Editor, – In his letter about 'Regular inhaled beta agonist drug therapy' (Aust Prescr 1993;16:53), Dr R. Munro Ford expresses concern about pharmacists supplying beta agonist bronchodilators 'to anybody who wants them, whether they have asthma or not'. Such supply would be illegal in Tasmania under the Poisons Regulations 1975, which allow the pharmacist to supply Schedule 3 substances either on prescription or if 'on consideration of the condition, disease or symptoms of the person (he) forms the opinion that the use of that substance in the treatment of the patient is justified'.
In the case of beta agonist inhalers, pharmacists have been directed to supply only continuation therapy to patients whose condition has been diagnosed by a medical practitioner, and to follow the National Asthma Campaign Guidelines. The suggestion by Dr Munro Ford that supply of beta agonist bronchodilators by pharmacists is unregulated is not correct.
John Galloway
Chief Pharmacist
for Kim Boyer
State Program Co-ordinator, Population Health
Community and Health Services
Hobart, Tas.
Editor, – I would like to write in reply to Dr R. Munro Ford who was staggered by then on-ratification of the restriction of inhaled beta agonists to prescription only. His statement of the spectacle of pharmacists selling these drugs to anybody who wants them displays a lack of understanding of pharmacists' statutory responsibilities, particularly in Victoria.
Pharmacists are currently being disciplined and indeed fined for non-compliance with the Pharmacy Board directions for counselling patients on such matters.
There are virtually no circumstances when a beta agonist would be sold over-the-counter for purposes other than continuing treatment initiated by a medical practitioner. Indeed, in my pharmacy, it is not uncommon for a refusal to be made and the patient referred to the doctor for accompanying preventive medication where either overuse is discovered, or the doctor failed to initiate appropriate therapy. I must also report that the sales of beta agonists have thus fallen in my pharmacy, while the sales of inhaled steroids have dramatically increased. Nowadays we do not see very many patients who are misusing their beta agonist inhaler.
G. Blackman
Pharmacist
Bennettswood, Vic.