Thursday, June 20, 2013

Woops

Arsen pointed out to me that my last entry didn't include anything from our work week.  I swear I wrote it, but at any rate, I guess I'll give a quick summary again:

Monday, June 17th:

Today we spent the morning doing an extensive review of antibiotics.  We ran through everything from B-Lactam drugs to Tetracyclines.

Most of our discussion revolved around mechanism of action, coverage, and adverse events.  In addition to learning, we had the opportunity to teach Mr. Nayak about some of the intricacies in the drugs.  As pharmacy education emphasizes industry and simple dispensing over here, he was unsure why B-lactamase inhibitors such as Clavulanate in Augmentin were used.  Arsen and I explained to him how some microbes secrete enzymes that break down drugs as a mechanism of resistance.  These inhibitors are given with the drug to prevent the bacteria from destroying the medication.

After our review, Mr. Nayak started to quiz us out of the pharmacy license exam prep book that we have talked about earlier.  These questions were a mix of very useful ones for US pharmacists and also ones specific to Indian medications.  There were also many questions about Ayurvedic medicine as this Ayurvedic medicine apparently got it's start in India.

Tuesday, June 18th:

We continued our Q&A regarding antibiotics today.  After a while, we urged Mr. Nayak to include questions from all areas of medicine.

(Really... I promise this section was longer, but 3 days removed makes it a bit difficult to remember)

Wednesday, June 19th:

On Wednesday Mr. Nayak was on leave so we were entrusted to the direction of Mr. Vasu, his 2nd in command.  We spent most of our time in the Inpatient Pharmacy learning the procedure for specialty departments regarding prescriptions.

In the morning during rounds (or at admission), the attending physician makes up the prescriptions each person will need for the entire day in a carbon copy book.  This book is taken to the pharmacy where the original is used to fill the prescriptions and then filed.  The pharmacists make the bills at this time and send them to the discharge center where they are either processed through insurance or the public assistance program, or prepared for cash collection.

The prescription copies are sent back to the ward where the nursing staff double checks the order upon receipt.

It was interesting to see this system work without the complexities of hospitals in the states.  The pharmacists are responsible for 90% of the billing.  The last 10% is the simple act of sending the bill to the company paying for the services.

Sorry for the mixup!!!  Also sorry for the lack of pictures!!!  There are far more reasons to take pictures on Sunday than during the week.  

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