REFINED DISTILLATION
Pharmacy.
Simplifying clinical guidelines, reference textbooks, and academic research papers. A comprehensive, structured study companion for provisional and practicing pharmacists.
Before You Read
Clinical practice has no absolutes, but is constantly evolving and heavily driven by current best evidence.
• Moreoever, conflicting advice on certain issues is common.
The pharmacist notes presented here are based on my personal readings and beliefs.
• They are intended to facilitate your learning process and should not substitute professional clinical judgement.
• I do not assume any responsibility for any potential loss resulting from the use of this information.
Feel free to explore beyond textbooks and journals to deepen your understanding.
💊Front Matter
Overview
The JourneyDream big, start small
PrefaceSomething that I want to tell you first at the beginning
Maximizing the Use of Rx NoteThe missing user manual
Pharmacist as CareerPursuit if that is your passion
Provisional Registered Pharmacist Training: Hospital or Community PharmacyThe decision making
New to PharmacyStudy the essentials first
Navigating the Pharmacist PathAdvice to fresh pharmacy graduates
Experience TalksConfidence in clinical recommendations
From Facts to PracticeThe gap in clinical insight
Mid-Career ReflectionThe job devolves into a dull routine
Passing the TorchBeyond the clinical surface
The EndThe need for a pause
The Invisible WorkForget to compete
💊Tools
Overview
RxMy personal notes on medicines and supplements
Drug AlbumTo quickly identify unknown drugs
Rx CalcTDM calculator via Microsoft Excel and Open as App
RxPedPediatric drug dosing verifier
RxProfileA patient medication profile generator
RxQuoteTo keep you motivated
Learning ModuleQuestions bank for PRP training
PilleyePill counting app
The Pharmacist InsiderA roadmap to be a professional clinical pharmacist
💊Legislation
Poisons Act and Dangerous Drugs Act
Poisons Act 1952 and RegulationsExploring License A, Poison Groups and Prescription Book
Poisons BoardMembers and Roles
Licensing Officer and Drug Enforcement OfficerStating the powers
Poisons (Psychotropic Substances) Regulations 1989Refresh on legislation requirements in dispensing
Poisons (Sodium Hydroxide) Regulations 1962For any substance containing not less than 12% of sodium hydroxide
Dangerous Drugs Act 1952 and RegulationsRefresh on legislation requirements in dispensing
Labelling of Dispensed MedicineTo learn about legislation requirements
Cautionary and Advisory LabelsTo provide supplementary information
Bringing Medication into MalaysiaFor personal use
Other Relevant Acts and Regulations
Sale of Drugs Act 1952 and RegulationsLegislation about power and duties
MAL No.Drug registration number
Medicines (Advertisement & Sale) Act 1956 and RegulationsTo learn prohibitions of medicine advertisement and Medicine Advertisement Board
Registration of Pharmacists Act 1951 and RegulationsPharmacy Board Malaysia and legislation aspects of provisional, full and temporary registration
Code of Ethics for Pharmacists 2018Patient as first priority
Pharmacy Enforcement DivisionDiscussing the subdivision and their roles
💊Essentials
Drug Basics
Drug NomenclatureDiscussing some principles
Drug Discovery and DevelopmentAn expensive and lengthy process with high failure rate
Generic DrugsDiscussing on generics drugs, authorized generics and quality concern
Tablet ExcipientsMany can be multifunctional
BiosimilarsHighly similar but not exactly the same as reference molecule.
Brand Name SearchIntroducing MIMS Malaysia and NPRA Quest 3+ Product Search
Common Generic Name and Brand NameA short list
Drug DosingExplaining dosing differences across references.
Paediatric Drug DosingCan paediatric dosing exceed adult dose?
Off-label UseLearn up some examples of off-label use
Drug-Drug InteractionsTwo or more drugs given at the same time can exert their effects independently or they can interact.
Drug-Food InteractionsPredominantly the effect of food on absorption
Drugs and PregnancyDiscussing FDA Pregnancy and Lactation Final Rule and Australian Categories for Prescribing Medicines in Pregnancy
Drugs and LactationDiscussing key references
Dosing in ObeseOne dose fits all?
