locum trouble?

Re: locum trouble?

Michael Woodhouse — Sat, 27 Oct 2012 00:40:13 GMT

[quote user="bob lehner"] We should use drugs responsibly and in accordance with manufacturer's instructions.[/quote]

Yes, but the two don't always go hand in hand. 100% with the responsible use part, but with the costs of licensing we are seeing more and more products with very specific limited datasheet indications. Clinical judgement dictates that the exact label advise may need modifying on a case by case basis.

Looks like some drugs may be fit for 40 YEARS after expiry.

http://archinte.jamanetwork.com/article.aspx?articleid=1377417

I don't (knowingly) sell OOD drugs but will use them up on charitable causes and on unowned animals.

Re: locum trouble?

Robin Grimmer — Fri, 26 Oct 2012 18:22:33 GMT

[quote user="Martin Atkinson"]

His name isn't Robin is it?

[/quote]

not guilty.

Re: locum trouble?

Anthony Todd — Fri, 26 Oct 2012 17:54:37 GMT

[quote user="Clive Ansell"]And be able and prepared to defend your actions to a civil court, the VDS, the VMD and the RCVS DC if something goes wrong with an OOD drug if you have illegally prescribed it.[/quote]

See what I mean?

By coincidence this week the "thought for today" posted every day at the Angel tube station was:

"Common sense is like a deodorant, those that need it never use it" which applies well to the post I quoted."

Re: locum trouble?

plantagenet — Fri, 26 Oct 2012 17:54:15 GMT

I wish we had all had the guts to stand up to the 28day breach rule and say - go on sue the lot of us.

We used to be a profession which was allowed to make professional decisions. bah, humbug!

Re: locum trouble?

Clive Ansell — Fri, 26 Oct 2012 17:49:39 GMT

[quote user="Anthony Todd"]

If there's a reason to say "no" grasp it with both hands and hang on!!!!!

[/quote]

And be able and prepared to defend your actions to a civil court, the VDS, the VMD and the RCVS DC if something goes wrong with an OOD drug if you have illegally prescribed it.

Re: locum trouble?

Anthony Todd — Fri, 26 Oct 2012 17:41:36 GMT

the human charities can't even use out of date disposables anymore

Don't we live in a funny world, where we would rather fellow humans die for want of medical intervention, than use our common sense and use what we judge (as professionals) still to be effective.

Yes, but it's the modern, up to date way!

If there's a reason to say "no" grasp it with both hands and hang on!!!!!

Re: locum trouble?

plantagenet — Fri, 26 Oct 2012 17:24:13 GMT

[quote user="patrick murphy"]

the human charities can't even use out of date disposables anymore

[/quote]

Don't we live in a funny world, where we would rather fellow humans die for want of medical intervention, than use our common sense and use what we judge (as professionals) still to be effective.

Re: locum trouble?

Dagmar Steele — Fri, 26 Oct 2012 17:12:48 GMT

[quote user="Martin Atkinson"]

[quote user="bob lehner"]Would you be happy for yourself/family to be treated with out of date medicines ?[/quote] Unless it had mould growing on it or it had all precipitated out and was 10 years old, erm...yes. A) because I know expiry dates are by and large a load of tosh and B) even if they weren't and the alternative was squat diddly and I/they couldn't be treated then it is a no-brainer. But come on we're probably talking about a few stray cats in Greece or whatever here not guaranteeing my family succession or saving the world - get real.

[/quote]

I have to second that. I am happy to use out of date medication on my own animals as flea protection, wormers and so on. I am afraid I have taken out of date medication myself, too. I would be happy to give them away to charities, but in Germany this is illegal

Re: locum trouble?

bob lehner — Fri, 26 Oct 2012 15:46:28 GMT

[quote user="Martin Atkinson"][quote user="bob lehner"]Would you be happy for yourself/family to be treated with out of date medicines ?[/quote]

Unless it had mould growing on it or it had all precipitated out and was 10 years old, erm...yes.[/quote]

Well, you're taking your slavish devotion to Lance Armstrong too far......

Re: locum trouble?

Anthony Dennison — Fri, 26 Oct 2012 14:53:31 GMT

most bottles of water have an expiry date on them too. mental.

Re: locum trouble?

Mark Holmes — Fri, 26 Oct 2012 14:46:25 GMT

[quote user="Hannah Wynne Richards"]

Here there's even an expiry date on salt Na Cl has sat in the earth for milenia-dig it out and it suddenly becomes perishable-or so whoever thought up that ridiculous piece of over-regulation thinks

Wynne

[/quote]

I thought an expiry date on pentobarb was silly but natural minerals beats that.

Re: locum trouble?

Hannah Wynne Richards — Fri, 26 Oct 2012 14:43:37 GMT

Here there's even an expiry date on salt Na Cl has sat in the earth for milenia-dig it out and it suddenly becomes perishable-or so whoever thought up that ridiculous piece of over-regulation thinks

Wynne

Re: locum trouble?

Tim Cheyne — Fri, 26 Oct 2012 14:23:01 GMT

[quote user="patrick murphy"]

the human charities can't even use out of date disposables anymore

[/quote]

Doesn't that illustrate the nonsense of many expiry dates? To what extent does a properly packed unopened hypodermic syringe expire? In many countries an expiry date, often of a fixed period, is mandatory for import to, and resale in, that country. Out here, burrowing in a cupboard, I found an unopened carton containing a block of chalk with an expiry date; and that in a country built largely on limestone.

Tim.

Re: locum trouble?

patrick murphy — Fri, 26 Oct 2012 12:57:00 GMT

the human charities can't even use out of date disposables anymore

Re: locum trouble?

