Treasures of the Sea products

Drugs of the Deep
Treasures of the Sea Yield Some Medical Answers and Hint at Others
by John Henkel

Don Hochstein raises a thin glass tube up to his eye level and flicks it with a fingernail. Inside the pencil-width vessel, a substance with the texture of gelatin shimmies and wobbles but doesn't move from the tube's bottom.

"There's endotoxin in there, you can bet on it," he says, slipping the tube back into a rack.

Hochstein, former deputy director of product quality control (he retired last Sept. 3) in the Food and Drug Administration's Center for Biologics Evaluation and Research, is demonstrating a simple analytical test. It's one that medical professionals, drug companies, pharmacies, and others use worldwide to detect the presence of endotoxins--dangerous toxic byproducts of "gram-negative" bacteria such as Salmonella and E. coli.

The test is the limulus amebocyte lysate assay and is, Hochstein says, "remarkable" for its origin: the horseshoe crab. The limulus test, along with an osteoporosis treatment derived from salmon and a bone filler made from coral, are approved medical products that come from the sea.

Until recently, virtually all medical products had terrestrial sources. For example, organisms found in soil have yielded products such as penicillin, amoxicillin, and other antibiotic compounds responsible for saving millions of Americans from suffering and death.

Sea-based products are rare, but some experts say the world's oceans and waterways may harbor the next generation of drugs, biologics, and even a few medical devices. Dozens of promising products, including a cancer therapy made from algae and a painkiller taken from snails, are in development at research laboratories right now. Other products, such as an anti-inflammatory drug extracted from an organism called the Caribbean sea whip, are under FDA review. Three approved products already have brought the healing power of the sea successfully into the world of public health.

Fat loss versus muscle loss

Fat loss versus muscle loss (and the importance of exercise and protein intake)
It is important to understand the difference between weight loss and fat loss. Weight loss typically involves the loss of fat, water and muscle. A dieter can lose weight without losing much fat. Ideally, overweight people should seek to lose fat and preserve muscle, since muscle burns more calories than fat. Generally, the more muscle mass one has, the higher one's metabolism is, resulting in more calories being burned, even at rest. Since muscles are more dense than fat, muscle loss results in little loss of physical bulk compared with fat loss. To determine whether weight loss is due to fat, various methods of measuring body fat percentage have been developed.

Muscle loss during weight loss can be restricted by regularly lifting weights (or doing push-ups and other strength-oriented calisthenics) and by maintaining sufficient protein intake. According to the National Academy of Sciences, the Dietary Reference Intake for protein is "0.8 grams per kilogram of body weight for adults."

Those on low-carbohydrate diets, and those doing particularly strenuous exercise, may wish to increase their protein intake. However, there may be risks involved. According to the American Heart Association, excessive protein intake may cause liver and kidney problems and may be a risk factor for heart disease [1]. There is no conclusive evidence that moderately high protein diets in healthy individuals are dangerous, however. It has only been shown that these diets are dangerous in individuals who already have kidney and liver problems.

How the body gets rid of fat?
All body processes require energy to run properly. When the body is expending more energy than it is taking in (e.g. when exercising), body cells rely on internally stored energy sources, like complex carbohydrates and fats, for energy. The first source the body turns to is glycogen, which is a complex carbohydrate created by the body.
When that source is nearly depleted, the body begins lipolysis, the metabolism of fat for energy. In this process, fats, obtained from fat cells, are broken down into glycerol and fatty acids, which can be used to make energy. The primary by-products of metabolism are carbon dioxide and water; carbon dioxide is expelled through the respiratory system.

Fats are also secreted by the sebaceous glands (in the skin).

ultrasonography

What is ultrasonography?

Ultrasonography is body imaging using ultrasound in medical diagnosis. A skilled ultrasound technician is able to see inside the body using ultrasonography to answer questions that may be asked by the medical practitioner caring for the patient. Usually, a radiologist will oversee the ultrasound test and report on the results, but other types of physicians may use ultrasound as a diagnostic tool. For example, obstetricians use ultrasound to assess the fetus during pregnancy. Surgeons and emergency physicians use ultrasound at the bedside to assess abdominal pain or other concerns.

A transducer, or probe, is used to project and receive the sound waves and the return signals. A gel is wiped onto the patient's skin so that the sound waves are not distorted as they cross through the skin. Using their understanding of human anatomy and the machine, the technician can evaluate specific structures and try to answer the question asked by the patient's physician. This may take a fair amount of time and require the probe to be repositioned and pointed in different directions. As well, the technician may need to vary the amount of pressure used to push the probe into the skin. The goal will be to "paint" a shadow picture of the inner organ that the health care practitioner has asked to be visualized.

The physics of sound can place limits on the test. The quality of the picture depends on many factors.

• Sound waves cannot penetrate deeply, and an obese patient may be imaged poorly.
  
  
• Ultrasound does poorly when gas is present between the probe and the target organ. Should the intestine be distended with bowel gas, organs behind it may not be easily seen. Similarly, ultrasound works poorly in the chest, where the lungs are filled with air.
  
  
• Ultrasound does not penetrate bone easily.
  
  
• The accuracy of the test is very much operator dependent. This means that the key to a good test is the ultrasound technician.

Ultrasound can be enhanced by using Doppler technology which can measure whether an object is moving towards or away from the probe. This can allow the technician to measure blood flow in organs such as the heart or liver, or within specific blood vessels

ultrasound

What is an ultrasound?

Ultrasound produces sound waves that are beamed into the body causing return echoes that are recorded to "visualize" structures beneath the skin. The ability to measure different echoes reflected from a variety of tissues allows a shadow picture to be constructed. The technology is especially accurate at seeing the interface between solid and fluid filled spaces. These are actually the same principles that allow SONAR on boats to see the bottom of the ocean.

Brain Cancer Symptoms: Headaches and Seizures

Most people seek medical care to make certain that nothing bad is happening in their body. They seek reassurance from their doctor that all is well. Unasked questions that linger fill patients and their families with dread until their concerns are addressed.

"Is my abdominal pain due to appendicitis?"

"Am I having a heart attack?"

And the 800 pound gorilla in the room: "Is there 'something really bad' causing my headache?"

For golf legend Seve Ballesteros, there is something bad happening in his body. Two weeks ago, he experienced a grand mal seizure for the first time. As part of the evaluation of a new onset seizure, a CT scan of his brain was done and revealed a large tumor. It is amazing that significant parts of the brain can be destroyed and yet the patient can have normal function. Looking back, though, friends had reported that Mr. Ballesteros had been complaining of headaches, and perhaps he had had a few episodes of unusual or erratic behavior. Often the clues are recognized after the fact and can help explain previous events.

Seizures are relatively common in children and younger adults, and some may be due to an area of the brain that has an abnormal wiring pattern that can cause electrical surges. This can spread to the whole brain and make brain cells fire randomly all at one. This causes the jerking and stiffening motions of the body that we describe as a seizure. The brain doesn't like the irritation, and like a computer, logs itself off and then reboots. During this time, the brain doesn't take in new input and the patient can be sleepy and less than normally responsive. After a period of time, the brain returns its function to normal, and the patient returns to normal as well.

