Rangeeniyan #3 : Frequently Asked Questions (FAQ)

Pharmacist in Pakistan is frequently exposed to same questions again and again and they are really tired of answering these questions repeatedly.

RPh is tired of answering these questions to all the uncle and aunties of the family.RPh is very much irritated with this situation and from now on he has decided to reply every question with sarcasm.

This blog contains all the FAQs with Rangeela's Answer and actual answer.RPh will try to write it as simple as possible so as to meet the I.Q level of those uncle and aunties

Following are these FAQs

Q) What is your qualification?

RPh : "Pharm-Deeh" 
Answer: Pharm-D

Q) So what do you basically do?

RPh : "Puncture lagata hun!!" 
Answer : Pharmacist is involve in every step related to drugs use and its manufacturing, from extracting compounds from the plants to manufacture it in different formulation and finally making sure that these drugs are used appropiately.

Q) Your name has a Prefix of Dr. ,Are you really a Dr.?

RPh: "Nai , Asal mai main Tire ka Engineer hun.Bataya na Puncture lagata hun!!."
 Answer: Yes I am a Doctor but you have to understand this that I am Pharmacist not a Physician.

Q) So What is the difference b/w a Physician and a Pharmacist?

RPh: "Jaisa billi Sher ki khala hoti hai waisa he Physician or Pharmacist hotay hain "
 Answer : Physicians are involve in diagnosing diseases and prescribing medications.Physicians usually consult Pharmacist to apropiately prescribed  medications with their right dose , frequency and duration. Pharmacist frequently intervene Physicians when these medications are not apropiately prescribed.

Q) You intervene them? does this mean that Pharmacist are more qualified than Physicians?

RPh : "Galti hogai baye ab nai karunga Intervene !!" 
Answer : No, this doesn't mean that Pharmacist are more qualified. Physicians are experts in their own field while we are experts in our own field.Both Physician and Pharmacists are a part of health care team with a single goal of Patient care.There are instances where Physician and Pharmacist conflict but this is just for the sake of Patient care.

Q) I have seen Pharmacist working in Pharmaceutical industries ,what they basically do?

RPh : "bus Asan sa kam hai! kuch machino k Nut tyt krnay hotay hain"
 Answer: There are a lot of departments in Pharmaceutical industries where the expertise of a Pharmacist is needed like QC , QA ,Production ,Sales and Marketing , R&D etc.They have different roles and responsbilities in these department.

Q) I have also seen a few of Pharmacist working in a medical store? what they are doing there?

RPh: "Dhoodh bechtay hain!!  Ap ko kitnay litre chaiya?
 Answer: This is the role where Pharmacist is directly helping community.Their responsibilities involve counselling the Patients about the usage of their medication.They counsell about when to consult their Physicians if they are expirencing any side effects with these medications and also when to stop taking those medications or continue till your Pharmacist or Physicians instruct you to stop it.

You might have expirienced these questions or not but now you know how to handle these kind of questions.You can choose to answer like RPh or the actual answer.

*Trust me he is the savior to this Profession.

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Help Me Out: An Inventory Paradox Results

The Original Question was:

Let suppose we have a limitation to physically move products from location A to B and we have to balance this inventory by making a system transaction.

The question is what transfer you have to make on system to balance this inventory?

Location A				Location B
	Physical	System	Difference		Physical	System	Difference
Product X	2	4	-2	Product X	6	4	+2
Product Y	4	2	+2	Product Y	2	4	-2

And Choices were:

·         Product X from Location B to A and Product Y from Location A to B

·         Product X from Location B to A and Product Y from Location B to A

·         Product X from Location A to B and Product Y from Location B to A

·         Product X from Location A to B and Product Y from Location A to B

 

The right answer is: Product X from Location A to B and Product Y from Location B to A

The survey results have shown that only 25% of participants come up with the right answer.

The key to solve this kind of problem when adjusting an inventory is that a difference of Positive means that you have to transfer  that item to this location to balance the inventory while a difference of negative means that you have transfer that item from that location to balance the inventory. You can easily remember this by a simple pneumonic mentioned below

“Positive is to attract and Negative is to repel”

Help Me Out!!! An Inventory Paradox

This is a real time problem that Rangeela Pharmasust (RPh) has faced while working at a Pharmacy satellite. RPh believes in Reflective Practice and he believes that if he shares his problems and discuss for the solution it will help both RPh and his readers.

Following is the description of that problem

There are two statelites i.e Location A and Location B and below is the inventory of Product X and Product Y at Location A and B.

Location A				Location B
	Physical	System	Difference		Physical	System	Difference
Product X	4	4	0	Product X	4	4	0
Product Y	4	4	0	Product Y	4	4	0

The problem arises when from Location A, product X (Qty :2 )is being dispensed instead of product Y while product Y is being charged. So after this transaction following is the inventory of X and Y at A and B.

