Actresses:

1. Anis Sofia as the pharmacist (Ph)

2. Clare as the narrator and the pharmacist assistant (PA).
3. Hidayah as the patient, Mrs Queen.

*Prepare the props

Narrator: Finding the perfect method of contraception can be difficult which is why guidance from the
pharmacist is an important part of woman's family planning.

A very good afternoon to our lecturer and to all my fellow friends. My name is Clare Tan and I
will be your narrator for today and act as a pharmacist assistant. Anis Sofia will act as a
pharmacist and Hidayah will act as Mrs Queen which is our customer.

Today, we will present a role play to you guys about Mrs Queen who is a 25 year old woman.
she just had sexual intercourse with her husband last night. She had heard from her friends
that there is a new pill that can prevent pregnancy.
So ladies and gentleman sit comfortably and enjoy the show. Scene 1.

Scene 1

PA is in the shop. Waiting for customers while arranging the racks.

Mrs Queen enters the shop and looks around. The pharmacist assistant spotted Mrs Queen and ask her
if she need any help.

PA: Hello Ms. May I help you?

Mrs Queen: Is the pharmacist around?

PA: Yes ms. Can you wait here for a moment while I call the pharmacist?

Mrs Queen: Yeah sure

In front of pharmacist room,

PA knocks the door

Ph: yes come in.

PA: There’s a customer that wants to see you.

Ph: okay I’ll be there.

Ph tidy up her table, stand up from her seat and walk out of the room to see the customer.

Outside her room, Ph meets the customer and greets her,

Ph: Hello ms. I’m anis, the pharmacist in charge here. May I help you?

Mrs Queen: Yes I want to talk to you about something. (Hesitate to continue the conversation)

Ph: okay sure ms. Do you comfortable to talk here or you want to come to my office?

Mrs Queen: I think I prefer your office. Ermm I need some privacy.

Ph: okay sure ms. Please follow me.

Scene 2:

In the room, pharmacist offers the seat to Mrs Queen.

Ph: Please have a seat Mrs.

Mrs queen sits down.

Ph: How may I help you Mrs……..

Mrs Queen: Queen. Call me Queen.

Ph: okay Mrs Queen. How old are you?

Mrs Queen: 25 years old.

Ph: Okay, can you tell me what’s your problem?

Mrs Queen: Actually, I was wondering about going on this new pill that my friends recommend to me.
They said that this pill is very efficient to prevent pregnancy.

Ph: okay ms. Just for double confirmation, is this pill intended for you?

Mrs queen: yes of course. I’m thinking to start over contraception.

Ph: Oh I see. Have you had any contraception method before this?

Mrs queen: Yes. A few years back I was on this pill that I took regularly but then sometimes I forgot to
take and eventually I didn’t take it anymore until now.
Ph: why is it that you need this contraception now? Are you currently on something?

Mrs queen: I’m actually not ready for having a kid at the moment. I like to travel. So I think it’s quite a
mess if I have a kid.

Ph: oh I see. First of all, I have to assess whether you are suitable to go on pills. It’s going to involve a
few questions and then I’ll check your blood pressure. It may take some times. Is that okay with you?

Mrs queen: Yes. I’m not in a hurry.

Ph: Okay good. I just want to say that everything you say here will be confidential except if you want to
share with your GP or your family doctor. So might I ask do you smoke?

Mrs queen: No.

Ph: okay. Have u ever smoked?

Mrs queen shakes her head.

Ph: okay. That’s good. And can I also ask you if you suffer from migraines or headaches?

Mrs queen: no I’ve got headache but nothing that I called migraine.

Ph: have you ever had hepatitis, jaundice or any sorts of liver problems?

Mrs Queen: No.

Ph: Do you have any history of having a blood clot or it’s called thrombosis?

Mrs Queen: No.

Ph: Any of your family members having it?

Mrs Queen: not as far as I know.

Ph: is any of your family members having a history of stroke or breast cancer that you know of?

Mrs queen: No.

Ph: do you take any medication like antifungal, antiepileptic or any other drugs including any herbal
preparations?

Mrs queen: no.

Ph: just bear in your mind if in future you intend to take any medication, please tell them that you’re on
this pill to avoid any possible interactions.

Mrs queen: okay sure.

Ph: when is your last period?

Mrs queen: about 5 weeks ago.

