Pharmacist prescribing of melatonin

Clinical

August 8, 2000

References

1. Goldstein, CA. Overview of circadian rhythm sleep-wake disorders. UpToDate [updated Dec 2023]. At: https://sso.uptodate.com/contents/overview-of-circadian-rhythm-sleep-wake-disorders?search=melatonin&source=search_result&selectedTitle=3%7E113&usage_type=default&display_rank=3
2. Insomnia in adults. Therapeutic guidelines [updated Mar 2021]. At: https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Psychotropic&topicfile=insomnia-adults
3. Treatment guidelines for pharmacists: insomnia. In: Sansom LN, ed. Australian pharmaceutical formulary and handbook. 26th edn. Canberra: Pharmaceutical Society of Australia; 2024.
4. Therapeutic Goods Administration. Notice of final decision to amend the current Poisons Standard in relation to melatonin. 2020. At: www.tga.gov.au/resources/publication/scheduling-decisions-final/notice-final-decision-amend-current-poisons-standard-relation-melatonin
5. Pharmacy Board of Australia. FAQ – For pharmacists on the compounding of medicines. At: www.pharmacyboard.gov.au/documents/default.aspx?record=WD15%2f16635&dbid=AP&chksum=rE0qmZcEafURzzXc3NBiuA%3d%3d
6. Therapeutic Goods Administration. Notice of interim decision to amend (or not amend) the current Poisons Standard. 2023. At: www.tga.gov.au/sites/default/files/2023-10/notice-interim-decisions-amend-not-amend-the-current-poisons-standard.pdf
7. Therapeutic Goods (Poisons Standard – June 2024) Instrument 2024. At: www.legislation.gov.au/F2024L00589/latest/text (edited)

4.30 am	Up and at it Never in my life did I think I would be one of those early morning risers to hit the gym, but the pandemic forced a change and that schedule gets me mentally prepared for the day.
7.30 am	Handover time A double-shot of cappuccino in hand, my day begins with a handover between the 24-hour retail pharmacy and hospital dispensary team. Urgent action might be needed on alteplase orders to replace stock used overnight for a stroke patient in ED, or ensuring discharge medicines that were completed are given to that ward’s pharmacist for patient counselling.
8.30 am	Hospital bed managers’ meeting Meeting daily with the ward and other multidisciplinary hospital team managers helps me reallocate pharmacy staff to areas that need support i.e. for timely discharges or immediate communication if a regular pharmacy staff member is on leave. On Thank You Thursdays, meetings end by nominating a team member deserving of recognition, who later receives a card and lunch voucher from the hospital executive team.
9.30 am	Current shortages Next meeting addresses state shortages – this time its fluids. This entails direct contact with other Ramsay Queensland hospitals via the state procurement manager who organises a consistent supply of fluids, such as saline.
10 am – 4 pm	Daily challenges Every work day is different. Overseeing a 24-hour pharmacy that never closes requires being prepared for anything, and problem-solving is a strong skill set in my role. If I have multiple staff on leave with the spread of colds and flu, I actively help cover an area, (which has helped me be a better manager with greater knowledge of what shifts entail or how wards operate). Urgent deliveries of home IV antibiotics for patients and expensive IV anti-fungals at short notice are part of it.
4.00 pm	Home time I start my second job, which could ideally be a paid Uber driver, but is actually driving my children to their various daily extracurricular activities. At least I’m off my feet!

Awareness	Whether people know about vaccines, where to get them, and their benefits and risks.
Acceptance	Whether people want to get vaccinated, subject to access and affordability.
Affordability	Whether people can afford the price of getting vaccinated and other costs of getting vaccinated, such as time off work if they have an adverse reaction to the vaccine.
Access	Whether people can safely and easily get vaccines, including physical and psychological safety.
Activation	Whether people who are aware of and accepting of vaccines are motivated to get the vaccine.

4.30 am	Up and at it Never in my life did I think I would be one of those early morning risers to hit the gym, but the pandemic forced a change and that schedule gets me mentally prepared for the day.
7.30 am	Handover time A double-shot of cappuccino in hand, my day begins with a handover between the 24-hour retail pharmacy and hospital dispensary team. Urgent action might be needed on alteplase orders to replace stock used overnight for a stroke patient in ED, or ensuring discharge medicines that were completed are given to that ward’s pharmacist for patient counselling.
8.30 am	Hospital bed managers’ meeting Meeting daily with the ward and other multidisciplinary hospital team managers helps me reallocate pharmacy staff to areas that need support i.e. for timely discharges or immediate communication if a regular pharmacy staff member is on leave. On Thank You Thursdays, meetings end by nominating a team member deserving of recognition, who later receives a card and lunch voucher from the hospital executive team.
9.30 am	Current shortages Next meeting addresses state shortages – this time its fluids. This entails direct contact with other Ramsay Queensland hospitals via the state procurement manager who organises a consistent supply of fluids, such as saline.
10 am – 4 pm	Daily challenges Every work day is different. Overseeing a 24-hour pharmacy that never closes requires being prepared for anything, and problem-solving is a strong skill set in my role. If I have multiple staff on leave with the spread of colds and flu, I actively help cover an area, (which has helped me be a better manager with greater knowledge of what shifts entail or how wards operate). Urgent deliveries of home IV antibiotics for patients and expensive IV anti-fungals at short notice are part of it.
4.00 pm	Home time I start my second job, which could ideally be a paid Uber driver, but is actually driving my children to their various daily extracurricular activities. At least I’m off my feet!