Location A				Location B
	Physical	System	Difference		Physical	System	Difference
Product X	2	4	-2	Product X	4	4	0
Product Y	4	2	+2	Product Y	4	4	0

Since premises of Location B is close to the target dispensing area and to solve the problem promptly, RPh dispensed product Y from location B and make Product X( i.e. wrongly dispensed from Location A) his inventory at Location B without making any further transaction on system. So after this event following is the inventory of X and Y at A and B.

Location A				Location B
	Physical	System	Difference		Physical	System	Difference
Product X	2	4	-2	Product X	6	4	+2
Product Y	4	2	+ou 2	Product Y	2	4	-2

Let suppose we have a limitation to physically move products from location A to B and we have to balance this inventory by making a system transaction.

The question is what transfer you have to make on system to balance this inventory?

Hint: There will be two transfer notes.

You can submit your answer to the link below

http://www.surveymonkey.com/s/6QSHNSB 

Bloom's Taxonomy:Cognitive Domain Simplified

"Knowledge is Power"

These 3 words have make me believe that Pharmacist in Pakistan can achieve their identity and respect by simply becoming competent.In Pakistan,most of the people don't consider teaching as science. There are a lot teaching and training methodologies and models to achieve intended learning outcomes one of them is Bloom's Taxonomy which addresses classification of intended learning outcomes.This article is one of the tiny efforts to provide solution to produce competent Pharmacist from our institutions.

Gaining knowledge is a science. Psychologist has worked on this subject extensively. Epistemology is the term related to the type of knowledge,methods of gaining knowledge and extent of knowledge.

In 1956, A committee of educators had a meeting to improve communication between educators from the world on the design of circular and examination. This committee was chaired by Benjamin Bloom that's why it is called Bloom's Taxonomy while taxonomy means  "set of classification principles".Educators from the world decides that they will set learning objectives for students to achieve at the end to every topic,course,session etc and this will also help them in evaluating students.This is why you will find a set of questions at the end of topic in many books. As I am a Pharmacist one of the relevant example is "Katzung and Trevor's Pharmacology Examination and Board Review", you'll find a checklist of learning objectives at the end of every topic. If you haven't noticed it yet do it now.

Blooms Taxonomy is divided into Three domains i.e.

Cognitive i.e Intellectual ability or thinking like knowledge of a particular topic or subject

Psycho motor: i.e doing things manually or physical skills like surgery, counselling patients etc

Affective  i.e emotion and attitude like participating in group discussion or being enthusiastic for action

I am going to discuss the cognitive domain of blooms taxonomy and its application in Pakistan's Institutions.Cognitive Domain is divided into Six Levels and its a hierarchy from the lowest to the highest are as follows.

Level 1: Remembering : it is simply recalling knowledge like You know Penicillin was discovered by Alexander Fleming.

Level 2: Understanding : Its about understanding or comprehending knowledge like You know Ampicillin is a Cell Wall Inhibitor and understanding that it inhibits cell wall to kill bacteria.

Level 3: Applying : Its about applying what you understand through knowledge like As You know Ampicillin is a cell wall inhibitor, you will never administer it to kill a bacteria that does not have a cell wall i.e. mycoplasma

Level 4: Analyzing : Its about breaking a concept into its parts or understanding interrelationships of different concepts like analyzing an interrelationship between a formulation of a extended release tablet and its bioavailibility

Level 5 : Evaluating : it can be simplified as you have a problem and you have two or more solutions , so evaluation its about choosing the best solution like you have many different guidelines for vancomycin dosing but  with your knowledge and expertise on topic you choose the one that fits for your population.

Level 6: Creating : its like putting parts together to create whole new knowledge or its simply about creating knowledge like calculating Pharmacokinetic Parameters of Vancomycin in a new Population

This was cognitive domain of blooms taxonomy and This is like a ladder you can't jump from Level 2 to Level 5. You have to take your learners from all this level step-by-step. I want educators from Pakistan's Pharmacy institutions to decide at the beginning of the course that on which level you want your learner to be at the end of a course , semester , session etc .I want them to write their learning objectives at the very beginning of their learning sessions and evaluate their learners accordingly. There are a lot of material on the internet and books on "How to write learning objectives using blooms taxonomy".

and Finally following are the learning objectives for this article

* Describe Three domains of Blooms Taxonomy
* Classify Six Levels of Cognitive Domain




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Rangeeniyan #2 - Patient Counselling

Patient counselling about the drug is one of the vital responsibility of a Pharmacist.Pharmacist in Pakistan is involve in every discussion with the Patient (e.g from the political situation of Pakistan to the divas of bollywood) except Patient Counselling.

Following is the conversation between Rangeela PharmaSust and the Patient

Patient: I need Metronidazole 400mg a.k.a Peeli wali goli (the yellow tablet) 

Rangeela: Sir do you have a Prescription?

Patient: No! Do I need one?

Rangeela: No you don't need one its just a piece of Paper and we are already sick of collecting those Papers.BTW who recomends you metronidazole?

