"I refuse to take my medicine, I'm a normal pregnant woman," Cinderella Pharmacist Ep11 observation record

Disclaimer: The content selected in this article is from the Japanese drama "Unsung Cinderella" (aka Cinderella Pharmacist). The author himself is an ordinary young pharmacist in a third-class hospital in China, and the reason why he chose the content of TV dramas with other countries is entirely because the plot itself resonates with the author, and there is no other reason. The author himself is a lover of drama, but has not met other film and television series with the same pharmacist theme at home and abroad, I hope that the majority of netizens do not question the original motive, I love the motherland!

Adapted from the comic of the same name, "Silent dedication of cinderella pharmacist" chooses the lesser-known pharmacist theme, telling the story of the enthusiastic young female pharmacist Xiao Aoi who grew up in the hospital even though her status and situation in the pharmacy department of the hospital were inferior to those of medical staff, but still in order to protect the "precious daily life" of patients. This article will introduce the story of the drug patient in the eleventh episode, and at the same time sort out the relevant professional knowledge and drug knowledge in the drama.

The main story of the drug addict in this episode

The pharmacist Xiaokui transferred to the maternity hospital to continue her work, met a pregnant woman with epilepsy, she has suffered from this disease since she was a child, her mother let her choose a career to work from home as much as possible, and often reminded her that "you are different from a normal pregnant woman". It was this long-term spiritual oppression that made her rebel although she understood her mother's good intentions. She hadn't had seizures in 7 years, so she thought she could stop taking anti-epileptic drugs privately during pregnancy, saying, "As long as I don't take the pills, I feel like a normal pregnant woman." Her "self-assertion" led to her epileptic absence seizures, after being known by Xiao Kui, the drug patients exchanged hearts, Xiao Kui told her that taking anti-epileptic drugs during pregnancy would not bring serious adverse effects to the growth and development of the fetus in the abdomen, and advised her to insist on taking medicine, take care of her body, and welcome the birth of the child.

Mothers of pregnant women with epilepsy put too much pressure on their daughters

Pregnant women with epilepsy avoid medication and want to be "normal" mothers

The story of the drug patient in this episode

This pregnant woman had miscarried once, so she was very much looking forward to the smooth birth of this fetus. Due to physical reasons, she had to take litojune, a drug to prevent preterm birth, so that the embryos in the abdomen could fully mature in the mother's body, but this drug was accompanied by adverse reactions such as bloating and hand shaking due to its β2 receptors. Pregnant women to the pharmacist Xiao Kui reflected her worries and uneasiness, Xiao Kui did not use professional terms to explain the reason, but chose to let pregnant women trust the help of the hospital's professional medical care, do not worry too much, full of confidence in the birth.

Pregnant women take medication to prevent preterm birth, and the adverse reactions worry her

Relevant expertise points

Epilepsy is a group of chronic brain disorders characterized by transient central nervous system dysfunction caused by abnormal firing of neurons in the cerebral cortex. Its seizures are classified as localized (including isolated localized seizures, localized seizures secondary to generalized tonic-clonic seizures, compound localized seizures) and systemic seizures (including absence seizures also known as small seizures, atypical absence seizures, myoclonic seizures, myoclonic seizures in young children, tonic-clonic seizures also known as major seizures)

Reference: Pharmacy (Intermediate) (2017). People's Medical Publishing House

Antiepileptic drugs are classified as barbiturates, such as phenobarbital; benzodiazepines, such as diazepam; hydantoin, such as phenytoin; dibenzonitride, such as carbamazepine; γ-aminobutyric acid analogues, such as gabapentin; fatty acids, such as sodium valproate; and succinate, such as ethosuximide.

Reference: Practicing Pharmacist - Pharmaceutical Expertise (II) (2021), China Medical Science and Technology Press

Preterm birth refers to delivery at 28 weeks' gestation but less than 37 weeks' gestation, and is classified as spontaneous preterm birth or therapeutic preterm birth. Tocolytics can be used in the treatment of preterm birth to prevent immediate preterm birth and to gain time for the completion of pro-embryo maturation therapy and the transport of pregnant women to hospitals where rescue conditions are available for preterm infants. Common types of tocolytics are calcium-channel blockers (e.g., nitrophenidine), prostacyst inhibitors (e.g., indomethacin), beta2 adrenergic receptor stimulants (e.g., litozon), and oxytocin receptor antagonists (e.g., atosiban).

