The newsweekly for pharmacy

February 7, 1987 a Benn publication

No surprises in

PGC s contract cash package Putfun into Rural pharmacy to suffer if ^ photography contract scrapped

Nathan explains PSGB Council's inner workings

GP dispensary falls at Bath planning hurdle

'No confidence' motion high on Guild agenda

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February?, 1987 Volume 227 No 5559 PGC gives details of Scottish contract cash details 184 128th year of publication ISSN 0009-3033 'No confidence' motion for Guild delegate meeting 185 Incorporating Retail Chemist GP dispensary falls at Bath planning hurdle 187 Editor: JohnSkplton BPharm, MPS NPA Board report: dismay at contract delays 187 Assistant Editor: Patrick Grice BPharm, MPS Rural pharmacy to suffer if contract is scrapped 188 Features Editor: Steven Titmarsh BPharm, MPS Personal opinion — Alan Nathan describes Councirs machinations 198 Technical Editor: Robert Darrarcit!, BPharrn, MPS Pregnancy & ovulation testing — special feature 209 Contributing Editor: Adrienne de Mont Introducing the quinolones — clinical matters 221 BPharm, MPS

Business Editor: Topical reflections by Xrayser 188 Letters 222 Nia Williams, BA

NPA Reporter Counterpoints 190 Business news 224 Liz Hunt BPharrn MPS Prescription specialities 195 Coming events 225 Beauty Reporter: Frances Qumn, BA Clinical pharmacy: CNS pt 3 218 People 230 Art Editor: Jack Parker

Price List Controller: Colin Simpson COMMEN Advertisement Manager: Peter Nichohs IP Council member responsibility". He suggests that Assistant Advertisement Alan Nathan's the scope of the information Manager: explanation of the available to Councillors can, of

Doug Mytton structure and day- itself, distance decisions from

Production: Shirley Wilson to-day workings of the grassroots understanding. It is Pharmaceutical Society of Great also evident from what he says Publisher: Britain's governing body is that the grassroots must make Ronald Salmon FPS clear, concise and constructive much more effort to cajole,

Director: (p200). However, it is his second coerce or lobby Councillors to Christopher Leonard-Morgan article (p204) that members will make their views known. There is doubtless find the most no merit in a silent majority. enlightening. Together, they Council faces an ever give a refreshing perspective on increasing workload — witness the opportunities and difficulties whitewash by the British the great swathes of facing the 21 good men and Pharmacists Association with documentation produced by women and true, culminating in some vigorous PR. The Society, Nuffield and the Primary Health Published Saturdays a bold solution to the challenge for the most part, has waged an Care paper alone — a workload by Benn Publications Ltd decisions health requires the support and Sovereiqn Way, Tonlindqf, of making Council effective war on the which KentTN9]RW relate more closely to the views decision makers in committee involvement of all pharmacists, Telephone: 0732 364422 of the majority of members — and in private, without raising its not just the activists personified Telex: 95132 Benton G referenda on major issues. head very far above the public by Mr Nathan. Not until the Facsimile. 0732 361534 One of the barriers to the parapet. It can and should do membership appreciates its understanding of those decisions more here, and has both the Councillors more; not until the

is, on occasions, poor opportunity and the means, if it ordinary pharmacist is enabled Subscriptions: Home £58 per annum. of Overseas & Eire £72 per annum in- communication both within and has the will. As Mr Nathan says: to make the sacrifice time and cluding postage. £1.20 per copy without the profession. The "Pharmacy today is confronted money necessary for Council (postage extra). Member i . of i Society has not always been by the most crucial challenges m membership these days; not until ol the Audit Bureau of I I

outgoing its 150 history . . . Strength pharmacists Circulations open and m year many more representing the pharmacy and unity of purpose are, communicate with Council —

standpoint in the public, rather therefore, absolutely essential if indeed with fellow members

Regional advertisement olficeB; than just the healthcare arena. we are to survive and prosper." through the branch system — MidlaiKb: 240 244 Stratforo Boad, Slin.ey, Of late the National Pharma- Mr Nathan explains how will the powerful argument that Solihull, W Midlands B'X) lAE 021 744 4427. North Edsl and North West Graeme ceutical Association has been former firebrands can be he puts forward for referenda on House, Chorlton Place, Wilbrahatn Road. maltmg most of the runnmg, with swallowed whole by Council, major issues get Manchester M21 lAO 061 8SIU112 West latterly the Pharmaceutical their bold flame be all but the credibility \\ Country & South Wales 10 n and \^ Badminton Road, Downend, PdlTt Services Negotiating Committee extinguished by the sometimes and hearing it Bristol BS 1 6 6BO 0272 S64827 responding to a national Press onerous burden of "collective deserves.

Chemist & Druggist 7 February 1987 183 NEWS

No surprises in PGC's contract cash package

how to apply have yet to be settled. The Pharmaceutical General The on-cost rate will be set at a flat rate Council has given details of the for all contractors, calculated on the gross remuneration package agreed with ingredient cost (before discount the Scottish Home and Health deduction). The PGC calculates the

Department. It includes a two-tier average gross ingredient package for Essential Small Pharmacy Scheme, 1987-88 will be 485p, giving an average on-cost of 29. per script. It looks as if a flat on-cost rate at 6 per cent of Ip fees will be paid at the rate of about llOp gross ingredient cost, and a per script for the first 1,300 scripts and compensation scheme for those in thereafter at 60p, but exact figures are not contract since 1985 June and yet available because negotiations have dispensing less than 1 ,300 scripts a not been completed on the precise amount month. of money due m the balance sheet, says The compensation scheme will run for the PGC. two years. To be eligible contractors must The PGC says that because there is a have been continuously on a Health Board higher number of ESPs m proportion to the Over exposure list since June 7, 1985, and to have total number of contractors in Scotland "Brits abroad" are often all too dispensed on average less than 1 ,300 compared to England and Wales, they obvious, and the National scripts a month in the 12-month period cannot be supported to the same level. Pharmaceutical Association's latest prior to applying for compensation. Secretary Colin Virden says the SHHD advertisement offers a painful The PGC warns that contractors who had made it quite clear that if contractors satisfy the criteria will not have an continue to lobby for a guaranteed reminder of the effects of careless automatic right to payment. Health Boards payment the Department will insist on a exposure. can award compensation bearing in mmd rigid application of the 2km rule: the result In an abrupt departure from the bucket their duty to provide an adequate would be the loss of ESP status for nearly and spade theme of the 1986 poster, this

pharmaceutical service. Payments will half the existing pharmacies. advertisement is reminiscent of the "bare only be made where a replacement Pharmacies dispensing between midriff" one which provoked some adverse pharmacy is unlikely to be justified. 1,300-1,800 scripts a month, although not comment from pharmacists. But Andrew The probable amount of compensation directly in the ESPS, will be paid at a level Carnegie, a director of the NPA's agency

will be equal to the amounts paid as fees which reflects their current income plus an advertising CTMC is confident that it is and on-cost over the best 12-month period essential pharmacy allowance. Whether unlikely to be controversial or offend from July 1, 1984. The sum will not be payments are made separately or included women pharmacists or the target audience greater than that paid at the time of giving m the fees has yet to be determined, but of housewives. "I think this sort of imagery

up a contract to an average contractor they will be no worse off. IS acceptable although there are those who

dispensing 1,300 scripts a month. For pharmacies dispensing up to 1,300 may feel it is exploitative. It was necessary Contractors who give up their contract items a month a sliding scale is proposed: to show enough to bring the message in the 1987-88 financial year will receive for each 100 scripts (or part of) below the home". the whole sum, those giving up in the next 1,300 level, a sum of £75 would be The advertisement was approved by

year half the amount. Exact details as to payable, to a maximum of £600 a month. the NPA Board members last week. And it

may reach the television screen if negotiations with the Independent Television Companies Association are successful {C&D, January 17, p72).

PGC: Suggestions that the new contract could be introduced unilaterally only in Scotland should negotiations in England and Wales break down have been dismissed by the Pharmaceutical General

Council. Concern that if legislation does PCS tC|C|7 not go ahead in England and Wales, then

it could not be implemented separately m Scotland was not a "notion" of the PGC as has been suggested {C&D last week, pl510), said chairman Ian Mullen this

week. "It IS a considered opinion based on information from the highest Department sources and advice from our constitutional experts". Chemist & Druggist 7 February 1987

"Do you think we're still right to call this the new contract, Mr Chairman?" li new;

have to consider it on Sunday morning PSNC and DHSS before the LPC conference and decide No confidence

what recommendation, if any, it would still deadlocked wish to make," said financial executive high on agenda Mike Brining. Despite further meetings this week "It does not imply the negotiating A motion of "no confidence" in the between pharmacy negotiators and process would conclude with that letter. It hospital pharmacists pay of Health there has the Department may be that conference would wish to send negotiating team looks set to be the been no break in the deadlock over the PSNC back to the negotiating table most contentious item on the introduction of the contract. the new with further instructions. We have again agenda of the Guild of Hospital PSNC officials met with the DHSS on pressed our various arguments and made Pharmacists branch delegates Monday and Wednesday, and were it clear that some movement on the meeting this Saturday. expecting a letter from the Department as Department's part before the conference is The motion, tabled by the Sheffield a result by the end of the week. "PSNC will vital," he said. Group, reflects concern about the enthusiasm with which the staff side of Eyes down for NI scheme. He wanted to see an Essential Whitley Council recommended Small Pharmacy Scheme introduced for acceptance of the final pay offer, which The Pharmaceutical Contractors the first time in the Province; one that many hospital pharmacists saw as only a would properly remunerate those small marginal improvement on previous, Qjmmittee in Northern Ireland is pharmacies recognised as "essential" to decisively rejected offers. expected to approve the contract the community under the new contract. Recruitment, grading and allowances regulations and guidelines this There would also need to be a significant are on the agenda, and the 1987 pay claim week before preparing for hard change in the global sum. will be presented to delegates. Guild (NI) negotiations with the DHSS on president Bill Brookes may also wish to a cash package. take the opportunity to gauge opinion on Secretary Mr Thos O'Rourke told C&D the proposed merger of ASTMS, of which Contact plus • • • that the guidelines said the PCC would the Guild is one section, with another advise the DHSS on the appointment of a white collar union TASS. non-contractor member of the pharmacy only, soys North practice subcommittee: he anticipated this Northern contractors continue to might be done in consultation with the vote strongly in favour of Complainaway Pharmaceutical Society of Northern implementing the new contract Ireland. Patients are reminded of their rights to only if the additional items sought Mr O'Rourke said he expected the NI complain about the standard of service cash package to differ markedly from that by PSNC are included. from NHS professionals by this month's negotiated for Scotlai d (see pl84). In NI Only 15 of the 269 replies received in Which? magazine, published by the there was a higher proportion of small response to an unprompted questionnaire Consumer's Association. pharmacies and they would not be able to sent out to 536 contractors wish to see the The article "Patient's orders" goes on recover their costs under the Scottish implementation of the new contract as it to explain exactly how to complain about a now stands. GP. Premises up Register up, up and away another 50 • 12000 The Pharmacists Charter trst introduced the concept ol rational The number of premises on the 11900 location through hnancial incentives, and the "new contract" of Pharmaceutical Society's Register May 1 985 was to do just that, with its compensation scheme and 11800. rose by 50 in December. The fourth loading ot fees against smaller pharmacies. However, rise of 50 or more in as many months 11700. at the beginning of February 1987, PSNC still has no cut-off date in England and Wales, no agreement takes the total to 11,748, up 312 in 11600. on a final package, and as the graph illustrates, an acceleration 1986. m the opening of new premises. As the graph on the right indicates, the /v^ AY '85 increase in the number of pharmacies, New confract from a post-war low in 1980, has been announced / fuelled by the announcement of the new / APR/t'84 contract with its proposed entry . / Pharmacists restrictions. Over 650 pharmacies have Charter been registered since May 1985. In December, England (excluding London) had a net increase of 43, with 47 additions, one restoration, and five deletions. Scotland had five additions, while the Welsh total was unchanged, with one addition and one deletion. London -i 1 1 1 h was up two overall, with five additions and three deletions.

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THE COMPLETE SERVICE FOR INDEPENDENT PHARMACISTS *Here we go, Difficulties for I here we go, GFs dispensary

A Bath doctor's plan to open a • . .7 here we dispensary at his surgery has been 'Something for everyone!' is the theme for turned down by the City's planning A muted chorus of "Here we are the NPA Show in St Albans on Sunday, committee. again" was Board members' June 21. Peter White, the show organiser Although the decision has to be reaction to news that no agreement (centre) is briefed by business services ratified by the full Council on Febmary 10, had been reached by the DHSS and manager John Goulding, and his assistant the PSGB's Bath Branch chairman Tom the Pharmaceutical Services Christine Houtman Moles is delighted with the outcome. Negotiating Committee, on Pharmacists in the city had, in fact, of the Leeds, reported that increasing financial aspects new faced the prospect of three new Government strictures and financial contract. competitors. One application to open a constraints would make it impossible for And the Board predicts "genuine and pharmacy in a Georgian building next to a the NPA to continue as a management justified anger" from LPC representatives doctor's surgery was withdrawn before the agent under YTS. The Board agreed that at their forthcoming conference if planning committee met. A second, next the NPA should withdraw from the scheme negotiators are unable to report further to the proposed doctor's pharmacy in as a management agent, and act only as a progress. It is felt that the delay is due Oldlield Park, was rejected by the link between commercial managing entirely to the dilatory attitude of the planning and highway department. agencies and those NPA members who Minister or the civil service for which there The same department recommended wished to participate in YTS. was no excuse at this late stage. that the planning committee accept Dr Reports that FPC administrators were NPA Clearing House Don Ross Derek Walker's application to open a "jumping the gun" and threatening (Lincolnshire) drew the Board's attention dispensary, but, says Tom Moles: "We delaying tactics even before their grading to adverse Press comment about delays in managed to convince them that such a and remuneration had been considered by the operation of the Clearing House in dispensary can only be registered as a the Whitley Council, were also relayed to December. NPA finance officer, Brian retail pharmaceutical business, so must be Board members at their January meeting. Dosser, said that the timetable for the treated the same way as the application to It was agreed that the Board's concern December Clearing House had been as open next door, and that was tumed down would be conveyed "urgently" to PSNC. usual. But the holiday shutdown may have because the highways department didn't Gansumer Protection Bill Director Tim triggered "stop" procedures in computers. want to encourage retail development in a Astill reported that he had had But there was no justification for residential area." considerable correspondence with a withholding supplies merely because he number of Peers as the Consumer had paid his account as usual through the Protection Bill went through its committee Clearing House in December. Copmanthorpe stage in the House of Lords. Mr Astill said NPA Shovs^ '87 Further plans were he intended to ask one of their Lordships to announced for the Show to be held in St fights on table an amendment at the Bill's Report Albans City Hall on Sunday June 21. The Stage confirming that pharmacists would organisers would shortly open a waiting The two-year fight for a pharmacy not be regarded as "holding themselves of list for gtand space. A subsidy would be in the Yorkshire village out as producers" if their name and offered to Branches or Regions prepared Copmanthorpe continues, with the address appeared on the label of a to organise a coach to the Show. local Community Health Council dispensed medicine. Corn solvents and diabetics A letter from reaffirming its support for Leeds Mr Astill also reported that he had the British Diabetic Association had pharmacist Colin Parker's bid. attended a number of consultation expressed concern that diabetics were not in meetings with the Consumer Affairs In 1983, doctors nearby Tadcaster receiving warnings about the dangers of were granted permission to dispense to Minister, Michael Howard, as a member of pads and solvents. The patients in the delegations from the National Chamber of com com BDA Copmanthorpe, and when suggested having such products made discussed in Trade and the Retail Consortium. At a had RDC Mr Parker's application POM. The Board agreed unanimously that things meeting attended by representatives of the November 1985 they decided had this would not be an appropriate it Consortium, the National Consumer move not changed sufficiently for to be because of inconvenience for non-diabetic considered within five of doctors' Council, the National Federation of years the patients, it was unlikely that such ie Consumer Groups and the co-ordinating and a application, before 1988. proposal would be acceptable to the In letter to the body for Local Authority Trading a Yorkshire Family Government on financial grounds. Practitioner Standards Officers, concern had been Committee, reported in the Yorkshire Evening Press, secretary expressed about the complexities of the Pharmacy Mutual Insurance Company CHC Hargreaves the proposed Code of Practice for pricing PMI manager, John Hart, reported that Don repeated Council's earlier opinion: "In view of the distance bargain offers. A joint approach was being insurance companies and similar financial from the nearest established pharmacy made to the Mmister, and it was hoped that institutions in the South-East of England strong support for the provision of a the final version of the Code would be were experiencing difficulties in in shorter, easier to understand and protect recmiting middle-management staff. PMI pharmacy Copmanthorpe should be retailers against legal loopholes. had been short of key staff during the expressed, principally because of the extensive residential development in the Youth Training Scheme NPA training transition from the old shop policy to the Immediate area and the likelihood of officer Ailsa Benson, and training sub- new "Pharmacover", and it had not been committee chairman, Leslie Calvert, possible to maintain the usual efficiency. continuing development." Chemist & Druggist 7 February 1987 187 M ^NEWSM ™ TOPICAL REFLECTIONS by Xrayser

Delay threatens advertising campaign has produced a A new deal? greater awareness of our availabiUty, with the great British pubhc just beginning to rural pharmacy There is to be a conference of Local catch on. I'm beginning to wilt already. I

