Rx Note

Introduction Drug expiration dates reflect the time period during which the product is known to remain stable when it is stored according to its labelled storage conditions. Nonetheless, at work, many patients may ask you, how long more you can keep using a solution or cream once opened. Or sometimes, is it still fine to keep using an expired medication? The old adage that "all good things come to an end" applies this situation very well. Medications last longer (up to expiry date) when they are stored unopened. Using expired medications may cause harm or it has lost its effectiveness over time. Antibiotic Suspension Please refer to products leaflet since the recommendation is brand specific. Amoxicillin 200 mg and Clavulanate 28 mg per 5 ml Syrup Augmentin - The dry powder should be stored in unopened containers in a dry place at below 25°C. Reconstituted suspension should be stored in a refrigerator (2-8°C) and used within 7 days. Clamovid BID - Refrigerate and use withi...

Introduction Pharmacist was not my lifelong dream, but it has been my career for the past decade. Initially, it was an exciting adventure filled with new learning experiences and professional growth. I believe I could excel in this field. Over the years, I have worked hard to keep up with the ever-changing medical field. However, reflecting on my journey, I realise that enjoying life and nurturing relationships are far more precious than achieving great career heights. Moreover, knowledge can be likened to a vast ocean, endlessly swept by waves of new information. There are not that many people whose names will be remembered by future generations. However, the crucial questions we must answer in life is: Upon leaving this world, will we be missed? Are there any regrets about things we wish we had done differently? NOTE:  Importantly, different stages of life and individuals may have distinct priorities that bring them joy and fulfillment. During their teenage years, young peo...

Introduction Nappy rash (also known as nappy dermatitis or diaper rash) is a nonspecific term used to describe inflammatory eruptions in the nappy. Nappy rash can range from mild erythema in the perianal region, to severe widespread erythema and ulceration. Causes Nappy rash can have many causes. Irritant nappy rash is the most common cause of nappy rash. It is due to loss of the skin barrier function, from overdehydration, friction and exposure to faecal enzymes. Persistent cases often become colonised with Candida albicans. NOTE: Infants usually develop psoriasiform nappy eruptions within the first 4 months of life. It presents as well-demarcated erythematous plaques. It can show scaling that resembles psoriasis, although this is uncommon. Involvement away from the nappy area is common and affects the limbs, face and scalp. Indicative of Referral Involvement of rash away from nappy area Suggests other causes such as psoriasis. OTC treatment failure and severe rash Requires prescripti...

Introduction Teething is the process in which the deciduous teeth (sometimes known as milk teeth or baby teeth) emerge through the gum. Most infants start teething around 6 months of age, but some can start as early as 3 months. Teething continues until the age of 2-3 years. NOTE: Primary tooth exfoliation occur as part of the process of permanent tooth eruption , which usually begins at approximately 6 years of age . Symptoms It is normal for infants whose primary teeth are erupting to be cranky, chew on objects, and have excessive drooling . Parents frequently report that their infants who are teething have fever, diarrhoea, or other systemic symptoms. Management The appropriate management of teething is to relieve local discomfort. Chewing on a chilled [not frozen] teething ring. For children who have been weaned, the supervise use of chilled fruit or vegetables (such as banana or cucumber) can be considered. The use of analgesics ( paracetamol suspension) for pain. Topical teethin...

Introduction Chickenpox is a highly contagious illness caused by primary infection with the varicella zoster virus, characterized by vesicular rash and fever. It is contagious from a few days before the onset of rash until all lesions have crusted over. Main route of transmission is through contact with infected persons via Inhalation of respiratory droplets and aerosols generated by skin lesions. Direct contact with droplets of vesicular fluid from skin lesions. Reinfection results in people suffering from shingles . Symptoms The incubation period is typically 2-3 weeks. Before the rash develops, the patient might experience up to 3 days of prodromal symptoms that could include fever, headache and sore throat. The rash typically begins on the face, stomach, and back before spreading to other parts of the body. Initially, lesions appear as small red lumps that rapidly develop into vesicles, which curst over after 3-5 days. New lesions form for up to 1 week with the total number of v...

Introduction Earwax (Cerumen) is a naturally occurring substance that cleans, protects and lubricates the auditory canal. A cerumen impaction is an accumulation of cerumen that causes symptoms such as hearing loss, ear discomfort (to variable degrees) and a sensation that the ear is blocked. Rarely, it can cause dizziness and nausea. NOTE: Young children, elderly , individuals with a cognitive impairment and hearing-aid users are at increased risk of cerumen impactions. Questions to Ask Management Cerumenolytics have been used for many years to help soften, dislodge and remove impacted earwax. Ideally, the ear should be examined prior to treatment. A Cochrane Review identified 10 studies with a total of 623 participants (900 ears) that examined oil-based treatments (e.g. triethanolamine polypeptide, almond oil, benzocaine, chlorobutanol) and water-based treatments (e.g. docusate sodium, carbamide peroxide, phenazone, choline salicylate, urea peroxide, potassium carbonate) and other...

Introduction Dandruff (pityriasis capitis) is a chronic, relapsing, noninflammatory hyperproliferative skin condition, which is often seen as socially unsightly and a source of embarrassment . The condition usually appear during puberty and reaches a peak in early adulthood. It is considered to be a mild form of seborrheic dermatitis, associated with an overgrowth of the yeast Malassezia furfur . Symptoms Dandruff is characterized by greyish-white flakes or scales on the scalp and an itchy scalp as a result of excessive scaling. It may also affect beards. Flakes of dead skin are usually visible in the hair close to the scalp and are visible on the shoulders and collars of clothing. Management The use of a hypoallergenic shampoo on a daily basis will usually control mild symptoms. In more persistent and severe cases, a medicated shampoo can be used to control the symptoms. Treatment options include Coal tar Unknown mechanism of action. Can cause skin sensitisation and is a photosensi...