Rx Note

#Draft# Introduction Antimicrobials are used to prevent and treat infectious diseases in humans, animals, and plants. These include: Antibiotics Antivirals Antifungals Antiparasitics Over time, coupled with frequent use (due to misuse and overuse of antimicrobials), microbials can evolve and become resistant to existing antimicrobials. As a result, these medications become ineffective, and infections can persist in the body. The 4 Moments of Antibiotic Decision Making Initiation of antibiotic therapy Does my patient have an infection that requires antibiotics? Decision to start antibiotics Have I ordered appropriate cultures before starting antibiotics? What empiric therapy should I intiate? Every day of antibiotic therapy Can I stop antibiotics? Can I narrow therapy? Can I change from IV to oral therapy? When infectious process is clear and patient responds to therapy What duration of antibiotic therapy is needed for my patient's diagnosis? AWaRe Classification The AWaRe classific

Introduction Many healthcare professionals find it challenging to change people's long-standing behaviours that pose significant health risks. Even when presented with facts and figures, individuals often persist in harmful behaviours (e.g. smoking, heavy drinking) or fail to adopt healthy lifestyle (e.g. taking medications as prescribed or exercising regularly). This can lead to frustration when advice is ignored or contested. However, in reality, behaviour change cannot occur without the individual themselves recognizing the need to do so. Motivational interviewing is a technique that aims to motivate people to change by balancing following (good listening) and directing (giving information and advice). Instead of acting authoritatively, motivational interviewing techniques involve a respectful and curious approach to empower individuals to change by drawing out their own meaning, importance and capacity for change. Through this collaborative process, we help patients identify th

Introduction Much of the public's perception of a pharmacist's role is shaped by their interactions in the ward and at outpatient or community pharmacies. However, a significant number of dedicated pharmacists work diligently in inpatient settings, ensuring accurate medication dispensing to hospitalized patients. Daily tasks often involve managing medication stock (through floor stock supply and filling medication trolleys ) and providing patient counselling, especially in wards without dedicated clinical pharmacists. Transition From Outpatient Pharmacy Having transitioned from outpatient to inpatient pharmacy, I personally prefer the latter due to reduced patient-related stress, such as dealing with aggressive patients and dispensing at crowded, noisy counters. Unlike outpatient settings with strict waiting time policies and crowded waiting areas, inpatient pharmacy work seems more flexible, but remains demanding. When staff are absent or in meetings, we still need to comple

Introduction Humans are living in a society where each of us is servicing the others, depending on the circumstances. Sadly, there are times or people who forgot to respect the others . As a practicing outpatient pharmacist, the majority of patients that I have met are friendly and nice. However, a few patients are demanding and unreasonable, refusing to listen to our explanations and turning us into heartless individuals . Some Common Complaints Often, pharmacy is the last station that a patient would end their hospital visit with. Undeniably, due to patient crowd and limited specialists available at outpatient clinics, they may have waited from the morning till afternoon (almost half a day). Hence, another waiting of 30-45 minutes at outpatient pharmacy frustrated some of them. However, please bear with us, because we have also been busy with the never-ending crowds since the morning. At government facilities, there exists a policy to supply one month medication at each visit . This

Introduction When I first entered the pharmacy profession, I was filled with excitement and a genuine desire to assist patients to the best of my ability. I was eager to make a difference in their lives. In fact, I was willing to stay late at work without extra pay and spend my weekends brushing up my clinical knowledge. However, as I encountered more patients and faced various situation at outpatient pharmacy, I found myself slowly losing my initial passion. After a long half-day of work, many of us are too tired to move at full speed, sorting things out for patients. We maintain effective stamina and speed until the end of the day, but then, the days repeat again tomorrow, and it numbs us out. While we understand that we cannot keep doing the same thing every day and expect different results , juniority cages our ability to enact pragmatic changes and leadership remains elusive. This gnawing powerlessness hollowed us out further. NOTE: Every job on this earth has its own difficulti

Introduction Giving medicines to infants and children can be challenging because they may refuse to take medications for many reasons, such as fear, taste, embarrassment or inconvenience. Choosing the Right Formulation When selecting medicines for children, it is important to consider factors such as Child's age Swallowing ability Ease of administration Accessibility of suitable formulations of the product Often, oral liquids are the preferred formulation for younger children as they are easier to swallow and allow for flexible dosing based on the child's age and weight. Multiple formulations of the same active ingredient are available and may contribute to dosing errors, such as paracetamol 120 mg/ml and 250 mg/ml suspension. Also, when choosing an oral liquid medicine, the following must be considered: Excipient content, including quantity and suitability Cumulative daily excipient intake from all products being taken Potential adverse effects due to excipients The risk-b

Introduction Atrial fibrillation is a common supraventricular tachyarrhythmia caused by uncoordinated atrial activation and associated with an irregular ventricular response. Atrial fibrillation is classified according to clinical pattern , with patients sometimes progressing from one pattern to another. These categories reflect observed episodes of AF and do not suggest the underlying pathophysiological process. Symptoms Patients with AF may have various symptoms but 50-87% are initially asymptomatic , with possibly a less favourable prognosis. Risk Factors The AF-CARE Approach The AF-CARE approach builds upon the AF Better Care pathway in 2020 and notably, takes account of the growing evidence base that therapies for AF are most effective when associated health conditions are addressed. C - Comorbidity and risk factor management A - Avoidance of stroke and thromboembolism in patients with risk factors, focused on appropriate use of anticoagulant R - Reduce symptoms by rate and rhyt