G6PD DeficiencyExplaining G6PD Deficiency
RamadanMedications during Ramadan fasting
Adverse Drug Reactions
Adverse Drug ReactionsAll adverse reactions are adverse drug event
PharmacovigilanceTo detect unreported ADRs
Drug AllergyManagement vary based on the signs and symptoms
Medicine-induced DiscolourationRed? Orange? Yellow? Green? Blue?
Drug-Induced PhotosensitivityEither phototoxicity or photoallergic
Medication Induced Ophthalmic IssuesSome common drugs
Pharmacology
Drug PharmacologyRelating it to daily practice
How Drugs Act?Discussing the 4 main drug targets
Functional GroupsQuick refresh on IUPAC nomenclature
pH and pKaDiscussing Henderson-Hasselbalch Equation
Drug PotencyDiscussing Maximal Effective Concentration (EC50)
Drug MetabolismDiscussing Phase I and II reactions, as well as CYP450 system
PharmacogenomicsDiscussing some examples
Miscellaneous
Learn and ApplySome life experience sharing
Pharmaceutical CalculationEssential skills
Continuous Professional DevelopmentNeeded for renewal of annual retention
TeachingA selfless effort driven by passion
Public HealthThe pharmacist's role
ImmunizationThe association of autism with MMR vaccination has not been proven.
Drug AdherenceDiscussing compliance, concordance and adherence
Dealing with Aggressive or Violent PatientsRemember these do's and don'ts
Dealing with MistakesForgive yourself ultimately
The Placebo EffectModulate treatment outcomes
Illness BehaviourIllness is the patient's subjective experience of ill health
ConfidentialityShould be maintained
Deaf AwarenessListing common medication instructions in sign languages
Global Trends in PharmacyThe evolving roles of pharmacists
Drug Pricing and AffordabilityA complex issue
TelehealthGood concept but challenging to implement
Biomedical EthicsRespect for autonomy, non-maleficence, beneficence, justice and veracity
💊Drug Administration
Overview
Oral Route
Oral AdministrationExploring oral formulations and bioavailability
Administration of Medicines to ChildrenSome recommendations and precautions
Measuring Oral LiquidNot to use household teaspoon or tablespoon
Reconstituting Oral SuspensionLearn how to do it right!
Oral Medications with Special Administration MethodDiscussing some examples
Before, With or After Food?Include a short list of medications that should be taken before or with food
Before, With or After Food: Case StudiesDiscussing on gliclazide, rivaroxaban and lenalidomide. Also discuss on co-administration of alendronate and levothyroxine.
Split Medication in HalfIs it safe to split all medication?
DysphagiaPractical considerations
Enteral AdministrationDiscussing administration through feeding tube
Ghost-PillDiscussing tablet-like looking structures in stool
Pulmonary Route
Parenteral Route
Other Routes
Eye PreparationsDiscussing eye drops and eye ointments administration method, 1 ml = 20 eye drops, storage and expiry date.
Nasal PreparationsRisk of rebound congestion with nasal decongestants
Otic Drug DeliveryMore commonly used for outer ear and some middle ear diseases.
Topical PreparationsDiscussing lotion, cream and ointment
Transdermal PatchesDiscussing transdermal patch application
Rectal RouteDrug absorption is often irregular and difficult to predict
Vaginal RouteIs sex-specific in nature
💊Reference
Overview
Selected Reference
UpToDate, DynaMed and BMJ Best Practice
Therapeutic Guidelines, Australian Medicines Handbook and APF
British National Formulary and BNF for Children
Lexicomp Drug Information Handbook
AHFS Drug Information
IBM Micromedex
Medscape
Martindale The Complete Drug Reference
Clinical Pharmacology by ClinicalKey
Epocrates
Frank Shann Drug Doses
Sanford Guide
NCBI Bookshelf
Critical Care Pharmacy Handbook
Calculate by QxMD and MDCalc Medical Calculator
Drug-Induced Diseases
Sarawak Handbook of Medical Emergencies
MIMS Malaysia
Drugs and Drugs
💊Hospital Pharmacy - Government
Overview
Drug Information and Formulary
Drug Information ServicesThe current roles
Ministry of Health Medicines FormularyExplaining MOHMF, Category of Prescribers, KPK application, Dossier
Drug FormularyExploring the concept of drug formulary
Drug Formulary AppListing mobile application options available.