Reference: Clinical Diagnosis and Treatment of Preterm Birth (2014), Obstetrics and Gynecology Branch of Chinese Medical Association

The U.S. FDA evaluates the therapeutic benefits of the drug to pregnant women and the potential risk to the fetus according to the teratogenicity of the drug to the fetus, and divides the drug into five levels: A, B, C, D, and X. Because the classification system is too simple to reflect valid available information, in 2015 the FDA developed new regulations, the newly revised instructions will remove the five-letter grading system for medication during pregnancy, providing more effective information for pregnant women, fetuses and lactating babies, including whether the drug is secreted into breast milk, whether it affects the baby, etc.

Reference: https://www.drugs.com/pregnancy-categories.html

https://www.fda.gov/drugs/labeling-information-drug-products/pregnancy-and-lactation-labeling-drugs-final-rule

The classification standard of hospital grade is the mainland according to the scale of hospitals, scientific research directions, talent and technical strength, medical hardware equipment and other hospital qualification evaluation indicators, unified nationwide, regardless of hospital background, all nature, etc. According to the "Hospital Grading Management Standards", the hospital was determined to be three levels after review, and each level was divided into A, B, C and other three, of which the tertiary hospital added a special level, so the hospital was divided into three levels and ten grades.

Reference: Hospital Grade Baidu Encyclopedia

Relevant drug knowledge points

Perception and perception

CURE DEPARTMENT CAKE ONLINE

Medication during pregnancy and lactation has always been a key difficulty in pharmacological monitoring, and although common drugs have clear pregnancy and lactation grades, the effects of drugs should also be individualized. Under the premise of minimizing the use of drugs, weigh the pros and cons to ensure the safety of pregnant women and children and the effective treatment. Even if the graded safe use of drugs, but also according to the specific situation to adjust the use of drugs, for example, gestational diabetes insulin regulation blood sugar, although the drug is safe, but the drug use effectiveness is the key to affect the growth and development of the fetus, blood sugar is too high, it is likely to appear macrosomia and neonatal hypoglycemia after birth; blood sugar is too low, very unfavorable to the growth and development of the fetus. Please forgive doctors and pharmacists for not being too clear about whether it is safe to take medication during pregnancy, and doing your best to help is the best answer.

In the last episode, the pharmacist Xiao Aoi was transferred from the position of pharmacist in the pharmacy department of the general hospital for special reasons and continued to work as a pharmacist in the maternal and child health hospital. Although colleagues repeatedly tried to persuade her to return to her original post, the staff of the Maternal and Child Health Hospital also said that "staying here, yielding.". But for Xiao Aoi, she believes that the experience here is also growth, and she does not think that leaving Qu Cai, but can help pregnant women, and can also accompany the child's laughter, which is a meaningful thing. In the same way, in our country, the health technicians of public hospitals basically have the experience of going to the countryside, and "going to the countryside" should be the best time to learn and repay their talents. Capable people can achieve something wherever they go. In addition, the graduate students of colleges and universities who support agriculture, and the female county magistrates who ride horses and carry goods are all "down" to the grass-roots level, and there are brave and resourceful doers, who can say that their development is inferior to staying in big cities? Although pharmacy work in hospitals is basically "general practice" work, with the sub-professional training of clinical pharmacists, the construction and exchange of branches of pharmaceutical societies at all levels, etc., it indicates that the work of pharmacy in hospitals will become more and more finely divided in the future, and the more experienced pharmacists in specialized hospitals are, and better development can be obtained.

HAPPY

"Outside the hospital, everyone has their own precious daily life. In the future, there will be their own colorful future, and guarding them is the job of a pharmacist.

Note: The pictures in the article are partly from the Internet and are used for public welfare communication. Thanks to the author of the picture! The variety involving the manufacturer is only for learning and interpretation, and does not represent a recommended position!

To watch the full episode, search for "Cinderella Apothecary" in the watermelon video

Author:Jingjing Ma(Second Hospital of Lanzhou University)

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