The post FGN ISSUES LASSA FEVER RED ALERT first appeared on CPAN WORLD.

The New National Executive Committee (EXCO) is to be Known as the “Consolidated Pioneer National EXCO of CPAN”.

THE MEMBERS OF THE CONSOLIDATED CPAN PIONEER NATIONAL EXCO are as follows.

1. Dr Joseph Madu FPCPharm, FPSN, PharmD.

(Chairman)

2. Dr (Mrs.) Maureen Ngozi Nwafor FPCPharm, PharmD.

(Vice Chairman)

3. Dr Moteehat Bukkie Olu-Lawal FPCPharm, MPH, PharmD.

(Secretary)

4. Dr (Mrs) Timipre Okeroghene Aghogho FPCPharm, PharmD

(Assistant Secretary)

5. Dr Obinna Nwanedo PharmD

(Finance Officer 1)

6. Dr Obiajuru Wayemeru PharmD.

(Finance Officer 2)

7. Dr Alphonsus Peter PharmD.

(Project Manager)

8. Dr Ibrahim Kolawole Bello FPCPharm, PharmD

(Public Relations Officer)

9. Dr Abdulmuminu Isah FPCPharm, PhD, PharmD.

(Edìtor in Chief)

10. Dr (Mrs.) Obianuju Onwuatuegwu FPSN, FPCPharm, PharmD.

(Unofficial member)

11. Dr Dauda Audi Dangiwa FPCPharm, FPSN, PharmD.

(Unofficial member)

12. Dr (Mrs) Daba Boyle FPSN, PharmD.

(Unofficial member).

CPAN!!! …………….. advancing direct patient care through Clinical Pharmacy

The post Minor Reshuflement in the Leadership of CPAN at the National Level as Approved by the National Council of the Association During Her Meeting of October 16th, 2021 first appeared on CPAN WORLD.

The post Rational Approach To The Management Of Scorpion Stings And Snake Bites: The Role Of The Pharmacists first appeared on CPAN WORLD.

CPAN RECOMMENDED STANDARD OPERATING PROCEDURES (SOPs) FOR ALL PHARMACISTS & CPAN MEMBERS IN NIGERIA/DIASPORA.

1)     Be professionally/ modestly/corporately or attractively dressed at all times.

A suit and a tie is highly recommended  for all males, while a sparkling white well ironed work coat with pharmacy logo is acceptable for both sexes.

2)     Address all your professional Colleagues (including junior colleagues) with their titles (eg. Pharm, Prof., Dr, etc) at all times, and not just their names alone.

When writing your name, endeavor to reflect the Profession against your name.

Examples include;

Pharm  ABC , Dr XYZ PharmD , Prof UVW FNAPharm etc .

You may also write Clinical Pharmacist in bracket when the situation is desirable for that.

3)     When Consulting with patients in a community Pharmacy, or at the patient’s Bedside in a hospital ward, emergency departments, nursing home, Managed Care clinics, Physician’s offices etc, please always remember that Patient Assessment ought to Precede all forms of treatment, recommendations or interventions.

Always adhere to utilizing the tools such as SOAP or FARM, and Never fail to document the care process.

If it is not documented, it is not done.

In all situations, avoid rushing to recommend treatment options or interventions without first conducting proper patient assessment, clerking or client interviews and documenting.

It is highly unprofessional and not expected of anyone that is a clinical pharmacist to do any form of therapeutic intervention without prior proper assessment of patients or clients.

4)     Always be compliant with the CPAN Standards for Use of language by her members.

Never refer to a pharmacy as a Retail Pharmacy.

Rather say a Community Pharmacy.

Avoid being analog all the time

Don’t say you will go to the Market to buy drugs.

Say you will contact or go to Medical Reps, distributors or Pharmaceutical manufacturing companies to Order drugs.

It is unethical to Order drugs from open markets as all medicines are potential poisons and must not be viewed as ordinary articles of trade.

5)     As a community pharmacist, when any client or patient compliments you by saying “How Market or Business?

Please, never⁷ fail to correct them by saying it should be How is the Practice?

And as a clinical pharmacist, please Never say my Business when referring to your Community Pharmacy activities.

It should be ….My Practice….

A Pharmacist is a professional who practices his Profession.

A trader doesn’t Practice but does business or sells, or retails just for profit.

6)     Talk corporately and professionally whenever in public view.

Stop referring to a pharmacy as Shop or even Pharmacy shop, Pharmaceutical Store,   etc.

Always say my Pharmacy or Pharmacie.

Also remember that the word Premises is not Synonymous with pharmacy or pharmacie, and can be used even for a mechanic workshop, banking, hospital, Clinic or carpenter’s workshop premises.

So learn to say Pharmacy or Pharmacie instead of Premises.

6)     Talk corporately and professionally whenever in public view.

Stop referring to a pharmacy as Shop or even Pharmacy shop, Pharmaceutical Store,   etc.

Always say my Pharmacy or Pharmacie.

Also remember that the word Premises is not Synonymous with pharmacy or pharmacie, and can be used even for a mechanic workshop, banking, hospital, Clinic or carpenter’s workshop premises.

So learn to say Pharmacy or Pharmacie instead of Premises.

7)     Don’t say Customers at the pharmacy.

Say Clients or Patients   at the pharmacy.

A Pharmacist or healthcare professional has clients or patients and empathizes with them, whereas a business person has customers and views them with profit in his mind.

Don’t Say we Sell Medicines, say we Dispense Medicines.

Dispensing and application of Pharmaceutical care are professional skills that require university education at a pharmacy school.

