Thursday, May 31, 2007

1st Year Pharmacy Frog Skeletal Muscle Practical

I really missed those days...

Mad-Mad Advertisement

Today, when i flipped open The Star newspaper, i came across this advertisement.
See anything familiar?
Are they the same?

Is this piece of sh*t worth RM 6.48?? You judge for yourself.. is not the same actually, one is Royal Danish and one is Royal Cookies, although the packing look the same. And please take note that it come from the same manufacturer.
Maybe someone can buy it and please provide me with the picture of the Royal Danish Cookies!!
Then we can compare..

(Previous post at

Tuesday, May 29, 2007

Do you take Blood Pressure Medication?

Why we must take blood pressure medication?

According to Veterans Administration study, patients with diastolic hypertension, reducing BP to a goal of <90mmHg reduced the risk of cardiovascular events. The risk for major CV events declined by 67% in patients with initially untreated diastolic blood pressure (BP) of 90-114mmHg, and by 96% in patients with initially untreated diastolic BP of 115-129mmHg.

Framingham heart Study (Hypertension 2005 Aug:46(2):280) concluded that hypertension at age 50 years associated with about 5 year reduction in life expectancy compare with normal people based on 3128 participants.

British Medical Journal 1997 Jan 25:314(7076):272 study also concluded that in hypertensive patients receiving treatment, the risk of stroke increased to 1.6x if systolic blood pressure 140-149mmHg, 2.2x with SBP 150-159mmHg, and even 3.2x if SBP 160 or greater. All these studies clearly showed the important of BP monitoring and the consequences of uncontrolled BP.

When we start treating it?

Prehypertension (120-139/80-89mmHg): Life Style Modification (weight reduction, DASH diet, sodium restriction, aerobic physical activity, reduce alcohol consumption)

Stage 1 (140-159/90-99mmHg): start with one type of medication

Stage 2 (160/100mmHg or higher): 2 drug combination So what is your BP reading and are you taking the medication?

Yes, i am taking blood pressure medicine, but which one is the best?

The Blood Pressure Lowering Treatment Trialists' Collaboration made a summary after reviewing data from 29 randomized trials, that Angiotensin Converting Enzyme Inhibitor (ACEI) based and Calcium Channel Antagonist based regimens were associated with 22% and 18% reduction, respectively, in the risk of total major CV events relative to placebo, whereas Angiotensin Receptor Blocker (ARB)-based regimens were associated with 10% reduction in risk.

Some of the major study:
LIFE (Losartan Intervention For Endpoint reduction in hypertension) study recruited participants 50-80 years old (mean 67 years) and concluded losartan was superior to atenolol with the decreased risk of fatal and nonfatal stroke by relative risk reduction 24.9%, P=.001.

ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial- Blood Pressure Lowering Arm Study) recruited 19257 hypertensive 40-79 years old with greater than or equal to 3 other CV risk factors. Patients were randomized to amlodipine or atenolol base therapy. There was no difference in the primary outcome of nonfatal MI and fatal CHD. However, Amlodipine based treatment was associated with significant risk reduction for secondary outcomes of fatal and nonfatal stroke (HR 0.77, P=.003) and also greater reducttions in systolic and diastolic BP than atenolol.

Summary from Epocrates CME
Therefore, BP control is paramount importance, but it is increasingly clear that it also matters which drug are used. Combination therapy, particularly with classes of drugs that have the most favorable outcome data in hypertension= thiazide type diuretics, ACEIs, ARBs, and calcium channel blockers- is now widely seen as the most efficient method of achieving optimal BP control in the majority of patients, and likely is associated with better outcomes.
Ask your pharmacist!
Although recent evidence shows that superiority of newer medicine compared to beta blockers (atenolol, propanolol, metoprolol), each individual is different and treatment is usually individualized. So, consult your health care provider!

Besides, if we take account of the cost of atenolol (generic available)= RM 0.40-RM 3/day compare with amlodipine =RM 3.00-RM 5.00/day, and compare with losartan =RM 3.00-RM 4.00/day; taking beta blocker is definitely a more economical option.

Last but not least, BE HAPPY AND DON'T STRESS yourself.

Friday, May 18, 2007

Do you know? (1) You can choose when to menstruate!

Do you know that US women with heavy menstrual flows work 3.6 fewer weeks yearly compared with women without mentrual problems and lose an estimated $1692 in wages per woman annually?

Actually, menstruation or not, does not pose any health advantages. In 2005, the Association of Reproductive Health Professionals (ARHP) surveyed 1018 women aged 18-40 revealed that women harbour many misconceptions about their period, including what is "natural" and have an incomplete understanding of menstruation.

What are the usual symptoms of mentruation?
According to the study, 84% of them will experience bloating, 84% moodiness, 84% irritability, 81% cramps, 80% pimples or acne, 76% less energy, 70% food cravings, 69% breast tenderness, and 59% headaches,64% often or sometimes experience heavy bleeding and 63% have "really bad cramps".

So, what can we do about it?

Women who wish to suppress their menstruation, are mostly women with menstrual-related medical or gynecologic problems, adolescents, perimenopausal women, athletes, females in the military, athletes, females with mental disabilities. Women who choose to menstruate less frequently are also candidates.

Since 1977, numerous randomized clinical trial have evaluated the safety and efficacy of extended use regimens of combination oral contraceptives. Extended contraception regimens eliminate the placebo week from the standard 21/7 day cycle.

