Friday, June 24, 2011

Nutrition and Anatomy

Since the beginning of the month, I've been working with students and their nutrition class. Last week, they looked at carbohydrates and this week's lecture topic is lipids. In order to encourage participation, the teacher requires that the students post onto a discussion board.

Here's what we came up with together in response to the given prompt:



Fat Digestion
How would removal of the gallbladder impact fat digestion? You might want to do a little research before answering this question since the answer to this question may not be as obvious as it first seems.


The gallbladder is an organ that lies directly under and abutting the liver. A duct system allows the gallbladder to be connected to the liver and the upper portion of the small intestine. The removal of the gallbladder would not entirely inhibit fat digestion. Instead, by removing the gallbladder, the rate at which lipids are emulsified and the total quantity of lipids emulsified would decrease.

Fat that arrives at the duodenum of the small intestine triggers a hormonal response that causes the gallbladder to release bile into the duodenum to deal with the fat. The enzymes that digest fat can only work on the surface of the fat globules. Indirectly, chemical digestion and ultimately absorption would be affected in the small intestine. Here in the small intestine chemical digestion occurs via lipase, which is assisted by bile from the liver and gallbladder. The positive feedback of a hormone trigger from the small intestine would no longer exist. Once a fat or lipid arrives in the duodenum of the small intestine, there would be no affect like triggering the gallbladder contraction of bile into the small intestine. There would also be a decrease in lipase activity since the presence of bile normally increases lipase action.


Bile is originally produced in the liver. This bile is made from cholesterol and stored in the gallbladder. The gallbladder stores excess, unused bile and concentrates it. This bile is only then secreted via feedback mechanisms when needed. As an emulsifying agent, bile breaks down large fat droplets into smaller droplets known as micelles, whose surface area allows for lipase activity. In other words, the bile acts as a detergent on the fat and causes the large fat globules to break down.


The removal of the gallbladder would mean that there would just be no storage center for excess, unused bile. However, at the time of digestion by lipase, there would be adequate, yet limited amounts of bile. When this initial amount is used up, the body and digestive system would have to wait accordingly until the liver can produce more necessary bile for emulsification. This waiting period indicates that there is a lag time where no emulsification is occurring, or decreased rate, and the presence un-emulsified lipids, halting digestion.

In real life stories, patients have reported their own gallbladder removal. Their post-operative comments and lifestyle adjustments have indicated changes from less fat consumption in their daily diet, reduction of spicy foods as well as alcohol, which are shared in an online blog found here at http://www.hgriggs.com/gallbladder.html#threeyears .


"2001: A Gall Bladder Removal." Hedonism with Henry. 30 May 2004. Web. 22 June 2011. .

"Digestive System." MCAT Review. MCAT Review and MCAT Prep Online, 2008. Web. 22 June 2011. .

Farr, Gary. "The Gallbladder." BecomeHealthyNow.com - Your Source for Natural Health Care with Results. BecomeHealthyNow.com, 20 June 2003. Web. 22 June 2011. .

Thursday, June 23, 2011

Current Update for the Transition

As the day looms sooner until school, the last minute details of the move are panning out. I was debating on flying there. The only problem with this option is that I wouldn't have a car while there...not necessary if I live close to campus. The school has a "Ride your Bike to School Week!"

I can't really imagine a life without one, even if that means going to the grocery store and running simple errands. The go-green in me thinks a bike or fixie will be my next best friend.

The apartment situation is panning out, all the options are within the 3 mile radius of the campus.

Driving there is plausible and the option I'm leaning more towards. I google mapped it with my dad, its 18 hour trip. I figure 2 days on the road by myself, or 1 whole day if I combine with someone. I'd ask my mom and dad to come with me, but it doesn't make sense to go there the first or second week of August, if the white coat ceremony is on August 19th. I don't think I would enjoy the back and forth.

So best bet sounds like a good personal and reflective road trip and have the parents fly out the weekend starting Thursday August 18th.

As far as scheduling this whole move is conflicting with work and I have to see if filter out of the summer program by the beginning of August pans out. If not, these road trip hopes are out of the door and i'll be flying there August 11th in time for Friday's orientation. Then, I can ask the 'rents to drive out there the next week with the car. Mind you, my dad dislikes airplanes, so it works out :)

On a lighter note, my CPR training for re-certification will be done this weekend and my immunization records are now on file. Yay for being 90% completed with everything! Now just waiting for another reforwar of official transcripts!

