.: As life continues :.

(this entry was written exactly a year ago)..

PCM is the most widely used medicine in the world. We, in health-care setting usually called it PCM as a short form for Paracetamol (in US, they call it Acetaminophen). It’s the same thing actually. Here, in Malaysia the brand Panadol is known by everybody. Why suddenly I’m writing about PCM?

I woke up this morning with a headache. I’ve slept since 9pm last night. Am i feverish? I can’t tell that. I don’t keep thermometer so i do the traditional way of putting the back of my hand on my forehead and neck. I didn’t feel any unusual rise in temperature. The question is, should I take PCM now? I got up and stared at the medicine box I own. I keep the basic medicines for emergency. Then, I decided not to take.

Hmm.. I’m thinking by myself. I can say that I’m not very fond of medicines/drugs, though I’m a pharmacist. Most probably because I’m one of those who are allergic to Penicillin group antibiotic. I developed whole body rash after I took Amoxicillin, and it scared me like h***. The second reason maybe as I know the mechanism of side effects of the drugs, I become paranoid enough to imagine how it might happen in my body.

But, I want to tell you that if you take them according to the therapeutic (prescribed) dose, it should be no problem. As medicines have undergone many stages of laboratory and clinical trials before they are approved to be marketed.

PCM overdose/poisoning is one of my favourite topic. Cases of alleged PCM poisoning are very common actually. In simpler words, meaning that people swallowing a lot of Panadol tablets at one time with the intention of committing suicide. I only knew that these cases really happen when I was doing housemanship in hospital.

There were cases of 18 year old (silly) Malay girl doing that as she just being dumped by her boyfriend, and another case I found during the time SPM result was out that year. The girl wanted to commit suicide as she was so frustrated with her SPM result. Hey, it’s just SPM result! The world has not ended yet. Another case I managed is a case of 45 year old Chinese female who did that as she found out that her husband was having an affair with another woman. She was very depressed at that time. I strongly feel that the dramatic action was just to grab her husband’s attention. She doesn’t really want to die as she immediately called her son after she took 20 tablets of Panadol . All these patients are alive, but with some degree of liver injury (In high doses, PCM produces toxic metabolite in the liver).

For general info, if you take like 10 tablets of PCM at one shot, you would not die. Chances of you getting serious hepatic (liver) toxicity is very high. And, surely pharmacist-on-call would be called (if is’s beyond office hour) to analyze your blood level of PCM; to know whether the level is toxic or not and to decide whether PCM antidote should be given or not. See, all government hospitals have the PCM antidote. So, this might be the reason you woke up in hospital bed after that instead of in heaven (or hell) as u intended to

I know how to calculate the toxic dose based on a person’s body weight (meaning, if you weighs 60kg, how many tablets of the 500mg PCM you should take if you wanna commit suicide). But, I won’t dare writing it here. I don’t wanna be the one contributing in that matter of case.

Ok, the take home message:

1. For adult, the recommended PCM dose is 1000mg (2 tablets), 3-4 times a day.
2. Do not exceed 4gram/day (8 tablets).
3. If you take the ‘normal’ daily dosing for a long period of time, you may also get the risk of liver side effects. So, if you take PCM as self-medication and the fever/pain not subside by 3 days, please see a doctor.

Lastly, suicide is haraam in Islam and other religions also prohibit it.

Yes, it is September. 1st day. And it is raining outside. I started writing this entry after Subuh prayer. It’s almost 2 months after my last entry. What I can say is life has been hectic for me for the past 2 months. They were eventful months.

Life has turned 360 degrees for me. I still remember a few months back when i was still struggling to finish my master degree.. And before I realize it, I am now a lecturer..right after I finish my 365-days study leave.

I was too busy adapting at work. Coincidentally, I reported for duty on July 1st and the new semester of this academic year started on July 13th. Perfect timing! Yea, for me to adapt with the teaching environment, to get things ready for the subject I am coordinating before the semester starts etc.

