Rx Note

Introduction Medical abbreviations are common part of healthcare communication. However, what one abbreviation mean to one person can mean something very different to another. Hence, it is more often best to write out what is meant rather than to use abbreviations. Ideally, error-prone abbreviations, symbols and dose designation should not be used when communicating medical information, for example in prescription. Examples Drug names AZT can be read as "zidovudine" or "azathioprine" CBZ can be read as "carbamazepine" or "carbimazole" CPZ can be read as "chlorpromazine" or "cefoperazone" HCT can be read as "hydrocortisone" or "hydrochlorothiazide" MXT can be read as "methotrexate" or "metformin" Do not use a trailing zero after a decimal point. Always use a leading zero before a decimal point. Common Medical Abbreviations Some could be institution specific. If there is any doubt, you ...

Introduction Case clerking using CP2 (Pharmacotherapy Review) form and medication review are often done concurrently. If the pharmaceutical case issue is significant to the patient's current medical plan, the issue should be highlighted to other healthcare providers during ward rounds or whenever necessary. Prior Starting First, we should make a comprehensive medication management review . Summary of all relevant past and current medical conditions Chief complaint - The reason patient is seeking medical care, documented in patient's own words. History of presenting illness - Description on progression of patient's current problem. Past medical history Reason for use of each medicine. All current medicines (including prescription, non-prescription and complementary medicines), compliance aids, therapeutic devices and appliances Medication history, including immunisations Dose, strength, dose form, directions, route of administration, duration of therapy and indication for...

Introduction Clinical laboratory tests are valuable tools used to Differentiate among possible diagnoses Confirm a diagnosis Assess current status Evaluate the response to therapy when history and physical exam alone are insufficient Related tests may be grouped together into a set called a profile or a panel, although small differences may exist between institutions panels. Reference Range The reference range is a statistically derived numeric range obtained by testing a sample of individuals assumed to be healthy. It is usually established as the mean ± 2 standard deviations. The reference population is assumed to have a Gaussian distribution with 68% of the values within one standard deviation (SD) above and below the mean (± 1 SD), 95% within ± 2 SD, and 99.7% within 3 SD. Reference ranges can vary between laboratories and facilities due to differences in analytic techniques, reagents and equipment. Reference ranges may also differ among populations and may change as new data are ...

Introduction Humans are living in a society where each of us is servicing the others, depending on the circumstances. Sadly, there are times or people who forgot to respect the others . As a practicing outpatient pharmacist, the majority of patients that I have met are friendly and nice. However, a few patients are demanding and unreasonable, refusing to listen to our explanations and turning us into heartless individuals . Some Common Complaints Often, pharmacy is the last station that a patient would end their hospital visit with. Undeniably, due to patient crowd and limited specialists available at outpatient clinics, they may have waited from the morning till afternoon (almost half a day). Hence, another waiting of 30-45 minutes at outpatient pharmacy frustrated some of them. However, please bear with us, because we have also been busy with the never-ending crowds since the morning. At government facilities, there exists a policy to supply one month medication at each visit . Thi...

Introduction Vital signs are measurements of the body's most basic functions , hence providing valuable information concerning a patient's general state of health . Any abnormal values require further investigation and recheck. The 4 main vital signs routinely monitored by health care professionals are: Body temperature (BT) Pulse rate (PR) Respiration rate (RR) Blood pressure (BP) NOTE:  The fifth vital sign may refer to a different parameters, such as  pain , oxygen saturation and  blood glucose . Body Temperature To maintain normal metabolic function, the core temperature of the body is regulated by hypothalamus to stay within a very narrow range. Heat production, which occurs primarily through metabolism and exercise, is balanced with heat loss, which occurs mainly through evaporation of sweat. The normal body temperature of a person varies depending on age, gender, recent activity, food and fluid composition, time of day, and in women, the stage of the menstrual cy...

Introduction A few years ago, a senior pharmacist described outpatient pharmacy as a "dark hole" where most newly registered pharmacists are placed. However, it can be a valuable place to build a foundation in pharmacy practice . In outpatient pharmacy , we receive prescriptions from various clinics within the hospital, including general medical, surgical, ophthalmology, dermatology, rheumatology, paediatrics, neurology, nephrology and more. To properly screen prescriptions within a short time frame, we must be familiar with indications, usual dosages, maximum dosages, off-label uses and contraindications of all medications. Additionally, these factors should also be taken into consideration. Medication safety during pregnancy and breastfeeding Tablet splitting Administration through Ryle's tube Paediatric dosing Availability of extemporaneous formulations Polypharmacy NOTE: Life in the outpatient pharmacy teaches you with what minimum amount of information you will b...

Introduction We once extracted active ingredient from natural flora and henceforth the development in western medicine started. Today, for our clinical decision making, it should always be evidence-based. However, the origins of these so called evidence practices, it all just started from off-label use too. Beyond Technology I once attended a course, discussing on the use of pharmacometrics, in which we can formulate a mathematical model of biology, pharmacology, disease and physiology to describe and quantify interactions between drugs and patients. With the computer software calculation, after inputting the data, we would be able to achieve precision medicine. Well, it seems sophisticated and promising in the future. However, are we on the right track? Again and again, in therapeutic drug monitoring practice, we have been emphasized to treat the patient clinical condition, but not the drug level and estimations that we calculate from the formulas. Carbamazepine is 70-80% protein bo...