Category of Prescribers in Malaysia MOH SettingEnsures quality of patient care while controlling cost
Inpatient
Outpatient
Logistics
Inventory SystemsAims to maximize inventory turnover while minimise inventory carrying costs (or holding costs)
Inventory ControlExperience Sharing
Stock HandlingDiscussing stock receiving, distribution and disposal
Drug StorageCold chain breach?
Product ComplaintActions to be taken
Drug RecallA brief overview
Sterile and Nonsterile Manufacturing & Prepacking
Extemporaneous CompoundingDiscussing on method of preparation, choice of container and safe handling
Extemporaneous FormulationDiscussing on references, vehicle in extemporaneous formulations and alcohol in compounding
Extemporaneous Preparation with Unknown StabilitySome recommendations
Compounding DocumentationMaster formulas and Compounding Records
Aseptic TechniqueA brief introduction
Syringes and NeedlesDiscussing glass filter needles
CleanroomControlled environment
Medications RepackagingImportant elements in department policy
SurfactantsTheir various names reflect their different functions
Clinical
Clinical PharmacyHistory and clinical pharmacist roles
Patient Care Processendorsed by JCPP in 2014
Medication Counselling"Garis Panduan Kaunseling Ubat-ubatan" and Topical Preparations Counselling Guide for Pharmacist
Motivational InterviewingBehavoiur change cannot occur without the individual themselves recognizing the need to do so
CONNECT-6 FrameworkA structured, evidence-based medication counseling tool that operationalizes Motivational Interviewing into a practical, six-step workflow.
The Teach-Back MethodInvolves asking the patient to repeat back information you have told them in their words.
Medication History Taking and Medication ReconciliationExplaining the purpose of CP1
MyMAATReplacing 8-items Modified Morisky Medication Adherence Scale (MMMAS-8)
STORIMAPA pharmaceutical assessment screening tool
Pharmaceutical Care IssuesCheat sheet for PCIs in CP2 form
Clinical InertiaBarrier to improving patient care and clinical outcomes
Medical Note EntryIn SOAP format
Laboratory DataReminders on few interpretation key points
Medical TermsSome common medical terms
Medical AbbreviationsSome common medical abbreviations
Antimicrobial ChoiceTo use National Antimicrobial Guideline, 2019
Antimicrobial StewardshipTo slow down and prevent antimicrobial resistance
Intravenous Antibiotics-Oral Switch Therapy (IVOST)Common oral antimicrobial options
Acute Kidney InjuryA general management
Chronic Kidney DiseaseDiscussing staging and general management
Renal Replacement TherapyDialysis and renal transplant
Geriatric PatientsIntroducing AGS Beers Criteria for Older Adults 2019
Prescribing in Hepatic ImpairmentDrug prescribing should be kept to a minimum in all patients with severe liver disease
Child-Pugh ScoreClassification of hepatic impairment
Definitions in NICUExplaining some common terminologies
Physical ExaminationInspection, palpation, percussion and auscultation
Vital SignsTemperature, pulse rate, respiratory rate and blood pressure
Glasgow Coma ScaleDetermine impaired consciousness
Bristol Stool Chart7 types of faeces
SepsisLife-threatening organ dysfunction caused by dysregulated host response to infection
Arterial Blood GasesLearn how to interpret
Schwartz FormulaLearning why we do not use Cockcroft-Gault equation for children CrCl
Discharge LetterDiscussing things to write
Drug Overdose and PoisoningDiscussing the general management and antidotes available
Dexamethasone Suppression TestTo rule out Cushing Syndrome
Therapeutic Drug Monitoring
Oncology
ChemotherapyIntroduction to chemotherapy and Carboplatin Calvert formula
Chemotherapy CalculationsDiscussing BSA and Calvert formula
CarcinogenDiscussing reviewing agencies
Safe Handling of Hazardous DrugsOccupational safety hazard
Cytotoxic Spill ManagementLearn the clean-up procedure
Chemotherapy Side EffectsAdvice to patients
Chemotherapy Safety at HomeLearn to protect your family members
Extravasation ManagementStop the infusion at the first suspicion
Tumour Lysis SyndromePrevention with allopurinol
Parenteral Nutrition
Research
ResearchAt a glance at designing
Good Clinical PracticeHighlighting the key points
Sample Size CalculationsCritical in study design
Read a PaperIntroduction to evidence based medicine
Critical Appraisal in Aetiology ResearchExploring the key thereotical considerations
Graphic Appraisal Tool for Epidemiological StudiesTo critically appraise epidemiological studies
Miscellaneous
Medical DocumentationThe legal material used to protect both patient and health care professionals
Medication SafetyThe 5 Rs of medication administration
Medication Error Case ExamplesLearn from others' mistakes
Mercury SpillageLearn how to manage
Back to FundamentalWe are one team!
