Home' Australian Pharmacist : Australian Pharmacist June 2013 Contents Australian Pharmacist June 2013 I ©Pharmaceutical Society of Australia Ltd. 31
'A pharmacist has responsibility to
the patient, whatever the product is --
compounded or not,' she said.
'That responsibility covers whether it is
suitable and safe for the patient to use. I
wouldn't support any pharmacist using the
excuse that the doctor ordered it so I just
'You can't abrogate your responsibility for
compounded or manufactured medicines
just like that.
'PSA's Professional Practice Standards say
the first step on receipt of an order for
a compounded prescription is for the
pharmacist to assess the risk, including
clinical risk, therapeutic risk and any other
risk to the patient.
'It is no excuse to say "I don't have
the time to do it". It's part of your
'Pharmacists also have a responsibility to
know about their products, so if you're
compounding peptides then it's your
responsibility to become educated about
when they can and when they can't be
used,' she said
What can pharmacists do?
Pharmacists have a role to play in advising
and educating athletes to help them avoid
taking prohibited supplements.
It should be remembered that while
athletes may be very health conscious, their
health literacy levels are often not very
high, putting them into the category of
vulnerable health consumers.
This is the view of Andrew McLachlan, who
said one of the biggest issues in sport at the
moment was medicines health literacy.
'Most athletes don't have a high
medication literacy level to understand
the complexities of different medicines,'
Professor McLachlan said.
"Pharmacists have a duty of care to all
their patients, and they have a special
duty of care to those who are particularly
vulnerable and I would put athletes
in this category. Often they are highly
driven individuals but often have an
underdeveloped understanding of the
nature of what supplements and medicines
can actually do for their performance.
We have an educational role in helping
to balance those messages about what
medicines can truly do.
'Many athletes believe if they can purchase
the medicine and it arrives as ordered
if they use online services, then it is not
prohibited and so is safe to use. If the label
doesn't show it containing any substance
which is likely to be prohibited they think it
should be OK to take in sport.'
Professor McLachlan said this had proven
dangerous on a number of fronts with
some people being banned after taking
supplements which they believed posed
'We have had people who have taken a
range of these supplements and stimulants
and their poor understanding of what is an
appropriate medicine or supplement to use
has actually led to them being sanctioned
or having a period of ineligibility,' he said.
'We know in Australia that medicines listed
or registered by the TGA have to meet
appropriate high-quality standards both for
contents and for labelling and manufacture,
whereas anything you can buy on the
internet has those requirements waived
so we have no confidence these products
This contradictory regime on labelling
added to the responsibilities placed
'One of the roles for pharmacists is
educating their customers about medicines
and understanding what is safe for the
athletes to use and what should be avoided.
We have responsibility to help athletes say
"No". We have to tell athletes not to buy off
the internet, but to go to their pharmacist
where you get advice,' he said.
'We know athletes take a whole lot of
supplements. Data from the Sydney
Olympics showed 80% of athletes declared
they were taking some sort of supplement
but at the time of the Olympics these
people are at the absolute peak of their
fitness and health. They have the best
dietary advice and medical advice but they
still felt compelled to take supplements so
there is that psychological aspect to the use
of different supplements and the like.
'There is also now the issue of professional
misconduct and we have a mandatory
obligation to report misuse.'
The eight anti-doping rule
violations (WADA Code)
1. Presence of a prohibited substance
or its metabolites or markers in an
2. Use or attempted use by an athlete
of a prohibited substance or
3. Refusing or failing without
compelling justification to submit to
sample collection after notification
as authorised in applicable
anti-doping rules, or otherwise
evading sample collection.
4. Violation of applicable requirements
regarding athlete availability
for out-of-competition testing,
including failure to file required
whereabouts information and
missed tests which are declared
based on rules which comply
with the International Standard
for Testing. Any combination of
three missed tests and/or filing
failures within an 18-month period
as determined by anti-doping
organisations with jurisdiction over
the athlete shall constitute an anti-
doping rule violation
5. Tampering or attempted tampering
with any part of doping control
6. Possession of prohibited substances
and prohibited methods
7. Trafficking or attempted trafficking
in any prohibited substance or
8. Administration or attempted
administration to any athlete
in-competition of any prohibited
method or prohibited substance,
or administration or attempted
administration to any athlete
out-of-competition of any
prohibited method or any
prohibited substance that is
or assisting, encouraging, aiding,
abetting, covering up or any
other type of complicity involving
an anti doping rule violation
or any attempted anti-doping
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