treatment plan

Utilizing the Friendly Pharmacist

BY WILLIAM D. TOWNSEND, OD
June 1999

One of the most challenging aspects of being a professional is trying to keep abreast of the latest technological developments that impact our
patients and our practices. There is simply too much new information for any practitioner to learn and retain (hence, the develop

much new information for any practitioner to learn and retain. One resource that I find vastly underutilized by eyecare providers are pharmacists. These individuals are amazingly knowledgeable about medications, their shortcomings and advantages in given situations, and the interactions between various drugs. Most pharmacists are more than happy to help when you seek their knowledge and expertise.

Pharmacy: The Profession

After completing two years of prepharmacy and four years of pharmacy school, the majority of pharmacists go to work for pharmacies, where they spend most of their time counting pills. I've found that pharmacists actually enjoy challenges that require them to use their hard-earned knowledge because they provide relief from the monotony of their everyday schedules.

New Technology

Unfortunately, many new inventions that could benefit both eyecare practitioners and their patients aren't widely known. For example, one pharmacist has developed a spray system for delivering mydriatic/cycloplegic agents to children and apprehensive adults. Simply spray the solution in the vicinity of the patient's eyes, and in a few minutes, the medications begin to take effect with very little systemic absorption or stinging.

Clarke Newman, O.D. (Dallas), in conjunction with a local pharmacist, developed a new delivery system that uses a sterile syringe filled with rose bengal. The tip of the syringe is capped with a micropore filter that prevents backflow contamination. This system can also be used to deliver fluorescein to the eye.

Compounding Pharmacists

When fortified antibiotics are required for treating infectious bacterial keratitis, it's helpful to know a pharmacist who can compound. For instance, we all know that tobramycin is available as a 0.3 percent ophthalmic solution and that the accepted concentration for treating bacterial corneal ulcers is 14 mg/ml. The process for compounding a fortified solution involves mixing sterile saline with the desired antibiotic powder to achieve the proper concentration. This procedure must be done under a hood to keep contamination to a minimum and can be performed by a compounding pharmacist for a price.

A Wealth of Knowledge

Just by calling a pharmacist, you can learn about any newly released medications, previously unknown side effects of existing drugs and interactions between commonly prescribed medications. Pharmacists can also advise us about the possibility of cross sensitivity between medications and inform us if any of the medications we prescribe have become available in generic form. Perhaps one of the most valuable services pharmacists perform for us is letting us know which medicines a given patient is taking, which allows us to review the medications and any potential side effects quickly and accurately.

In our busy day-to-day schedules, it's comforting to know that well-trained professionals with an extensive knowledge of medications are as close as a phone call away. The next time you need help with some of the items mentioned in this article, call your pharmacist. After you develop a good relationship with them, you might be surprised to find that in addition to being a great source of knowledge, they can also become a very good source of referrals for your practice.

Dr. Townsend is in private practice in Canyon, Texas, and is a consultant at the Amarillo VA Medical Center. (doctorbill@amaonline.com)