Friday, July 23, 2010

Where are you summer?

Hi all,
Thought it was time for a blog. I haven't written one since my last week in St. Augustine over a month ago. I just completed my Adult Medicine Elective at Baptist Hospital in downtown Jacksonville. My preceptor was awesome!! I learned so much from her! I just wanted to post a few things we had learned during the past 4 weeks that I think everyone should know...

- There is a "weight limit" for the birth control patch. Use over this weight will decrease the effectiveness due to varied absorption.
- Depo Provera may make you infertile for life, even after only one injection.
- Viagra is best absorbed with a fatty meal, so go eat a big ole steak!
- What's the new statin available for cholesterol? pitavastatin (Livalo)
- Pantoprazole (Protonix) is now available in granules
- What's the reversal agent for clopidogrel (Plavix)? desmopressin (DDAVP), titrate up based on urinary output
-Can only shock a patient with a rhythm (VF/VT), don't shock a patient in asystole
-Can you give platelets to reverse abciximab (Reopro)? No, because it has a short duration of action
-What's the treatment of hyperkalemia? Regular insulin 0.1 units/kg IV with 50 ml D50W (50% dextrose)
-What's the dose of aspirin in Aggrenox? 25 mg, so it's ok for your patients to keep taking their 81 mg
- What would be the color of the urine if patient is experiencing severe myopathies? pinkish
- Brand name of Vitamin K? Mephyton
- If patient has HIT, don't use heparin to line the tubing
What's the pretreatment for contrast induced nephropathy? Nabicarb, NAC

I also got in to see a surgery during my last week at Baptist. I watched a pancreatic resection surgery. It was similar to a gastric bypass in that they did the Roux en y technique except it was done on the pancreas. I watched from the very beginning when they put the patient to sleep, saw the intubation process, an A line and central line started, and then the stomach cut wide open and splayed everywhere. I was feeling very woozy. I stood with the anesthesiologist for most of the procedure at the head of the patients table. It was neat to see what he did during the surgery, controlling all the medication administrations and learning about all the machines used for monitoring. Surgery is definitely a different world. And definitely not an interest to me, I thought I was going to pass out the whole time!

So, I've just finished up this elective rotation and I am about to head to Tampa for a month for my transplant rotation. This will not be so bad because David gets to come with me. His last day of work was Friday (yesterday) so he will have 3 weeks with me in Tampa before he has to come back and start pharmacy school! It's kind of a weird feeling that we will both be jobless for about a year, but no worries, the Lord will provide for us.

About 10 more months until I graduate (and hopefully pass my boards)! I'm so ready to be a pharmacist already!

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