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How to do a medication history?

4/18/2013

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1. Review the patient’s chart or profile (if available ) before interviewing patient and make a list of current conditions.
2. Introduce yourself and tell them why you’re there and verify the identity of the patient.
3. Build rapport (Smile, make eye contact, find something in common to break the ice, active listening, touch when appropriate (shake hands).
4. Look at source of information (ie patient, spouse, translator – preferably NOT family member).
5. Ask patient if they brought their in their medications from home.
6. What to ask about prescription medications/supplements/OTCs? Name, strength, route directions, duration, compliance, efficacy “is it working for you?” and adverse effects.
7.  Vaccine history (influenza, pneumoccoccal, shingles, DT, hepatitis B etc)?
8.  Habits? (ie alcohol, tobacco, caffeine, recreational drugs etc) You have to worry about withdrawal in hospital! How to manage? (ie give patient nicotine patch, monitor for s/sxs of DTs etc).
9. Allergies to medications, food, preservatives, latex, pollens etc.?
10. Past medications? (inquire about any medication changes (ie Why was the strength increased? Was it too expensive?)
11. Look at patient's compliance/adherence (ie via blood levels, surrogate markers, etc).
12.  Develop a plan based on medication history such as discontinuing a drug, reducing or increasing a dose, adding another drug, recommending monitoring paramenters etc.

Posted by: Stephanie Shieh

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9 Steps to calling a drug company?

4/16/2013

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  1. Look up phone number (ie via online, reference book, directory)
  2. Ask for who you need to speak with
  3. Consider time, location of where you are calling (ie EST)
  4. Have questions ready
  5. Know relevant background information
  6. Introduce yourself, name, and affiliation
  7. Get name and title of everyone you talk to
  8. Get info sent to you in writing (email or snail mail) à evidence for future reference
  9. How to reference a phone call? Name of source: company, date, time, phone # you called
Posted by: Sam Shimomura, PharmD
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Athlete's Foot and other fungal infections: A self treatable condition

4/3/2013

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Athlete's foot (Tinea Pedis) is a skin infection of the feet. In other areas of the body fungal infection of the skin are called Tinea Capitis (scalp area), groin area (Tinea Cruris or jock itch)  superficial body skin area (Tinea Corporis or ringworm).  Dandruff is also caused by a fungus.

Athlete's foot is a very common infection. The fungus grows best in a warm, moist environment. It is commonly found in shoes, socks, swimming pools, locker rooms, and the floors of public showers. It is most frequent in the summer and in warm, humid climates. It occurs more often in people who wear tight shoes and who use community baths and pools.

However, one can diagnose such fungal infection very easily by visually looking at signs and symptoms such as itching, burning or redness, cracking, blisters on skin between toes and figures areas of feet. For a definitive diagnosis, a skin scraping can be examined under a microscope after dissolving the skin tissue with potassium hydroxide (KOH).

Available OTC treatment options for athlete foot are topical antifungal agents such as  tolfnaftate (Desenex), miconazole (Micatin), clotrimazole, (Lotrimin AF), butenafine (Lotrimin Ultra), Terbinafine (Lamisil AT) etc.

While most topical antifungals take a month or more to be effective,  Lotrimin Ultra (butenafine) or  Lamisil AT cream between the toes or bottom and sides of feet for 2 times day can be effective in as little a week.   Read the instruction on each product carefully for frequency and duration of therapy.  Also be aware that different dosage forms of a product may have different active ingredients e.g. Lotrimin AF (clotrimazole), Lotrimin Ultra (butinafine), Lotrimin AF Antifungal Deodorant Powder Aerosol Spray (miconazole).  This is important when taking a drug history to know when drug the patient is taking in case they become allergic or have an adverse effect.

Also you can prevent fungus infections by doing following simple steps:                              

 - Keep your feet dry, especially between your toes.
 - Change socks and stockings regularly.
 - Alternate pairs of shoes and don't share shoes

-Use antifungal powder in the shoes after wearing to prevent reinfection
 - Protect your feet in public places.

Note:
  • For finger nail treatment there is no effective OTC medication available. Best treatment is Rx Lamisil (terbinafine) 250mg a day for 6 weeks.
  • For toe nail treatment there is also no effective OTC medication available. Best treatmentt is Rx Lamisil (terbinafine) 250mg a day for 12 weeks.  At the end of the 12 week treatment, the nail may still look infected but do not continue therapy.  It takes time for the infected nail to grow out.
Posted by: Ankit Bhalodia, PharmD Candidate 2014 



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Relief Now, Relief Later: Pepcid Complete

4/3/2013

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Dual action Pepcid Complete is an over-the-counter product that will relieve acid caused by indigestion, heartburn, or upset stomach. What sets it apart from other products is that it starts neutralizing acid within seconds and will continue to control acid all day or night. How this works is by its three active ingredients: calcium carbonate 800mg, magnesium hydroxide 165mg, and famotidine 10mg. Calcium carbonate and magnesium hydroxide works as an antacid to provide immediate relief while famotidine is an acid reducer to provide all day relief.
One thing to keep in mind is to pay attention to the active ingredients - these are the same found in Tums (calcium carbonate) and Pepcid (famotidine). So essentially, if you have both these products available at home, you can take them and they will provide the same relief as Pepcid Complete. Like many other over-the-counter products, Pepcid Complete is a combination product that is available for convenience and optimal relief.


Pepcid Complete comes in 3 flavors: tropical fruit, berry, or cool mint. Adults 12 years old and older, chew 1 tablet completely and then swallow. Do not take more than 2 tablets in 24 hours.

Do not use: if you have pain swallowing, vomiting with blood, or blood in stool. These may be signs of a serious condition and you should see your physician.

Ask your doctor before use: if you have had heartburn > 3 months, frequent chest pain, or chest pain spreading to left arm, neck or shoulders. As prescriptions may interact with antacids, consult your doctor or pharmacist before using Pepcid Complete. 

For more information, visit http://www.pepcid.com/pepcid-complete

Posted by: Stephanie Shieh, PharmD Candidate 2014

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