STATION 1

Pharmacist: Good morning, how are you? my name is, I’m a pharmacist, how can I
help you?
Patient : I have Blure vision, Increase frecuency of urination,tired walking since 5
days, do you have any medication of that?
Pharmacist : sure, but before that Do you have 10-15 minutes of time? I wish to ask
you a few questions regarding your medical condition
Patient : Sure
Pharmacist : Could you please tell me your name and your age?
Patient : my name is Mrs SLM, 35 Y,O
Pharmacist : Now Can you please tell me if you have history of any chronic diseases
like Diabetes mellitus, TB, Asthma or hypertension?
Patient : I Diabetes melitus since 5 years.
Pharmacist : Okay thank you for this information. Do you have a prescription or a list
of medicines that you used during the last few days or do you have any medicines
with you in your bag?
Patient : Yes the doctor prescribed Metformin 500 mg twice daily and glargine 8 units
once daily for 30 days.
Pharmacist : Now I'd like to ask few more questions about your social history and
family history. Does any of your family members have similar symptoms or medical
problems?
Patient: As long as I know none of my family has a similar medical problem
Pharmacist: Okay, Are you smoking? or is there anyone in your family who smokes
or are you exposed any kind of tobacco smoking?
Patient: I’m not smoking but my uncle is
Pharmacist: okay so you’re often to exposed to tobacco smoking. now, I would like to
know if you have any allergic to any food products or any substance that you know
or any medication that you currently know?
Patient : I do not have any allergic to any food products, any substance, or any
medications.
Pharmacist : Have you been vaccined recently?
Patient : Yes, I’v been vaccined for covid vaccine
Pharmacist : okay, what kind of covid vaccine did you get?
Patient : Corona-vac
Pharmacist : Do you feel some side effect because of that vaccine? Like fever,
nauseous or anything?
Patient : No
Pharmacist : Do you exercise regularly?
Patient : Yes, I walk from home to office 30 minutes everyday.
Pharmacist do you do any diet, or any spesific diet?
Patient : no
Pharmacist : Do you travel recently to other country?
Patient : No
Pharmacist : okay thankyou for this information, now I would like to recollect all the
information from you. So earlier you informed me that you have complaint with have
have Blure vision, Increase frecuency of urination,tired walking since 5 days,you
have Diabetes melitus since 5 years and you have taken Metformin twice 500 mg
and glargine 8 units once daily for 30 days. You also informed me that there’s none
of your family member who has similar symptoms and medical problem, and you are
not smoking but your uncle is smoking so your’e exposed to this tobacco smoking.
You don’t have any allergic to any food products, any substance, or any medications.
You ‘re doing exercise reguraly 30 minutes everyday by walking from your home to
your office. You’ve vaccined recently with covid vaccine,its corona vac, and there is
no side effec from the vaccination. you didnt do any diet, and didnt travel regularly.
So all of your complain is the symptomp of Diabetus Miletus. Some times the dm 2
patient have complain with Blure vision, Increase frecuency of urination,tired walking
(or feel so exhauted) if their sugar level doesnt controled. So you can continue your
medication but you should take Metformin in the morning and night and you can use
the glargine 8 units once daily for 30 days in night. Please take this medication
regularly. and you should lose your weight do some low carbohydrate and low sugar
diet and eat healthy food. You also need to tell to your uncle not to smoke in house
area. You can do some exercise regulary and try to do healtier life style. You need to
take controle your sugar level by using like glucose test every night, . And I
recommend you to increase the dose by 2 units after 10 days if fasting blood sugar is
not controlled and purchase a glucometer for monitoring blood glucose levels
everyday. Or you can come bact to dr. SM, to level up your medication (like adding a
dosis or chare the medication)
Do you have any question?
great, if you don’t mind I would like to ask you to repeat the information that I already told
you, to make sure that you’re understand about how to take and use this medication

Thanyou very much for your time, I’m finished with this session hope you get well
very soon you can visit me anytime you need help. Thank you very much and good
bye.
 STATION 2

