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藥劑連線
試左生活習慣先，同埋可以用啲輕啲嘅暗瘡膏，唔洗下下食藥
跟住觀察1 - 2 個月，睇下有冇改善先再決定洗唔洗睇醫生
不過，因為暗瘡有分grade，如果巴打你暗瘡好嚴重
成塊面都係又出濃咁，都係要睇醫生的
跟住觀察1 - 2 個月，睇下有冇改善先再決定洗唔洗睇醫生
:^(
不過，因為暗瘡有分grade，如果巴打你暗瘡好嚴重
成塊面都係又出濃咁，都係要睇醫生的
藥劑連線
似濕疹生係眼皮
但你個位太近眼，我會建議你買啲無藥啲潤眼膏 (笠啲個啲最好)
跟住拎棉花棒當潤膚膏搽，因為本身潤眼膏都可以入眼所以好過用普通潤膚膏個啲 (個啲入眼會刺激同埋冇眼膏咁乾淨)
一日 3-4 次，試1-2 星期睇下有冇改善先，你個問題要有耐心，可能要做長期鬥爭
同埋儘量唔好R，因為所有皮膚問題都係越R越痕的
一痕就搽潤眼膏啦，跟住記得支潤眼膏跟返指示開蓋一個月就要換一支
如果完全冇用就可能要用類固醇啦，不過真係太近眼啦，所以儘量都唔好
(但我都有見專科醫生開過)
但你個位太近眼，我會建議你買啲無藥啲潤眼膏 (笠啲個啲最好)
跟住拎棉花棒當潤膚膏搽，因為本身潤眼膏都可以入眼所以好過用普通潤膚膏個啲 (個啲入眼會刺激同埋冇眼膏咁乾淨)
一日 3-4 次，試1-2 星期睇下有冇改善先，你個問題要有耐心，可能要做長期鬥爭
:^(
同埋儘量唔好R，因為所有皮膚問題都係越R越痕的
:^(
一痕就搽潤眼膏啦，跟住記得支潤眼膏跟返指示開蓋一個月就要換一支
如果完全冇用就可能要用類固醇啦，不過真係太近眼啦，所以儘量都唔好
(但我都有見專科醫生開過)
木頭人頭目
睇了一陣，長期係講緊1-2年起
維他命B12吸收下降*(有一定爭議)
鐵質吸收下降*
鎂吸收下降*
鈣吸收下降*
骨折*(被guidelines接受)
腺瘤性息肉病fundic gland polyps(唔少證據，但未被guidelines接受，可能存在爭議)
Johnson, D.A. 將有星個啲全部都認為有爭議.
下面有啲quote 你可以睇睇
B12:
"In a five-year LOTUS study, no difference was found in vitamin B12, folic acid, vitamin D, and calcium values in terms of the initial and end of follow-up levels" (Hatemi & Esatoglu, 2017)
"Decreased serum vitamin B12 concentration[/red] (long-term use >2 years)" (AMH, 2018)
Fundic polyps:
"In the meta-analysis of OBS, long-term (>1 year) PPI use increased the risk of fundic polyps, but no risk was found in shorter use"(Hatemi & Esatoglu, 2017).
"Conclusion We herein describe gastric black spots as a new gastric mucosal finding that arises only in the fundic gland region. Adverse events of PPIs and parietal cell protrusion caused by PPI use are strongly considered to be one of the etiologies of black spots."(Hatano, 2016)
"Long-term use of PPIs was noted in 39 (23.1%) patients in the FGPs group and in four (2.3%) patients in the control group. The difference in the long-term use of PPIs was statistically significant between the two groups (χ2=33.98,P<0.05, OR=12.83, 95% CI: 4.47–36.80)" (Hwang C. et al, 2014)
"Proton pump inhibitor usage is associated with a significantly increased prevalence of fundic gland polyps, and there is a trend for this to increase with longer length of PPI exposure. However, the meta-analysis is limited mainly to cohort studies." (Martin, Chenevix-Trench & Yeomans, 2016)
Fracture
"for patients at risk of osteoporosis and taking PPIs long term (>1 year) "(AMH, 2018)
Australian Medicine Handbook. 2018. Proton pump inhibitors
Hatano, Y., Haruma, K., Ayaki, M., Kamada, T., Ohtani, H., Murao. T., Manabe N., Mori, H., Masaki. T., Shiotani, A.. 2016. Black Spot, a Novel Gastric Finding Potentially Induced by Proton Pump Inhibitors. Internal Medicine. 55(21):3079-3084, 2016.