Selling does Not necessarily require professionalism or university education and can be carried out very well by anyone including quacks.

Pharmacists remain high profile Professionals with university education and they Practice Pharmacy,   rather than trading or selling medicines.

If you work in the hospital or clinic, please don’t use or make sign posts bearing such trading jargons like

“Buy your drugs from the hospital Pharmacy Shop or Store“.

You should rather say,

Obtain or Procure   your medicines (or Fill your Prescriptions)   from the hospital Pharmacy or Pharmacie.

Don’t say that you want to Cost drugs,

Say that you want to do Prescription Assessment, Review or Audit.

Don’t allow too many stickers to litter “see through” or sliding glass Pharmacy doors.

Infact, write Post no Bill on the Pharmacy glass doors or Pharmacy departmental walls.

8)     Avoid creating or reinforcing wrong Perceptions in the minds of the public by using such phrases   like.

“Doctors & Pharmacists” or Doctors, Nurses and Pharmacists“, when you are speaking to the public or anyone. Rather, use consistently such phrases as Pharmacists, Physicians and Nurses.

The Pharmacist should come before others whenever a Pharmacist is speaking, that is an honor to one’s Profession.

Furthermore, learn to use Physicians or Medical doctors when referring to the twin professionals of Pharmacy who are graduates of medicine.

This is because there are different kinds of doctors in Patient Care such as dental doctors, veterinary doctors, medical doctors, Pharmacy doctors, doctors of optometry, doctors of nursing practice, etc.

The title doctor is never an occupational title solely or exclusively for any healthcare Profession.

When you say doctors but you actually mean Physicians, you have basically excluded optometry doctors, dental doctors, pharmacy doctors, veterinary doctors etc from also being doctors whereas all possess clinical doctorates which are about direct patient care.

It is archaic and obsolete to tag only Physicians as doctors within the health care system.

The general public are always watching the way you say or do things & they create their perceptions of your profession.

9)     Also, Don’t use such phrases as “Doctors and other health care Workers.”

Learn to say Physicians and Non Physician Healthcare Providers, whenever you want to talk about Physicians and others that are Healthcare providers.

Except you mean all “Clinician Doctors” (dentists, optometrists, DPTs, MDs,  PharmDs etc)  and all  ordinary healthcare staff who are not medical professionals or Clinical  staff (eg cleaners, accounting and administrative  staff etc).

It is then you can address them as doctors and other health care workers.

Other Clinical Professionals aside medical doctors are alternatively addressed as Non Physician Health Care Providers.

10)    If you are a PharmD holder, PhD or Prof, and your annual license does not reflect that, please write to PCN officially either directly or through your DPS, so that your title can be reflected wherever your name is written by the council.

And always be proud of your title (Pharm, Prof, Dr etc) as a pharmacist because you earned it meritoriously.

N.B. These little things matter & and it is absolutely necessary to put many things in the right perspective.

Courtesy.

CPAN THINK TANK & STANDARDS COMMITTEE.

Dr Moteehat Bukkie Olu-Lawal FPCPharm, MCPAN, PharmD.

National Secretary.

Dr Joseph Madu FPCPharm, MCPAN, PharmD.

National Chairman.

The post CPAN RECOMMENDED STANDARD OPERATING PROCEDURES (SOPs) FOR ALL PHARMACISTS & CPAN MEMBERS IN NIGERIA/DIASPORA. first appeared on CPAN WORLD.

From:

CLINICAL PHARMACISTS ASSOCIATION OF NIGERIA (CPAN)

To:

All Pharmacists in Nigeria.

All CPAN Members in Nigeria & Diaspora.

RE: ADOPT/ADAPT AS A WORKING DOCUMENT.

CPAN RECOMMENDED STANDARD OPERATING PROCEDURES (SOPs) FOR ALL PHARMACISTS & CPAN MEMBERS IN NIGERIA/DIASPORA.

1)     Be professionally/ modestly/corporately or attractively dressed at all times.

A suit and a tie is highly recommended  for all males, while a sparkling white well ironed work coat with pharmacy logo is acceptable for both sexes.

2)     Address all your professional Colleagues (including junior colleagues) with their titles (eg. Pharm, Prof., Dr, etc) at all times, and not just their names alone.

When writing your name, endeavor to reflect the Profession against your name.

Examples include;

Pharm  ABC , Dr XYZ PharmD , Prof UVW FNAPharm etc .

You may also write Clinical Pharmacist in bracket when the situation is desirable for that.

3)     When Consulting with patients in a community Pharmacy, or at the patient’s Bedside in a hospital ward, emergency departments, nursing home, Managed Care clinics, Physician’s offices etc, please always remember that Patient Assessment ought to Precede all forms of treatment, recommendations or interventions.

Always adhere to utilizing the tools such as SOAP or FARM, and Never fail to document the care process.

If it is not documented, it is not done.

In all situations, avoid rushing to recommend treatment options or interventions without first conducting proper patient assessment, clerking or client interviews and documenting.

It is highly unprofessional and not expected of anyone that is a clinical pharmacist to do any form of therapeutic intervention without prior proper assessment of patients or clients.

4)     Always be compliant with the CPAN Standards for Use of language by her members.

Never refer to a pharmacy as a Retail Pharmacy.

Rather say a Community Pharmacy.

Avoid being analog all the time

Don’t say you will go to the Market to buy drugs.

Say you will contact or go to Medical Reps, distributors or Pharmaceutical manufacturing companies to Order drugs.

It is unethical to Order drugs from open markets as all medicines are potential poisons and must not be viewed as ordinary articles of trade.

5)     As a community pharmacist, when any client or patient compliments you by saying “How Market or Business?

