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Thursday, April 24, 2014

Clerk Case - Pharmacist Concern

Below is the list of information i get today during discussion with the pharmacist.
Thiazide is more potent than other types of diuretics.
Spironolactone is more preferable than other diuretic in chronic liver disease patient because spironolactone also exhibit aldosterone antagonist.
Decrease aldosterone with decrease water retention and thus decrease ascites volume.
If heart rate < 50, beta blocker should be withold.
For hypoalbuminemia, salt intake will increase dehydration state. Therefore this patient should take high protein  diet.

Hypoalbuminemia will cause hypotension and dehydration because of water moving out into peritoneal cavity.
AST level usually 2x ALT level
Acute liver disease has albumin level >30 (normal albumin)
Chronic liver disease has albumin level <30 (abnormal)
Alcohol consumption will cause hypoglycemia and vitamin B1 deficiency in brain. This vitamin B1 deficiency will lead to wernicke encephalopathy.

Treatment: Give vitamin B1 first followed by glucose. If give vice versa order, this will cause depletion of B1.
CaCo3 is a phosphate binder.
CaCO3 has 40% calcium but Ca lactate has 30% calcium
Insulin may cause hypokalemia because glucose movement into the cell couple with potassium.
Oral hypoglycemic agent should be off when the patient is in stress condition.
Lactulose can be used as ammonia detoxicant beside treating constipation.

Friday, April 18, 2014

Visit CCRC (PUSPEN) Gambang

Assalamualaikum,
My post today is somewhat like diary telling my experience visiting CCRC. It is one of the requirement for my subject to go visit and interview with the person there.
In a small group, we interviewed a ganja user who is also from Felda. He has been in and out for many times because of the drug issue. For him, it is easy to get the supply and easy to use since he has no money problem.
The most important issue that I really want to highlight here is :
PLEASE SUPPORT THEM MENTALLY & EMOTIONALLY.
(if the person really want to quit. if they don't, it is not easy to persuade them since they themselves need to have desire to stop first & then people surrounding can help)
They feel embarrased and shy to meet people outhere. They have inferiority complex. His family do not even know what happen to him. From his story, he has not very good relationship with family members and he thinks that it is better to be on his own. He did not even meet his family for almost 7 years.

Tuesday, April 01, 2014

Self-Reload Machine

Assalamualaikum, konnichiwa, 

I just try this machine. It charges RM0.30 for the transaction. Expensive lorrrr.. dont want to use this after this except in emergency.

This week going to Tasik Kenyir.. okaasaaaannnnn... i wish i am not able to go. But what to do. I decide something that maybe important to me. •.• Teguhkan niat. 

Only about less than 1 year left to grad. Aiyooo cannot imagine how am I working a *****ist.
Need to improve my nihon & my mandarin. Almost forget everything.. @.@