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Friday 24 July 2015

Treatment for myocardial infarction



1. Oxygen — Used to maintain blood oxygenation as well as tissue and
cardiac O2 levels.

2. Aspirin — If administered when myocardial infarction is detected,
the antiplatelet properties of aspirin may reduce the overall size of
the infarction.

3. Thrombolytic therapy — If employed in the first 1 to 4 hours following
the onset of a myocardial infarction, these drugs may dissolve
clots in coronary blood vessels and re-establish blood flow.

4. Vasodilator drugs — Intravenous nitroglycerin can increase blood
flow to the myocardium and reduce myocardial work.

5.β-Blockers — Blunt the effect of catecholamine release on the myocardium,
reduce heart rate and myocardial work.

6. Pain management — Sublingual nitroglycerin, morphine if necessary

7. Antiarrhythmia drugs — To treat and prevent a number of potentially
life-threatening arrhythmias that might arise following a myocardialinfarction.

8. ACE inhibitors — Drugs that block activation of the renin–angiotensin
system and thus reduce the negative effects of vasoconstriction
and salt and water retention on the myocardium.


Types of Drug Information Questions






ADVERSE DRUG REACTIONS
Adverse reactions
Allergies
Teratogenicity
Toxicology

DOSING
Age-specific dosing
Dosing in patients with altered organ function (liver,
kidneys)
Indication-specific dosing

DRUG ADMINISTRATION
Commercial dosage form alterations (crushing, dissolving)
Drug administration methods
Product preparation (reconstitution, admixing,
compounding)
Compatibility, stability, and storage
Timing (with or without food or enteral products)

DRUG INTERACTIONS
Drug-disease interactions
Drug-drug interactions
Drug-food interactions
Drug–laboratory test interactions
Drug-nutrient interactions

INDICATIONS AND THERAPEUTIC USE
Approved drugs
Investigational drugs
Unapproved drugs

POISONINGS
Signs and symptoms
Treatment

PRODUCT-SPECIFIC CONCERNS
Constituents (sugars, dyes, adjuvants, alcohol)
Formulations
Identification
Storage

MISCELLANEOUS
Drug use during pregnancy and lactation
Pharmacoeconomics
Product-specific assays
Veterinary drug information

Drug Administration - Formulation


Formulation


Clinically useful drugs are formulated by drug
companies into preparations that can be administered
orally. intra\"enously. or by another route. The fonnu·
lation of a drug depends on the following factors:

-The barriers that the drug is capable of passing.
Intravenous drugs are injected directly into the blood
stream. In contrast, oTal preparations must pass
through the wall of the gastrointestinal tract and
blood vessel walls before entering the bloodstream.

-The setting in which the drug will be used. An
intravenous preparation might be appropriate for a
drug which is administered during surgery, but
would be inappropriate for home administration of
aspirin
.
-The urgency of the medical situation
. The delaybefore onset of action varies between preparations of
the same drug. Emergency situations often caU for
intravenous administration of agents which might
normaUy be administered by another route.

-Stability of the drug. Drugs which are denatured by
acid are not good candidates for oral preparations
because they may be destroyed in the stomach
(stomach pH = 2).

First Pass Effect. 
Blood from the gastrointestinal tract passes 
through the liver before entering any other
organs. During this first pass through the liver, a
fraction of the drug (in some cases nearly all) can be
metabolized to an inactive or less active derivative.
The inactivation of some drugs is so great that the
agents are useless when administered orally.


Thursday 23 July 2015

FDA Approves New Prescription Acne Treatment


FDA  approved Galderma Laboratories’ antibiotic-free adapalene and benzoyl peroxide 0.3%/2.5% gel (Epiduo Forte Gel) for the once-daily treatment of acne vulgaris.

“Acne is a challenging condition to manage. It can vary greatly from patient to patient, can have a significant physical and psychosocial impact on sufferers, and patients can find treatment adherence difficult to maintain,” said clinical investigator Jonathan Weiss, MD, in a press release. “For many patients, rapid results are especially important, and some acne treatments take time to show effect. We were very excited to see in the clinical trial that people using Epiduo Forte Gel saw results as early as 1 week, with efficacy continually improving through week 12.”

