lexipharm

NAPLEX08, I am not sure if I understand your question or not. B-blockers do not mask symptoms of diabetes. They mask symptoms of HYPOglycemia (palpitations, tremor, etc). Hypoglycemia can occur in patients with diabetes who are taking antidiabetic medications. It is important that these patients recognise the symptoms of hypoglycemia, so that they can adjust their insulin dose accordingly. So if they are taking B-blockers, these patients might not experience the symptoms of hypoglycemia and therefore they will not realise that their blood sugar has decreased too much. In patients who have diabetes, B-blockers may cause blood sugar to rise. I do not know how they do this. I would like to find out! Maybe someone can help us figure this out!

Hello, has anybody heard about pharmacy-based health clinics? I tried looking this up on the internet but I have not found much information about it. If anybody has information or a link to a site which addresses this subject, please let me know. Thankyou.

NAPLEX08, they offered me $16 an hour for first 6 months and $35 an hour for the next 500 hours. I know 16 is not a lot but its only 6 months so I'm not really worrying about the money at the moment. I am more concerned about working with people who can help me. I haven't started working yet so I cannot share my experiences, but I will let you know how it goes once I start working. Regarding the site I was talking about, go to Pharmacist.com | Your Access to the World of Pharmacy and home of the American Pharmacists Association APhA You will find all the information there. I chose the membership that cost $60. The CE classes are not desgned to help us pass NAPLEX, but i think they are very intersting and will help me become a better pharmacist. Hope this was helpful.

Do B blockers effect triglyceride and cholesterol levels and if they do...how do they do this?

Hello, can someone please elaborate on this issue? Because I still cannot understand what it is?

Hi, I didn't pay for a pharmacist's membership. I paid for resident/graduate membership which was $60 as opposed to a pharmacists membership which was about $280. I don't really know what the difference between the two is, but I can take CE classes with this membership and I have access to their online journals too which is all I need at the moment! And their books have a discount for members. The discount is only a few dollars but its better than nothing. Anyway if I were you I would check out their site. Hope this helps!

Rubygq that was so helpful. Thank you. We are going over the topics together and sharing information. Keep us posted and if you have any questions, we can work together to figure out the answer! Lexi

Naplex 08, thanks a lot for that site. I love using these sites. Its an interesting way of studying without getting bored. When I was studying for FPGEE I used the following site FPGEE practice questions and answers | Pharmainfo.net I found it quite helpful. I am also using CPR and APhA and I joined the american pharmacist association and I am taking continuing education classes online. I find them very practical and I think these classes will help me improove my skills as a pharmacist apart from increasing my knowledge on the subject. I am also living in VA by the way. I live in Chesapeake. I'm waiting to start my internship too (so I have a lot of time on my hands at the moment). I will be starting as soon as I receive my internship licence. I found an intern position with Wal-Mart. You said that you still have to do 1000 hours of internship? Isn't it 1500 hours in VA? Anyway, after internship, I'll take NAPLEX so I'm thinking it will probably be around January 2009. Anyway, I'm almost done with hypertension because at the moment I'm focusing on reading and understanding the subject, and I'm not really trying to memorise much. After hypertension, I'll probably start diabetes because I'm getting bored of the CV system. I need to switch to something else. What about you?

NAPLEX08, thankyou for your feedback. You are right, I looked it up and found that patients with bilateral renal artery stenosis predictably develop renal failure if treated with ACEIs, because in this case, glomerular filtration is maintained by angiotensin 2 mediated constriction of the efferent arteriole (due to low afferent arteriole pressure in this case). On CPR (chap 56 - renal failure) ACE inhibitors are actually used to treat CHRONIC renal failure because "they help preserve renal function and delay progression of CKD". So ACEI's may cause ACUTE renal impairement. However they are beneficial in chronic renal failure since they treat the oedema and "they act preferentially on angiotensin-sensitive vascular beds, which include those of the kidney, and sustain adequate perfusion of these organs". So that is why when the compelling indication in hypertension is chronic renal failure, ACEI's can be used! What do you think?

Hello everyone, I hope you are all still intersted in sharing what we're learning. I have moved on to hypertension now. I know NAPLEX08 has already covered this topic. So maybe you can answer my question. It says on APhA that patients with hypertension and chronic kidney disease can be treated with ACEI's or ARB's. But these drugs can cause renal impairement right? So how come they are used in hypertension when chronic kidney disease is a compelling indication? Thank you

Hello everyone, I have been reading and hearing a lot about MTM services and although I know what it consists of, I do not understand whether this term can apply to all pharmacists, or just those who work in hospitals. Can you give MTM services in a retail/chain pharmacy and is the patient charged for such service? How does it work here in US? Thank you all in advance for your feedback regarding this matter. Lexi

Hello everyone, First of all, thankyou NAPLEX08 for your reply. I was reading about loop diuretics being preferred in heart failure over thiazide diuretics. This is because loop diuretics are more potent. CPR explains that another reason is that loop diuretics have the added advantage of reducing venous return, independent of diuresis. Can anyone elaborate on this point please?

