End of Day Two
There really isn't much to do in the morning before the patients are seen by the doctors.
And because in the afternoon one doctor would be in the surgery room, there really is much less to do in the afternoon after lunch.
So the busy hours are about 10.30am to 12.30pm.
That's not too bad, because those times I would be struggling to keep up with the Thai language.
Labels here are written manually, with templates pre-printed on sticker papers - eye drops, syrups, tablets, antibiotic steroid creams, insulin injections. All in Thai with standard instructions - _____ tablets _____ times per day, L/R eye/ear/nose, before/ after food, morning/ afternoon/ night etc.
And its more laborious for them to speak English than for me to speak Thai. So I just have to improve miraculously some how.
I guess I'm getting much better. It's like doing my Thai kaan baan (home work) about 15 times per day.
Reading and understanding.
Hardest thing now is actually reading cursive Thai handwriting from the receptionist. If I get it wrong then we won't be able to label the medicines properly.
And also getting used to different practices here.
Beta lactams are eaten before food, whilst I learnt it was better absorbed before food in school, I remember being shot down in preceptorship year 3 for the same thing. Because the GI SEs for empty stomach ingestion of augmentin & friends are just too common in my place of practice, we suggest post-meal administration.
I wasted at least 5 labels today for such errors.
Feel silly, but was a good point of discussion for my fellow friend.
Next week onwards, I'm the only pharmacist around. GG.
Well, cases are usually simple here.
Vitamins, Painkillers, Anti-fungals... But today we got a long script (by local standards).
I felt relieved when I found it all too familiar - HTN, HLD & DM medications. 82 year-old gentleman seen at OPD for back pain along with chronic disease management follow-up.
I checked and couldn't find any recent SCr tests done.
He was on the classic furosemide, aspirin, enalapril and short term ibuprofen combination.
Too often in Sg we rely on many lab results, I was rather uneasy when I didn't see any SCr tests done.
Upon asking, I found the test to be at least the cost of 5 average meals. And usually folks don't eat out too...
As I discussed and explained to my fellow pharmacist as to my concerns, and explained the pathophysiology of AKI, my thoughts inevitably wondered back to the thought I had as a pre-registration pharamcist.
The thought that there is so little emphasis on pharmaco-economic research use of medications/ lab tests etc, where I come from. There is so much wastage, so much costs involved in just getting well due to medico-legal issues, due to quality assurance validations etc.
Then we discussed the US military's 2006 research on the extendable drug shelf life beyond manufacturer's labelled expiry date. The longest is 66 months - yeah do the math, that's like how many years can......
All that money on the ridculous electricity bill to keep the temperature within range, and freeze the humans working in them. !@#$%%^&&*()
There really isn't much to do in the morning before the patients are seen by the doctors.
And because in the afternoon one doctor would be in the surgery room, there really is much less to do in the afternoon after lunch.
So the busy hours are about 10.30am to 12.30pm.
That's not too bad, because those times I would be struggling to keep up with the Thai language.
Labels here are written manually, with templates pre-printed on sticker papers - eye drops, syrups, tablets, antibiotic steroid creams, insulin injections. All in Thai with standard instructions - _____ tablets _____ times per day, L/R eye/ear/nose, before/ after food, morning/ afternoon/ night etc.
And its more laborious for them to speak English than for me to speak Thai. So I just have to improve miraculously some how.
I guess I'm getting much better. It's like doing my Thai kaan baan (home work) about 15 times per day.
Reading and understanding.
Hardest thing now is actually reading cursive Thai handwriting from the receptionist. If I get it wrong then we won't be able to label the medicines properly.
And also getting used to different practices here.
Beta lactams are eaten before food, whilst I learnt it was better absorbed before food in school, I remember being shot down in preceptorship year 3 for the same thing. Because the GI SEs for empty stomach ingestion of augmentin & friends are just too common in my place of practice, we suggest post-meal administration.
I wasted at least 5 labels today for such errors.
Feel silly, but was a good point of discussion for my fellow friend.
Next week onwards, I'm the only pharmacist around. GG.
Well, cases are usually simple here.
Vitamins, Painkillers, Anti-fungals... But today we got a long script (by local standards).
I felt relieved when I found it all too familiar - HTN, HLD & DM medications. 82 year-old gentleman seen at OPD for back pain along with chronic disease management follow-up.
I checked and couldn't find any recent SCr tests done.
He was on the classic furosemide, aspirin, enalapril and short term ibuprofen combination.
Too often in Sg we rely on many lab results, I was rather uneasy when I didn't see any SCr tests done.
Upon asking, I found the test to be at least the cost of 5 average meals. And usually folks don't eat out too...
As I discussed and explained to my fellow pharmacist as to my concerns, and explained the pathophysiology of AKI, my thoughts inevitably wondered back to the thought I had as a pre-registration pharamcist.
The thought that there is so little emphasis on pharmaco-economic research use of medications/ lab tests etc, where I come from. There is so much wastage, so much costs involved in just getting well due to medico-legal issues, due to quality assurance validations etc.
Then we discussed the US military's 2006 research on the extendable drug shelf life beyond manufacturer's labelled expiry date. The longest is 66 months - yeah do the math, that's like how many years can......
All that money on the ridculous electricity bill to keep the temperature within range, and freeze the humans working in them. !@#$%%^&&*()
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