More than Words~

Banyak yang hendak diungkapkan, namun kekangan masa seringkali menyebabkan aku bermonolog dalam fikiranku sendiri sahaja. Oh, alangkah bahagianya jikalau komputer ini boleh disambungkan kepada otak dan semua yang tersirat akan menjadi tersurat lantas segala peristiwa yang ingin disampaikan akan di"upload" di blog ini.

(Err.. What's up Iqa? Tetiba je menulis BM yang mcm pelik je ayat ko ni?)
Okay2, saje jer..
Menguji BM diri sendiri yang jarang sekali digunakan dalam penulisan sejak berada di universiti.. huuhu..
and I am DEFINITELY not good at it!(please understand that I'm NOT proud of it.. terasa malu sebenarnya..)

There are just so many things that are revolving around me.
So many things that has happened since the last post..
and so many reports to be submitted!
Sometimes it makes me wonder..
Am I going to be a pharmacist or reporter in the future..


Anyway, these are my first handmade capsules!~

Hahah!
Poyo gle ni..

Kononnye bangga la ni..
Padahal tinggal masukkan je powder tuh dalam capsules tuh haa..
hahah!
Terima kasih buat ahli kumpulan~

Every week we would have to go to the hospital..
With the H1N1 cases and all.. It does make me worry.
Anyway, that would mean, every week, we would have to be prepared for case presentations and reports..
Terpaksalah menahan the pressure from everything..
And I still have the problem talking in front of so many people!
(Duk teketaq2.. Awat la cek oii..?)
The thing that bugs me most is the fact that SUSAHNYA NAK INGAT SEMUA UBAT NI!
huhu.. From drugs to doses~
Oh, ya. Markah report pun x seberapa ni haa..
Got so much to improve!

Oh, yeah!
did I mention that I was bowling on the 13th August?
Yeah, we had an IntraBatch Bowling Tournament..

It was so funny! I was like.. err.. terrible.. horrible.. ~
Haha!

Anyway, before Iwent bowling with my friends..
I received this "love letter"..

and I say this with lots of love.. Apesal marah2 ni??
Seriously, I'm so sorry if I was blocking your way.
But you really didn't have to make it sound so bad.
I really hope that you would evaluate the situation.

The reason I am posting this in my blog is NOT because I am dissatisfied, because if I did, that will make me just as equal as you are.
I just think that I need to justify a few things..

Don't you think it's a little unfair when you associate medical students as being unable to think and making other people unable to understand too?
Kesian budak2 medic tau...

Nevermind.

Anyway, exam is just around the corner.
Around the "sharp" corner.. hahah!
It's next week!
Errrghhh!
Scarry~

Perlu bekerja keras ni!!

Ok, sekian saje nasi lauk campur dari saye.. (dalam erti kate lain: entri yang bercampur aduk dgn cerita yg x berkait antara satu same lain~) Hahah!
Have a nice day everyone!
and most importantly..
SELAMAT BERPUASA~

Oh, yeah!
Almost forgot~

Hmm..
Last week's lesson~
Sorry, I'm sort of sleepy right now..
So, I'll just cut and paste from Medscape's Multi-Drug Interaction Checker
I like using this link because it provides the references as well..

DRUG-DRUG INTERACTION:
Theophylline and Erythromycin Ethylsuccinate(EES)

Moderate Interaction
XANTHINE DERIVATIVES/SELECTED MACROLIDE ANTIBIOTICS
Theophylline Oral and Erythromycin Ethylsuccinate Oral may interact based on the potential interaction between XANTHINE DERIVATIVES and SELECTED MACROLIDE ANTIBIOTICS.



Xanthine Derivatives/Selected Macrolide Antibiotics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

MONOGRAPH TITLE: Xanthine Derivatives/Selected Macrolide Antibiotics

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: The macrolides may inhibit the metabolism of the xanthine derivatives at CYP P-450-3A4. Theophylline decreases the bioavailability and increases the renal clearance of erythromycin by unknown mechanisms.