When an underlying problem is found, though, it needs to be addressed. While a CT scan can identify that a tumor is present, it can't say what type of tumor it might be. Tissue samples must be obtained to help make the diagnosis and plan treatment. Since the brain isn't the most accessible organ, a neurosurgeon is needed to open the skull and biopsy the tumor. At the same time, it may be necessary to cut away parts of the tumor (debulk) to prevent increased pressure on the remaining normal brain.

This is what happened to Mr. Ballesteros, and that led to two more bad things. The first is that because the normal brain tissue started to swell after the operation, another surgery was needed to remove more of the skull to allow that swelling to happen. The second bad thing was the diagnosis. The tumor was malignant, a cancer called an oligoastrocytoma, which arises from glial cells (support cell within the brain) that can be rapidly growing.

Treatment options include further surgery to cut away tumor. Because the tumor grows into areas of the brain that have vital functions, it is often impossible to remove all of it, and radiation therapy is required to help shrink and control the size of the remaining tumor.

Survival rates depend upon many factors, including how aggressive the tumor acts and how quickly it grows, the age of the patient, and any underlying medical problems. Mr. Ballesteros has many hurdles to face. He has already had two brain operations and is now undergoing a third within two weeks. Time will determine whether his brain can recover enough to tolerate radiation therapy. And then there is the question of function. While medicine can keep people alive, the goal is much loftier. The brain needs to be able to return to normal function so that the patient can enjoy life.

It is never good to be an interesting patient. Much of medical practice deals with routine complaints, and tests are performed to make certain that serious conditions are not present. The reason to perform those tests lies in the fact that some people do have bad things. It's tragedy that the odds didn't favor Mr. Ballesteros. After years of facing and conquering challenges in the golfing world, he now faces an opponent far more ominous than he did on the field of play. Hopefully, he has the ability to win one more round.

The Truth Behind 10 Diet Myths

Does Eating at Night Make You Fat? Is Caffeine Bad for You? Get the Facts on These and Other Diet

Those are all diet myths that got busted today in Chicago at the American Dietetic Association's annual meeting.

Meet the diet myth busters:

• Christine Rosenbloom, PhD, RD, CSSD, of Georgia State University in Atlanta
• Roberta Duyff, MS, RD, FADA, CFCS, the St. Louis-based author of the American Dietetic Association Complete Food and Nutrition Guide.

Here are 10 diet myths Rosenbloom shattered at the conference, and Duyff's tips on telling diet fact from diet fiction.

Myth: Eating at night makes you fat.

Reality: Calories count, whenever you eat them.

There's no proof for this myth, Rosenbloom says. She notes some small studies with mixed results, tests on animals, and a belief that because eating breakfast is linked to lower BMI, eating at night isn't as good. But all in all, Rosenbloom says, it's your calorie total that matters, day or night.

Myth: Avoid foods with a high glycemic index.

Reality: You could use the glycemic index to adjust your food choices, but don't make it your sole strategy for losing weight or controlling blood sugar, Rosenbloom says.

"For those people that are already counting carbs, this can be a way for them to fine-tune their food choices, but it isn't the be-all, end-all for weight loss," she says.

Myth: High fructose corn syrup causes weight gain.

Reality: "There's probably nothing particularly evil about high fructose corn syrup, compared to regular old sugar," Rosenbloom says.

She explains that this diet myth arose in 2003, when researchers noticed that obesity was rising along with the use of high fructose corn syrup. "They speculated that ... maybe we handle [high fructose corn syrup] differently than we do sugar," but "there really isn't any evidence to support that," she says.

The American Medical Association recently concluded that high fructose corn syrup doesn't contribute to obesity beyond its calories.

Myth: Caffeine is unhealthy.

Reality: Rosenbloom says there is some evidence that caffeine may have a positive effect on some diseases, including gout and Parkinson's disease, besides caffeine's famous alertness buzz.

Also, caffeine doesn't dehydrate people who consume it regularly, Rosenbloom says.

But she cautions that caffeine isn't always listed on product labels, and children who drink a lot of caffeinated energy drinks may get more caffeine than their parents expect. "Kids tend to guzzle these things, whereas an adult may sip a beverage," Rosenbloom says.

Myth: The less fat you eat, the better.

Reality: "For some people, counting fat grams can work for weight control, but it isn't the be-all end-all for people," Rosenbloom says.

She says that people with heart disease, diabetes, and metabolic syndrome may benefit from adding a little healthy fat -- the monounsaturated kind -- and cutting back on carbohydrates. But they shouldn't increase their overall fat intake -- just swap saturated fat for monounsaturated fat.

"If you go out to an Italian restaurant and you have triple cheese-meat-sausage lasagna but then you have a little olive oil on your bread, you're not doing much for your heart," Rosenbloom says.

Myth: To eat less sodium, avoid salty-tasting foods and use sea salt in place of table salt.

Reality: Your sense of taste doesn't always notice sodium, and sea salt or other gourmet salts aren't healthier than table salt.

"Just because it doesn't taste salty doesn't mean that it isn't salty," Rosenbloom says. She says many processed foods contain a lot of sodium -- check the label.

Sea salt, Rosenbloom says, contains slightly less sodium per teaspoon than table salt only because sea salt is coarser, so fewer grains fit into the teaspoon.

Myth: Drinking more water daily will help you lose weight.

Reality: There's no evidence that water peels off pounds.

Foods containing water -- such as soup -- can fill you up, "but just drinking water alone doesn't have the same impact," Rosenbloom says. "Our thirst mechanism and our hunger mechanism are two different things."

Myth: Whole grains are always healthier than refined grains.

Reality: Whole grains are a healthy choice, but you needn't ditch refined grains. "You can have some of each," Rosenbloom says.

The U.S. Department of Agriculture's "My Pyramid" dietary guidelines recommend getting at least half of your grain servings from whole grains.

"It doesn't say you have to replace all of your breads with whole grains or all of your foods with whole grains," Rosenbloom says. She adds that enriched grains -- refined grains with certain nutrients added (such as wheat enriched with folic acid, an important nutrient for preventing neural tube birth defects) -- have some perks.

"Enriched grains generally are going to have more folate, thiamin, riboflavin, niacin, and iron. The whole grains usually have more fiber, vitamin e, selenium, zinc, potassium -- so there's kind of a trade-off," Rosenbloom says.

Myth: Sugar causes behavioral problems in kids.

Reality: You might want to check your expectations about sugar and children's behavior.

For most children, "the excitement that kids have when supposedly they eat sugar is probably more related to the event and the excitement of the event than it is to actually consuming sugar," Rosenbloom says.

She cites research showing that when parents think their kids have been given sugar, they rate the children's behavior as more hyperactive -- even when no sugar is eaten.

Myth: Protein is the most important nutrient for athletes.