Please, never⁷ fail to correct them by saying it should be How is the Practice?

And as a clinical pharmacist, please Never say my Business when referring to your Community Pharmacy activities.

It should be ….My Practice….

A Pharmacist is a professional who practices his Profession.

A trader doesn’t Practice but does business or sells, or retails just for profit.

6)     Talk corporately and professionally whenever in public view.

Stop referring to a pharmacy as Shop or even Pharmacy shop, Pharmaceutical Store,   etc.

Always say my Pharmacy or Pharmacie.

Also remember that the word Premises is not Synonymous with pharmacy or pharmacie, and can be used even for a mechanic workshop, banking, hospital, Clinic or carpentar’s workshop premises.

So learn to say Pharmacy or Pharmacie instead of Premises.

7)     Don’t say Customers at the pharmacy.

Say Clients or Patients   at the pharmacy.

A Pharmacist or healthcare professional has clients or patients and empathizes with them, whereas a business person has customers and views them with profit in his mind.

Don’t Say we Sell Medicines, say we Dispense Medicines.

Dispensing and application of Pharmaceutical care are professional skills that require university education at a pharmacy school.

Selling does Not necessarily require professionalism or university education and can be carried out very well by anyone including quacks.

Pharmacists remain high profile Professionals with university education and they Practice Pharmacy,   rather than trading or selling medicines.

If you work in the hospital or clinic, please don’t use or make sign posts bearing such trading jargons like

“Buy your drugs from the hospital Pharmacy Shop or Store“.

You should rather say,

Obtain or Procure   your medicines (or Fill your Prescriptions)   from the hospital Pharmacy or Pharmacie.

Don’t say that you want to Cost drugs,

Say that you want to do Prescription Assessment, Review or Audit.

Don’t allow too many stickers to litter “see through” or sliding glass Pharmacy doors.

Infact, write Post no Bill on the Pharmacy glass doors or Pharmacy departmental walls.

8)     Avoid creating or reinforcing wrong Perceptions in the minds of the public by using such phrases   like.

“Doctors & Pharmacists”

or Doctors, Nurses and Pharmacists“, when you are speaking to the public or anyone.

Rather, use consistently such phrases as

Pharmacists, Physicians and Nurses.

The pharmacist should come before others whenever a Pharmacist is speaking, that is an honor to one’s Profession.

Furthermore, learn to use Physicians or Medical doctors when referring to the twin professionals of Pharmacy who are graduates of medicine.

This is because there are different kinds of doctors in Patient Care such as dental doctors, veterinary doctors, medical doctors, Pharmacy doctors, doctors of optometry, doctors of nursing practice, etc.

The title doctor is never an occupational title solely or exclusively for any healthcare Profession.

When you say doctors but you actually mean Physicians, you have basically excluded optometry doctors, dental doctors, pharmacy doctors, veterinary doctors etc from also being doctors whereas all possess clinical doctorates which are about direct patient care.

It is archaic and obsolete to tag only Physicians as doctors within the health care system.

The general public are always watching the way you say or do things & they create their perceptions of your profession.

9)     Also, Don’t use such phrases as:

Doctors and other health care Workers.

Learn to say Physicians and Non Physician Healthcare Providers, whenever you want to talk about Physicians and others that are Healthcare providers.

Except you mean all “Clinician Doctors” (dentists, optometrists, DPTs, MDs,  PharmDs etc)  and all  ordinary healthcare staff who are not medical professionals or Clinical  staff (eg cleaners, accounting and administrative  staff etc).

It is then you can address them as doctors and other health care workers.

Other Clinical Professionals aside medical doctors are alternatively addressed as Non Physician Health Care Providers.

10)    If you are a PharmD holder, PhD or Prof, and your annual licence does not reflect that, please write to PCN officially either directly or through your DPS, so that your title can be reflected wherever your name is written by the council.

And always be proud of your title (Pharm, Prof, Dr etc) as a pharmacist because you earned it meritoriously.

N.B. These little things matter & and it is absolutely necessary to put many things in the right perspective.

Courtesy.

CPAN THINK TANK & STANDARDS COMMITTEE.

Dr Moteehat Bukkie Olu-Lawal FPCPharm, MCPAN, PharmD.

National Secretary.

Dr Joseph Madu FPCPharm, MCPAN, PharmD.

National Chairman.

The post CPAN RECOMMENDED STANDARD OPERATING PROCEDURES (SOPs) FOR ALL PHARMACISTS & CPAN MEMBERS IN NIGERIA/DIASPORA. first appeared on CPAN WORLD.

The man told her that it was written by a paeditrician for his newborn baby girl, less than a week old. Knowing the adverse effects of the barbiturates, especially on such age groups, the Pharmacist immediately raised eye brows and only sternly enquired from the father if the baby has convulsions or seizures or for any reason is restless, keenly explaining the signs and symptoms of each in clear terms to the man. The father confirmed that nothing of such nature is happening to his neonate, quickly adding that he overhead the paeditrician saying he should buy the medication to help clear the baby’s jaundice, trying to provide tangible information to assist the Pharmacist in helping him. Jaundice? The Pharmacist asked, looking quite astonished and confused. She couldn’t relate the barbiturate with jaundice, but reached out for her phone to double check with the Emdex app & seeing nothing of the like, she flared up, countered the prescription and refused to dispense.

