DISPENSATION OF INPATIENT PRESCRIPTIONS
Inpatients are supplied with drugs via their yellow treatment card, which is kept by the nurses in the hospitalisation ward and serves as a guide for the administration of your drugs. Upon admission, it is very important that you inform your doctor about any other medicines you are taking, so that they can be prescribed on your treatment card. The medication is handed over to the nursing staff that will ensure their safe keeping.
- Drug prescription is made on the treatment card by your doctor, who signs separately for each drug to be administered to you.
- Based on the treatment card, the pharmacist will verify the dose, the administration interval and the duration of the administration and will administer the required quantity of drugs for your treatment.
Outside normal opening hours of the pharmaceutical department, the Centre is serviced by an on-call pharmacist, both on weekdays and on the weekends, who supplies drugs to inpatients and provides relevant information.
DISPENSATION OF OUTPATIENT PRESCRIPTIONS
Outpatient prescriptions include the drugs of outpatients visiting the Centre’s Outpatient Department or inpatients who are discharged and will take their drugs home with them.
Your prescriptions can be dispensed in our pharmacy daily, from 8.00 a.m. until 4.00 p.m.
IMPORTANT INFORMATION ON THE DISPENSATION OF YOUR PRESCRIPTION
- The prescriptions of patients who are not registered at the Centre and prescriptions not signed by doctors employed at the Centre are not dispensed.
- The drugs are always prescribed by your doctor and drugs cannot be dispensed without a prescription.
- The pharmacist will explain to you the correct way of taking the drugs, how they should be properly kept and, if requested, any side effects and interactions with other drugs.
- All the prescriptions are entered in the pharmacy’s software system. Each patient’s medication record includes entries on all the drugs which have been dispensed, the instructions of use given to the patient as well as the name of the doctor who has prescribed the drugs. Your pharmacist can inform you of the dates and quantities of drugs dispensed to you in the past.
- The drugs can be obtained from the pharmacy either by yourself or another person or the driver of a cancer patient association, once the following fees have been paid:
- 6 Euros registration fee for the visit to the doctor and the issuance of prescriptions,
- 50 cents fee for each drug, with a maximum charge of 10 Euros (health stamps).
To avoid any inconvenience, it is important that you are aware of the following:
Where can I register and from where can I obtain the health stamps?
At the reception at the main entrance.
Where do I affix the registration sticker?
If during your visit to the doctor, the doctor will prescribe drugs, he/she is responsible for affixing the registration sticker on the prescription.
Which health stamps must I obtain?
The doctor will number the drugs written on the prescription and will indicate the total number in a prominent place on the prescription. This number corresponds to the number of health stamps that you will need to obtain.
Where do I affix the health stamps?
You will affix the stamps, which are in the form of stickers, at the back of your prescription, before coming to the pharmacy.
Do inpatients need to register and obtain health stamps?
The same procedure applies also to patients who are discharged from the wards of the Centre, in case they are prescribed drugs upon discharge.
Do I need to register and obtain health stamps for repeat prescriptions as well?
It is necessary to register and obtain stamps also for the repeat prescriptions, which are issued by the pharmacy according to applicable regulations for certain drugs which are subject to control in terms of their availability.
Do I need to pay again for the drug which is not available today?
In case a drug is not available, the pharmacy issues a form with which you can come and receive the drug without registration and stamps, since this has already been done for the original prescription.
Make sure you have followed all these steps to avoid any inconvenience.
If you are non-eligible, then you must obtain your drugs from a private pharmacy and not from the Centre’s pharmacy. In case the drugs are not available in the private sector, the pharmacist will stamp the prescription with the indication “Not available in the private sector”. In this case, you may purchase the drugs from the Centre. If the drugs are available in the private sector, but not in the specific pharmacy, the private pharmacist has the obligation to supply you the drugs within the same day.
INFORMATION ON CHEMOTHERAPY
A) Injectable Chemotherapy – control of protocols
- The Centre has a Central Drugs Dilution Unit where chemotherapy is prepared by trained nursing staff. Dilutions take place in the “clean room” which is designed according to international specifications. Inside the room, there are two special safety cabinets in which chemotherapy drugs are diluted in order to ensure product sterility and the safety of the staff that dilute the drugs.
- Part of the “clean room” is the chemotherapy pharmacy where the pharmacist carries out tests, which contribute significantly to the safety of administration of your medication.
- All chemotherapy protocols are pre-printed.
- Your doctor will choose the chemotherapy regimen to be administered to you and prepare the chemotherapy protocol.
- The nurse will measure your weight and height in order to calculate the dosage of the drugs.
- The chemotherapy protocol is monitored by the pharmacist in order to confirm the correctness of the dosage and the drug dilution medium.
Before the chemotherapy drug is diluted, the pharmacist checks:
- The completeness of the protocol (date, patient data, doctor’s signature).
- The interval between the cycles.
- The calculated dosage based on the patient’s weight and height.
- The anti-nausea drugs.
- The biochemical tests and indicates the manner of reconstitution and the required volume that needs to be sucked from the syringe.
- Once the chemotherapy is diluted, it is administered to the patient (see information on extravasation of drugs).
If you have any questions about the chemotherapy regimen, you may contact your doctor, pharmacist or nurse at the Centre.
Β) Oral chemotherapy
In case you are given pills for chemotherapy, your doctor will prescribe them on the special yellow prescription form and the pharmacist will inform you of how to take them. Generally:
- It is preferable to take your medication from the box yourself.
- If given by another person, this person must wear protective gloves to prevent absorption of the drug from the skin.