Pharmacist: Good morning, how are you? my name is, I’m a pharmacist. Could you
please tell me your name and your age please?
Patient : My name is … I;m … yo
Pharmacist : Okay, now I would like to do some examination on you, would that be
okay?
Patient : Sure
Pharmacist : Okay, I have sanitized my hand following the procedure.
- First I would like to examine your pulse (Radial-pergelangan tangan). Okay
your rate, rhythm, volume of your pulse are normal.
- Now I would like to check your temperature (forehead-jidat, arms-tangan
panjang deket telapak bukan tempat vaksin, wrist-telapak atas and legs-
telapak atas kaki)
- Now I would like to chek your Xerosis-dehydration – dicubit, Now I would like
to check if there any jaundice (kuning- diliat tangan). Diaphoresis-keringet
dingin
- Now I would like to check you respitory rate (cek pulse di radial -pergelangan
tangan sambal liat jam) normal 12-18 rate/60 sec. your rr is normal
- Now I would like to check your blood pressure rough estimate, your blood
pressure is…. Now I would like to check your blood pressure using
stethoscope.. your blood pressure is..
- first I’ll check to your hair. You have normal line hair, and grow hair. You don’t
have brittle hair
- now I’ll looking for the forehead Skin: pale skin (pucet), pruritis (biang kringet),
depigmented skin (putih-putih vitiligo), dry skin, xerosis (busik), wrinkled skin,
jaundice (kuning), reddish skin, diaphoresis (keringet dingin)
- Now I’ll looking for your eyes Pallor on your eyes (look at lower eye lid). Now
I’ll looking for Cyanosis on your eyes Bluish color in lower eyelid)
- Now I’ll looking for Icterus on your eyes (Tarik atas liat bawah) ,
- Jaundice, (pale edema of conjunctiva = pupil pake senter) (liat aja)
- Now I’ll looking for your nose (mucosal congestion, mucosal erythema) = liat
aja
- Now I’ll looking for your mouth you don’t have cyanosyst around your lips
- Now can you open your mouth (Stomatitis – mirip sariawan tapi ada putih,
Cyanosis, angioedema (bengkak), beriberi (merah), Gingivitis (berdarah di
gusi), Glossitis (lidah kemerahan), oral ulcer (sariawan), oral hygiene
- Can you lift your tounge up, there’s no cyanosis bllow your tounge
- Now I’m looking for your neck (Lymph nodes (Submental-di tengah bawah
dagu double chin, submandibular- rahang samping deket kuping,-,
preauricular- deket telinga deket anak rambut,
- (Liat kanan) cervical-deket jvs, Supraclavicular-deket tulang selangka) there’s
no Lymph adenopathy , no Jugular vein distention.
- No Goiter (gondok),
- Now I’m looking for your chest. There’s no Scars, no Barrel shape,no pigeon
shape
- Now I’m looking for your shoulder level. no kyphosis, no scoliosis.
- Now I’m looking for your Abdomen: No Tenderness (pegang-begang perut
lembek), No Ascitis -busung lapar buncit (pegang-pegang perut)
- Now I’m looking for your palm hands (telapak)- cyanosis (no blues color),
erythema (merah-merah), diaphoresis (keringet dingin), skin turgor test (cubit-
elastisity).
- Now I’m looking for your nails, no Clubbing, no Cyanosis, no capillary
bleeding, capillary filling
- Now I’ll do some pulse examination. First I’ll check to your radial pulse
(pergelangan), brachial pulse (atas siku), carotid pulse (leher kanan), popliteal
pulse (dibalik lutut), medial tibial pulse (deket mata kaki), dorsalis pedis pulse
(deket jempol kaki)
- Now I’ll do some Pithing edema examination on your feet, Foot ulcer
(telapak), clubbing nails, cyanosis, capillary filling
- Now I’ll do Auscultation test. (kanan -aortic antara tulang 2 dan 3, kiri-
pulmonic, Tricuspid dibawah pulmonic lurus, mitral lurus tricuspid
sebelah kanan) there’s no murmur, s1 and s2 are heard there’s no sign of
s3 and s4 and no sign of aritmia.
- Now I’m gonna do the sensation test
- Okay now I’m going to do Proprioception test to test your sense of joint
position. So with your toe. This is up and this is down.
- I’d like you to tell me if feel the vibration and tell me when it stops. So I’m
gonna give the example of monofilament sensation on your sternum, it
normally feel like this.
- Okay so close your eyes.
- Now I’m going to do the Babinski response test. So I’d Stroke the lateral aspect
of the sole of each of your foot with blunt object to looking for your Babinski
response, would that be okay? (respon geli)
- Okay now I’m going to do the Evaluation of graphesthesia and stereognosis.
So I’ll trace a letter or number on the palm of your hand, and ask you to
identify it. Would that be okay? (nulis angka)