Anthony Todd — Fri, 26 Oct 2012 12:25:50 GMT

[quote user="bob lehner"] e.g. Big problems apparently with resistance to anti-malarials rising rapidly due to people using ineffective/counterfeit (and possibly o.o.d ) meds widely available over-the -counter in the third world.[/quote]

Sorry Bob, here we go, see what I mean...

We've certainly got resistance.

We've certainly got ineffective or counterfeit drugs.

So we extrapolate that to include o.o.d. genuine effective drugs because they may be ineffective when there is absolutely nothing else available for treatment.

Come on, at the expiry date the drug is tested to be 100%, at least, effective and who knows at what rate the drug deteriorates [the manufacturer certainly won't tell you!]

So some folk are refusing to use said "expired" drug because it may break some law or regulation in another country.

I repeat; bah, humbug!

Re: locum trouble?

plantagenet — Fri, 26 Oct 2012 12:20:45 GMT

[quote user="An On MRCVS"]Anon as the said person I think may use this site from time to time[/quote]

He/she is probably going to recognise themselves aren't they?

It wouldn't really bother me.

Re: locum trouble?

Martin Atkinson — Fri, 26 Oct 2012 12:16:30 GMT

Re: locum trouble?

bob lehner — Fri, 26 Oct 2012 12:07:39 GMT

[quote user="Anthony Todd"]I do think the "I certainly would not break the law" response is an extreme example of modern ethics, in that there seems to be an attitude which finds a reason not to do something ,which is obviously good, by way of reason which is obviously bureaucratic and always a cop-out.[/quote]

But what is actually 'good' about using a product which may not be effective. How long 'out-of-date' would you consider acceptable to use? Do you have the faintest idea as to how long beyond the expiry date (which the manufacturer has put there for a reason) efficacy remains ?

Would you be happy for yourself/family to be treated with out of date medicines ?

e.g. Big problems apparently with resistance to anti-malarials rising rapidly due to people using ineffective/counterfeit (and possibly o.o.d ) meds widely available over-the -counter in the third world.

We should use drugs responsibly and in accordance with manufacturer's instructions.

Re: locum trouble?

Jo Cobbett — Fri, 26 Oct 2012 11:58:14 GMT

Ethically and legally, I think selling out of date drugs would be wrong.

Giving them away is a different matter, and more of a grey area.

[quote user="Clive Ansell"]

What - even if it breaks the law? I may disagree with it, but I certainly would not break the law.

I've worked in 2 practices that have a box of out dated and opened drugs for selling cheap/giving to charity cases and clients with limited funds, sensible thing to do, but not sure how it stands legally?

[/quote]

Re: locum trouble?

Anthony Todd — Fri, 26 Oct 2012 11:44:31 GMT

"Put the charities animals first please, something even charities don't do sometimes"

Sorry the above should have read:

"Put the animals first please, something even the charities sometimes don't do"

I do think the "I certainly would not break the law" response is an extreme example of modern ethics, in that there seems to be an attitude which finds a reason not to do something ,which is obviously good, by way of reason which is obviously bureaucratic and always a cop-out.

Re: locum trouble?

Clive Ansell — Fri, 26 Oct 2012 11:32:38 GMT

[quote user="Anthony Todd"]

"I would use an out of date drug happily and enthusiastically if there was nothing else, or if limited funds had to go as far as possible"

Thank goodness! Common and humane sense at last!

Put the charities first please, something even charities don't do sometimes.

[/quote]

What - even if it breaks the law? I may disagree with it, but I certainly would not break the law.

Re: locum trouble?

Anthony Todd — Fri, 26 Oct 2012 11:14:41 GMT

"I would use an out of date drug happily and enthusiastically if there was nothing else, or if limited funds had to go as far as possible"

Thank goodness! Common and humane sense at last!

Put the charities animals first please, something even charities don't do sometimes.

Re: locum trouble?

Mark Holmes — Thu, 25 Oct 2012 20:54:06 GMT

[quote user="bob lehner"]

[quote user="Mark Holmes"]

[quote user="bob lehner"]

I believe the received view nowadays is that we should not be gifting out-of-date medicines to charities anywhere.

[/quote]

Yess well thats a silly view from somebody in an office somewhere trying to look important. Best ignore him/her and hope he/she goes away.

[/quote]

Well, perhaps not entirely without merit - you wouldn't use o.o.d products on your own patients, for obvious reasons. Should you really be giving something which may not be fully effective to a charity - do you know at what point beyond the expiry date the product loses efficacy ?

Just out of interest I had a look at the WVS website:

'Veterinary Supplies:
_{Please note that
to adhere to VMD regulations, veterinary practices must only send
medicines to WVS which are within their expiry date.'}

Perhaps if Luke is watching this he might have a comment ?

[/quote] I would use an out of date drug happily and enthusiastically if there was nothing else, or if limited funds had to go as far as possible

Re: locum trouble?

Jo Cobbett — Thu, 25 Oct 2012 20:31:55 GMT

[quote user="James Laidlaw"]

I don't do a lot of charity work so haven't felt the need to take drugs.

[/quote]

Is charity work really that bad?!

Re: locum trouble?

Anthony Todd — Thu, 25 Oct 2012 20:30:00 GMT

[quote user="bob lehner"]Should you really be giving something which may not be fully effective to a charity - do you know at what point beyond the expiry date the product loses efficacy ?[/quote]

So give nothing at all, don't want to break VMD regulations in a far off land with no drugs at all do we.

Bah humbug.