Jumoke is typically a vibrant, inquisitive and clinically sound community Pharmacist determined to be distinguished in the practice. On one of her routine practice in the popular & respected Pharmacy, she receives a single drug prescription sheet requesting the dispensing of the drug, Phenobarbitone 7.5mg b.d for 7 days from a young man presenting to the Pharmacy, rather nervous & bewildered. As was her custom, she asked the man a few questions in order to validate the prescription, especially the dosage.

The man told her that it was written by a paeditrician for his newborn baby girl, less than a week old. Knowing the adverse effects of the barbiturates, especially on such age groups, the Pharmacist immediately raised eye brows and only sternly enquired from the father if the baby has convulsions or seizures or for any reason is restless, keenly explaining the signs and symptoms of each in clear terms to the man. The father confirmed that nothing of such nature is happening to his neonate, quickly adding that he overhead the paeditrician saying he should buy the medication to help clear the baby's jaundice, trying to provide tangible information to assist the Pharmacist in helping him. Jaundice? The Pharmacist asked, looking quite astonished and confused. She couldn't relate the barbiturate with jaundice, but reached out for her phone to double check with the Emdex app & seeing nothing of the like, she flared up, countered the prescription and refused to dispense.

The resultant interception between the prescriber and the Pharmacist may be an unnecessary prevarication for this piece.You see? Phenobarbitone has a clinically proven effectiveness in the management of neonatal jaundice which is still off label for this purpose but the Pharmacist is totally oblivious of this, and possibly, a host of other clinical Pharmacists too. Off label use of drugs may not be a daily occurrence in routine practice, but the drug Lord should never be caught off guard. Other common examples of off-label drug use include, Clomipramine, tramadol and dapoxetine to delay ejaculation, Amitriptyline and fluoxetine for fibromyalgia and propranolol for stage fright or performance anxiety.

Pharm. Ochiaja Emeka is a Pharmacist with General Hospital Onitsha.