Rx Note

Introduction Each insulin injection device has its own advantages and drawbacks. Insulin Syringes To be used with insulin vials. Reusable insulin pens Not all insulin cartridges can be used in all insulin pens, but they are brand specific. e.g. NovoPen, INSUPen. Pre-filled insulin pens Disposable once finished, but more costly. Insulin Syringes Insulin syringes are available by prescription in 3 sizes: 0.3 ml, 0.5 ml and 1 ml. Choose a syringe based on the dose (units) of insulin you require. A 6 mm and 8 mm needle is recommended over a 12.7 mm needle due to a higher risk of intramuscular injection. NovoPen 3, NovoPen 4, NovoPen 5 and NovoPen 6 Although NovoPen 4 has been phased out and replaced by NovoPen 5 in the UK, NovoPen 4 is still marketed in Malaysia. NovoPen 5 offers an additional feature of a digital display that shows the dose memory. Time elapsed: Each segment represents an hour since the last injection. Last dose volume: Records the last insulin dose in units. On ...

Introduction In general, cancer cells are cells that tend to grow extraordinarily fast in our body and chemotherapy works by targeting these actively dividing cells. However, chemotherapy is not specific in their action, and hence our normal, healthy cells that are fast-growing (e.g. hair follicles, blood-forming cells in the bone marrow, and cells in the mouth, digestive tract, and reproductive system) are also damaged. Hence, the patient experience side effects. NOTE: Chemotherapy safety at home is discussed separately. Hair Loss (Alopecia) Depending on the type of drug received, hair (body hair and scalp hair) may be unaffected, thinned, or completely fall out. Hair loss may start anywhere from 7 to 21 days after the first chemotherapy session. It will grow again following the completion or termination of chemotherapy, it may have a different texture or colour, but these changes are usually temporary. Near total hair loss is expected with doxorubicin, etoposide and ifosfamide. H...

Introduction Pharmaceutical care has been defined as medication-related care provided through direct patient contact and intended to improve quality of life. One of the fundamental components will be patient education and counselling. In United States, concerns regarding improper medication use led to mandates requiring pharmacists to provide patient counselling and education (e.g. The Joint Commission), professional association standards of practice (e.g. ASHP) and federal regulations (e.g. The Omnibus Budget Reconciliation Act of 1990 [OBRA-90] ). Ideally, medication counselling should extend to all patients and their caregivers regardless of the patient care setting. Collaboration with other healthcare professionals may help to individualize counselling. However, barriers do exist , such as excessive workload, lack of financial compensation and patient's attitudes. At Malaysia, due to high patient load at government facilities, we tend to counsel only the essentials. Hopefully, ...

Introduction Prefabricated transdermal patches are designed to deliver a constant and controlled dosage over extended periods for systemic therapy. They offer advantages over conventional oral dosage forms in that Drug administration through the skin avoids the pH variations seen with gastrointestinal transit. The drug reaches the systemic circulation whilst avoiding first-pass hepatic metabolism (though the skin has some metabolic activity). Patches can be removed easily and quickly in cases where adverse drug reactions occur. Patient adherence is high. Designs of Transdermal Patches The simplest transdermal systems contain the drug in an adhesive, with more complexity introduced in matrix-type patches and reservoir systems. Simple drug-in-adhesive patch These patches are formed by dissolving or dispersing drug within an adhesive, which is then coated onto a backing layer before a release liner is applied. Different daily dosages can easily be delivered by increasing the surface ar...

Introduction A colleague once stumped me with a question: "What is the medical term for coughing out blood?". My mind went blank for a moment. In outpatient pharmacy, we are trained to avoid medical jargons with patients. There are also times when patients describe symptoms in their native language (such as Mandarin), adding another layer to communication challenge. NOTE: Each medical term has a root word that forms the foundation of its meaning. Prefixes and suffixes are then added to modify of clarify that meaning. Prefixes A, as in atypical - Opposite of the word Bi, as in bilateral - Pertaining to two or both sides. Brady, as in bradykinesia - Slow Cardio, as in cardiologist - Heart Dys, as in dysmenorrhea - Painful Enceph, as in encephalopathy - Brain Endo, as in endoscope - Within Eu, as in euthyroid - Normal Glyco, as in glycosuria - Sweet Haem, as in haematuria - Blood Hepato, as in hepatotoxicity - Liver Hetero, as in heterosexual - Different, other Homo, as in homo...