Week 6 Community Posting in Pharmacy Shop
There are various situations that can be observed as usual. Usually there is less customers when there is holidays in between the weekdays. Firstly, there is customer who do not know that POP is causing her not to have menses. After discussing with the pharmacist, she changed to COC (Microgynon) since she wants to have regular monthly menses. Next style of customer is that the customer only want the pharmacist preparing and dispensing their medication and thus they usually will only come when the pharmacist is available. There are also customer who take so many combination of medication for pain-relieving such as Lyrca, Celebrex, and Tramadol. Another case is about acne which requested by a girl. Initially she requested for the acne but then asked whether the cream able to heal the scar. According to the pharmacist, Clindamycin is given if there is pus, while Vitamin E is given to heal scar acne. Important things to be remember is about warranty card. There are customers who just buy blood pressure (BP) device set and have not yet use the device, the warranty could not be traced and the cuff already damaged. Then, a customer requested antibiotic for an accident injury and Cloxacillin is being dispensed. Lastly, there are customer who have lost voice to speak and was dispensed with Denzo and Amxol. Denzo is for throat inflammation and Amxol to remove phlegm.
FINISHED!!!!!
Woahhhh it takes so long to finish compile this up. Already get tired. haha... There is a long list of my posts waiting to publish...
Here is the link for your reading on Week 1 if you have not read it yet. haha
Jaane~
Activities this week is mainly
continuing the activities done previously. Since there are holiday in between this
weekdays, less customers can be observed during that days. The sales usually will
be bit slow on that day. When there is less customers, I able to discuss and
learn many things with the pharmacist.
When the medication needed by the
customer is not available at the pharmacy, the following steps usually take
place. First, the pharmacist will take the order, take the name, phone number,
cash deposit from the customer and finally produce receipt of payment. After
that, the pharmacist will check in the MIMS book about the availability and
price of the item and the company supplying the item. Then a phone call is made
to the company to survey about the item and immediately make the order. When
the product arrived to the pharmacy, a phone call will be made to the customer.
The information that I gained during
this week is about counterfeit EYEMORE product which will have 5 years
shelf-life but the original one will only have 3 years shelf-life. Next thing
is about dispensing tramadol. The drug is usually being given for customer who
are continuing the medication, not for those who request for the strongest
painkiller since not many people can tolerate with the drug and thus may experience
nausea and vomiting. For consumption of anti-constipation tablet, time taken
for the Bisacodyl tablet to show its effect (going to defecate) will take about 8 hours. That’s why the
customer will be counselled to take before sleep at night and then they will
defecate as soon as they wake up in the morning. Next information is about the
use of Dyfazine cream. The active ingredient of the cream contain silver
sulphadiazine 1% w/w which is given for burn (melecur) cases in order to
prevent the skin from forming bubble (kembung). The cream usually keep
by some people when emergency happen. Another new information about Gingko
biloba tablet, beside for warming the body, it is also being given for the
cases which he/she become bit ‘deaf’ because of fever.
Since there are things that is not very
clear to me about the choice to be given for gout patient, I asked the locum
pharmacist. He told that Colchicine (Goutnor) and/or NSAID can be dispensed
when the patient is having gout attack. However, in practice at the pharmacy
that I observe, colchicine is more preferably and commonly dispensed than
NSAID. When the patient is not in gout attack, Allopurinol can be given.
Ural/U-lite can also be given simultaneously which will help to reduce uric
acid level in the blood. Ural and U-lite have same ingredients and only differ
in price and company producer. However, Allopurinol should be withhold during the
attack and only colchicine can be taken at that time. Throughout the attachment
weeks, I can observe that all of the gout patient are male.
I am also able to discuss in details
with the pharmacist about the blood glucose device set. I just come to realise
that there are two types of enzyme being used in the glucose test strip which
are FAD and PQQ enzyme. FAD is more accurate and more preferable since the result
will not be interfered with other type of glucose which are present in the
blood such as maltose and galactose. The presence of another type of sugar will
cause false-high result. This is dangerous especially for a self-medicated
patient who are on insulin since there have been some cases which the patient has
die because of hypoglycemic. Another precious information about the blood
glucose strip is that, it requires special handling care such as do not expose
to heat/ sunlight, do not transfer into another container, and do not expose to
the air. For each type of strip from different company, it will have different
amount of blood to be withdrawn.
Next thing that I learnt this week is
about topical steroid. Steroid can be categorized according to onset of action
and potency. Hydrocortisone (cortisol) is short acting while Prednisolone,
prednisone, methylprednisolone, triamcinolone are intermediate acting.
Dexamethasone and betamethasone are long acting steroid. For classification of
steroid according to the potency (when compare with hydrocortisone), there is an
informational booklet by KotraPharma/Axcel which explains in details.
Class
1 – Very potent (up to 600x) :
Betamethasone dipropionate
& Clobetasol propionate
Class
2 – Potent (50-100x) :
Betamethasone dipropionate,
Diflucortolone valerate, Fluticasone valerate, Hydrocortisone 17-butyrate,
Mometasone
furoate, Methylprednisolone aceponate.
furoate, Methylprednisolone aceponate.
Class
3 – Moderately potent (2-25x) :
Clobetasone butyrate,
Triamcinolone acetonide, Fluocilonone acetonide, Betamethasone valerate
Class
4 – Mild : Hydrocortisone 0.5 - 2.5%
According to ‘Four Generation of
Progestins in Oral Contraceptives’ article by Davtyan C (2012), there are four
generation of progestin. The generation refers to how long it has been on the
market, 1st generation having been available the longest and so on.
1st generation: Estranes derived from
testosterone (norethindrone, norethynodrel, norethindrone acetate,
ethynodiol diacetate) & Pregnanes derived from 17-OH progesterone (medroxyprogesterone
acetate, chlormadinone acetate)
2nd
generation: Gonanes derived from testosterone (levonorgestrel, norgestrel)
3rd
generation: Gonane (Levonorgestrel) derivatives (desogestrel, gestodene,
norgestimate/norelgestromine, etonorgestrel)
4th
generation :Non ethylated estranges (dienogest, drospirenone) &
Pregnanes (19-norprogesterones) (nestorone, nomegestrol acetate,
trimegestone).
2nd generation
progestin has deep vein thrombosis (DVT) as side effect while the 3rd
generation progestin which has cardiovascular (CVS) effect.
There are various situations that can be observed as usual. Usually there is less customers when there is holidays in between the weekdays. Firstly, there is customer who do not know that POP is causing her not to have menses. After discussing with the pharmacist, she changed to COC (Microgynon) since she wants to have regular monthly menses. Next style of customer is that the customer only want the pharmacist preparing and dispensing their medication and thus they usually will only come when the pharmacist is available. There are also customer who take so many combination of medication for pain-relieving such as Lyrca, Celebrex, and Tramadol. Another case is about acne which requested by a girl. Initially she requested for the acne but then asked whether the cream able to heal the scar. According to the pharmacist, Clindamycin is given if there is pus, while Vitamin E is given to heal scar acne. Important things to be remember is about warranty card. There are customers who just buy blood pressure (BP) device set and have not yet use the device, the warranty could not be traced and the cuff already damaged. Then, a customer requested antibiotic for an accident injury and Cloxacillin is being dispensed. Lastly, there are customer who have lost voice to speak and was dispensed with Denzo and Amxol. Denzo is for throat inflammation and Amxol to remove phlegm.
FINISHED!!!!!
Woahhhh it takes so long to finish compile this up. Already get tired. haha... There is a long list of my posts waiting to publish...
Here is the link for your reading on Week 1 if you have not read it yet. haha
Jaane~
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