Hi NAPLEX08, I would like to join these discussions. Since you said you're studying heart failure, I started going over that subject too. And I have some interesting points to share. HF is usually accompanied by other comorbidities. Medication must be tailored accordingly: If renal insufficiency is present, Diuretics and ACE inhibitors must be avoided. (I think its because ACE inhibitors may furthur impair renal function and diuretics cannot function well if the kidneys are impaired. Please write back if you disagree with me on this). Arthritis can also be present. NSAIDs are usually used to treat arthritis. NSAID's have been associated with inc risk of HF. Also NSAIDs may cause renal function and MAY ANTAGONISE EFFECTS OF DIURETICS AND ACE INHIBITORS (both these are HF medications). Also, NSAID's inc risk of GI bleeding with may worsen anemia and in turn worsen HF. Atrial fibrillation may coexist with HF. B-blockers and digoxin can target both conditions. Use of ACE inhibitors and angiotensin 2 receptor blockers is qeustionable. B-blockers should not be taken without diuretics in patients with current or recent history of fluid retention to avoid its development and to maintain sodium balance....DOES ANYONE UNDERSTAND THIS? i DIDN'T QUITE UNDERSTAND WHY B BLOCKERS CANNOT BE TAKEN WITH DIURETICS IN THIS CASE???I hope this information has been helpful. I think if we all share with each other information which we think is important, we will cover the topic well! lexi

I would like to write a note of encouragement for all those who are planning to take their TOEFL and are getting discouraged after reading about other people's experiences. I am from Malta. My first language is NOT english. And i passed TOEFL on my first attempt. I scored 27 in speaking section. Although my english is good, i practiced for the speaking section to train myself to talk about a topic after thinking about it for only 15 seconds. I hope this helps anyone!

I agree with bigmoonstar. Thiazides are first-line treatment in hypertension. The lowest dose of hydrochlorthiazide should be used and if that is not effective then increase dose to max of 50mg. Increasing the dose any furthur will not help. At that point you can combine with other antihypertensives.

Hello, I am in Chesapeake, Virginia! Is anybody from around here? I will be starting internship soon and just started studying for NAPLEX. It would be great to have a study partner and somebody to share experiences with. Lexi

Hello, I will be starting my internship soon and I am trying to prepare myself for this next step. I am studying abbreviations and trade names at the moment so that when I start working, I will not feel completely lost! Does anybody have any suggestions regarding what I should focus on over the next couple of weeks, before starting my internship? Thank you, Lexi

Hi guys, What books are you using? -

I guess it depends on where you live in virginia. I live in Hampton roads and I was called for an interview one week after submitting my resume online. I will start working as soon as i get my internship licence because I am still waiting on that to be issued. In VA you have to make 1500 hours of internship before taking naplex! -

Hello, have you guys ever heard of specialty pharmacy? I have been trying to look this up online but I cannot find enough information about it. I am still working on getting my licence but once i do get my licence, I want to furthur my education. So does anyone know anything about this field of pharmacy?

Your next step is to wait for FPGEE certificate. You can call nabp to make sure that it is being processed. While you are waiting, you should start looking for internship positions so that once you receive certificate you can go ahead and apply for internship licence with Pharmacy Board in your country. I think the proceedure is different from state to state so you should go to the site of your state's Pharmacy Board and look up what you have to do to apply for internship. Congratulations and good luck.

Hello, I have an interview on friday for internship position at Wal-mart. Can anyone give me advice on what kind of interview to expect? and how much do they pay? and also whether it would be good for my career to do internship at Wal-mart! Thank you all!

Hello, Thank you for your reply. I went on the site online and clicked on carreers. And I posted my resume online. I did the same thing with all chain pharmacies. That is how i applied and after a week, Wal-mart contacted me. I have not gone for interview yet. I will keep you posted.

Hello, I just received a call from walmart for an interview to work there as pharmacy intern. Could anybody tell me what they think about working in walmart? do you think it would be a good environment in which to learn and advance in my career? Thank you.

Hello everyone, Can anyone suggest chain pharmacies other than walgreens and cvs? I am looking for pharmacies that are not connected to supermarket. Thank you and good luck to you all, alexia