Healthcare SystemsDiscussing the Bismarck Model, the Beveridge Model and the Out-of-Pocket Model
💊Community Pharmacy
Overview
Community Pharmacy FAQAdvice to first day in community pharmacy
Business Nature of Community PharmacyTo survive in today's market
Community Pharmacy Business ModelDeconstructing the current trend
Community Pharmacy BooksCommunity Pharmacy: Symptoms, Diagnosis and Treatment, 2020 and Symptoms in the Pharmacy, 2018
Analytical Thinking in Community PharmacyA crucial aspect
Responding to SymptomsMnemonics are rigid, inflexible and often inappropriate.
Dermatological ComplaintsVisual examination is important
Specific Product RequestsExploring the situation
The Ever Changing Community PharmacyNumerous supplements have surfaced in the market
Into the Animal WorldSome human OTC products are potentially toxic
Herbs and SupplementsUse with caution
OTC Medication Use in PregnancyCovering few common ailments
OTC Medication Use in BreastfeedingCovering few common ailments
HomeopathyNot better than placebo
Dispensing SeparationComplex and debated issue
Services
Blood Pressure MonitoringDoes body posture affect BP measured?
Blood Glucose MeasurementFasting blood glucose and HbA1c
Blood LancetFor capillary blood sampling
Glycemic Index (GI)A measure of the relative impact of carbohydrate-containing foods on serum glucose
Pulse OximetryUses spectrophotometry to measure peripheral arterial oxygen saturation
Incentive SpirometerLearn how to use
Wound CareLearn about interactive wound dressing
Respiratory
CoughReferral to doctor if duration longer than 3 weeks
Common ColdAntihistamines are not so effective in reducing nasal congestion
SinusitisTypically do not need treatment with antibiotics
Seasonal InfluenzaVaccination is the key to prevention.
Sore ThroatNot to use honey for children <1 year old
Smoking CessationDrug treatment and behavioural support
Gastrointestinal
HeartburnAntacids or H2 antagonists for mild symptoms
ConstipationAvoid drinks with caffeine
DiarrhoeaRehydration as the main treatment
Intestinal Gas and BloatingBelching, flatulence, abdominal bloating and distension
Intestinal Bowel SyndromeIn the absence of abnormality
SteatosisFatty liver
HaemorrhoidsAlso called piles
GallstonesAsymptomatic gallstones can be managed expectantly
Nausea and VomitingThe site of action determines the circumstances in which an antiemetic is effective.
ThreadwormNight-time perianal itching is the classic presentation
Oral ThrushUnusual in healthy adults
HiccupsMost commonly are self-limited (<48 hours)
Faecal IncontinenceUnintentional passage of stool
Pouching SystemsAvailable as one-piece or two-piece systems
Eye
Watery EyeTreatment depends on the underlying cause
Dry EyeEvidence of superior efficacy among any of the ophthalmic lubricants is lacking
Soft Contact LensesA basic overview
Red EyeDiscussion on few possible conditions
StyesWarm compresses are the mainstay of treatment
Eye FloatersIt is not often treated, except in severe cases.