Ph: okay. May I ask when is your latest sexual intercourse?

Mrs queen: I was having one last night.

Ph: so what I’m going to do now is to weigh you and then we’ll check your blood pressure. And also I
need you to do the pregnancy test. If everything is okay, I’ll teach you about the pill later.

Mrs queen: yeah okay.

A moment of silence…….

Narrator: Pause. As you can see just now the pharmacist greet the patient warmly and ask all of this
question to gather all of the important information in order to avoid dispensing error. Please
take note that the patient may be sensitive to talk about her reproductive history so it is best
to make them understand and feel comfortable to ensure that the customer are able to
cooperate with you throughout this process.

You might wonder why some of the question seem unrelatable to this patient. Let me explain. The
pharmacist asks if the patient is smoking, having complications like blood clot or thrombosis and if she
had history of stroke is because by taking the oral contraceptive pills it can worsen the patient condition
which may lead to deep vein thrombosis. Having a migraine and headache is part of the side effect of
the oral contraceptive pills so it might worsen the patient's condition and she might need to take mild
pain killer like paracetamol or ibuprofen if that takes place. For patient who has a history of breast
cancer is not advisable to take OCP as it may cause the occurrence or reoccurrence of it. Other than
that, the effectiveness of oral contraceptives may be impaired by concomitant treatment with
antimicrobials. This is because the oral contraceptive pill is being metabolize in the liver. Presence of
antimicrobials like antifungals and antibacterial can causes the metabolism of oral contraceptives pill to
takes place in a faster rate which will lead to the therapeutic action of OCP cannot be achieved. Not only
that, if the patient suffer from hepatitis, jaundice and liver problem is also not recommended to use OCP
as the drug may accumulate in the liver causing other complications to takes place.

Now let us proceed to the role play. Scene 3

Scene 3

PA comes into the office and announcing the result.

PA: The result for Mrs Queen pregnancy test is negative, body mass index is 23 and the blood pressure
is 110 over 70.
Ph: So that’s all fine. Now I’m going to teach you about the pill. Actually we have three types of
contraceptive pills in the market. The first one is emergency pills like you inquire, next one is the
combination oral contraceptives which in short is COC and the last one is progestin only pill also
called as mini pill or POP.

(silent act between the pharmacist and the customer).

Narrator: Pause. As being mention by the Pharmacist, there are three types of OCP which is combination
oral contraceptives (COC), emergency pills and progestin only pill (POP aka mini pill). What's the
difference?

COC it contains both estrogen and progestin. Progestin component basically inhibits ovulation &
thickens the cervical mucus while estrogen component will inhibit the follicular development by
maintaining the endometrium & prevents unscheduled bleeding. Initiation of COC are considered for
any woman who seeks a highly effective, reversible & coitally-independent method of contraception.
The failure rate in the first year of use is 0.3 % in perfect user & 8% in typical users.

POP as the name itself it only contains low doses of progestin. It is suitable for any woman who may be
contraindicated with estrogen. For example, women more than 35 years old who smoke, women who
experience migraine, headache with neurological symptoms, history of thrombosis, with systemic lupus
erythmatous (SLE), those who breastfeed or just recently had postpartum. The effectiveness of mini pill
is more than 99% when it is being used correctly and consistently. The failure rate is the same with COC
which is 0.3% in compliant patient and 8% in typical users.

Emergency pill is offered as soon as possible to women who have had unprotected or inadequately
protected intercourse (eg, condom breaks or leaks, cervical cap dislodged, missed pill and etc) & who do
not desire pregnancy (ex, sexual assault, family planning). It is also known as postcoital contraception or
morning after pill. It is only intended for occasional use, mainly to backup usual method of birth control.

So guys, which one do you think will be suitable according to the customer's condition? Let's see what
the pharmacist has to say.

Mrs. Queen: oh I see. In my case, what would be the best for me to take?

Ph: So, I would suggest that you take the emergency pill first for today and then start the regular pack of
the contraceptives which is COC. It is best to start on the first day of your period or within first five
days of period in case you forget to take. For emergency pill, it actually helps to prevent pregnancy
within five days after the last intercourse. So I will give you Escapelle that contains levonorgestrel. It
only contains one pill in one pack and it has the least side effects to most people. However, this pill
does not work as the regular contraception method. You can only take one pill within one menstrual
cycle. If you take more than once, it will upset your menstrual cycle resulting in irregular periods.