Pharmaceutical Committees on Sunday. A didn't reahse how tight a shop I ran. But Delay in the implementation of the vast expenditure of time and energy and not getting through the routine work contract as agreed in June 1985 will money so that our representatives, or because of "interruptions", no matter how seriously impede the adoption of rather, contractor representatives can ego boosting, is causmg me to wonder recommendations in the made "chew the fat" about what they would hke about staffing levels when there is no Nuffield report and the Primary in the new contract. From a reading of the visible increase m turnover. With the

Health Care paper, according to an resolutions it is my opinion that some of report of the course held at St George's RPA sponsored report. them are close relations to "pie in the sky". Hospital, London to discuss ways The report — "The distribution of The reality? The Government wanted pharmacists could tackle drug abuse, I'm medicines and chemist sundries in rural to reduce the numbers of pharmacy beginning to wonder at which point the areas" — has been written by Professor contractors. We objected to the increasing retail pharmacist wlU start to baulk. All this Marsland of Brunei University, at the number of leapfroggers. What more help on so many drug related themes, instigation of RPA member Keith Jenkins. natural than to strike a bargain producing whose spectra take in all the paid and An essential finding of the survey is a reasonable, calculated saving, while voluntary social services will require locaJ that negotiations between PSNC and the conferring a degree of security for directories in hardback folders, if we are Department of Health have concentrated contractors — both those already to do justice to our pretensions. on the distribution of pharmacies, and established, and those who satisfied the ignored dispensing doctors whose new criteria for openings. Who could have Idiots all surgeries constitute 3,000 extra dispensing foreseen the Government being bluffed or panicked into a two year delay by groups points, says Mr Jenkins. Tom Wilson of Kent tells the tale of the who didn't want restrictions, which has If these are phased out over the next dispensing doctor patient, unable to get to utterly destroyed the basis on which the five to ten years through the appropriate the surgery for his drugs, who called at the agreement was made? working of the Rural Dispensing pharmacy for help. The surgery, on being AU we are left with is a confusion. I Committee and pharmacy practice 'phoned, asked the pharmacist to supply, would have thought it time to call a halt to subcommittees, extra rural pharmacies but instead of forwarding a script to cover, this shambles and start again. I suggest it is could be established and present ones sent the patient back with replacement the ultimate futility to waste any time enlarged to provide pharmaceutical stock. talking about what we fancy, when the services to a catchment area of It happened to me too — but only resolutions themselves are sufficient 5,000-6,000 residents. once. After that I invariably asked to have indication to the PSNC about how we feel. "The operation and distribution of a script sent to me "since I was not able to The meeting should be reconvened when pharmacies is affected less by the opening dispense a NHS supply without a written

there is something to discuss . . . of 1,000 urban premises than the prescription". A colleague, faced with the continuation and increase of doctors same proposition, sent a letter and a bill dispensing . The financial effect of this has for services rendered to the GP, pointing been estimated as a saving of £20m a year Cold catching out that having accepted a 'phoned script through the new contract. Uncovenanted in good faith, its non receipt was a breach Aren't I a siUy! Fancy my not realising that profits of 3,000 dispensing doctors of contract. Benylin has nothing to do with Parke probably account for another £20m." Davis, although they made it and Mr Jenkins argues that increasing the marketed it for at least 40 years, but rural dispensing Umit to three miles should Why buy? belongs to Warner Lambert Health Care! produce enough extra revenue to be able (see p222) But then who would have The headline read "Pharmacists as to eliminate essential small pharmacy thought of sending 11,000 retail chemists a profiteers?" Apparently pharmacists are payments within five years. note telling them that if they wanted Parke seen by consumer groups in France, Davis prescription items they would have Germany, and the UK as determined to to spend £1,000 per order to get 10 per recommend the expensive brands. This, Tax alternative cent discount, when practically every by consumers over the age of 40. Other interesting conclusions from the Prescription charges should be retailer contractor will be picking up about 5 per cent on day-to-day orders via consumer discussions were that price was replaced by direct taxation, or an his wholesaler. It is doubtful whether more most important. Yet in the UK people were increase in national insurance than a handful would be in a league big prepared to pay 30% over the odds for contributions, says the National enough to contemplate direct orders recognised branded products! Advertising Pharmaceutical Association in its remotely approaching the size demanded. was not seen as an important factor. formal submission to the DHSS on While advertising may not have been the Primary Healthcare document. perceived as important by the buyers it is of product is Such a system would be a more imphcit that their choice Addictive? In which case "equitable way" for the Government to conditioned by advertising. the price is taken as being part of the recoup NHS costs, it suggests. Giving advice is seen as part of our job it happens my ethics do not The NPA is also calling for at least one and not unnaturally we are looked to for package. As pharmacist on the organisation replacing help on drug abuse and addiction. But point me towards high-priced items as in any sales, customer the Health Education Council. The basis of increasingly I am finding the advice such, but making must play a large part in their this submission is given in the NPA's July workload biting into my time. preference

Board report {C&D July 5, 1986). There is no question about it. The ultimate choice. 1987 188 Chemist & Druggist 7 February Since when did this range extend

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Calvm Klein are introducing an Obsession for the body range m March. All oval shaped and m amber and gold For you, dirty rat! colours, the range includes bath soap Gerhardt are introducing a rodent killer (£9.50, 4.5oz); foaming bath crystal and insect powder. (£27.50, 7oz), and body cream (£37, 5oz). The Bromadeth all weather rat and Distributed by: Pascal! Ltd, Warton mouse killer (£2.49) is packed loosely and House, 150 High Street, London E15 2ND. needs no mixing with other materials. And Dethlac ant and insect powder (£1.19) is designed to destroy home and garden A face in the sun pests. Both products should be kept away from children and pets, say Gerhardt Philips have launched a new face and Pharmaceuticals Ltd, Thornton House, shoulders UV-A solarium, model no Now concentrate Hook Road, Surbiton, Surrey KT6 5AR HP3205. It features six 18in UV-A tubes Tabac Original men's fragrance is now which tan the head and shoulders. A timer available m a concentrate form. and session memos are included (£79.95). Dettol book it up The eau de toilette super concentrate Philips Home Appliances, City House, (£9.50, 100ml) comes in an opaline glass 420 Croydon Road, Croydon CR9 3QR. Reckitt & Colman are offering a free child flask with a natural spray and is available care book with proofs of purchase from m a display. The range is being backed by Taylor of London are offering a sachet of Dettol until the end of August. Promotional consumer advertising later m the year, say foaming bath seeds covermounted on the packs will be available from March 2, from distributors: Eylure Ltd, Grange Industrial March issue of Annabel as part of the Reckitt & Colman Products Ltd, Estate, Llanlrechia Way, Cwmbran, promotions planned for their centenary. Pharmaceutical Division, Dansom Lane, Gwent. Taylor of London, The Dean, Alresford. Hull HU8 IDS.

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For eyes

Blackmores are introducing a Cornflower

eye balm (£3.20, 30g). It is a water based gel containing cornflower and eyebright extracts and arnica. Available from March Barry M bring 23, it will be backed by magazine Kodak make advertising, say Blackmores Laboratories Ltd, Poyle Tech Centre, Willow Road, out three it snappy! Poyle, Coinbrook, Bucks. Barry M are introducing three new products to their cosmetic range. Kodak hope to change from a "sleeping, Foundation creme (£2.95) comes in retreating, monopohst" into an twelve shades, ranging from a dark shade "aggressive, major competitor" in 1987. Classic looks claimed to be ideal for black skins, Their first onslaught begins with a Well-groomed but understated is the look through to white, which can double as a package of Spring and Summer for Spring, according to Elizabeth Arden, cover-up for dark circles and broken promotions. to be achieved with their new shades: veins. The product is cartoned and The "find the Kodak pot of Gold" neoclassic pink, coral, peach or magenta packaged in a black plastic tub. competition is featured on sleeved twin for hps and nails, with lips highlighted by Barry M eyeliner is available in 12 packs of Gold film m 135, 110 and 126 twist of gold glossover, and steel blue/pale colours, three conventional and nine jewel formats, and the first prize is £10,000. The pink or graphic grey/graphic steel for colours, in a transparent case with silver closing date is June 30. Gold film is also to eyes, finished with lilac slenderline pencil. cap and synthetic brush (£1.75). be promoted in television advertising. Elizabeth Arden Ltd, 13 Hanover Square, contour The second major consumer And Natural Dazzle brush-on London WIROPA. dust is now available in a solid compact competition offers a prize of a Jaguar XJS form, in a slim black case with a mirror cabriolet car and an XJS coupe for an (£5.95). A display box is available, independent dealer. The competition, holding 18 units plus a tester. None of the called "put a Kodak camera to the test," is Maybelline all products have been tested on animals. to be advertised in the TV Times with the Barry Mero Ltd, Unit Bittacy Business, chance for trade dealers to feature in at sea 1, BittacyHill, Mill Hill East, London NW7. regional advertisements if they put in a Maybelline's Spring make-up shades are minimum order for Kodak cameras. based on South Sea colours. Kodak also plan a national photographic A new split colour lipstick called competition, "snap to it", to be run as a PR Care-ful change colour fusion (£1.55) is available in Papaya exercise through the Press. shine and Anemone shine and nail enamel The Kodak 35MD camera is being Clairol are revamping the packaging of (£1.55) now comes in coral reef and sea launched at around £65 to fill a gap in the their Loving Care haii colourant. urchin; single shadow in sunbaked company's range of compacts. In the same (£1.65) A new slim-line plastic bottle with

peach sunkissed lilac ; kohl styhng as the AFl, the 35MD features an and eye pencil applicator cap replaces the glass one, and (£1.45) in palm green and paradise pink, f4.5 pre-focussed lens, motor drive, it is now packaged in a taller carton with and brush blush (£2.40) in soft mango and electronic flash, automatic film speed the Clairol name strengthened and the "no cassis. Distributed by; setting and automatic exposure. Rimmel ammonia, no peroxide" claim on-pack. International Ltd, 17 Cavendish Square, In an attempt to compete directly with This comes in conjunction with current London WIMOHE. own brand films, Kodak will be selling television advertising, which will be their VR (value range) film at £1 .99 in 24 repeated later in the year. Distributed by: exposure sizes of the most popular films — Bristol-Myers Co Ltd, Swakeleys House, CLllO, CL126, CP135 and disc (twin A Maja package Milton Road, Ickenham, Uxbridge UBIO. packs of disc film will retail at £3.79, says the company). For Kodachrome and RDM are offering two new merchandisers Ekiachrome the "save at least £1.50" on and an introductory package to promote Dark deeds twin packs offer is being repeated. the Maja range, with reduced product Lastly, there are vouchers with Kodak prices and retailers' discounts. Morgan's Pomade are introducing a hair E180 video tape offering a free bottle of The merchandisers contain twelve bath darkening mousse (175ml, £2.10). They wine with a Beefeater or Stakis meal for soaps (£1.85, 150g) with free travel have also repackaged their hand cream two. The promotion is to run from March to containers, 18 eau de toilette atomisers and moisturising cream into 75ml tubes, June. For retailers ordering a stock box of (£6.85) with £1 off each and with a tester which sell at the same price as the previous 40 tapes there is a voucher for a free bottle provided. And the introductory package, 50ml jars (£1.38). Morgan's Pomage Co of champagne with a meal for four at with 10 per cent off trade price (normally Ltd, Colewood Road Industrial Estate, Beefeater or Stakis restaurants. around £80) and containing free display SwalecliHe, Whitstable, KentCT52RT. The business development plan for material includes: 25g soaps (£0.25 each); retailers continues this year offering 20 75g soaps (£4.20, pack of three); 150g Wella are offering 20 per cent extra free Kodacolour VRl 10 films free with orders soaps (£5.85, pack of three); parfum on Shock Waves super firm gel and styling of 200 Gold films delivered between atomisers (£11.75, 30ml); talcum powder creme, and their Hard Rock hairspray is February 23 and May 15. Kodak Ltd, (£2.25); shower gel (£3.75) and body lotion on offer with a free banded-on handbag Kodak House, Station Road, Heme! (£3.75). R.D.MLtd, Bath Gardens, size. Wella Great Britain, Wella Road, Hempstead, Herts. Bakewell, Derbyshire DE4 IBT. Basingstoke, Hants.

Chemist & Druggist 7 February 1987 193 iCOUNTERPOINTS

men buy women's fragrances, men at least

twice a year. But it is men who are best off

when it comes to gifts. With 66 per cent of women buyng fragrances for them, they

are top of the list for receiving scent, with

wives second and mothers first. About 33 per cent of people use one brand regularly, says the report, many women keeping a special one for the evening. Nearly half of consumers are happy to buy new brands, but one third, Insignia down particularly the young and single, prefer a line with matching toiletries. on the farm Television, it says, is the most Pacified in the important source of information about Shulton are offering new display material fragrances. Yorkshire Television, for Insignia, and the chance to win Television House, 32 Bedford How, holidays at a health farm. First Years London WC1R4HE. The new POS material comprises a window card and a counter card, plus a The First Years have introduced a range of Jenks Brokerage are now responsible for to hold the whole one-piece paciiiers. The clear natural merchandiser designed the distribution of Hermsetas products in It will available to Insignia's top coloured vinyl paciiiers are 100 per cent range. be the chemist trade. Jenks Brokerage, stockists, say Shulton. nitrosamine free with soft nipples. The Castle House, Desborough Road, High unit features secret irritations and has The counter two pliable shield prevents Wycombe, Berks HPll 2HS. numbers, and retailers whose numbers been designed to pull inwards to keep match up to those held by their territory growing teeth in proper alignment. will a weekend for two at The range comprises a one-piece manager win ON TV Henlow Grange health farm in Berkshire. pacifier (£0.55); one-piece Kip There are three weekends to be won orthodontic pacifier (£0.65); and a one- April, three more piece newborn Kip orthodontic pacifier NEXT WEEK during March and and in July August. All the pacifiers are sterilisable and (£1.15). GTVG.amp.an UUlslei STV Scotland (cenlial) Pharmacists stocking and displaying dishwasher safe. The pacifiers are B Bordei G Granada and CCenltal A Anglia YYorkshue Islands TSWSoulhWest HTV Wales & West the counter unit throughout the incentive blister onto colour coded small CTV Channel packed LWT London Weekend TTV Thames Telev.si 3n TVS South TTTvneTces period will qualify for entry to a draw, with square cards for display. Scuba Marketing, C4Channel4 Bt TV-am prize of one week at Henlow Grange and 93 Canning Road, Wealdstone, Harrow, a Aapri wash cream: All areas, C4 of will be given Middx. two free bottles aftershave Actifed: All areas except Ulster away each time the territory manager Askit powders: GTV,STV calls, if the unit is correctly stocked. Atrixo: All areas, C4,Bt Shulton (UK) Ltd, Shulton House, Bonylin day & night: Y the Alexandra Court, Wokingham, Berks. Hogging show Benylin expectorant/paediatric: All areas, C4 Clairol Loving Care: AU areas, C4(C,TVS,U) Ronbinson's baby foods are spending Complan: All areas £500,000 m the first half of the year on a Contac400: STV,G,C,TVS,LWT,C4, new natonal campaign on TV-am to (LWT,TVS,C,G,STV) Blue period support the relaunch of their dry baby Cymalon: GTV,STV,A,LWT,TTV,C4 Gillette UK Ltd are running promotions on food range. Dimotapp: All areas their Blue II range and Contour Plus, in The new 40 second commercial Fisherman's Friend: All areas February and March. entitled "My friend John" features Spikey Hill's Balsam: U,G,Y,TT Y,C,TVS,LWT,TTV Added value packs of Blue II are the hedgehog who is also used in specialist Junior Paraclear: Karvol: All areas available 6 for 5 — and 12 for 10 — with Press advertising. It is the first time Kleenex Velvet toilet tissues: All areas "Step into the blue" television advertising. Robinsons have been on TV since 1984 All areas Listerine: A trial pack of a Contour Plus razor and and the first burst runs until May. A further STV,G,C,HTV,TSW,LWT,TTV Mu-Cron: two blades (£0.79) will also be available for burst is for later in the year. planned Nurofen: All areas a limited period, say Gillette UK Ltd, Caimans of Norwich, Carrow, Norwich. Optrex: All areas Great West Road, Isleworth, Middlesex. Paracodal All areas except LWT,TVS,Y,U,G Peaudouce Babyslips: Bt Robinson's babyfoods: Bt Yorkshire nose Robitussin: All areas Sanatogen: All areas, C4, Bt An alternative about fragrance Seclodin: A Sensodyne toothpaste: All areas egg Over 95 per cent of women in Yorkshire except CTV,C4 use fragrance, 50 per cent daily, and over Simple skin care: C4 Sunwheel Foods Ltd have introduced a lOOg half the purchases are made in chemists. Sinutab: All areas Kalibu carob Easter egg. Each egg GTV,STV,BTV,G, These figures are reported in a Solpadeine: (£1.99) contains 30g bag of carob and C,A,HTV,TSW,TVS raisms. Yorkshire television survey, which also yoghurt coated peanuts and LWT,TTV,TT,C4 Ltd, House, points out that 70 per cent of users buy for Sunwheel Foods Granary Strepsils: All areas themselves. Wetmore Road, Burton-on-Strent, Veno's Night Time: All areas Three quarters of women and half of Staffordshire DEM 1 TE.

