Blogposts from pebblepad: all-smiles-day

24 June 2010

Today is a happy day! What makes me even happier at the end of a long day was an email from my lecturer saying that she enjoyed reading my blog! Maria and I couldn't stop laughing, and it's just out of pure joy! We hope what we have been writing is what our lecturers are looking for and we do enjoy very much in keeping a record of what has happened everyday.

Well, i started my day feeling that i won't have much to do at the pharmacy today because I had a feeling there will be quite alot of staff working today.

When i arrived, i did a few scripts. One had 7 items on it but it was fairly straight forward. Another had 10 items. The person was going to come back in 5-10 minutes so i tried not to pick that script but the pharmacist insisted i did it. Out of 10 items, 5 were last repeats and so i had to put stickers here and there to remind myself which of the 10 needs a last repeat sticker. And then while i was stressing out, trying to put things together within 5 minutes, the label printer went out of labels. Thankfully it happened before, so i quickly changed the roll and continued dispensing. The customer came back just when i finished. Phew!

After that, another pharmacist came in, so she took over the computer and asked me what i was going to do. I remember saying to her "Well, i'll just hang around or maybe clean the bench". She is one of the pharmacists that do HMRs, so i thought i might as well read her letters then. However, having nothing to do was a blessing in disguise because the pharmacist came up with a brilliant idea of letting me have a go at doing one of the HMRs. She has interviewed the patient but has not got around looking for the issues or doing the recommendations yet. I was a bit uncertain at first but i took up the challenge. When i finished doing it, i had a good discussion with the pharmacist and she thought i did quite well. She taught me so much and because she is doing HMRs, she is very updated in terms of all the current studies/ researches. I'm privileged to learn from her and am very proud that my uni has taught me well, so much so i can at least have a little go in doing HMRs in real life.

One thing i learnt today was that, the reason why ACEIs and SARTANs are not used together now, is because although it doesn't seem to increase proteinuria, it still reduced the GFR a little bit, so it is not recommended. Other bits of new things i've learnt today are such as, the incidence of aspirin-induced asthma is about 10-20% (or thereabouts), the cholesterol levels for people with concurrent diseases like diabetes should be below 4 instead of the normal 5.2, and Hiprex (for the prevention of UTIs) is ineffective in renal impairment.

I was stretched over and over again today, being pushed out of my comfort zone a few times. One was the 10-item script, another was doing the HMR which i quite enjoy, the other was giving counselling to the patients/ customers.

I was quite reluctant at first but the pharmacists encouraged me to go and assured me that i can do it. The first case was for a patient needing Lactulose and Normafibe. The pharmacist gave me alot of guidance and stood by me when i gave the counselling. When i finished, she added a few things and once again i had the chance to learn from her. I learnt that 5ml is about a teaspoon, that Normafibe comes as granules and is a bit difficult to swallow, so it's not usually given to people unable to swallow in case they choke. Also, we should start it low because too much fibre at once will make the stomach bloat and feel unwell. So about 5ml once or twice a day would be good to start with to increase faecal bulk. It is also very important to drink plenty of water when taking bulking agents so as to avoid blockage. Lactolose, on the other hand,is 'disgustingly sweet' (according to the pharmacist), so taking it with some juice might be a good idea. The script says 10-30ml but the pharmacist suggested 20ml to start with, using a measuring cup. Whilst Normafibe helps bulking up, Lactulose will make the bowels move. The pharmacist also told the patient that he could increase the doses a little if it's not good enough and go down when his bowel movements become fairly normal.

The other counselling i had to do was Augmentin for a dental infection. I asked about allergies and other medications, told the customer to take 1 twice daily and to take it with food, best before breakfast or dinner (according to the pharmacist) and to take it until all finished. The pharmacist told me that he would counsel patients about antibiotics everytime, not just if the patient is taking it for the first time.

I also finished dispensing for the Webster packs due on Friday and i felt such a sense of achievement when i left for home at 5pm. Hence, the happy day. Or rather, the all-smiles-day! =)

Looking forward to the last day of the week! Time really flies!

p/s: my! so many grammar mistakes and typos in all my pebblepad blogposts! i've edited my pebblepad blogposts but i won't do it here.. hehe! can't be bothered cos i know u know i mean dig when i say fig. haha! good nite!