Until the next Rx,

- Nicole

White Collar Meets Pharma's Squalor

If you don't know what squalor means, and trust mean, dictionary.com definitely helped,
squal·or/ˈskwälər/
Noun: A state of being extremely dirty

In other TV news, the hit series "White Collar" featured a quick glimpse of a Big Pharma company. In this episode a Pullitzer journalist is on the brink of uncovering a Pharmaceutical companies ploy to internally destroy any evidence of a recall and repackaging of their blockbuster drug. Undercover FBI agents pose as FDA and meet with Pharma executives and threaten them with potential lawsuits if the relevance "smoking gun" of sample numbers isn't revealed. It turns out that the list of sample numbers were packaged from a "bad batch." In that case, the company did not nationally recall the batch, fearing economic backlash. Instead, they took the samples that were not dispensed and exchanged them from newly designed packages, which the company indicated was for marketing purposes. This steps were taken to prevent any liability and backlash that would result from those that were actually administered as prescriptions.

Spoiler alert: the R & D scientist was the journalist's source, who ends up being murdered at the end! Imagine that!

From a realistic analysis, this picture painted by thriller suspenseful TV proves to be a glimpse and inadequate picture of Pharmaceutical companies. In essence, most companies try to remain as transparent as possible. FDA is also the governmental agency that ensures situations like these won't happen. Credit to the R & D scientist, but a Pharmaceutical company should follow ethical procedures to not only serve their business demands, but more importantly, the needs of the public and their own customers and patients.

White Collar full episode gallery:

Rachel Ray Meets GABA: an haphazard revelation?

I happened to catch a glimpse of Rachel Ray's morning talk show.

Show link

Actual Clip Excerpt


On this particular episode, her guest star was a doctor applying a facial cream on an audience member. In any case, looks like a standard information. However, this clip stands out because this guest star doctor mentioned that this particular treatment was unique in that the cream was synthesized from GABA, or "mimicked Botox." In my mind, I was just shaking my head. Totally two different things: if only everyday people knew of this. One was a topical ointment, Botox is usually administered via injection. Besides this simple comparison, the doctor also mentioned to the audience GABA is a natural transmitted. Little did he distinguish that Botox is synthesized to a toxin made by the bacterium Clostridium botulinum.

Not that I've taken pharmacotherapy or pharmacology II recently, but I definitely know that these GABA receptors in the brain and hypothalamus have a different effect.

Not saying that the topical ointment can diffuse and have those therapeutic outcomes, but I definitely suggesting holding off using this type of wrinkle-remedy so soon. Continue with caution and just wait for the long term effects of such effects. Wrinkles are bad, but too much or too little GABA definitely is worse.

GABA interesting article:

Who's Excited? 2011 Mock Draft | NBADraft.net

Aside from the application, I've had NBA TV and Espn on all day for the NBA Draft Preview:
Who knows will Cleaveland rebuild?
Yes Lakers have 4 picks, but can Lakers really come back after the Dallas upset with the newbies?
What's Utah going to look like? Still excited to see how Howard plays this year.
What's the mark left by international players this year? Thinking Pau, (before his 2011 western conference debacle)





2011 Mock Draft | NBADraft.net

Pharmacy Intern Position

So this week has been light as it the week before Summer School Program starts at work.

So glad it worked out, because I finally had time to work on my Pharmacy Intern application.

Take a look! All together, the intern questions and an updated resume took about 3 hours. Time well-spent, what do you think? Any comments or suggestions before final submission?

Until the next Rx
Nicole

College Activities/Honors/Achievements


• UCI's Share Tutorial Program: coordinated with fellow club members and students at low-income high school Saddleback High School, collaborated with school teacher’s to distinguish student’s areas of focus
• Community Care Health Center: Grand opening El Modena Women’s Health Center and Clinica Medica De Ella, Teen Clinic Outreach Volunteer, Collaborated with Dr. Tomlinson on increasing foot traffic and community awareness through neighboring high schools
• Development and Marketing Volunteer: coordinating grant paperwork and media publications for the center at Huntington Beach Community Clinic
• Sacred Heart of Jesus Retreat Center After School Program: Arts and Crafts coordinator
• Hobbies and Interests: Family, Fitness, IWFL,Buddhism, Rockclimbing, Entrepreneurship, Blogging

What are your pharmacy career goals?



I foresee myself organizing clinical trials and communicating within a Pharmaceutical company’s divisions. I would also serve in a community relations capacity to assure new and current drug adherence and improve therapeutic outcomes. In the community setting, my position can help improve the quality of life. As a pharmacist, I can aid in affecting local and global change and work towards a positive future. My interest in Pharmacy is not strictly limited to the immediate and long-term effects on a patients’ health. Instead, the statement “think globally, act locally,” highlights my passion for Pharmacy extends to Pharmaceutical Outcomes as well as Research and Policy. My future career aspirations include graduating with a dual degree PharmD/MBA or MS in Research and Policy.


What do you hope to experience and or gain from this internship?