CLINICAL EFFECTS: The concurrent administration of xanthine derivatives and some macrolides may result in elevated levels and increased clinical and adverse effects of the xanthine derivatives. The serum levels of erythromycin may be decreased.

PREDISPOSING FACTORS: This interaction may be more severe in patients who have decreased xanthine clearance rates secondary to CHF, viral URI's, hepatic impairment, acute pulmonary edema, or cor pulmonale. Large xanthine doses may also pre-dispose patients to the clinical effects of the interaction.

PATIENT MANAGEMENT: Patients receiving concurrent therapy with these agents should be monitored for signs of xanthine toxicity (e.g. nausea, seizures, nervousness, etc.). Theophylline levels should be monitored during and following concurrent macrolide therapy. The dosage of the xanthine derivative may need to be adjusted.

DISCUSSION: Several controlled studies have demonstrated that concurrent administration of erythromycin and aminophylline,(1-5) oxtriphylline,(6) and theophylline(7-17) may reduce theophylline clearance and increase theophylline serum levels and half-life. Theophylline toxicity has been reported with concomitant administration of these drugs, usually after concurrent therapy exceeds five days. In contrast to these reports, other studies found that concurrent erythromycin and aminophylline(18-20) or theophylline(21-24) had no effects on theophylline levels.

Studies have shown that aminophylline(3) and theophylline(7-8,25) can increase the clearance of erythromycin, resulting in lower erythromycin levels.

Elevated theophylline levels have also been reported during concurrent administration of theophylline with clarithromycin.(26)

Elevated theophylline levels have also been reported during concurrent administration of theophylline with troleandomycin.(27-28)

Azithromycin,(29) dirithromycin,(30-32) miocamycin,(33-34) ponsinomycin, (35) roxithromycin,(36-38) and spiramycin(39) have been shown to not have clinically significant effects on theophylline levels.

PS:
You might want to check out the references by yourself using the link..(banyak tuh kalau nak letak kat sini...)
Or check out other references like Micromedex (tak rajin nak check skarang)..
heheh~


<---- lamenya tak tidur lepas sahur!! huhu..

13TH AUGUST 2009

Dear Bro,
I still remember the days when we used to fight over things a lot.
Hahah! Ingat tak mase kita berebut peluru pistol kat dalam kereta sampai meletup tuh? hahaha! Pastu aku beraya dengan bulu mata terbakar! Bongok gle!~

I still remember the days when we used to get scolded together.
Hahah! Ingat tak mase kita ponteng sekolah bersama2 pastuh dgn banggenya kantoi? Siap amek gambar bsama2 lagi dgn patung rabbit aku yang bernama Emily itu. hoho. Bongok btol~

I still remember the days when we used to quarrel a lot.
Hahah! Ingat tak mase kite kejar-kejar dlm rumah? Siap test sparring lagi tuh. Pastu dua2 saket tapi buat2 macho. Aku ingat lagi kau cucuk aku dgn mechanical pencil kat peha aku dlu. Hahah! Bongok gle~


I still remember the days when we used to play treasure hunt together.
hahah! Ingat tak mase kite buat2 clue bsama2 dlu? klaka gile! entah pape entah yang kita maen lagi. dah la main berdua jer.. Bongok btol~

I still remember the days when we used to scream together.
Hahah! Ingat tak mase kita kena kejar anjing mase tgh naek basikal kat lorong rmh yg hujung skali tuh? Hampeh btol anjing tuh.. boleh plak die nak kejar mase tuh.. Bongok gle~

Klaka kan?

Despite all of the "bongok" things we used to do, I just want you to know that I love you dear..

Happy 21st Birthday!

Twinkle.. Twinkle.. Little Star~

Iqa, jangan tidur lepas maghrib.
Nanti mlm x blh tidur plak.
Kalau dah tak tidur malam, nanti esok mengantuk pulak dalam kelas kan?
Takkan laa nk tidur dlm klas lg kan? kan?
huhu..