The most commonly reported adverse events experienced by trial participants treated with Epiduo Forte Gel were skin irritation, eczema, atopic dermatitis, and skin burning sensation. Most of the side effects associated with the drug’s use were mild and moderate in severity, a finding that Galderma considers particularly relevant to acne patients with sensitive skin.

Galderma plans to launch Epiduo Forte Gel in early September 2015, according to a manufacturer press release.

10 Things to do during every interview.



Here is a list of ten things I tell my clients before they go into an interview to do. If these are done correctly the chances of success go up dramatically.

1) Dress properly-This maybe a no brainer but there are some out there who do not wear a suit to an interview. The guideline usually is to dress as if you are going to church or court which ever you're more comfortable with. Just Because the interviewer or organization is casual, does not mean we can be.

2) Always Smile and make eye contact- When you first meet the interviewer extend your hand and make eye contact. Introduce yourself and listen for their name so that you can use it at the end the interview to thank them for taking the time to interview you.

3) Bring 2 copies of your resume- This is important that you bring a good clean copy of your resume with you on resume paper. I say bring two because usually the director is going to need to pass your resume on to his Hr department and we want him to have one as well.

4)Stay away from money- It is improper to discuss money at the first interview. If they ask you about money it is ok to say your negotiable. Money is always the last thing to discuss even if it is the first thing on your mind.

5) Do your research- This is important, you want the potential employer to know you have looked into them and it will tell you what their recent success have been and where they are going as an organization.

6)Always ask questions- The only way to hear what you want to hear is to ask questions. The questions should revolve around duties and the company. Some questions should also revolve around the research you have done prepare some questions about things you have seen on the organizations website.

7)Always speak good of the past- Never criticize a current or former employer. Your potential boss would not want you to go around bad mouthing him if you leave his organization.

8)Mentally prepare yourself- You do want to walk into an interview with an air of confidence, in your mind you should already know that you have done the research and have good questions prepared, the only thing standing in your way is the attitude you present to your interviewer. Always make sure you are enthusiastic about the opportunity and convey that to them.

9)Know somebody- Always have references available to provide to your potential employer.

10)Exit with a smile- At the end of the interview shake your potential employers hand and thank him again for taking the time to interview you and reiterate how much you are interested in the position. I always say to follow up with a thank you note it is always best.

How Innovation Differs from Invention

Invention   

This is usually defined as the discovery of a new item. Whether it is a new drug, device, or other piece of technology, it is unique and no similar one exists. Unfortunately, most invention comes from outside of the profession, with individuals using their skills to bring inventions to pharmacy practice. The invention should result in a patent submission because of its novelty and lack of prior art. 

Innovation 

This term usually comes after the invention has occurred. This can either be an improvement on a current system or a process that makes things better than their current state. Innovation could also involve taking an existing idea that was implemented at 1 site and replicating it at another. Because anything unique is often considered innovative. They are improvements of an existing service, as opposed to the creation of new technology.

 Entrepreneurship 

This term applies when someone takes a novel idea and creates a new business from it. The entrepreneur is usually the founder who gets an equity stake in the start-up company. 
The company could be based on an invention or innovation, but it has to have a commercial base to support it. Those who start and own an independent pharmacy would be considered entrepreneurs. Starting and running a business requires very different skills than inventing and innovating. 
Some might choose to turn their invention into a business, while others might allow someone else to use their invention to start a company. 

