Rx Note

Introduction In August 2018, I launched a self-initiated drug database project, called "RxLookup". My motivation stemmed from a lack of existing databases that met my daily workplace needs, combined with a desire for a more organized way to document my reading material. Furthermore, existing unofficial MOH Formulary mobile applications were infrequently updated and required users to pay a fee to remove advertisements. It wasn't until early March 2025 that the official MyFormulary app was launched by the Ministry of Health, Malaysia. About the Project As a full-time pharmacist at a government hospital in Malaysia, I built this self-initiated database on the foundation of the Malaysia Ministry of Health Medicines Formulary (MOHMF) . In daily practice, we frequently consult the MOHMF for crucial details such as prescriber categories , approved indications and procurement methods. The formulary also comprises a vast selection of cost-effective, essential medications. Howev...

Introduction Ministry of Health Medicines Formulary (MOHMF) is a valuable resource for healthcare professionals practicing at Malaysia. It provides quick information on indications, dosage, availability and prescribing category. Also, it forms the hospital/clinical drug formulary foundation for all government healthcare facilities at Malaysia. Self-Driven Initiatives Over the years, several unofficial attempts have been made by practitioners to bridge this accessibility gap. These first started with My Blue Book by My Pharmacist House (last updated to MOHMF 2016-2) , followed by Blue Book (Updated+Brand Name Search) by Apicel (last updated to MOHMF 2020-2), and Blue Book + CPG Malaysia by Ice Cream App (last updated to MOHMF 2025-1). More recently, independent tools like Antimicrobial QR (developed by a Family Medicine Specialist, bundling NAG guidelines with MOHMF 2025-3) have emerged. However, most of these community-driven apps eventually suffer from update lag or remova...

Introduction The four leading evidence-based clinical resources widely utilized by healthcare professionals are: UpToDate DynaMed BMJ Best Practice ClinicalKey NOTE: All four resources require a paid subscription, though institutional access is common. UpToDate Nearly 30 years ago, Dr. Burton "Bud" Rose sought a way to update his nephrology textbook, Clinical Physiology of Acid-Base and Electrolyte Disorders , more rapidly. When his publisher declined to digitize the book, he created the software himself, leading to the birth of UpToDate . Among point-of-care tools, UpToDate covers the broadest range of topics and incorporate Lexidrug monographs and interaction tools directly into its database. Although the content is comprehensive and highly detailed, its length can make it challenging to read through during time-sensitive situations. However, it now features UpToDate Expert AI , which delivers fast, evidence-based answers grounded in expert-authored medical content. In ...

Introduction Pharmacists play a vital role in providing accurate drug information to patients and other healthcare professionals. As technology advances, it is increasingly common for pharmacists to utilize several medical mobile applications for daily works. NOTE: All the hyperlinks below are for Android devices. Malaysia Localized Apps MyFormulary A progressive web app that provides drug information on the latest Ministry of Health Medicines Formulary (MOHMF) in Malaysia. Brand name search is not available. MIMS Malaysia MIMS Malaysia requires internet access. Antimicrobial QR Provides an interactive, offline search experience for both the Malaysian National Antimicrobial Guideline (NAG) and the Ministry of Health Medicines Formulary (MOHMF) . CPG Malaysia An app created to help medical professionals to obtain and read CPGs easily. MyUbat An offical app developed by Ministry of Health to help verify FarmaTag hologram and apply pharmacy value-added services at government health c...

Introduction Medscape is a comprehensive medical resource that provides up-to-date information on drugs, diseases and clinical procedures. Access is completely free and only requires a basic account registration. Launched on 22 May 1995, the platform has expanded to feature breaking medical news and Continuous Medication Education (CME). Mobile Application The Medscape mobile application was released for iOS in 2009, followed by an Android version in 2011. Users can also download its clinical database directly to their devices for reliable offline usage at the point of care. Medscape AI In November 2025, Medscape launched Medscape AI , a generateive AI clinical reference tool available for free to all Medscape members worldwide. The tool integrates Medscape’s proprietary clinical content, peer-reviewed literature, and real-time medical news to deliver timely, specialty-specific insights designed to support evidence-based decision-making. Keep in mind that Medscape’s primary datab...

