What to review for hospital rotation?

[camjames]

Hi all,

I know this may seem like a stupid question, but I am a 4th year pharmacy student about to begin my first hospital rotation. I have been brushing up on some pharmacokinetics and antimicrobials. What else should I review that is not regularly used in the retail setting? How far into detail should I know the pharmacokinetics equations? Thanks.

Cam

---

Members don't see this ad.

 

[Quiksilver]

Hi all,

I know this may seem like a stupid question, but I am a 4th year pharmacy student about to begin my first hospital rotation. I have been brushing up on some pharmacokinetics and antimicrobials. What else should I review that is not regularly used in the retail setting? How far into detail should I know the pharmacokinetics equations? Thanks.

Cam

Depends on if its a specialty rotation. But if its just general medicine I would know ID, electrolytes, and common cardiac drugs

And know how to read labs

 

[cycloketocaine]

Depends on if its a specialty rotation. But if its just general medicine I would know ID, electrolytes, and common cardiac drugs

And know how to read labs

And maybe brush up on IV meds.

 

[All4MyDaughter]

I'm curious when you started your rotations. I started in July and am more than halfway done. How have you avoided the hospital so far?

I also need to know what type of hospital rotation this is before I can make suggestions.

 

[Sparda29]

Is it an "institutional" rotation or "internal medicine"?

If it is institutional in the beginning you'll probably be doing order entry/delivery/IV and then they would move you into looking at cases, farming/soaping them out and then maybe some rounding.

Internal medicine, you're gonna be doing a lot of cases, drug information consults, rounding.

 

[WVUPharm2007]

Also depends on what your preceptor specializes in. I had one hospital rotation where the woman did a 2nd year residency that pretty much focused on nutritional support and metabolism. Totally didn't expect to get a straight month of that type of stuff on a rotation marked "internal medicine."

 

[spacecowgirl]

anticoagulation

 

[psychoandy]

Hi all,

I know this may seem like a stupid question, but I am a 4th year pharmacy student about to begin my first hospital rotation. I have been brushing up on some pharmacokinetics and antimicrobials. What else should I review that is not regularly used in the retail setting? How far into detail should I know the pharmacokinetics equations? Thanks.

Cam

I'm assuming this is an internal medicine rotation.

I didn't do any PK equations/calcs bc there weren't too many people on AGs. The majority of pt's I had were all CAP/UTI/cellulitis pts, and a couple endocarditis, all of which should be an easy sanford guide consult. You're more likely to get pimped on mechanisms. However do go over concepts of PK/steady state stuff... This will matter when your preceptor asks you when vanco levels should be drawn, or what to do with a coumadin pt with an INR out of range.

Other basic stuff that I wish I knew, or you might not be too familiar with from a retail background:
-pubmed or google scholar is your friend, don't let your preceptor see you use uptodate, and most certainly do not tell anyone you don't know how to use pubmed.
-bowel reg and VTE ppx when needed
-DVT/PE stuff such as wells criteria, heparin sliding scale, when/when not to use LMWH, and etc.
-systolic/diastolic heart failure...
-ACE-I/beta blocker equivalence and IV forms
-warfarin interactions and target INRs...while you're at it, might as well read up on dabigatran, so on the off chance someone is admitted on it you can actually educate/impress the team.
-acute renal failure. pre-renal, intrinsic (ATN vs AIN), agents that cause it, etc. learn it, live it, love it.
-antiplatelet drugs, primary/secondary MI/stroke prevention, still makes my head spin

 

[spacecowgirl]

don't let your preceptor see you use uptodate

why?

 

[All4MyDaughter]

why?

That's what I was thinking. Everyone uses UpToDate at our facility. I just used it to research a presentation on heart failure that went pretty good. UpToDate, Micromedex, Lexi-Comp... these are good resources.

Now one should let a preceptor see you use WIKIPEDIA...

 

[spacecowgirl]

I would marry UpToDate.

 

[Praziquantel86]

That's what I was thinking. Everyone uses UpToDate at our facility. I just used it to research a presentation on heart failure that went pretty good. UpToDate, Micromedex, Lexi-Comp... these are good resources.

Now one should let a preceptor see you use WIKIPEDIA...

My attending on one of my last rotations used Wikipedia as a teaching aid for the team...and this was at a large academic teaching institution. It was a great talk, by the way.

 

[psychoandy]

Don't get me wrong, I like uptodate. It's a great intro to pretty much any topic, and it's continually updated, and you can easily pull references from it. But both of my preceptors (one faculty, the other critical care) completely dislike tertiary resources...such as uptodate.

I kind of agree with them; it's a crutch if you're afraid of pubmed or doing a lit search, and I think you get a better understanding thru reading primary literature vs essentially a meta-analysis type of review. But at the same time I also think that mentality is kind of a nostalgic holdover from the days of paper charts and orders and specific drug information pharmacists and no interwebs.

In any case, without knowing the specific preceptors, I'd rather err on the side of caution and not display weakness.

ps: i <3 wikipedia

 

[spacecowgirl]

Don't get me wrong, I like uptodate. It's a great intro to pretty much any topic, and it's continually updated, and you can easily pull references from it. But both of my preceptors (one faculty, the other critical care) completely dislike tertiary resources...such as uptodate.

I kind of agree with them; it's a crutch if you're afraid of pubmed or doing a lit search, and I think you get a better understanding thru reading primary literature vs essentially a meta-analysis type of review. But at the same time I also think that mentality is kind of a nostalgic holdover from the days of paper charts and orders and specific drug information pharmacists and no interwebs.

In any case, without knowing the specific preceptors, I'd rather err on the side of caution and not display weakness.

ps: i <3 wikipedia

If I pulled primary literature every time I needed to look up something, I'd never get anything else done. Has nothing to do with being a crutch or afraid of pubmed as I use the latter daily. I don't need to reinvent the wheel for every DI search, that's just not a good use of time.

So I would firmly disagree with your preceptors.

 

[Sparda29]

What I was told by my preceptor:

Quick look up for general knowledge: Wikipedia and look for the resources/references on the Wiki article. Now go and try and acquire those primary literatures via Google Scholar, PubMed.

Lexi-Comp/Micromedex - For quick info on drugs, use them.

Now for writing DI consults and other presentations, my preceptor told me that if I use UptoDate, that I should find the primary literatures that were referenced by the UptoDate article.

 

[Praziquantel86]

What I was told by my preceptor:

Quick look up for general knowledge: Wikipedia and look for the resources/references on the Wiki article. Now go and try and acquire those primary literatures via Google Scholar, PubMed.

Lexi-Comp/Micromedex - For quick info on drugs, use them.

Now for writing DI consults and other presentations, my preceptor told me that if I use UptoDate, that I should find the primary literatures that were referenced by the UptoDate article.

Agreed...I'll almost always use the reverse literature search. For something like a DI paper or inservice, it would be foolish to do an exhaustive literature search when you know the information is readily available in a compilation. Before I cite anything, however, I'll take a look at the primary literature referenced within UpToDate to make sure it wasn't misrepresented or there isn't something more current/appropriate.

For a publishable manuscript or conference poster/presentation, I do the literature search. You're the expert on the topic and, in theory, could be writing the tertiary reference. Granted, if you don't already have an in-depth knowledge of the topic this is a pain in the neck, but that's just another reason to stay on top of the literature and know your history.