The Modern Pharmacist

The reason I can’t be a vegan is because I could never give up on yogurt or cheese! And the perfect on-the-go refreshing snack for me is just throwing Alove yogurt in my bag. It gives me life. I am really into texture, and the aloe vera gel cubes are a perfect touch. I don’t know, I am that girl that likes mochi in my froyo. So this was heaven for me. I included some recipes that I have been addicted to lately. It’s been my go-to breakfast meal lately.



Simple Yogurt Bowl
1 cup of strawberry flavored Alove yogurt
Slices of strawberries
Blueberries
Vanilla granola
Sprinkled in some hemp seeds

Berry Smoothie
1 cup of strawberry flavored Alove yogurt
Hemp seeds
1 frozen banana
Blueberries
Raspberries
1 cup of coconut water
Blend away!

I really wanted to share some of my favorite products since I do get asked about my regime from time to time. But first I wanted to clarify my skin type and concerns, so you have somewhat of a reference. Winter in New York is rough and really left me dry. Currently, I have dry and sensitive skin. Generally, I am paranoid of products breaking me out and I am cautious of what I put on my face or body. I especially look for harmful ingredients such as parabens (including derivatives such as methylparabens, propylparabens, butylparabens, and ethylparabens), but I also look for beneficial ingredients such as antioxidants, vitamin C and retinoids (anti-aging). 

My current skincare routine:

I am in love with OSEA products lately, especially because it's organic certified and free of harmful synthetic ingredients. This non-toxic skincare line uses seaweed in most of the products, which is a good source of vitamins, minerals, amino acids, antioxidants and essential fatty acids: elements that help restore depleted skin. What got me to start checking ingredients was when I first became pregnant. This is when switched out my deodorants and a lot of my skincare products. I think its so important to do your research and be an informative consumer.  Here is a complete list of some products I am using:

Cleansers: Ocean Cleansing Milk. I first wipe my entire face off with Simple cleansing wipes. However, to make sure I get all my make- up off, I love using cleansing milks! Cleansing milks are something I use to use a lot back in the day. It is commonly used in a lot of Indian facial regimes, and it's something I grew up seeing my mom use for years. This product has soothing ingredients such as organic algae and water lily, which leaves your skin so soft and cleansed. Currently, I am using this morning and night, it's that gentle! The best thing about cleansing milks are that you can use it as a make-up remover as well.

As a make-up remover: Pump some on a cotton pad and gently remove all of over your face and then eye area to remove make-up.

Moisturizer: Advanced Protection Cream.This ultra rich organic seaweed and botanical anti-aging moisturizer deeply hydrates and firms skin.  It also has grape seed, jojoba and avocado oils which aide in minimizing the appearance of fine lines and wrinkles. This stuff is such a luxury product, and I feel like my skin just drinks it up, without leaving a greasy residue.

Serum and Things:


Face Oils: Drunk Elephant luxury virgin marula facial oil is my current favorite. It is extremely nourishing and high in antioxidant. I love this for an extra boost of hydration, especially for those dry patches!

Vitamin C Probiotic Face Polish: It's important to exfoliate! Otherwise all your serums and creams are just chilling on a dead layer of skin. Exfoliating will help slough off all the dead skin cells and allow better absorption of products. I immediately noticed a brighter complexion with this exfoliant. It is the texture of the finely ground organic bamboo and rice powders is what I liked most, since I actually like to feel the product is doing something to my face. It also has pure Vitamin C (for anti-aging) and vegan probiotics (known to combat redness, acne, and eczema). If I had to chose one product from this line, this would be it!

One of the challenges I faced was communicating with doctors, despite my outgoing personality.  I quickly had to develop a rapport with MDs/PAs in order to get my message across. I learned to be concise and to the point, not telling my whole life story. Communication is imperative to our daily functioning. And with so many different health personnel involved (including nurses, doctors, PAs, and pharmacists), there should be only one goal set in mind, and that is providing a positive outcome for the patient.

I am so grateful to co-author with Dr. Cher to provide insight on successful ways to communicate with colleagues, both from a doctor's and a pharmacist's perspective.

Here are some helpful tips for effective communication:

 

The Pharmacist's POV

Written by Dr. Sandhya Kumar

(@the_modernpharmacist)

 

Be Confident and Concise

Confidence will come with experience and time. As you　make initiatives to communicate via phone, you will become more comfortable. The trick is to keep your calls short and sweet. You want to get your message across in a clear fashion.

Investigate

Take initiative and investigate. Sometimes you can do a little digging through the notes and medication history to find out about allergies or other clarifications that might be needed!

Convey trustworthiness

Trustworthiness is another critical factor in collaborative relationships, therefore　know what you are talking about and make sure you are conveying the correct information. If you need to look up something, do it before you get on the phone!

 

Call the physician back

Alternatively, if doctors are calling you for information, you can always give a call back if you don't know the answer off the top of your head. It's better to give the correct information than to guess. You will be respected much more!

Respect time

The truth of the matter is, doctors are extremely busy. One thing I found helpful was to　go through a comprehensive problem list of orders before making a phone call. If there were multiple issues to be found, you can address them at once rather than making multiple phone calls. It will make life much easier for everyone, trust! Late night calls should be for true emergencies only. If you can get a hold of a in-house PA or MD, try to do so.

 

The Physician’s POV

Written by Dr. Cherilyn Cecchini

(@doctor.cher_c)

 

I absolutely love when pharmacists join the team on family centered rounds. I can field questions to them about dosing of medications and when to time levels of peaks or troughs for certain therapies.