The resultant interception between the prescriber and the Pharmacist may be an unnecessary prevarication for this piece.You see? Phenobarbitone has a clinically proven effectiveness in the management of neonatal jaundice which is still off label for this purpose but the Pharmacist is totally oblivious of this, and possibly, a host of other clinical Pharmacists too. Off label use of drugs may not be a daily occurrence in routine practice, but the drug Lord should never be caught off guard. Other common examples of off-label drug use include, Clomipramine, tramadol and dapoxetine to delay ejaculation, Amitriptyline and fluoxetine for fibromyalgia and propranolol for stage fright or performance anxiety.

Pharm. Ochiaja Emeka is a Pharmacist with General Hospital Onitsha.

The post Off Label Drug Use, Noteworthy For The Clinical Pharmacist. first appeared on CPAN WORLD.

In the Nigerian Pharmacy space or Drug World , it is becoming almost impossible to differentiate between some supermarkets, provision shops, patent medicine stores , unregistered pharmacies and the properly registered & licensed pharmacies.
In all these, you find almost apparently same types of drugs and related products. All appear to offer same services of drug provision, but many are without the provision of the required & accompanying professional Drug Information.

This is because these Drug Outlets aside the properly registered and licensed pharmacies, are not manned by Pharmacists. It is only in properly Registered and Licensed Pharmacies manned by Superintendent Pharmacists that one can receive professional pharmaceutical services or care like Drug Information through Effective Medication Education & Counseling. Even licensed Patent Medicine Dealers are not knowledgeable to counsel Patients on ethical drugs.

The populace are even more confused as a good number of them tend to rush to the non pharmacies as they claim they spend less time, less amount of money etc in these so-called Drug Stores.

It has been observed that an appreciable number of Nigerians tend to shy away from patronizing the registered and properly licensed pharmacies that are manned by pharmacists, on the account and alleged belief that services in the Pharmacies are costlier, more time consuming etc.

What most Nigerian Clients or Patients do not know is that, it is not just about drugs being given out but also about the associated dispensed drug Information that accompany such medications .

It is also important to emphasize here that , it is not the size of a Church building that makes it a Cathedral, but the presence of a Bishop.
Every drug has a set of specific & accompanying Drug Information that rightly guide its proper usage, otherwise such use could turn out to be harzadous.

Some of the deleterious effects may not manifest immediately but years later. Those who rush to these Unlicensed Drug Outlets to obtain their drugs without the correct & associated information are like someone who rushes or attends a church or mosque service without actually hearing & receiving the main sermon. It is not by visiting or occupying space in church or mosque ,but by how one utilizes & applies the sermon in his life. What changes one is the message or sermon preached . Without the Sermon or Gospel, attending a Church or Mosque service is grossly incomplete. So also is getting the right and sufficient information when you visit a Pharmacy Establishment.

Currently, there is an upcoming report from some recent studies & findings that Drug Related Deaths are now ranking third place after Cancer & heart disease globally. If such findings are seen in advanced societies where drugs are strictly utilized under the supervision of Pharmacists or other highly qualified medical personnel & are mainly obtained through legal means such as Prescription or Pharmacy Only Medicines ( Pharmacy Initiated Medicines), how much worse will the case be in a country like Nigeria with chaotic drug distribution ?

In Nigeria, almost everyone is misusing or abusing drugs , irresponsibly self-medicating with drugs as well as being non adherent to their medications’ guidelines for usage. Suffice it to say that the incidence & prevalence of Drug- Related complications or deaths are expected to be unimaginably high & unreported in Nigeria.

One keeps wondering at the negative impacts & Drug-Related complications that could have been created & caused by the unchecked activities of quacks & traders who have infiltrated & hijacked the pharmacy Practice in Nigeria.

Effective Drug Education, Medication Review & Counseling are therefore the only ways out of this menace . Such could only be accurately provided by Pharmacists who are the healthcare Professionals globally known and trained to excel on the knowledge and actions of all types of drugs.

Since Pharmacists are the highest trained healthcare Professionals on drug knowledge and matters, any other person who assumes the post or duty of a pharmacist & involved in drug refilling, dispensing or handling as an occupation with respect to Patients or clients care, is best described as an Impersonator or an Usurper. Such a person’s action could pose a great danger to the health of the citizenry and must be discouraged. Even when other trained healthcare professionals are involved in medications handling, it should be done under the direct supervision of Pharmacists. That is the position of science and the proper or healthy practice too.

Many of our people are much more concerned in some cases about cheap cost of their medications & less time spent in non pharmacies or other non properly registered drug outlets , but are oblivious of the fact that majority of such drugs obtained in these non pharmacies could be either substandard, fake or subject to misuse due to absence of professional guidance. This partly explains why many Nigerians suffer from treatment failure, drug resistance, adverse drug reactions, drug induced diseases & even untimely death.

Many people in the society think that every person who handles drugs in a drug outlet is qualified to do so & that one does not need to spend some time with the pharmacist. Some don’t even know who is a Pharmacist , and think he is just anyone in a drug store. Many are not even aware or do not care to know that any Pharmacist they see in Nigeria must have graduated from the University and licensed, after spending about six or seven years (depending whether it a doctor of pharmacy or Bachelor of Pharmacy Programme) plus an additional one year NYSC programme.
Some Pharmacists also have advanced degrees in Clinical Pharmacy or Patient Oriented Pharmacy Practice.

Of importance too , is the fact that many of the fake drug outlets do not have signposts clearly indicating their names. That is dangerous as it makes them unidentifiable.
An establishment dealing in drug matters should have a proper signage to show if it is a Pharmacie, Patent Medicine Shop, or Supermarket.