Dermatology
Ingredients in Skin CarePrioritize your skin specific needs
Benign Skin LesionsLearn the ABCDE criteria
Fungal Skin InfectionsAthlete's foot, ringworm, pityriasis versicolor, cutaneous candidiasis
OnychomycosisFungal nail infection
AcneFirst-line treatment should be benzoyl peroxide
Itch Without RashDry skin is the most common cause
DermatitisSore, red itchy skin
UrticariaAvoid identified triggers
DandruffGreyish-white flakes or scales on the scalp
Eczematous CheilitisLip dermatitis
Soap-Free CleanserMilder nature and pH-balanced
SunscreenLearn about sunscreen SPF and 5S to minimize solar damage
SunburnAcute cutaneous inflammatory reaction to UV radiation
BurnsTreated to a full 20 minutes under cool running water
AntisepticsSuitable for cleaning contaminated or traumatic acute wounds and bites
Topical AntibacterialFrequently, their use is not necessary
Subungual HematomaBlood under the nail
Acute ParonychiaInflammation of nail folds
Ridges in FingernailsVertical are fairly common and nothing to worry
AlopeciaHair loss
Cold SoreCaused by herpes simplex virus type 1
BedsoresGenerally affect patients with limited mobility
Corns and CallusesResult from incorrect distribution of pressure
Warts and VerrucaeSpontaneous resolution is seen
VitiligoCan have a marked psychological impact
Hair RemovalPlucking, waxing, shaving and laser
ScabiesIntensely itchy skin especially at night
Head LiceMostly transmitted by head-to-head contact
ChickenpoxSelf-limiting in otherwise healthy children ≤12 years old.
ShinglesReactivation of the varicella zoster virus
Ingrown ToenailsFor surgical correction
Prickly HeatAvoid conditions that may cause sweating
HyperhidrosisExcessive sweating
Acanthosis NigricansDarkening and thickening of skin folds
ScarsNot every scar requires treatment
RhytidesWrinkles
MelasmaPatches of discolouration
Ear, Nose, Throat
Allergic RhinitisIntranasal corticosteroids are most effective medication class for controlling symptoms of allergic rhinitis
Earwax (Cerumen) ImpactionNo apparent difference in cerumenolytic agents
Otitis ExternaGenerally caused by bacterial infection
Acute Otitis MediaSelf-limiting infection that mainly affects children.
VertigoSpinning sensation
TinnitusRinging in the Ears
Motion SicknessOptions include hyoscine hydrobromide and sedating antihistamines
Mal de DebarquementSickness of disembarkation
Hearing LossCan be sensorineural, conductive or mixed
Perforated EardrumMost heal without treatment within a few weeks.
NosebleedNose pinching is likely to resolve bleeding
Women's Health
Primary DysmenorrhoeaPeriod pain
MenorrhagiaHeavy menstrual blood loss
Cystitis in WomenCharacterized by pain when passing urine.
Uncomplicated Vulvovaginal CandidiasisDiscussion on clotrimazole pessary
Urine Pregnancy TestWaiting a week or two after a missed period before performing a urine pregnancy test
ContraceptionA basic overview
Plan B Pills"Morning after pills"
Delaying A PeriodNorethisterone 5 mg TDS, to be started 3 days before expected onset.
Stretch MarksDevelops when our skin stretches or shrinks quickly.
Nutritional Supplementation in PregnancyFolic acid is recommended in all women of childbearing age
Musculoskeletal
Minor Sprains and StrainsUse PRICE therapy for the first 48-72 hours
Muscle CrampGenerally resolves by itself
Low Back PainUsually acute
BunionsValgus malformation of the great toe
Trigger FingerAlso called stenosing flexor tenosynovitis
Plantar FasciitisOne of the most common causes of heel pain in adults
CrepitusJoint noises
Baker's CystMay require needle aspiration or an intraarticular corticosteroid injection
Nutrition
Vitamin SupplementationA healthy and balanced diet remains the best source
Vitamin D DeficiencyOccurs even in developed countries
ProbioticsMost studies have been small and use highly variable probiotic preparations
Organic FoodsConsumer demand has grown steadily
Infant FormulaTo closely mimic human milk
Neurology
Cardiovascular and Hematopoietic
Dental
Mouth UlcersMinor aphthous ulcers are self-limiting
Angina Bullosa HaemorrhagicaOral blood blister
Bad breathTreatment depends on the underlying cause
ToothpasteDental caries vs fluorosis
ToothbrushingToothbrush should be replaced every 3-4 months.
Dental FlossingIs recommended once daily
MouthwashNot a replacement for daily brushing and flossing
Denture CareDentures are custom-made prosthetic devices used to replace missing teeth.
