WAKE-UP PHARMACIST WAKE-UP !!

Here we Share Some  problems associated with Pharmacy Graduate/Students/Professionals Problems:
1. In civil services (Central & State) Pharmacy is not a optional Subject
WAKE UP PHARMACIST – Inclusion of Pharmacy Subject in Civil services
2. In CSIR-UGC-NET – Pharmacy is not a optional subject.
WAKE UP  PHARMACIST – Inclusion of Pharmacy Subject
3. In Most of the CSIR/ICMR/DBT funded labs- a clear & open opportunity for B.Pharm & M.Pharm Qualified candidate to enter as JRF/SRF/ RA/Project Assistant.Because in all the vacancy mention by these funded body institutes -
Eligibility Criteria mention for JRF & SRF is as follow
MSc in Biotechnology/Chemistry/Toxicology/Life Sciences /Biochemistry/Microbiology/Botany/Zoology + Research exp. + CSIR -UGC- NET
Now – what about Pharm.d/M.Pharm/B.Pharm (Pharmacy is not a optional subject in CSIR-UGC-NET )-
However most of the labs are working in the field of Drug Research. So you can imagine how only a counted few can enter as a JRF/SRF/RA or Scientist positions with Pharmacy degree.

WAKE UP PHARMACIST WAKE UP take a INITIATIVE.
 

 -Inclusion of GPAT as a Eligibility criteria for JRF

GPATINDIA filed a RTI & recieved Following reply
Show the following document if  you applied for JRF/Project Assistant but Eligibility criteria not to mention as GPAT qualified.

Pharmacist should have prescribing rights!!

Revolution pharm.d inclined to ask for prescribing rights for every pharmacists from the first day they qualify because even the most incompetent pharmacist is more competent than any other health care professional when it comes to medicines.

Prescribers frequently under dose their patients when prescribing antibiotics which is just as bad as overdosing because it encourages resistance and makes the infection harder to eradicate .The point about doctors is that if they're allowed to pick up experience from practice, why can't pharmacists who study 6 years solely about medicines. In any case pharmacists wouldn't prescribe everything even if given the right, but it could help us to get out of awkward situations legally by being able to prescribe, e.g. if you ran out of the pharmacy only version of  levonell one step one could prescribe the POM version and get out of it legally without breaching the law.

Ironically we're allowed to give daktarin oral gel for thrush for children from 2 upwards, yet Nystatin is actually safer for children because there is less systemic absorption associated with nystatin. If  we were allowed to prescribe we would recommend Nystatin to the patients instead.

There are easy conditions to treat if we were allowed to prescribe even with very limited diagnostic skills which will undoubtedly very rapidly develop.

Please share ur views on this topic in the comment box below

JAAGOO PHARMACIST JAAGOOOO

Pharmacy Practice Regulation planned, clinical pharmacy mandatory in hospitals.

Nandita Vijay, Bangalore

  

 In a major development to give a fillip to medical services in the country, the Union government is working to enforce the Pharmacy Practice Regulation. The directive will mandate all hospitals to set up departments of clinical pharmacy manned by Pharm D graduates.

The government under the direction of Pharmacy Council of India (PCI) is in the process of finalizing the same. Details on the time-frame for implementation are not available. But experts opine that this move would have a positive impact for pharmacy education in India

Moreover, US and UK governments now recognize only Pharm D as a minimum entry qualification for jobs. The hospitals in the Middle East prefer Pharm D over B Pharm degree holders. In India too, once the Regulation is enforced, the government will insist on Pharm D as the basic degree for candidates to work at the departments of clinical pharmacy in hospitals.

So long the government has not provided adequate attention for the development of clinical pharmacy services in hospitals. Departments of Clinical Pharmacy are in vogue abroad. However, only a handful of hospitals have started the Clinical Pharmacy department. These include KMC, Manipal, JSS, Mysore, KLE, Belgaum and Ramakrishna Hospital, Coimbatore.