Okay, I have done with Cardiovascular dm examination thankyou very much for
your time. Bye.
 STATION 3

Pharmacist: Good morning madam, my name is, I’m a pharmacist how here. Do you
have 10 to 15 minutes of time? I’d like to give you the counseling session regarding
your medication.
Patient : Sure, It’s sounds okay
Pharmacist : Okay, Thankyou very much for your cocern. Now I’d like to explain the
purpose of this counseling session. So right now, in this session I would like to
explain regarding your medical condition also your medication therapy including the
benefits of these drugs, proper use and the possible side effects of this drug. And the
other important purpose are To reduce prescription medications to be taken
improperly, To help patients to recognize the importance of taking their medications
for their well being and To ensure better patient compliance.
Patient : Okay.
Pharmacist : Okay, before I explain about the medication I’d like to verify your
personal data, would that be okay?
Patient : Sure
Pharmacist : okay thankyou for your concern. So, your name is Mr Joudi, you’re 38
years old, your address is in Sharjah you don’t have any allergy and you were
admitted in hospital because you were complaining of frequent feeling of dizziness,
blurred vision and frequent urination, is that correct?
Patient : Yes it’s correct.
Pharmacist : Okay now I Would like to ask you a few more question regarding your
medical condition would that be okay.
Patient : Ya, it’s okay
Pharmacist : Do you know what disease you have been diagnosed with and why this
medications has been prescribed for you?
Patient : Yes, because I’ve been diagnosed with Diabetes Mellitus Type II.
Pharmacist : Yes you’re correct, Do you know what kind of diease Diabetes Mellitus
is? And why the doctor diagnosed you with DM type II?
Patient : I only know diabetes is a disease caused by high blood sugar, other than
that I have no idea about this disease.
Pharmacist : Okay, now if u don’t mind I’ll explain the detail information about your
medical condition.
Patient : Sure
Pharmacist : It’s correct what you told me earlier, Diabetes is a chronic disease
characterized by high levels of blood sugar (glucose). Glucose that accumulates in
the blood due to not being absorbed by the body's cells properly can cause various
organ disorders. Sugar levels in the blood are controlled by the hormone insulin
produced by the pancreas, the organ located behind the stomach. In people with
diabetes, the pancreas is not able to produce insulin as needed by the body. Without
insulin, the body's cells cannot absorb and process glucose into energy. Type 2 of
diabetes is a more common type of diabetes. This type of diabetes is caused by the
body's cells becoming less sensitive to insulin, so the insulin produced cannot be
used properly (the body's cell resistance to insulin). About 90-95% of diabetics in the
world have this type of diabetes.
So the doctor prescribed you with Metformin, and Insulin Pen. Now I will explain the
purpose, dose and timing, duration and the possible side effect of each drug.
So first you’ve got the drug named Metformin, Metformin is an antihyperglycemic
agent that improves glucose tolerance in patients with type 2 diabetes, lowering both
basal and postprandial plasma glucose by decreasing hepatic glucose production
and intestinal absorption, and improving insulin sensitivity by increasing peripheral
glucose uptake and utilization. The dosage that given for this Meformin is 500 mg
and you shoud take it twice daily, the adverse effects of this drug are for the common
case it can cause endocrine metabolic, GIT and neurologic problem. You can
storage this drug in the dry and cold place and avoid direct sunlight also Keep the
drugs out of the reach of children.
The second drug is Insulin Glargine Pen (Lanctus) you’re given 8 units for Once
daily. Lanctus Insulin Glargine Pen is a preparation containing Insulin Glargine which
belongs to the long-acting analog insulin group. Insulin is used for treatment diabetes
melitus type 1 and 2. Like other types of insulin, the primary action of insulin glargine
is to regulate glucose metabolism. Also, insulin glargine lowers the blood glucose
concentration by stimulating glucose uptake especially by muscle and fat. It also
inhibits hepatic glucose production. Insulin also inhibits lipolysis in adipocytes,
inhibits proteolysis, and enhances protein synthesis. The Side effects of insulin is
hypoglycemia so if you developed dizziness, sweating , palpitation and flushing please take
a piece of chocolate or sweet juice