Introduction The third World Health Organization Consultative Group on the Role of the Pharmacist held in 1997 proposed the concept of " Seven-Star Pharmacist ". Three additional roles (researcher, entreprenuer, agent of positive change) were introduced later, leading to the "Ten-star pharmacist" model. One of a pharmacist's key responsibilities is to assist with the education and training of the public and future generations of pharmacists. My English teacher's words still ring true: "The more you use what I teach, the more it becomes your own." This sentiment deeply resonates with my passion for knowledge sharing. I intend neither to show off my expertise nor to scold you for my own amusement. I simply hope to provide you with the guidance that I missed out on when I was a junior. Experience Sharing Our teaching methods are mostly modeled on past experience (i.e. how we were trained as provisional registered pharmacists) and how we believe thin...

Introduction Despite the shifting of pharmacy focus to pharmaceutical care, the practice of compounding pharmaceutical formulations remains an essential skill for pharmacists. Being a drug expert, we are expected to know them all. In the 1920s, hiring a hospital pharmacist in the United States was necessary for controlling the inventory and manufacturing alcohol-containing preparations, which were expensive to obtain commercially. Nowadays, it is recommended to use commercially available products whenever possible . If no suitable commercial product exists and no therapeutic alternative, then extemporaneous preparations should be made based on evidence-based references . When no stability information is available, pharmacist may dispense oral tablet or capsule and direct the caregiver to freshly prepare just prior to administration . Extemporaneous Formulation References There are many references available for extemporaneous formulation, including Australian Pharmaceutical Formulary ...

Introduction For years, I told myself that one day I would write an ebook to help junior pharmacists navigate the daunting start of their careers. In reality, for a variety of reasons, I rarely sat down to actually plan it out. However, as I began this journey, I found myself forging a clearer path while frequently repeating my own core ideas - a subtle form of "self-plagiarism" or echoing my past work. Content The objective of this booklet is not to provide an exhaustive guide on disease management, nor is it a summary comparison of pharmacological drug classes. If it were, you would find yourself expecting a new edition every few years just to keep up with updated management protocols. Instead, The Pharmacist Insider is a synthesis of the wisdom and insights I have accumulated on how to truly function as a professional clinical pharmacist. Unlike my blog posts, which were written by different versions of myself at various points in time, this represents a final roadmap. It...

Introduction While I have always envisioned writing a book for junior pharmacists to help them navigate their new careers, I hesitated because I needed a unique angle. I wanted to provide extra value beyond what already exists in standard pharmacy textbooks. Recently, I was validating the medication counseling skills of fresh provisional registered pharmacists (PRPs) on insulin injection techniques , using the checklists from the Garis Panduan Kaunseling Ubat-ubatan 2025 . While the information in the guide is factually complete, it lacks clinical insight - the "why" behind the facts. Because these insights are missing, most PRPs resort to memorizing factual information instead of truly making sense of it. Beyond Memorization Consider administration times. Guidelines state that we should inject short-acting regular human insulin 30 minutes before meals, whereas rapid-acting insulin analogues can be injected 0-15 minutes before, or immediately after, meals. If we only memorize...

Indications Unlike its use for treatment of cancer, methotrexate is administered as long-term, low-dose therapy, usually 7.5 to 25 mg weekly in rheumatoid arthritis and other disorders. Sometimes, it might be a good idea to have a discussion with patients to select a day for them to take this medication. It could be a Monday, since methotrexate starts with a "M", or it could be a Sunday, since patient is going to church in the morning. Method of Administration In terms of prandial advice , methotrexate should be taken with an empty stomach. Milk-rich foods may decrease its absorption. However, under management, Lexicomp did suggest to administer without regards to food , which is interesting to be take note of. Being an antineoplastic agent, methotrexate is listed in  NIOSH List of Hazardous Drugs in Healthcare Settings, 2024 . The 2.5 mg methotrexate tablet should not be cut or crushed in an unprotected environment. If a weekly dose is missed , it can be taken as soon as ...