Saturday, December 22, 2007

Medical and Pharmacy Myth

According to British Medical Journal, below are the myths in medical field

1) People should drink at least eight glasses of water a day
2)We use only 10% of our brains
3)Hair and fingernails continue to grow after death
4)Shaving hair causes it to grow back faster, darker, or coarser
5)Reading in dim light ruins your eyesight
6)Eating turkey makes people especially drowsy
7)Mobile phones create considerable electromagnetic interference in hospitals.


According to pharmalogik, below are the myths in pharmacy field

1)Dr study more about drugs than pharmacist

2) Pharmacist in Malaysia dont need to serve the government for the total of 4 years before they can work elsewhere.

3) The working hours of a typical owner of community pharmacy is not 12 hours a day 6 days a week.

4) All doctors know how to perform complex calculation for therapeutic drug monitoring.

5) Pharmacist no need to go for Continue Medical Education every year

6) Pharmacist is richer than the Dr

7) Pharmacy profit margin > 25%

8) All medications are poison

9) Pharmacist not suppose to get their dispensing right

10) Pharmacist also can be called Farmist, Blood sucker, Vampire, Hantu, Mr. Discount, or Dr. They cannot be called pharmacist, Big Boss, Tau Keh, or Leng Cai. Ha haahaa......

Monday, December 17, 2007

Fake 50 cents coins appearing

2 different version of 50 cents, lima puluh sen, tipu, appearing in town.

Judge for yourselfCan you spot the different? Same year of manufacturing but diff design on both side?

The Wau design is clearly different in the middle.
Front design

One is real and one is fake.

Ask the pharmacist
1) Only ask health related questions. Do not ask the pharmacist what to do if u got this type of fake coin. Cause i also dont know wat to do.....Hahaha....

2)I dont know what gov will do about this. I also dont know the reason why the gov withdrawn RM 1.00 coin last time. Maybe due to this issue?

3) I believe the first one is fake and the second one is real. But does anybody care? Elderly people are the groups that can be duped easily since they can't see clearly and identify them.

4) Since the syndicate can make and copy this real 50 cents coin, why dont they do it exactly like the real? Mmmmm....

Thursday, December 13, 2007

Application of chemistry in supplements labelling

Zinc sulphate 66mg
Dose: take one tablet 3 times daily or as directed.

Customer: Can u explain what is written on the label? I read from somewhere we should take more than 50mg/day. Here is written 66mg. Three times a day somemore...wont it become toxic to our body?

66mg x3=198mg? toxic dose?

USRDA stand for United States Recommended Daily Allowances.
When used orally, zinc is safe in the amounts that do not exceed the tolerable upper intake level of 40-50mg/day. This is because higher dose might decrease copper absorption and result in anemia.

Ask the pharmacist!
This is how we pharmacist calculate

Zinc sulphate= ZnSO4. 7H20
Molecular weight=65+32+16*4+7(2+16)=287

Assume 287mg zinc sulphate contains 65mg of zinc, therefore 1 tablet 66mg of zinc sulphate contains how much zinc?
66*65/287= 14.9mg lor....

14.9mg* 3 is only 44.7mg = NON TOXIC DOSE

Another common misunderstanding is Calcium.
Is Calcium Lactate 300mg = Calcium Carbonate 300mg?

The calculations is more complicated than it is shown. Pls ask your pharmacist or me if u want to know more.

Calcium Molecular Weight=40
Calcium Carbonate= CaCO3 =100.1
Calcium Citrate= C12H10Ca3O14,4H2O =570.5
Calcium Lactate=C6H10CaO6,xH2O =218.2 (anhydrous); 308.3 (pentahydrate); 272.3(trihydrate)

Questions: (if u think u understand)
1)Are all calcium salts the same?
2)So do u know which calcium contain the most elemental calcium?
3)Is Calcium Lactate 300mg = Calcium Carbonate 300mg?
4) How many calcium carbonate 300mg u have to take/day if the recommended dose is 1200mg/day?
5) Which one is the best calcium?

Answer 1:
No. Usually government hospital supply calcium lactate, retail pharmacy sell more on calcium carbonate and calcium citrate.

Answer 2:
Calcium Carbonate 40/100=40%.
Calcium Citrate 40*3/570.5=21%
Calcium Lactate 40/308.3=13%

Answer 3:
Calcium Lactate 300mg= 13%*300mg = 39mg of elemental calcium
Calcium Carbonate 300mg= 40%*300mg = 120mg of elemental calcium

Answer 4: USRDA: 1000-1200mg/day
1200mg /39= 30 tablets. HAHAHA. Now u should know how many tablet of calcium u should eat if u r getting them from the hospital.