All Drugs are potential Poisons.
Before drugs can be assured to be safely and appropriately used, they will be accompanied by some professional information & Education from the pharmacists who are the medications experts. It is the pharmacist that designs and manufactures all orthodox medicines & really understands the workings of the drugs. For instance, in developed world, their citizenry are familiar and deeply understand the sign; ” Pharmacist on Duty” or ” Pharmacist not on Duty”. These patients or clients are never in a hurry while in the pharmacies as they patiently wait for their pharmacist’s Medication Education & Counseling.
o wonder did USA passed a Bill called , “OMINIBUS BUDGET DRUG RECONCILIATION ACT”. This ACT makes it mandatory that the pharmacist owes the patient the duty of providing Drug Information & must educate & counsel the patient on the proper use of drugs. Some other countries have theirs too.

It is very unfortunate in Nigeria, that non pharmacists & quacks have invaded pharmacy Practice , a Practice that is supposed and meant to safeguard the health of people.
Almost all our streets are occupied with drug stores that are in many cases operated by illiterates, semi literates, school dropouts, & non pharmacists. What a madness !

Almost every Tom, Dick & Harry in Nigeria wants to invest in pharmacy Practice without being aware of the dangers such action can pose on the health of the unsuspecting public.
People see drugs as ordinary articles of commerce. But In other countries citizens are jailed if caught with drugs or medicines when they are not a licenced pharmacist, or not a patient with a valid Prescription (or other recognized means of medicines possession).

Dispensing, Effective Medication Education & Counselling are even more important than the actual provision of the drug itself , as the wrong use of any drug could kill or harm rather than cure the patient or client.

Drug Dispensing is a course in the Pharmacy Curriculum which students must pass with a “B – grade”. It is therefore very risky for a non pharmacist to dispense drugs. If a non pharmacist is to dispense drugs, then it should be done under the direct supervision of a Pharmacist. Else many people can be silently harmed. No wonder the life expectancy for Nigerian is about 54 compared to the US and the UK with 98 and 97 respectively. Also the Nigeria health index according to a recent WHO ranking is 189 out of 191 countries surveyed. What a tragedy !

What then is this EFFECTIVE MEDICATION EDUCATION & COUNSELING ?

In a nutshell, it is simply the Responsible Provision of Drug & Disease Related Information which aims at improving the Patient’s knowledge about the proper use of his drugs to prevent Drug-Related errors as well as elicit some behavioural changes that will result in expected positive lifestyles, Wellness & Wellbeing of the patient (Oparah AC , 2020). It also talks about how the patient could be actively involved in co-managing his disease state, how to identify failure or effectiveness of medication therapy, all about drug interactions, Adverse Drug Reactions, refilling , untreated indications, medications reconcilation, disposal of drugs etc. It must also be stated that this is patients’ right & a duty every pharmacist owes the patient.

Your pharmacist by virtue of his training on drugs, is fully equipped to provide the salient drug information to you through Effective Medication Education & Counselling. That is why you have no other option than to submit your prescription (and other self selected medications) to your pharmacist for proper evaluation, rationalization & appropriateness.
The pharmacist then provides the basic information vis a vis your disease condition.

For instance, contrary to the apparent general or erroneous belief that every drug should be taken with food, Ampicillin should be taken on an empty stomach. Anti ulcer drugs like our popular OMEPRAZOLE & its family members could only work at optimum level if taken 30-60minutes before meals especially in the morning. Also many patients who use such type of drugs are not aware that concurrent intake with Antacids will destroy the beneficial effects of such anti ulcer drugs.

The pharmacist will also educate & counsel patients that there are aggravators of stomach Ulcer like taking unripe oranges, spices, peppery food, high calcium products, misuse of pain relievers like Ibuprofen.
It will also amaze you that those who take their anticholesterol drugs like Rosuvastatin & its family members outside bedtime periods may not get the best out of such drugs.

Those who use their Antihypertensive Diuretics Drugs(Water Pills) like Hydrochlorothiazide at night time could be wasting their drugs as it will push up their Blood Pressure as a result of sleep disturbances, and waking up to urinate at night, rather than bringing down the blood pressure. Furthermore, Water Pills (diuretics) when concurrently used with pain killers (NSAIDs) such as diclofenac can completely damage the kidneys.

Many hypertensive Patients who use much table salt or eat fried food are indirectly worsening their Blood Pressure.
Also those who take blood builders (Iron preparations) with milk are wasting their drugs & may even become more anaemic.
Most patients using the antidiabetic Insulin, who do not consult with their pharmacist or who prefer to patronize quacks may never be counseled or educated that it should be stored in a functioning refrigerator & used within a specified period of time.

The bitter truth is that many Nigerian patients end up wasting their time, energy & wealth after visiting their prescribers, if they fail to complete the chain or cycle of care by not visiting & directly interacting with their pharmacists about their prescriptions. Some patients or clients send their wards,relatives, spouse or children to refill their drug Prescriptions. This is called “Dispensing by Proxy” & is a big error. There is no ” Reported speech” in Effective Medication Education & Counseling.

As you start the chain of care in your health-seeking behaviour by visiting your prescribers, you should complete the same cycle by passing through your pharmacist & demanding for the provision of Effective Medication Education & Counseling. Your pharmacist is the ultimate drug expert who is most equipped with the mandates, skills & trainings to provide you with the Authentic & Effective Medication Education & Counseling & any other Drug -Related Services.
Do not allow anybody to deceive you as Information & Knowledge are Power!

Dr Charles N Nwako PharmD, MCPAN.

Chairman National Publicity Committee of the CLINICAL PHARMACISTS ASSOCIATION OF NIGERIAN(CPAN)

The post IMPROVING PATIENT CARE IN NIGERIA THROUGH EFFECTIVE MEDICATION EDUCATION, REVIEW & COUNSELING BY PHARMACISTS. first appeared on CPAN WORLD.

