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Monday, June 22, 2015

Pharmacy Community Posting (4/6)

Here is for Week 4 Community Posting in Pharmacy Shop

        Activities for this week are observing blood test done by the B***** Laboratories people and auditor’s work, continuing the usual activities such as helping and observing the activities done by pharmacists and sales assistant, and entertain/attend the customers. I also learn how to key-in stock in the computer system by key-in the information regarding supplier name with ID, invoice number, quantity, and unit price (RM).

        The blood test was done XX Month 2014. In the early morning, the customers are seen to come early even before the pharmacy open. Two person from the Laboratories in-charge for the test whereby one for registration and another for withdrawing blood. After around 6 people, they change place/task that they currently doing. Needle 21G size is used and I can see that they can withdraw blood easily by just only one try. After blood withdrawal, the blood is divided into three test tubes containing solution which I think the function of solution is to prevent blood clotting. The biggest needle available is 18G and when the size decreased to 21G, it means decreasing the intensity of pain. From my reading, the main reason of using that needle size is because the RBC will lyse/rupture if the needle is too small. The price of blood test is offered at a half-rate than normal price. There are also free hormone test offer available for 20 early customers which the normal price usually would be RM50. When I ask about why we need to do the hormone test, the person from the laboratory explained that the test will check the oestrogen level in women whether balance or not and therefore intervention can be done early if any problem arise.

   At first I wonder why the lab assistant can withdraw blood since from my memory, I only remember that only the nurse and the medical doctor that can withdraw blood. However, according to the locum pharmacist that present during that day, he told that anybody can withdraw blood or even do operation as long as the person is competent/able to do the tasks. When I ask the pharmacist on the other day, she told they require special certificate for doing blood withdrawal.

        Auditor also come this week and therefore I’m able to observe the actual process of auditing happen. Two people come and they already informed the pharmacist earlier. A printed document of stock containing the prices and balances of each item is already prepared by the pharmacist. Then, the auditor checked and ticked certain item on which they will do the actual/physical stock check. Around 10 types of items have been checked which involve the expensive and high quantity product. It takes around one to two hours of checking. According to the pharmacist, during the last year, the auditor inquire if the balance stock shows negative value. However, this year has no negative value because of some adjustment of stock has been done. Negative value may happen sometimes as human mistakes can occur at any time such as entering/scanning the product more than one times which then cause the value to become negative and even the cases where the customer return/exchange the product.

        There are many things that have been discussed with the pharmacist. First, the pharmacist corrected the wrong use word of ‘shingles’ in the last week diary. Actually, shingles is caused by viruses. Steroid should not be used since it will worsen the disease condition. Next thing is about Isotretinoid which can be prescribed and dispensed only by dermatology/skin specialist. Isotretinoid is categorized in pregnancy class X which mean teratogenic. Therefore, the consumer should not get pregnant with 6 month before and after use of the drug.

        Next information is about inhaler. Asthalin (Cipla) and Ventolin (GSK) has the same active ingredient which is Salbutamol. However, Asthalin is more fast-moving item compared to Ventolin which can be because of Asthalin is much cheaper (imported from India) while Ventolin is around three time expensive (imported from Spain). There are many types of medication available for nausea and vomiting which are Celendid (cinnarizine) tab, Primetil, Mexomide, Properazine, Novomin, Stugeron, Veloxin (Mecloxine, Pyridoxine), Ganaton (Itopride), and Dymenate syrup. The most common drug given for pregnant women is Veloxin. However, most of the nausea and vomiting medication are having Pregnancy category B and C only.

        Additional information is about KKM MAL number, KKM reference number, and hologram sticker. Herbal preparation in liquid & powder form do not require to be registered. Only tablet or capsule product require both KKM number and hologram. But there are some herbal product do have reference number, MAL number, and hologram sticker. Ecolite Pu Yao Jing is the herbal product that have both hologram & MAL number while Tonik Tuan Haji is an example of product having KKM reference number only. Reference number is obtained when they submited the registration form and receive a reply form. The product is now being approved to be sold legally at the pharmacy.

        Another thing is about the oral contraceptive pills (OCP) use. Mercilon, Yasmin, Liza which has low dose of estrogen are the choices that can be recommended if the customer concern with weight gain problem. While OCP with high dose of estrogen can be recommended if the customers do not concern with weight gain.

        Various style of customers can be observe throughout the week. There are one customer show a blister strip having ingredients indicated for schizophrenia and he asked for the indication. However, it is bit hard to say that the drug is for mental problem. So the pharmacist ask about the symptoms such as “who take the medication?”, “does she get angry to you suddenly?”, and “does she ‘talkative’ to you?”. Another customer told that she will check blood cholesterol level weekly and an uncle who feels dizzy but still ride motorcycle.

        Another customer requested medication for pain-reliever for a ‘disease’ because Celebrex use still cannot relief the pain. Therefore, the pharmacist has recommended Ponstan. Observation of dispensing process for this week are Ketozol cream is given for ‘Panau’, Melaqun cream for skin pigmentation at face, Orapaste is given for kid having mouth ulcer, Diosmin (Daflon 500mg) given for haemorrhoid, Hurix’s Ginseng to increase body heat/temperature, Cerumol ear drop to soften and wet the earwax, Mecomin for neuron, Carinox for running nose, Rigevidon + Sunolut for period problem (to have menses), Antasone cream for itchiness without ‘biji-biji’, Zepid (Hyosine)/ Drotaverene for abdominal pain (perut memulas).


Qatruuun said...

Muaha. Km baca yg ventolin tu ja.and mmg pun, selalu beli Asthalin sbb murah

Shizune Otani said...

hohoho.. qatrun bc. yeay~ haha kami tak tau sebelum ni. lepas kerja situ baru la tahu. pakai ka lg skg?

Qatrun said...

jarang sangat dah. alhamdulillah