Answer 5: Here, we also need to apply the solubility of Calcium into calculations.

Simplified way:
Calcium carbonate is practically insoluble in water, but dissolve in hydrochloric acid. CaCo3+2HCL= Ca2+,2Cl-, H+, HCO3- (if i am not mistaken, my chemistry a bit karat liao)
This is also why we recommend to take calcium with food as food stimulate acid secretion in the stomach. And do not take antacid or your gastric medicine with your calcium supplements.

Calcium lactate= soluble in water (can take with food or without)
Calcium citrate= slightly soluble in water but freely soluble in diluted hydrochloric acid (can take with food or without)

BEST CALCIUM? I think it would be Calcium Lactate, provided u dont mind swallowing 30 tablets/day. Or else just stick with the 2 tablets of Calcium Carbonate 600mg with food.

For further informations, feel free to ask me. Absorption is a very complicated process.

Tuesday, December 11, 2007

Comparing Vitamins in Pregnancy

Best vitamins to take pre and post pregnancy

Iberet Folic Obimin Pramilet
Elemental Iron 105mg 30mg 5mg
Vitamin C 500mg 100mg 60mg
Niacinamide 30mg 20mg 10mg
Calcium Pantothenate 10mg 7.5mg 1mg
Vitamin B1 6mg 10mg 3mg
Vitamin B2 6mg 2.5mg 2mg
Vitamin B6 5mg 15mg 3mg
Vitamin B12 25mcg 4mg 3mg
Folic Acid 800mcg 250mcg 500mcg
Vitamin A
6000USP 4000IU
Vitamin D
400USP 400IU
Calcium Lactate
0.1mg 0.15mg
0.1mg 0.1mg




Ask the pharmacist

1)Vitamins to be taken during pregnancy are:
a)B12 >5mcg
Especially for vegetarian women, because they may give birth to infants who suffer early and serious signs of megaloblastic anemia and failure to thrive due to low B12.
b)Folic acid > 400mcg will reduce the incidence of neural tube defects by 50%
c) Elemental iron 30-65mg/day
d) Calcium: Milk, cheese and yogurt should be taken.
2)Energy requirement: 300 more kcal/day (less in first trimester, more during 3rd trimester)
Protein: 10g/day increase to support fetal and placental growth.
Weight: Average women gain 25-30pounds during pregnancy.

4)Which vitamin better to take?
After comparing these 3, Obimin seems the winner for normal pregnancy without complications. I like the high doses of B6 in Obimin, which can reduce complications of nausea and vomiting happens during the first 4-8 weeks. Furthermore it is the cheapest vitamin in the market. Due to lower folic acid, we would usually recommend Obimin+folic acid supplementation from milk.

Iberet Folic seems to be the taikor as it has high doses of iron, folic acid and B12, vitamin C (to enhance absorption of iron). So it is the most useful in anemic pregnant lady.

Just remember do not take several prenatal vitamins as it may expose mother and baby to the toxicity and teratogenic dose of vitamin A.

5)Remember, each individual is different. Always ask your Dr or pharmacist if u r not clear.

6) Want to know expected date of confinement?
Rough calculation:
Last menstrual period+ 7days -3months+ 1 year.
(assumes ovulation on day 14 of 28 day cycle)

Hope u will get a healthy baby!

Saturday, December 01, 2007

Is pharmacy retail profession really good?

How much margin do u think pharmacy is making for each sale transaction?

Ask the pharmacist

1) <2% Is it possible? Yes, we offer blood pressure and referral letter to hospital free of charge. For blood glucose test and cholesterol test, we only charge for the strips and lancets. We consider this as our profession service.

2) 2-10% Most of our medicine margin in this group especially for common medicine.

3)10-30% Enough to cover. We do have products at this range. Or else, we wouldn't have survive until now.

4) 30-50% Living comfortably. Hard to achieve, i would said. That is why i am still using the hard backside car.

5) >100% Blood sucking? I don't know who are the people who vote for this...and i really hope that this perfect situation will come true somehow. Right now i dont even dare to dream to Maybe by selling Nospan, codeine cough syrup, sleeping pills, Cofdex etc to drug abuser? But as the name implies, pharmaLOGIK do not deal with drug abuser.
Don't believe me? Send your son/daughter to study pharmacy after Form 6, then work as houseman in hospital for 1 year, then serve the government 3 years, and open his own pharmacy, then u will know the truth.

Come back to my question: Is pharmacy retail profession really good? Ask your neighborhood retail pharmacist.