194 Chemist & Druggist 7 February 1987 COUNTERPOINTSI

SEATONE

WLHC tonic in Cold comfort the Press The Wellcome Consumer Division is launching a radio advertising campaign Warner Lambert Health Care are for its Sudafed range, with emphasis on supporting Metatone tome with a £650,000 the cold and flu tablets. Seatone is now available in a 330 capsule Press advertising campaign. The advertisements will be broadcast pack (£16.85). Free copies of "Relief from Running through until April, Metatone on Capital, Piccadilly, Clyde and BRMB arthritis, the natural way", which details master paintings advertising will feature in in Birmingham to reach an estimated the use of the mussel extract in the magazines like Woman 's Own, Family audience of 16.2 million. The campaign, treatment of arthritis, are available to Ciicle, She, Prima, and newspapers with actor Peter Barkworth, will feature 35 pharmacists from Dietary Specialities Ltd, including the Daily Mirror, Sun, Daily spots per week on each station until March DSL House, 159 Mortlake Road, Kew, Star, Sunday Express 22. The Wellcome Foundation Ltd, Crewe and supplement. Surrey TW94AW. Warner Lambert Health Care, Mitchell Hall, Crewe, Cheshire CWl lUB. House, Southampton Road, Eastleigh, Hants SOS 5RY. PRESCRIPTIO: SPECIALITIES

Not for softies peppermint flavoured granules containing 1 per cent carbenoxolone sodium Brolene eye drops have been reformulated Coming off Uses Treatment of aphthous mouth ulcers and now contain benzalkonium chloride Dosage One level 5ml spoonful of solution BP 0.01 per cent v/v. benzodiazepines granules (2g) dissolved in 30 to 50ml warm Like all preparations containing water and used as a mouthwash three times benzalkonium chloride, Brolene eye drops A course of treatment aimed at weaning daily and at night until ulcers have healed. should not be used m patients who wear patients off benzodiazepine hypnotics is being introduced Mouthwash must not be swallowed soft contact lenses, say May & Baker on February 12 by Adverse effects None reported. Blood Pharmaceuticals, Rainham Road South, Farmitalia Carlo Erba. levels of carbenoxolone insignificant Dagenham, Essex RMIO 7XS. The temazepam capsules Planpak following use of the mouthwash. However, (£8.57 trade) consists of six colour-coded the daily dosage of carbenoxolole (80mg) strips each containing seven capsules of in the mouthwash if infested may, in temazepam in reducing doses. For the first Dramamine elderly patients and those suffering from two weeks the patient takes one cardiovascular, renal or hepatic disease, temazepam lOmg capsule every night, for cause sodium and water retention, agent out the next two weeks a 5mg capsule every increased blood pressure and night and for the last two Dramamine travel sickness tablets are weeks 2mg per night. hypokalaemia being reformulated to exclude tartrazme Supply restrictions Prescription Although withdrawal symptoms are only colouring agent. The new white tablets will Packs Tubs of (£9.20 trade) minimised by this gradual reduction, 50g be phased in to replace existing stocks. the A Product Licence 0181/0029 company believes that patients will still minimum trade bonus of 15 per cent is Issued February 1987 need counselling and support from their available until March with new POS Further information doctor pharmacist, Manufacturing material available shortly from Searle and and leaflets are Biorex Laboratories, Bioplex is available to help. being reps, Searle Pharmaceuticals, Whalton promoted to hospitals only at present. Road, Morpeth, Northumberland. The pack is also being recommended as a course of short term therapy for sleep Ayerst Laboratories apologise for disturbances. Farmilalia Carlo Erba Ltd, Merieux's mono difficulties retailers have experienced in 23 Grosvenor Road, St Albans, Herts ALl obtaining supplies of BC500 effervescent, SAW. Merieux are launching their MFV-ject these have now been rectified. Ayerst monovalent influenza vaccine containing Laboratories Ltd, South Way, Andover, the A/Singapore/6/86-like strain (H , N ), Hants SP105LT. , Bioplex granules that has been recommended by the chief Forceval junior capsules will also be medical officer as additional protection for available m packs of 10 (£0.98) from Distributor Thames Laboratories Ltd, 5 "at risk" groups. The single-dose prefilled February 16, from Farillon Ltd, Ashton Lower Road Square, Isleworth, Middx syringes are priced at £4.07 each (trade). Road, Harold Hill, Romlord, Essex RM3 TW7 6RL Merieux UK Ltd, Fulmer Hall, Hay Lane, SUE. Description White or off-white Fulmer, Slough SL3 6HH. JjMPeniational perfume-3Promotk)ns

iTJ iclOFF ^FREE |k %OrF RRPf6.85,RRP£6.85, I '•"^RpunoW*Reynolds ^^j^^ Attractive Travel ^i^Ml^M GenerousQenerous promotion price containers free discounts Direct £5.85 on > with IZxlSOgm given on orders Marketing Ltd 18 X 30ml ft Bath Soap k placed Jan, Tel: 062981r339S EOT Atomiser ^ I Feb, March.

Chemist & Druggist 7 February 1987 2 47 BEECHAM PROPRIETARIES 1 PRESCRIPTION SPECIALITIES BEECHAM HOUSE, BRENTFORD, MIDDLESEX TW8 9BD TELEPHONE 01-560 5151

Prices effective from Retail Units Olal lUdl U 2nd March 1987 Status Price per Wtiolesale per Case Price unit per Case Product Description inc VAT exc VAT c r z. Ql c Ashton & Infants Powders Oo D 1 Molipaxin 150mg nQi OA odCilfcrlb \0) OldriudrU OO 1 4.U0

Powders Sactiets (20) Large p 1 51 6 6 02 Roussel are launching Molipaxm ISOmg tablets in a 30-tablet Single Sachet GSL .15 60 598 pack, giving a month's treatment under a new, single node Tablets (18)Standard GSL .99 12 7 89 dosage regime Tablets (36) Large P 1.39 6 5 54 7 CI 1 o no Manufacturer Roussel Laboratories Ltd, Broadwater Park, North Mentholated Sachets (8) OO 1 Z uapsuies(iu) btanoara GSL 91 1 7 25 Orbital Road, Denham, Uxbridge, Middx UB9 5HP 1.52 Capsules (20) Large GSL 12 12J2 Description Salmon pink, film coated, round biconvex tablets, Cephos Powders (8) GSL 88 1 7 02 approximately 11mm m diameter with a white core, containing Tablets (16) GSL ^88 12 7.02 150mg trazodone hydrochloride. The tablet is embossed Day Nurse Liquid (160ml) p 2 25 g 8 97 "Molipaxm" and "150" on one side with a breakline on the other Capsules p 1 .97 1 15.71 (20) Uses Antidepressant Dinneford's Gripe Mixture (125ml) 12 7 89 GSL 99 Supply restrictions Prescription only Diocalm Standard (20) PCDI 1 53 12 12 20 Packs 30 tablets, two blister strips of 15 (£10.30 trade) Family pack PCDI 243 6 9.69 (40) Product Licence 0109/0133 Ellimans Embrocation (70ml) GSL .95 12 7,57 Issued February 1987 Embrocation (110ml) GSL 1.30 12 1036 Eno 10 Sachet GSL .92 12 733

Standard (109g) GSL 1 24 6 4.94 Large (218g) GSL 2.02 6 805 Lemon 10 Sachet GSL 92 12 733 Ismo 10 tabs Lemon Standard (109g) GSL 1.24 6 4.94

Fynnon Salt 200g GSL 99 12 789 MCP are introducing a lOmg strength of their Ismo brand of Calcium Aspirin (24) Std, P 1.03 12 8.21 isosorbide mononitrate. The lOmg tablets have previously only Calcium Aspirin (48) Lge. P 1.65 6 6,58 been available in the Ismo Starter pack, launched last April; Germolene2 Standard GSL .76 12 6.06 (30q) requests for separate packs have prompted the move. Ismo 10 Large (5bg) GSL 1.15 12 9,17 will be packed lOO-tablet Secuntamers (£5.80 trade). Family (120g) GSL 1.80 6 7,1 m MCP Pharmaceuticals Ltd, Simpson Parkway, Kirkton Campus, Germolene Ointment Tube (27g) GSL .76 12 6.06 Plasters .78 12 622 Livingston, West Lothian EH54 7BH. New Skin (13ml) .99 6 3.95

1 7A c will Iron Standard (75) P I .1 H D D y4 Sinthrome 4mg tablets m 100s soon be packed in O Jelloids Large (160) P O D.DD secuntamers. The tablets themselves and the price remain Mac Original Tube (12) GSL ,26 36 6-22 unchanged. Ciha-Geigy Pharmaceuticals, Wimblehurst Road, Lozenges Original Carton (27) GSL Horsham, West Sussex RH12 4AB. Honey & Lemon Tube (12) GSL .26 36 6.22 Honey & Lemon Carton (27) GSL .59 24 9.41 Blackcurrant Tube (12) GSL .26 36 622 The 125ml bottle of Vallergan Forte syrup has been replaced Blackcurrant Carton (27) GSL .59 24 9.41 by a 100ml bottle (£2.24 trade). May & Baker Pharmaceuticals, Mint Tube (12) GSL .26 36 6 22 Ramham Road South, Dagenham, Essex RMIO 7XS. Mint Carton (27) GSL .59 24 9.41 1 Extra (24) GSL .yb 1 d / .t30 The smallest pack Uniphyllin Continus 400mg tablets will Night Liquid (160ml) P 2.25 6 8 97 change from 60s to 56s from the end of February (£7.24 trade). Nurse Capsules (10) P 1.47 12 11.72 Napp Laboratories, Cambridge Science Park, Milton Road, Oxy Oxy 5 P 239 6 953 Oxy 10 P 2.71 6 10 80 Cambridge CB4 4GW.

Phyllosan Standard (50) GSL 1.30 6 5.18 Medium (100) GSL 2 12 4 5 63 CP Pharmaceuticals' Monoparin 1,000 units per ml — heparin Large (200) GSL 1

Veno's Expectorant (100ml) GSL 1 OO 1

Honey & Lemon (100ml) GSL 1 35 1 10 76 Industrial Estate, Craigavon, Northern Ireland BT63 5QD.

Honey & Lemon (160ml) GSL 1 79 6 7 14

Adult Formula (100ml) GSL 1 35 12 10 76 Stemetil 5mg tablets have been reformulated. They are now Adult Formula {160ml) GSL 1 79 6 7 14 slightly smaller in size and more creamy m colour. Lactose is Night-Time (100ml) P 1 46 12 11 64 Night-Time {160ml) P 1.94 6 773 now an ingredient. Packs of 25 tablets have been discontinued;

Yeast-Vite Standard (20) GSL .91 12 7.25 250s and 1,000s remain available. May & Baker Large (50) GSL 1.61 6 6.42 Pharmaceuticals, Rainham Road South, Dagenham, Essex. Economy (100) GSL 282 6 11.24

All prices per case ace subiecl lo the addition of VAT wtiicti will be charged at the rate efleclive at the Windsor Pharmaceuticals would like to remind pharmacists time of despatch All goods marked GSL or Por PCDI are resale price maintained PCDI: Sa'e is restricted to persons lawfully conducting a retail pharmacy business or to holders of a Wholesale Dealers Licence that Laxoberal, a sugar-free liquid laxative which is suitable for

(Ivledicines Act 1968) and registered under Schedule 1 ot the lutisuse ol Drugs Regulations. 1973 lor diabetics, is available on prescription under its generic name, sale to the lawlul conductor of a retail pharmacy P: Sale is restricted to persons lawfully conducting a retail pharmacy business or to holdersof a Wholesale Dealer 's Licence (Medicines Act. 1968) for sale to sodium picosulphate elixir. Windsor Pharmaceuticals Ltd, the lawful conductor of a retail pharmacy GSL: l^edicines tor general sale Wholesalers must hold a Wholesaler Dealer's Licence (fyledicines Act, 1968) EUeslield Avenue, Bracknell, Berks RG12 4YS.

196 Chemist & Druggist 7 February 1987 THERE'S LAXATIVES AND THERE'S DUPHAR LACTULOSE

Clear advantages for your customers

Lactulose IS widely prescribed by the medical profession. They know that

i lactulose produces a change in bacterial populations more favourable to a normal

- bowel function.' ' Unlike many laxatives j which cause irritation and griping, lactulose I has no serious side effects.^

That's why lactulose IS prescribed

far all kinds of patients from infants and pregnant women to the elderly.

Clear advantages for you Duphar Laboratories, the manu- facturers of Colofac, Sere, Influvac Sub-

! unit, and other valuable prescription medicines, will continue to support your

important healthcare role in the community. In addition, Duphar will help both you and your customers, providing educational materials and information. You can confidently recommend Duphar lactulose to your customers who seek laxative relief without the unwanted

i effects of conventional laxatives. duphar bctulose H lactulose solution BP The clear solution in constipation

PRESCRIBING INFORMATION: Presentation l aituK.st- S.ilution BP tontaiiiiiin (.'ontra-mdications: Galactosaeirna. tiastro-mtestiiial ohstriie tion Preeautions, Lactose

bauli.sr 1. S ( (i4; 42 (1): 12(i-l.^ll,

C:i>nstipatlon. Starting dose - Adults IS ml twice- daily. Childrc-n S-I(l years HI ml twice daiK 4, Sanders Ger Sex l')7S; 2J(.-23'». J. I Am 26 (5): Children under S years ml twite daily. Babies S nil daily I lepatit eiie ephalnpathy: !(I-S() ml I'lirther tntoimation is available from: Diipliar Labor.itories I united three times daily, and adjust according to response. Centra-indications. Warnings, etc. liaters Hill. West End, Southampton S03 3JD. Tel: (I7II3 4722SI duphar

I. oi,-l.l. lulIllV.K Suh- rt'ish l(.d ll.iili Iti.irks . SCH .UkI PERSONAL OPINION I

The machinations of PSGB Council - Alan Nathan explains all

December 1985, I was leading a organisations. New members of the Council In Alan Nathan was elected to the breakaway organisation, Pharmacists are given the Ughtest load of duties, yet even

Against the Contract (PAC) fighting the Council of the Pharmaceutical I am already spending at least five working pharmaceutical establishment over the Society of Great Britain last days per month on Council engagements, proposed new NHS contract for community May with many members and and there is scarcely a week in my diary pharmacy and its implications for the small without some Society commitment. Senior Councillors independent pharmacist. I had had no perhaps regarding members are required to do much more, previous involvement in pharmaceutical him as a dissident. Before and for some it is nearly a full-time job. paid but they do not cover loss politics and, I believe like the majority of announcing his candidature he Expenses are pharmacists, my opinion of the of earnings, and cannot compensate for the the chair of "establishment" Council of the renounced the disruption to one's business affairs or career. Pharmaceutical Society of Great Britain British Pharmacists Association was Operative structure a negative one. I considered that its (UK), a body which in its members were unrepresentative of The operation of the Society falls into two various guises, had cam- pharmacists as a whole; that they were out of categories: — touch with the situation at grass roots, and paigned long and vigorously (a) Administration. This is run by the that their decisions were made without against the new contract and professional secretariat who deal with the regard to the opinions or aspirations of the the pharmaceutical estab- day-to-day running of the Society's affairs, average pharmacist. and implementation of the Council's this article Life is fuU of ironies, and one year further lishment. In Mr decisions. on, I find myself a member of the very body Nathan says how his former (b) Policy making. This is the responsibihty elected representatives, and of which I was so recently a critic. I have now prejudices match up to the of the Society's been a member of the Council for over six made independently, with technical advice reality of life on Council. months, and have had the opportunity to And from the senior administrative staff. look at the situation from the other side. As he sets out for the grass roots The structure of the pohcy making might be expected, my experiences have to pharmacist the structure and apparatus is hke a pyramid. At the base are some extent modifed my outlook, and have a large number of subcommittees and operation of Council. dispelled some of the wilder myths that I had working groups, which often contain co- held to be fact in common with thousands of opted members from outside the Council other pharmacists. On the other hand, my with specialised knowledge or experience. time as a Council member has confirmed Their deliberations and decisions are then some of the opinions and criticism I then passed up for consideration by the relevant held. Standing Committee of the Council, of

I am a great believer in the value of which there are eight. These are composed communication. I feel that a failure in exclusively of Council members, except for communication between pharmacy's leaders the Education Committee, which has five and the bulk of its practitioners is what lies at heads of schools of pharmacy and a students' the root of our undeniable apathy. It is this representative as co-opted members. It is in apathy that prevents us coming together as these committees that recommendations the strong and united force that we must be li from the subcommittees are either adopted we are to successfully face and overcome the or rejected. Decisions of a more political challenges threatening our professional nature are also taken directly in the Standing survival. I have proposed to the Council a Committees. The proceedings of the campaign to improve communication with Standing Committees are then passed the members of the Society, and work on this forward as recommendations to the main final of will begin soon. In the meantime I feel I can Council, which has the power make a contribution by describing how the acceptance or rejection. The majority of the are Council operates, as it is vital that standing committees extend over two-and-a- Standing Committees' recommendations pharmacists understand how the decisions half days. In addition Council members are approved "on the nod", but the more that crucially affect their lives and required to serve on the various contentious issues are generally thrashed out livelihoods are arrived at. subcommittees and working groups of the m Council, and recommendations from rejected on a To start with I can dispel the notion that Society, and to represent the Society on a Standmg Committees are often propose being on the Council is a cosy sinecure — multitude of outside committees and bodies. vote. Council members may also Council members have to work very hard. They are also expected to address meetings Each month meetings of the Council and its of local branches of the Society and other continued on p200

198 Chemist & Druggist 7 February 1987 m

SALES PROJECTION + 757 PRnnUCTION CAPACITY NIL

On the evening ot February 7th 1986 we were looking forward to a year of healthy sales growth - some 7S% increase on the previous year. By the next morning this was literally in ruins. During the night we sultered a factory hre which wiped out a large section of our production facility. For the next week we worked through freezing conditions trying to conduct our business from four telephones. Since February 7th 1986 we have rebuilt our production Compounding capability and Laboratories with the latest in new

plant technology. This returns us tt^ the position of offering high volume tabletting and hard shell capsules production in one of ttie most modern and efficient facilities in the UK. With the opening of the new factory we now have the strong support of a production capacity of 1007o. A far cry from February 1986. Sussex mm\

Sussex Pharmaceutical. Back on track for business. Talk to us on 0342 311311.

