Rx Note

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 There are currently 3 main types of aerosol-generating device for use in inhaled drug therapy. Pressurized metered-dose inhalers Dry-powder inhalers Nebulizers Inhaler Techniques Poor inhaler technique has been reported among children and adults , including experienced inhalers. Incorrect technique → More symptoms →Worse adherence → More exacerbations → Higher environmental impact. Hence, correcting patients' inhaler technique can improve asthma and COPD control, quality of life and lung function. To learn step-by-step guide of how to use an inhaler , you may refer Handling of Inhaler Devices, 2011 Garis Panduan Kaunseling Ubat-ubatan, 2025 A Guide to Aerosol Delivery Devices for the Respiratory Therapist, 2018 Lung Foundation Australia Inhaler Device Technique, 2018 Asthma + Lung UK Inhaler Demonstration Videos, 2022 National Asthma Council Australia - How-to videos Common Errors Experience shows that patients commonly make a few key errors when using inhalers, and ...

Introduction The absorption pattern of drugs differs considerably between individual drug substances, as well as between the different administration routes. A medication administration route is often classified by the location at which the drug is administered, such as oral or intravenous. The choices of routes in which the medication is given depends not only on the convenience and compliance, but also on the drug's pharmacokinetics and pharmacodynamic. The right route of administration and dosage form is selected to maximise outcome of treatment. To illustrate, 32 years old epileptic male with fever and infection on nasogastric feeds , prescribed with phenytoin 300 mg daily. Which dose form do you choose (capsules, suspensions or injections) and why? 48 years old patient with osteomyelitis, microbiological culture positive for the bacteria Methicillin Resistant Staphylococcus Aureus (MRSA). Which dose form do you choose (IV or oral) and why? 4 years old boy diagnosed with bron...

Introduction Ramadan Ramadan is the 9th month of the Muslim calendar and the daylight fasting that accompanies it is 1 of the 5 pillars of Islam. The month-long (29-30 day) fast is obligatory for all healthy Muslims who have reached puberty. Followers must refrain from eating and drinking between dawn and sunset, and must also abstain from using oral medications, sexual activity and smoking. Exemptions include the elderly, children, the sick, those who are traveling (journey >89 km) and breastfeeding or pregnant women. Instead, they can honour Ramadan through charity, such as by feeding a less privileged person in lieu of fasting. Medical Treatments that DO NOT nullify fasting Use eye drops, ear drops and ear cleaning (provided no limit to the eardrum). Sublingual tablet (beneath the tongue) provided placed beneath the tongue and not swallowed. Perform dental procedures; fillings, extractions, cleaning teeth or brushing provided the individual who fasted did not swallow any su...