Reality: "It is true that athletes need more protein than sedentary people. They just don't need as much as they think. And they probably don't need it from supplements; they're probably getting plenty in their food," Rosenbloom says.

But timing matters. Rosenbloom recommends that after weight training, athletes consume a little bit of protein -- about 8 grams, the amount in a small carton of low-fat chocolate milk -- to help their muscles rebuild.

"That's probably all you need," she says. "You don't need four scoops of whey powder to get that amount of protein."

How to Spot a Diet Myth

New diet myths can crop up at any time; fads come and go. To Duyff, the task of telling nutrition myth from reality boils down to this: Step back, check out the evidence, and be a bit skeptical. Here is Duyff's specific advice:

• Look for red flags, such as promises that sound too good to be true or dramatic statements refuted by reputable health organizations.
• Think critically. Consider the "facts" touted in diet myths. Are they from biased or preliminary research? "One study doesn't make a fact," Duyff says. "The messages need to be evidence-based," which means multiple studies conducted in large groups of people and reviewed by independent scientists.
• Ask an expert. A registered dietitian or other health professional can help you tell nutritional fact from fiction.
• Remember, there are no magic bullets. "The true approach to good health includes an overall healthy eating pattern, enjoyed and followed over time," Duyff says.

10 Lifestyle Tips for Cancer Prevention

Looking for ways to cut your risk of developing cancer? Here's a list of 10 diet and activity recommendations highlighted this week in Chicago at the annual meeting of the American Dietetic Association (ADA).

• Be as lean as possible without becoming underweight.
• Be physically active for at least 30 minutes every day.
• Avoid sugary drinks, and limit consumption of high-calorie foods, especially those low in fiber and rich in fat or added sugar.
• Eat more of a variety of vegetables, fruits, whole grains, and legumes (such as beans).
• Limit consumption of red meats (including beef, pork, and lamb) and avoid processed meats.
• If you drink alcohol, limit your daily intake to two drinks for men and one drink for women.
• Limit consumption of salty foods and food processed with salt (sodium).
• Don't use supplements to try to protect against cancer.
• It's best for mothers to exclusively breastfeed their babies for up to six months and then add other liquids and foods.
• After treatment, cancer survivors should follow the recommendations for cancer prevention.

Why These Cancer Recommendations?

Walter Willett, MD, DrPH, an epidemiology professor who leads the nutrition department the Harvard School of Public Health, was on the international team of scientists that wrote the recommendations.

At the ADA meeting, Willett said the first recommendation -- to be as lean as possible within the healthy weight range -- is "the most important, by far."

But there is one recommendation that Willett says may be a "mistake" -- the one about not taking supplements. Vitamin D supplements may lower risk of colorectal cancer and perhaps other cancers, notes Willett. He predicts that that recommendation will be a top priority for review.

How to Follow the Recommendations

Karen Collins, MS, RD, CDN, is the nutritional advisor for the American Institute for Cancer Research. She reviewed the recommendations before they were issued last year, and she joined Willett in talking to ADA members.

Collins provides these tips for each of the recommendations:

• Be as lean as possible without becoming underweight: Don't just look at the scale; check your waist measurement as a crude measurement of your abdominal fat, Collins says. She recommends that men's waists be no larger than 37 inches and women's waists be 31.5 inches or less.
• Be physically active for at least 30 minutes every day: You can break that into 10- to 15-minute blocks, and even more activity may be better, notes Collins.
• Avoid sugary drinks and limit consumption of energy-dense foods: It's not that those foods directly cause cancer, but they could blow your calorie budget if you often overindulge, notes Collins, who suggests filling up on fruits, vegetables, and whole grains.
• Eat more of a variety of vegetables, fruits, whole grains, and legumes such as beans: Go for a variety of colors (like deep greens of spinach, deep blues of blueberries, whites of onions and garlic, and so on). Most Americans, says Collins, are stuck in a rut of eating the same three vegetables over and over.
• If consumed at all, limit alcoholic drinks to two for men and one for women per day: Watch your portion size; drinks are often poured liberally, notes Collins. Willett adds that the pros and cons of moderate drinking is something that women may particularly need to consider, weighing the heart benefits and increased breast cancer risk from drinking.
• Limit red meats (beef, pork, lamb) and avoid processed meats: Limit red meats to 18 ounces per week, says Collins, who suggests using chicken, seafood, or legumes in place of red meat. Collins isn't saying to never eat red meat, just do so in moderation.
• Limit consumption of salty foods and foods processed with sodium: Don't go over 2,400 milligrams per day, and use herbs and spices instead, says Collins. She adds that processed foods account for most sodium intake nowadays -- not salt you add when cooking or eating.
• Don't use supplements to protect against cancer: It's not that supplements are bad -- they may be "valuable" apart from cancer prevention, but there isn't evidence that they protect against cancer, except for vitamin D, says Collins.
• It's best for mothers to breastfeed babies exclusively for up to six months and then add other foods and liquids: Hospitals could encourage this more, Collins says.
• After treatment, cancer survivors should follow the recommendations for cancer prevention. Survivors include people undergoing cancer treatment, as well as people who have finished their cancer treatment.

Making Cancer Prevention Simpler

Overwhelmed? Collins boiled the 10 recommendations down to these three:

• Choose mostly plant foods. Limit red meat and avoid processed meat.
• Be physically active every day in any way for 30 minutes or more.
• Aim to be a healthy weight throughout life.

Keep in mind that these tips are about reducing -- but not eliminating -- cancer risk. Many factors, including genes and environmental factors, affect cancer risk; diet and exercise aren't the whole story, but they're within your power to change.

medical careers

Medical Malapropisms

These are some funny things we hear in the ER all the time from patients, following the incorrect term, is the correct one with the definition. Feel free to add ones you have heard! Of course I would not surprised if our president used a few of these!

1. “Administrations” or “‘ministrations” - for “menstruation”, as in “I’m having my ‘ministrations right now Doctor.”

2. “Seahorses in my Liver” - for “cirrhosis of the liver” , as in “Doc, my liver ain’t so good - I got seahorses”.

3. “Sugar” - for “diabetes”, as in ” Sugar runs in my family, Doc.”

4. “High Blood” - for “High Blood Pressure”, as in “How high is my blood?”

5. “Sick-as-Hell-Anaemia” - for “Sickle Cell Anaemia”, as in “I’m carrying the trait for Sick-as-Hell-Anaemia”

6. “Groins”- for “groin”, as in “Doc, there’s pains in my groins.”

7. “Weasling” - for “wheezing”, as in “My son was awake all night weasling.”

8. “Vomicking” - for “vomiting”, as in “I feel like I am about to vomick!”

9. “Water Pill” - for “diuretic”, as in “My doctor gave me a water pill so my legs don’t swell up.”

10. “Fluid” - for “Congestive Heart Failure”, as in ” I keep catching fluid so I can’t breathe.”

11. “Arthur-itis” - for “arthritis”, as in ” My joints hurt from my Arthur-itis.”

12. “Diarhear” - for “diarrhea”, as in “I’m having vomicking and diarhear.”