PLUS TIPS FOR BETTER SLEEP

The results of a large recent study, tracking thousands of people from age 50 upwards, suggests those who sleep six hours or less a night are more likely to develop dementia in their late 70s. Thus it is advisable to sleep for more than six hours a night. Mental health disorders are known to be quite strongly linked with sleep disturbances.

The research which was published in the journal Nature Communications, studied nearly 8,000 people in Britain for about 25 years. All the subjects were 50 years old or older.

For many years, scientists have pondered whether getting too little sleep could affect physical and mental health and questions about how sleep relates to cognitive decline. Figuring this out had been difficult because it was hard to establish a relationship between insufficient sleep and the physiological changes that occur in the brain that underline the development of dementia.

The large new study highlights very persuasive new findings that clearly suggest that people who don’t get enough sleep in their 50s and 60s may be more likely to develop dementia when they are older.

Precisely 8,000 individual subjects (people) were followed in Britain over a period of about 25 years, beginning when they were 50 years old. The findings from the study show that those who consistently reported sleeping six hours or less on an average weeknight were about 30 percent more likely than individuals who regularly got seven hours sleep (defined as “normal” sleep in the study) to be diagnosed with dementia nearly three decades later.

Dr. Kristine Yaffe, a professor of neurology and psychiatry at the University of California, San Francisco, Said “It would be really unlikely that almost three decades earlier, this sleep was a symptom of dementia, so it’s a great study in providing strong evidence that sleep is really a risk factor,”.

Accumulations of proteins associated with Alzheimer’s are known to begin about 15 to 20 years before people exhibit memory and thought coordination problems, these characterize the Pre-dementia changes in the brain. So sleep patterns within that time frame could be considered an emerging effect of the disease. According to Dr. Erik Musiek, a neurologist and co-director of the Center on Biological Rhythms and Sleep at Washington University in St. Louis, “that has posed a chicken or egg question of which comes first, the sleep problem or the pathology,”

“I don’t know that this study necessarily seals the deal, but it gets closer because it has a lot of people who were relatively young,” he said. “There’s a decent chance that they are capturing people in middle age before they have Alzheimer’s disease pathology or plaques and tangles in their brain.”

A review of data from a prominent study of British civil servants in the mid-1980s, called Whitehall II, researchers tracked how many hours 7,959 participants said they slept in reports filed six times between 1985 and 2016. By the end of the study, 521 people had been diagnosed with dementia at an average age of 77.

According to the New York Times several behaviors and characteristics that account influence individual sleep patterns were considered in the study. These include smoking, alcohol consumption, level of physical activity, body mass index, fruit and vegetable consumption, education level, marital status and conditions like hypertension, diabetes and cardiovascular disease, whether or not people were taking sleep medication and whether or not they had a mutation called ApoE4 that makes people more susceptible to develop Alzheimer’s disease. Depression is also considered a risk factor for dementia.

The researchers separated out people who had mental illnesses before age 65 and the study’s analysis of participants without mental illnesses found a similar association between short-sleepers and increased risk of dementia.

The researchers found no general difference between men and women.

Short sleep is very common among the elderly and because of that, even if it’s modestly associated with dementia risk, it can be important at a societal level. Short sleep is something that we have control over, something that you can change.

Experts say most of the data in the research is self reported and therefore subjective. Thereby challenging the data accuracy. This is one of the limitations of the study.

At one point, nearly 4,000 participants did have sleep duration measured by accelerometers and that data was consistent with their self-reported sleep times, the researchers said. Still, that quantitative measure came late in the study, when participants were about 69, making it less useful than if it had been obtained at younger ages.

In addition, most participants were white and better educated and healthier than the overall British population. And in relying on electronic medical records for dementia diagnoses, researchers might have missed some cases. They also could not identify exact types of dementia.

Robert Howard, a professor of old age psychiatry at University College London says “Insomniacs — who probably don’t need something else to ruminate about in bed,” he added, “shouldn’t worry that they are heading for dementia unless they get off to sleep immediately.”

Studies have found that cerebrospinal fluid levels of amyloid, a protein that clumps into plaques in Alzheimer’s increase in people deprived of sleep. Sleep is also thought to be important for clearing proteins from the brain or limiting the production. One theory is that the more people are awake, the longer their neurons are active and the more amyloid is produced. Another theory is that during sleep, fluid flowing in the brain helps clear out excess proteins, so inadequate sleep means more protein buildup, he said. Some scientists also think getting sufficient time in certain sleep phases may be important for clearing proteins.

Too little sleep might also function indirectly, fueling conditions that are known dementia risk factors. Someone who commonly stays up too late to have snacks or because they get very little sleep, they have low motivation for physical activity will likely be predisposed to obesity, diabetes and hypertension all of which have been pretty robustly linked to dementia risk.

Another theory is “a shared genetic link,” genetic pathways or profiles that go along with both shorter sleep and increased risk of Alzheimer’s. It is also postulated that the sleep-dementia relationship is “bidirectional,” with poor sleep fueling dementia, which further reduces sleep, which worsens dementia.

The new study also examined whether people’s sleep changed over time. There appeared to be slightly increased dementia risk in people who shifted from short to normal sleep, a pattern which may reflect that they slept too little at age 50 and needed more sleep later because of developing dementia.

How Can You Get More Sleep:
Four out of five people say that they suffer from sleep problems at least once a week and wake up feeling exhausted. What you need is deep sleep and sleeping pills and a lot of other sleep aids don’t really give you deep enough sleep.

