the MAP
and verily it came to pass – the chains
of British immorality did invade our
fair green land and poison our pure
maidens with the tablets of the devil.
If you listen very carefully the noise
you hear in the background is De
Valera spinning in his grave. The Green Party want
to magnetise his bones and encase him in copper
wire – he could generate enough electricity to power
a small city, or the beer cooler for a Brian Cowen singa-long.
Remarkably, when you consider the tortuous
history of contraception in this country, there was
little or no comment about the Boots initiative on
moral grounds. The main media focus was on the
Uniflu advert rework 19/10/2009 10:24 Page 1
outsIde edGe
Each Uniflu Coated Tablet Contains Active Ingredients: Paracetamol 500 mg, Diphenhydramine hydrochloride 15 mg, Phenylephrine hydrochloride 10 mg, Caffeine 30 mg
Each Gregovite ‘C’ Chewable Tablet Contains Active Ingredients: Ascorbic acid (Vitamin C) 300 mg (as ascorbic acid/sodium ascorbate)
benefit of easier and
cheaper availability
of an essential health
service. However, the
normally media-savvy
GP representatives
handled the issue
very badly, and came
across as just trying to
protect their own financial interests. They would have
been better off to concede gracefully.
There are a couple of positives in this development
for the rest of us pharmacists. Now that Boots have
paved the way it makes sense for the IPU to press
ahead with their work on Patient Group Directives.
Most of us need the business more than Boots does.
It should go without saying, but I’ll say it anyway, that
we all better keep our noses clean on this one. The
debacle last year when several pharmacies sold Alli
to a size 8 journalist from the Indo did the rest of us
no favours. There is also a slight cause for concern in
Before Taking Uniflu Tablets Consult you doctor before taking UNIFLU tablets if any of this applies to you: If you are already taking other paracetamol-containing products. If you are allergic to paracetamol or any of the other ingredients. If you are
currently taking metoclopramide, domperidone or cholestyramine (as these medications can interfere with the paracetamol). If you are currently taking blood thinning tables (warfarin and other coumarins). If you are currently taking antidepressants
(monoamine oxidase inhibitors) or within 14 days of stopping such treatment. If you are currently taking chloramphenicol. If you are suffering from breathing problems. If you are currently being treated for, or suffering from an overactive thyroid, high
blood pressure or heart disease. If your liver or kidneys do not work properly, or if you have an enlarged prostate gland causing difficulty in passing urine or suffer from epilepsy or glaucoma. If you are planning a pregnancy or are pregnant or breast
feeding. If you are taking any other regular medication. Special Warning The risk of overdosage is greater in patients with certain types of liver disease. Drowsiness may be experienced whilst taking UNIFLU tablets. If you are affected, DO NOT drive
or operate machinery. Avoid alcoholic drink whilst taking UNIFLU. UNIFLU tablets should not be used to treat persistent or chronic coughs such as occurs with smoking, asthma or emphysema or if cough is accompanied by excessive mucus (phlegm),
unless directed by the doctor. DO NOT take other paracetamol-containing products with UNIFLU tablets. DO NOT exceed the stated daily dose. Uniflu tablets contain Sucrose, Gregovite ‘C’ tablets contain Sucrose and Lactose. If you have been told
by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. Dosage Adults and Elderly: One UNIFLU tablet to be swallowed whole with water and one Gregovite ‘C’ tablet to be swallowed
whole, sucked or chewed. Dose to be repeated every SIX (6) hours until the symptoms disappear. NOT MORE THAN FOUR (4) UNIFLU TABLETS TO BE TAKEN IN 24 HOURS. Children: - Under 12 years - Not Recommended. Over 12 years
- One UNIFLU tablet to be swallowed whole with water and one Gregovite ‘C’ tablet to be swallowed whole, sucked or chewed. Dose to be repeated every EIGHT (8) hours until symptoms disappear. NOT MORE THAN THREE (3) UNIFLU TABLETS
TO BE TAKEN IN 24 HOURS. If you do not feel any better after taking a course of the medicine, consult your doctor or pharmacist. Overdosage Uniflu Tablets - Overdosage may lead to increased heart rate, high blood pressure, sickness, liver damage
and breathing problems. Immediate medical advice should be sought in the event of an overdosage, even if you feel well, because of the risk of delayed, serious liver damage. Gregovite ‘C’ Tablets – No cases of overdosage have been reported.