Wednesday 22 July 2015

TYPES OF DOSAGE FORMS - LECTURE

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CAPSULES

CAPSULES


  Are solid dosage forms in which one or more medicinal and or inert substances are enclosed within a small shell or container generally prepared from a suitable form of gelatin.  Depending upon their formulation, the gelatin capsule shells may be hard or soft.
Characteristics:
1.  May be swallowed whole by the patient
2.  May be inserted into the rectum for drug release and absorption from the site
3.The contents may be removed from the gelatin shell and employed as a pre measured medicinal powder, the capsule shell being use to contain a dose of the medicinal substance.
Example: Theo-dur Sprinkle
4.  Elegance
5.  Ease of use
6.  Portability
7. Tasteless shell to mask the unpleasant taste/odor of the drug
8. Permits physician to prescribe the exact medication needed by the patient
9.  conveniently carried
10. readily identified
11. easily taken
12. tasteless when swallowed
13. commonly embossed or imprinted on their surface the   manufacturer’s name and product code readily identified
14. available in variety of dosage strength
15. provide flexibility to the prescriber and accurate individualized dosage for the patient
16. packaged and shipped by manufacturers at lower cost less breakage than liquid forms
17. more stable and longer shelf life
Components Of Capsules
1.  Gelatin
2.   FD & C and D & C colorant
3.  Sugar
4.  Water - 12 to 16 % but may vary depending on the storage condition
5.  Sulfur dioxide (.15%) - prevent decomposition during manufacture
6.  Opaquants/Opacifying agent - titanium dioxide

H   HARD GELATIN CAPSULES
A   Also referred to as “DFC” Dry Filled Capsule. Manufactured into two sections, the capsule body and a  shorter cap. 

A A recent innovation in capsule shell design is the Snap-Fit, Coni-Snap, and Coni Snap Supro hard gelatin capsules.

CaCapsule size
F  For human use, empty capsules ranging in size from 000 the largest to 5 the smallest.   Generally, hard gelatin capsule are used to encapsulate between 65 mg to 1 gram.


  SOFT GELATIN CAPSULES 
Also referred to as as Soft ElasticCapsule.  Are prepared from shells of gelatin from which glycerin or a polyhydric alcohol and as sorbitol has been added to render the gelatin elastic or plastic like.
Tthe gelatin is plasticized by the addition of glycerin, sorbitol or polyol.  The shell may contain preservatives to prevent from fun 

soft gelatin capsule has a seam at the point of closure of the 2 halves, and the contents can be liquid, paste or powder.










ACCORDING TO WHO ROLE OF HOSPITAL PHARMACIST

Hospital pharmacy
Hospitals and other institutions and facilities, such as outpatient clinics, drug-dependency treatment facilities, poison control centres, drug information centres, and long-term care facilities, may be operated by the government or privately. While many of the pharmacist’s activities in such facilities may be similar to those performed by community pharmacists, they differ in a number of ways. 

Additionally, the hospital or institutional pharmacist:

• has more opportunity to interact closely with the prescriber and, therefore, to promote the rational prescribing and use of drugs;

• in larger hospital and institutional pharmacies, is usually one of several pharmacists, and thus has a greater opportunity to interact with others, to specialize and to gain greater expertise;

• having access to medical records, is in a position to influence the selection of drugs and dosage regimens, to monitor patient compliance and therapeutic response to drugs, and to recognize and report adverse drug reactions;

• can more easily than the community pharmacist assess and monitor patterns of drug usage and thus recommend changes where necessary;

• serves as a member of policy-making committees, including those concerned with drug selection, the use of antibiotics, and hospital infections (Drug and Therapeutics Committee) and thereby influences the preparation and composition of an essential-drug list or formulary;

• is in a better position to educate other health professionals about the rational use of drugs;

• more easily participates in studies to determine the beneficial or adverse effects of drugs, and is involved in the analysis of drugs in body fluids;

• can control hospital manufacture and procurement of drugs to ensure the supply of high-quality products;


• takes part in the planning and implementation of clinical trials.

MANAGEMENT- COMMUNICATION



Communication
The exchange of ideas, messages, or information by speech, signals, or writing.

Communication Skills
Communication skills are the tools that we use to remove the barriers to effective communication.

Goal
·         The goal of communication is to convey information &
·         the understanding of that information
from one person or group to another person or group.


