Hello ECP Chatters!
This is the first item to be sent out, and it would be appreciated if a few of you would respond so that I know the e-mails are coming through my e-mail address group system smoothly. There are 68 of you so far. A wonderful response for 24 hours. I will add a bit of news about nausea treatment to this message. I will start sending your input back out on Monday.
Have a good weekend.
Cheers
Diane
The following re-classification of prochlorperazine took effect from 1 August 2002:
The manufacturer’s original pack restriction on pharmacists’ supply of prochlorperazine has been lifted, as has the requirement only to supply the buccal dose form.
Pharmacists now can supply as a pharmacist only medicine up to 10 tablets of prochlorperazine for the treatment of nausea associated with migraine.
In addition, pharmacists (and nurses) accredited for the supply of the emergency contraceptive pill now can supply up to 10 tablets of prochlorperazine for nausea associated with this treatment .
Note that up to 10 tablets of Buccastem, Stemetil and Antinaus tablets may be supplied without prescription only for these indications. Any other indication or undiagnosed nausea requires medical intervention.
The minutes of the Medicines Classification Committee and the New Zealand Gazette notice announcing this change to the availability of prochlorperazine can be seen on the Medsafe website www.medsafe.govt.nz. Select the prof icon, then classification of medicines.
See Minutes of MCC meetings and Recent NZ Gazette notices relating to classification.
Euan Galloway
B.Pharm FPS FHPA MNZCP ED
Manager - Pharmacy Practice & Legislation
Pharmaceutical Society of New Zealand
PO Box 11-640, Wellington
Phone 04 802-0032
Fax 04 382-9297
E-mail e.galloway@pharmacy-house.org.nz
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27 th August 2002
Hi Diane
Yes I am happy to become part of the chat group.
My most recent ECP was for a couple, both came into the pharmacy, who had had a condom break and weren't using any other form of contraception, and the most helpful part for them apart from ECP supply was having a good look at which condoms were available both ss and nss and I had some samples I was able to give them to try including a creamy vanilla from Ansell. So it ended

up very light-heartedly and no embarrassment for them which was super.
Regards
Susan Donaldsoon MPS
Waihi
28 th August 2002
Dear Diane
I think this is a great idea..perhaps it can be extended to generalised professsional chat..to help overcome the professional isolation of community pharmacy
The experience that I have had with ECP
1 South Auckland no requests ( very low sales of oc's) they just keep on having babies!
2.West Auckland no requests ..most customers in older age group
( although neither of the proprietor pharmacists have shown any interest in providing the service)
3, Central Suburban Auckland After Hours Pharmacy growing number of requests..even referals from Auckland Hospital almost all the staff ( all ladies) have undertaken the accrediting course and are offering good service.
A lot of young, working girl customers..prefer the anonimity..are very grateful for the service,,have a feeling that some are just keeping them as an insurance policy in their bags...mainly girls who are not in a relationship,however this has not been admitted in interview.Usual reason for unprotected sex is broken condom story.Advised to keep using condoms as a protection against STD's
First client ( must admit I was a bit nervous) said I had been absolutely wonderful..made my day..week..year!!
No problems experienced as yet..find promp sheet provided, very helpful to keep on track.
Thats all for now Best wishes John Bockett
29 th August 2002
Hi chatters
Here is a direct request from Otago Uni. If anyone wishes to reply directly to Nerida Smith, sounds like that would be greatly appreciated.
Cheers
Diane
----- Forwarded by Diane Harries/Hermes on 29/08/2002 08:25 AM -----
Hi Diane
We are planning an application to the HRC for a study on ECP usage (plan to survey ECP & non-
ECP pharmacy manager &, pharmacists and customers purchasing ECP). We have started initial discussions with the statistician involved, and she needs to know (to calculate power stats), roughly:
What pharmacists think the % breakdown is for main reason so far for women choosing to buy the
ECP from the pharmacy, such as
FPA not open

Time - no appointment needed
Handy location
Can be anonymous
Other: ???
Replies from the chatters would be really helpful!
Cheers
Nerida
Dr Nerida A. Smith BPharm(Hons) PhD MPS MAACT
Senior Lecturer (Clinical Toxicology)
Councillor, Pharmaceutical Society of New Zealand
Consultant Pharmacist, National Poisons Centre
T (03) 479 7239
Fax: (03) 479 9140
Email: nerida.smith@stonebow.otago.ac.nz
Website: http://antagonist.otago.ac.nz/researchpz.htm#Nerida_Smith
Department of Pharmacology and Toxicology,
University of Otago
P.O. Box 913
DUNEDIN, NEW ZEALAND
30 th
August 2002
> Hello Diane,
We've only processed two ecp's so far.
After the second one where the person didn't normally use any contraception it occured to me that one should ask the age of some people.For example should it be supplied to some one under a certain age?
Cheers,
Neil McKinnon
Timaru
Hi everyone
The response from Dr Helen Roberts on this one was -
If you are over 50 and have had no periods for a year, you no longer need contraception.
If under 50, you need to have had no periods for 2 years, before no contraception is needed.
Hope that helps on that question.
Cheers
Diane
2 nd
September 2002
Hi everyone -

