OTC BID Pseudoephedrine Assignment
OTC BID Pseudoephedrine Assignment
OTC BID Pseudoephedrine Assignment
OTC BID Pseudoephedrine Assignment
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Elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. The patient is also complaining of a runny nose, cough, and head/chest congestion. He has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. Approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. Below is a list of the patient’s medications, his physical examination, and his laboratory findings: Medications Digoxin 0.25 mg QD Cimetidine OTC BID Pseudoephedrine SR 120 BID Warfarin 7 mg QD Allergies: NKDA Physical Examination VS: BP: 180/95, HR 75, irregularly irregular, RR 17 Weight: 95 kg HEENT: WNL ABD: + Bowel Sounds EXT: Bruising on arms and legs NEURO: Alert & Oriented x 3 GEN: Well developed, well-nourished male ECG: atrial fibrillation Laboratory Na 143 mEq/L K 4.5 mEq/L Cl 99 mmol/L CO2 25 mEq/L BUN 18 mg/dL SCr 0.9 mg/dL INR 4.8 Hct 42% Hbg 15 mg/dL Digoxin 3.8 ng/ml
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Pseudoephedrine
Although pseudoephedrine has a legitimate place in the relief of nasal congestion associated with acute or chronic rhinitis, it can also be diverted for the production of illicit amphetamines.
Project STOP
Pharmacists are required to record all over the counter (OTC) sales of pseudoephedrine products on Project STOP. This means pharmacists have access to ‘real-time’ records of pseudoephedrine purchases from pharmacies across Western Australia. Use of Project STOP reduces the chances of inappropriate purchases of pseudoephedrine products from a pharmacy as the system allows the pharmacist to review the history of previous supplies which supports quality use of medicine in individual patients and aids in reducing diversion.
You can report suspicious requests for pseudoephedrine products can to the WA Police Chemical Diversions Desk:
email: chemical.diversion@police.wa.gov.au
telephone: 9223 3868 (weekdays)
CrimeStoppers 1800 333 000 (after hours or weekends).
Therapeutic need
A therapeutic need must be established for a sale of pseudoephedrine, and the amount sold must be reasonable for the individual therapeutic circumstances.
Sales and supplies
A pharmacist, or a pharmacy intern or technician under the personal supervision of a pharmacist, may sell a pseudoephedrine product to a purchaser providing:
the purchaser is known; or
the purchaser’s identity has been verified by photographic evidence.
The product must be labelled with the name and address of the pharmacy and a unique number or alpha-numeric code. The sale must be recorded in Project Stop with the following information:
date of sale
name and address of purchaser
name and address of the person the medicine is intended to treat (if not the purchaser)
name and quantity of medicine supplied
unique identification number or alpha-numeric code.
Records of pseudoephedrine sales must be kept for at least 2 yea
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