Anyway, as we always realize..time DO flies fast. Today, my students will sit for their mid semester exam. All the best for them (hope they can answer my questions).

I’m thinking.. whether I need a high dose of caffeine or a SLAP in the face! Reason being.. ngantuk!!

What is happening to me? I take substantial hours of sleep, but still sleepy. My body is aging? I couldn’t deny that, too. I can feel that my metabolism is slower than my youngers years..huhu..

I still have a lot of things to do..I’m at the final part of my master’s program. Have to do major tasks in May..and preparing to submit in June. I only have pieces of them now..here and there. Owh.. Ya Allah.. And it’s May 12th. Only a few weeks before June comes. I’m really behind time.. Isk.. On the contract, my one-year study leave will end soon.. on June 24th, 2009. After that, will start working back.

Ya Allah..please gimme strength and courage..so that I can finish this program.. and after that only I can plan for the next big step in life – kawen start applying to do PhD, maybe.

My final examination starts tomorrow. Hopefully this would be my last examination so that I can complete this MPharm program this June after I complete da short clinical research.

During my revision week, I went to study in IIUM Gombak library for a few times. My sister is also facing her end-of-sem exam. So we studied together.

I have 3 papers:

- Pharmacotherapeutics 2 (Apr 20th; Monday).
- Pharmacotherapeutics 3 (Apr 22nd; Wednesday).
- Pharmacotherapeutics 4 (Apr 24th; Friday).

Please pray for me..

P/S: This entry was scheduled to be published today. I’ve prepared this a few days back..

I wrote the entry Psychiatric on March 24th ’09. This is the second part.

I remember the time when i went to the female psychiatric ward again. Still as cautious as before, I browsed through the patient’s medical records to search for interesting cases. Suddenly, a voice stopped me. There was a chinese patient approaching me, with a magazine in Bahasa Melayu in her hand.

“Bole saya nak tanya sesuatu..?”

I was like.. Damn! Please don’t ask me something I don’t know…

“Apa maksudnya ini.. KALAU TAK DIPECAHKAN RUYUNG, MANAKAN DAPAT SAGUNYA ?”

“Ermm.. maksudnya.. kalau tak berusaha, takkan dapat hasilnya…”

“RUYUNG tu apa? Macam mana bentuknya?”

Owh..No! I’ve never thought of how a RUYUNG would look like.. Image of ruyung has never been stored in my memory.. *sigh*..

I couldn’t remember the ridiculous final answer I gave her. But she replied with a thanks and a smile on her face.

What did I do? I crawled walked out the area, slowly..while hoping that nobody heard that conversation.

I Googled, and finally found how a ruyung looks like from the blog Minda Bahasa.

I’m doing Psychiatric (elective) attachment. This is my final attachment before I finish my program..(Insha Allah..).

I went to the female psychiatric ward.. (didn’t have the courage to go to male ward). There were some patients who wandering around in the ward.. I believe they are those with mild symptoms. Otherwise, they would be restrained. I was doing my work at the sofa, facing the TV. And there was this girl (a patient) sitting beside me. She was eyeing me curiously..while I was afraid sitting there & hoping that she won’t ask me anything.. as I don’t know how to respond appropriately. And thank God she continued to watch TV peacefully beside me..and I managed to watch TV as well continue my work.

I think the picture I put above might reflect my condition now. Quite depressed. Having to undergo my current attachment (Psychiatric) but still working on my previous attachment (Pediatrics). I’m preparing for the delayed pediatrics major presentation as I was still warded when others presented their cases. And final exam is in April! Oh my..

My Feng Shui master said that this year 2009 will be a better one for me compared to last year. Whether to believe him or not, I can see some truth in it. Nevertheless, all are under Allah’s will.

I’m anticipiting a few big events / tasks this year. What I can say, my 2009 is full of plans. The only thing now, I’m focusing and praying hard on them so that Allah will make it come true. Ameen.