The six-year Pharma D course, started in 2008-09, will now will now open up employment opportunities, Dr N Udupa, principal, Manipal College of Pharmaceutical Sciences and sub-committee member, Pharm D, PCI.

Currently, India has over 10, 000 hospitals. There are 1,000 pharmacy colleges with 60 seats each; creating 50,000 B Pharm graduates annually. Of these 5,000 are selected by the industry, 2,000 go abroad and the remaining seek teaching jobs or are under employed. The huge supply-demand gap has resulted in fall of takers to pharmacy courses by half with 25,000 vacant seats. The speedy enforcement of the Pharmacy Practice Regulation could change the face of employment for candidates as Pharm D will be the minimum qualification to seek postings at the departments of clinical pharmacy in hospitals, said Dr Udupa.

Colleges offering Pharm D require a dedicated hospital or a tie-up with a reputed medical centre having a full-fledged department of clinical pharmacy. Only science candidates after pre-university can opt for course. There is also a lateral entry programme for B Pharm degree holders who can join up for the same during the fourth year. The fee between Rs 1.2 lakh and Rs 1. 5 lakh annually for the five year course and the sixth year will be a residency programme.

The key theory and practical focus includes. Therapeutic Drug Monitoring, Drug Information, Adverse Drug Reaction, Patient Counselling and Poison Information supported by case study presentation, ward round participation under the supervision of clinical pharmacy teachers and doctors.

Other than hospitals, pharma industry and clinical research organizations are also keen to employ Pharm D candidates to work qualified coordinators for human studies and BA/BE projects.

PCI has created considerable awareness organizing special sessions at IPC and IPA events.

Classification Of Food Poisoning

I. Based on symptoms and duration of onset:
a. Nausea and vomiting within six hours (Staphylococcus aureus, Bacillus cereus)
b. Abdominal cramps and diarrhoea within 8-16 hours (Clostridium perfringens, Bacillus cereus)
c. Fever, abdominal cramps and diarrhoea within 16-48 hours (Salmonella, Shigella, Vibrio
parahemolyticus, Enteroinvasive E.coli, Campylobacter jejuni)
d. Abdominal cramps and watery diarrhoea within 16-72 hours (Enterotoxigenic E.coli, Vibrio cholerae
O1, O139, Vibrio parahemolyticus, NAG vibrios, Norwalk virus)
e. Fever and abdominal cramps within 16-48 hours (Yersinia enterocolitica)
f. Bloody diarrhoea without fever within 72-120 hours (Enterohemorrhagic E.coli O157:H7)
g. Nausea, vomiting, diarrhoea and paralysis within 18-36 hours (Clostridium botulinum)

II. Based on pathogenesis
a. Food intoxications resulting from the ingestion of preformed bacterial toxins. (Staphylococcus
aureus, Bacillus cereus, Clostridium botulinum, Clostridium perfringens)
b. Food intoxications caused by noninvasive bacteria that secrete toxins while adhering to the
intestinal wall (Enterotoxigenic E.coli, Vibrio cholerae, Campylobacter jejuni)
c. Food intoxications that follow an intracellular invasion of the intestinal epithelial cells. (Shigella,
Salmonella)
d. Diseases caused by bacteria that enter the blood stream via the intestinal tract. (Salmonella typhi,
Listeria monocytogenes)


Bacterial Etiology Of Food Poisoning:

Food infections by bacteria can be divided into two types:
1. those in which the food does not ordinarily support the growth of pathogens but merely carries them. E.g.
Salmonella, Shigella, Vibrio etc.

2. those in which the food can serve as a culture medium for growth of pathogens to numbers that can infect
the person.
Food borne infections by bacteria can also be classified as toxicosis and food-infections. In toxicosis, the toxins are
released by bacteria such as Clostridia, Bacillus and Staphylococcus. In food-infections, the bacteria are ingested,
which later initiate the infection

Steps on How to Use Medications Safely ?