SusM X iitn.il Ll.l Ii.mIw,,, 1 ( I I'l I'lwrni.n. ,( hK K. .ist Iriristcul, Sussi \ U I ?l i I M IIM2.M1.MI Tckx yS.M 5 TOI' IMU ,

w\ continued from pl98

motions to the full Council, but this is new and proposed legislation on the generally reserved for major issues which profession, and recommends appropriate The Council can significantly affect the future of the action. It also considers breaches of the law profession. by pharmacists, with the power to refer cases The Council consists of 24 members, 21 to the Statutory Committee. corset — of whom are pharmacists each elected for a 5. Organisation: Responsible for running three year term. Three are distinguished the Society's branch and regional structure, experts m other fields appointed by the Pnvy and arranging meetings for them which a personal Council. eventually feed back through the

The procedure m the mam Council is Organisation Committee to the Council. It is fairly formal with strict Standing Orders to responsible for the Society's publicity and view of its be followed. However, these can be relaxed pubhc relations, and the annual conference. at the president's discretion, and often are to 6. Practice: Oversees all branches of allow an issue to be fully debated. In the professional practice: community, hospital constrictions

Standing Committees and subcommittees and industrial. It processes the expert input the atmosphere is more relaxed, and from subcommittees for each branch. The In the preceding article Council decisions are normally taken by concensus, community pharmacy subcommittee for member Alan Nathan although formal proposals and votes do example, has, as well as twelve Council described the structure and occur if there is not full agreement. members, the director of the National Pharmaceutical function of the Council of the Committee structure Association, the chief executive of the Pharmaceutical Services Pharmaceutical Society. He The complexity and organisation of the work Negotiating Committee, and the pharmacy now gives his personal view of of the Council can be seen more clearly by superintendents of both Boots and the Co- looking more closely at the Standing operative Chemists. The decisions, for some of the constraints on the Committees and their subcommittees. The example, to make machine-produced labels actions of members of the

eight Standing Committees are: — compulsory, and to make it a requirement of Council. He also takes a critical 1. Education: This deals with all aspects of the Guide to Good Dispensmg from lanuary look at the undergraduate and postgraduate education, 1987 to use wammg labels, came up through way the system preregistration training and continuing this Standing Committee. works and makes suggestions education for gualified pharmacists. Some 7. Science: Deals with technical and for reforms which he believes of its contributing committees are the scientiiic matters concerning pharmacy. For would make Council decisions postgraduate education subcommittee; the example, the recent statement by the Society committee oi the heads of schools of on homoeopathic medicines was more representative of the pharmacy; the working party on education formulated, in essence, by this Committee, views of the membership as a and training, which is currently involved on although it was amended after discussion by whole, so leading to greater making a complete review of the the full Council. undergraduate course for pharmacists and 8. Stafi: Is responsible for employing the strength and unity within the preregistration framing; the preregistration Society's staff, for negotiating their salaries profession. review group, and the manpower and for their welfare. All senior subcommittee. appointments are made with the direct I feel that pharmacy today is confronted 2. Ethics: This considers matters relating to involvement of members of this Committee. by the most crucial challenges m its 150

professional conduct, and much of its time is It IS also responsible for fixing the scale of year history. The decisions and actions taken taken up considering breaches of the expenses for Council members. The now will mean either that we can look Society's Code of Ethics, such as unethical members of the Staff Committee and forward to the future with confidence, or that advertising and canvassing, and ensuring Finance and General Purposes Committee within a few years pharmacy as we know it that improper commercial relationships do are senior members of the Council. will all but have ceased to exist, with

not exist between pharmacists and doctors What I have given is a brief and very consequent massive unemployment operating in the same building or m close simplified description of the extremely throughout the profession. Strength and therefore, proximity. It was the responsibility of this complex, although excellently organised, unity of purpose are, absolutely committee to formulate the Society's policy system through which the decisions are essential if we are to survive and prosper. of the greatest, although necessary, on the dispensing of parallel imports. It has taken that affect the running and future of One barners to freedom of action and expression the power to recommend referral of cases to the profession of pharmacy. I hope that I the Statutory Committee, but this must be have dispelled some of the commonly held for a Council member is the policy of approved by the full Council. misconceptions about the work Council collective responsibility. Once an issue has debated a vote taken all are The Statutory Committee is a body members do, and shown that the job mvolves been and bound completely independent of the Council, more than a few cosy meetings and a by the majority decision. There can be no consisting of five pharmacists (who are not monthly dinner. alternative if the Council is to be effective m Council members), with a judge as implementing its decisions, but it can prove frustrating to those whose views are not chairman. It is only this Committee which has the power to take disciplinary action always m line with the majority. against pharmacists. Decisions are sometimes taken by the to run counter to the 3. Finance and General Purposes: Council which appear profession as a whole Administers all the finance and day to day opinion held by the running of the Society. Votes monies for new because Council members have access to projects. far more information than the average they are right or 4. Law: With mput from its subcommittees pharmacist. Whether

on law and legislation it assesses the effect of I continued on p204 200 Chemist & Druggist 7 February 1987 Prescribing information along with creatinine clearance. Adequate hydration of elderly patients taking Presentation Each pinit, shield-shaped tablet is high oral doses of Zovirax should be maintained. Special attention should be impressed "ZOVIRAX 400" on one side and a triangle given to dosage reduction in elderly patients with impaired renal function. '~. irvT? on the obverse, and contains 400mg acyclovir. Uses Experience in human pregnancy is limited so caution should be exercised in Treatment of acute herpes zoster infections. Whilst a beneficial prescribing for pregnant women. ^ effect of treatment on acute pain has been shown, studies have not Side- and adverse effects Skin rashes have been reported in a few (^c(4^ yc' demonstrated an effect on post-herp)etic neuralgia. Dosage patients receiving Zovirax Tablets; the rashes have resolved on Adults: Two 400mg tablets five times daily for seven days. Treatment withdrawal of the drug. In trials, the incidence of gastrointestinal should start as early as possible after rash onset. Contra-indications events has not been found to differ from placebo. Contra-indicated in patients known to be hypersensitive to acyclovir. Basic NHS cost 70 tablets (PL3/0227) £119.00 Precautions For patients with severe renal impairment (creatinine clearance less Further information is available on request. than 10ml/minute)adoseof800mg twice daily is recommended. For those with clearance from 10- 25 ml/ minute a dose of every six to eight The FCHNOLOGICAL OCHtfVEMEN creatinine 800mg Wellcome Foundation Ltd in IHf WEILCUMF RfStARCH In the elderly, total acyclovir LABOHATOaiES Of IHf hours is recommended. body clearance declines Crewe, Cheshire WellCOme WELLCOMt F

ZOVIRAX 400mg Tabs

/ it five times a day^

With the above prescription, Wellcome announce the introduction of an orally administered, specific antiviral therapy for the treatment of shingles. The seven-day treatment, using the new 400mg

tablets, is presented as a complete course in one pack — the 7 day Shingles Treatment Pack. Promotion to doctors starts immediately and supplies are 9VENCH available through the normal wholesaler channels.

THE WELLCOME New 7 day FOUNDATION LTD 20VI AX* ^^^^ Treatment R Pack - A LEADER IN ANTIVIRAL RESEARCH acyclovir 400ing tablets Trddc Mark In I Insignia was a runaway success

THE Insignia all-over body programme. 3| DUE TO Insignia. And because our range When we launched 15 months ago, the DOESN'T STOP AT AFTERSHAVE, SALES DIDN'T

i 5 toiletry market didn t know what had hit ^ STOP AT Christmas. We soon realised

IT Static for years, the mass fragrance THAT our initial SALES FORECAST HAD BEEN

sector suddenly grew by 11%. More to CAUTIOUS, TO SAY THE LEAST

'''-''^"i. the point all that growth was directly We actually sold double the amount we HAD v4 AND

anticipated, not bad for starters. and range of display and merchandising

we re following it up with a national material. All OF which guarantees EVEN .

advertising campaign that's even heavier MORE profit in YOUR POCKET IN 1987 than last year, IThis Spring we're spending £1 million on H U LTO N - j television. And backing that up with a wide The leaders in male toiletries. .

PERSONAL OPINION

continued from p200

wrong, is seen onJy in the light of subsequent

events. If the decision does turn out to be wrong a dissenting member cannot be distinguished from the rest, nor can he or

she make his or her views pubUc. This is why

it sometimes appears that Councillors who have been elected on the strength of a strongly reformist manifesto have sunk without trace into the establishment, and perhaps let down those who voted for them. No roads to freedom?

Many pharmacists are unaware of the constraints on the freedom of action of Council members imposed by the Society's Charter and by certain legal decisions. Because of this they may have unreal bailor made expectations of what Council members can do for them. Although the Supplemental Charter of 1953 required the Society to "maintain the honour and safeguard and finance promote the interests of members m the exercise of the profession of pharmacy", the Jenkin judgment of 1919 had already

. . . Council determined that it could not involve itself in for Chemists members live in matters affecting members' remuneration an ivory tower, and conditions of service. In 1965 the If you are thinking of buying a pharmacy, and take Dickson case further restricted the Society when the High Court decided that it could or extending your present business; the decisions in a vacuum' not control the types of goods sold in new guarantee scheme now available from pharmacies m order to raise professional standards, although this measure appeared AAH group wholesalers is worth to have the overwhelming support of the

measuring up. membership. In my view it was this decision that prevented British pharmacy from

developmg mto the true profession that it has Advantages over other schemes are always aspired to be, and was a blow from

which it has never recovered. • No early repayment penalty One of the powers left to the Council is to • No restriction on the resale of your pharmacy regulate standards of professional behaviour through the Society's Code of Ethics. It has • Competitive interest rates the power to refer sufficiently serious • No limit to the size of the loan breaches of professional conduct to the Backed by a comprehensive Statutory Committee, which can exercise wholesaler service from the sanction of striking the pharmacist off the member companies. Register. But it is not so easy as it may seem for Council members to raise professional standards by rigorously enforcmg the Code

Please send me the of Ethics because, in the final analysis, it Statim Rnance Limited carries only moral force, and a Statutory information booklet. Committee striking-off order can be appealed against and overturned in the Name High Court. Since the Dickson judgment the Society of business Name has seemed afraid to test its powers over new challenges to ethical standards

(leapfrogging is one example), perhaps fearing that sanctions against offenders Address might again be challenged successfully in the courts on grounds of "restramt of trade", as Dickson did. Nevertheless, swift and

Send to your local brancfi of Hills Pfiarmaceuticals Ltd. resolute action by the Council in the early days of leapfrogging may well have stopped 1 Herbert Ferryman Ltd., it. I believe there is now httle prospect of the ^A-^ Mau/son & Proctor Pharmaceuticals Ltd., Society being able to increase its influence / M \ Northern Pharmaceuticals Ltd., over the running of the profession, as the

( ) or Vcstric Ltd. Charter would need to be amended,

Members of the AAH Holdings pic Group. Chemist & Druggist 7 February 1987 requiring a change in the law. In this free participate actively in the branches, and

market, anti-restrictive practice era, it is share a similar outlook. In addition, the unlikely that the Society would be given serving Council member, in becoming greater powers to restrain the commercial unavoidably more and more involved with activities of its members in order to raise bureaucracy and officialdom, grows even professional standards. further out of touch with grass-roots opinion. Although Council members' powers and My experience on the Council has freedom of action may be much more tended to confirm the views that have been restricted than is generally realised, the expressed to me by many pharmacists — questions still remain to be answered as to that Council members hve m an ivory tower, whether they are representative of and take decisions in a vacuum. pharmacists as a whole, and whether their ...on referenda decisions reflect the thinking of the majority

of the profession. They are certainly not Because of the kind of candidate who is able be taken by postal referenda of the entire "representative" if that term implies and willing to stand there is nothing to be membership. "average". gained by changing the method of election. The Council could continue to be The demands of the office m terms of Perhaps the best way to make decisions responsible for day-to-day policy making, time money and preclude the majority of more democratic and representative would and advise the membership on how it thinks

pharmacists, who in any case are not be to change the decision-making process it should vote on major issues, but the actual interested in serving. So Council members itself. Issues that affect the livelihoods of decisions would be taken by everybody

tend to be political activists from the higher 35,000 pharmacists are too important to aifected by them. Once pharmacists felt that echelons of the profession, to who have come leave decide to twenty-one individuals, they had a genuine say m their future I am up mainly through the Society's branch and eminent and well-mtentioned as they are. sure that the present apathy would vanish regional infrastructure. Their feedback Those few decisions that are crucially and members would become eager about feelings withm the profession comes important to the future of the whole participants in the affairs of their profession.

not from the main body of (admittedly profession (eg the new NHS contract and At least, if the wrong decisions were made apathetic) pharmacists, with whom they relaxation of supervision of dispensing and then, the blame could not be laid at the door have no contact, but from a minority who Pharmacy-only medicine sales) might best of the Council.

LOOK OUTFORTHISNEW Pm?NA CAMPAIGN Am HELP USHELPAGECONCERN

Every can or tube of ALGIPAN you sell will guarantee a donation from Wyeth Laboratories to Age Concern.

Show cards and shelf talkers are

available to assist you in selling the product and promoting the appeal to your customers.

kubandSpray

muscular aches and pains

•rjl WYETH mA FAMILY HEALTH

Chemist & Druggist 7 February 1987

Do you ever get the feeling that pressures are bearing down on you?

Pressure to stock this and sell that. Pressure to take larger quantities than you want. Pressure to find sonnewhere just to put It all. Not to mention pressures on your cash flow.

Dealing with Evans is rennarkably free from pressure.

As market leaders in the retail genenc sector, we've devised the means to supply you with high quality pharmacy medicines at competitive prices, in any quantity you want, at any time you want. We keep our prices competitive across a comprehensive range of over 350 products that includes profitable leading OTC brands like Mycil, Nylax, Dequadin, Dequacaine, Haliborange and Minadex.

If you'd like to feel a lot freer to operate your business the way you want, rather than the way some suppliers want you to, pick up the phone and check Evans products and prices first.

Our unique combination of quality medicines and wholesale sense will give you plenty of room to manoeuvre.

JUST WHAT THE PHARMACIST ORDERED -

YOP' ARE ABOUT •ENTER A

M Every year 2 million couples try with confirmation of pregnancies for a baby, with over 1 in 6 having from successful kit users.

problems of reduced fertility. M First Response has opened up M Millions of women have seen an expanding new market. the First Response commercial in So don't miss out on this unique our pioneering £300,000 national profit opportunity TV campaign. STOCK UP NOW! M More million women

buying Tampa. V /uive received First

^ ^ Response in- - leaflets, offering an introduct 2.50 coupon.

fS. Thousands s have requested First Response informa- tion packs.

H Our Freephone advisory service has been receiving hundreds of enquiries about First Response. FIRST B Available in both 6 day test and RESPONSE 3 day refill packs. First Response Predicts the day a woman is most has already had outstanding results able to become pregnant.

l,iinhi.uKls I imitid. Dunshmv W.u. Il.n.mi. Il.im- I'D" MX, ,

PREGNANCY & OVULATION TESTING

A MATTER OF TIMING

A reminder of the hormone changes taking place during the menstrual cycle and early pregnancy and how they form the basis for ovulation and pregnancy tests.

The "average" menstrual cycle is considered to be 28 days but many women have shorter or longer cycles and the cycles can vary from month to month in the same woman. The normal range is 25-35 days, with ovulation occuring at any time between the sixth and 20th day of the cycle (counting the

first day of menstruation as day one), but usually between days 12-15. The average

menstrual flow is five days but anything

between three and seven is considered normal. The cycles may be irregular and anovulatory at the onset of menstruation in adolescence and approaching the menopause.

During the first half — follicular phase — of the cycle an ovarian foUicle containmg the egg enlarges and comes to the surface of

the ovary. The 14 days or so after ovulation is the luteal phase during which the corpus Colour tests, the most popular pregnancy tests for home use, detect luteum, formed from the ruptured foUicle, is change now active. hCG a few days after implantation

The menstrual cycle is controlled by the two pituitary hormones — foUicle stimulating pituitary, reducing the amount of FSH 12-36 hours later. Detecting this sudden hormone and luteinising hormone — released. peak of LH is the basis of ovulation tests. together with oestrogens and progesterone Towards mid cycle, oestrogen A small number of women have an LH secreted by the ovaries. At the beginning of concentrations reach a peak (about 37 hours surge but, for medical reasons, may not the cycle, FSH stimulates a few sensitised before ovulation) then fall rapidly ovulate or may have poor ovulation at certam follicles to mature and induces the ovary to immediately before ovulation. These higher times of the year. secrete oestrogens (mainly oestradiol). This oestrogen levels exert a positive feedback At ovulation the follicle that has rising concentration of oestrogen exerts a causing a second peak of FSH and a much developed the most quickly releases the egg negative feedback on the hypothalamus and larger surge of LH which induces ovulation continued on p210

Production of ovarian hormones^ - Production of pituitary hormonef, OVULATION

OVULATION PROGESTERONE

•••• z / \ z \ o / o FSH OESTROGEN \ I— \ \ I V \ LU \ 5 ••••••••

y I V-....

