PRP Week 26 to 29 - Drug Info Service (DIS)

Alhamdulillah, I just finished another station which was Drug Information Service (DIS) which took a month there.  There workload was of course not very distressing like clinical department. I quite enjoyed my stay in DIS.

So what are the tasks and job scope?

1. Check JKNJ email from Mohcube website everyday. Any email came from Bahagian Farmasi are sent to this email. The email will be screened, saved and also forwarded to the respective staffs.

2. Register adverse drug reaction (ADR). Doctors and pharmacists who encounter any ADR will send their forms to DIS to be processed and recorded. Then we will mail the form to KKM.

3. Kad Alahan Ubat. We also responsible to produce allergic card to patients who develop anaphylactic reaction to certain drugs. Some common drugs which caused allergic reaction are ceftiaxone, ciprofloxacin and tramadol.

4. Application for KPK and non-standard drugs. These are for doctors who want to start patient with drugs which are not available in hospital formularies and KKM formularies. It means that the drugs must be purchased overseas. Their prices can reach thousands of ringgit. That's why it's non-standard.

5. Arrangement for CME sessions. Every month, we will conduct CME sessions to give chances to the staffs to collect CPD points by listening to talks. There will be sales rep who will come and promote their stuffs. There's one slot for PRP to present as well. I already presented my turn which was about Child Psychiatry. We also order food for the CME and book for the place. Usually we book the seminar room if available. 

6. Setting up laptop and projector. If there's a meeting, we are the one who responsible to set up the laptop and projector in the meeting room. However,  this service excludes PRP presentation. They have to set up by themselves.

7. Answer calls and inquiries. Everyday there will be phone calls from doctor asking for weird weird questions. So we need to find the answers by referring to books, internet or experienced staffs. Sometimes the answers are not in the book thus we need to ask around from others. There's one day I called Pusat Racun Negara because a doctor wanted to find how to manage Ethylene Glycol Poisoning. Alhamdulillah we found the answer. :)

DIS office

HSI after subuh

setting up laptop and projector

updating Drug Chart as requested by doctor

A visit by Pengarah Hospital and pihak pengurusan for 5S

Files and folders

Photobook #5 - Berlin | Germany

I still remember, Berlin was my first trip outside UK when I studied there in 2011. In fact, this trip happened during our first summer break after we finished our summer semester. We simply planned it, only went to Berlin for 3 days but I think it's just enough to cover the important places. Plus, our whole summer trip not only covers Berlin, we also spent 3 days in London, and the remainders in Bath, Bristol and Manchester.

For me, Berlin is a very interesting place to visit, there's a lot of history to learn and many great photos could be captured. The weather was quite nice. Although it was summer, but it's still cold and windy.

I chose Museum Island for the cover page

Hard Rock Cafe, a must visit attraction for us.. :)

Postcards

Gendarmenmarkt

View from above the tower

World time clock, it displays time for the whole world

One of the significant landmarks in Berlin, Brandenburg Gate.

Berlin Wall used to separate Berlin into two parts

Sehitlik Mosque

PRP Week 24 & 25 - Clinical (ICU)

ICU a.k.a Intensive Care Unit is where the most critically ill patients are admitted. Some conditions are life-threatening which requires them to be closely monitored. So, for the final two weeks in clinical department, I was attach in ICU. Although there are only 12 or less patients in ICU, however the treatment is far more complex than any other wards. The medications are usually given in high dose and some patients were on expensive antibiotics because apparently they are many microorganisms had become resistant to the common antibiotics. The emergence of MRO (multiple-drug resistant organisms) is very worrying in hospital setting.

Like usual, in the morning I will clerk case in ICU, updating the CP2 and then follow specialist round. I'm not sure why, but the specialist kept on changing day by day. It's confusing some time. Here, specialists from other teams such as medical, surgical, or ortho will also do their rounds around the same time. So which one to follow? Follow the anaes team. Usually there are around 3 HO, 1 MO and 1 specialist. Some staff nurse will follow the round as well.

Common cases in ICU include MVA, severe sepsis, acidosis, hypertensive emergency and many patients were transferred in from another ward because the need of ventilation and support. Post-operative patients who are in critical conditions are placed here too.

During my attachments here, there were paediatric patients as well. One with nosocomial pneumonia, one with dengue fever and another one I forgot already. 

Some patients were admitted for one or two days only in ICU, which they will be transferred out when their conditions improved.

Important point in becoming ICU pharmacist:

1. check the renal adjustment dose, because many ICU patients has deteriorating renal function

2. remind the doctor about the antibiotic frequency and the proper day to off it

3. suggest dose adjustment if required

4. answer inquiries especially which drugs are available in the hospital and the dosage form

5. drug interactions, whether any drugs should be stopped and removed from the treatment

6. some doctors will even ask about drug price

I already presented the ICU case this week, the case is about necrotising fasciitis or also known as flesh eating infection. The bacteria involved are sure very nasty one.

Me in ICU.. untuk kegunaan hospital sahaja.. lol

A very useful reference.. can download online too.. 

Sanford Guide

Were bored listening to talk

It was raining one day and the hospital form a swimming pool on the roof top.. :D

Everolimus, a drug used in cancer patient..

Alhamdulillah, out first Oovoo video conference since came back to Malaysia..

Kedai Kopi Hai Peng | Kemaman

Assalamualaikum and salam ceria everybody!

Finally, I got the chance to go for a trip with my family member. Alhamdulillah. This time we chose Kuala Terengganu and Cherating as our destination.

During our journey to Terengganu, we dropped by a coffee shop namely Kedai Kopi Hai Peng. It was featured in Jalan-jalan Cari Makan too. So why not we try it?

It's located in Chukai, Kemaman. I'll put up the address later ok.

So we tried the famous toasted bun/bread with butter and kaya *roti bakar la senang cerita*. One set consisted of either 2 buns or 2 breads cost only RM1. Since we're here just for a quick bite, we're opt not to try other heavy dishes. So we ordered two sets of the breads.

For drinks, my dad tried the hot latte. It's a coffee with a sprinkle of cinnamon powder while my mom tried the classic coffee. Each cup cost around RM4 plus. For me, I had this fantastic cold ice blended Coco-Lava. It's an ice blended coffee with chocolate ice cream and whipped cream. It's definitely yummy! :) This drink cost RM7.30.

So that's all for now. Our JJCM journey will continue later of the day. Cheers!

Photobook #4 - Andalusia | Spain

This time, it's about my trip to Andalusia, Spain. We covered 3 cities in Spain which were Seville, Cordoba and Granada. Plus one more place, Gibraltar. Gibraltar is another country under British Territory but it's located just beside Spain. 

Front cover - Spain

Back cover - Gibraltar

A very nice view from the peak.

Enjoying the chill weather above.

Souvenirs. Since Andalusia was previously ruled by Islam therefore some Islamic souvenirs are still made.

Madinat al-Zahrah, Cordoba

Plaza Espana, Seville. Where this place was used as a filming location in Star Ward Episode 2.

The very famous Cordoba Mezquita.

The magical Alhambra, Granada.

It was very memorable since 9 of us joined the trip. I remember the chill weather here, it was veryyyy windy and cold! =)

I should explore more of Spain, to Barcelona, Madrid whatnot.