Red Wine May Slow Aging

As a lover of wine - especially red wine, I have to say I am biased towards articles such as this. Apparently red wine may slow aging! (taken in moderation ie 1 -2 drinks a day). We have lots of evidence that alcohol, especially red wine in MODERATE quantities (this does not mean a case of beer or a pint of vodka a day!) has a cardio-protective effect. The ingredient, resveratrol seems to be promising in the research for a “life elixir” to extend life span. In fact a pharmaceutical company has been formed (Sirtris) just to study this and other compounds that have showed promise in rodent research. Well, I am a little dubious but my fingers are crossed! It is rare that anything that is truly pleasurable has been shown to be beneficial to ones’ health! Consider me an early embracer……

The Definition of Allergy

. I need to help inform you about what an “allergy” is - at least in terms of what we in the medical profession call an allergy.

What is NOT an allergy(to a medication):

Nausea

Vomiting

Diarrhoea

Reflux or Heartburn

Feeling “weird“, “loopy“, or “out of it”

Going “crazy”

Anxiety or Palpitations

Urinary Symptoms

These are all INTOLERANCES or SENSITIVITIES, not allergies, which means you CAN take them if they are really necessary - often a dosage change or taking the drug with food or not can minimise the side effects.

What is an allergy:

A Rash - usually reddish or blotchy -often accompanied by:

Hives

Wheezing

Sneezing and Watery, Itchy Eyes

Swelling of the Tongue, Lips, Face, or Throat

Cardiovascular Collapse. (anaphylaxis)

Note, there are only a few things(other than foods) that are common to be allergic to:Antibiotics - mostly Penicillin and Sulpha -based drugs like Bactrim.

Everything else is very rare. Yet somehow once you develop a chronic pain condition you mysteriously develop an “allergy” to every pain medication out there except for narcotics……

Please be aware of this terminology when you are asked by the triage nurse whether or not you have allergies

Medical Terminology and Terbutaline on the MedicCast Podcast

Many EMS providers learn the basics of medical terminology but don't venture far afield from the terms needed to pass their classes. However, the benefits of learning the ways medical terms are developed can help EMTs and paramedics decipher new terms as they come across them. This week's episode focuses on some of the tricks to learning, reading and understanding medical terminology.

The Google Method for Finding Chinese Drug Names

It’s a little bit tricky and there’s some shooting in the dark, but it’s the best I’ve come up with. Here’s what you do:

  1. Go to www.google.com
  2. Click on “Advanced Search“
  3. On the 5th line you’ll see “Language Return pages written in” and a little box that says “Any language.” Change that to be “Chinese (Simplified)”. I guess traditional characters would work too. I just always use the simplified ones.
  4. Now, on the first line in the topmost search box type your term (in this case “Albuterol”).
  5. Click “Search“

Here’s where it gets tricky. What you’ve done is asked Google to show you any pages that are written mostly in Chinese characters that also contain the English word “Albuterol.” What you’re looking for is a page that has the hanzi characters for Albuterol and then the English definition right afterwards, which might look something like this:

  沙丁胺醇(Albuterol)是一种非常有效的肾上腺素类β-激动剂

(this is on the 5th result page at the time of this writing)

If you don’t read hanzi characters, it will be difficult for you to tell the difference between bona fide medical information pages and spam and junk pages. So you might have to try these next steps several times.

  6. Grab that whole string of hanzi and dump it into a translator site that gives you the breakdown of each character, like the one here.
  7. If it feels right, copy the hanzi and pinyin to a text file or Word document for your reference later.

Ok, so how do you know if it “feels right?” Look at the translation of the hanzi above (click here to see it). See how it says:

  “shā dīng àn chún 沙丁胺醇 (Albuterol) is one type kind of extremely effective adrenaline.”

That’s good because that is in fact what Albuterol is (you might have to do a little learning about the drugs you’re looking for).

How do I communicate what I need to the pharmacist?

Hands down, regardless of how good your Chinese is, the best way is just to take the hanzi characters in on a piece of paper and show them to the pharmacist. Technical and medical terms leave little room for error and the pharmacists will understand the hanzi much easier than a verbal rendition or explanation.

As it happened with me, the pharmacist took one look at my paper and said, “Nope, don’t have it.” I then pointed to the second translation (shā dīng àn chún 沙丁胺醇) and she said, “We have that.” It turned out to be Ventolin, one of the name brands for the inhaler with English on the box! I’m glad I brought hanzi translations with me.

Just a warning, if you are trying to find over-the-counter drugs in China, you’ll probably be able to get most things you want without a prescription. But if they look at your paper, you should be prepared to hear them say you need a

  * chǔfāng 处方 = prescription

In that case, you’ll have to get in to see a doctor.

How do I know which of the Chinese terms to use?

If you are able to find multiple terms for the same drug, just collect all of them. For example I found two equally believable translations for Albuterol:

  1. ā bù shū chún 阿布叔醇
  2. shā dīng àn chún 沙丁胺醇

The first seemed to be an attempt at transliterating the sound. The second looked like it might be a translation of the technical name of the drug, salbutamol sulfate. I just took both with me to the pharmacy. Which brings me to the last point.

How do I find the Chinese translation for a medical term or drug?

The first thing to do is find the generic or technical name of the drug. For example I was looking for Albuterol, but is that a name brand or the actual name of the drug? With a little research online I was able to find out that Albuterol is the generic name and there are other brand names. I also found out the World Health Organization recommends calling the drug salbutamol sulfate.

Then I checked my favorite online and paper dictionaries. Of course, none of the names of the drug appeared in any of them.

So, I had to resort to what I call the “Google Method” to find the hanzi translations for the drug. Skip to the bottom of this post for a tutorial on how to use the Google Method.

NURSING STUDENT STORY - MEDICAL TERMINOLOGY

First semester nursing students have a lot of stresses as they begin their journey towards becoming a registered nurse. One of the main stresses is to perform a practical examination. That is the “make believe” portion of nursing school although we try to make the situations and equipment as real as possible. These examinations are performed in make believe hospital rooms complete with hospital beds, call lights, bedside tables, and various types of mannequins used for different skill check-offs. Not only are the nursing students stressed about getting graded on a pass or fail system, they have to verbalize back to the instructor what they are doing and why they are doing it. The students are responsible for knowing basic physical assessment of all of the body systems but are accountable for two systems during their practical examination. They have to pick these systems from folded pieces of paper in a cup. The unknown can also be very stressful.  

During the physical practical examination first semester nursing students needed to memorize how to examine selected body systems as well as begin to learn and pronounce medical terminology. This was always not that easy since many medical terms are quite lengthy and oddly spelled. This can make for some interesting pronunciations of medical terms as the student are performing their exams.

