Wednesday, June 20, 2012

BMT: a badge of honor

Posted by Anna at Wednesday, June 20, 2012

I can't believe my first rotation is coming to a close. Five weeks have really flown by, and I'm shocked by how much I have learned in such a short period of time. While I am thrilled to be coming out of this rotation only mildly battered, I am sad to leave the welcoming health care team that staffs 7W as well as the amazing patients.

As promised in my last post, I wanted to briefly touch on how pharmacists (and student pharmacists!) make an impact on this service. Pharmacists are well recognized as experts on medications, and their wealth of knowledge is not lost upon the health care team running adult BMT. In order to keep this concise, below you’ll find just a small taste of the questions directed at pharmacy:
  • A patient has consistently dropping cell counts, which is not altogether uncommon in this patient population. However, could any of the patient’s medications be contributing to this trend? If so, what change would you recommend?
  • A patient is unable to keep anything down due to the chemotherapy regimen we conditioned her with. What do you recommend after standard anti-emetic therapy has been attempted?
  • The patient is still throwing up. What else can you suggest?
  • A patient has been admitted with severe graft-versus-host disease of the skin. What type of therapy would you recommend to control the disease? What literature is your recommendation based on?
  • A patient is experiencing significant changes in mental status. Which drugs could be the culprits? Are there any specific tests or concentrations you need to assess? What about drug interactions?
  • Your poor patient has been hiccuping non-stop for a day with no relief in sight. We've tried Thorazine, but what else could help him?
  • A patient has end stage renal disease. Does this change your recommendation for chemotherapy doses? What is the basis of this decision?

Overall, this rotation was eye-opening. It truly helped me to determine my strengths and weaknesses, and it also allowed me to start developing important skills crucial to a successful career in pharmacy. I highly recommend this rotation for anyone who wants exposure to a unique and dynamic patient population. You also typically have at least a few other classmates on rotation with you, which honestly was pretty awesome!

The next time you hear from me I will be reporting from my rotation with a generalist pharmacist in the Pediatric Emergency Department!

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