Online Pharmacy Training

Inhalational anesthetic induction Inhalational induction is common in pediatric patients, and the potent inhaled anesthetic agents are excellent bronchodilators. The only exception is desflurane, which has mild bronchoconstriction activity. The potent inhaled agents decrease skeletal muscle tone in a dose-dependent fashion, which often improves surgical exposure. Mode Of Action Acts on GABA-A, glycine, and glutamate receptors. Disadvantage Inhalational induction time is longer; therefore, this technique is not suitable for rapid sequence intubation (RSI).  Higher incidence of postoperative nausea and vomiting.  All potent volatile anesthetic agents cause dose-dependent systemic vasodilation and may decrease blood pressure. All potent inhaled agents cause dose-dependent respiratory depression. Inhalational anesthetic drugs

Noradrenaline  -  norepinephrine Drug name Sympathomimetic   (Vasopressor) Group Stimulates alpha-receptors in arterial and venous beds and beta 1 receptors of heart, resulting in peripheral vasoconstriction and stimulation of heart rate and contractility. Coronary vasodilation occurs secondary to enhanced myocardial contractility. Mechanism of action duration Interval dose Uses Cont. infusion 0.01–0.4 µg/kg/min IV infusion via a central vein           Septic shock ,with low SVR Severe hypertension may occur if noradrenaline is given to patients taking tricyclic antidepressants since tricyclics block the uptake of noradrenaline into nerve endings. Drug interaction Bradycardia Hypertension Arrhythmias Myocardial ischaemia peripheral ischaemia Side effects Hypovolaemic ...

What Is It? Yaws is an infectious disease that affects the skin and bones. It's a tropical illness that was once common in West Africa, Indonesia, New Guinea, the Solomon Islands, Haiti, Dominica, Peru, Colombia, Ecuador and parts of Brazil. In these countries, yaws most often affects children between the ages of 2 and 5, especially children who wear few clothes, have frequent skin injuries and live in areas of poor hygiene.

decrease Increase Normal range SI conventional Hyponatremia 1-( dilutional hyponatremia ) excess accumulation of body water due to: CHF, cirrhosis, severe burns, chronic renal failure, nephrotic syndrome. 2-Sodium depletion Due to: SIADH, cystic fibrosis, mineralocorticoid deficiency, Na free fluid replacement SIADH= (syndrome of inappropriate antidiuretic hormone) SIADH may be associated with disease states such as cancer or  the use of medications including chlorpropamide, thiazide diuretics, and carbamazepine .   Hypernatremia 1-Increased sodium intake. 2-Increased fluid loss. hypernatremia usually occurs in individuals who are unable to obtain adequate fluid intake. Fluid loss from - gastroenteritis - diabetes insipidus, - Cushing disease, - hyperaldosteronism - administration of hypertonic saline sol...

The U.S. Food and Drug Administration today announced it is requiring the removal of certain restrictions on prescribing and use of the diabetes drug Avandia (rosiglitazone) to reflect new information regarding the cardiovascular risk of the medicine. Today’s actions are consistent with the recommendations of expert advisory committees. Results from the Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycemia in Diabetes (RECORD) clinical trial showed no elevated risk of heart attack or death in patients being treated with Avandia when compared to standard-of-care diabetes drugs. These data do not confirm the signal of increased risk of heart attacks that was found in a meta-analysis of clinical trials first reported in 2007. In addition to Avandia, rosiglitazone is available in combination with other diabetes medications, including metformin under the brand name Avandamet and glimepiride under the brand name Avandaryl.  http://www.fda.go...

Abnormal Normal Appearance and color The presence of   -WBCs - RBCs - bacteria - Phosphates - Urate Cloudiness Appearance and Color The normal urine color should range from clear to dark yellow. - myoglobin (from muscle breakdown from seizures, cocaine, or injuries)   hemoglobin, - medications - rifampin -phenazopyridine - phenolphthalein - phenothiazines foods - beets - carrots - blackberries Red-orange