1) Naps are okay to catch up on missed sleep, but getting a good night’s sleep should make naps unnecessary. Scientists recommend people with sleep disorders or apnea should consult sleep specialists,

2) Having a regular sleep schedule, avoiding caffeine and alcohol before bedtime and removing phones and computers from the bedroom are recommended.

3) Stretching and meditative movement like yoga before bed can improve the quality of your sleep and the amount you sleep. Try short and calming routines like 11 stretches and exercises.

Reference : Belluck Pam, 2021, Sleeping Too Little in Middle Age May Increase Dementia Risk, Study Finds, Health, New York Times, accessed at https://www.nytimes.com/2021/04/20/health/sleep-dementia-risk.html?campaign_id=51&emc=edit_mbe_20210421&instance_id=29489&nl=morning-briefing%3A-europe-edition&regi_id=158757475&segment_id=55992&te=1&user_id=ae364b2b5baf8ea0ff972231bd5e2a8f.

The post TOO LITTLE SLEEP CAN GIVE YOU DEMENTIA first appeared on CPAN WORLD.

First of all lets get one thing straight. If you opened this article because you actually wanted to learn how to mix drugs then you are miss guided. No be insult, I say that with every sense of responsibility. I will now guide you on why you should never attempt to consume drugs as a mixture. And why you must stop if you are already doing so.

Your lesson number one is that DRUGS ARE POISONS. Oya memorise that! Even if that is all you can memorize in the next 24 hours just sit down and memorize it. DRUGS ARE POISONS! DRUGS ARE POISONS!! DRUGS ARE POISONS!!!

A few years ago while Superitending a Pharmacy in Abuja I was waiting on clients one afternoon. I had just told the sales staff that today seems quiet. So since there wasn’t much to do I dispatched her to the wholeseler to refill drugs which were out of stock in the Pharmacy. That would be a full days job for her so I decided to man the front counter in her absence.

My mind was wandering on different topics when a middle aged man walking into the Pharmacy. I instantly recognised him as a former Super Eagles player and Atlanta 96 Football Gold Medalist. Being a major football buff myself it took a lot to comport myself and not scream my head off hailing him with his nickname. It was one of the Babayaros. But I will not tell you which one.

After transacting we had a long conversation. Then he was a big fan of Buhari who was then a Presidential Candidate. He guaranteed me Buhari will win the election. I was on the other side of the fence sha! He talked about conversations he had had with his brother. Look at me, I was being privy to internal gist between international football stars. Thats why I love Community Pharmacy practice.

One of the topics we crossed swords on was drugs. He said Nigeria had way too much tolerance for drug misusers and abusers. He categoricaly told me that a country like Singapore will execute you without hesitation once they find control substances in your posession. He said at the Singapore Airport the first thing your see when you disembark from the plane is a bold sign which clearly reads “DRUGS IS DADA!” Meaning “Drugs is Death”. The message simply wants you to note that the penalty for bringing drugs into the tiny country is death.

Drugs can be dangerous substances. When consumed they are subjected to processing in the body similar to the way a manufacturing process converts raw materials to finished goods. Many of the final products of the conversion of drugs and herbs by our bodies are very toxic and poisonous. They also circulate within the body and cause a lot of damage before being excreted in our urine, stool, sweat and saliva. This is why you should never consume drugs without appropriate professional guidance and advise.

Drugs pass through 4 stages when consumed :

1) Absorbtion – from the stomach into the blood stream.
2) Distribution from the blood stream to the organs of the body.
3) Metabolism – Mostly occuring in the liver where the drugs are converted to less usefull waste product some of which are toxic and poisonous.
4) Excretion – elimination of the waste from no 3 above via stool and urine. This is why you go to toilet.

Understanding these processes is highly complex and trust me you are not equiped to have the general picture. Only your healthcare professional is trained to do so.

Consuming drugs in mixture and/or outside of recomended doses could result in damning consequency for your body organs. This is why Healthcare professionals are trained to do an extensive assemssment of a disease condition and formulate a strategy to apply drugs if needed. Its not always that drugs are needed to treat illness. Many times non-drug interventions such as councelling, surgery, Physiotherapy etc are used to solve the health related problem.

The scourge of drug misuse and abuse in Nigeria is so old that it is fast becoming ancient. It iriginates from a phenonenon called Self Medication. In fact as health professionals we are getting tired of y’all attitude towards drugs. It is a major motivator for crime and is the etiology of many Kidney and Liver failures.

We classify Self Medication as either Responsible or Iresponsible Self Medication.

Responsible Self Medication primarily refers to the consumption of over-the-counter-medicines which do not require a prescription. This is because such medicines have a wide safety margin (called therapeutuc index) or you would need to have consumed a large quantity of the drug for it to start causing you harm. So they can be requested in a Pharmacy without prescription to alleviate minor symptoms and illnesses such as cough, cold, Malaria, headaches, fever and pains.

Irresponsible Self Medication refers to consumption of prescription only medicines and/or control substances without appropriate prescrption or recomendation by a qualified medical professional. Take note of my use of the word ‘qualified‘. Because not everyone you call ‘Dokita‘ is actually qualified. You need to verify if he is a Native Dokita, Babalawo, herbalist, spiritualist or quackist ……in fact “ask am weda e go school at all. Tell am to show you him qualification and license“.

Precription only medicines involve many of the Antibiotics you abuse every now and then. You like to buy one capsule of Ampiclox to flush your system….yes thats you …you’re an abuser. A drug abuser.

