When I got to the hospital ward of the department of oncology, I could not find Dr. Bubalo and Michael, Pharm.D student.  They had gone to the round with 4 hematologists. Almost all patients lost their hair. Anytime Joe was asked about medicationby the hematologist, he can always the appropriate answer. From what I hear, this go around would been carried out from 7 AM to 8 AM for this week. It means I have to wake up at 5:30.  Wow!  Really tough job. 

Today’s lessons were “ventricular arrhythmias” by visiting assistant professor with PhD and “pharmacokinetics” by Sandy. Today’s theme is clearance. In Japan, “pharmacokinetics” appeared to be disliked most by the students, in general. But Sandy‘s lecture is funny and practical. So, almost students enjoyed the lesson. And “pharmacokinetics” was carried out almost every day, because it seemed to be important.

After lunch I returned to Dr. Bubalo’s office, and he told me “Sumio, do you want try to challenge something different?” And I answered “I do not have many experiences in this field, but I would like to try, if I can.” “Then, check the medications, labo data, and vital status of four patients with leukemia and lymphoma”

The way of writing medical record is totally different from Japan. In Japan the amount of dose in prescription was shown as total amount of the day , but in US, the amount of drugs was shown as one dose.  BID does not mean every 12 hours, so if a physician want to direct to the patient to take every 12 hours, he or she should write as 8:00 and 20:00 concretely.  A dose of medicine to be taken only once when the symptom is appeared is shown as PRN. PRN stands for pro re nata, means “as you needed.”  And the brand names are often different from Japan.  The old drugs like hydraladine are still used. Nystatin was often used instead of Fungison syrup, etc.

After Completed my work, I discussed about the patients with Joe just like as folows.

Joe: “Explain, who is first?”

Me: ” Neutrophil’ s percentage is 90%, extremely high in this case. ” 

Joe: “Why do you think? .”

Me: “I think the cause should be predonisolone.”

Joe: “That’s right!”

今日習ったこと；10/17

ステロイド投与によりレフトシフトが顕著になる。

LDHは細胞のturnoverのマーカーになる。そのため白血病のの再発のマーカーとなる？

BCLP: OncologyのSpecialistの薬剤師

BCPS: pharmacotherapyの専門薬剤師