The following are some notes on what I learned while working at a pharmacy in Costa Rica.

Day 1

I watched people get injections for allergies and pain relief. I was surprised to see this as injections are not commonly given in Canada. There was a back room with a bench that was for giving the injections. Only the pharmacist can give injections and if you want to learn how you can practice on one of the employees who work there.

I learned how to and practiced taking blood pressure manually. I did not know how to do this at all previously and I could still use more practice.

The average wage for a pharmacist in Costa Rica is $1500 American/month working 9 hours 5 days/week

All drugs ending in “pam” are locked away except one which is on the shelf. A special blue papered prescription is required for these medications. Normal prescriptions are on white paper.

Narcotics are locked away

Many drugs can be given with or without a prescription

Label is only used when a prescription was given and the only required information is the name of the patient, drug, and directions.

Many drug reps stopped here to talk about their companies drugs and one drug company gave us a PowerPoint presentation on Gaurdacil and bought us all pizza and pop. All drug reps MUST be pharmacists. I liked this as the drug reps understood the drug products and it provides more employment for pharmacists.

Pharmacists must wear lab coats to work but they can wear regular clothing under their coat (jeans, etc)

Day 2

Patients can negotiate prices of the drugs. When people buy more than one package of the same drug they can get a discount (10 or 15%) When someone pays in colones they can get a 15% discount but 10% is the highest discount for American Dollars and credit cards. A 23% discount is given to medical students for immunizations.

Day 3

Pharmacy technicians have no training and call the pharmacist for permissions to give drugs when the pharmacist is not present. A pharmacy can be open with no pharmacist present.

Pharmacists can not give antibiotics and Viagra without a prescription. This rule is not strictly folllowed in all Costa Rican Pharmacies.

No prescription is required to give out Prosac

Many of the drugs are only stalked in highest doses. For example Viagra is only carried in 50mg and 100mg not 25mg like North American pharmacies. The pharmacist there said North America carries more “pediatric doses” than Costa Rica.

Pharmacy students can learn to give injections in a pharmacy before taking training in school.

All pharmacists do not have to give injections but some employers will not hire them if they will not do this procedure.

Day 4

Today I started working independently with the computer. I wrote a manual label for a prescription (sometimes they are typed on a type writer). This prescription required the doctors name.

For injections the pharmacist only washed his hands for the first injection of the day and not the other. The pharmacist did not wear gloves.

Pharmacy technicians can not give injections. The location for injections give for pain are in fatty tissue in the lower back/upper butt region.  It is injected in fat because it will stay in the system longer and it will release slower.

Immunizations are give on the shoulder of side of the quads into muscle.

Drugs are all in blister packs. There were very few drugs in bottles. Due to the fact all medications do not have to labeled and that people can buy one or two medications at a time blister packages are more convenient for the pharmacists. Sometimes they put blisters of medications into an envelope when a label is require or give the patient the whole box depending how many they want.

Band-aides and almost everything else sold in the pharmacy can be sold in quantities of 1.