Rx Note

Introduction A customer walked into your community pharmacy and would like to buy some iodized salt. Types of Salts Essentially, salt is sodium chloride (NaCl). Sea salt is a general term for salt produced by evaporation of ocean water or water from saltwater lakes. It retains trace minerals which add flavour and colour. Celtic salt is a type of sea salt harvested from coastlines after seawater evaporates. Originally sourced from the Celtic Seas near northwestern France, it is now produced in other coastal regions as well. Its characteristic grey colour originates from the inclusion of extra minerals such as magnesium, calcium, potassium, zinc, and iron. Rock salt , also known as halite, is the salt from the ocean that has already formed a rock. Similar to sea salt, it contains very small amounts of minerals such as zinc, copper, iron, manganese, potassium, calcium and copper. Himalayan salt, is rock salt primarily mined from the Salt Range mountains in the Punjab region of Pakistan...

Introduction Graduating from university is not the ending of learning, but the beginning of self- learning . Never in my university years, I have heard of the term ARNI (angiotensin-receptor nerilysin inhibitors). An example of it is Entresto, which consists of sacubitril and valsartan in a fixed combination. Valsartan, in formulation, is more bioavailable than other tablet formulations; 26 mg, 51 mg and 103 mg valsartan is equivalent to 40 mg, 80 mg and 160 mg respectively. Entresto is a novel therapy recommended for patients with Chronic heart failure with reduced ejection fraction (HFrEF) to reduce morbidity and mortality Essential hypertension What Benefits does Entresto Offer over ACEI in Heart Failure? A randomized double-blind trial ( PARADIGM-HF ) in patients with HFrEF found that sacubitril-valsartan (Entresto) reduced all-cause mortality as well as cardiovascular mortality and hospitalization for HF compared with a proven dose of the ACE inhibitor enalapril. How about Safe...

Introduction Hypertension (or high blood pressure ) is a silent disease ; in 2015, for every 2 diagnosed patients in Malaysia, there are 3 undiagnosed patients. Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors. Untreated or sub-optimally controlled hypertension leads to increased cardiovascular, cerebrovascular and renal morbidity/mortality and overall mortality. Definition Hypertension is most commonly defined as persistent elevation of systolic BP of 140 mm Hg or greater and/or diastolic BP of 90 mm Hg or greater . However, definition vary by professional organization. NOTE: For stage 1 hypertension (SBP 130-139 mm Hg or DBP 80-89 mm Hg) in patients with estimated 10-year ASC...

Introduction Blood pressure monitoring is one of the bread-and-butter services that we offered at a community pharmacy . Hypertension is mostly defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, but definitions vary by professional organization. Blood Pressure Monitoring Ideally, the patient should sit quietly for 5 minutes before the BP is measured. BP should be taken at least twice on each visit , with the measurements separated by one to two minutes to allow the release of trapped blood. If the second value is more than 5 mm Hg different from the first, continued measurements should be made until a stable value is attained. The recorded value on the patient's chart should be the average of the last two measurements. # Note: Australia Heart Foundation Guide for the diagnosis and management of hypertension in adults, 2016 suggests to take 3 measurements and average the last 2 instead. If reading vary more than 10 mm Hg systolic or 6 mm Hg dia...