THE COMMUNICATION PROCESS



The main components of communication process are as follows:
1.         Context - Communication is affected by the context in which it takes place. This context may be physical, social, chronological or cultural. Every communication proceeds with context. The sender chooses the message to communicate within a context.
2.         Sender / Encoder - Sender / Encoder is a person who sends the message. A sender makes use of symbols (words or graphic or visual aids) to convey the message and produce the required response. Sender may be an individual or a group or an organization. The views, background, approach, skills, competencies, and knowledge of the sender have a great impact on the message.
3.         Message - Message is a key idea that the sender wants to communicate. It is a sign that elicits the response of recipient. It must be ensured that the main objective of the message is clear.
4.         Medium - Medium is a means used to exchange / transmit the message. The choice of communication medium varies depending upon the features of communication.
5.         Recipient / Decoder - Recipient / Decoder is a person for whom the message is intended / aimed / targeted. The degree to which the decoder understands the message is dependent upon various factors such as knowledge of recipient, their responsiveness to the message, and the reliance of encoder on decoder.
6.         Feedback - Feedback is the main component of communication process as it permits the sender to analyze the efficacy of the message. It helps the sender in confirming the correct interpretation of message by the decoder. Feedback may be verbal (through words) or non-verbal (in form of smiles, sighs, etc.). It may take written form also in form of memos, reports, etc


FORMS OF COMMUNICATION:
Oral
Oral communication makes up the bulk of business communication today. Effectively communicating orally requires knowledge of the topic at hand, critical thinking ability and great interpersonal skills. Those skilled with oral communication are also typically good listeners who pay attention to verbal and nonverbal communication clues.
Nonverbal
People communicate nonverbally via body language and facial expressions. Eye contact, gestures and proximity to the speaker are all examples of nonverbal communication.  It's important to pay attention to your body language and posture when speaking or listening to someone else.
Written
Written communication in today's workplace commonly takes the form of email. Effective communication and proper etiquette are no less important in electronic form than they are on the written page. Keep business correspondence professional. Use correct grammar, punctuation and spell check every message before sending. Follow the same rules of etiquette in email that you would in any other business setting. Many employees consider email the most effective form of office communication.
  

COMMUNICATION BARRIERS
Communication Barriers are the various obstacles and hurdles which arise in between of an effective communication leading to misunderstandings and misinterpretations by the receiver. They result in distortion of the message and the goal is never accomplished.

Impatient Listener
The listener should be patient enough to absorb the complete information and then respond accordingly. Always jot down your points and start off with your queries once the sender is through with the communication. Don’t jump in between the conversation.
           
Misinterpretation
This can stem from poor communication efforts by the message sender. Language and communication differences are common as companies become more diverse. Additionally, noises and distractions in the work environment can cause confusion during the reception and interpretation of messages.
Low pitch and tone
Sometimes even the pitch and tone can play a communication barrier. Your content might be accurate and related, but if your pitch is low your information will never reach the listeners. The tone has to be very clear and loud for delivering correct information.
Ignoring the content
One should lay emphasis on the content of his speech. The content has to be clear and above all interesting. Don’t just speak; take some time to find out what you are speaking. Don’t make your speech monotonous otherwise the listeners after sometime will definitely fall asleep or bored.
Unorganized Thought
Unorganized and haphazard thoughts also are instrumental in poor communication and a very important barrier to effective communication.
Cultural level
In any organization, an individual can never think on the same line as his boss does. There is always a difference in their thought process.
Lack of Knowledge
 Employees generally lack knowledge about the company, its products and their jobs. This can contribute to poor production, creativity and results within the organization. It can also lead to poor communication and ineffective results during interactions with clients or customers.



7Cs OF COMMUNICATION
The 7 Cs provide a checklist for making sure that your meetings  , emails  , conference calls  , reports  , and presentations   are well constructed and clear ,so your audience gets your message.
According to the 7 Cs, communication needs to be:
Clear.
Concise.
Concrete.
Correct.
Coherent.
Complete.
Courteous.

1. Clear
Your messages need to be clear if they are to be effective. When writing or speaking to someone, be clear about your goal or message. What is your purpose in communicating with this person? If you're not sure, then your audience won't be sure either.
To be clear, try to minimize the number of ideas in each sentence. Make sure that it's easy for your reader to understand your meaning. People shouldn't have to make assumptions on their own to understand what you're trying to say.
2. Concise
If you want your messages to be read by busy people, make them brief. Remove all words phrases and sentences that serve no purpose. You can also eliminate wordiness by substituting one word for wordy, overused expressions.When you're concise in your communication, you stick to the point and keep it brief. Make sure to check,
Are there any unnecessary sentences?
Have you repeated the point several times, in different ways?