Here is a clinical one - and the answer from Mimi, the FPA doctor is also attached.
Cheers, Diane.
If a patient forgets to take their Noriday tablet within the 3 hour time frame, they have been taking it for 6 months, have had no periods since they have been taking it - how long do they need to take extra precautions for? (the product leaflet also states to take the tablet they have missed even if that means taking 2 tablets on the same day)
Marie Bennett
All Seasons Pharmacy
Dear Diane/.Marie; with regard to your question relating to Noriday: (or any POP)
>If a patient forgets to take their Noriday tablet within the 3 hour time frame, they have been taking it for 6 months, have had no periods since they have been taking it - how long do they need to take extra precautions for? (the product leaflet also states to take the tablet they have missed even if that means taking 2 tablets on the same day) -
You still have to wait the statutory 2 days (48 hours). We regard the main reliable contraceptive effect from the POP to be due to its effect on the cervical mucous, which will take 48 hours to re-establish. As far as taking
2 tablets on the same day is concerned, in the case of realising the following day, it won't make any difference to how long that you would have to take the extra precautions for. The point about the amenorrhoea is that most likely this particular woman is possibly not ovulating at least SOME of the time (so therefore she may have an additional contraceptive mechanism in place in addition to the mucous effect) but there is no guarantee that she isn't going to be ovulating this month!
Does this help?
Regards
Mimi Tanaka
3 rd
September
Hi Diane, great idea to share ideas. I've just completed training and upon completion of our new consult. room will be anxious to offer the service.
Questions I have at present.
Has price been a problem to anyone - thinking of school age girls , students , unemployed etc?
How are records being keep , in order to maintain privacy etc. - computer only / or written record?
Have many women presenting for ECP been happy to go away without if once they have been shown they are in not risk or do the majority still want ECP - incase?
Cheers Heather Burton , Mt Maunganui.

Response to Heather
Not had anyone who didn't need it yet
Most women know whether they would or not
School age, unemployed etc go to Family Planning so no the price has not put anyone off - it is cheaper than bringing up a child really
Linda
Hi Diane
Yes please add my name to your chat group
I had an interesting experience with a girls sister who came in. She was at work and it would have been inconvenient for her and embarrassing to field a call to her. Luckily her sister who had resumed the role of counselling could answer all the question asked. I asked as it was at the 72 hour limit and i felt it was necessary to prevent further delay to give it to her sister and requested she please come in and see me. I was delighted when she actually did come in to see me.
I felt this was a very positive realtionship and she was keen to tell me it was not like her to do this sort of casual sex thing.
Had an opening to give her info on both contraceptive and std matters
Similiarly a young girl whose 1 st sexual experience resluted in a visit.
I feel quite priveledged to be taken into confidence in these sort of situations and i feel it is important to commend them on coming in. It is embarrassing fot them but they are being responsible
Viv
Keri Keri-
4 th September 2002
Dear Diane
My first ECP turned out to be a young woman who do not get period because of special sport she does, her last period was last yr.!The GP is aware of that and has done a hormone level test and it was normal. She wanted to know what are the chances of getting pregnant without having a period? This might be an interesting case to look at.
Regards
Shirin
Barrington Health Centre Pharmacy
Ch.Ch.
Response from FPA doctors -
It is likely that the girl who has exercise induced amennorrhoea is not ovulating, but I would give ecp anyway, as cannot be sure - actually she should probably be considering a pill for her bones.
The issue is that she may be lowish on oestrogen because of the exercise induced amenorrhoea, therefore a bit of extra from the COC could be considered an asset.

5 th
September
Hi everyone
This is a quick note to point out that there is an audioconference scheduled for Wednesday evening 16th
October on STI's. I am only mentioning it because it is so relevant to the supply of ECP. This is a clip from the leaflet about it.
Dr Margaret Sparrow will present this topic to complement the launch of pharmacy supply of the emergency contraceptive pill. It is important for a pharmacist, who is providing ECP, to advise women at risk of picking up an STI that they should seek further medical help. Did you know that the incidence of chlamydia in New
Zealand is still increasing and is five times more common than in Australia? Have you come across any STI issues while supplying the emergency contraceptive pill? Find out about the latest diagnostic testing procedures. Any questions for Dr Sparrow?
To enrol for the audioconferences please access the enrolment form on the internet. Go to the site of the
Pharmaceutical Society of New Zealand (www.psnz.org.nz) and look on the page for the College of
Pharmacists. The enrolment form is listed on the menu. Otherwise phone the College.
Cost: CPC® pharmacist (Accredited or Registered for CTA funding) and College Member $70
College Member $85
Non-College members $110
Dear Dianne, I'll make a start with a wee story that involved a patient who came in to get the ECP.
The patient was in her late 40's and was unsure if she need the ECP or not.
Her husband had passed away a few years before and she was starting out with a new relationship. He husband had had a vasectomy many years before and so while he was alive she had never had to worry about contraception.
But her new partner hasn't had a vasectomy and she needed to know if she could possibly get pregnant at her age and if so should she be on a contraceptive?
The answer was yes, she did need the ECP and yes she should be on a contraceptive. Women are deamed to be safe from pregnancy only when they have had 12 months with no period or bleeding. And this lady did not fit that description at all.
Maybe someone else has met this question or situation.
Patti