Insomnia - an overview

"Have you got anything to help with sleep?" - This is one common question that people ask at the pharmacy. A simple question it may sound but there is really more to it than meets the eye...

Here's some questions for you to think about when finding your insomnia remedy:

1) How long have you had the insomnia?

Insomnia can be broadly classified into 3 types: Source: MedicineNet

• Transient insomnia usually is due to situational changes such as travel, extreme climate changes, and stressful events. It lasts for less than a week or until the stressful event is resolved.
• Short-term insomnia usually is due to ongoing stressful lifestyle or events, medication side effects or medical conditions and lasts for one to three weeks.
• Chronic insomnia (long-term insomnia) often results from depression, digestive problems, sleep disorders, or substance abuse and continues for more than three weeks.

 2) The causes...

Is it mood or stress-related?
What medications are you on? Have you just started on a new medication?
Do you have poor sleep habits?
Is there any recent lifestyle changes disrupting your sleep pattern?
Do you have any underlying medical conditions that could be causing your insomnia? eg. heartburn, back pain etc...

Sleeplessness can also be the cause of a mix of physiological and psychological factors. If it is transient sleeplessness, it would often go away with adequate rest and the help of short-term sleeping-aid.

Here are some possible causes and risk factors.


3) What have you tried?

You may have tried things like melatonin, other sleep supplements or even sleeping pills expecting to have a quick remedy. Have you also tried any lifestyle changes eg. exercises or relaxation techniques and environmental changes to aid you in falling asleep? Find out through trial and errors what worked for you and what didn't. Remember there isn't such a thing as one size fits all. Over-reliance on sleeping pills for a 'quick fix' may cause dependence and make insomnia worse in the long run without truely treating the root cause of the problem.


You can read up more here - Sleep Hygiene

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Stress-induced stomach ulcer

Gastric problem seems to be getting very prevalent these days. Dr. Joseph F. Montague, author of the book Nervous Stomach Trouble - "You do not get stomach ulcers from what you eat. You get ulcers from what is eating you."
 
To treat stomach ulcer, it is not just about taking medications (of course medications can play a part in reducing your stomach acid and treat any H. pylori infection). It also involves lifestyle adjustments and behavorial treatment such as time management, pacing and relaxing yourself and having regular meals. Also avoid eating food that are very spicy or oily. I ever heard from a doctor who said "The food you most hate to give up is the one that you should avoid when you have a stomach problem."

If you have a gastric problem that persists more than 2 weeks despite a course of gastric medicines  or on and off for over 3 months despite medicines and lifestyle changes, you should see a doctor to check against any ulcer or H.pylori infection.

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Top (worst) pharmacy etiquette

Let Angry Pharm-mist share with you the top 5 worst 'etiquette' displayed by customers or patients at the pharmacy.

1) Shout / swear / threaten at the pharmacist when they can't get their aphrodisiacs.

2) Cut queue without a care that there are other people already queuing before them.

3) "Bargain" for a prescription medicine without a prescription or a legally valid one. They 'want just one tablet' even after telling them where is the nearest doctor they can visit.

4) Demand that a medication be supplied when the pharmacist has deemed it inappropriate to do so for health and safety reasons.

5) Lie to the pharmacist that they have a prescription or would get one for an emergency supply of asthma inhaler and did not come back with one.

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Dear reader, I hope you are guilty of none above. If you are and have no intention of repent, please do not let me meet you at my pharmacy.

We all want a more gracious society in Singapore and courtesy goes a long way. Thank you.


[Disclaimer: The above mentioned behaviours cannot be generalized to all patients / customers and may account only for the minority.]

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How to be Pharmacy-Smart and Medicine-smart?

You visit the pharmacies in Singapore but have many frustrations or misunderstandings when communicating with the pharmacist. You wonder why the pharmacist can't dispense you certain medications that you can buy off the shelves oversea. You wonder why the pharmacist can't dispense your prescription. If that is what you are experiencing, here is a quick guide on how to be Pharmacy-Smart and Medicine-smart.

1) Present your IC when purchasing Pharmacy Only medicines.

This will shorten the time needed for the pharmacist to ask if you are already registered or verbally verifying your IC number /name. If you do not know why you must do that, please refer here regarding the mandatory recording of P-med sales.

2) Bring along your original prescription signed by the doctor whenever you need to collect your prescribed medicines - whether it is new or partially supplied previously.

Just like you need real money to buy stuff. DO NOT bring faxed, photocopied, duplicate or altered (without dr's signature, note: it is illegal to alter your prescription) prescriptions and expect them to be dispensed. And please convert your foreign ones to local ones too before you come to the pharmacy. No digitally signed prescription either even if your visited GP is high-tech enough to have digital/ online prescribing.
Once the prescribed quantity of medicines are fully dispensed, the pharmacist will have to file your original prescription away. You may ask for a photocopy but that will not allow you to get further supplies.

3) Check your prescription before leaving the clinic.

If you want a particular medication but the one written on the prescription looks different, verify with your doctor on the spot on why is that so. This will save the pharmacist and your time from having to call the doctor to make an intervention on your script. For safety reasons and by law, pharmacists will not supply medication that is different from the one prescribed without getting the doctor's approval.

Some prescriptions which are not signed by the doctor are not allowed to be used for medicine collection in other pharmacies except that of the hospital visited eg. National Skin Center. Polyclinics do not except outside prescriptions

4) If you want to know if a medicine requires prescription or is registered in Singapore, you can do a search at the HSA website.

5) If you want to learn more about the medicine you are using, please refer to the product inserts.

Product inserts would usually list the dosage, usage instructions and side effects. If you are still unclear, check with your pharmacist.

6) Let your pharmacist know if you have any allergy to medicines, medical condition (including pregnancy, lactation) or using any medications currently when purchasing medications.

7) Do not expect any medications to be free of side effects or would not cause allergy. Unless you want a placebo.

As different people has different genetics, response to the medications and extend of side effects experienced may vary.

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So there you go - 7 simple things to ensure yourself efficient and effective services from the pharmacists.

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Mandatory recording implemented for all P medicines

The final phase of full mandatory recording of Pharmact Medicine as required by HSA has started from 1st Feb.

For the purchase, customers / patients are required to provide the following:

• Name, identity card number, contact details (address, phone or email) of person to whom the medicine is dispensed
• Purpose of treatment

The pharmacist would also be documenting any drug allergy, medical conditions and medications that patients are currently on. The medicine dispensed would also have its quantity, dose, dose frequency and expiry date captured in the electronic pharmacy system centralize to the respective pharmacy institution.

Reference: https://www.hsa.gov.sg/publish/hsaportal/en/health_products_regulation/western_medicines/reclassified_medicines.html

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Choosing sunscreen for children

Thinking of bringing your children to the beach? Infants less than 6 months of age to advised to avoid direct sun exposure (have shades, have lightweight fabric or clothing to limit skin exposure to the sun), whereas for older infants and young children limiting exposure time and avoidance of peak sunlight exposure would prevent sunburn /damage to skin. If you still insist on bringing your children outdoor, further sun protection measures such as the use of sunscreen may be necessary.