Fall PY2 Week 1

Classes have officially begun on a new school year!  The PharmD program always begins a week earlier than the rest of the university, but then we also finish earlier too.  As expected, this was a week of introductions.  But any excitement for the new year was quelled by a family trauma.

Augi had a ruff week

To start the week, I had an afternoon meeting of CAPS leaders.  Deciding to get to campus early and work a little in the library, I took the dogs out for their last pee break about 10 am.  After a few moments of running around like normal, Augi got a weird look on his face.  He stopped moving and stood in place.  I had to tug on him to get up the stairs and into the house.  I thought he was going to throw up or have a problem on the other end.  He didn't respond to any commands or even his name.  He just laid down struggling to breathe through his very white mouth.  I called the vet who told me to go to the emergency vet immediately.

Getting a collapsing Augi into the back of an SUV was not easy, but he was in the emergency room within 30 minutes of showing signs of shock - white gums, cold ears and limbs, unresponsive.  He did not care about any of the people in the waiting room.  And the nurse had to put him on a gurney to take him back.  The scariest part was signing a sheet to authorize CPR on a dog, which is $600 and has a 10% success rate.  The vets in the emergency room did a great job though.  He was hooked up to fluids immediately and started getting some tests done.  He started getting fluid in his abdomen and had low platelets and high ALT.  Augi was in Acute Liver Failure.  The cause is still unknown.  Maybe a mushroom or some kind of infection.  But thanks to the staff at the Vet Specialty Hospital of Durham, Augi is back at home after 3 days in the ICU.  We are still worried about him and giving him a wide assortment of medications.  Most importantly though, he is home again.

So a lot of my enthusiasm for the beginning of classes was diverted toward worrying about Augi and Emily.  But I did have some excitement and learned a lot in just three days.

Monday - No classes yet.  
We had a CAPS Leaders Meeting at 1 pm, which I was late to.  My main role that day was to take the pictures of the leaders.  Sounds easy, but for some reason I am missing quite a few people.  Some of my spare time this week was spent updating the CAPS website.

Tuesday - Official first day of classes.
Our first class of the day begins at a lazy 9 am - two hours of Drug Literature.  After some introductions, the Drug Information Specialist at UNC Hospitals began the first of three classes.  This is all about how to handle requests for information from doctors, nurses, or patients about a medication.  Most important message - understand the question.  All requests fit into some kind of category - Interactions, Reactions, Compatibility, etc.  Knowing what kind of question you have lets to pick the right resource and tailor your response.  Remember, an expert is not someone that knows all the answers, but the most efficient way of reaching it.

After Drug Lit, we were introduced to Medicinal Chemistry.  The professor went over the syllabus and that class ended in about 15 minutes.  After lunch we met with Pharmacotherapy.  Our first unit is dermatology and we jumped right in.  We had to review 100 slides before class to be ready to go over the first set of cases.  Not to bad.  Remember to moisturize, moisturize, moisturize.

Wednesday
During registration I chose the Wednesday morning lab.  I like it.  We met the professors in charge of the class, and then headed to our groups.  My group was very quiet, but efficient.  I think I decided I am ready to take the lead in the small section.  I want to assert myself and answer questions.  Taking the backseat just gets you through.  For the agenda, we took a quiz (23/25) and went over the drugs for next week's quiz.  For compounding today, we made a hydrocortisone semisolid in what looks like a deodorant stick.  The process was more complicated than I expected.  We used beeswax as the stiffening agent, which had to be melted.  No problem there until you remove the heat.  Beeswax cools incredibly quickly, even when mixed with mineral oil and hydrocortisone.  I cannot guarantee that my compound will pass inspection this time around.  I may be going back to redo it in a couple weeks.

After lunch, we had Pharmacokinetics.  As another introductory class, the professor explained the course and his travels over the summer.  Mostly he was making time until the Dean showed up for the second hour.  The Dean talked about the tragedy of a professor that was murdered over the summer just off campus and the changes to the school.

Thursday
The courses are a repeat of Tuesday's schedule, but we did more work.  In Drug Lit, we went over the Tertiary Sources for Drug Information.  These are the textbooks or databases that we all search online.  I have two booked marked on my computer.  There are some resources that are specific to certain questions, especially IV drugs or Pregnancy questions.  Essentially, a tertiary source provides a summary of the research available.  Some are more detailed and others are more specialized.  It is just important to know where to look for what information.

MedChem had one of my favorite professors reviewing some terms.  Autocoids are signaling molecules that usually send information over a short distance.  They usually activate a GPCR (G-Protein Coupled Receptor).  All of this was covered last year in Biochem and Therapy.

Dermatology was very similar to the previous class.  This time we talked a lot about fungal infections like dandruff and an allergic reaction to codeine.  The answers are fairly similar.  If it itches, take diphenhydramine (Benadryll).  If it is inflammed, a steroid should work (hydrocortisone, triamcinolone).  Always check the vehicle that carries the drug.  Creams, ointments, and lotions are not all the same thing.  Apparently, general practitioners only pick the right vehicle 50% of the time (they aren't dermatologists).  This is where the pharmacist can intervene and make sure the patient gets the right combination.

Friday - NO Classes
Friday is my day off.  Well, off is a relative term.  I hope to write my weekly update on Fridays.  And then I have a lot of work to do for the next week.  We already have our first SOAP Note due next week.  SOAP Notes are a patient case that we have to analyze and make recommendations for treatment options.  This one is about dermatology so I am sure moisturize will be one of the answers.