If, however, you think you may have taken too many tablets, drink plenty of water and contact your doctor or pharmacist immediately. Legal Category: (P) Marketing Authorisation Number - Ireland: PA 1455/1/1 Marketing Authorisation
Holder: Uniphar Group.
For further information please contact:
Uniphar Group
4045 Kingswood Road, Citywest Business Campus, Co. Dublin. Ph: 01 428 7777
ACTIVE INGREDIENTS
Paracetamol 500mg,
Diphenhydramine hydrochloride 15mg,
Phenylephrine hydrochloride 10mg,
Caffeine 30mg
Ascorbic acid (Vitamin C) 300mg
ONLY AVAILABLE FROM PHARMACIES NATIONWIDE
LOOK OUT FOR THE TV
ADVERT THIS WINTER
fINtAN moore
issue 2 volume 13 • FeBRuARY 2011
that a lot of GPs are less than happy with all this, and
I hope they don’t find an equivalent loophole in the
law which allows them to dispense various products.
I would not describe myself as a fan of Boots, but
I don’t resent them either because I regard them
as being in a different niche to mine. I am however
grateful that in setting a fee of €45 for the MAP
they have put a respectable figure on the value of
a pharmacist’s time. Given that the price of drugs is
being driven down, and that we are being pressurised
to adopt the HSE rates for all our business, it is
good to have a benchmark established on what a
pharmacist’s time is worth. on the issue of the HSE
rates, it seems downright nuts to me that somebody
would spend five years studying pharmacy then
voluntarily use a lower mark-up in their specialist area
than they use in their front-of-shop sales for stuff like
hair gel. As the saying goes, you can be the busiest
man in town if you want to work for nothing.
Fitness Workout
I don’t know whether it was just a slow news day, or if
it was the novelty of the first ever Fitness to Practise
pharmacy hearing, but the sale of an out-of-date
bottle of Benylin Dual Action to some woman in
Tallaght generated more than its fair share of column
inches. I suppose that we should be grateful that
it was such a non-story, given that no real harm
came to anybody, but it seems somewhat harsh for
a pharmacist to garner so much negative press for
a trivial error, although I can’t say it was much of a
shock to read that the complainant felt drowsy after
taking the Benylin. The funny thing in the reporting
of the story was that the Indo and the Examiner said
that the woman felt ill, then read the expiry date. The
Irish Times said that she felt ill after reading the expiry
date. So was the illness due to a reaction to the syrup,
or due to an over-reaction to reading the date? The
pharmacist was ‘admonished’ for not having proper
procedures in place, but his real crime was that he
should have contacted the IMB and borrowed the
magic wand that they used to extend the shelf-life of
the country’s supply of Tamiflu.
still going PostAl
There is a saying that if you can’t trust a man with
little things, then you can’t trust him with big things.
For all the talk in the HSE about finding ‘efficiencies’
and cutting back on unnecessary expenditure they
still find ways to waste money stupidly. I recently
needed Emergency Registration forms for the
Drugs Payment Scheme, and summary sheets for all
schemes, so I rang the PCRS and ordered them. Now it
may seem churlish to complain about a swift service,
but the paperwork got delivered the following day
by a DHl courier. A few weeks ago, the PCRS sent me
a pack of treasury tags also by DHl. I would love to
know just how much money is spent every year on
courier charges for completely non-urgent stationery
supplies that could be sent by ordinary post. Better
still, let the HSE have a chat with the pharmacy
wholesalers and come to some arrangement whereby
they could each keep a stock of the supplies in their
warehouse and deliver them to us as needed. or
would that be too easy?