Okay, kita recap blk ape 1 bnda br yg blaja dari attachment hari ni.
Patient saya ni DM tapi kena hypoglycemic attack sebab tak makan lepas makan ubat. huhu..
Lebih kurang sama seperti keadaan saya sepanjang hari di hospital dan case presentation tadi.. (Wuhuuu!~ Pening gle.. Mcm nak tumbang dah tadi~ Tak tahan tuh! Jawab soalan pun maen jawab je.. Tak ley nak pikir sgt..)

Lesson for today:

Metformin is contraindicated in patients with poor renal clearance because Metformin can cause lactic acidosis and lead to death.

Sedikit maklumat yg di copy dan paste dari sos cili dan sos tomato seperti Katzung dan Centre for Adverse Reactions Monitoring (CARM), Dunedin untuk memahami konsep ini:

"Lactic acidosis appears to result from biguanide (Metformin ni biguanide tau..) interference causing an increase in production and decrease in clearance of lactate leading to higher cellular lactate levels. Intracellular redox potential then shifts from aerobic to anaerobic metabolism A decrease in pyruvate carboxylase activity, the rate limiting enzyme in the formation of glucose from lactate, can also decrease hepatic metabolism of lactate."

Betol la kot sebab metformin can
1. reduce hepatic and renal gluconeogenesis.. pas2..
2. it slows the glucose absorption of glucose from GI with increased glucose to lactate conversion.. and then..
3. it causes stimulation of glycolysis in tissues
4. it reduces plasma glucagon level

Oleh itu, Biguanides are actually..

Contraindicated in patients with renal disease, alcoholism, hepatic disease, or conditions predisposing to tissue anoxia (eg: Chronic cardiopulmonary dysfunction) because of an increased risk of lactic acidosis induced by biguanide drugs in the presence of these diseases~

Okay?
Dah2.. Cukup satu je..
Sekadar untuk memastikan tak tidur lepas maghrib~

Jom study?

All Good Things Come To An End~

Huhu..

kecewa!

Kelmarin..
Saya dapat rambutan. (Thanks buat orang itu.. saya tau, saya sepatutnya ucapkannya sendiri..)
Tapi saya tak boleh makan.
Tekak saya sangat sakit dan tonsils saya dengan bangganya telah membengkakkan diri.(dah la tambah kes H1N1 yg menakotkan plak skang ni.. eee..~)

Semalam..
Saya dapat pergi ke TM (finally dapat pergi! hari2 pun banyak kelas, blk ptg, sure dah penat!) Got things to settle..
Tapi rupa-rupanya benda tak boleh settle lagi..

Hari ini..
Saya dapat parcel (the FIRST EVER since I've been in Kuantan! Sila faham.. actually, seumur hidup pun baru penah dapat 2 parcel je.. bukan parcel pon.. surat tp pkai courier.. haha! .. 1st from Feeza 2nd from Abg Long. Oh, sy sgt excited bile dpt parcel! Pernah sekali masa skolah dlu sy rs mcm nk anta parcel kpd dri sndri.. Hahah! Yelaa.. Seumur hidup pun, ni la first time ddk hostel yg jauh dr rumah~). Anyway, it is supposed to contain the CD of pictures of my Egypt trip.
Tapi tengok-tengok hanya ada 1 gambar je dalam CD tuh! Masalah laa~

Eurrgghh~


@1030 pm
huhu.. nk tmbah jgk lg~
and Oh, just now after breaking fast with Mar, we went to Secret Recipe..
I teringiiiiin sgt nk mkn Yogurt Cheese..
Tapi bila sampai sana.. Huhu.. Habis rupanya~ (huhu.. apekah???)