Dry MouthMay consider artificial saliva
GingivitisGood oral hygiene is key
Paediatric
Endocrine
Miscellaneous
Set Up A Retail PharmacyThings to consider
CMEd ProgramComplementary Medicine Education
Self-Test COVID-19 Test KitLearn how to use it
Travel Medical KitsList of items that you could consider
Altitude SicknessTo ascend slowly
Insect Bites and StingsReactions are generally mild
Insect RepellentsDEET is the gold standard
Alcohol IntoleranceMost often found in Asians
Lactose IntoleranceUsually due to lactase deficiency
Varicose VeinsSwollen and enlarged veins
Compression StockingsAnti-embolic stockings (TED) and gradient pressure stockings
Kidney StonesConsider hydration and pain control first
FatigueA common, nonspecific symptom.
💊Clinical Management
Cardiovascular
HypertensionLearn the BP target
Hypertensive Disorders in PregnancyDifferentiating chronic hypertension, gestational hypertension, preeclampsia and eclampsia
Acute Coronary SyndromeDiscussing the initial and chronic management
Stable Ischaemic Heart DiseaseChest pain (angina) from exertion
Atrial FibrillationAnticoagulation, rate +/- rhythm control
Heart FailureTreat all patients with ACE-I, beta blocker, MRA, SGLT2 inhibitor
DyslipidemiaStatins are first-line lipid-modifying therapy for the reduction of CVD risk
Venous ThromboembolismDiscussing DVT and PE
Endocrine
Addison DiseasePrimary adrenal insufficiency
Diabetes MellitusType 1 vs Type 2
Advanced Carbohydrate CountingFor stable Type 1 or Type 2 DM patients
Gestational Diabetes MellitusMetformin and insulin as treatment options
Ramadan and DiabetesDiscussing risk stratification and lifestyle/medication change
OsteoporosisPharmacologic therapy should be considered in people with presence or history of minimal-trauma fracture or when BMD is low
Thyroid DisordersDiscussing hypothyroidism and hyperthyroidism
Cushing SyndromeResults from excess cortisol
Respiratory
Dermatology
Atopic Dermatitis (Eczema)Skin hydration is the key
PsoriasisTopical treatment options include emollients, topical corticosteroids, coal tar preparations, and topical vitamin D or vitamin D analogues.
Ichthyosis VulgarisFish scale disease
Infantile HaemangiomaMost small nonfacial hemangiomas do not need treatment
Infectious Disease
Pain
Paediatric
Neurology
EpilepsyRecurrent seizure
Pregnancy in Patients with EpilepsyLamotrigine and levetiracetam are the safer antiepileptic drugs during pregnancy
Status EpilepticusContinuous seizure activity or repeated seizures without full recovery of consciousness
Dementia50 to 75% of cases is Alzheimer disease
Parkinson DiseaseTreatment is based on symptoms
Myasthenia GravisPyridostigmine for ocular or mild generalized disease
Male & Female Health
Benign Prostatic HyperplasiaAssociated with LUTS
Erectile DysfunctionMay be an indicator for unrecognised disease
Polycystic Ovary SyndromeMost common endocrine disorder in women of reproductive age
Morning SicknessExpected to improve around the end of the first trimester
MenopauseOccurs at median age of 51 years
EndometriosisGrowth of endometrial tissue outside the uterus
Psychiatry
Attention Deficit Hyperactivity Disorder (ADHD)Stimulant medications as first-line
SchizophreniaFirst- and Second-generation antipsychotics
Anxiety Spectrum DisordersBenzodiazepines should be used at the lowest effective dose for the shortest period of time.
DepressionPsychological therapies +/- antidepressants
Bipolar DisorderConsider mood stabilizers, such as lithium or valproate, and second-generation antipsychotics
Eye
Blood Disorders
Nephrology
💊Drugs
Overview
Activated CharcoalAs decontaminant for majority of poisoning.
Alfacalcidol and CalcitriolAre they interchangeable?
Allergy to Contrast MediaDiscussing corticosteroid premedication
AntacidsBest to separate taking antacids and other medications by at least 2 hours.
Antibiotics Cheat SheetSummary for specific pathogens
AntihistaminesSimilar efficacy across first- and second-generation antihistamines
Antihypertensive DrugsDiscussing beta blockers, calcium channel blockers, diuretics and renin-angiotensin system.