I I N

14 6 10 12 14 16 18 20 22 24 26 28 10 12 14 16 18 20 Days of menstrual cycle Days of mensfruo/ cycle

Chemist & Druggist 7 February 1987 209 ^PREGNANCY & OVULATION TESTING^™

Continued from p209 and collapses. LH stimulates the ruptured HEALTHY AND follicle to form the corpus luteum which HAPPY PREGNANCIES secretes progesterone. BEGIN HERE. In the early cycle, build up of the utenne endometrium is attributed mamly to oestrogens. After ovulation progesterone maintains the endometrium in a state of readiness to receive the fertilised egg.

Progesterone production is almost absent during the follicular phase, starts rising at about the time of the LH peak then rises more rapidly after ovulation. Oestradiol rises to a second maximum durmg the luteal phase and falls before menstruation. The increase m progesterone leads to an increase in body temperature from which it is possible to estimate a woman's fertile period. The drawback of this method is it indicates ovulation has already occurred and the woman may miss part of the crucial 12-24 hours of fertility. Readings can be An example of the type of POS material Unipath believe has contributed to the unreliable because other factors such as increased display and customer awareness of home pregnancy tests infection can affect body temperatare.

If a fertilised egg is not implanted the corpus luteum degenerates, with a rapid reduction in progesterone secretion. This, together with the fall in oestrogen, causes the endometrium to break down and A Year For New Arrivals menstruation to occur. Reduced levels of the ovarian hormones provision of POS material which has So far. 1987 has been the year of prompt the pituitary to secrete increased encouraged pharmacists to display these amounts of FSH and the cycle begms again. the pregnancy test — with the products more prominently. If an egg is fertilised it moves down the launch of three new OTC Other influences have been the attitude fallopian tube and into the uterus where it of women themselves. There has been an products in the first three implants in the thickened lining about six to increase in the numbers of women at work weeks. eight days after concephon and usually four who reqiiire early diagnosis of pregnancy to to eight days before the period is due. The These products — Evatest Blue 5, Evatest plan their futures. Many working women are implanted embryo starts secreting human Rapid and New Predictor {C&D January 17, leaving childbearmg until later m life when chorionic gonadotrophm which maintains p80,84) — are expected to give a further they may need to do more pregnancy tests — the corpus luteum and its production of boost to the £4-5 million home pregnancy the average age of women starting their progesterone for several weeks until the test market which has grown dramatically families has crept to about 26-27 and about developing placenta takes over hormone over the past 18 months. 30 per cent of all births are to women over production. New technology and the advent of 30. Finally, women are becoming more Low levels of hCG can be detected in the monoclonal antibodies has expanded the aware of the importance of early diagnosis so urine within the first week of conception. At diagnostics market as a whole, attracting they can take the right antenatal care, such this stage and throughout early pregnancy, more manufacturers into pregnancy testing as improvmg the diet and stoppmg smolong. the amount of hCG rises rapidly, doubling and resulting in widespread product It is predicted that 600,000-700,000 home every two to three days. The most sensitive improvements. pregnancy tests will be done this year, but home pregnancy tests detect hCG levels of Sales of home pregnancy tests had been manufacturers believe there is still a large 50iu per litre which can be reached soon fairly static until the introduction of the first potential for growth. These sales are less after implantation. In theory it is possible for colour test. Predictor Colour, followed by than the total number of live births (about these tests to detect pregnancy in some Clearblue in June 1985. Unipath say the 800,000 a year) and usage in the UK, at less women five days before the period is due but market grew by 48 per cent m the year after than 35 units per 1,000 women, lags behind to be on the safe side manufacturers do not the Clearblue launch and figures from other European countries such as Italy, recommend that the tests are done until at Chefaro indicate over 25 per cent growth m where 80 units per 1,000 women are sold or least the day of the missed period. 1986 with a likely increase of at least 15 per Holland, with sales of 75 per 1,000 women. hCG production peaks at 60-80 days cent this year. The main users of home tests are still after conception. Levels then decline and Apart from the speed, convenience and perceived to be single women who don't plateau for the remainder of the pregnancy. privacy of home tests, several factors have want to be pregnant, but a Unipath survey of hCG and LH are glycoproteins with contributed to their growth, say over 1,000 women has shown a bias towards similar structures. The earlier antibody manufacturers — the increased advertising married women, particularly younger ones pregnancy tests often reacted to LH, giving which backed the introduction of colour who have not experienced pregnancy false positives, but the development of wholly tests, a 10 per cent mcrease in the number of before. When asked where they would go for specific monoclonal antibodies has led to the women of childbearing age, pressure on a pregnancy test, most women mentioned introduction of accurate tests for the two NHS resources leading to restrictions in the doctor rather than the pharmacist but hormones. pregnancy-testing services, and the Continued on p212 210 Chemist & Druggist 7 February 1987 ...Evatest BlueS the end of the pregnant pause

For a long time now women have been forced to wait Complete this coupon and send it to (No stamp - 2 hours - I hour - 30 minutes (according to required):- TGL, FREEPOST WREXHAM, technical developments) to know the answer to that CLWYD, LLI3 9BR. all important question - Am I pregnant?

Please send me a free sample pack of Evatest Blue 5 Now the answer is just five minutes away with in its own P.O.S. display. (This offer is limited to one Evatest Blue 5, a new, accurate, reliable and easy to pack per pharmacy). use five minute pregnancy test. Name For your free trial pack of Evatest Blue 5 in its own individual point of sale dispenser, simply complete and Address 5 return the Freepost coupon. Evatest Blue 's R.S.P. is £6.60 (with our compliments). Future supplies of this Postcode brand new product offer a very attractive P.O.R. deal for you; and for your pregnancy test customers, the Phone No. end of a long wait. ^PREGNANCY & OVULATION TESTINGS™

continued from p210 about one quarter said they were likely to Spreading the word buy a home test — a further indication that Unipath are continuing to advertise bonuses are available for both Discover the market is far from saturated. Clearblue in major women's magazines this Colour and Discover 2. Carter-Wallace also The mam trend in the market has been year with a similar spend — £250,000 — to run a professional advice service. the move towards colour change kits, which last year. There will be edrtonal coverage in Chefaro are supporting the launch of now account for over 50 per cent of sales and consumer magazines backed by trade New Predictor with a record £300,000 are expected to grow m the future. promotions encouraging pharmacists to advertismg and promotional campaign. The

Clearblue, for example, became brand display the product. A shelf organiser is advertising breaks next month m women's leader three months after its launch in June designed to display a number of pregnancy magazines and runs throughout 1987, with 1985 and is now claimed to sell twice as tests. London tube cards appearing in April and much as its nearest competitor. Unipath also run a training scheme for May. A drop-feed counter dispenser has While some manufacturers predict the pharmacy assistants, with talks on been developed following research which eventual demise of the ring tests. Carter pregnancy and its diagnosis. The session showed that the rate of sale in pharmacies Wallace are mamtammg Discover 2 because lasts about l'/2 hours and can be organised more than doubled when self-selection was they feel there is a place for both types of through Unipath representatives or the possible. There are shelf edgers and fact test, particularly as Discover 2 was Clearblue advice line (0234-50408). boards for chemist assistants. upgraded last year to use monoclonal Meetings for pharmacists can also be The company says the new product is a antibody technology. However, the arranged. logical development from Predictor Colour, company's mam promotional effort will be The advice line took several queries from which will still be marketed because it has a behind Discover Colour. women wanting information on strong consumer franchise. An advice

Pharmacies are likely to continue to preconceptual or early antenatal care, service is available for all Chefaro's dominate the market. Unipath believe which led to the company producing a diagnostics. pregnancy tests should be sold only through leaflet, "Healthy and happy pregnancies Thames Genelink, who claims that their these outlets because of the advice users begin here", available free from five-mmute Evatest Blue 5 heralds "the end might need. On the other hand, Carter pharmacies. A poster gives similar advice of the pregnant pause", are supportmg their Wallace acknowledge that some drug stores on preparing for pregnancy. products with bonus offers and PCS have always stocked pregnancy tests and The launch of Discover Colour last including door stickers, shelf talkers and there is nothing that can be done to stop Autumn was backed by a £250,000 counter units. Product advice is available on them, although the company would never advertising campaign which runs until the the Evatest helpline 0483-505546. support price-cutting. end of this month in leading women's Abbott Laboratories, makers of Test In spite of the ease with which tests can magazines. There are plans to extend the pack hCG-urine, are running a public be done at home, many women prefer the campaign throughout the year. relations campaign in women's magazines reassurance of a professional service and it is There is a counter display unit holding aimed at encouraging women to have their estimated that pharmacies carry out six packs, a counter card with leaflets pregnancy tests professionally done at a 400,000-500,000 tests a year. The pharmacy providing full information on the product, a pharmacy. pregnancy test market has been fairly static door sticker for pharmacists and a free Organon are hoping to introduce a in the same way that home testing was until booklet called "Discovery", a practical pregnancy test, Pregcolor, this year. It is recently, but Unipath believe the guide to early pregnancy written by Wendy currently marketed m Europe by their introduction of more sensitive, easy-to-use Rose-Neil, editor, Parents magazine. Trade international company. tests will expand the market. Britpharm think that increased awareness of the Press towards community pharmacy is also encouraging women to turn to in-pharmacy tests. An average price for a pharmacy test is about £5 with a range of £4-£8 dependmg on the area, say Unipath. Medimar Laboratories advise that pharmacists who sell several home pregnancy tests of high sensitivity should be usmg highly sensitive tests if they offer an m- pharmacy service. Sometimes women obtain a positive result with an OTC test measuring 50iu hCG/1 but when they ask the pharmacist to check with a professional test the result is negative. This may be because the pregnancy is at an early stage and the urine levels of hCG are not high enough to be detected by the less sensitive tests.

Launched last Autumn, Discover Colour is supported in women's magazines and at point of sale

212 Chemist & Druggist 7 February 1987 Now other pregnancy tests are turning green.

In the year since Clearblue was launched, in this country. That's twice as many as its more and more women hove come to appre- nearest competitor ciate its advantages: Accuracy Speed of result. Not only that, awareness and confidence

And above all, simplicity and ease of use. in home tests has grown so much that, in cash

A few months after launch it was brand terms, there are now nearly 70% more tests leader-an enviable record in sold overall. itself. So shouldn't you make ( But now Clearblue 1 sure you're stocking the \^ NOT -^PREGNANT -^PREGNANTJ accounts for well over 40% of pregnancy test that women Clearblue It's decisive colour change gives an oil home pregnancy tests sold answer women can rely on clearly prefer?

Clearblue. Britain's best selling pregnancy test

For further inirjrmation contact Unipath Customer Services (0234) 50408 Unipalh Ltd , Norse Road, Bedford MK4f OQG Clearblue and tlie fan device are trade marks, «' 1986 Unipatfi Ltd Thanks to Mr. Baker Mrs. Wilson is now pregnant,

Chefaro proudly announce the birth of spending half a million pounds on advertising a new product. and promotion.

We've named it Discretest: the first of a All of which bodes healthy profits for new generation of Ovulation Tests. the pharmacist with Discretest on his shelves.

Discretest, quite simply, eases the path to If you'd like more information, telephone conceiving by telling women when they're us on 0223 312956. at their peak of fertility. You can be sure that a lot of women will Which, in many cases, could save be seeking your advice about Discretest. months of fruitless trying. And soon after a good few of them will Naturally, we expect our new arrival to be hearing the patter of tiny feet. grow healthily. Thanks, in no small degree, to their

We estimate that as many as 1 million local chemist. women a year will be interested in a product I I like Discretest. DISClC

To make sure they know about it. we're CHEFARO DIAGNOSTIC CARE ^PREGNANCY & OVULATION TESTING^™

PREGNANCY TESTS FOR HOME OR IN-PHARMACY USE

Use in HCG pharmacy *Scientific level Time Positive Other Product Manufacturer or home Form principles (iu/1) Used from Steps (mins) result Accuracy Cost details

Beta Clone Medimar Pharmacy Slide MA DA 500 About 20 4 3 Clear (no 95°'o 50, £34 latex (distributors) days after agglutination) trade conception Beta-Quix V Alpha Pharmacy Tube MA/EIA 250 Few days 4 15-30 Blue colour 100, £71.50 Contains alter missed trade controls period

Clearblue Unipath Home Urine MA/EIA 50 Day period 3 plus 30 Blue c ilour Over 99% £6.75 rsp Double lest sampler due washes Also as professional pack 20, £26.08 trade Conlirm Ctietaro Home Tube MA/DA 125 Three days 1 90 No ring 99% £6-35 rsp Double test after missed period

Directaclone- Alpha Pharmacy Slide MA DA 300 Few days 1 2-3 Granular 98-6% 30, £28.80; Contains CG aiter missed latex 1 nn f 7Q f;n positive and period agglutination trade negative controls

Discover Carter- Home Stick MA/EIA 50 Day period 5 30 Lower bead Over 99" b £6.50 rsp Control Colour Wallace due greeny blue bead for colour comparison Discover 2 Carter- Home Tube MA/AI 75 First day of 4 60 Ring 99% £6.35 rsp Double test Wallace missed period Evatest Blue 5 TGL Home Stick MA/EIA 50 Day period 4 5 Blue colour Over 99% £6.60 rsp due Evatest Rapid TGL Home Tube, MA/AI 150 Day period 2 30 Ring Over 99" £6.20 rsp Double lest due Gravindex Ortho Pharmscy Slide MA/AI 800 30-35 days 2 2 No Over 75, £24.70

beta hCG from day 1 agglutination 99.8% trade; last period 25, £18.40

Neo-Planotest Organon Pharmacy Slide MA/DA 500iu Four days 1 2 Agglutination Over 99% 30, £33; Duoclon Teknika after missed 100, £63 period New Predictor Cheiaro Home Stick MA/SPIA 50 Day after 3 30 Pink colour 99°/o £7.35 rsp missed period Pregna-Cert Merlin Pharmacy Slide AI 200 5 days after 2 2 No 99"/o 50, £39.99 Contains missed agglutination trade positive and period negative controls \A A /CDT A Predictor Chefaro Home 1 uPe MA/or l/\ 150 Three days 3 30 Pink liquid 99% £6 75 rsp Colour after missed goes clear period

Pregnospia Organon Pharmacy Tube MA/SPIA 200 Three days 1 30 Blue to clear Over 99% 30, £41.50 duoclon Teknika after missed grey trade period Pregnosticon Organon Pharmacy Slide AI 2,500 12 days 2 2 No 98% 20, £24; Planotest Teknika after missed agglutination 100, £58; period 500, £115 RAMPhCG Medimar Pharmacy Rapid MA/EIA 50 10 days 4 3-4 Blue dot Over 99% 50, £60 (distributors) absorbent after trade matrix pad conception Roche Roche Pharmacy Slide AI 2,000 12 days 3 2 No 99% 50, £35 Controls pregnancy ±500 after missed agglutination trade available slide test period at 2 min separately Tandem Britpharm Pharmacy Cylinder MA/EIA 40 Day period 4 3 Blue dot Over 99% £1 50 each Icon (distributors) with due (from 24); permeable £1 35 each membrane (from 48) trade Test packhCG Abbott Pharmacy Disc MA/EIA 50 Day period 4 Blue cross Over 99% 20, £38 Built-in

urine missed trade filter UCG Carter- Pharmacy Slide AI 200 5- 12 days 4 2 No 97% 30, £25 Wallace after missed agglutination trade period

"AI = Agglutination inhibition DA = Direct agglutination EIA = Enzyme immunoassay MA = Monoclonal antibody SPIA = Sol particle immunoassay

Addresses Abbott Laboratories Ltd, Queenborough, Kent MEl 5EL Alpha Laboratories, 40 Parham Drive, Eastleigh, Hants SOS 4NU

Britpharm Laboratories Ltd, Progress House, Albert Road, Aldershot, Hants GUll 1 BR (Distributors for Hybritech) Carter-Wallace Ltd, Wear Bay Road, Folkestone, Kent Cheiaro Proprietaries Ltd, Science Park, Milton Road, Cambridge CB4 4BH Medimar Laboratories, Sarum House, 17 The Queensway, Chalfont St Peter, Bucks SL9 8NB (Distributors lor Monoclonal) Merlin Pharmaceuticals Ltd, 11 Picardy Street, Belvedere, KentDA17 5QQ Monoclonal Antibodies, 28 Crown Road, Wheatley, Oxon OX9 INB Organon Teknika Ltd, Science Park, Milton Road, Cambridge CB4 4FL Ortho Diagnostic Systems, Enterprise House, Station Road, Loudwater, High Wycombe, Bucks HPIO 9UF Roche Products Ltd, PO Box 8, Broadwater Road, Welwyn Garden City, Herts TGL (Thames Genelink Ltd), The Old Blue School, Lower Square, Isleworth, Middlesex TW7 6RL Unipath Ltd, Norse Road, Bedford MK41 OOG

Chemist & Druggist 7 February 1987 215 ^PREGNANCY & OVULATION TESTING^™

Birth of another market

Activity in the ovulation predictor test market is matching that in pregnancy tests, with new products joining Discretest and First Response.