Kelly was a young 22-year-old who had always wanted to be a nurse. Her partner Cindy was a little older and 35-years-old with the same goal. They were going to perform their physical assessment on each other to get checked off either pass or fail. I had the cup with the folded pieces of paper in my hand. I explained to both they were responsible for two body systems. “Who wants to go first,” I said. They both looked at each other. Neither wanted to go first but knew it was a 50/50 shot. Finally after 15 seconds Cindy volunteered. “I may as well get it over with now,” she tells Kelly and me. I held the cup for her to pick out her first body system. She looked briefly at the sizes of some of the pieces of paper. Some were irregularly shaped compared to others. There were six pieces of paper. I knew the logic for some of the students would be the smaller piece of paper would be the easiest system to assess and get graded on. She picked the smaller piece of paper and opened it up to see what system she would need to assess. “I picked the respiratory system,” Cindy said with a sigh. “That is one of my least favorite,” she tells Kelly and me. I got the grading sheet ready and stood at the bedside table. “Okay. You can begin,” I told her. She looked at me like she wanted to cry.

She stood in front of Kelly. “Can you sit on the bed?” she asked Kelly. Trying to be the good partner Kelly sat on the bed with good posture. She knew it would be easier for Cindy to assess the respiratory system if she sat straight. “Okay first I am going to watch her breaths,” said Cindy. “I will watch for 30 seconds and multiply by 2,” she says. Then there was silence. Kelly was motioning downward with her eyes trying to give Cindy some clues. I knew she was stuck already. I waited a few more seconds before giving her a little push. “I will need to listen for bowel sounds,” says Cindy. “No, we are doing the respiratory system,” I told her. She slaps her hand to her head. “I know. I am nervous,” she replied. “I know. Just take your time. Think it through,” I told her. There was more silence. I knew she probably was praying to get the abdomen for one of her check-offs. The bowel sounds gave me the clue. “What are you looking for when you are watching somebody breath?” I asked. “You have to look at the systimitry,” said Cindy. “Do you mean symmetry?” I ask. “Oh yeah. Symmitry,” she replied. She was close enough. Cindy stood in front of Kelly and with her hands motioned out and in. “Ummm. Well… Abdomen?” she asks. “She liked the abdomen,” I thought to myself. I proceeded to prompt her a little more to get her to say rate, depth, accessory muscle usage but it took a while. She was not as prepared as she should have been.

It was time for Cindy to auscultate (listen) the lungs. “I am going to listen for the appacal,” said Cindy. “You mean apical?” I asked. “Oh yeah. Appical,” she replied. It wasn’t part of the check-off for respiratory but I did not want to confuse her anymore than she was. She finally started to listen to the lungs. “Tell me what sounds you are supposed to hear where,” I said. “You will have brachial sounds here,” as she puts the diaphragm on one side of Kelly’s neck. “Do you mean bronchial sounds?” I asked. “Oh yeah. Branchial,” she replied. “Close enough,” I thought to myself. Cindy put the stethoscope on Kelly’s chest. “You should hear branchialvoscular sounds here,” she said. “Do you mean bronchovesicular?” I ask. “Oh yeah. Branchoviscular.” I knew the terms would come with time.

After Cindy was done with auscultating the lungs I asked her what abnormal sounds she may hear. She stood there for a while with the ear piece of her stethoscope still in her ears. I motioned to take the ear pieces out of her ears so she could hear. She did. I asked her again what abnormal sounds she may hear. She stood there for a while. “What if you have a cold or are an asthmatic?” I prompted her. “Oh. You can hear weezles,” she said. “Do you mean wheezes?” I asked. “Oh yeah. Wheezes,” she replied. We were done. Now it was Kelly’s turn. I made a mental note. “Work on medical terms with Cindy.”

Kelly looked at the cup with the remaining pieces of paper. There were five left. I knew she was thinking if Cindy picked a small piece and got what she did not want, she would pick one of the larger ones. She slowly opened up the paper and looked. I looked over her shoulder. She picked head and skin. I heard a small sigh. I prepared another grading sheet. “Okay. Begin,” I said. “Can you sit on the bed?” she asked Cindy. Cindy complied and was happy she was done with one of her assessments. “Well, you look at the face sysmetry and the color,” she said as she placed her hands on Cindy’s face feeling her skin. “Do you mean symmetry? I asked. “Oh. I made the same mistake as Cindy huh?” she replied. “That’s okay. Just keep going. You’re doing well,” I responded. She continued to look at Cindy’s face. “I need to check her popples,” she said. “Do you mean pupils?” I asked. “Yeah. Popples,” she replied. Kelly had a little of an accent. Maybe that was as close as she could get. “She’s not paler,” said Kelly. I stood there for a while. “Do you mean pale?” I asked. “Yes. Pale. She’s not,” she responded.

Kelly continued to work her way down Cindy’s face and skin on her body. “What are you looking for when you are looking at the skin?” I asked. I knew she was stuck. “Well, you would look for cuts and bumps and migules,” she responded. “It’s okay if you called them moles for now until you get used to the term. They are called macules if they are flat and papules if they are raised,” I said. “Ok.” She continued feeling Cindy’s skin and naming every little bump and moles she had on her legs. Then we were done. Now it was time for Cindy to assess her second system and repeat it with Kelly. There were 26 students left. It was going to be a long morning. Cindy picked neuro for her next assessment.  

Medical Assistants Learning Medical Terminology

As with anything in life, persistent study and practice is what makes your knowledge of medical terms stronger. There are various methods, which can be utilised, and all are successful in their own way. The more methods you can use to learn medical terminology, the better understanding you will have. Below are various methods, which can be used.


Aural
There are many software programs, which you can use to study medical terms via the aural method. These programs will have most terms on a CD, which are played with an interval, which allows you to repeat the term. It then gives you the definition of that term. Over time, you will benefit by this study method as it allows you to leave the books and concentrate on the terms, their correct pronunciation, and their meanings.


Internet
The Internet has many online medical terminology dictionaries and resources. The majority of these are free which will allow you to practice effectively. These resources will usually cover all of medical terminology reviews consisting of:

· Prefixes
· Suffixes
· Root Words
· Medical Terms
· Medical Abbreviations
· Medical Definitions
· Surgical Abbreviations
· Diagnostic Abbreviations


Medical Dictionaries
Dictionaries such as the Mosby’s Medical, Nursing, and Allied Health have a dedicated section on Medical terminology. It assists with the breaking down of combining forms, roots or stems, prefixes and suffixes of a term. There is also the option of online medical dictionaries found on the Internet.

Mosby’s Medical terminology is categorised under:

Prefixes Suffixes Roots and combining forms in external anatomy Roots and combining forms in internal anatomy Greek and Latin verbal derivatives Greek and Latin adjectival derivatives Miscellaneous words and combining forms.


Flash/Cue Cards
One of the best methods of learning terminology is to use Flash cards, which has the term on one side and the definition on the other side. There is software, which will allow you to enter your own terms and definitions and will work based on random selections.


Writing the term down
After some time, the student will be able to recognise enough terms and their definitions to begin writing them down. Another person calling out either the term or the definition can assist via this method. The student is then able to recall their medical terminology knowledge. This is one of the best methods as it allows tests to take place.


Anatomical specific
Another method is to select an anatomical part of the body and write down or verbalise as many terms pertaining to that part of the body. This will enhance your body specific knowledge greatly.

