[Basic] Skill of the week: Pharmacy and Poisons

[johndallman]

Pharmacy is the IQ/H TL skill of preparing medicines to treat illness. Specialisation is required. (Herbal) is for medicines made from plants, which you need to use the Naturalist prerequisite to find. This defaults to IQ-6, Biology-5, Herb Lore-5 or Naturalist-5. This is the only specialisation available before TL5, and in many low-TL settings, is used with Esoteric Medicine in place of Physician. (Synthetic) appears at TL5, and covers preparing drugs under laboratory conditions; it becomes much commoner than (Herbal) as pharmacists become a widespread profession, and defaults to IQ-6, Chemistry-5 or Physician-5. Prescribing drugs (and presumably administering them, if that's complicated) comes under Physician. The skill appeared in Compendium I for GURPS 3e, and the only skill that defaults to it is Poisons.

Poisons is the IQ/H TL skill of preparing poisons, for people, animals and plants. It defaults to IQ-6, Chemistry-5, Pharmacy (any)-3, or Physician-3, but no skills default to it. Thing you can do with successful rolls include: recognise a poison-bearing plant; extract poison in a usable form; identify a poison by taste, or by its effects (you get +3 if you're the victim); know an antidote; recognise or prepare antidotes. Acute and Discriminatory Snell and Taste give substantial bonuses, if you're willing to use them. The skill appeared at GURPS 1e.

Rules for poisons and drugs are on B437-44. Bio-Tech provides a useful clarification: dispensing medicine only requires a Pharmacy skill roll if the medicine is not pre-packaged. I deduce that the main job of professional pharmacists working in retail pharmacies in wealthy countries is checking that prescriptions make sense.

There are a number of tasks which could require use of both of these skills. Preparing weed-killers and the like that don't poison the wrong things is one, as are some categories of medicine: the first chemotherapy for cancer was discovered via an accidental release of mustard gas. In terms of design/repair/use triads, these skills seem to cover both design and manufacturing, although large-scale synthesis will probably also involve professional skills for operating chemical plants.

Pharmacy is a standard skill on templates for doctors and other kinds of healer. They also often have Poisons as an option, as do assassins. Action has rules for truth serum, contact poisons, and treating cinematic plagues and poisons. After the End deals with toxic wastes, chemical warfare for those who feel the apocalypse ended too soon, and rules for inventing cures for diseases. Bio-Tech has inventions done with Pharmacy, and plenty of medicines. Creatures of the Night 1 has a species that lives on poisons, and DF has fantasy poisons, diets that make you resistant to them, and rules for making, extracting and identifying them. Fantasy offers an early version of Pharmacy (Synthetic), and High-Tech has rules and labs for more modern settings. Horror has useful herbs, scientists and witches, and Lands Out of Time gives a penalty to Pharmacy (Herbal) for Colour Blindness. Low-Tech has a lot on both of these skills, and the transition from (Herbal) to (Synthetic); LTC1 adds more. Magic has spells that help identify poisons, and one that requires a successful Poisons roll to work at full skill. Martial Arts: Gladiators offers herbal pharmaceuticals to assist with massage, and Monster Hunters has invention rules for cures for magical plagues. Just as one would expect, Mysteries has more about poisons, and Power-Ups volumes 3 and 7 have example Talents and Wildcard skills that cover these skills. Powers has even more about poisons, Enhanced Senses has an ability to help with identifying them and The Weird lets you do some amazing things with Pharmacy (Synthetic). The Psi books have more things to do with Pharmacy, including one of the least ethical medical procedures I've ever seen. Thaumatology: Alchemical Baroque has uses for Pharmacy (Herbal) and Chinese Elemental Powers has its own uses for both skills. Ultra-Tech has its own very advanced poisons.

I started trying to turn Poisons skill into Pharmacy (Poisons), but it won't quite fit, as far as I can tell. This would fit some fictional schools of assassins, such as Pratchett's in Ankh-Moorpork, but not all of them. Any ideas?

I've never played a character who had these skills, but that's due to change, since I'm developing a 1930s Romany wise-woman. She has plenty of uses for them.

[Captain Joy]

Bio-Tech, p, 156 addresses how alien biochemistries will react differently to drugs; the drug usually has no effect. Bio-Tech, p, 156 also has a nice "Name That Drug!" table that allows you to easily come up with convincing technical names.