Tambrands are assessing the effect of the Authority received no complaints about the in progrees. A mailshot was recently sent to television commercial for First Response, the television advertisement on grounds of taste, GPs and a team of 15 nurses gives talks to first ovxilation predictor test to be advertised but half a dozen viewers queried the medical and pharmacy personnel about in this way. suggestion that women could conceive on infertility. An education video designed for Marketing director Ian Jenkins believes only one day a month, which the IBA's health professionals (£3.99) explains the the short campaign m December was medical advisory panel recommended physical and emotional problems successful but the company is reviewing the should be changed to two-three days a encountered by couples suffering from effect over the next three months before month. subfertility.

deciding whether to repeat it. Television was Sales in the UK have mirrored closely A similar video for consumers includes chosen to give rapid awareness of a totally those in the US where the product was interviews with infertility specialists and new product category while the Press launched over a year ago, and by the couples who discuss the difficulties they campaign, which continues until the end of beginning of January were "well above experienced when trying to conceive. the year, sims to give more detailed expectations". The company was "inundated" POS includes leaflet dispensers and information. The brand is supported by a with calls to the free linkline advisory window stickers, and a detailed booklet on

promotional spend of over £1 million in its service, mainly from consumers but also "Fertility and infertility" is available free. first year. from GPs and pharmacists. Tambrands Ltd, Dunsbury Way, Havant, The Independent Broadcasting A professional programme is currently Hants POS 5DG. FOR USE UNDER DOCTOR'S GUIDANCE UNIPATH PLANS

The recently introduced Ovustick self test a surge guide which acts as a colour control. Unipath are developing an ovulation test ovulation predictor kits are extensions of the The difference between the 6 and 9 kits which they hope will have the same impact Ovustick 100 kit used by many infertility relates to the woman's ability to judge her on the market as Clearblue had on the clinics and private gynaecologists. peak fertile day accurately. The 9 test pregnancy test market. The company While Ovustick is simple to use and (£40.50) IS used mainly for women on in vitro beheves the market for ovulation detectors is cheaper than in 1986, distributors Medimar fertilisation, artificial msemination or natural potentially much bigger than that for regard the product as a professional testing conception programmes who have irregular pregnancy tests. system for use primarily in clinics and under cycles. The 6 test (£27) is intended for a doctor's supervision. They are making the women who have a better indication of their self test kits available through pharmacies date of ovulation. The test kits are available NO RISK OF AIDS of the from clinics and direct from Medimar at because of increased awareness TESTING system, but will not advertise them to slightly less cost. Medimar Laboratories, FROM consumers. The tests are manufactured by Sarum House, 17 The Queensway, Challont AIDS experts have said that pharmacists Monoclonal Antibodies Inc. St Peter, Bucks SL9 8NB. carrying out pregnancy tests should not The Ovustick self test 6 and 9 can detect Medimar have recently set up tnals m the be at risk from the disease. Ahhough the the LH surge some 24-36 hours before UK on a test which detects pregnanediol in AIDS virus has been cultivated from ovulation, compared with the less sensitive the urine of ovulating women. The RAMP urine there is no evidence that the tests which give only 12-24 hours warning. Progesturine detects this urinary metabolite infection has been spread in this way.

But they still cannot be used as a natural of progesterone, in less than five minutes Protective gloves or plasters to cover contraception system because of the sperm and helps the clinician to let the patient open wounds have been recommended

lifespan. The dipstick gives a permanent know quickly if ovulation has occurred or if as an additional precaution. record of the colour change and each kit has chemotherapy is working. TWO TESTS A DAY The recently launched Organon LH Color predictmg ovulation with certamty, the com- solparticle immunoassay (SPIA). Gold par- [C&D, January 31, pl57) uses two tests per pany says. For this reason, Organon regard ticles are coated with monoclonal antibodies day to minimise the risk of missing the LH the test as bemg suitable for use at home, but to LH, which, when exposed to the hor- peak. Organon say that to ensure highest with a doctor's guidance. mone, disperse and agglutinate m a probability of catching the LH surge, profes- The accuracy of Organon LH Color has sandwich-type reaction. The original sional guidance is needed for beginning the been confirmed by testing more than 3,000 reddish-purple colour of the test material seven-day test series. This should take ac- urme samples; results were 99.6 per cent fades to a greyish-blue. In the absence of count of the average length of previous correct to positive urme (greater than 50 lu LH, the original colour remams unchanged. menstrual cycles. LH/litre) and 99 per cent correct to negative Each Organon LH Color kit (£44.95) Large retrospective studies indicate that urme. In practice, however, because of provides 14 tests. A colour reference chart 90 per cent of conceptions take place within biological factors such as irregular cycles, IS provided, together with patient notes and a five-day period which spans the LH peak short LH surges of less than 12 hours, and doctor notes giving guidance on when to Ltd, by -f 3 or - 2 days. Professional advice peak LH concentrations of less than 50 lu, start the tests. Organon Laboratories which takes note of long or short cycles, and accuracy of detection can be reduced. Cambridge Science Park, Milton Road, a twice daily detection test can be crucial to Organon LH Color is based on the Cambridge CB4 4FL.

216 Chemist & Druggist 7 February 1987 WHICH OVULATION TEST?

Today's women increasingly ask their Pharmacist for professional advice on fertiUty testing. When asked, can YOU recommend to them a simple once a day dipstick self test which ...

. . . has been available in the UK since 1984

Many leading NHS and private clinies have been using this dipstick in natural and artificial fertilisation programmes

. . . offers a permanent record of results

of value in charting monthly fertility times and for consultation with medical adviser

. . . has kits for normal and irregular cycles

one kit for normal cycles and another for irregular or long cycles for women follow ing a recent birth or cessation of a contraceptive programme

. . . gives 24 - 36 hours warning of likely ovulation time

the extra hours can be most helpful to couples planning conception

. . . has a colour surge guide control

unique to each kit and allows the user to clearly identify her LH surge

. . . has excellent correlation with well established tests

thoroughly tested in parallel and against basal body temperature, cervical mucous, serum and urine radioimmunoassay, serum progesterone and ultrasound tests

. . . and is very easy to use at home?

Yes you can With confidence you can recommend OvuSnCK

S E L F T H S I Urine hLH Dipstick Assay

Now available to pharmacists for OTC sales in two packs at new, reduced 1 987 prices:

For women with normal cycles For women with irregular or long cycles '^ OvuSTICK Self Test 6day kit RRSP £27.()() OvuSTICK™ Self Test 9 day kit RRSP £40.50 (Pharmacist cost £15.65 + P & P + VAT ) (Pharmacist cost £23.50 + P'& P + VAT)

For full information contact 'jOO MediMar Laborat:ories frP A Division of MediMarketing Ltd " Sarum House 17Tlic Oucciisway, ChaUont St Peter, Bucks SL9cSNB Tel : 0753 S845()2

0«' .( » )' 1 0»««OOOijOO Sole distriliutors tor

f\\ifib Monoclonal Antibodies, Inc. CLINICAL PHARMACY

CNS 3: Depression - sadness We all experience a depressed mood from time to time. Feelings of sadness are considered an appropnate response to a beyond the norm recent loss or disappointment. They are expected to remit spontaneously sooner or later, depending on the personality of the bad luck wU] cause the attempt to fail. They In the third article of this sufferer and the cultural norms of his society. will take 200 tablets not 20 (ironically, often We must differentiate between this and a series, Russell J. Greene, of tncychc antidepressants, whose toxic effects are so difficult to manage). They will plan the disease state. One criterion is, like anxiety, the Chelsea Department of suicide carefully and, though ostensibly whether it is socially incapacitating. Another Pharmacy, King's College, IS whether society regards the apparent keeping it secret, may give covert hints of causes as meriting a period of depressed London, continues our survey their intention. mood. The death of a close relative is a good of psychiatric disorders with In very severe ED, psychotic features may become evident. The general feehng of example: almost all cultures recognise a depression, another common mourning period, although this varies worthlessness becomes a fixed, unreahstic condition met in general greatly. In the UK, perhaps six months to a false behef which no appeals to reason can

year is regarded as average for a spouse. practice. shift, ie a delusion. Patients believe themselves to guilty, people", Much less seems callous; but to dwell on it be "bad for much longer, staying pessimistic and common, whereas neurotics merely feel responsible for destroying their family and tearful, would be regarded abnormal. sorry for themselves. letting down their workmates. This may be are Alternatively, someone who is depressed but Psychosomatic problems common: reinforced by hallucinations in which they often these whose life gave no apparent evidence of are gastrointestinal symptoms may hear voices chastising them as evil and substantial adverse events, would also be such as constipation or dyspepsia. In corrupt. Their perpetual misery makes regarded as suffering from a morbid reactive depression, as in anxiety, there is suicide an appealing option. difficulty getting off to sleep, whereas the depression. Aetiological theories This implies two main groups of diurnal variation in endogenous depression in of fall depression. In one there is an exaggerated produces the worst symptoms early the Biochemical theories depression into response to events which might be expected morning, causing early waking. two classes, amine imbalance and to depress anyone to a certain extent, but In more severe depression there is a electrolyte imbalance. The former loss of drive, vitality, of with which the patient is unable to cope: this marked ambition and traditionally postulates a deficiency reactive depression (RD; reaction to zest for life, more pronounced in ED. Since catecholamines, chiefly noradrenaline marital can follow the reduced mainly in the limbic system. This is external circumstances) is neurotic in problems (NA), character. libido, and impaired performance at work partly supported by the action of tricyclic The second type, endogenous depression the loss of drive, the patient's low seli-esteem antidepressants, which block amine re- (ED), seems to arise from within the patient, is reinforced. uptake and so increase local levels. In severe the neurotic patient postulates abnormal and is unrelated to external events, RD may be The second theory suggesting an unsure grasp of reality and driven to an impulsive suicide attempt fluid distribution between various body lack of insight, which are psychotic features; (parasuicide), but this rarely involves such compartments. A current version proposes a commitment as jumping in front of a train or defective membrane sodium as the see table 1. Disorders of mood (depressive or pump otherwise) are termed aHective disorders. out of a high building: usually it means a cause of this, which perhaps correlates with couple of dozen tablets or perhaps some the action of lithium salts in affective Clinical features clumsy wrist slashing. However, when ED disorders.

The principal features are summarised in patients decide to commit suicide they are However, some authorities regard only or learned, table 2. Unfortunately, patients rarely fall usually very determined: ignorance depression as a inappropriate neatly into one or other group. A pahent may show some psychotic features but be Table 1 — Comparison of reactive and endogenous depression predominantly neurotic, or may seem largely psychotic (eg with delusions) but Feature Reactive Endogenous have an obvious recent loss as a likely Psychiatric class "neurotic" "psychotic" trigger. Although many features are Psychotic features absent delusions; rarely, common to both types, a differential hallucinations diagnosis can be based on a number of Self-image self-pity self-reproach distinct symptoms. Cause/trigger response to loss or no obvious cause The cardinal feature is a depressed disappointment mood (sadness, dejection, pessimism). Onset acute insidious However, neurotic depressives do react to Family history possible probable the mmor joys and disappomtments of hie to Mood variation labile; sensitive to minor ups regular diurnal variation some extent, whereas endogenous and downs depressives tend to have a fixed daily Sleep disturbance increased latency early waking variation in mood — dreadful in the morning Suicide risk parasuicide genuine risk and improving slightly by evening. In Sex variation twice as common m females about equal endogenous depression, feelings of guilt, Psychomotor disturbance agitation agitation and/or retardation self-reproach and worthlessness are

218 Chemist & Druggist 7 February 1987 . .

and some loss of recent memory, which may Table 2 — Clinical features of depression be beneficial since subsequent ECT procedures will not cause undue anxiety. Common features Reactive features Endogenous features Controversy still surrounds the possibihty of long term bram damage, but keeping Mild depression courses to a maximum of 12 is a precaution. variation Depressed mood . labile diurnal On the other hand, ECT has none of the Pessimism, sadness, adverse effects or contraindications of

dejection . self pity self reproach drugs. It can be used safely in pregnant women and the elderly, and there is no long Severe depression term toxicity or suicide risk. However, ECT Drive/vitality reduced Parasuicide has no place in the treatment of reactive Apathy depression. Social withdrawal Drug therapy Loss of interest/pleasure

Libido reduced Antidepressant medication (table 3) may not be needed mild reactive depression — Very severe (psychotic) m sometimes simple psychotherapy, Delusions supplemented perhaps by a short course of

Hallucinations benzodiazepine anxiolytics, is all that is Retardation needed. Monoamine oxidase inhibitors Suicide (MAOIs) may be better than tricyclics Additional features (may be present) (TCs), especially if there are features like anxiety or phobia. However, toxicity limits Anxiety, agitation their use, and TCs are commonly first obsessions Phobias, choice. Treatment should be stopped as the Psychosomatic illness patient recovers and maintenance therapy is

. . difficulty getting to sleep early waking Sleep problems not indicated. disturbances Appetite In endogenous depression, the TCs Key: Different manifestations of common feature in reactive or endogenous depression. (including the newer drugs of different structure but similar action) seem to be the behavioural response to difficult Q relative effectiveness in different types of most effective. Maintenance therapy may be circumstances, with biochemical changes depression advisable if the disorder has a cychc pattern, being only secondary. Q presence of severe psychotic features especially if there are phases of mania, and potential harmfulness of treatment lithium IS then the drug of choice. Lithium is Course of the illness [J Psychotherapy is the treatment of choice about as effective as TCs in unipolar

Depressive illness is naturally self-limiting, for reactive depression, and is also important depression but the need for serum-level although prone to recurrence. The for endogenous depression. Although long monitoring limits its use. Tryptophan has

endogenous kind develops over the course and costly it does hold out hope of a genuine not lived up to its promise.

of months, and episodes may last for months recovery. At its simplest it is no more than Tricyclics. The newer drugs such as the

or even years. These may alternate with counselling and support. It is important to tetracyclic mianserin share many features

periods of normal mood, (unipofar affective reassure the patient that he is eventually with the traditional agents such as disorder). More rarely there may be going to get better. The team approach amitriptyline. They are no more potent but intervening periods of mania (abnormally involves a clinical psychologist and a social generally less toxic; see table 4. Two elevated mood) resulting in bipofar affective worker. In endogenous depression one of the important properties govern antidepressant

or manic-depressive disorder. Reactive main aims of the therapist is to restore the choice. Toxicity determines contra-

depression is usually acute m onset and may patient's self-esteem. In both types it is indications and the predominant remit almost as abruptly, sometimes after important to advise the patient agamst taking nonspecific CNS effect — depressant or only a matter of days. important decisions while depressed, stimulant — determines indications. Management strategy although decision-making is hard for The adverse effects of tricyclics tend to depressives anyway. be mild anticholinergic actions such as dry

The aims of managing depression are, in ECT is without doubt rapidly effective in mouth, constipation, etc, and drowsiness order of importance: severe suicidal depression, and its proven with some, which may remit on continued Q to prevent suicide (in severe cases) harmful effects are few. It consists of passing use. One potential problem is the activation n to identify any possible organic causes, a brief electrical pulse through the brain. of mania m patients susceptible to bipolar such as chronic illness The patient receives a short-acting mood swings. Patients must also be Q to select the most appropriate acute intravenous anaesthetic and a muscle encouraged to persist with medication since symptomatic therapy relaxant to prevent a physical seizure. A the drugs take several weeks before any to investigate any adverse social, course of ECT consists of eight to 12 benefit is noticed. domestic or financial circumstances treatments, given about 3 times weekly. The Toxicity is important because they are n to initiate long term, potentially radical procedure seems to produce a more rapid often involved in suicide attempts. There is therapy elevation of mood in the severely depressed, no specific antidote and all complications

The three main treatments used are minimising the risk of suicide at the most must be managed symptomatically . These psychotherapy, drugs and electroconvulsive vulnerable phase of depression and include cardiac conduction defects and therapy (ECT). The criteria for choice are: enabling the patient to start psychotherapy. vagal inhibition, causing arrhythmias and n speed of onset of action Common adverse mental effects include, heart block; and CNS effects, mainly Q cost not surprisingly, headache and confusion. continued on p220

Chemist & Druggist 7 February 1987 219 CLINICAL PHARMACY^ Table 4 — Some newer tricyclic-like antidepressants

Doxepm less cardiotoxic Dothiepin

Table 3 — Comparison of main antidepressant drugs Mianserin* less anticholinergic Lofepramine less CNS & CVS toxicity Tricyclics MAO inhibitors Trazodone

General CNS effect Sedative Stimulant Stimulant Thioxanthines neuroleptics with some Examples Amitnptyline Protriptyline Phenelzme antidepressant action (eg Trimipramine Nortriptylme Tranylcypromine Indications Endogenous (and reactive) Reactive? "atypical" flupenthixol) Adverse reactions Drowsiness CNS stimulation CNS stimulation * no amine reuptake block Anticholinergic Anticholingergic CNS = central nervout; system Postural hypotension Postural hypotension CVS = cardiovascular system Activation of mania Activation of mania compliers because they enjoy their manic Other autonomic disturbances attacks. The goal in is Toxicity/Overdose Arrhythmias Hypertension hthium therapy a serum level within the narrow therapeutic Seizures "Cheese reaction" window 0.5 - Interactions MAOIs? Sympathomimetic amines l.Smmol/litre — towards the high end for acute attacks and reducing for Anticholinergics Tyramme foods maintenance. This entails regular CNS depressants measurement of serum lithium, monthly at Narcotics first and six-monthly in stabihzed patients. Dosage Once or twice daily Two or three times daUy A stable serum level throughout the day continued from p219 tricyclics. Overdose is easier to manage, is desirable, as acute adverse effects such as epileptiform seizures and confusion. There with specific alpha-adrenergic blockers (eg polyuria, oolydipsia and fine tremor seem may also be profound hypotension. phentolamine). However, there are a wide related to post-dose peak levels. This means The principal advantage of the newer variety of potential interactions, mostly that slow release preparations and/or agents is a reduced incidence of these serious. Although other prescription frequent daily doses are desirable. If levels complications, as well as less troublesome medication can usually be controlled, rise too high, warning signs include antichohnergic adverse effects. However, problems with OTC preparations containing diarrhoea and vomiting, coarsening of the patient responses are highly variable, so a sympathomimetics (eg decongestants) and tremor and CNS depression. Sustained flexible approach is required. tyramine-containing foods are more levels above 2 mmol/litre cause Generally they are well absorbed, but difficult. The resulting hypertensive crisis hypotension, convulsions and coma.

