Monday, 18 August 2014

S2W7: Life on the Pharm

Quote of the week: "There is no surgery that we cannot make worse" - orthopaedic surgeon taking us for a lecture on fractures. That quote would certainly make many patients feel uneasy going into surgery.  Also from the same lecturer, "orthopaedic surgeons have a 'rule of three', reduce, hold and rehab... any more would be too complicated". This was probably the most humorous lecture all week as he also shared/bragged (jokingly) about how fast he could perform surgeries "my personal best time for a hip replacement was 15 minutes, all before the bleeding starts - but then I have to reopen them...".

The week began on Sunday with an early morning isolation to study at the university computer lab suites... we're talking 7am here! The computer suites have 24/7 access via a scanner that reads a chip in your Student ID card (then you enter your access code). I had to catch up on a few lectures of pharmacology for there was a mid-semester test on Tuesday morning!! I closely associate pharm with big/long chemistry words like 'phenylethanolamine N-methyl transferase' and gibberish drug names like 'suxamethonium'... often we would rather suck meth on a mmmmm... just kidding!! Methamphetamine is really dangerous! Meth can act indirectly to release noradrenaline from neural vesicles, which then increases heart rate, BP, dilates pupils, inhibits gastric activity etc. Methamphetamine addicts can be identified by shining a bright light into their eyes (when their pupils don't constrict you may think 'Meth!?!'), also they are likely to be constipated (don't go monitoring your flatmates toileting habbits though! There are plenty of other, more observable-friendly, signs)

Our pharm mid-term exam covered aspects of pharmacokinetics, pharmacodyamics, antiplatelet & anticoagulants, cholinergic and adrenergics, anti-inflammatory drugs, analgesics & anesthetics, some drug interactions etc! Pharm is interesting and challenging - there are many pathways, receptors, sites of action and classifications to know. Lucky it was a multiple choice test!! When it comes to clinically treating patients, this course will be super helpful, but often I will be looking drugs up and suggesting patients to see their doctor or pharmacist.

There was a class photo on Tuesday too. This was organized by the physio student executive for the second and third year students. The class photo is to be purchased, so I don't think I will get a copy up on this blog.

I'm still medicing for Dunedin Tech, but the season is drawing to a close in a few weeks. We've had a good mix of wins and loses and are currently running for second place in the Otago premier league. Hopefully the team running to win will lose a few games so we can catch up on points (if we draw equal our team will win the league based on goals scored over the season). I'm medicing again this weekend and as the team is playing two games a week to finish the season on time, there are a lot of strapping and massages given to battered bodies before the games - one player broke his fibular (but unfortunately I wasn't medicing on that day!)

And so I had a birthday... I arrived in on Monday to the 8am lecture to be greeted with a birthday card! This was prepared last Thursday (I discover this having thought that I missed a class, because surely I would see this being done!) and I was completely oblivious! Well done to my peers for organising such a great surprise!

This was the last week of new material on the lower limb in anatomy. We learned about Tom, Dick and very naughty Harry... a.k.a Tibialis posterior, flexor digitorium longus, artery, vein, tibia nerve and hallucus longus! Did you know that some people do not have the muscle 'peroneus tertius' in their leg? Well, now you do! The next half of the semester will focus on the upper limbs.

We had another clinical placement debrief and heard stories from peers about patients with schizophrenia seeking treatment in a physiotherapy setting. This tied very well in with a lecture on ethics focusing on patient's rights. In New Zealand health practitioners must comply with the legal legislation "Code of health and disability consumers' rights" which is basically the 10 commandments of patients rights.

The semester finished with a pharmacology lecture on muscle relaxants covering spasmolytic and paralytic (neuromuscular) agents. We were informed about the toxin used on arrow heads by native American tribes and how we could load arrow heads and shoot patients with muscle spasm in our clinical practices. I'm joking, of course! Curare is however the plant substance that spasmolytic (spasm stopping) agents are derived from. Curare itself has been useful for hunting animals as it is an antagonist to ACh receptors at the neuromuscular junction (stops the muscle from firing). Hunters can eat the animal meat and not be affected because Curare is not bioavailable orally. Surgeons most commonly use paralytic agents to immobilise their 'pray-tents'... but make sure they administer an analgesic as well before operating! Oh, and the medical application of botox was covered too - it's not only used to make people's faces more "beautiful".

In more personal news, I have a flat sorted for 2015 and have been employed for 10 hours per week (on top of being a full time student). We are now on a one week mid-semester break. When we get back it will be spring (September)!

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