on The downhill portion

Ok. I can do this.

Thursday has passed…slipped by, really. Wednesday was the first day that I felt like I could stand on my own two feet, not looking wildly around and wondering, “What the heck am I supposed to be doing? Am I doing this right? Am I in the right place? What is everyone else doing? Holy goodness I have no idea what I’m doing… Quick! Look like I know what I’m doing!”

You know, normal stuff.

Saranne has been a godsend…she’s so sweet and calm and willing to help with EVERYTHING. A quality lady if I ever knew one!

Today was the first patient assessment lab…we role-played with each other for three different patients, filled out medical history charts, and absorbed functional drug knowledge from our professors. I have a feeling that this acronym will be drilled into my head:

OLDCART

Onset: When the symptoms started

Location: Where is the problem located in/on the body?

Duration: When during the day are the symptoms present?

Characteristics: Please describe the symptoms

Aggravators: Does anything make it worse?

Relieving factors: Does anything make it better?

Treatment: Have you tried any OTC or home remedies?

Our three patients were a woman with dry, itchy red eyes, a man with severe constipation, and another man with a very runny nose/eyes.

The woman had been taking an OTC sleep aid for some time, 1 a day, and we found that prolonged ingestion of the sleep aid (Nytrol) could produce her very symptoms: dry and itchy eyes.

The first man had only had one bowel movement in the last 7 days, and though he had eaten more fiber (bran flakes) at the suggestion of his wife, he was still a bit ‘backed up’…(trying not to laugh). Upon examination of his medications (Celebrex, Norvasc, and docusate sodium), we found a possible problem. Celebrex is a calcium channel blocker. Smooth muscle is stimulated by calcium channel activation. Our GI tracts are lined and controlled by smooth muscle….so its possible that the Celebrex was causing decreased GI motility. The suggested remedy was a round of glycerin suppositories, drinking lots of fluids, and a salt-based laxative like Miralax.

The third patient was a college student with a runny nose and eyes who was already taking Zyrtec to no avail. His symptoms appeared around the time he moved back to Pullman and began working on the yard; the symptoms consistently improved when he left the house ( you know, when he goes to Rico’s, as Tasha put it) or was indoors. He also had a history of mold allergies. First of all, the patient was taking his medication at night before bed…er…well, it would probably be smart to take it during the day, since Zyrtec doesn’t cause drowsiness and he probably needs allergy medication to work when he is awake. We also suggested that he use an OTC allergy eye-drop to stop the watery eyes and give the Zyrtec a chance to work; sometimes drainage from the eyes can inhibit drug action in the olfactory area. If the symptoms continued, we suggested he try Claritin, an antihistamine that works differently in the system than Zyrtec.

Whew! I can’t believe I remembered all that!

After a morning of Pharmaceutics (drug design and dosage….SO interesting), where we learned WHY some things can’t be injected into the blood stream and why some things need to be inhaled and why some things have to be taken sublingually, I had lunch at the Co-Op (salad bar is astoundingly good on a hot day) with the lovely Tiffany. Give me a plate of greens, cheese, BBQ tofu, and kale slaw…plus a dear friend, and you’ve got one happy girl on your hands!

A couple hours of laundry and studying made me antsy, so I busted out a late evening run. Now, it’s time to devote one more chunk of time to pharmacy before I hunker down with the latest Lie to Me episode before bed. Oh the joy of going to sleep at 9:30. I’m a grandma, I know. Respect the bedtime.

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