subject to quite high first-pass metabolism. can be fatal. As a result MAOIs are likely to Lithium IS distributed throughout body

The extent of hepatic clearance varies remain minor antidepressants. water, generally following sodium, and is greatly, and they are widely distributed. Lithium. Lithium has an antidepressant cleared by the kidney. This gives potential

Plasma drug is quite highly protein-bound action similar in potency and onset to problems because in circumstances which

but this does not give rise to interactions. amitriptyline for single episodes. But its real cause the kidney to increase sodium Only recently has there been any good value Ues in the maintenance prophylaxis of reabsorption, (electrolyte depletion, evidence of a relationship between plasma recurrent unipolar or bipolar depression. dehydration or diuretic therapy), lithium

level and clinical effect. The overall effect is Here it is safer and more effective than clearance is reduced and this results m to give long half-lives, so that a single daily tricylics. dangerously high levels. Patients must be

dose is usually adequate: this may be best Lithium treatment should only be warned about this.

given m the evening, to minimise sedative considered if there is a strong likelihood of Despite these potential problems, hthium side-effects. recurrent episodes, either of endogenous is a popular, widely used drug. Moreover,

The contraindications and precautions depression or mania, where it abolishes or diligent monitoring has enabled patients to

in the use of tricyclics stem directly from reduces the frequency, duration and be on hthium for decades with httle ill effect. their adverse effects. Patients with heart intensity of mood swings. A few patients Many of the factors considered above

disease, narrow-angle glaucoma, urinary complain that it produces a flattening of can be conveniently presented as a decision

retention (eg prostatitis) or constipation will normal mood, and manic patients are poor tree (fig 1). need to use the newer agents. Patients on antihypertensive medication should use Figure 1 — Drug selection in depression mianserin, which does not interact with yes amines. However, the long half-life can severe/suicidal? -> EOT cause problems in the elderly. no^ MAOIs. These drugs seem to be of some yes recurrent/bipolar? - Lithium value in reactive depression, especially if no^ features such as phobia or yes phobia? yes there are neurotic reactive/atypical? Clomipramine anxiety. Nevertheless they tend to be second no no ^ I MAGI or third line drugs for all but hospital cardiovascular disease? yes Doxepin Mianserin impatients managed by psychiatrists, elderly? Lofepramine because of the toxicity and the problems of anticholinergic contraindications? dietary compliance, added to those of no ^ yes .medication compliance. There is agitated? Amitriptyline disagreement over their value in ^ over-sedated? endogenous depression. Imipramine Normal use produces various yes retarded? cardiovascular and gastro-intestinal Protriptyline disturbances, although less than with the Desipramine

220 Chemist & Druggist 7 February 1987 .

A new breed of resistance fighter

search ior new, effective antibiotics TThe Recent advances in IS a constant and ever more challenging antibacterial exercise. No sooner is there a breakthrough therapy than the bacteria hit back and develop have been limited by resistance. In some specialised units m large problems of bacterial hospitals, muhtple- resistant, "super" bactena resistance and the have evolved that are virtually immune to all absence of oral but the most powerful parental formulations. A new antibactenals. Even the treatment of urinary group, the quinolones, tract infections in the community is facing a seem to offer benefits steady increase in resistance of roughly 2 in both areas, as per cent a year. Bayer UK explain. Many of the older antibiotics have been rendered virtually useless; if it was not for some of the newer broad spectrum drugs, Respiratory: active against most mode of action. The 4-quinolones have been bactenal infections would by now be gaining respiratory pathogens including shown to inhibit the enzyme, DNA-gyrase, the upper hand. Haemophilus influenzae^ ^{97 per cent), which IS responsible for a process withm

a group of drugs — the ^ Now new Pseudomonas aerugmosa^ (65 per cent), bacterial DNA called "supercoiling"'V It 4-quinolones — has been developed, the Klebsiella^ ^ (100 per cent), and Legionella, appears that supercoiling is necessary m first of which, ciprofloxacin, is being as well as mycoplasma and pneumococcal order to pack the bacteria's vast amount of launched shortly. These antibiotics, with infections. nuclear material withm its cell membrane. their exceptionally broad spectrum, clinical Gastrointestinal : active against By inhibiting DNA-gyrase, the bacteria is '" ' efficacy, excellent tolerability and oral, as Salmonellae' (100 per cent), ShigeUae" effectively prevented from carrying out any well as parenteral formulation, could see the (100 per cent), and Campylobacteria physiological process and dies, whether or start of a new era antibacterial therapy. m Venerial : highly active against not it's replicating at the time. The 4-quinolones are not entirely new. Gonococci — single oral doses give cure The vast majority of bacterial resistance The first, nalidixic acid and oxolinic acid, rates approaching 100 per cent^ develops through the appearance of special were developed m the 1960s. But poor Gynaecological'", biliary", bone^ areas within their DNA called plasmids. By absorption and poor tissue penetration, and (osteomyelitis), and even skin infections all acting directly against the DNA, plasmid a relatively high incidence of side effects', respond with high cure rates. formation cannot occur, so the only way together with the advent of more powerful Finally, there are certain areas, such as resistance can develop in 4-quinolone antibiotics, relegated to meant they were pseudomonal chest infections m cystic treated infections is for the bacteria to mutate second or third Ime therapies, and then only fibrosis patients, where the drug's (a rare occurence). Since this will usually in uncomplicated urinary tract infections. efficacy^ (77 to 100 per cent), combined leave the bacteria in the weakened state, it In the today's 1970s, work began on "new with its oral formulation and twice daily means 4-quinolone-resistant bactena tend to generation" 4-quinolones. By substituting dosage, could revolutionise management. be less virulent. piperazme and fluorine molecules, a group As for side effects'^, there are In summary, both orally and of antibiotics with markedly improved remarkably few view of the potency of parenterally 4-quinolones are m , pharmacokinetics, an mcreased spectrum of these drugs, and the marked side effects fundamentally bactericidal, they are activity and very significantly enhanced found with the use of the earlier effective against many organisms that are potency were developed. The most 4-quinolones — gastrointestinal intolerance resistant to beta-lactam and aminoglycoside important compounds so far produced (nausea and diarrhoea) — occur in fewer antibiotics, they have a low incidence of side include ciprofloxacin, enoxacm, than 3 per cent of patients. The incidence of effects, and the development of bacterial norfloxacin, ofloxacin petloxacin. and diarrhoea m particular is lower than that resistance appears to be less than with other Efficacy seen with other broad spectrum antibiotics antibiotics. Only time will tell if, with the (probably because although the aerobic launch of ciprofloxacin and its relations, Extensive clincial trials are still being bacteria are killed off, the anaerobes these drugs live up to their early promise. carried out on a number of these drugs, but remain). Skin rashes and CNS disturbances Reierences something of their potential can be seen occur. by sometimes 1 Ronald A R N Eng 1 Med 1966,275: 1081-9 loolong at the proven indications for the first In tests on young animals '\ the 2 Auckentheder R Proceedings ol the 1st inlernational Ciprolioxacm workshop, 1985 42 to reach the market, ciprofloxacin^ (the 4-quinolones were found to produce erosive 3 ZeilerHJ Eur I Chn Microbiol 198-1, 3: 339-43 figures in brackets show percentage lesions on articular cartilage, so although no 4 NaberKG ibid 2: 314 5 SchachtP ibid 2; 435 eradicated). such effect has been reported in humans, 6 Khan F ibid 2: 252 Urinary tract: Ciprofloxacin has been they are not recommended for children. 7 DiridlG ibid 2:370

8 Schonwald S ibid 2: 353 shown to be exceptionally effective m killin g The 4-quinolones bring another major 9 PereaEJ ibid 2: 338 all common urinary pathogens'"' (eg E.coli benefit: they are seemingly able to treat 10 GoormansE ibid 2: 189 98 per cent), and in treating both uifechons without producmg the same levels 11 BiogardIM ibid 2: 130 12 Bendor S W Inleclion 1986, 14: 17-21 complicated' and uncomplicated urmary of bactenal resistance as other antibiotics. 13 Schluler G ibid 2: 61 tract infections^ The key to this ability lies m their unique 14 KavseiFH Res Clin Foruma 2/2

Chemist & Druggist 7 February 1987 221 1986, because he "could not condone" the I therefore mvite the PGC to confirm Richardson INPA NPA Board's decision to provide members the figures with me, and then go back to with labelling software. the Government and demand they live up As an NPA member, he will have read to their promise. Who knows, the computer split the Pink Supplement introduction to our Government might yet be persuaded to new labelling software, which lays great give us the much better deal offered m Pharmacists will now be aware that my stress on the merits of a complete system England and Wales — a guaranteed company's products are no longer being for those "with heavy dispensing business minimum income. recommended by the National or those seeking maximum ease of use". Finally, I urge all Scottish ESPs, Pharmaceutical Association. I am sure that Indeed the article concluded: "the especially those with high ingredients both John Gouldmg and Jim Downing at excellent ready made labelling systems costs, to do their sums very quickly, and Mallinson House will agree that this is in given by Park Systems Ltd are, in our view, complain to the PGC and the Government no way connected with the quality of our the systems of choice where extra speed where necessary. If they need any help, products, or our service, which we shall and extra features are important." they should not hesitate to contact me on continue to maintain. Indeed, it is our Our £99 software is offered to those Kilbarchan (05057) 4142. dedication to the wellbemg of pharmacists who have said to us that they cannot justify Graeme M. Park which has led to a basic disagreement, in (or afford) £1,000 or more for a system plus Johnstone principle, between us. maintenance. They can see high capacity We have always believed (and recent hardware on local sale for under £400 and surveys and television programmes Classic case? know that we can maintain it nationwide confirm our views) that after-sales service for an annual charge starting at £36. There I note with interest Mr Allen Tweedie's IS of vital importance to any business IS also a three month free hotline for threat to resign from PSNC over the new computer installation. It is also wise to advice. Having been thus weaned from a purchase both equipment and program contract {C&D Janujary 31, pl53) m order typewriter to low cost computer, many a to speak at the LPC conference. Am I to from the same supplier, so that if problems will soon be more than ready to move up take it that no other member of the arise, there is no doubt as to who to turn to market. Northern Region is capable of expressing for help. This is m direct conflict with the We agree that most Richardson users point of view? NPA recommendation that pharmacists that region's satisfied with the quality of are more than I understood that purchase NPA software and obtain their have always their systems, although we have had an equipment from dealers who often have committees applied the principle of volume of complaints about increasing collective responsibility, and if a member little knowledge themselves. I advise that maintenance charges. These added felt so strongly on principle that the final this option is chosen only by those familiar to cost of £257.50 (from day one) the each is unacceptable to his conscience with computers or by those prepared to decision system and any user who chooses not to spend considerable time learning. he would resign on principle on the spot. unstuck he requires a pay becomes when Presumably if Mr Tweedie could I am concerned that the NPA program update — the price is £266! Chairman's permission to recommendation, as a concept, will lead to receive the Accordingly we were increasingly finding against at the LPC a surfeit of programs flooding the market speak PSNC ourselves to having to defend our not resign — a and the situation returning to the conference he would recommendation of his system and it was of running with the hare and confusion of some three years ago, when classic case therefore with mixed feelings that we pharmacists made costly mistakes as hunting with the hounds! accepted the faite accompli finally C.A. Benjamin suppliers came and went. It must also be imposed upon us. This also explains the Leeds borne in mind, that while software withdrawal of the Richardson stand from suppliers may allow a trial before the NPA's June show which provides a purchase, computer dealers, as a rule, will unique platform for our recommended House cleared on not. We therefore intend to continue suppliers. supplying only complete pharmacy labelling systems with an adequate trial time period, and a dedicated after-sales I am pleased to find that the practical service. We shall continue our research Xrayser is a user of our Clearing House but and development program, and looking No worse off in sorry to leam that he encountered for ways to help pharmacists further. problems with some of his suppliers over It is regrettable that we must progress Scotland? the Christmas period (January 17, p77). without NPA backing and that perhaps we May I first refute the suggestion that will be deprived of a fair recommendation I have had a letter from the Council there was any delay by our Clearing of the quality of our products. It is also Pharmaceutical General House. As always our cheques went out on unfortunate that we are not to be permitted (Scotland) outlining the probable the contract for the due date. Not only that, we went out of to exhibit at the NPA show in St Albans. remuneration under new to many suppliers essential small pharmacies in Scotland our way accommodate Nevertheless, I must sincerely thank all physically with a calculator who sent representatives to those at the NPA who, in the past, have (see pl84). A few minutes health collect their cheques and many others who helped to further the aims of my company. and my statements from the board wanted their remittances sent by Datapost John Richardson, have shown that my pharmacy will be paid or other special treatment. If payments Managing director, John Richardson somewhat less under the new system. were not cleared the fault lay either with Computers Ltd. This cut in my income is frankly firms were closed for the incredible in view of the repeated those who Christmas holiday or from postal delays. John Gouldmg, NPA business services guarantee by PGC officials and Scottish B. Dosser manager replies: Government ministers that ESPs Finance oHicer, National Pharmaceutical Mr Richardson withdrew from the NPA would be "at least no worse off than under procedures". Association. scheme himself as long ago as October 19, the existing renumeration 222 Chemist & Druggist 7 February 1987 .

The Myers Dispensary System An effective tonic for the Pharmacist

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Telephone: South (0474) 60671 , North (0204) 793316, Scotland (03552) 38521 BUSINESS NEWS

Election time • • • The 'M' team Macarthy Medical have tidings for industry restructured their retail supplies division sales force to create a co- ordinated national sales team The UK pharmaceutical industry controls on profitability, pricing and marketing, the industry would remain covering all retail pharmacy has most to fear from a Labour "relatively stable" if the Conservatives supplies. Government victory in the next were re-elected. The team is headed by Steve Lakm, General Election, according to Among other trends over the coming sales director, who has made the following Jordan's latest financial survey. years, the survey predicts that innovative appointments: John Herbert is appointed But "The British Pharmaceutical companies will spend larger proportions national sales manager and is supported Industry" predicts that, whoever wins, the of their turnover on research and by two new regional sales managers: Mike new Government will maintain and even development. The UK will remain their Gregory, regional sales manager (West), extend controls on GP prescribing mam research centre, helped by costs based at Redditch, and Richard Crawford, through the limited list, "the threat and of much lower than in America. regional sales manager (South), who will generic substitution will continue to hang The report also predicts that operate from Romford. Also based at over the industry." companies will be seeking overseas Romford will be Mike Stafford, key report The points out that a Labour acquisitions to broaden their research accounts manager, retail supplies division. Government, committed to nationalising base, and to break into major work The Scottish Region will_have its own sales one or more drug companies to provide markets. team, directed by Frank Verrall. cheap generics for the NHS, could "The British Pharmaceutical Industry" The hospital sales force has also been provide major upheavals. But it says that is priced £125, from Jordan & Sons Ltd, reorganised into three teams. John Owen although the past three years have been Jordan House, Brunswick Place, London IS appointed national sales manager — the worst ever for the industry in terms of Nl 6EE. disposable and pharmaceutical products. Clive Watkms is theatre products sales in the luncheon voucher limit to £2 per manager and John Kelly has been made NPA seeks lower working day; the threshold limit for higher responsible for special product sales paid employees should be raised from covering the Macarthy Medical range of VAT penalties... £8,500 to £12,500, and the cost of private dialysis and cytotoxic products. medical insurance be allowed against tax. Changes in the penalty system for late VAT returns, and an increase in No trade merger the VAT registration threshold, are . . • makes loans Plans for a merger between the being called for by the National A new loan service from the National Chamber of Trade and the Pharmaceutical Association in their National Pharmaceutical Association of British Chambers of 1987 Budget submission. Association may be extended to Commerce (C&D, May 10, 1986) The present penalty system is "harsh include cash for personal items if its have been suspended because of and unreasonable" leading to delays in launch proves successful. "unacceptable conditions" refunding, says director Tim Astill in a NPA Finance Leasing Ltd has been letter to the Chancellor. And an increase proposed by the ABCC. formed to provide loans for business the registration threshold, making it The is insisting on retaining its m purposes of up to £10,000. NPA members ABCC optional to £100,000, would reduce the own regional structure with its with established businesses only will be "uneconomical" cost of collection. concomitant financial claims from VAT eligible initially. Finance and Simplification of the forms for Special chambers after two and a half years of administration officer Mr Brian Dosser Retail Schemes, and no further increase negotiations. This is not the wish of the m says the NPA has been looking for ways to the VAT base despite European pressure majority of NCT members who want a two- better utilise its deposited funds. "The low are also requested. tier or parallel system of membership of rate of interest is possible because we are is This In addition the Chancellor asked to presently borrowing from the bank." any new national organisation. would consider the following: All retail stores cater for the differing level of services and service buildings should have a Unichem's first phase in moving their required by local chambers, the NCT

writing down allowance of 4 per cent; the Croydon depot to a bigger site begins on says. It believes a merger would double tax charge on the capital gain February 7, when counter lines are moved strengthen the chamber movement as a

arising when members sell their family to the new branch m New Addmgton. whole, and says it will keep this under companies etc, be abolished; an increase Medical lines will follow spon. review.

