Why we don't smile sometimes (1)

     Was quite happy today until i met these few customers :

Customer A : Do you have these medicine?? ( showing a few types of pills without labels, indication or 
                     any  marks on the tablets)

Me              : Oh, can i know what are these for? I need to know before i can give you any medicine.

Customer A : HUH?! You don't know what are these??? Are you sleeping in class ?? How am i suppose
                     to know what are these? you are suppose to tell me. Ai.. Don't know you have license 
                     or not.

Customer B : Do you have this product ? ( a direct selling product or some unknown product or some 

                     products from overseas)

Me              : Sorry, we don't have this, if it is ok for you, i can recommend you with something that has 
                     the same active ingredient.

Customer B : What ? ! Pharmacy XYZ has this. Why your shop don't keep this. Everything also don't 
                     have. You are causing so much trouble for me.  @!%* @ ( rude words)

       I know usually we need to great customers with a smile, but, don't forget that we are humans too. When you meet with just one unreasonable people, you maybe able to ignore it; but if you encountered a few of the same kind in a row, it would really ruin one's day. 

        Now, let me explain why we can't give you your medicine, customer A:

       First of all, a pharmacist is not any "super computer" who can just scan the unknown medicine that you passed us and get the right one for you. There are so many pharmaceutical companies that produce different drugs today.Without knowing the name of the drug or the indication, we won't be able to provide you with the medicine that you want. Won't you be afraid if i just pass you some white tablets if you show me some white tablets? Won't you ask what are they? What are the danger that it will cause?? You maybe in great risk if you take the wrong medicine. So, it would be best if you could bring us the prescription =)

      About customer B,

      There are many companies that produce the same drug. It is quite impossible for us to keep products from each and every company ( especially overseas company, as some are not even imported into Malaysia). So, please try to be a little more understanding before you start opening your mouth.  

Just a joke of the day

Glucose–6–Phosphate Dehydrogenase Deficiency ( G6PD deficiency )

Customer A : My son/ daughter has G6PD , can they take this medicine??

What is G6PD ??

       G6PD is a protein found in red blood cells (rbc) that help the rbc to function normally. If there is not enough G6PD, the rbc maybe destroyed when one have fever or taking certain medicine ( haemolysis ) and this may lead to haemolytic anaemia. G6PD deficiency is a genetic- inherited - disease. The gene affecting this disease is linked to X-chromosome and so, affect males  more than females.

What are the dangers G6PD deficiency posses??

     Usually, people with G6PD deficiency have completely normal health. However, problems can occur occasionally when they are exposed to a drug or chemical that can cause a sudden attack of red cell breakdown.The affected person may feel unwell, pale and jaundiced (yellow) , have a backache and pass dark urine.  

Problems for newborn babies

      The babies with G6PD deficiency may get jaundiced in the newborn period. It is usually treated by putting the baby under a special UV light for a few days and sometimes blood transfusion. Many babies with G6PD are diagnosed because they have jaundice soon after birth. Normally, these babies will not get other complications once their jaundice have been treated, unless they took broad beans and drugs listed below. G6PD deficiency does not cause any problem in unborn child.

List of drugs that a person with G6PD should avoid: 

• Ciprofloxacin
• Dapsone
• Levofloxacin
• Methylthioninium Chloride (Methylene blue)
• Moxifloxacin
• Nalidixic Acid
• Nitrofurantion
• Norfloxacin
• Ofloxacin
• Primaquine
• Rasburicase
• Sulphonamides including Cotrimoxazole (Septrin®)

Avoid eating:

• Fava (Broad) beans

Points to remember

1) Make sure to let your Dr and pharmacist knows if you have G6PD deficiency.

2) In people with severe G6PD deficiency, haemolysis may occur in other situations, e.g : infection 

Some articles that you can read :

1) Medicinenet : G6PD deficiency

2) NHS : G6PD deficiency

3) NHS : Drugs And Chemicals To Be Avoided In G6PD Deficiency

Is Fish Oil Suitable for Pregnant lady?

Customer A : I am pregnant. Can i take fish oil?? Is it safe ??

Customer B : What are the advantages of fish oil for pregnant lady or the baby?

Omega 3 ( DHA & EPA)

Benefits of fish oil for both pregnant ladies and babies: 

       Many believes that taking DHA (docosahexaenoic acid), especially during the 3rd trimester of pregnancy can help in the development of baby's brain, eyes & central nervous system. Other benefits of fish oil includes reducing pre-term labour and delivery and increase birth weight. Also, it may decrease mother's risk of depression.

Benefits of consuming DHA

         However, currently there is not enough evidence to draw any firm conclusions that fish oil can really help in the development of cognition in babies.

Is it safe to take fish oil during pregnancy?
        There are some unpleasant effects that some mother-to-be may experience, e.g : reflux or 'fishy burps', stomach upsets and maybe fishy taste in the mouth. These are usually rare and not dangerous and usually go away with time or when you stop consuming these products. 

Some products that are available in Malaysia

There are many brands available in the market today. So, how do we choose?? 

1) The right proportion of DHA : EPA
2) Odour & taste : should be fresh and odourless ( risk of vomiting if not)
3) Mercury free

Points to remember :
When we mention fish oil in this article, we are not referring to cod liver oil. Consuming cod liver oil during pregnancy may posses a risk of developing vitamin A toxicity that is harmful to babies.

Some articles that you can read :
1) American Pregnancy Association : Omega fish oil and Pregnancy
2) Mayo clinic :  Pregnancy and fish

A joke to lighten up your day