What to do during the pharmacists' dispute

ANALYSIS: If you find yourself short of essential medication, first contact the HSE at 1850-241850

ANALYSIS:If you find yourself short of essential medication, first contact the HSE at 1850-241850

WITH SOME uncertainty persisting over Health Service Executive (HSE) arrangements for the supply of medication to patients on community drug schemes, following the withdrawal of a significant number of pharmacists from their contracts from today, where does this leave people who rely on regular medication for the treatment of chronic disease?

While those who require medicine for short periods of illness, such as antibiotics for acute infection, are likely to receive some medication from treating doctors and hospitals, it is people with chronic heart, lung and neurological disease who could be affected most. Typically, they take between two and four different medications a day.

While it may appear, at first glance, that doing without tablets for a few days may not be harmful, patients would be unwise to assume that this is the case.

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For the thousands of Irish people on long-term treatment for coronary heart disease and high blood pressure, the sudden cessation of regular medication could be harmful. Beta blockers, which work by slowing the heart rate to take pressure off the heart, are commonly prescribed to treat angina; however, their sudden withdrawal can lead to chest pain and could precipitate a heart attack.

People with diabetes are usually treated with either injectable insulin or tablets, or a combination of both. Oral agents work by increasing the release of insulin from the pancreas and by making circulating insulin more effective in the control of blood sugar. Going without these tablets for a few days could precipitate high blood-sugar levels; missing an insulin shot could cause trouble even more rapidly.

With more than 400,000 people with asthma in Ireland, they too need to ensure a continuous supply of inhalers and other medication. If you require a “preventer” inhaler, then stopping it suddenly may precipitate some wheeze or shortness of breath. It is likely to result in you needing more frequent doses of “reliever” medication and could trigger an avoidable acute asthma attack.

Steroids are one of the most powerful therapeutic agents available. Some patients with a variety of chronic illnesses require steroids on an ongoing basis. And while dosages are kept to an absolute minimum, the acute withdrawal of relatively high-dose steroids can be dangerous.

People with epilepsy must not miss their regular medication. Designed to dampen down “excitable” areas in the brain that act as a trigger point for seizures, a sudden drop in levels of anti-epilepsy medication may trigger convulsions.

Be careful about “borrowing” medication from neighbours and friends for the duration of this dispute. It is very easy to get dosages wrong and, in a worst-case scenario, you could end up mixing up drugs with similar names with potentially catastrophic results.

If your regular pharmacist has withdrawn his services and you find yourself suddenly short of essential medication, first contact the HSE information line at 1850-241850 for details of the nearest alternative pharmacy.

If you or a friend cannot access an alternative supply, it is worth contacting your local pharmacist to discuss your predicament. Ethical guidance from the pharmacy regulator means it is highly unlikely a pharmacist would leave you without at least a short-term supply of medication.