Awareness	Whether people know about vaccines, where to get them, and their benefits and risks.
Acceptance	Whether people want to get vaccinated, subject to access and affordability.
Affordability	Whether people can afford the price of getting vaccinated and other costs of getting vaccinated, such as time off work if they have an adverse reaction to the vaccine.
Access	Whether people can safely and easily get vaccines, including physical and psychological safety.
Activation	Whether people who are aware of and accepting of vaccines are motivated to get the vaccine.

4.30 am	Up and at it Never in my life did I think I would be one of those early morning risers to hit the gym, but the pandemic forced a change and that schedule gets me mentally prepared for the day.
7.30 am	Handover time A double-shot of cappuccino in hand, my day begins with a handover between the 24-hour retail pharmacy and hospital dispensary team. Urgent action might be needed on alteplase orders to replace stock used overnight for a stroke patient in ED, or ensuring discharge medicines that were completed are given to that ward’s pharmacist for patient counselling.
8.30 am	Hospital bed managers’ meeting Meeting daily with the ward and other multidisciplinary hospital team managers helps me reallocate pharmacy staff to areas that need support i.e. for timely discharges or immediate communication if a regular pharmacy staff member is on leave. On Thank You Thursdays, meetings end by nominating a team member deserving of recognition, who later receives a card and lunch voucher from the hospital executive team.
9.30 am	Current shortages Next meeting addresses state shortages – this time its fluids. This entails direct contact with other Ramsay Queensland hospitals via the state procurement manager who organises a consistent supply of fluids, such as saline.
10 am – 4 pm	Daily challenges Every work day is different. Overseeing a 24-hour pharmacy that never closes requires being prepared for anything, and problem-solving is a strong skill set in my role. If I have multiple staff on leave with the spread of colds and flu, I actively help cover an area, (which has helped me be a better manager with greater knowledge of what shifts entail or how wards operate). Urgent deliveries of home IV antibiotics for patients and expensive IV anti-fungals at short notice are part of it.
4.00 pm	Home time I start my second job, which could ideally be a paid Uber driver, but is actually driving my children to their various daily extracurricular activities. At least I’m off my feet!

Why is antibiotic prescribing in aged care so high?

What antibiotic is most commonly prescribed?

What impact is this having on antimicrobial resistance?

What is the pharmacist’s role in antimicrobial stewardship?

Why did you choose pharmacy?

What led you to your current role?

How do you and your staff cope with the late-night and overnight hours?

What are common requests from patients who visit in the wee small hours?

What are your strategies to deal with barriers to overnight care?

If you could change anything about your 24-hour pharmacy, what would it be?

What’s your advice for ECPs?

South Africa: Improving access to HIV treatment and prevention

Spain: Pharmacy reporting of stock shortages helps detect shortages sooner

The Netherlands: Palliative care kit improves access to care at end-of-life

Thailand: Medicine reviews for high-risk CKD patients

Australian pharmacist on SA TV!

High-risk populations

What to look out for

Sensitively screening for syphilis

Case one scenario

Case two scenario

Learning Objectives

Vaccination and the role of the pharmacist

Access

Alternative pathway to primary care

Understanding and awareness

Vaccination in adults

Implementing pharmacy-led vaccination programs

Conclusion

Case scenario one continued

Case scenario two continued

Key points

References

Our author

Our reviewer

Disclaimer

Why is antibiotic prescribing in aged care so high?

What antibiotic is most commonly prescribed?

What impact is this having on antimicrobial resistance?

What is the pharmacist’s role in antimicrobial stewardship?

Why did you choose pharmacy?

What led you to your current role?

How do you and your staff cope with the late-night and overnight hours?

What are common requests from patients who visit in the wee small hours?

What are your strategies to deal with barriers to overnight care?

If you could change anything about your 24-hour pharmacy, what would it be?

What’s your advice for ECPs?

South Africa: Improving access to HIV treatment and prevention

Spain: Pharmacy reporting of stock shortages helps detect shortages sooner

The Netherlands: Palliative care kit improves access to care at end-of-life

Thailand: Medicine reviews for high-risk CKD patients

Australian pharmacist on SA TV!

High-risk populations

What to look out for

Sensitively screening for syphilis

Case one scenario

Case two scenario

Learning Objectives

Vaccination and the role of the pharmacist

Access

Alternative pathway to primary care

Understanding and awareness

Vaccination in adults

Implementing pharmacy-led vaccination programs

Conclusion

Case scenario one continued

Case scenario two continued

Key points

References

Our author

Our reviewer

Disclaimer

Why is antibiotic prescribing in aged care so high?

What antibiotic is most commonly prescribed?

What impact is this having on antimicrobial resistance?

What is the pharmacist’s role in antimicrobial stewardship?

Why did you choose pharmacy?

What led you to your current role?

How do you and your staff cope with the late-night and overnight hours?

What are common requests from patients who visit in the wee small hours?