Communication is key to effective delivery of medical therapies and it is crucial for the entire team to communicate clearly. This may seem easy, but it can definitely prove more difficult than expected, especially when a large group of dynamic individuals are placed together. Teams are constantly changing, and this creates an even more difficult situation. Just as you start to learn the style of one team member, another person replaces that individual and takes over the role. I definitely agree that the overall goal, despite these challenges, remains positive patient care outcomes.

 

Additional tips for effective communication:

 

Ask questions

If you are unsure about certain medications, the pharmacist is a wonderful resource to utilize on family centered rounds. If you do not have a pharmacist rounding with you, be sure to jot down your question to ask them later. Organizing all of your questions in one place allows for easy reference.

 

Ask for clarification

Are you confused about the dose of a medication? Ask for help before ordering the drug. Are you worried about possible medication side effects or interactions? These are perfect questions to ask the pharmacist to look into while you continue conducting rounds. The pharmacist serves as a vital resource for these types of inquiries and they are always happy to clarify dosing, dosing schedules, medication side effects and interactions.

 

Redirect the conversation

So, you’ve found yourself completely off topic and rounds are lasting a bit longer than expected. If you’re the senior physician, encourage the members of the team to revisit the conversation after rounds are complete. If the pharmacist has a teaching point, encourage him or her to share it between patient rounds in order to manage time effectively and round efficiently.

 

Respect time

Pharmacists are generally covering as many patients as physicians and may not always have immediate answers to any questions. Allow the pharmacist to consult resources and get back to you. Try to cluster questions together in order to eliminate frequent phone calls. Lastly, always practice closed loop communication to ensure that nothing falls through the cracks while providing excellent patient care.

I really had to change my study strategies from when I was in undergrad. I quickly came to realize that I had less time to procrastinate and more information to go through. And no matter what, I never felt ready for an exam and almost always felt like I just needed one more day! Therefore, I put something together that may help not just pharmacy students, but it may help just any student.

Here are some helpful tips:

Outlines and Drug Charts

✅One thing that helped me was to outline each topic or disease state, and then highlighting the important information. For example, for each topic I would generally list epidemiology, etiology, clinical presentation, and diagnosis. And when I mean general, I mean general. This was not much of my focus as a pharmacy student.
✅For me, it was all abut the drugs! In which, I would handwrite or type the drug charts, including the mechanism of action, side effects and anything unique that sticks out. I would then go in with different color pens and add in more information if something important was brought to my attention. All of the above information was condensed into 1-2 sheets, and provided me a quick reference. Especially, if you don't have time to go over everything again. I would take these notes everywhere and pull them out randomly and study (my study spot was the NY subway guys, I had a long commute). Example shown below.



Breaks and Coffee

✅Take breaks, especially if you find your self just staring at your notes and not retaining anything. Get some fresh air or have a cup of coffee. Coffee gave me life!
✅Group studies was always a good break. Teach back to each other, sometimes you will have a better understanding and may learn more that way.
✅ If you have multiple exams (which is always the case), try switching topics. I feel like that helped me when I couldn't take it anymore!


Note to Self

✅Yes, you will have to memorize a lot. But try to understand your material. I feel like you retain much more long-term.
✅ Make sure you get adequate sleep. Trust me, you need it and your brain will function much better. I was NOT a night owl, and called it quits if I realized I wasn't retaining information. In that case, I would just wake up super early and just start again!
✅Sometimes a little confidence goes a long way, so trust yourself. You know more than you think.
✅Do not wait until the last minute. You will get overwhelmed! Grad school is usually information overload. So it's always good to pace yourself and schedule your topics and study outlines.

Hope this helps, and good luck to all you students. I was there not to long ago, so I feel your pain. You will get through this!

As many of you already know, I am really into proper skincare routine and anti-aging products. There are so many products available that claim youthful and clearer skin. Sometimes its worthwhile researching the active ingredients and knowing what you are putting on your face. Therefore, I believe retinoids is a topic worth understanding!

As our skin naturally ages, the skin tends to loose elasticity, developing wrinkles or fine lines. Retnoid based products are shown to reduce wrinkles, increase blood flow in skin, fight acne, increase cellular turnover, boost collagen and even skin tone.

WHAT ARE RETNOIDS?

Retinoids are a class of chemical compounds that are derivatives of vitamin A. It can be dispensed as prescription medications or it is available in a range of over-the counter products. Retinoids work by promoting the skin to rapidly turn over cells. Old cells die and new cell growth is generated.

WHAT IS RETINOL?

Retinol is a form of vitamin A, that naturally occurs in the skin. Over-the-counter skin products contain 0.05-2% of retinol. The mechanism action of retinol is that it is converted to retinoic acid, which is the active ingredient that show improvements in wrinkles and texture of skin. The fact that it has to go through a conversion process, it takes time to notice results (~3-6 months).

Retin- A (Tretinoin)


WHICH ONE TO CHOOSE?

What to choose depends on your skin type and reaction. It's a good idea to start with over-the-counter products to see how your skin reacts. If you do not see the results you are looking for, your dermatologist may recommend a prescription based retinoid, such as Retin-A.

TRUST ME, I AM A PHARMACIST

• Do not use retinoid products if you are pregnant or breastfeeding. These agents are teratogenic, which means it can cause fetal harm.
• Waxing can cause further irritation and redness; don't use a retinoid for several days before a treatment.
• Avoid use of benzoyl peroxide and alpha hydroxy acids, these may deactivate retinoids.
• Side effects include redness, irritation, sun sensitivity (wear your sunblock SPF 30 or higher) and swelling of the skin.