Ethyl Alcohol (S.V.R.) f Fermentation and synthetic qualities both available to British and all well known International Specifications and Pharmacopoeias. James Burrough (EA.D) Ltd.

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224 Chemist & Druggist 7 February 1987 .

BUSINESS NEWS:

Co-opting Feeds for sale pharmacies The steady shedding of Beecham's "fringe" businesses carries on with Drug stores are a safer bet than the decision to sell their animal pharmacies, in the opinion of the Sussex Pharmaceuticals managing feeds division. North Eastern Co-op. And to director Harry Shepherd thanking Talks are being held with companies demonstrate the point, the Co-op colleagues for the "tremendous suppori interested in the business, which has a has opened a new drug store at and help" they had given the company in turnover of about £5m. The firm is based at maintaining business Keynsham, near Bristol, where it Whitley Bay, with a "more modern, since the factory burnt down on February 7, last year. manufactures a range of protein price-competitive image". Speaking at a dinner for 280 guests held to concentrates and vitamin/mineral The new shop — the group's fourth celebrate the recommissioning of their supplements for trade customers and drug store — is the first to carry the name 40,000 sq ft plant, he said the company hvestock farmers. Disposing of this "1st Stop" and a red, white and grey hvery. intended to regain its position in the business will let Beecham Animal Health Other stores, now called Drug Stop, will pharmaceutical and health industry as one concentrate on their veterinary and pet also take on the new image. The Co-op of the most modem and efficient factories animal health and hygiene products. says 1st Stop will be aimed at the middle in Europe. Lowfield Distribution have signed I I a market and carry "competitively priced" "significant" distribution contract with the toiletries. British Tissues have acquired the Beecham Group pic with effect from The group also has 12 branches with Gloystame group of companies which March 1. The firm — part of the Imperial dispensaries, and pharmacy group operates a distribution and warehousing Foods division of Hanson Trust — manager Jim Smith says more areas are set business in Rotherham, South Yorkshire. specialises in food, drink and household for expansion in the North East. According Their managing director, Ron Day, products. Lowfield will be working to group controller Richard Capell, the the chairman. Leslie becomes Wilson directly with PDS, the in-house drug store side of the business has "much continues as managing director. distribution arm of Beechams.

growth potential . . . not least because it

is not as vulnerable as the traditional pharmacy business, which depends totally EVENTS; on factors outside our control, like locations of doctors' surgeries, or health Somerset Branch National Pharmaceutical Association. 7.30pm at the County Hotel, Taunton. centres, and government policies". NPA local organisations officer Mike King on "The But he added that the society would Britchem's NPA". still be looking for opportunities to expand Thursday, February 12 profitably the pharmacy sector. Gala event The British Society for the History of Pharmacy The Britchem Gala Ball takes place PSGB joint meeting, 7pm at the Pharmaceutical Society's Headquarters, 1 Lambeth High Street, on March 7. in the Kings Suite. London SEl 7JN. Mr James Coleman, secretary, Irish An eye for a buy Metropole Hotel, NEC, Birmingham. Society for the History of Pharmacy, on "Irish Pharmacy's struggle for Identity: The Impact of The reception commences at 8.30pm Boots have added to their growing Politics and Achievements by English Pharmacists". and is followed by dinner, cabaret and Glasgow and West of Scotland Branch, optical division by buying a five- dancing. Tickets are £48 per head and Pharmaceutical Society 7.30pm, The Walton Suite, branch chain of registered proceeds of the evening will go towards Southern General Hospital, Glasgow. Mr John K. opticians. the Pharmaceutical Society Benevolent Todd, consultant general surgeon. Royal Infirmary, Glasgow, and annual report of the School of The acquisition of Edmund Wilkes Ltd, Fund. Details from Valerie Day, Tabcon Pharmaceutical Sciences. University of Strathclyde. who have outlets in Essex and Sussex, Marketing Ltd, The Courtyard, 14 North Staffordshire Branch, National brings the number of Boots' optical Muswell Hill Road, Highgate, London N6 Pharmaceutical Association, 8pm at North Staffordshire Medical Institute, Stoke-on-Trent. NPA practices to 191. The company bought 5UG, public relations officer Tanya Tumton. Clement Clarke last year — to be turned Sunday, February 8 into "Boots Opticians" stores by April — Advanced Information College of Pharmacy Practice. Scottish area study and have 102 practices within stores. The Hertfordshire Branch. National Pharmaceutical day. Gleddoch Country Club, Longbank. Details on Association, 8pm, joint open evening with the West new chain will also eventually be taken in 0389-54121, ext215. Herts Branch of the Pharmaceutical Society, at the under the "Boots Opticians" banner. NPA's head office in St Albans on February 26. Monday, February 9 Boots' Terry Steel said more optical Numark wholesaler S. Haydock & Co Ltd of Belfast, Clinical Pharmacist's Training Group, business was planned, both through Diamond Anniversary Trade Show in the Drumkeen "Dermatology," 6pm. The Lecture Semmar Room 1, Hotel, Belfast on May 6-7, 1.30pm-9.30pm each day. generic growth and further acquisitions. Glasgow Royal Infirmary. Further details from Tom Hutchinson, S. Haydock & The company is now the second biggest Co Ltd, 31 Ballynahinch Road, Carryduff, Tuesday, February 10 Belfast. optical retailer, after Dolland & Aitchison Unichem Convention. A limited number of places Edinburgh and Lothians Branch. Pharmaceutical — and aims to overtake them as well. are now available, for further details, Ros lones/Nicky Society, 7.45pm, 36 York Place, Edinburgh. Mr C. Everard of Granard Communications on 01-930 671 1 Hollands, director of the Scottish Society for the Prevention of Vivisection on "Animals in PoUtics". The Association of the British Pharmaceutical Lanarkshire Branch. Pharmaceutical Society, 8pm Industry is sponsoring "The Health Debate", with "Can Boots are introducing children's haircare in the Old Mill Hotel, Motherwell. "Drugs in Sport". we beat AIDS?", in Manchester on February 10 centres in their Children's World chain 6.30pm, at the Stopford Building, Manchester opening this month. Called Snips, the first Wednesday, February 11 University, Oxford Road M13- Speakers include National Pharmaceutical Association, Skin care Health Minister Tony Newton, and of a planned 35 will open to the public on the conferences are course, 10am-4.30pm at the Great Northern Hotel, aimed at health care professionals. Details available February 20 in Dudley, West Midlands. London. Cost, members £38. from Ehzabeth Bird on 01-388 3111.

Chemist Si Druggist 7 February 1987 225 ——

ICLASSIFIEDi

Post to Publication date Display/Semi Display Box Numbers £3.00 extra Classiiied Advertisements, Every Saturday £14.00 single column Available on request. Druggist, Chemist & Copy date 4pm Tuesday prior centimetre, min 30mm. AU rates subject to Benn Publications, to publication date. Column width 42mm. standard VAT. Sovereign Way, Tonbridge, Cancellation deadline Ring Adrian Smith Ext 414 KentTN9 IRW^ Half Page £700.00 5pm Monday prior to for further information Telephone Tonbridge (0732) (125mm x 180mm) publication date. 364422. Telex 95132. Quarter Page £350.00 (125mm x 88mm)

Appointments Agents AGENTS RETAIL PHARMACY SALES REQUIRED THE COMPANY ALL UK AREAS We are a privately owned British Pharmaceutical Company to deal direct with which markets a wide range of quality own label generic and Chemists, Drug O.T.C. products in the retail pharmacy sector. Stores and THE POSITIONS Healthfood shops. in order to accelerate our sales momentum, we are expanding our existing salesforce by a further 8 positions across the UK. You will be given full profit responsibility within your territory Please wriie with and we expect to recruit people with a high level of defails fo: interpersonal skills and initiative. Initially recruited as sole BOX C&D3193 agents, we would expect the 'high flyers' to be able to negotiate with us a package leading to full-time employment KENT within a short period of time. Pbatmaccuticaii THE CANDIDATES AGENTS We are looking for EXPERIENCED chemist sales personnel with up-to-date retail pharmacy contacts. Preferably, in the Kent Pharmaceuticals REQUIRED generic or ethical pharmaceutical sector. Let ra set Site Agents wanting to earn Age is no barrier, just enthusiasm, as we feel that the well Wotton Road extra commission Ashford connected mature salesman is probably the ideal candidate. contact: Kent If you would like to know more about the attractive package on Alpa TN23 2LL offer, please send a CVin strict confidence to Denis O'Neill or on 01 595 7836 0233 41802 (24 hrs) ring film on Ashiford 0233 41802 (24 firs).

Agents SALES EXECUTIVES A leading group of international AGENTS pharmaceutical companies requires two experienced Sales Executives to promote O.T.C. and generic/ethical pharmaceutical REQUIRED products, both in the U.K. and export ALL AREAS markets. UK Attractive terms and incentives offered to sell new range of adult according to experience and ability. incontinence diapers to

Please reply stating all experience with chemists and other retail C.V. to date, to: — outlets. Generous Marketing Director commission paid. For Regent Laboratories Limited Cunard Road, North Acton, further details contact: London NW10 6PN. MR HARRIS on 0923 29487

226 Chemist & Druggist 7 February 1987 Agencies Required Labelling Programs

ATLASTA LABELLING PROGRAM Castlereagh THA TPUTS OTHERS IN THESHADE! Pharmaceuticals Limited For Your AMSTRAD PCf512 the last three months have Over we ; IBM PC Compatibles significantly increased the available storage space at our warehouse in Belfast. Tel: 021 643 7144 We are now in a position to accept new agencies for the distribution of pharmaceutical and medical products to Wholesalers, Hospitals and Retail Pharmacies. Warwick Chambers 14 Corporation Street Birmingham B2 4RN

In 1987 we will be strengthening our service further by engaging a representative to Labels cover the province.

For details, please contact: — MR. GEORGE McCOUBREY: LUCKY 87 GENERAL MANAGER FREE PRICE GUN & LABELS 155-157 Glenville Road The first 87 chemists ordering price labels for Meto guns in this new year can choose either a Whiteabbey free price gun or a free box of labels. Co. Antrim PHONE 0702 333761 (Anytime) Telephone: 0231 53041 LOW PRICE LABEL CO FREEPOST TOM LYDON 88 SOUTHBOURNE GROVE, WESTCLIFF-ON-SEA SSO 3BR. Business Opportunities TOILETRIES AND

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Chemist & Druggist 7 February 1987. 227 Contract Ma nufacturin^ Shopfitting Par Excellence EXDRUM — STOREFITTERS-J

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228 Chemist & Druggist 7 February 1987 Professional Prescription Computer Labelling John nidianlion Professional labelling systems Compuieii lid for the professional pharmaGist COMPLETE LABELLING SYSTEMS FOR COMPLETE SATISFACTION! COMPLETE MAINTENANCE & BACK-UP FOR COMPLETE PEACE OF MIND!

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Available as: Adalate PL55 13/0004; Halcion PL55 13/0 132 reps? Wmolate PL55 13/0205; aomid PL55 13/0030; Wewill buy yourexcess UKethicals, counter medicines, generics, TELESALES |P(J clearance lines. Anything considered. We will .0864 - 50733 eOrochem collect. Tel: David on (066J4) 2253 or 091 413 8583 (offer 6pm), BRANDED TOILETRY/ ATTENTION ATTENTION ATTENTION PERFUMERY Merchant Drug Co. Will buy your pharmaceutical specialities and Medicines, Antibiotics, Filled gelatins-capsules. available at competitive prices. Filled ampoules, Vitamins, Sulphur, Pharmaceutical raw materials, Laboratory and Contact: Hospital equipment, Baby core products and so on; ESAM INTERNATIONAL AIRMAIL CATALOGUES AND PRICES TO: 137 Junction Road, Archway, London MERCHANT DRUG CO. LTD, P.O. BOX 945 N195PX. YABA, NIGERIA. TEL: 01-263 2316 TELEX 201 17 NG. ATTEN TDS 335.

Chemist & Druggist 7 February 1987 229 IPEOPLE

lones heads up All change under Wellcome R&D crooked spire

Dr Trevor Jones is being appointed Philip Robinson has succeeded research, development and medical David C. Robinson as chief director for Wellcome UK, in a week executive, with David Robinson of Press speculation over recent remaining on the board as an active resignations from the company. director. Dr Jones, MPS, C.Chem, FRSC, David F. Robinson, presently company MCCP, has been with the company since secretary, is appointed a director, and Second prize m the Ayrshire & Bums 1977, when he joined as head of technical Stewart WaUis becomes managing Country Tourist Board shop window development. He started his career director of the packaging division, display competition went to "Apothecary lecturing at Nottingham University and replacing Philip Robinson. Paul Cox wiU cures of the 18th century" at H.C. Liddle, then spent some time with Boots. He is a take over as director and general manager Ayr Street, Troon visiting professor at King's College, of both rigid packaging and Robmson- London. White plastics and Keith Newsome is He will take on part of the job left by appointed divisional finance director for 53-year-old Dr Ronnie Cresswell, who is Postscript the dressings division. of research, co- A small operating board has been resigning as head Arun Products say they are unable ordinating USA and UK operations. He formed to streamline trading operations to continue to supply Potter's follows other research executives and co-ordinate and control the various asthma remedy because they including his predecessor, Nobel prize businesses. This board consists of the new cannot find a manufacturer to winner Sir John Vane who left in 1985, and chief executive, the two divisional in 1986 William Sullivan and Dr Pedro produce it. managing directors, the finance director Cuatrecasas, of the American operation A spokeswoman for the company said (Jonathan Wicksteed) and the company

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Kent TN9 IRW Typesetting and graphics by Magset Ltd, Sidcup, Ken* Printed by Riverside Press Ltd. Whitslable. Kent Published by BENN PUBLICATIONS LTD. Sovereign Way, Tonbridge, part this publication may be reprodured stored m a retrieval system, mecrianical Registered at the Post Ofhce as a Newspaper 26/26/ 1 6s Contents 'Ai Benn Publications Ltd 1987. All rights reserved. No of photycopying, recording or otherwise without the prioi p*-"^rmission of Benn Publications 230 Chemist & Druggist 7 February 1987 — — It's an education and there's fun to be had after school

Catch up with the latest ideas stakes. And along with this education from the biggest names in the business some will want to treat themselves to Keep up with the newest fun after school— an evening at the developments and business Gala Ball. opportunities in fields such as OTC, Don't miss Britchem. For a day, cosmetics and photography. or for the whole weekend (professional All visitors to Britchem- care is laid on for children) it's the best pharmacists or their assistants trade event yet for the forward- will give themselves a head start looking chemist, planned for in the "pharmacist of the future" pharmacists by pharmacists.

BR TCHEM THE BRITISH CHEMISTS' EXHIBITION, NEC, SATURDAY 7 AND SUNDAY 8 MARCH 1987. Exhibition and weekend package details from Tabcon Marketing Limited, The Courtyard, 14 Muswell Hill Road, Highgate, London, N6 5UG (telephone 01 444 1777).

Britain's fastest growing exhibition for retailers

a diafV March 15-18, 1987. At the National Exhibition Centre, Birmingham

There you will find tiie latest ideas in retailing, store design, display and equipment. At Hxpo Shop '87, an exhibition conceived to innovate

and interest retailers — large and small,

Wliether you're looking for a complete refit for your shop, a new retail design image or |ust simply one or two items of equipment, you can

get it all together at F,xp(j Shop '87 — the retail environment, interior design and display exhibition.

Don't miss it. It's the retail show of the year. Apply now for tickets to the address below. DESIGNERS FORUM

See the work of some of the world's top retail designers In a special exhibition feature area. Talk shop with names like John Michael Design, The Jenkins Group, Farmer Design Group, Retailing Planning Associates of the USA and many more.

To Batiste Exhibitions & Promotions, Pembroke House, Campsbourne Road, Hornsey, London N8 7PT, Tel 01-340 3291 Telex 267727

Please send us tickets to Expo Shop '87

Name Status

Company Tel no

Address . Chemlsl & Druggist

Chemist & Druggist 7 February 1987 231 You'll find the real beauty of it is the way it sells

Efamolia Evening Primrose Oil These days, the major topic in health and beauty circles seems to be Efamolia Evening

Primrose Oil skin care products . Efamolia has already been featured prominently in such magazines as She, Vogue, Harpers & Queen and Woman's Journal.

'to reinforce this editorial interest, we are running a high-impact campaign in 8 leading women's magazines that is targeted to motivate millions of readers to become regular Efamolia us( Efamolia Enriched Night Cream, Skin Lotion and Moisture Cream are produced by Efamol Ltd, the world's leading authority on Evening Primrose Oil. Efamolia products will nourish and moisturise skin helping to preserve natural radiance and beauty.

EVENING PRIMROSE OIL

For the natural life of their skin

oil. Make money by striking Efamolia and are Registered Trade Marks of Efamol Ltd. Copyright Efamol Limited. For details of bonus deals and speeial introduetory samplers, Efamol Limited, Efamol House, Woodbridge Meadows, Guildford, Surrey GUI 1BR. phone FREEPHONF EFAMOLIA on Guildford (0483 ) 570248.