Mrs Queen: May I know what the possible side effects are?
Ph: Just simple and light headache, nausea and some dizziness. But don’t worry because it will disappear
in a very short time. A few women may experience vomiting. If you vomit within 3 hours after taking
the pill, you may have to take another pill. But if you vomit after more than 3 hours, you don’t have
to take another one. Do you follow?

Mrs Queen: yes of course

Ph: Next, I will explain about the regular pack which we call COC. There are 21 pills in one pack which
you need to take one each day for 3 weeks and break for 7 days before consuming the next pack.
Bear in mind that you should not break longer than 7 days. If you do that, I’m afraid that the pills will
not work for the next pack. Then, you will find that in the seven days break, you will menstruate.
After 7 days off the pill, you have to start the new pack even though you’re still bleeding.

Mrs Queen: Is there any specific time that I have to take the pill?

Ph: There is no specific time but try to take the pills at the same time every day. The more accurate you
are, the better it works. So now, what happen if you miss the pill? If you miss one pill, that’s still
okay. But you have to take the pill within 12 hours before the next pill. You may have to take 2 pills
at one day. And make sure the rest of the pills are to be taken at the same time as usual. If you miss
two pills, then the pack will no longer works for you. What you have to do is to wait for the next 7
days before starting on a new pack. Within those 7 days, if you intend to do any sexual intercourse,
you have to use extra protection like using condoms or the best thing to do is avoid having sex at all.
If you miss 2 pills in the last week, you may have problem starting on the next pack. What you have
to do is you don’t have to take the 7 days break. Immediately start on the new pack without having 7
days gap. In this time, you probably will not have period or if you do, it’ll only be fine lines and that’s
fine because you don’t make period in the first place.

If you miss two pills in the first week, you may have problem with any unprotected sex which occurs
during the preceding break. If that happens, make sure to seek medical advice.

Ph: The most important thing to remember is when you have diarrhea or vomiting, you will lose the pill
to the system and definitely it will not show its effect. In the meantime, make sure you use
protection before having sex.

So if you stick to the rules, it’s a very good contraceptive with at least 99% of success rate.

Next, I will talk about the side effects. When you start taking the pill, you may feel some sort of
breast tenderness, dizziness and mild headache and also nausea. Actually, most of the people will
feel perfectly fine.

Mrs Queen: Oh I see. Is that true I heard from people saying that the pills will cause weight gain?
Ph: It doesn’t usually in itself do that at all. In fact, the only hormonal method that we really know
associated with weight gain is injection. But what happen actually when you’re on the pill, you get a
little bit hungrier and you tend to eat more. That will put on weight. If you are aware of it and control
your eating habit, you should be okay.

For the first three months of taking the pill, you will have irregular period. But don’t worry after
sometimes the pill will sort it out for you. If you’re not sure or scared, you can come and see me.

Are there any questions you would like to ask?

Mrs Queen: Do I need to keep the pills in the fridge?

Ph: No. But the pills need to be kept in cool and dry place. You should not leave it in the car or under the
sunlight. It will be good if you can carry the pills with you in your handbag for your convenience. Is
there any more you would like to ask? I know it’s a little bit complicated but you can always refer to
the leaflet enclosed in the packet. I recommend you to reread the leaflet and all the instructions
before starting on the pack. If it’s okay with you, can I call you 2 weeks later just to ensure your
condition? And please don’t hesitate to come and see me any time if you have any doubts.

Mrs Queen. Yes of course. Thank you so much for your time.

Ph: My pleasure.

Narrator: My dear lecturer and friends, based on the overall scene 3, we can observe the pharmacy
assistant mention the name of the customer. This is to ensure that the result obtain from the test done
is for the right person. Not only that, we can also observe that the pharmacist really played her role in
educating the customer. She explained in detail about the oral contraceptive pill that she can take
according to the customer's condition. Guide the customer on the indication of the drug, frequency,
dose, storage and most importantly about the side effects and precaution that she should be aware of.
After explaining to the customer, she gives recommendation according to the patient condition. To
conclude the counselling session, the pharmacist asks if there is anything that she enquires about. The
pharmacist also offers a follow-up session with her. Lastly, the pharmacist bid farewell to Mrs Queen.
Mrs Queen leaves the pharmacist with a satisfaction and a smile on her face.