- The boxes of medicine that are given to you by the pharmacy bear a warning label: «Cytotoxic drugs, handle with care, use protective gloves».
- Some chemotherapy drugs in the form of pills must be stored in the refrigerator. These drugs bear a warning label: “Keep in refrigerator, do not freeze”.
- Do not break or crash your medication.
- Do not dispose of your medication in a toilet or a sink.
- Keep your medicine out of the reach of children
PROTECTION MEASURES FOR PATIENTS RECEIVING CHEMOTHERAPY
Can I come in contact with other people now that I receive chemotherapy? My chemotherapy is not injected but is in the form of a pill. Are the same protection measures required?
Chemotherapy is not transmitted from person to person. It is safe to embrace and kiss your loved ones during chemotherapy. However, care must be taken to avoid contact with your medicine, whether orally administered or injected.
Today I underwent chemotherapy and I will go home. How long should I take protection measures?
48 hours. The drugs enter the bloodstream and are excreted through the body’s biological fluids (blood, urine, stools, tears, saliva, vomiting, sweat, sperm and vaginal fluid) on average of up to 48 hours after the end of chemotherapy.
Can I use the same toilet my family uses?
Yes, it is safe to sit on the toilet. Flash the toilet twice for better cleaning. Wash your hands with soap and water and dry with a paper towel.
On the day following my chemotherapy I vomited in the toilet. What should I do?
Flash the toilet twice and clean its surface with soap and water. If you vomited in a container, wash it thoroughly three times with soap and water and dry with a paper towel. The container should only be used for vomiting. It is preferable to use a disposable container.
At home I have a caregiver. What should he/she be careful of?
The caregiver should use disposable gloves when giving you your chemotherapy pill as well as for your hygiene and wash his/her hands thoroughly after removing them. Used gloves, sanitary napkins and diapers should be placed in a plastic bag, tightly closed and disposed of in the garbage. If the caregiver comes in contact with your body fluids, he/she should thoroughly wash the affected area three times with soap and water.
Can I wash my clothes in the washing machine?
Wash your clothes separately from the clothes of the rest of your family in the washing machine using pre-wash and main wash. Avoid handwashing.
Can I have sexual intercourse with my partner?
During sexual intercourse, a condom should be used because there is chemotherapy in the sperm and vaginal fluids.
My daughter is pregnant. Can she become involved in my care?
Pregnant and breastfeeding women should avoid coming in contact with chemotherapy
I find it difficult to swallow, can I open the capsule of the drug and put its content in my juice?
You should neither break your pills nor open the capsules. Capsules should be swallowed whole without chewing. If you find it difficult to swallow, you should inform your doctor.
In the morning I took my chemotherapy drug and I vomited three hours later. Should I take the same dose again?
I forgot to take the chemotherapy drugs at the specified time and I remembered it 3 hours later. Can I take them now?
You can take your medication within a maximum period of 12 hours from the prescribed time. Otherwise, skip the dose and inform your doctor.
I accidentally took more pills. What should I do?
Inform your doctor immediately. You should know how many pills are included in your treatment, when it starts and when it finishes.
I have finished my treatment and I have some medication left. Can I return them to the pharmacy?
It is safer to return them to the pharmacy for proper handling. Do not throw medicine in the toilet or garbage.
Where can I store my chemotherapy drugs at home?
Keep them in a safe place out of the reach of children and pets. Follow the pharmacist’s instructions for storage in appropriate conditions and not together with food.
INFORMATION ON DRUGS
What is Tamoxifen;
Tamoxifen (trade name Nolvadex) is a hormone administered mainly for the treatment of breast cancer.
How does Tamoxifen work?
Oestrogens, which are a natural hormone in women, contribute, in some cases, to the multiplication of breast cancer cells. Oestrogens are found in the body both before and after menopause.
Tamoxifen is an anti-estrogenic medicine that blocks the action of oestrogens in breast cancer cells and can reduce or stop multiplication. Tamoxifen does not stop the production of oestrogens by the body but stops their use by cancer cells.
How should I take the medicine?
Tamoxifen is administered orally, with or without food. The usual dosage is 20 mg daily.
For how long should I take Tamoxifen?
The time for taking the drug varies from woman to woman. Usually, it is administered for 5 years. Some women may need to change their treatment and, therefore, the treatment with Tamoxifen may stop before the end of 5 years.
What should I do if I forget one dose?
If you forget to take your medication, you should take your next dose normally and not double the quantity of the drug to make up for the missed dose.
What side effects can mainly occur with this drug?
The most common side effects usually reported by women taking the drug resemble the symptoms of menopause, namely:
- Hot flashes (sudden sweating or feeling of heat). They are observed in 1 in 3 women who have not yet experienced menopause. Symptoms are usually mild. If they are very annoying, contact your doctor.
- Irregular period. If your age is close to menopause, your period may stop.
- Vaginal bleeding.
- Reduced sexual desire due to vaginal dryness.
- Tamoxifen can rarely cause nausea. In this case, you can change the time you take your medication, with food or before bedtime.
What is the benefit for taking this drug?
It may reduce the chances for breast cancer recurrence by 30%. Furthermore, Tamoxifen reduces the risk of developing second breast cancer by 50%.
The drug reduces blood cholesterol levels and, therefore, the risk of heart attack. It also reduces the progression of osteoporosis in post-menopausal women.
Is there a possibility of getting pregnant while taking the drug?
Yes, if you have not had a normal menopause. Tamoxifen is not a contraceptive drug. In addition, we do not know the effect of the drug on the foetus.
When taking the drug, contraceptive measures should be taken. Do not take a contraceptive pill. Normal pregnancy is possible after the end of the medication