T. Cold Chicken 0.5 mg OD

Yesterday..
10.30 am class..
Dr Z: Betol tak, Syafiqah?
Me: Err.. (Okay, saya baru bangun... terlelap jugak aku rupenye... haish~ angguk jelaa~)

Today..
9 am class..
Mr S: Syafiqah!
Me: Hmm.. (adoiii!! apekah? sila bgn Iqa!)
Mr S: What does it mean when we say to potentiate...
Me: Err.. (Okay, Iqa.. Jangan buat malu. Sila tengok slide dan jawab dgn bangganya..)
It means that we need to increase the dose..
Mr S: Ok, yes.

Fuh~
Nasib baik!

10.30am class..
Dr Z: Syafiqah!
Me: *Hanya mampu tersenyum* (hahah! bongok btol ko ni Iqa.. kantoi lg plak~ uuw.. uuw~ malunyer..)

Dr Z: What's the difference between central cyanosis and peripheral cyanosis?

Me: Errr... (aku tau jawapannya.. peripheral: fingers and nails.. central: lips.. erk? apsal x terkeluar dari mulut ni??)

Dr Z: Tak pe, balik cari..

Fuh!~ Lega.. Nasib baik he let it go..
Maybe he realized that I was struggling with all my might to stay awake before he caught me dozing off. Kot..
hahah!

Okay, seriously Iqa..
Being called in class.. 2 days in a row.. and 2 classes in a row.. Very bad!
Bangun tido n x blh jwb soklan.. Worst!
Teruk ni.. Slalu klu tido pun boley nak goreng lg..
UuuuW uuuWWw~ Malu~
Hari ini Syafiqah famous dalam kelas yer..
Tak pela.. Looking on the bright side~
My lecturers love me..~ (Prasan nak mampos!)

Terima Kasih Cinta~

Yes, I was home during the last weekend.

I had to go home.
I was having a major homesick crisis.
Ibu wanted me home, so there was no way I was going to say no.

TokMak, Iqa suka tengok Tok senyum macam semalam.
TokPak, nanti kita makan sama2 lagi yer?
MakSu, thank you gorengkan cempedak! yay! dah lame tringin nak mkn ni..

Alhamdulillah..

Everything went well(yeke? ok2, sort of..).

Friday..
After giving directions to Ejad, they managed to find their way to Shah Alam. (I hope the directions I gave were clear..)
The guys stayed at my house while the girls slept at Mar's.
Hahah. Mesti diorang tak percaya when I said that my house is behind Mar's!
So close that Mar can even hear a person singing in the shower(if they did laa..)!
Only on the first night I had Tk, Atiq and McWa at my house.
Hahah. Sronok jgk ade diorang. But it was already late that night, so tak buat ape2 pun.
Terasa terharu jugak having them at my place.
Tapi segan la.. Hehe..
Rumah tak seberapa pun.. Serba-serbi tak ada..
Terima kasih laa sudi ke rumah saya..~
Huhu. I was just hoping that they had a good night sleep.

Saturday..
At the career carnival..

I was hoping tho see more pharmacy-related booths, but there were only a few.
But nevermind, I had a great time with my classmates.
Lame tak klua ramai2 mcm tuh..

In the evening, I was with the adek2 from Alex. (wuhuu~ this statement makes me feel so OLD! yek! )

(Oh, saya sangat skema.. benci~ lesson: jangan pergi hangout di Sunway Pyramid setelah pulang dari Career Carnival kerana anda akan kelihatan seperti baru pulang kerja! hahah!)

Ade Mas, Nana, Shima and Ejad.
Oh, sangat sronok jmpe mereka!

Sunday..
Driving back to Kuantan was the funniest part.
Hahah!
Konvoi beramai2..~ Dengan kereta yang pelbagai warna..
I'm starting to think that I may want to redefine the word "slow".
Hahah! Teruk betul la aku ni.. Dah tak reti nak bawak slow2. (Sorry yer kawan2 yg tersesat2 tuh.. sedaya upaya dah mantain speed tuh..)

Alhamdulillah..~
sampai juga di Kuantan.

Now, I feel so MUCH better!
and ready for the days ahead of me!

"Ya Allah, permudahkanlah urusanku..."

Ayuh, berusaha!!