This internship would provide valuable experience in private health care to and to prepare me for a career in the Managed Health Care specialty. In the end, I hope that this intern experience can help me provide a strong background to step into a pharmacy advocate role and serve the community's healthcare needs. This internship experience combined with (insert school name) Pharm.D. program would only enhance my perspective in Pharmaceutical Industry and future contribution to the policies that currently exist. I believe that the altruism, think globally, act locally will allow me to collaborate with other pharmacists and medical professionals to better our health community. This internship will serve as exposure for me to gain valuable clinical experience to create a pharmacy that provides quality care for the members and families and contribute to the well-being of communities.



What is the job of an intern, and why are you a good candidate?


An intern’s job is to work with and report to the pharmacist and staff in order to facilitate their duties in helping patients and fulfilling the mission of the Kaiser health care organization for members and families. Under direct supervision of a licensed pharmacist dispenses and distributes pharmacy products. As an intern I would be consulting with Kaiser patients and medical personnel about medication therapy and product identification. While upholding Kaiser Permanente's policies and procedures, I would be considering cognitive, physical, emotional & chronological maturation process in the delivery of services to patients, interviewing patients and assessing the patient's needs & provides pharmaceutical care needed in accordance w/ department policy. This intern position requires that I am evaluating and resolving medication therapy problems and discuss with medical personnel pharmaceutical care and treatment of patients.

Growing up I was a Kaiser member and I realize the utmost quality of care that Kaiser health professionals and staff provide for their members. My first-hand experience with their professional has shown me how to act in an empathetic and consistent way. Their professionalism and my own experience has enabled me to deal with problem solving situations. When caring for a person it is important to be sympathetic and supportive and not to lose one’s patience. Indeed, when working in a hospital, pharmacists can show compassion and respect in addition to their pharmacological competency. This same compassion, respect and competency are traits I wish to learn from and emulate. Kaiser's environment focuses on patient-centered care and my experiences have prepared me to pool resources and work efficiently especially when dealing with the dynamics of health care and specific patients.
As a Kaiser intern, I would be able to communicate effectively with members and staff. I am capable of shaping my words and my message for not only to my Kaiser preceptors about my assigned tasks, but also Kaiser members and families about their prescriptions. Most importantly, as a professional, I act in a manner that is not only best for all but also contributes to a positive and harmonious health care environment. I am a candidate best suited to this intern position because I can be professional as I can cope with the challenges and conflicts inherent in professional health care setting.

How will your academic and extracurricular activities contribute to your success as an intern?


I feel that the culture and diversity here has imprinted an appreciation of new cultures and traditions that my preceptors, fellow interns and other staff members bring to the table. My educational foundation at UC Irvine has brought me in close contact with research-based professors in the field of pharmacology and pharmacotherapy. An extraordinary caring yet adventurous attitude to help people has excited me and made the pharmacy profession my role model. The changing global environment, increased life expectancy, and ever-increasing population are offering unmet challenges. These challenges offer an opportunity to use my abilities to find new and innovative solutions. Over the years I have developed myself in countless ways in terms of a hardworking, persistent and focused personality. My UC Irvine education and Orange County community health experience has prepared me to engage with the faculty and front-line clinicians to be in service within the Kaiser organization. With this, I believe the Kaiser's program can help me face these current health care challenges.
With my diverse perspective and experiences, I have a strong feeling that I will able to finish the Kaiser organization Pharm.D. program as a professional who will advance patient care and facilitate the discovery, understanding and cost-effective use of medicines for the community and society.
In order to prepare myself I have immersed myself in multi-cultural setting to help me develop the skills necessary to interact with Kaiser and community members and other healthcare professionals. From those under-served within my health community to my students and parents of different ethnic backgrounds, these various settings have allowed me to interact with those from diverse backgrounds.

More recently, I have recently been able to return to school to fulfill pharmacy requirements. At that time I earned an A's in all three courses: Statistics, Chemistry and Calculus all while working full-time and managing over private clientele of students. I believe this work ethic and time management skills can carry over into my Pharmacy intern experience, because I am fully capable of managing the responsibilities as a Kaiser intern while completing my Pharmacy education.

Applicant Signature (electronic) Date

Wednesday, June 22, 2011

Cards to help with Rx

Hi everyone,

It is literally getting down to the wire. Two months until school starts
Today I was sent an email about supplies I need to purchase! I am more excited

Check it out! Look what I'm going to have in my handy-dandy pocket at all times!


A Sincere Rx

Sunday, June 5, 2011

Late Night TV

So a recent showing on MTV proved valuable, True Life, I'm on Steroids.

Midway through the showing, I googled the True Life Synopsis and was sad to find

It surreal to read this, especially after working with students who were preparing for their Biology exam studying the macromolecules of life.

Weird to think how something so simple and essential in life can be utilized in a way that causes these side effects.