3. Concrete
When your message is concrete, then your audience has a clear picture of what you're telling them. There are details (but not too many) and vivid facts, Your message is solid. You have a choice in your writing to use concrete (specific) or abstract (vague) words. However, concrete items terms are typically mare accurate and, in some cases, more believable.

4. Correct
Correctness includes proposes spelling, grammar, punctuation, and format. For spelling, punctuation and grammar.
When your communication is correct, it fits your audience. And correct communication is also error-free communication.

5. Coherent
When your communication is coherent, it's logical. All points are connected and relevant to the main topic, and the tone and flow of the text is consistent. Ideas need to flow from on to the next through smooth transitions. You can achieve this by outlining your messages, writing simple sentences ad focusing each paragraph on one idea.
6. Complete
In a complete message, the audience has everything they need to be informed and, if applicable, take action. Make sure that you included all relevant information, contact names, dates, times and locations etc.
7. Courteous
Your message should be positive i.e. building goodwill and focused upon the reader. Courteous communication is friendly, open, and honest. There are no hidden insults or passive-aggressive tones. You keep your reader's viewpoint in mind, and you're empathetic to their needs.


 IMPORTANCE OF COMMUNICATION SKILLS:

Communication skills are very important for all managers and leaders.
Good communication skills allow managers and leaders to perform their role more effectively. Their role requires that they communicate. They must communicate many things to many people: they must communicate effectively to the team, to their suppliers, to their customers and financiers.
So it is important that leaders and managers are good communicators.
Communication skills for managers and leaders consist, mainly, of six subset skills:
1.         The ability to set out the goal or the target to be hit.
2.         The ability to communicate the plan of action that, it is hoped will describe successful action, capable of achieving the goal.
3.         The ability to communicate delegated actions: who is going to do which task?
4.         The ability to give corrective critical feedback to the people who are not performing in the proper manner and, in addition, to be able to get them to correct their performance and get "back on track".
5.         The ability to give praise and appreciation to those who are doing a good job.
6.         The ability to communicate the need for constant change, adaptation, refinement and flexibility to the conditions, whilst still remaining faithful to the overall goal and plan.


What are STEROID HORMONES

Steroid hormone is a steroid that acts as a hormone.

They are grouped on the basis of the receptors they bind.
vGlucocorticoids
vMineralocorticoids,
vProgesterone
vAndrogens

vEstrogens
The natural steroid hormones are generally synthesized from cholesterol in the gonads and adrenal glands.
These forms of hormones are lipids.
They can pass through the cell membrane as they are fat-soluble, and then bind to steroid hormone receptors which may be nuclear or cytosolic depending on the steroid hormone, to bring about changes within the cell.
Steroid hormones are generally carried in the blood bound to specific carrier proteins such as SHBPs and CHBPs.
Further conversions and catabolism occurs in the liver, in other "peripheral" tissues, and in the target tissues.
A variety of synthetic steroids and sterols have also been contrived.
Most are steroids, but some non-steroidal molecules can interact with the steroid receptors because of a similarity of shape.
Some synthetic steroids are weaker, and some much stronger, than the natural steroids whose receptors they activate.
Examples Of Synthetic Steroids
ØGlucocorticoids: alclometasone, prednisone,dexamethasone,
ØMineralocorticoid: fludrocortisone
ØVitamin D: dihydrotachysterol
ØAndrogens: apoptone, oxandrolone, oxabolone, testosterone, nandrolone (also known as anabolic steroids)
ØEstrogens: diethylstilbestrol (DES)
ØProgestins: danazol, norethindrone, medroxyprogesterone acetate, 17-Hydroxyprogesterone caproate.
Some steroid antagonists:
ØAndrogen: cyproterone acetate
ØProgestins: mifepristone, gestrinon