I have also seen many people abuse over-the-counter medicines. We have heard paracetamol is used to cook meat comercialy because it softens meat, accelerates the cooking process thereby reducing fuel or firewood consumption and reduces food production lead time.. I know of several instances where a man makes it a point of duty to consume one satchet (12 tablets) of Paracetamol every single day. And he drinks alcohol ontop. I wonder what his liver would look like under a microscope. I have seen ladies who drank 10 tablets of misoprostol……die! die!! die!!!…..the foetus must die….by fire by force. Afterall the man dumped her so his Baby must bear the penalty for her mistreatment. The same lady would come to me and say since she took the 10 tabs of Misoprostol she has not “seen anything”, she beleives the tablets may have been fake. So she wants me to give her the original brand. The one made by Pfizer. Before she says “Pfiz………… ….” I don pick race. For my mind “my hand no dey.”

The one that pains me the most is when you people come to the Pharmacy and say you have Malaria (you have already diagnosed yourself) and instruct the Pharmacist to MIX drugs for you. See ba! Take time oh, you better just take your time. So you carry two left legs enter Pharmacy, diagnose illness for yourself, prescribe for yourself, instruct Pharmacist make him come mix de drugs for you. Bros/Sis, you for cucuma just siddon begin mix de drugs by yourself na. I go give you pot, stove and plate…….and em spoon too. Because me I no be native dokita. I am a Profesisonal. I don’t mix drugs. I identify, prevent and resolve Drug Therapy Problems (DTPs). I am a public Health expert. Abi you see me wear red cloth with Juju for my hand and cowries around my neck?. Na white overall with tie you see me wear na! Why you dey cast me like dis! Na wa4you ooooh!

When you interact with a Pharmacist you are interacting with a porblem solver, a solution provider. And if he/she doesnt know the solution he/she surely knows where to find it. So next time you interact with a Pharmacist do your best to maximize your time with him and tap into the wealth of knowledge.

So now that you have learnt How NOT To Mix Drugs, …….Oya make you dey waka for road dey hala “DRUGS ARE POISONS! DRUGS ARE POISONS!! DRUGS ARE POISONS!!!”

The post HOW TO MIX DRUGS : Free Tutorial first appeared on CPAN WORLD.

Health supply chain experts have been reviewing the federal governments nCovid 19 Vaccine distribution and administration strategy across Nigeria.

This month the National Primary Health Care Development Agency (NPHCDA) during an online sensitization seminar (webinar) released details of how batches of the nCOVID-19 vaccine doses will be distributed across Nigeria. According to the Executive Director Faisal Shuaib, NPHCDA will receive 100,000 doses of the novel Pfizer/BioNTech vaccine within the month of January 2021 with direct administration starting early February 2021. The strategy of the NPHCDA is to administer the Vaccine in 4 phases, targeting states with data showing higher percentage of patients positive for the nCov19 Virus. This would be after vaccinating frontline health workers, the elderly and vulnerable persons with co-morbidities based on World Health Organisation (WHO) guidelines. The aim is to achieve an appreciable level of herd immunity in these states with at least 40% of the entire population vaccinated by end of 2021 and additional 30% by in 2022.

As a precondition, the NPHCDA requires that cold chain storage facilities providing optimum conditions for storage and distribution of the temperature sensitive vaccines are put in place by states before receiving the vaccine.

So the priority states are: Kano, Lagos, Katsina, Kaduna, Bauchi and Oyo will receive more doses for health workers.

The breakdown is as follows: Kano, 3,557; Lagos, 3,131; Katsina, 2,361; Kaduna, 2,074; Bauchi, 1,900; Oyo, 1,848; Rivers, 1,766; Jigawa, 1,712; Niger, 1,558; Ogun, 1,473; Sokoto, 1,468; Benue, 1,423; Borno, 1,416; Anambra, 1,379; Kebbi, 1,361; Zamfara, 1,336; Rivers, 1,306; Imo, 1,267; Ondo, 1,228; Akwa Ibom, 1,161.

Others are: Adamawa, 1,129; Edo, 1,104; Plateau, 1,089; Enugu, 1,088; Osun, 1,032; Kogi, 1,030; Cross River, 1,023; Abia, 955; Gombe, 908; Yobe, 842; Ekiti, 830; Taraba, 830; Kwara, 815; Ebonyi, 747; Bayelsa, 589; FCT, 695; Nasarawa, 661.

Requirements:

1) Cold chain storage facilities (warehousing and Transportation/ logistics)

2) Adequate Staffing to ensure administration of the doses within 5 days of receipt. 

3) Data collection tools to ensure proper tracking, documentation and follow up.

4) Adequate mechanisms to ensure 100,000 doses to be administered to 50,000 people with 21 days. (Each individual is to take a second dose after 3 weeks)

Experts say implementation will require a seamless flow of information and agile decision-making structures between the Federal, state and Local governments with civil society and traditional organisations involved to ensure optimal mobilization of the population. The information Technology (IT) support has to be robust accurate. The existing technology infrastructure for previous vaccines programs will have to be leveraged and upgraded. Adequately trained staff and step down of training from Federal to state to LGA level and the rural communities is also needed. All this will require massive planning and orientation across the states.

The private sector healthcare institutions and logistics systems have to be brought onboard and partnered for shared learning because they are well exposed and very robust in their operations especially in the areas of Cold chain end-to-end supply chain management.

In all, experts agree it will be a continuous learning and improvement process requiring commitment from everyone involved.

Don’t forget to drop a comment below

The post REVIEWING THE FEDERAL GOVERNMENTS COVID 19 VACCINE DISTRIBUTION PLAN first appeared on CPAN WORLD.