Hatemi, I.. Esatoglu, S.N.. 2017.What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?Turkish Journal of Gastroenterology. 28(Suppl 1):S57-S60, 2017 12.
Huang, C., Lai, R., Mai, L., Zhou, H., Chen, H.,Guo, H.. 2014.Relative risk factors associated with the development of fundic gland polyps. Medline.
Johnson, D.A.. 2016.Nutritional consequences of long-term acid suppression; are they clinically important? Current Opinion in Gastroenterology. Volume 32(2), March 2016, p 136–140
Martin, F. C., Chenevix-Trench, G., Yeomans, N. D.. 2016.Systematic review with meta-analysis: fundic gland polyps and proton pump inhibitors.Alimentary Pharmacology & Therapeutics. 44(9):915-925, 2016 11.
維他命B12吸收下降*(有一定爭議)
鐵質吸收下降*
鎂吸收下降*
鈣吸收下降*
骨折*(被guidelines接受)
腺瘤性息肉病fundic gland polyps(唔少證據，但未被guidelines接受，可能存在爭議)
Johnson, D.A. 將有星個啲全部都認為有爭議.
下面有啲quote 你可以睇睇
B12:
"In a five-year LOTUS study, no difference was found in vitamin B12, folic acid, vitamin D, and calcium values in terms of the initial and end of follow-up levels" (Hatemi & Esatoglu, 2017)
"Decreased serum vitamin B12 concentration[/red] (long-term use >2 years)" (AMH, 2018)
Fundic polyps:
"In the meta-analysis of OBS, long-term (>1 year) PPI use increased the risk of fundic polyps, but no risk was found in shorter use"(Hatemi & Esatoglu, 2017).
"Conclusion We herein describe gastric black spots as a new gastric mucosal finding that arises only in the fundic gland region. Adverse events of PPIs and parietal cell protrusion caused by PPI use are strongly considered to be one of the etiologies of black spots."(Hatano, 2016)
"Long-term use of PPIs was noted in 39 (23.1%) patients in the FGPs group and in four (2.3%) patients in the control group. The difference in the long-term use of PPIs was statistically significant between the two groups (χ2=33.98,P<0.05, OR=12.83, 95% CI: 4.47–36.80)" (Hwang C. et al, 2014)
"Proton pump inhibitor usage is associated with a significantly increased prevalence of fundic gland polyps, and there is a trend for this to increase with longer length of PPI exposure. However, the meta-analysis is limited mainly to cohort studies." (Martin, Chenevix-Trench & Yeomans, 2016)
Fracture
"for patients at risk of osteoporosis and taking PPIs long term (>1 year) "(AMH, 2018)
Australian Medicine Handbook. 2018. Proton pump inhibitors
Hatano, Y., Haruma, K., Ayaki, M., Kamada, T., Ohtani, H., Murao. T., Manabe N., Mori, H., Masaki. T., Shiotani, A.. 2016. Black Spot, a Novel Gastric Finding Potentially Induced by Proton Pump Inhibitors. Internal Medicine. 55(21):3079-3084, 2016.
Hatemi, I.. Esatoglu, S.N.. 2017.What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?Turkish Journal of Gastroenterology. 28(Suppl 1):S57-S60, 2017 12.
Huang, C., Lai, R., Mai, L., Zhou, H., Chen, H.,Guo, H.. 2014.Relative risk factors associated with the development of fundic gland polyps. Medline.
Johnson, D.A.. 2016.Nutritional consequences of long-term acid suppression; are they clinically important? Current Opinion in Gastroenterology. Volume 32(2), March 2016, p 136–140
Martin, F. C., Chenevix-Trench, G., Yeomans, N. D.. 2016.Systematic review with meta-analysis: fundic gland polyps and proton pump inhibitors.Alimentary Pharmacology & Therapeutics. 44(9):915-925, 2016 11.