• Keep a list or inventory of all the medications that you take.  Be sure to include all prescribed drugs, over the counter medications, herbal supplements, home remedies and medical foods.  Share this list with your physician or upon admission to the hospital to prevent complications.
•     When speaking with your healthcare providers tell them how you actually take your medications, especially if this is different from how they are originally prescribed.
•     When starting a new medication ask if there are certain foods, drinks, other medicines or activities that you should avoid while taking the drug.
•     At least once a year take all your medicines with you to your doctor’s appointment so you both have a complete understanding of what each drug does and why you should continue to take it.
•     Don’t share prescriptions.  Allergic reactions, overdosing and reproductive side effects in young woman are just some of the risks of sharing a prescription from a friend or family member.
•     Take antibiotics only to treat illnesses caused by bacteria.  Bacterial illnesses include strep throat, tuberculosis and many types of pneumonia.  Taking antibiotics when they are not needed only contributes to the serious problem of antibiotic resistance.
•     Finish the full course of a prescribed antibiotic.  Stopping the medication when the symptoms reside will also add to antibiotic resistance.  If treatment stops too soon, some bacteria may survive, re-infect.
•     Speak to your physician before abruptly stopping certain medications.  Hormone therapy, thyroid, blood pressure and heart medications should not be stopped cold turkey.  Doing so could lead to serious side effects or even kill you.
•     Store all prescription medications in a safe place away from children.
•     Dispose of medications in a safe manner.  Follow any specific disposal instructions on the drug label or patient information that accompanies the medication. Do not flush prescription drugs down the toilet unless specifically instructed.   When in doubt ask your pharmacist.

Have you ever shared a prescription with someone?  Do you question your physician when he grabs his prescription pad if there is another alternative?  We would love your comments on your prescription experiences.

Urinary Tract Infections (UTI)

Epidemiology

UTI are far more common in women than in men, probably because of the shorter urethra in the female. Prostatic secretions in the male may have some antibacterial effect.

Pathogenesis

Nearly all UTI arise by the "ascending route." Fecal organisms, principally Escherichia coli, colonize the vaginal introitus. Their entry into the bladder is facilitated by sexual intercourse, contraceptive diaphragms, and spermicides. The contraceptive pill has no effect on the incidence of UTI.

Some women are prone to have multiple urinary reinfections. These women may be colonized by strains of E. coli with "stickier" fimbriae (anchoring them to the epithelial cells) or may have "stickier" epithelial cells (a phenomenon related to certain blood groups). In addition, the factors noted earlier may contribute to multiple reinfections. In elderly women, vaginal atrophy leads to a reduction in the counts of lactobacilli in the vagina: thus, the vaginal secretions become less acidic and gram-negative enterics more easily colonize. The most potent risk factors for UTI in women are: sexual intercourse, the use of a diaphragm/spermicide, and a history of UTI. In men, prostatic hypertrophy is the main risk factor. In both sexes, Foley catheters are a major risk factor.

Once bacteria reach the bladder, they may cause cystitis or they may reside there asymptomatically.Symptoms of cystitis are urgency, frequency and dysuria. (The symptom of dysuria can also be caused by certain STDs causing urethritis, and may be confused with the symptoms of vaginitis.)

From the bladder, bacteria may ascend to reach the kidney, producing pyelonephritis, an invasive infection which can cause bacteremia and severe illness.Pyelonephritis is typified by fever, chills, flank pain and tenderness, and an elevated peripheral WBC. Ascent from the bladder to the kidney is facilitated by urinary stasis and obstruction (as occurs in pregnancy and certain neurological conditions). Sticky E. coli have an advantage here, too.

The defenses of the urinary tract against infection are minimal, mainly the flushing effect of urine and the sloughing of colonized epithelial cells.

