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Being a pharmacist is about more than dispensing AEDs


20 August 2014

Eisha Gosrani became Epilepsy Society's resident pharmacist six months ago. Although her work can sometimes be challenging,  she wouldn't have it any other way. Here she talks about why she loves her job.

'I am a scientist, but first and foremost I'm a people person, so being a pharmacist here at Epilepsy Society certainly ticks all the boxes for me. Most people think of a pharmacist as someone who just makes up prescriptions to dispense, but my work here is so much more than that.

I have the pleasure of really getting to know people well,  especially some of the residents who live here in Epilepsy Society's residential care homes.  I'm part of a multi-disciplinary team, including professors of epilepsy, specialist nurses, occupational therapists and care home staff, we all work together to make sure the people in our care are achieving optimum seizure control.

Complex epilepsy

Because I work with people who have complex epilepsy, seizures do still happen, despite our best efforts.  Sadly injuries, usually caused as a result of falling, often need medical intervention and part of my job involves advising people with any wounds they may sustain. Injuries I've had to help manage range from burns to nasty cuts, bruises and broken bones.

I also work with people  from all over the country who have uncontrolled seizures. They are usually referred here by their doctors to try and get better seizure control with complex anti-epileptic drug (AED)  changes and this happens here in the Sir William Gowers Centre, which  is a National Health Service hospital unit offering in-patients and out-patients, tertiary care from world-class epilepsy experts.

All AEDs work by controlling the electrical activity in the brain that causes seizures, they don't cure epilepsy and they can't stop seizures while they are happening. AEDs work best when taken regularly at around the same time every day. The aim of any treatment is to stop seizures with the lowest dose of the fewest number of AEDs and with the least side effects. Finding the right drug at the right dose can sometimes take time as it differs in each person.

Hospital pharmacist

As the medicines expert on site at Epilepsy Society I wear my 'hospital pharmacist' hat to ensure people understand why changes to their AEDs, have been made. I dispense new medication and give patients  medication counselling and discuss treatment plans to make a record of the number and type of AEDs to take and when to take them. This is vital as some  people with epilepsy have memory issues and may  find it hard to remember. We have medication aids such as drug wallets to remind people to take their tablets or I explain to them about using an alarm on their phone.

Working as a pharmacist at Epilepsy Society's Chalfont Centre is a far cry from my previous job working as a community pharmacist in a central London supermarket. There, dispensing was not so specialist and I have to admit I now know a huge amount more about epilepsy than I did then. Here I even get involved in the research carried out by Epilepsy Society specialists, which is very exciting.

In the short time I've been working here I'm pleased to say I've gained a far greater understanding and awareness of the anxiety some people have surrounding their drug management.

Switching between different epilepsy drugs

It is essential for anyone with epilepsy to maintain a consistent supply of the same version of their AEDs. Switching from a branded to a generic drug, or from one generic to another, may affect the bioavailability of the active ingredient in the medication and cause a breakthrough seizure or side effects and could lead to confusion when drugs look different from one prescription to the next. Therefore consistency of supply is key for people with epilepsy as a breakthrough seizure can have devastating impact for the individual concerned and their family.  Driving licences must be surrendered and often employment becomes difficult. There are also potential health care cost implications.

My job role here is so much more than just giving out anti-epileptic-drugs. Epilepsy is an amazingly complex neurological condition and I feel privileged to be part of the team which is working so hard to try and improve the lives of the people living with this condition.'