Now I would like explain how to use this insulin pen.

You can inject Subcutaneously in abdomen, buttocks , Upper Outer Thighs, and
Upper outer arms. The parts of the pen oinsuline is a, Cap; needle, cartridge,
plunger. You need to make sure There’s no air bubble or particles
First you have to clean your hand Wipe the tip of the pen where the needle will
attach with an alcohol swab,(if you have to attach it).
Twist plunger/ dosage knob in order to select your appropriate dose (6 units or 12 units
etc…)in this case you need 8 units

Clean the area where you will inject and Pinch up the skin around where you will inject
only in areas that does not have a lot of fat).You may not need to pinch if giving into a fatty
area like the abdomen or if you are using a short needle

Insert the needle at a 45 to 90 degree angle,(longer needles may require 45 degree angle,
where shorter needles may be given straight at a 90 degree angle.

Press the injection button slowly; Keep needle for 1-2 seconds; Once the needle is removed
don't rub the area.

Every time you are injecting yourself change the location otherwise you will have a pain
lump in the area which is frequently injected.

First you have to clean your hand first then you need insulin pen, 2 alcohol swabs, a
new needle, a home sharp container. Then I remove the cap of this insulin pen then
wipe the rubber seal at the top of the insulin pen with an alcohol swab. Open the new
pen needle then unscrew it to the insulin pen. Face the pen up straight like this the
tap the insulin pen slowly then twist the insulin pen like this to the number 2 then
press the button if the insulin come out that means you can use it if not you can
repeat do that and if still the insulin won’t come out you can change the needle then
repeat that. Then according in this prescription you must take 10 unit insulin
everyday that means you must choose number 10 in the dosage selector. First you
have to clean my area injection with the alcohol swab then gently pinch up my skin at
the injection site. In one smooth, quick motion, push the whole needle into your skin
at a 90-degree (straight up and down) angle. Push gently so I see a small dimple in
your skin around the tip of the pen. Push the injection button down firmly, being
careful not to press the pen into your skin more. Once you press the button all the
way down, keep holding it down and slowly count to 10. This gives the insulin time to
come out of the pen. You should also see the numbers in the dose window go back
to zero. After you count to 10, take your thumb off the injection button and pull the
needle straight out of your skin. Put the large outer needle cap back on the
needle. Don’t put the small inner cap back on. Unscrew the needle from the insulin
pen. Twist it off in the opposite direction you put it on. Put the needle in your sharps
container. Put the pen cap back on the insulin pen. Store this insulin into the
refrigerator if not open yet but if this insulin pen have opened you can s tore the
insulin pen at room temperature away from too much heat, too much cold, and direct
sunlight.
Do you understand?
Patient : yes.
Pharmacist : okay now I would like to ask you a few more question about your
lifestyle would that be okay?
Patient : sure.
Pharmacist : Okay, are you smoking or is that anyone in your home who smokes?
Patient : no
Pharmacist : are you doing some sugar diet?
Patient : no
Pharmacist : do you exercise regularly?
Patient : no
Pharmacist : Okay now, I would like to give you some non-pharmacological advice. I
recommend you to reduce eat sweet food and high carbohidrat food such as white
rice you can replace that with brown rice, do the exercise everyday at least 30
minutes a day, avoid tobacco and drink more water. And I recommend you to
increase the dose by 2 units after 10 days if fasting blood sugar is not controlled and
purchase a glucometer for monitoring blood glucose levels everyday.
Do you understand?
Patient : Yes, but I don’t know how to use that glucometer.
Pharmacist : Don’t worry I would tell you how to use that just know
First Switch ON and Test the glucometer before using it.
Wash your hands thoroughly, including the area from which you are going to draw blood.