 Diagnosis

Laboratory diagnosis of UTI is made problematic by the fact that it is difficult to obtain a truly sterile urine specimen from voided urine: contamination by meatal organisms is frequent. If a urine sample is left at room temperature for hours, these organisms may grow to high numbers. Thus, for patients with asymptomatic bacteriuria (no symptoms), a high threshold is required to document true bacteriuria (vs contamination), i.e. 10⁵ bacteria per ml. By contrast, in patients with typical symptoms, a much lower threshold is accepted, i.e. 10² bacteria per ml. Most patients with true bacteriuria have pus cells in the urine (pyuria), at least 10⁵ per high-power field under the microscope or a positive leukocyte esterase dipstick test. Pyuria is a fairly sensitive indicator for true bacteriuria but it is not very specific as a guide to treatment because many patients with asymptomatic bacteriuria (of whom only selected subgroups should be treated) have pyuria as do some patients with noninfectious inflammatory conditions (e.g. allergic interstitial nephritis).

Treatment

The most common causes of UTI are E. coli (85%), Staphylococcus saprophyticus (5-10%), and other enteric gram-negatives (5-10%). These organisms are nearly always susceptible to quinolones. Nowadays, about 20-30% are resistant to TMP-SMX. For reasons not entirely clear, quinolones and trimethoprim-sulfamethoxazole (TMP-SMX) are more effective than beta-lactams for UTI even if the organisms are susceptible to the beta-lactams. For cystitis, a superficial infection, 3 days of treatment usually suffices. For uncomplicated pyelonephritis (no obstruction or other anatomic problem), 2 weeks suffices.

Recurrences (relapse vs. reinfection)

While most UTI respond readily to treatment, some are followed by recurrences.These may take two forms:relapse and reinfection.

 Relapses

Relapses signify that the original infection was never eradicated. The organism cultured is identical to that from the previous episode and symptoms usually recur within 2 weeks of the end of treatment for the previous episode. If the previous episode was treated with short course therapy, the first thought should be that there was subclinical pyelonephritis and that a longer course of treatment is needed. If a longer course is followed by another relapse, "imaging" (CT scan or ultrasound) is warranted, to look for an anatomic abnormality.

Reinfections

Reinfections may be caused by the same or a different organism, and usually occur at intervals > 2 wks after the preceding infection. Multiple reinfections usually point to pathogenetic factors such as those outlined above. They can be addressed by changing the contraceptive to "the pill", applying estriol cream in the postmenopausal woman, and, if necessary, by giving low dose chronic antibiotic prophylaxis.)

"Complicated" UTI

This term refers to UTI in the patient with an anatomic or functional abnormality facilitating UTI and making UTI difficult to eradicate. Obstructive lesions are a good example of complicated UTI but the most common association is with the Foley catheter. Patients with complicated UTI undergo many symptomatic episodes and courses of antibiotic treatment, which leads to infection by antibiotic-resistant organisms. The Foley catheter serves as a "highway" for bacteria from the outside world into the bladder: most organisms seem to travel by the extraluminal route. The rate of acquisition of bacteriuria with a Foley catheter is about 5% per day so that, by day 10, more than half of patients have bacteriuria. Irrigation of the urine bag by antibacterials and systemic administration of prophylactic antibiotics are of no benefit in preventing bacteriuria. (There are important technical issues which are of value, e.g. never raising the bag above the level of the patient's bladder.) Despite the frequency of bacteriuria, it is mainly asymptomatic. Nevertheless, long term indwelling urinary catheters should be avoided if possible.

Asymptomatic bacteriuria

One of the most important, and common, questions involves patients with asymptomatic bacteriuria. Although it may seem intuitively obvious that bacterial infection should be combated wherever possible, in fact, in most groups of patients, including the elderly and diabetic patients, treatment of asymptomatic bacteriuria has been shown to produce no benefit. It is usually difficult to eradicate, readily recurs, and exposes the patient to the cost and adverse effects of antibiotics - with no clinical benefit. There are three groups of patients in whom there IS a benefit to treating asymptomatic bacteriuria: pregnant women (because, untreated, 30% will go on shortly to develop symptomatic pyelonephritis), newborns (who have a risk of renal scarring from untreated infection), and patients about to undergo a urological procedure (because they have an appreciable risk of pyelonephritis).