Are there any side effects?
The major side effect of extended use hormonal contraceptives is unscheduled bleeding and spotting during the first few cycles of use. This side effect typically abates within a few months as the body adjusts to the new hormonal balance. No worry, as no endometrial hyperplasia or significant pathology has been observed in trials and the endometrium quickly reverts to normal cyclic changes after discontinuation.How about benefits?
Nonmenstrual benefits of extended regimens OCs
medical conditions include iron-deficiency anemia, mentrual related migraines or seizures, dysmenorrhea, prementrual syndrome and premenstrual dysphoric disorder, and menorrhagia.

Is it safe?
A lot of women may not aware that it is not medically necessary to bleed while taking hormonal contraceptives. No ovulation occurs and menstrual blood does not build up with hormonal methods. Monthly bleeding episodes are false periods designed to make cycles with the pill seem more "natural".

No serious side effects have been detected across dozens of studies involving thousand of women. There are no harmful effects on the uterine lining. Data on conventional pills use are reassuring regarding breast cancer risk. One study showed no increase of breast cancer related to OC dose, duration of use, young age at initiation, or family history. Return to fertility after discontinuation is expected to be the same as for conventional OCs.

Ask the pharmacist! He would counsel u on how to
1) Carefully select your hormone free days and create a full pharmaceutical care plan for you.
2)Expect unscheduled spotting and bleeding initially.
3)Stick to your schedule given by your pharmacist.

The author can be contacted by email: or msn:

(Sources: Epocrates CME)

Saturday, May 12, 2007

Royal cookies yum yum!!!

I love cookies...just like Sesame Streets Cookie Monster.
Who dont like cookies? Especially chocolate cookies, which is my favourite.

So when i saw the offer from a leading retail chain pharmacy, i cant stop myself and get one box of Premium Chocholate Chip Cookies. Yum Yum (i think)
Royal cookies? Supposed to eat by the royalties?

Chunky Chips with BIG Chocholate Flavour!!!

Premium Chocolate Chip Cookies!!!

Product of Malaysia!!! Malaysia BOLEH!!!!

My cookies????? Comparing with the first picture..
Is it the same? Anyone can tell me?Or is it my eye??

Is this leading chain pharmacy or the manufacturer lead by this gang?

Thursday, May 10, 2007

Medical Error

Greek physician Hippocrates swore," I will follow the system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischieves". "As to diseases, make a habit of two things--to help, or at least, to do no harm."

A landmark 1999 report by the National Institute of Medicine, "To Err is Human: Building a Safer Health System, found that medical error is one of the leading causes of death and injury in America. Each year, an estimated 44,000 to 98,000 US hospital patients are killed by medical errors that could be prevented. This figure is almost certainly higher, since many patient go to outpatient clinics or surgical centers, or simply to the doctor's office, and never go to the hospital.

One of the most common forms of medical error has to do with medication mistakes. Hippocrates oath also states: "I will give no deadly medicine to anyone if asked". But medical error occurs if patients are mistakenly prescribed wrong drug, wrong level of a drug, or a drug that has dangerous interactions with other drugs they are taking, or a drug to which patients are allergic.

Infamous cases, 1994, death from a chemotherapy overdose of Betsy Lehman, a nationally renowned medical reporter for the Boston Globe who was being treated for breast cancer at the prestigious Dana-Farber Cancer Institute in Boston.
She was the most informed and engaged patient imaginable, and Dana Farber one of the nation’s top cancer centers. Yet Lehman died of an overdose of a potent cancer drug. She was mistakenly given four times the daily dose of a powerful anticancer drug and died of heart failure.
Worse, she received the overdose for four straight days, even though another woman in the same ward had collapsed of a drug overdose less than a week before.

What you should do?
You can do a lot to reduce your risk of being a victim of medical error. You will be safer and healthier if you become more involved in your own health care. Just because the doctor is the expert and wears white coat doesn't mean you should stop paying attention to your own treatment.

The following advice is from the federal government's Quality Interagency Coordination Task Force.

1. Speak up if you have questions or concerns. Choose a doctor you feel comfortable talking to about your health and treatment. It's okay to ask questions and to expect answer you can understand.

2. Keep a list of all the medications you take.

3. Tell both your doctor and pharmacist about each one, including over-the counter medicines such as aspirin, panadol, and dietary supplements like vitamins and herbal products.

4. Bring the medications with you to show your doctor, to avoid medical errors that you may cause by not getting your own drug information right.

5. Tell your health care provider about any drug allergies you have. Make sure you can read your doctor's handwriting on the prescription.

6. And ask your doctor to write down the reason for the medicine right on the prescription.

7. Ask your pharmacist about side effects and what foods or activities to avoid while taking the medicine.

8. When you get your medicine, read the label, including warnings seriously. Make sure it's the medicine your doctor ordered, and that you know how to use it.

9. If the medicine looks different from what you expected, ask the pharmacist about it.

10. Support dispensing separation. HAHAHA...

Studies show that outcomes are better for patients who remain involved in their own care.But if you believe that an error has occurred, let somebody know, and not just your lawyer. It is important to report errors so they can be investigated and by doing so can often prevent further errors. Ask for help from your friendly pharmacist...hehehe....

(Sources: Risk, Houghton Mifflin, D. Ropeik, G.Gray.)