[whswhs]

Originally Posted by Captain Joy

Bio-Tech, p, 156 addresses how alien biochemistries will react differently to drugs; the drug usually has no effect. Bio-Tech, p, 156 also has a nice "Name That Drug!" table that allows you to easily come up with convincing technical names.

Heh. I always liked James Blish's reference to a powerful explosive known for some arcane reason as "polybathroomfloorine."

[Myrion]

Actually ,modern day pharmacists do a lot more than checking whether prescriptions make sense.
They do consultations and perform vaccinations, for example.

Their main use for the pharmacy skill is to prepare medicine according to prescriptions, however.
There are, according to my pharmacist friends, a lot of cases where they need to modify existing medicine. Lower or higher dosages, turn pills into ointments etc.
That's why, at least here in Switzerland, many pharmacies actually have a lab in the back.

[Anders]

That depends a lot on the country you're in. In Sweden they don't perform vaccinations or change the formulation of a drug.

[Myrion]

Really?

Do they also study at university and if yes, why?
I mean, that just sounds like they're specialised salespeople.

Oh, and just to be clear, they do these modifications on doctor's orders!

[Flyndaran]

Originally Posted by Myrion

...
Their main use for the pharmacy skill is to prepare medicine according to prescriptions, however.
There are, according to my pharmacist friends, a lot of cases where they need to modify existing medicine. Lower or higher dosages, turn pills into ointments etc.
That's why, at least here in Switzerland, many pharmacies actually have a lab in the back.

That sounds horribly difficult to monitor to prevent accident, abuse, or incompetence.

[Myrion]

I don't know about abuse, other than that it is illegal and they can lose their license.

As to accident and incompetence:
No more difficult than it is with doctors or any other highly educated and skilled professional. There are organisations overseeing standards in the labs and I think they have to do periodic trainings. What makes you think it's particularly bad for pharmacies?

There was actually a poll recently about how the Swiss trust their pharmacies, with 53% 'trusting strongly' and a further 44% 'trusting somewhat' and only 1% negative, with 2% neutral.

[ericthered]

When speaking to doctors and pharmacists, (I've got a stupid number of family medical professionals on my fathers side) They've stated that one of a pharmacist's main jobs is to tell the doctor when there is something better and to help with dosages and so forth.

[Humabout]

Having managed a pharmacy for almost ten years and worked in a hospital pharmacy as a tech, I can speak a little to what pharmacists in Florida can and do do in both a hospital and community setting.

Community pharmacists tend to do less technical work, primarily verifying that what doctors prescribe a) exists, b) does what the doctor thinks it does, c) makes sure the prescription is legal to fill, d) consults patients about deug therapies, and e) provides customer service. As of a few years ago (specifically during the H1N1 outbreak), the US government was giving away the vaccination and Walgreens siezed in the idea that pharmacists could get a separate license to administer the vaccine and Walgreens could charge for the free medicine. Since then, vaccinations have been a part of community pharmacists' jobs, but that isnt part of being a pharmacist.

Hospital pharmacists do all of the above minus customer service (hospital pharmacies serve the nurses, not the patients) and vaccinations (that's what nurses are for). But in addition to the above, hospital pharmacists also consult doctors on drug therapies, check prescriptions against lab results, check kinematics, and other clinical duties.

In both cases - and this varies by state - pharmacists can alter and even write prescriptions. Generally, they do not both for liability and ethical reasons. Additionally, all pharmacists supervise pharmacy technitions, but that wouldn't fall under the Pharmacist skill. And while they can make drugs and fill prescriptions, that is generally the perview of pharmacy technicians who have their work checked by pharmacists. That way a pharmacy can have 3 to 4 techs working per pharmacist and more work gets done for less money.

And yeah, the line between medicine, drug, and poison is damned thin. Chemo is basically just poison, foxglove is use to treat some heart alements, and you can get stoned on enough of just about anything. So merging Poison with Pharmacy isnt unreasonable in a realistic setting, even if it violates cinematic or stereotypical norms.

It's also worth noting that Chemistry and Biology could probably serve as complimentary skills to clinical uses of Pharmacy (dosing, treatment, etc.).