I'll start this off with the disclosure that this blog is about my experiences and is in no way to represent the opinions of the Project HOPE organization as a whole...that being said buckle up...this will be in true Heather Heskett fashion: blunt and often disjointed thoughts, lacking nearly all proper punctuation and hopefully entertaining and informative
Thoughts before I leave…
I am both
anxious and excited for this upcoming rotation. Anxious because you never know
what to expect with all new places and people (that dreaded 1st day of school feeling). I’m embarking on this journey with Emily…she still counts as new
because I’ve only seen/talked to her through VTC/Facebook a couple of times...we’ll
actually meet for the first time at the airport. Another source of anxiety is that I don’t know ANY spanish. However, the
anxiousness fades fairly quickly as I prepare for what is ahead and watch this motivational speech:
Here’s the short list
of things I’m excited about:
1. Uh hello I’M ON A BOAT!
2. I don’t have to “dress
up”! (This might very well be #1…after all I was “most likely to wear
sweatpants”)
A uniform is very much welcomed in my book since I don’t have to worry
about doing my hair (YAY for hats) or putting together a stylish professional outfit.
3. Project HOPE has been around longer than the Peace Corp so clearly they know
what they are doing and I'm someone who craves efficiency and a plan.
Some of you may be wondering: What does Project HOPE do?
When you go on
their website (http://projecthope.org/) there is an extensive list but the summary is: “Project HOPE
delivers essential medicines and supplies, volunteers and medical training to
prevent disease, promote wellness, respond to disaster and save lives around
the globe.” Now what did I take away from that statement?
ESSENTIAL: (adjective)
absolutely necessary; extremely important.
We are so lucky to live in
America…land of the free, home of the brave…where many think a morning
Starbucks coffee is essential to daily life. Louis C.K. puts it in perspective...
While first-world-problems.com and the assortment of Internet
memes provide plenty of entertainment...I get the opportunity to experience a totally different
side of the world and hopefully witness what it is really like to be able to
provide the very definition of essential healthcare to more than deserving patients. In
our country we have Urgent Cares and MedClinics on nearly every corner making access to healthcare easier than setting up a successful LinkedIn profile…who knows how often these
patients get healthcare attention? I will not take these experiences lightly!
What do I know about the places I will be visiting?
We will
be in port at Buenaventura, Colombia…all it takes is quick Google search to
know it is not the place you want to be
Here’s a
link for you to read at your leisure:
Next stop: Roseau, Dominica
Now to tie it all back to pharmacy...after all this is part of my APPE 4th year rotations
Preparing for Malaria
Prophylaxis
· From Lexicomp:
·
MALARONE: Atovaquone and Proguanil (a TOE va
kwone and pro GWA nil)
o
Prevention of malaria (prophylaxis):
Atovaquone/proguanil 250mg/100mg once daily starting 1-2 days prior to entering
a malaria-endemic area, continue throughout the stay and for 7 days after
returning
o
Administer with food or milk-based drink at the
same time each day
o
Adverse reactions: abdominal pain, N/V (nausea/vomiting), elevated LFTs (liver function tests)
§
Less common: HA (headache), dizziness, pruritus, diarrhea,
anorexia, neuromuscular and skeletal weakness
o
MOA (Mechanism of Action):
§
Atovaquone: selectively inhibits parasite
mitochondrial electron transport
§
Proguanil: the metabolite cycloguanil inhibits
dihydrofolate reductase, disrupting deoxythymidylate synthesis.
§
Together: atovaquone/cycloguanil affect the
erthrocyctic and exoerythrocyctic stages of development
o
Atovaquone: >99% protein binding, Proguanil: 75% protein binding
o
Metabolism: Proguanilàhepatic to active metabolites:
cycloguanil (via CYP2C19) and 4-chlorophenylbiguanide
o
Bioavailability: 23% when administered with food
·
Why no doxycycline? Because I didn’t want to
deal with the photosensitivity and esophageal erosion...my twin sister took
doxycycline for awhile and was so nauseous she couldn’t even…So why? Why? Why would I put myself through that when I’m expecting to already be motion sick
half the time?
"It's not your life, it's life. Life is bigger than you. Life isn't something that you possess, it's something that you take part in and you witness" - Louis C.K.
#firstblogEVER #HOPEyoulearnedsomething #moretocome #2LouisCKquotes?
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