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Report - Internship in a Community Pharmacy
Student Exchange program
5th year of study, practical training
Faculty of Pharmacy, Comenius University, Bratislava, Slovakia
2th October 2016 Sunday
The day of my arrival from belgian city Mons (where I have done 2 months of my intenship
in a community Pharmacy) to Sittard station. I had a short stay (only for few hours) in
Maastricht and than I retook direct train to Sittard where Mr. Sikkes have been already
waiting. Firstly, we went wind-surfing on belgian lake near borders (me, I was only
observing) and then we arrived home.
3th October 2016 - Monday
Meeting with a doctor
My first task in a Pharmacy was to look at the medical history of few patients. We had 5
patients whose treatement we needed to discuss with their generalist. It consists of elderly
patients with more than 5 medecines. According to their medical history of the last year and
their health problems, we were searching for interactions, contraindications, overdosing,
duplicitating of medecines or other therapeutical problems.
My responsibility was, at first to class molecules according to their ATC groups and to
prepare my questions.
I could see how NCARE system works (the system which shows interactions, CI or missing
Examples of problems, questions:
Elderly patients without supplement of vit. D
ACE-inhibitor + codeine Does the patient suffer froma dry cough? No, codeine was
prescribed as a pain-killer.
Doxisosine + B-blocator Doesnt the patient posses some problems because of this
In the afternoon I helped with labelling (name of a patient, name of a doctor, name of
a medecine, specials warnings, interactions) pairing of receiptts with the medicine.
Form of dutch prescription (on the left side) and slovak prescription (on the right side)
At the end of my first day, I controlled dosage and drug interactions with Mr. Sikkes
(especially methotrexate - 1x/week, at once take).
And after work, short bike trip in the surronding
4th October 2016 - Tuesday
Introduction to the work in the Pharmacy
Rossetta explained me the system of work in a Pharmacy how the receipt looks like, what
is smart filling, 2 possibilities of receiving receiptt in printed version from a patient or by
electronic system, what we need to control, the system of ranging the medicines, how to pair
medecine with the receipt and required control of prepared treatement for a patient. There is
at least double control the first one during choosing the right medecine (according to the
prescription). The last step before delivering the medicine to the patient is the packing or
preparing for blister. Patients can come to take their treatement at the Pharmacy , at the
branch Pharmacy or their is also the possibility of delivering medicine at home (manly for
When the new therapy is on, the first time, patient is well informed about taking the
medicine. The second time, he receive the questionnary and is asked if he observes any
problem during treatement.
With Rossetta we went to Grevenbicht where Ive been also solving therapeutical problem of
a patient, man of 53 years old who has a problem with cold hands, muscle stiffness. His
treatement conssist of: pantoprolol, clopidogrel, ASA, metoprolol, perindopril and
simvastatine. According do SPC, we concluded that metoprolol as B-bloc. can be responsible
for cold hands and simvastatine can cause muscle stiffness (undesired effect - myalgia).
In the afternoon, Nastacha explained me the system of ordering, preparaing received orders
for smart filling. They received one order every day in the early morning (once per day) in
contrast with Slovakia, where the most of pharmacies received their orders 3 or more times
per day. I learnt more about using the information system in the Pharmacy where to control
the location of a medicine, how to control the stocks, how to print PIL etc.
For received derivates of opium, it is necessary to control the number of received products,
sign the document of incomming opioids and control the stocks of these products.
I helped with delivering of the medecines in a branch Pharmacy.
With Mr. Sikkes, we discussed what the parallel export means, what the grossery must do
before libere these medicines to trade (change PIL into official language and translate outer
package of a medicine by sticking a label on it).
Kind of a stick English translation
To stock in a fridge
Do not swallow
Inhalation by mouth/ nose
May influence your reaction time
Shake before use
To deliver at home
To Obbicht (branch Pharmacy)
Therapeutic education needed
Blister is necessary
To use 1 month after openning
Ask us for help, advice
5th October 2016 Wednesday
In the morning, I helped assistants with arranging received order, controlling the stock of
opium drugs and put them on their place. I also labelled medicines, controlled rightness of the
dosage and strength.
Afterwards, I had a preparation to do.
Phenobarbitalum 22,48 g
Phenytoinum 30,00 g
Cellulosum micro 43,02 g
D.t.d. No 300
Capsules No 0 were used.
I participated on a meeting in the Pharmacy main themes that were discussed how to get
more people on smart filling? Note always the dosage on a label. etc.
Searching information about some molecules/ medicines:
= oral antidiabetic
It is a GLP1 receptor agonist. Dulaglutide has been shown to cause thyroid cancer in rats.
Is used for treatement of increased pressure in eye (ocular hypertension), open angle glaucoma.
It is an analog of PG.
Indication: irritable bowel syndrome, chronic irritable colon, spastic constipation, mucous colitis. It is
a musculotropic antispasmodic with a direct action on the smooth muscle of GIT, without affecting
normal gut motility.
At the end of this day, we played tennis (me, I tried to play) with Mr. Sikkes and his friends.
6th October 2016 Thursday
Again, I arranged received order, controlled the stock of opium and I put them on their place.
When it was necessary, I used the information system for finding the right location or
controlling the stocks. I also paired recips and prescribed drugs with controlling everything
what is necessary.
It is necessary to put received medicine into drawers or shelfs every morning.
Searching for information:
Sulfametazoltrimetoprim = Bactrimel
Its an antibiotic, combination of sulfamethoxazole which block. Synth. Of dihydrofolic acid
by competing with PABA, and trimethoprim that reversibly inhibate dihydrofolate reductase,
whch produce tetrahydrofolic acid from dihydrofolic acid.
This combination is used for:
Urinary tract infections
Acute otitis media
Acute exacerbations of chronic bronchitide in adults
Travelers diarrhea in adults
Mupirocine = Bactroban (creme)
Its an ATB that acts by inhibiting of synthesis of bact. Prot. by reversibly and specifically
binding to bacterial isoleucyl-transfer RNA synthetase. Mupirocine is used again infections
caused by S. Aureus, S. Pyrogenes.
Hydroxychloroquine sulfate = Plaquenil
Has an antimalarial action Plasmodium vivax, P. Malariae, P. Ovale, P. Falciparium. Is
used against lupus erythematosus, rheumatoid arthritis.
Its an antidepressant. Inhibits re-uptake of NAD and DOP without inhib. Of 5-HT re-uptake.
Is an immunosupressant that is used to prevent organ rejection after transplantation kidney,
7th October 2016
Participation at doctor assistants lesson and visit in Pharmacy assistantss practical lab
With Mr. Sikkes, I participated at the lesson talking about pain killers their classement,
dossage, side effects, CI
a) Paracetamol group
Normal dosage: 3x/day
Max dosage: 4x/day 2 tbl
Preaparing medicines for their delivery to patients according to the receipt, typers had to
choose the right medicine (preference of inssurance), strength and then print labels. Labels
are than sticked at the packages (the cross on a pachage means, that this package has been
already open). The choice of right medicine is controlled by computer system.
At the end of the day, I controlled medical prescription right datas, right molecule, right
Is used in a treatement of acute lymphatic leukemia. Competes with G and hypoxanthin for