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藥劑連線
係有機會
根據啲美國drug database資料顯示，個機率大概係：
Abnormal Ejaculation 異常射精 (1.2% to 7.2%)
Reduced Libido 性慾減少 (1.8% to 10%)
咁始終佢個藥理就係減少雄性荷爾蒙，有呢啲副作用都合情合理
如果真係驚自己係個1.2% - 7.2%，咁唯有用其他外用藥物
(詳情參考其他樓層，答過)
:^(
根據啲美國drug database資料顯示，個機率大概係：
Abnormal Ejaculation 異常射精 (1.2% to 7.2%)
Reduced Libido 性慾減少 (1.8% to 10%)
咁始終佢個藥理就係減少雄性荷爾蒙，有呢啲副作用都合情合理
:^(
如果真係驚自己係個1.2% - 7.2%，咁唯有用其他外用藥物
(詳情參考其他樓層，答過)
藥劑連線
其實呢樣野係外國好common，如果藥劑師有專科資格係要每7年考一次試的 (冇記錯的話)
而且每年續牌都要做一定數量嘅CE先可以續
就我個人而言，我係贊同架，因為咁樣先可以保持到行業嘅專業水平嘛
歡迎各位行家討論下
而且每年續牌都要做一定數量嘅CE先可以續
就我個人而言，我係贊同架，因為咁樣先可以保持到行業嘅專業水平嘛
:^(
歡迎各位行家討論下
:^(
木頭人頭目
藥劑其中一個職能就係做呢樣嘢
Check dose
Check route of administration
Check medication
甚至home medicine review
Check dose
Check route of administration
Check medication
甚至home medicine review
藥劑連線
想睇下有冇成份同Enzyplex差唔多
咁真係冇，因為佢個配方好綜合，有B雜，化氣藥，消化酶
(https://www.drugoffice.gov.hk/eps/drug/productDetail/en/consumer/31428)
而且我聽小道消息話佢間廠係今次出事後都打算改配方，等到香港再有得賣可能都講緊幾年後
如果真係想replace 佢，唯有
將 消化酶 (Combizym) + B雜 + 化氣藥 (Simethicone) 分開食了
btw 你有冇話食咩先會咁？ 有冇試過食益生菌？
咁真係冇，因為佢個配方好綜合，有B雜，化氣藥，消化酶
(https://www.drugoffice.gov.hk/eps/drug/productDetail/en/consumer/31428)
而且我聽小道消息話佢間廠係今次出事後都打算改配方，等到香港再有得賣可能都講緊幾年後
:^(
如果真係想replace 佢，唯有
將 消化酶 (Combizym) + B雜 + 化氣藥 (Simethicone) 分開食了
btw 你有冇話食咩先會咁？ 有冇試過食益生菌？
藥劑連線
以我所知 piracetam 同 pentoxifylline 應該有得賣個wor
而且唔洗醫生紙，兩隻都係Non-Poison
如果普通街房冇，你試下問下萬x，屈x 啲藥房，應該有得訂
(利申：非打手)
:^(
而且唔洗醫生紙，兩隻都係Non-Poison
如果普通街房冇，你試下問下萬x，屈x 啲藥房，應該有得訂
(利申：非打手)
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Oseltamivir
最好最好一定係清水 凍熱水都有啲影響 最好暖水
可樂咖啡茶一黎係弱酸性/弱鹼性 會影響藥物溶解 二黎咖啡因可以抑制某啲藥既代謝(姐係身體除走啲藥既速度慢左)
重有幾種飲品係要注意
一般唔建議病人用果汁送藥
特別係西柚汁 原因上面有講
牛奶都唔好 因為含鈣可以同藥物有chelation 影響吸收
同埋因為牛奶有油 又係會影響吸收
酒就唔使多解釋 用酒送某啲經肝代謝既藥係會死人
可樂咖啡茶一黎係弱酸性/弱鹼性 會影響藥物溶解 二黎咖啡因可以抑制某啲藥既代謝(姐係身體除走啲藥既速度慢左)
重有幾種飲品係要注意
一般唔建議病人用果汁送藥
特別係西柚汁 原因上面有講
牛奶都唔好 因為含鈣可以同藥物有chelation 影響吸收
同埋因為牛奶有油 又係會影響吸收
酒就唔使多解釋 用酒送某啲經肝代謝既藥係會死人
:^(
藥劑師咪可以上ward 做clinical 野 or 甚至係其他service，例如上門探訪做medication review
其實外國每個ward 都至少會有一個pharmacist
而香港就 ...... 全港嘅ward 加埋 clinical pharmacist 都唔知有冇50個