back to OPD - syrup Enalapril, pessary counselling, colchicine+allopurinol

my last attachment at OPD was last year October

things changed 

felt a bit lost today

it was 8:30am and there was no one c/f the DD

hmmm.. i was thinking who is the 'lucky' one today

after briefing with the HOD, i was assigned to do so

OMBBBBBBBBBBBB

what's worse was i forgot to jot down the patients' name that i filled 

luckily Loke helped me to find out who is the patient

millions thanks to her

learned to make enalapril syrup

Syrup Enalapril

strength: 0.1mg/ml

vehicle: distilled water

tablet: 10mg (orange long thin tablet)

procedure: crush -> mixed with some water --> make up to final volume

refreshed on pessary counselling - thanks to Adila

1. go to toilet + wash hand

2. lie down on bed

3. bent legs like this 

4. insert pessary into "ruang peranakan" OR "ruang bersalin" OR "ruang datang haid" OR "rahim" OR "ruang persetubuhan" OR "vagina" (use applicator if not pregnant: pull plunger -> insert drug -> insert into vagina -> push)

5. lie down for at least 20 minutes or until the next morning

6. wear pantyliner as there may be discharge 

7. NO sexual intercourse for at least 3 days, AFFECT latex contraceptive 

learned colchicine + allopurinol - thanks to Chow

acute attack: take colchicine 0.5mg TDS until pain relieved or diarrhoea ensues 

patient may continue allopurinol dose as usual

if it's a new patient, the patient with acute attach should be on colchicine until pain relieved then only start allopurinol