PERMOHONAN KEMASUKAN PELAJAR SEBAGAI MAHASISWA DAN MAHASISWI KE SEGI UNIVERSITY DALAM IJAZAH SARJANA MUDA FARMASI (KEPUJIAN) TELAH DIBUKA SEKARANG.
UNTUK DAPATKAN SURAT TAWARAN DAN PINJAMAN PENGAJIAN SEGERA SILA HUBUNGI:
NAMA : AMRAN
TEL : +6012-3791 871
Email: universityintake@counsellor.com
Sesiapa yang berminat untuk mendapatkan surat tawaran SEGI UNIVERSITYdiminta untuk mesej SMS <SEGI, NAMA PENUH, NOMBOR KAD PENGENALAN EMAIL, dan NAMA KURSUS> yang hendak diambil, sama ada diploma atau sarjana muda atau tahun asas kepada AMRAN, TEL : +6012-3791 871 untuk rujukan seterusnya bagi memudahkan urusan pinjaman pengajian.
Sebarang pertanyaan mengenai kemasukkan ke SEGI UNIVERSITY COLLEGE bolehlah menghubungi AMRAN, TEL : +6012-3791 871 atau email ke universityintake@counsellor.com untuk perbincangan selanjutnya.
(Term and conditions apply-bergantung kepada pihak university)
Out-patient Pharmacy & Counseling Clerkship
Group report
Scenario 1
Group B
NAME:
MD HASHIMIE BADDRUDIN BIN MAT HASSAN (95304)
LIM KOK HAN (95298)
Lecturer : Prof. Madya Dr. Azmi Sarriff
Discussion
1. Be prepared to counsel a patient about a new prescription for budesonide
inhaler medication
Mr. Abu is a 29-years-old patient which is a regular client and present with the attached
new prescription. The techniques apply during the counseling are:
Some important point to remember:
First, identify who is our patient-geriatric? Pregnant women?, etc. Then we should
1. Establish a relationship with the patient and to develop trust.
2. Demonstrate concern and care for the patient.
3. Help the patient manage and adapt to their illness.
4. Help the patient manage and adapt to their medication(s).
5. Identify and minimize factors that may contribute to noncompliance.
6. Empower the patient to be an active participant in their health care.
PRIME QUESTION TECHNIQUE is applied to counsel a patient about a new
prescription of budesonide inhaler
1)What did your doctor tell you the medication is for?
Access the patient’s understanding on drug therapy by first asking the patient if he knows
the indication of the medication prescribed to him and why he needs to take the medication.
For example what is the use of budesonide inhaler? Why you need to take this? Pharmacist
should support any lacking of information given by the patient to make sure patient always
get the right information. In this case, this patient is already on terbutaline inhaler, so a
SHOW and TELL technique might be useful be applied to access how good is the patient
use the inhaler. Thru this way,we evaluate how the patient administer the medication. If it
is wrong, then must ready to teach the patient the proper way how to use inhaler.
2)How did your doctor tell you to take the medication?
Ask the patient how often, how much and how long he should be taking the medication.
For example in this situation we use budesonide inhaler (200µg); 1 or 2 puffs twice daily.
Use the show and tell technique, ask the patient to show how to use the inhaler if the
patient not able or done the error, pharmacist should show/guide the patient with the proper
technique and information. So the pharmacist must know the proper way of using inhaler so
that he/she can really counsel the patient on this. Emphasize the patient should not take the
double dose when his miss the dose but try to take as soon as possible if his remember and
proceed with normal dose if the dose interval is quite close with the next dose. Explain about
the proper storage of medication. Suggest that inhaler should be always bringing together
wherever he/she goes and protect the medicine from heat exposure.
3) What did your doctor tell you to expect from this medication?
Clarify with the patient his expectation toward the treatment which include the beneficial
effect that he supposed to expect, for example relieve the asthmatic symptoms. Ask him
how to ascertain the medication is working or not for example if the symptom is not relieve
after taking the medication, this may associated with the way he uses the inhaler
(inaccurate dose) or might need special intervention from physician.
(inaccurate dose) or might need special intervention from physician.
Tell the common side effect of the medications he is taking, and how to handle them. For
example, the most common budesonide side effects are headache, nausea, respiratory
infection, mild cough or wheezing. If the bad reaction occurs advise patient to refer/report to
the physician or pharmacist.
Then, at end of counseling session, don’t forget to do final verification by verifying the
patient if he/she has fully understood what had explained, if possible ask them to repeat what
had been explained by pharmacist or ask them some question regarding medication use
and pharmacist should correct the mistakes and add-in the missing information.
2) What concerns might a patient have about a new diagnosis of asthma?
Based on the case given to us,
This patient was a bit worried about his new diagnosis as he is still young (29 year old) and
he doesn’t want to end up his life like her aunty who has emphysema and on oxygen
He was curious about his current condition as he was referred to specialist and was
prescribed with a new medication. So this patient might become more worried about the
severity of his condition.
Besides, the patient also reported the increased troublesome of the asthmatic condition.
He has wheezing and increased in coughing at night and has difficulty in breathing. From
these complaints, the patient might think that his health is worsening. He also might have
concern on the additional side effects of the new medication given, added to this concurrent
medications.
So to conclude, the patient become more worried about his new diagnosis of asthma and feel
that the increased symptoms he experienced had affect his quality of life a lot. He became
worried if the new asthmatic condition will make his condition worse. The illness he had he
might think become more and more severe.
In general,Individuals with persistent asthma have a higher incidence of both anxiety and
depression than those without chronic disease. Many of these individuals do not follow or
are not capable of following the recommended treatment plans
3) What information and skills will the patient need to manage her condition?
Information and skills the patient includes the following:
-Basic facts about asthma-including the risk factors that may exacerbate the conditions, the
contrast between asthmatic and normal airways; whathappens to the airways in asthma attack
-Roles of medications
The patient should know, in general, how the medications work
• Long-term control: medications that prevent symptoms, often by reducing inflammation
• Quick relief: short-acting bronchodilator (terbutaline) relaxes muscles around airways
Stress the importance of long-term-control medications and not to expect quick relief from
them.
-Skills: access the correct use of aerosol delivery devices and show the proper way of
using/handling inhaler to ensure the optimal delivery and efficacy of the medication.
Inhaler use (ask patient to demonstrate). For example,in this case, the patient is now on 2
inhalers—for rescue and longterm control. Since a bronchodilator (terbutaline) and
maintenance medications (budesonide) were prescribed, the patient needs to use the
bronchodilator first, wait 5 minutes, and then use the maintenance inhaler.
Other skills needed: Spacer/holding chamber use; Symptom monitoring, peak flow monitoring,
and recognizing early signs of deterioration; and use of peak flow meter and/or symptom diary for self-monitoring
-Environmental control measures
Identifying and avoiding environmental precipitants or exposures that may precipitate the
asthmatic attack
-When and how to take rescue actions
Responding to changes in asthma severity (daily self-management plan and action plan)
Explain and emphasize on the importance of compliance to medications.(what should do if a
dose is missed, etc)
Pharmacist also needs to explain about the expected side effects from the medications, how to handle them and also when the patient is expected to see the beneficial effect from the therapy given. Follow up and
monitoring patient progress is required to access the efficacy (improvement in signs based
on patient report and lung function test)/symptoms, interaction and toxicity (adverse effect of
the medications-based on patient complaints and lab data) of medications which may require
new intervention.
Source: http://www.malaysianpharma.com/index.php/component/content/?view=featured&start=60
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