Wah scary

http://www.straitstimes.com/ST%2BForum/Story/STIStory_134414.html

June 30, 2007

Cough syrup should have been allowed after checks
WE
REFER to the letter by Ms Ong Seok Hwee, 'Airport needs to be clearer about
medication' (ST, June 26). We have contacted Ms Ong to address her concerns and
would like to thank her for her feedback.

Since May 8, restrictions have
been implemented on the amount of liquids, aerosols and gels that can be taken
in hand-carried luggage on flights from Singapore. Liquids, aerosols and gels
must be in containers with a capacity of less than 100ml each. These containers
are to be placed in a transparent re-sealable plastic bag of a capacity not
exceeding one litre and presented at the security screening point. Liquids,
aerosols and gels in containers larger than 100ml will not be accepted, even if
the container is partially filled.

Medications in liquid, aerosol or gel
form (such as insulin, cough syrup or nasal sprays) in quantities needed for the
flight are exempted from the restriction. A doctor's letter or prescription,
while not mandatory, would help to facilitate the security screening. If the
medications are in containers of a capacity of less than 100ml, passengers are
encouraged to place them in the re-sealable plastic bag. If this is not
possible, or if the medications are in containers larger than 100ml, the
medications will be subjected to further checks at the security screening point. Passengers may also be asked to taste their
medications. We encourage travellers to visit Changi Airport's website
http://www.changiairport.com/to find out more about the guidelines.

In
Ms Ong's case, the security screening staff should have allowed her to take on
board her cough syrup in the 125ml bottle, after making the necessary checks. We
regret the inconvenience caused to her. We would also like to reassure her and
the public that our screening procedures allow for flexibility without
compromising security.

Phillip Mah
Head (Aviation Security)
Civil Aviation Authority of Singapore


Toh Boon Ngee
Assistant Director
(Media Relations) (covering)
Singapore Police
Force

I think the following "Passengers may also be asked to taste their medications." is rather scary.
-The sample taste is of an unknown quantity - may lead to O/D
-The timing of tasting may be close to previous dose - may lead to O/D
-There may not be an experience doctor on the flight - so patient may die of O/D
- If bottle not handcarried may break in cargo hold, patient no med to take - patient may get a U/D.

What are they thinking!? They think that medicine as mere sugary placebos?! They are potent drug substances where a little will trigger a therapeutic effect and a little more may kill. I soooo dun wan to be at the scene where the patient is told to sample liquid digoxin.

Dendrobium lichenastrum

Bought from WL last time. Think was sourced from TW. High light. Smells funky. Normal form has red lip.

This week

Last week before the GST hike kicks in.

A lot of patients trying to get the long supply ( approx 6 months +) items before the extra 2% comes in and to get their more expensive drugs such as Forsamax, Actonel and Evista.

Some patients came in with their expired prescriptions (normal scripts - 1 yr from date; CD scripts expire in 30 days). Some of them really bugged me at triage while I'm clearing the nong nong queue - and I tot I could have it easy since the chewren hols are soooo over. But noooo the ladies are now free-er since their chewren or grandchewren are in skool.

Met a patient who came in without script and insisted we dispense - it is as if not many knew that a original complete script (date, signature of doc, name of doc, place of practice of doc, drug, dose, duration, patient's name and address) is required. Depending on the severity of the matter or whether we can entertain such cases, we had to call the doc and ask for authorisation and a prescription to dispense.

Got another bring a photocopied script and left the original for safekeeping.... Luckily that patient not so hard-up one.

Got another no show at clinic for so nong and so many times then come in to ask for emergency supply to tie over until next appointment.

Then there's one who came down from the wards to ask whether nutritional supplements are claimable by medisave or not then about this supplement that supplement. What's worse was the patient came down during the peak hours. The patient was a bit unhappy that we could not entertain her enough.

Then we had drugs with short expiry and the patient complained why the expiry is so short and the patient demanded a discount for the product in lieu of the short expiry. Shouting at the pharmacist some more. The script calls for a short supply and what we issue is within the expiry date (= manufacturer's warranty). As long as it works, please take it or forego a period of therapy. So do you want to withhold therapy for some time while waiting for "better expiry date" or would you want to take the medication which is still under the manufacturer's warranty? Choice is yours. The price is fixed by the hospital's board, so please quit yelling - I assume you don't yell at your doctor or nurse right?


After knocking off, I had to stay back a while to check through some papers since my uni's e-library membership is expired. Then the EP people ask me to pop by to do some translation for a Chinese patient. My Chinese sux, need to revise. Apparently the hyperative son had a severe attack of asthma but themother didn't want him to be warded. Turns out that she had gotten an aerochamber and was using it wrongly.

The dose of the salbutamol was very high although tapering and the turbuhaler worked better than the MDI. The son had been using a spacer the following manner:
- Spray
- Breathe
- Hold for 10 seconds....=,=
- Spray

Should be be
- Spray
- Breathe in and out 10 times.
- Spray again

I would like to reiterate the role of the pharmacist.
- We are not there as shopkeepers
- We are there to help you make sense and make the best of your drug therapy
- We are there as authorities in drug therapy and there to ensure rational use of drugs to reach therapeutic endpoints.
- We would appreciate a level of respect given to all the other medical professionals. Work with us, and we'll work with you to ensure optimum health.
- We need time to prepare your medications and do the necessary intervention lest a mistake happens and there's dire consequences.
- We hope that you give us a listening ear, so as to understand the reason behind why you are taking such steps in your health management.

Wah liaoz ehz

Yyyyy today so siong?! All the chewren shoulda gone back to school. Then one huge mob of gynae patients flood in =.=

Hit about 500 by noon. Constant stream of people - losing voice until one momma had to lean close to me to listen to me.

Bad time for me to do triage - couldn't cope with the mob. Had a whole bunch of people asking for OTCs and I'm still a bit noob with OTCs. I think tomorrow I should take a break from triage and do the extempo liaoz. Need to do at least 2.

One patient wanted return but then meds > 3months post dispensing liaoz. Even the meds changed colour liaoz.

May be I'm the zhao cai mao - I stand there scripts come in. Eeeeee

Brain's busted until so many people said I looked tired when I was collecting my gown - lilac purple trimmings ^^. So special. My fave crochet cotton colour.

Reminders:

Vagifem ok for lactating ladies as it's localised in vagina.
Dimetapp as an antihistamine mix (brompheramine + pseudoepi) but polaramine is the preferred knock out drug
Gentamicin in chewren infusion approx 2-3 mg/kg
Promethazine syr can be used up to tds although it stated bd