Patient: God bless our Sabziwala he said to me that the Peeli goli works like a magic pill its not only treats your stomach-ache but also let go away all the miseries of life.

Rangeela: Indeed the Peeli goli certainly is a Magic pill. How much do you need?

Patient: 2 strips

Rangeela: Here it is?

Patient: How do I have to take this tablet

Rangeela: Oh Sorry let me counsell you.its very easy you just have to push that tablet untill its gets out of the strip ,pour a glass of water ,place the tablet on your tongue and drink the glass of water.Simple as ABC. 

Patient: Thanks alot.

This is how the patient is being counselled.Rangeela has provided every information a patient might need.

*Trust me he is the savior to this Profession.

Rangeeniyan #1-Clinical Decision Making

Pharmacists in Pakistan are extensively involve in critical clinical decision making.They are very vigilant in observing the clinical situation of the patient and acting promptly.

Following is the conversation between the Rangeela PharmaSust and the Patient ; shows that how much he is involve in critical decision making.

(A Retail Pharmacy Setup)

Patient: Sir I need a Pamper!

Rangeela: What size of Pamper do you need?

Patient: I don't know my wife just said to me that if you want me to allow you to enter the home bring chunno's Pamper.

Rangeela: Sir how old is Chunnoo?

Patient: I don't know, today when I leave my home at morning for my office there was No chunno.

Rangeela: Sir i am getting your Point this problem often occurs with our customers wait a little bit and let me calculate.(few minutes later)So according to the theory of relativity and Newton's 3rd Law of motion,Chunno should wear a Pamper of size Zero.

Pharmacists are the integral part of the health care profession and we are being blessed with the expertise of Rangeela.Imagine the world without the skills and expertise of Rangeela.

*Trust me he is the savior to this Profession.

Rangeela PharmaSust Introduction

RPh -Rangeela Pharmasust is a Pharmacist from Pakistan.He believes that he belongs to a lost Profession.He is also suffering from an identity crisis and trying to convince the people that his name has a prefix of Dr. but still he is a Pharmacist not a Physician.Rangeela PharmaSust will share his experience,thoughts and all the rangeeniyan invovle in a life of a Pharmacist at Pakistan.So stay tuned for some exciting stuff.

Trainee Pharmacist - The Super Hero (Specially for AKU Trainees)

A Trainee is a person who carries the superpowers of many Superheroes in one. He is like a Gola-Ganda of Superheros.He has the superpowers of Spiderman, The Transporter, The Chota from the Mechanic etc.Following are some superpowers of a Trainee

Spidey Sense 

it is generally used to mean a vague but strong sense of something being wrong, dangerous, suspicious, a security situation.A Trainee should posses this spidey sense so he can sense that when the change is going to arrive at the Bank and once you missed the stimulus of the spidey sense you’re going to be doomed. 

The Transporter 

Transport one item from one Satellite to another satellite sound easy but it is not that easy as it sounds like. It’s become very difficult when you are transporting 3 items from or to 3 different satellites and remembering to debit and credit it. It’s like solving a Samurai Sudoku. What you need is skill of a Transporter still you can’t afford to be as egoistic as Jason Statham in the movie because you’re not driving an Audi A8 while transporting these items.

The Chota

You people might be thinking that the Chota is not a superhero. Yes Chota is not a Superhero even Chota doesnot have any comic book published yet but soon it will be in the stores. Chota is the upcoming superhero from Pakistan. Chota has a superpower of frequently ending up doing those activities which he shouldn’t be doing.Every now and then you’ll be listening to the phrases like  

“Oye Chotay! Critical tau kar day yar “ 

“Oye Chotay! Coins tau bana day yar” 

“Oye Chotay! Mera Cash tau Submit karwa dena yar” 

“Oye Chotay! Tu bara kab hoga yar?” 

`The Guru 

The Trainee is the one who can do things which no one can do or you can say like that The Trainee is the one who had to do things which no one wants to do Like separating a pile of coins worth 100 from a pile of coins worth 1000 following a specified protocol (and that protocol is a variable which changes from Place to Place or Person to Person). 

  

Lord of the Tape Ball 

This Lord of the Tape Ball is not a person but it’s basically an interesting story. Following is the story of the Lord of the Tape ball narrated by him with a similar desperation as you people have seen in the skyshops ads. 

Lord of the Tape Ball:  I was very worried about my low self esteem. Whenever I use to play cricket with my friends at roadside I was always insulted by them because I don’t know how to tape a tennis ball. I was so worried that I think of committing suicide but one day I was informed by the training coordinator that next month you are selected to be trained for compounding. I never knew that taping the compounding bottles I am passively learning to tape a tennis ball. Now I am very happy it’s just like achieving the inner peace I Love my life Thank You Compounding. 

Conclusion 

I think now you people have understood its how cool to be a trainee and you are not a novice you are a superhero dealing with  different and new situations everyday and every situation is pulling a out the hero within you.