Medical words of the moment

Over the past few months I’ve been steadily collecting medical terms that I like. To make them last longer I’ll try to dole them out across a few posts. Also, I’m sure I’ll continue to identify other cool ones as time goes on, so watch for updates.

hyperammonemia - the presence of an excess of ammonia in the blood [This one holds a special place in my heart because I encountered it on my first day as a medical editor. Terms like that proved the new job would definitely be a change from editing elementary school math textbooks.]

[Actually, I kind of like all -emia words. Some examples:]
hypercalcemia - the presence of an excess of calcium in the blood

hyponatremia - deficiency of sodium in the blood

Note: Although AMA and my work both use Stedman’s as the preferred medical dictionary of reference, I plan to use slightly abridged definitions from the online Merriam-Webster’s Medical Dictionary for their broad appeal (you don’t have to look up another definition for a word that’s describing the definition you actually want to know - that’s always a turnoff).

Cool brain and drug words

At work recently we’ve been editing materials about sleep disorders and their treatments, especially in elderly patients. Last week a set of slides on that topic netted lots of cool-sounding medical words:

suprachiasmatic nuclei - A pair of neuron clusters in the hypothalamus [in the brain] that receive light input from the retina via the optic nerve and that regulate the body’s circadian rhythms.

alpha synucleinopathies - A class of neurodegenerative disorders (such as Parkinson’s disease, certain types of dementia, and multiple system atrophy) that are caused by alpha-synuclein (alpha-SN) accumulating on vulnerable neurons.

fluoxetine - An antidepressant drug that enhances serotonin activity (better known as Prozac).

mirtazapine - A tetracyclic antidepressant (better known as Remeron).

venlafaxine - An antidepressant drug that acts by inhibiting the reuptake of serotonin and norepinephrine by neurons (better known as Effexor).

pramipexole - A dopamine agonist used treat the symptoms of Parkinson’s disease (better known as Mirapex).

anticholinesterase inhibitors - A class of drugs that decrease breakdown of the acetylcholine (a chemical messenger in the brain) and can be used in conditions where there is an apparent lack of this messenger transmission, such as in Alzheimer’s disease.

5 yr degree program in pharmacy

 Recently, the Pharmacy Council of India (PCI) has proposed a plan to start a 5-year PharmD program in India. The PCI has selected 20 pharmacy institutions in India and submitted the proposal to the Indian Ministry of Health and Family Welfare for their review and approval. The idea is to educate and train pharmacy students in India to meet the shortage of pharmacists in Indian hospitals and also to match the entry-level PharmD curriculum in the United States. The National Association of Boards of Pharmacy (NABP) new requirement that a foreign pharmacy graduate have 5 years of pharmacy education before applying to take the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) in order to then take the North American Pharmacist Licensure Examination (NAPLEX) and finally obtain a license to practice pharmacy in the United States is the key reason for this change in pharmacy education in India.1-4 The movement towards a clinically oriented curriculum is already afoot and we believe more countries in the Indian subcontinent and around the world will soon follow the PCI decision.5 In fact, many pharmacy institutions in India, like Jadavpur University have started offering a master of science (MS) course in clinical pharmacy to expand upon the basic pharmaceutical courses in the 4-year curriculum. Dr. Dutta, a Jadavpur University alum, was invited to his alma mater to provide a workshop for the faculty in teaching clinical courses to pharmacy students. We believe that students with advanced training in clinical courses meet the 5-year pharmacy requirement for taking the FPGE. Currently, Jadavpur University is identifying us universities to establish collaborative faculty and student exchange programs in pharmacy whereby faculty members from both institutions can visit the host institution to gain valuable experience in teaching and research. Jamia Hamdard (Hamdard University), Dr Ghilzai's alma mater, has also started an MS course in pharmacy practice at the Faculty of Pharmacy.

The course is sponsored by Faculty of Pharmacy with Hamdard's Hospital and will be of 2 years duration, out of which 2 semesters will cover course work and another 2 semesters will be devoted to a research project and practice experiences to be undertaken in the Hospital. The new course has been established in Hamdard Hospital and the facility of Drug Information Services, which also publishes a bimonthly newsletter on the current drug information, has already been developed. Besides pharmacy faculty members, 2 clinicians from Hamdard's Hospital are associated with this course.

We really appreciate the PCI decision, which came after a visit by the Accreditation Council for Pharmacy Education (ACPE) delegation to India to meet with the PCI. Although this bold decision came very late, it is a positive step in the right direction to popularize pharmacy education and to graduate skilled and knowledgeable pharmacist who can work in clinical settings and counsel and manage drug therapy and improve patient's health care.

Until now, Indian pharmacy graduates have been mainly trained to work in the pharmaceutical industry as product and formulation scientists. Pharmacy education in India has mainly focused on pharmaceutical sciences courses, while clinical or pharmacotherapeutic courses have received far less coverage in the curriculum and no students have ever undergone pharmacy practice experiences. According to one article, there are over 600 pharmacy colleges and schools in India producing over 13,000 pharmacy graduates yearly.

In the last few years, the issue was hotly debated and discussed throughout India to get a consensus to revamp the pharmacy curriculum. It is suggested that the new pharmacy curriculum will entail courses in pharmacogenomics and biotechnology and a significant portion of the curriculum will focus on pathphysiology, pharmcotherpaeutics, and practice experiences.

According to one article, there are over 600 pharmacy colleges and schools in India producing over 13,000 pharmacy graduates yearly.

In the last few years, the issue was hotly debated and discussed throughout India to get a consensus to revamp the pharmacy curriculum. It is suggested that the new pharmacy curriculum will entail courses in pharmacogenomics and biotechnology and a significant portion of the curriculum will focus on pathphysiology, pharmcotherpaeutics, and practice experiences.
The All India Council for Technical Education (AICTE) is a statutory regulatory body for technical education in the country that had been limited to overseeing technical education. However, in 2003, the AICTE announced that it will constitute a National Engineers Registration and Licensing Board (NERLB) to provide registration and licenses for practice of engineering in India. We would suggest that the PCI should work in close association with the AICTE to introduce and mandate a similar national board examination for pharmacy graduates to qualify to practice pharmacy in India.

We have contributed twice here in the past to raise the issue of pharmacy education in India and in those letters we suggested that pharmacy education in India needed to be more clinically oriented. We personally appreciate the PCI's decision to explore and involve an international accreditation agency and also congratulate the ACPE for supporting the PCI.
We would like to thank AJPE for promoting the cause of pharmacy education in foreign countries. Many foreign pharmacy graduates are employed as pharmacy educators in US colleges and schools of pharmacy. Also, foreign pharmacy graduates constitute a large and growing number of the total pharmacist workforce in some US states.
REFERENCES
1.
Ghilzai NK. In response to the letter entitled, “Pharmacy Graduates from Foreign Countries Flooding US Job Market” [letter]. Am J Pharm Educ. 2004;68(1) Article 23.
2.
Dutta A. In response to the letter entitled, “Pharmacy Graduates from Foreign Countries Flooding US Job Market” [letter]. Am J Pharm Educ. 2004;68(1) Article 23.
3.
Dutta A. The FPGEE Curriculum Requirement: An Insurmountable Hurdle? [letter]. Am J Pharm Educ. 2005;69(5) Article 105.
4.
Ghilzai NK. New FPGEE Guideline [letter]. Am J Pharm Educ. 2006;70(2) Article 46.
5.
Babar ZU. Pharmacy Education and Practice in Pakistan [letter]. Am J Pharm Educ. 2005;69(5) Article 105.

