Magazine article Drug Topics

Letters

Magazine article Drug Topics

Letters

Article excerpt

As the owner of an independent pharmacy in Brooklyn, I was moved to write this letter when a couple leaving my pharmacy said one to the other, "This is a real, old-fashioned drugstore."

That is probably the ultimate compliment I could expect, since I try to conduct business in the same manner I learned it many years ago. While the pharmacy is computerized and customers are the beneficiaries of my attendance at continuing education classes, an atmosphere of friendliness and understanding pervades the store.

Today, the educators in our profession, as well as our leadership, are promoting the Pharm.D. degree along with a new six-year educational requirement. They want us to be designated as specialists in various skills such as diabetes, hypertension, and asthma. Whatever happened to knowing enough about each of these ailments to be able to help a customer take better care of himself and guide him to proper medical care for further and more complete treatment?

Stores such as mine are becoming more and more difficult to find, especially in those areas where the large chains have come in and bought or frightened out the smaller stores. But no matter how much money these 10,000-sq. ft. discount stores with the "pharmacy department within" signs spend advertising the Rx department, they are not substitutes for the "old-fashioned drugstore" where you are greeted by name and treated as a person, not a number.

Why would a student want to invest the time, the cost, and the effort to achieve the Pharm.D. degree to do nothing more than count pills for someone else? Whatever happened to the desire to be an entrepreneur, a businessman, to own your own pharmacy? There is simply no way you could do, as an employee in such a situation, the things you would want to do as an owner. The challenge of conducting business, or serving your customers with knowledge accumulated, is what should drive you-not the silly hypothetical dreams of a leadership that does not practice community pharmacy. Ask your friends and relatives where they would want to shop, given the opportunity.

To be called an old-fashioned pharmacy is really an achievement in today's marketplace. Our leadership should work harder towards making the smaller pharmacy a viable option, not accepting its demise as a matter of course. The public needs us.

Bertram Drahtman, B.S., R.Ph.

Seventh Avenue Pharmacy Brooklyn, N.Y.

For the record

Thank you for covering the U.S. Food & Drug Administration's regulatory clearance of the antiseizure medication Gabitril (tiagabine hydrochloride) from Abbott Laboratories ("Seize and desist," Drug Topics, Nov. 15). Gabitril is indicated as adjunctive therapy, and therefore it is critically important to understand how it interacts with other antiepilepsy drugs (AEDs).

However, your article incorrectly states that Gabitril enhances the metabolism of carbamazepine and phenytoin, therefore necessitating an increase in dosage of these drugs. In fact, as a non-enzyme-inducing AED, Gabitril has no effect on the steadystate plasma levels of either carbamazepine or phenytoin. However, carbamazepine and phenytoin do have an effect on Gabitril.

The clearance of Gabitril is affected by the coadministration of hepatic enzyme-inducing drugs such as carbamazepine and phenytoin. Gabitril is eliminated more rapidly in patients who have been taking hepatic enzyme-inducing drugs.

Drug analysis indicates that Gabitril clearance is approximately 60% greater in patients taking carbamazepine or phenytoin. Therefore, in these patients, greater amounts of Gabitril are needed to achieve therapeutic plasma concentrations than in patients taking non-enzyme-inducing AEDs. …

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