Decrease Increase Normal ranges CBC item SI Conventional leukopenia   viral Infection, Aplastic anemia, Bone marrow depression caused by the use of chemotherapy or anticonvulsants. Leukocytosis Infection, Leukemia, Trauma, Thyroid storm, Corticosteroid use. Emotion, Stress, Seizures. When WBC count is greater than 50,000 cells/mm3, false elevations in Hgb and MCH can occur. 3.2-11.3 × 109 cells/L 3,200-11,300 cells/mm3 White Blood Cell (Leukocyte) Count WBCs The total number of WBCs in a given volume of blood. Mature white blood cells exist in many forms, including - neutrophils - lymphocytes - monocytes -eosinophils            - basophils

Decrease Increase Normal ranges CBC item SI Conventional anemia of all types, particularly iron deficiency anemia blood loss, hemolysis, pregnancy, Fluid replacement increased fluid intake. polycythemia vera chronic obstructive lung disease chronic smokers regular vigorous exercise Live at high altitudes. 8.7-11.2 mmol/L 7.4-9.9 mmol/L Male: 14-18g/dl Female: 12-16g/dl Hemoglobin (Hgb) carrying compound found in the RBCs

It is important for pharmacist to learn how to read laboratory report and interpret its data that will help him in: 1. Recognize normal ranges for common laboratory values in adults. 2. Identify common causes for abnormal laboratory values.

Problem: We are aware of numerous reports of serious errors associated with the misadministration of insulin. These events have involved various types of practitioners, including physician house officers (HO), nurses, and a pharmacist. Human error (e.g., mental slips, lapses, forgetfulness)

 Our institutional guidelines at Memorial Sloan-Kettering Cancer Center have used the same 4 emetic risk categories used by all the major guideline groups: high, moderate, low, and minimal. For the high-emetic-risk chemotherapy programs, including the combination of an anthracycline and cyclophosphamide, we recommend using palonosetron, dexamethasone, and aprepitant. In our practice setting, the tablets of aprepitant are the most effective, and we also use tablets of dexamethasone, but again, that may vary depending on your practice setting. [For moderate emetic risk, the MSKCC guidelines recommend the use of palonosetron and dexamethasone.]

Your first few days of dispensary work will make you very tired – especially your feet! This is why dispensary staff place great importance on tea breaks; if you are working hard in the dispensary, you definitely need to take all your allocated breaks. Be sure to take them on time too, because you may delay other people’s breaks if you are late going on yours – and people do not thank you for this.

Patient services  ‘Patient services’ is a term that is widely used to describe all the pharmacy services that are provided through the dispensary. For argument’s sake, we define patient services as everything that happens in the dispensary, and

The ward environment is a great learning experience, not just from patients’ notes and drug charts that you read. The other health care staff on the ward are a great source of information and learning too.

Ward-based pharmacy   Many people equate ward-based pharmacy with ‘clinical’ pharmacy, but we think that these are two very different things.  we demonstrated our belief that all pharmacists, no matter where they are working, should regard themselves as ‘clinical’ pharmacists. Just because you are on a ward does not necessarily mean that you are thinking ‘clinically’. It depends on your workplace what your ward duties are as a pre-reg, and in reality, when you start your ward based duties, many of these are of a technical rather than a clinical nature.

A guide to rotations First rotation   You will feel a certain amount of trepidation when you start your first rotation, whichever area you may have been allocated to. You have just joined a new organization and are still getting to grips with how things work and who all these people are. You are also unclear about other people’s expectations of you as a pre-reg because you have never been in this position before.

The first few months of the training program can be very intense and it is not unusual to think that you did not learn anything useful at university; this of course is not the case because, otherwise,   how did you get through?

Making the transition from student to professional: how to get through the year When you first arrive in your pre-reg placement, you are very much the student because, although some of you may have experienced pharmacy practice, you will not have done this from the viewpoint of a pharmacist. All that knowledge that you got from your university degree will need to be applied in practice and the pre-reg year is the time to do this. What do we mean by a student?  

WHAT CAN GO WRONG?   There are many things that can go wrong with your tutor; some of them may be of your making and others may be outside your control but frustrating nevertheless.

M A N A G I N G  T H E   B O S S   We would recommend that, in your early meetings with your tutor, you try to find out a bit more about him or her in terms of what he or she does in the department and how his or her diary works. The more senior your tutor, the busier the diary will invariably be. It is important to find out the tutor’s interests, for example