Future of Indian Pharmacy!

Guys i jus wann we people to discuss our thoughts on why pharmacy proffesion is lagging behind in india?
why dont we have respectable oppurtunities like engineering,Medicine.(lack of funds in univ to run reaserch)
We all have been listening to word GLOBALISATION for a long time.How it can benifit we students..
I wish our students to open our minds and make some thing good to our profession!
he Educational Infrastructure will continue to churn out Pharmacy Graduates as it has been doing successfully since maybe forever, in regards to the Profession of Pharmacy and the career as such, Pharmacy graduates at least in India need to create a niche for the Pharmacy profession. The Pharmaceutical industry seems to be indifferent to the Pharmacy graduates, folks I am not complaining here, myself an average or possibly a below average graduate, can't think of competing for a satisfactory career in India, glad to know that few multinationals are outsourcing the clinical trials, and generics production to India. Individuals who decided to work in India are doing well. The world is rethinking its approach to Globalization. Globalization as far as i know is the use of resources in an optimal way to create wealth. Developing nations and "Third world" are finding themselves at the short end of the bargain, the evidence is the complications in the WTO talks, well "complications" is just an euphemism the word is FAILURE. Traditional economics emphasize Globalization is a good thing, Nuclear Physicist turned activist Ms. Vandana Shiva argues otherwise. hey am i talking philosophy here, got to stop!
comments and critics appreciated.

Future of Pharmacy Informatics

Pharmacy informatics will likely continue to grow in its scope and importance for some time. When, in 1999, the Institute of Medicine (IOM) published the report To Err is Human, the pharmacy community was at once called out for allowing unsafe medication management practices to preponderate and called upon to dramatically improve the safety of medication use in the United States. The Institute for Safe Medication Practices (ISMP, [4]), a leading patient safety organization, is well positioned to advance medication safety efforts. ISMP continues to focus on pharmacy informatics and patient information management as key areas of both promise and concern, promise that the application of new information technologies will improve patient safety and concern that the diffusion, adoption and best-practice use of medication management technologies is happening too slowly. Time will tell if pharmacy informatics, as an area of applied information sciences and as a sub-discipline of health informatics, will indeed positively transform medication use so that patients benefit from improved safety and efficacy with respect to the medications they require.

History and Trends in Pharmacy Informatics

The application of computerized information technology to pharmacy practice, including highly specialized software and hardware, is not new. In fact, the term pharmacy informatics is much newer than the domain it specifies. Pharmacists, computer scientists and other specialists brought the first generation of pharmacy-specific computer technology to retail and hospital pharmacies in the 1970s through the 1990s.

A present, major trend in pharmacy informatics is to move from pharmacy-specific systems to larger, fully-integrated information systems that include pharmacy functions as a component of larger clinical information systems, retail prescription management systems and drug supply chain management systems. Another major trend is the accelerating technology diffusion of computerized provider order entry (CPOE) for medication orders in hospitals and electronic prescribing (e-Prescribing) of prescriptions sent via networks from physician offices to retail pharmacies.

Pharmacy informatics professional activity has been growing demonstrably over the past several years. For example, the American Society of Health-System Pharmacists (ASHP) created a new organizational section in 2006, the Section on Pharmacy Informatics and Technology (SOPIT), that is expressly, "dedicated to improving health outcomes through the use and integration of data, information, knowledge, technology, and automation in the medication-use process." Also, the American Medical Informatics Association (AMIA, [1]) has created a pharmacoinformatics working group to, "promote interaction among AMIA members who are interested in the intersection of technology and medication management."

As a profession, pharmacy practice encompasses many different practice venues including retail, community pharmacy, hospital pharmacy practice, long-term care, mail-order and others. This diversity of pharmacy practices is reflected by a like diversity of stakeholder groups interested in pharmacy informatics and the automation of the drug supply chain. One group, the American Society of Automation in Pharmacy (ASAP, [2]) is notable for its retail-oriented mission, "to assist its members in advancing the application of computer technology in the pharmacist's role as caregiver and in the efficient operation and management of a pharmacy."

In the academic sphere, as of July 1, 2007, pharmacy informatics is a required component of professional pharmacy degree programs. The latest standards from the Accreditation Council for Pharmacy Education ([3]) require colleges of pharmacy to address pharmacy informatics within their curricula. ACPE expects Doctor of Pharmacy graduates to be familiar with informatics terminology, justifications for systemic processing of data and the consequences, both advantageous and undesirable, of using technological information and communication innovations in healthcare.

Pharmacy informatics practitioners put their energies toward creating standardized, high-reliability workflows developed through an integral approach that aligns the physical-chemical characteristics of drug products, pharmacy staff needs and requirements, work process expectations and outputs, and available information, machine and robotics technologies. The practice of pharmacy informatics also may involve drug information analysis, project management, customer and vendor relations, communications, system administration, technical troubleshooting, computer programming, contracting and business leadership.

Pharmacy Informatics

Pharmacy informatics, also referred to as pharmacoinformatics, is the application of computers to the storage, retrieval and analysis of drug and prescription information. Pharmacy informaticists work with pharmacy information management systems that help the pharmacist make excellent decisions about patient drug therapies with respect to, medical insurance records, drug interactions, as well as prescription and patient information.

Pharmacy informatics is the study of interactions between people, their work processes and engineered systems within health care with a focus on pharmaceutical care and improved patient safety.

Pharmacy informatics can be thought of as a sub-domain of the larger professional discipline of health informatics. Some definitions of pharmacy informatics reflect this relationship to health informatics. For example, the Health Information Management Systems Society (HIMSS) defines pharmacy informatics as, "the scientific field that focuses on medication-related data and knowledge within the continuum of healthcare systems - including its acquisition, storage, analysis, use and dissemination - in the delivery of optimal medication-related patient care and health outcomes"

The future of pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists will be paid for their patient care skills.[9]

This shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. In the United Kingdom, pharmacists (and nurses) who undertake additional training are obtaining prescribing rights. They are also being paid for by the government for medicine use reviews. In the United States, pharmaceutical care or Clinical pharmacy has had an evolving influence on the practice of pharmacy.[10] Moreover, the Doctor of Pharmacy (Pharm.D.) degree is now required before entering practice and many pharmacists now complete one or two years of residency or fellowship training following graduation. In addition, consultant pharmacists, who traditionally operated primarily in nursing homes are now expanding into direct consultation with patients, under the banner of "senior care pharmacy.