Place a test strip into the slot provided on the glucometer.
Swab the area you are going to use to draw your sample from with an alcohol swab.
Wait for the readout on the diabetic glucometer to tell you to put the drop of blood on the
strip.
Use the lancet provided with the diabetic glucose meter and prick the area for the sample
Place a drop of blood on the test strip.
Read and record your results.
Do you understand how to use glucometer now?
Patient : Yes
Pharmacist : great, if you don’t mind I would like to ask you to repeat the information that I
already told you, to make sure that you’re understand about how to take and use this
medication
Patient : Sure.
I’ve been diagnosed with Diabetes Mellitus Type II which characterized by high levels of
blood sugar and my pancreas couldn’t produce the insulin. So, the doctor prescribed
you with Metformin, and Insulin Pen. For Metformin 500 mg and I shoud take it twice
daily, the adverse effects of this drug are for the common case it can cause
endocrine metabolic, GIT and neurologic problem. I should store this drug in the dry
and cold place and avoid direct sunlight also Keep the drugs out of the reach of
children.
The second one is insulin pen 8 units for Once daily I should increase the dose by 2
units after 10 days if fasting blood sugar is not controlled and purchase a glucometer
for monitoring blood glucose levels everyday. The Side effects of insulin is
hypoglycemia so if you developed dizziness, sweating , palpitation and flushing
please take a piece of chocolate or sweet juice. This insulin pen can inject
Subcutaneously in abdomen, buttocks , Upper Outer Thighs, Upper outer arms. The
parts of the pen, Cap; needle, cartridge, plunger. I should make sureThere’s no air
bubble or particles
First I have to clean your hand Wipe the tip of the pen where the needle will attach
with an alcohol swab,(if you have to attach it).
Twist plunger/ dosage knob in order to select your appropriate dose (6 units or 12
units etc…)
Clean the area where you will inject and Pinch up the skin around where you will
inject only in areas that does not have a lot of fat). Insert the needle at a 45 to 90
degree angle,(longer needles may require 45 degree angle, where shorter needles
may be given straight at a 90 degree angle. Press the injection button slowly; Keep
needle for 1-2 seconds; Once the needle is removed don't rub the area. Every time
you are injecting yourself change the location otherwise you will have a pain lump in
the area which is frequently injected.
I should Store this insulin into the refrigerator if not open yet but if this insulin pen
have opened you can store the insulin pen at room temperature away from too much
heat, too much cold, and direct sunlight
For the glucometer
First Switch ON and Test the glucometer before using it.
Wash your hands thoroughly, including the area from which you are going to draw blood.
Place a test strip into the slot provided on the glucometer.
Swab the area you are going to use to draw your sample from with an alcohol swab.
Wait for the readout on the diabetic glucometer to tell you to put the drop of blood on the
strip.
Use the lancet provided with the diabetic glucose meter and prick the area for the sample
Place a drop of blood on the test strip.
Read and record your results.
And I should reduce eat sweet food and high carbohidrat food such as white rice you
can replace that with brown rice, do the exercise everyday at least 30 minutes a day,
avoid tobacco and drink more water.
Is that correct?
Pharmacist : Yes that’s perfect.

You can visit this pharmacy anytime and inform us if you feel alright or even if you
have any side effects from these medication. You may visit the doctor if your
symptoms become worse in the next few days.
Do you have any question?
Patient : no

Pharmacist : Okay Great, This is my contact number for you to call for any help.
Thank You for your time. Get well soon.
 STATION 4

MDI :
before u using that u should wash your hand with soap, Shake the inhaler, Breathing
out slowly and away from the device, With the mouthpiece between your lips, press
the canister and breathe in at the same time, Hold breath for 10 seconds, Breath out
slowly, repeat after at least 30 sec-1min

