Reminder to self

"We are not out there just to tell patients ji zgi sa bai, sa liap ji bai, as pharmacists we supposed to do more" - wise words of the only local male BCPP (Board Certified Pyschiatric Pharmacist) in Singapore.

Today was counselling session - pharmacist do not just blapper the name and instructions for meds to patients - if like that, our training can just pour down the drain. Given the opportunity we should do more. Opportunity begets opportunities - more you value-add to the patients' drug therapy, more would they want to seek help and advice from you. Got to let the doctor rest hor =p.

Other reminders - Anti-coag can take with Anti-platelet (according to guidelines) since there are 2 different mechanisms of action. But then antiplatelet's order (safety considerations and patient's profile withstanding) should be aspirin, clopidogrel then ticlopidine.
The following format is advisable for medical hamper scripts:

1. Explain every drug in detail
2. Ask if there are any questions
3. Summarise and simplify dosage and regime

Classic signs and symptoms of metabolic syndrome:
1. Obese
2. high LDL and TG
3. Low HDL
4. Poor glucose control
5. HTN

H2 blockers also given to prevent GI bleeding during anticoag therapy

Q1W dosing of alendronate 70mg produces less GI effects than QD dosing alendronate 10mg
It is advisable to bring the patient down to the shop floor to explain supplements (e.g. calcium supplements) in detail so that the patient understands better when needed.
Vit D supplement needed for those people who are housebound, do not see much of the sun - since cannot auto synthesis.
Alendronate to be taken 2 hours after last intake of med or food. Best method is as follows:
Take alendronate first thing when you wake up with a full glass of water (nothing else- the rest will interfere with alendronate absorption). Stay upright for 30min before you take anything else - in the mean time can go walk walk, etc.


Remember to write in full as possible e.g. supp = supplement or suppository - calcium suppository anyone?

Digoxin increases ejection fraction not ejeculation fraction.

Chemotherapy induced nausea and vomitting (CINV) comes in 3 types - anticipatory, acute and delayed.
Acute use a sedative, e.g. lorazepam. Loarazepam can also cause amnesia which may help forget the previous noxious effects leading to vomitting.
Acute CINV is usually given prophylaxis or just before the chemo itself.
Delayed CINV is treated for 5-7 days post chemotherapy
Aprepitant is only approved for cisplatin -containing regimes. (120mg, 80mg, 80 mg)