Separation of prescribing from dispensing

In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. Specifically, the legislation stipulates that the practice of prescribing must be separate from the practice of dispensing.[citation needed] These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments. However, the American Medical Association (AMA) Code of Ethics provides that physicians may dispense drugs within their office practices as long as there is no patient exploitation and patients have the right to a written prescription that can be filled elsewhere. 7 to 10 percent of American physician practices reportedly dispense drugs on their own.[8]

In other jurisdictions (particularly in Asian countries such as China, Hong Kong, Malaysia, and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is sometimes integrated with that of the physician, particularly in traditional Chinese medicine.

In Canada it is common for a medical clinic and a pharmacy to be located together and for the ownership in both enterprises to be common, but licensed separately.

The reason for the majority rule is the high risk of a conflict of interest. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects. This system reflects much similarity to the checks and balances system of the U.S. and many other governments.

A campaign for separation has begun in many countries and has already been successful (like in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia).

Pharmacy informatics

Pharmacy informatics is the combination of pharmacy practice science and applied information science. Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or for healthcare information technology vendor companies. As a practice area and specialist domain, pharmacy informatics is growing quickly to meet the needs of major national and international patient information projects and health system interoperability goals. Pharmacists are well trained to participate in medication management system development, deployment and optimization.

Military pharmacy

Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal. State laws of Technician patient counseling and medication checking by a pharmacist do not apply.

Nuclear pharmacy

Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients.

Veterinary pharmacy

Veterinary pharmacies, sometimes called animal pharmacies may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill the pharmaceutical needs of animals. Because the needs of animals as well as the regulations on veterinary medicine are often very different from those related to people, veterinary pharmacy is often kept separate from regular pharmacies.

Internet pharmacy

Since about the year 2000, a growing number of Internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as Online Pharmacies) are also recommended to some patients by their physicians if they are homebound.

While most Internet pharmacies sell prescription drugs and require a valid prescription, some Internet pharmacies sell prescription drugs without requiring a prescription. Many customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There also have been reports of such pharmacies dispensing substandard products. Of course as history has shown, substandard products can be dispensed by both Internet and Community pharmacies, so it is best that the buyer beware.

Of particular concern with internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin, generically known as hydrocodone) via the internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are many instances where a practitioner issues a prescription, brokered by an internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship.

Canada is home to dozens of licensed Internet pharmacies, many which sell their lower-cost prescription drugs to U.S. consumers, who pay the world's highest drug prices.[citation needed] In recent years, many consumers in the US and in other countries with high drug costs, have turned to licensed Internet pharmacies in India, Israel and the UK, which often have even lower prices than in Canada.

In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.

Consultant pharmacy

Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work in nursing homes, but are increasingly branching into other institutions and non-institutional settings.[7] Traditionally consultant pharmacists were usually independent business owners, though in the United States many now work for several large pharmacy management companies (primarily Omnicare, Kindred Healthcare and PharMerica). This trend may be gradually reversing as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services.

Compounding pharmacy

Compounding is the practice of preparing drugs in new forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated lollipop that contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead.

Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies.

Clinical pharmacy

Clinical pharmacists provide direct patient care services that optimizes the use of medication and promotes health, wellness, and disease prevention.[6] Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside Hospitals and clinics. Clinical pharmacists often collaborate with Physicians and other healthcare professionals. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They work collaboratively with physicians, nurses and other healthcare personnel in various medical and surgical areas.

Hospital pharmacy

Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues.

Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) and patient compliance issues ( in the hospital and at home) many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy. For example, there are pharmacists who specialize in haematology/oncology, HIV/AIDS, infectious disease, critical care, emergency medicine, toxicology, nuclear pharmacy, pain management, psychiatry, anticoagulation clinics, herbal medicine, neurology/epilepsy management, paediatrics, neonatal pharmacists and more.

Hospital pharmacies can usually be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding.

Community pharmacy

A pharmacy (commonly the chemist in Australia, New Zealand and the UK; or drugstore in North America; retail pharmacy in industry terminology; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers.

Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications; there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients.

All pharmacies are required to have a pharmacist on-duty at all times when open. In many jurisdictions, it is also a requirement that the owner of a pharmacy must be a registered pharmacist (R.Ph.). This latter requirement has been revoked in many jurisdictions, such that many retailers (including supermarkets and mass merchandisers) now include a pharmacy as a department of their store.

Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional household items such as cosmetics, shampoo, bandages, office supplies, confectionary, and snack foods.

Japanese pharmacy

In ancient Japan, the men who fulfilled roles similar to those of modern pharamacists were highly respected. The place of pharmacists in society was expressly defined in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists -- and even pharmacist assistants -- were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor

Chinese Pharmacy

The beginnings of pharmacy in China are ancient. It stemmed from Chinese alchemy. Shennong is said to have tasted hundreds of herbs to test their medical value. The most well-known work attributed to Shennong is The Divine Farmer's Herb-Root Classic. This work is considered to be the earliest Chinese pharmacopoeia. It includes 365 medicines derived from minerals, plants, and animals. Shennong is credited with identifying hundreds of medical (and poisonous) herbs by personally testing their properties, which was crucial to the development of Traditional Chinese medicine.

Pharmacists

Pharmacists are highly-trained and skilled healthcare professionals who perform various roles to ensure optimal health outcomes for their patients. Many pharmacists are also small-business owners, owning the pharmacy in which they practice.

Pharmacists are represented internationally by the International Pharmaceutical Federation (FIP). They are represented at the national level by professional organisations such as the Royal Pharmaceutical Society of Great Britain (RPSGB), the Pharmacy Guild of Australia (PGA), the Pakistan Pharmacists Society(PPS) and the American Pharmacists Association (APhA). See also: List of pharmacy associations.

In some cases, the representative body is also the registering body, which is responsible for the ethics of the profession. Since the Shipman Inquiry, there has been a move in the UK to separate the two roles.

sidhhamdicne for heart disese

there are so many variets of heart diseases are there.. according to the variety and severity we have to take mode of therapy....
some conditions need only surgery... tof or valve replacement like kind of diseases.... but in case of cardiac failure or single or double vessel diseses we can try siddha medicine vaai.. arrithamyas.. irregular heart beats.. some commn medines are arunja marutham pattai. avaram poo thamaraipoo and orthalthamarai semparuthi powders vey good for heart.. and also some combination avail.. then garlic pepper.. vanga parpam.. thamira parpam silver parpam available.

Healing heart diseases

endocarditis,heart valve diseases,various symptoms of pericardium,various symptoms of the heart itself,palpitation,angina pectoris,and all known and unknown heart related problems....

heal the following points 3 minutes each....
heart
liver
stomach
intestines
pancreas
kidneys
spinal cord

important:
healing the heart from the back instead of chest side is always better and safer,particulaly if devices like pacemaker are installed,never heal from the chest side.

2nd degree healers can use the sympols to purify and heal the above points.i personally prefer the 1st degree hands on healing.

try this technique.it works fast.