AntiplateletsDiscussing aspirin and P2Y12 receptor inhibitor
Antiretroviral TherapyDiscussing NRTI, NNRTI, Integrase Inhibitor and Protease Inhibitor
Augmentin 228/5 ml SyrupLearning the paediatric dosing of Augmentin syrup
Benzyl Benzoate 10-25% LotionEffective yet inexpensive medication in scabies management
BenzodiazepinesStopping these medications is often difficult
Benzoyl Peroxide and Topical TretinoinDiscussing why topical tretinoin and benzoyl peroxide cannot be applied at the same time
Bowel Preparation Before ColonoscopyDiscussing dietary preparation and other key consideration
ChlorhexidineBisbiguanide antiseptic and disinfectant
ClozapineOffered for treatment resistant schizophrenia
Combined Oral Contraceptivescontain an oestrogen and progestogen.
Co-trimoxazole in Pneumocystis Jiroveci PneumoniaUsed for treatment and prevention
Emollients (Moisturizers)Key counselling points
EntrestoNovel therapy for heart failure to reduce morbidity and mortality
Exjade (Deferasirox)From dispersible to film coated tablet
Fibrinolytic TherapyLearn the indications and contraindications
Ferric Ammonium Citrate 400 mg/5 ml Mixture86 mg/5 ml of elemental iron.
FluidsDiscussing crystalloids and colloids
GalactagoguesAttempts nonpharmacologic treatment first
Gamma Benzene Hexachloride 1% lotion (Lindane)Not for children <50 kg.
GLP-1 Receptor AgonistsShould not be combined with DPP-4 inhibitors.
GTN TabletFor acute angina or angina prophylaxis
InsulinsDiscussing insulin initiation and titration
LevothyroxineDosing based on TSH and free T4 concentration
Lipid-Lowering DrugsDiscussing PCSK9 inhibitors, fibrates and inhibitors of cholesterol absorption
Low-dose MethotrexateFolic acid supplementation to reduce gastrointestinal adverse effects
Lugol's SolutionFor thyroid storm
NSAIDsRefresher on NSAIDs
Oral AnticoagulantsDiscussing warfarin and DOACs
Oral BisphosphonatesLearn the correct administration method
Oral Glucose Lowering DrugsDiscussing metformin, sulfonylureas, meglitinides, acarbose, glitazones and DPP-4 inhibitors
ParacetamolAll you should know about paracetamol
Parenteral IronLearn about Ganzoni equation for anaemia
Potassium Permanganate 1:10,000 - soak, bath, wash, dabDiscussing how and when to use this preparation
Proton Pump InhibitorsLearn the stepping down approach.
StatinsNot all statins need to be taken at night.
SGLT-2 InhibitorsPromote the glucose excretion into the urine
Systemic antifungalsA brief discussion on the indications
TerazosinOff-label use in ureteral stone(s) expulsion
Topical CorticosteroidsApply thinly on the skin using fingertip unit.
Tranexamic AcidTo treat or prevent excessive blood loss
💊NPRA Drug Safety Updates
Overview
Metformin: Risk of Vitamin B12 DeficiencySeptember 2022
Domperidone: Not for Under 12 YearsJune 2020
Loperamide: Risk of Acute PancreatitisJune 2022
Pholcodine: Risk of Anaphylaxis to NMBAsMarch 2023
Esmya (Ulipristal Acetate 5 mg): Risk of Serious Liver InjuryDecember 2020
Febuxostat: Increased Risk of MortalityNovember 2019
Ondansetron: Risk of Birth DefectsJan 2021
Smecta: Not for Children Below 2 YearsOctober 2019
Olmesartan: Risk of Autoimmune HepatitisJune 2022
💊Miscellaneous
Overview
The Pharmacy Education ReformTo face the future challenges
Traditional Chinese MedicineSome basic theories
COVID-19Updates on COVID-19
GlovesAn important component of PPE
Face MaskingDiscussing how to wear it correctly
Basic Life SupportTo maximize the chance of survival
BreastfeedingHuman milk is the optimum source of nutrition
Child-Resistant PackagingHow does it work?
Revised Food PyramidLimit ultra-processed food
FiguresElemental iron and calcium content?
TaxonomyClassification system and naming of organisms
National Essential Medicines ListEnsures that essential medicines remain available and affordable for the Malaysian population
Patent Search for MedicinesLearn how to conduct
Global Public Health Days
The Breakfasteur - Playdough SurgeryThis is an interesting yet educating YouTube Channel