Opioid Med Flyer for patient

This is a pdf file from Mendocino county opioid coalition. It's meant for patients. It makes me wonder about its claim:

Side Effects of Opioids include these following peculiar ones:

• Loss of strength
• Decreased sex drive
• Infertility
• Low testosterone in males
• More pain and pain sensitivity
• Compromised Immune System
• Memory loss

How in the world do I explain these side effects??

Monday, Happy Monday...

I feel like an outsider inside the pharmacy, and so I'm going to keep writing until I can rise above :)

It was manageable all day until the afternoon until flood gate opens and everything just sort of spirals out of order...

• INTUNIV (guanfacine ER)
• ADHD - there is a target dose, increase weekly by clinical response and tolerability
• MALARONE (atovaquone & proguanil) 
• MINOXIDIL 
• Indicated for HTN
• DOXEPIN (SILENOR)
• Indicated for SLEEP, 3-6mg 30-min before bed (MAX = 6mg daily)
• PYRANTEL PAMOATE 
• Indicated for PINWORM
• Other treatment options for PINWORM
• PENTOXIFYLLINE
• Indicated for INTERMITTENT CLAUDICATION, 400mg TID

SUNDAY...oh, SUNDAY...

SUNDAY is busy...I guess I'll have to get used to that fact it'll never be like Ft Bragg's Sunday :(
Here we go:

• ADDERALL side effects are...
• OMNITROPE equivalent (from the perspective of the insurance company) 從沒聽過 :(
• GENOTROPIN
• HUMATROPE
• NORDITROPIN flexpro
• LIDEX cream
• SERTRALIE side effects are...
• What about other SSRI??

Saturday minus 1 person

➞This sounded like a disaster to begin, but Ashton is totally amazing in his super energetic and caring demeanor! We have lots things to go over, and so here we go:

• 
  
• BASAGLAR (insulin glargine)  VS. LANTUS (from Sanofi Aventis)
• Another long acting insulin, from LILLY
• A biosimilar drug to LANTUS, might be cheaper
  
  
  
  
• LOTRISONE (betamethasone & clotrimazole)
  
• PROVIGIL (modafinil) vs. NUVIGIL (armodafinil)
• 
  
• METRONIDAZOLE 0.75% (cream, gel, lotion) for the ACNE ROSACEA
• Apply BID
• AVENOVA 
• OXYTROL vs. OXYBUTYNIN ER
• HYDROQUINONE 
• Indicated for - bleaching for areas on the skin where there are changes in color; 
• MOA - reversible suppression of melanocyte metabolism --> so UV/sun light can produce re-pigmentation of the bleached area 
• METHENAMINE hippurate
• Indicated for - UTI prophylaxis/suppression to keep urine acidic
• 1,000mg AM & PM
• CEFDINIR (3rd generation cephalosporin)
• stored reconstituted suspension at room temperature x 10 days (so need to pay attention of how to dispense to patients so that in case the dose needs to be > 10 days; however, most direction call for 10-day treatment)
• CLEOCIN / CLINDAMAX (clindamycin 2% vaginal cream)
• 7 Disposable plastic applicators are provided with this package. They are designed to allow proper vaginal administration of the cream.
• 
  

  

  Remove cap from cream tube --> Screw a plastic applicator on the threaded end of the tube --> Rolling tube from the bottom, squeeze gently and force the medication into the applicator.
  

  The applicator is filled when the plunger reaches its predetermined stopping point.
  Unscrew the applicator from the tube and replace the cap.
  While lying on your back, firmly grasp the applicator barrel and insert into vagina as far as possible without causing discomfort.
  Slowly push the plunger until it stops. Carefully withdraw applicator from vagina, and discard applicator.
  

  

• Indicated for - bacterial vaginosis
• Nightly for either 3 or 7 nights for non-pregnant, 7 nights for pregnant women
• 
  

Happy Friday

Nothing out of ordinary today.

I did chat with a co-worker at lunch break about balancing life and work. I feel like it's one or the other, and it might not EVER be balanced!

And Tianhang kept wanting to visit grandpa in China :( 

• What exactly differs between ADVAIR HFA vs. ADVAIR DISKUS??
• ADVAIR HFA 
• (+) uses propellent, so less effort to inhale
• (-) breathe and hand coordination needed to maximize effectiveness
• ADVAIR DISKUS
• (+) no need for coordination; ready to use
• (-) expired after unwrapped from foil for 1 month / need to forcefully inhale
• SOOLANTRA 1% cream, my first reaction is "what is this?" Sounds like a start-up company :P
• Indicated for ROSACEA
• Apply each affected area on face daily
• ELMIRON (pantosan)
• 
• Indicated for interstitial cystitis
• Dose - 100mg TID with water, 1 hr before or 2 hr after meals
• What is better than SINGULAIR (montelukast)?
• Cannot say because the only other leukotriene receptor antagonist is ZAFIRLUKAST (ACCOLATE), which is indicated for 1) asthma (20mg BID), 2) chronic urticaria  (20mg BID), and zafirlukast has no indication for allergic rhinitis, which MONTELUKAST (SINGULAIR) has indication for 
• MONTELUKAST has indications for
1. allergic rhinitis (perennial or seasonal)
2. Asthma
3. Bronchoconstriction, exercise-induced (prevention)
4. Chornic urticaria (hives)
• What is an alternative to RESTASIS (cyclosporine)??
• XIIDRA (lifitegrast)
• NIACINAMIDE vs. NIACIN??
• NIACINAMIDE is a form of water-soluble vitamin B3
• Indication -  prevent and treate pellagra (niacin deficiency); CANNOT be used in place of NIACIN to treat hyperlipidemia
• (+) better tolerated than NIACIN for flushing

Post 7-9pm shift

Luckily, the day starts at 3:15pm :)

• Dispensed a BUTRANS (buprenorphine) patch pack, weekly dose
• NEED to learn about SYNCING up medications of a patient 
• Why do AZITHROMYCIN / AMOXICILLIN need a loading dose while others need not??
• Also, AUGMENTIN suspension expired in 10-days
• CEFDINIR suspension is room temp storage
• FLUOCINONIDE gel to replace UREA cream for a small bump on the skin of the arm
• Long term side effect of steroid topical?
• What is TRANDOLAPRIL?? It is ACE inhibitor, approved in 1996, indicated for hypertension, heart failure, or post-MI heart failure or LV dysfunction
• TRIUMEQ 
• Triumeq is a combination of three drugs: Tivicay (dolutegravir), Ziagen (abacavir) and Epivir (lamivudine).
• Administration
• with or without food
• 
  

Tianhang first day home

Today's unusual that I'm working from 7-9pm, and surprisingly I got to go home at around 11:40pm

• A girl came in with pink eye that's been bothering her. Doctors from urgent care did not seem to offer her good advice. One prescribed VIGAMOX (moxifloxacin) while another prescribed POLYTRIM (trimethoprim / polymyxin B). I had to look up, but turns out that both are indicated for bacterial conjunctivitis. The difference is $$$
• A pediatric patient, 3 year old, was taking RANITIDINE syrup with dose of 0.75ml (15mg/mL); makes me wonder why?!!?
• PILOCARPINE was prescribed for dry mouth
• CLOTRIMAZOLE has vaginal dosage form!! (GYNE-LOTRIMIN)