Nebulizer :
So the parts of this nebulizer are, there’s a hose, mouth piece, mask, air
compressor, and medicine cup
First you have to clean your hands with the warm water and soap, then dry your
hand with the clean towel.
And then you should Connect the hose to an air compressor.
Fill the medicine cup with normal saline and your prescription wich is 2 ml
budesonide.
To avoid spills, close the medicine cup tightly and always hold the air mask straight
up and down.
Attach the hose and mask to the medicine cup
Place the air mask over the nose or the nasal probes into the nostrils, turn on the
machine.
Breathe through your mouth normally until all the medicine is used. This takes 10 to
15 minutes.
Turn off the machine when done.
Wash the medicine cup and mask with water and air dry until your next treatment.
Store this medicine at room temperature and in a sealed container, so that it is not
exposed to direct sunlight. Keep this medicine out of the reach of children
Glucometer:
For the glucometer
First Switch ON and Test the glucometer before using it.
Wash your hands thoroughly, including the area from which you are going to draw blood.
Place a test strip into the slot provided on the glucometer.
Swab the area you are going to use to draw your sample from with an alcohol swab.
Wait for the readout on the diabetic glucometer to tell you to put the drop of blood on the
strip.
Use the lancet provided with the diabetic glucose meter and prick the area for the sample
Place a drop of blood on the test strip.
Read and record your results.

Insulin Pen :
This insulin pen can inject Subcutaneously in abdomen, buttocks , Upper Outer
Thighs, Upper outer arms. The parts of the pen, Cap; needle, cartridge, plunger. I
should make sureThere’s no air bubble or particles
First I have to clean your hand Wipe the tip of the pen where the needle will attach
with an alcohol swab,(if you have to attach it).
Twist plunger/ dosage knob in order to select your appropriate dose (6 units or 12
units etc…)
Clean the area where you will inject and Pinch up the skin around where you will
inject only in areas that does not have a lot of fat). Insert the needle at a 45 to 90
degree angle,(longer needles may require 45 degree angle, where shorter needles
may be given straight at a 90 degree angle. Press the injection button slowly; Keep
needle for 1-2 seconds; Once the needle is removed don't rub the area. Every time
you are injecting yourself change the location otherwise you will have a pain lump in
the area which is frequently injected.
I should Store this insulin into the refrigerator if not open yet but if this insulin pen
have opened you can store the insulin pen at room temperature away from too much
heat, too much cold, and direct sunlight

Turbohealer
Hold the turbohaler upright and twist the grip.
Twist the grip back in the other direction till you hear a click.
Breath out gently away from the device
Place the mouthpiece between the lips and close it tightly.
Breath in quickly and deeply
Remove the device from your mouth and hold your breath for 10 seconds.
Breath out slowly.

Nasal Spray:
Close the nostril that is not receiving the medication. Do this by gently pressing on that side
of your nose.

Gently insert the bottle tip into the other nostril.

Breathe in deeply through that nostril as you squeeze the bottle. Remove the bottle and
sniff once or twice.

Repeat if directed. Wait at least 10 seconds between sprays.

If directed, repeat steps 1–4 for the other nostril.

Diskus
So earlier I already told you that the doctor prescribe you with a new medication, it is seretide diskus
50/250mg, you need to take this medication 1 inhalat twice daily. In the morning and night.

so before u using that u should wash your hand with soap,

To load a dose, hold the Diskus in your left hand. Place your right thumb in the thumb grip. Push
your thumb as far away from you as it will go. This action opens the Diskus to expose the lever
underneath.

Hold the Diskus in a level, flat position. Slide the lever away from you until it clicks. This action loads
the dose of medication. You will see the dose counter decrease by one

Turn your head away from the Diskus and breathe out as much air as you comfortably can. Place the
Diskus mouthpiece in your mouth, breathe in strong and steady, but not too fast, and completely fill
your lungs.

Hold your breath for 10 seconds. Remove the Diskus from your mouth and exhale slowly. Wipe off
the mouthpiece.
Close the Diskus by placing your thumb in the thumb grip and sliding the grip back toward you as far
as it will go. This action resets the inhaler so it is ready to use for the next dose.

The seretide Diskus contains a steroid, rinse your mouth and gargle (do not swallow), then spit.