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Pharmacy Residency Podcast

Jul 3, 2018

I've got 24 US and 25 UK Audiobook codes for this contest. Simply post a quick how this book could help you then get the most Facebook likes by Sunday, July 8th, 2018. I'd ask that you take the time to provide an honest review once you've got the book. Thanks, for promoting the first round and Michael Lenz for his voice.

You can find the book here for a 5-minute audio sample:


Full Transcript:

welcome to the pharmacy leaders podcast
with your host Tony Guerra the pharmacy
leaders podcast is a member of the
pharmacy podcast network with interviews
and advice on building your professional
network brand and a purposeful second
income from students residents and
innovative professionals hey welcome to
the pharmacy leaders podcast I wanted to
wish you all a happy 4th of July I'm
recording this the day before so I'll
probably release it as soon as I'm done
recording it I just wanted to talk a
little bit more about this new book and
kind of some of the old books because
I've I think I'm up to seven books in
English and then there's one translation
of one of the books and I wanted to go
through them and kind of tell you where
it is that that each of these books fit
in but what I do want to give you during
this episode is others I have 24 more US
audiobook free codes and then 25 UK
audiobook free codes and the limitation
with the UK codes is that you probably
can only use them on your desktop so I
know many of you like to commute with
these types of books and things like
that so that may or may not work for
your situation but others of you it's
gonna be kind of background so that
maybe you're doing something else and
you can listen to the book a lot of
times what I'm organizing my office I
tend to put on an audio book and listen
to the book while I'm doing something
that's kind of mindless and then when
I'm in traffic I like to put it in there
so but let's get started and kind of
talk about the reason I would spend a
year putting something like this
together I found that you know the
memorizing pharmacology book a
best-seller it talks a lot about
suffixes and prefixes and how you link
200 drugs together so that you don't
lose it after you learn a little bit and
then you lose it for the next one so the
analogy I like to make is the spinning
plates if you've seen that in the circus
somebody starts the spinning plate and
then another spinning plate and then
another spinning plate but eventually
the first one's gonna fall the second
one's gonna fall and the third one's
gonna fall if you don't
actively work at it and if you think of
pharmacy school it's really thousands of
spinning plates that you've got to put
together the book is meant to be kind of
a person sitting there just spinning the
plate for you so you don't have to go
back or maybe you just have to help a
little bit but the work to remember what
I put in these mnemonics is certainly
much less than it was but I want to make
clear if you've never had pharmacology
before or if you've never done the top
200 before memorizing pharmacology a
relaxed approach that's the book you
want to start with then if you need to
learn more than just 200 you can go to
g'night farm the audio book that has the
expansion to 350 medications if people
tell you or you hear it a lot that maybe
you're having trouble pronouncing many
of the drug names this is a very polite
society so it's very much like where
somebody won't tell you your house
smells but they'll walk in and kind of
brave it until it's not bad but if
you've got pets or you've got smoke and
things like that to somebody who's not
been in there before then they're gonna
have a tough time staying in there but
eventually the nose kind of adapts to it
and the same thing is true for
pronouncing medication names people
aren't going to tell you that you're
putting an extra vowel and Meissen
because it's not just a myosin it's
gentamicin or vancomycin there's only
two syllables there or maybe you're
subtracting a syllable or a patient is
subtracting and still one you just don't
know how to politely say it's not quite
Simba stin or it's not at all or it's
not genetic maybe using the wrong word
altogether and you don't know how to
approach it so what I've done is I've
broken down 350 drug names the same ones
that are in good-night pharmacology and
I've broken them down into plain English
words so you can break down
acetaminophen for example into the six
component word
that make it up and where people really
struggle is understanding what to do
with him so acetaminophen actually
begins with what's called a schwa it's
an upside down e if you look at it in
phonetics and pronunciation but an AA
can be an a an e an eye an O or a U and
that seems crazy that we could have that
many different sounds from one one
different one one common sound and have
five different words but if you take a
second to maybe think about it and if
you want to kind of challenge yourself
right now you know what are the choise
so think about the word about okay what
does about start with starts with an a
right but what about pence oh is that an
a there's no a in pencil so pence oh
isn't I so what about something like
memory the ivory is actually an O and
then you've got supply which is a you
but you've got something like I think
there was a book called Sybil someone
with multiple personalities and that why
isn't uh also where this comes into play
is that when you're giving a verbal
order or you're hearing a verbal order
you can't distinguish the vowel as an a
e i o or you you just have to know it
already so i have another book how to
pronounce drug names this is really for
someone that I'm English isn't my first
language and that's why I wrote it I
knew it wouldn't sell the way that the
other ones do Amazon even tells you
don't don't publish a dictionary but I
think it's important to have someone go
through these like a vocabulary and to
go through 350 drugs and I started off
twenty-five medications that are
over-the-counter 25 that are
prescription for kids because I think
it's most impactful when you're working
with children or you know trying to help
your own children making sure that they
can pronounce the words and it really
becomes once it becomes engaging for
them it's a lot easier to take them to
the store and get their medicine when
they're part of the process so if you're
talking about how to get kids to take
their medicine make them involved get
them involved in it I've got a youtube
video with my daughter getting a flu
shot that's got almost 200,000 views
which is nuts but that's a real problem
and one of the ways to do it is to make
sure the child can pronounce it instead
of just burning through hey you know
this is amoxicillin three times a day
you can put it in the fridge you don't
have to make sure that you know anyway
whatever you want to counsel on it but
when you're talking about amoxicillin
you've got that first letter and what is
the UH
well you know it's a because you know
it's an amino penicillin but that
doesn't mean the child does and the
child would be very proud of that
you know I can pronounce my medicine
amoxicillin and then they become part of
the process so anyway getting getting
wrong too
then that's the kind of the first three
books I've written memorizing
pharmacology to make it much faster for
you to memorize more drugs quickly by
knowing the prefixes suffixes and in
fixes just English in general doesn't
have in fixes in general but we use them
all the time like methylprednisolone is
an example of a in fix and then
goodnight farm that extension to 350
drugs and the final one how to pronounce
drug names really going all the way back
to make sure that you are articulate
when you're whether you're interviewing
for pharmacy school whether you're
practitioner who keeps hearing whispers
that such-and-such can't pronounce
something or other it's a way to gently
introduce it and audible always gives
you your first book free well now to get
to the
publication I have now it came about
because I saw over and over again that
there were mnemonics but these mnemonics
didn't make sense they would combine
brand and generic names or they were
just factually wrong I put one single
mnemonic in there in my book just to
tell you a factually wrong one but for
example somebody put that a through M is
a certain type of beta blocker and then
n through Z is another type of beta
blocker so we don't have to get into the
generations now but that's an example
that here is the cognitive bias where
somebody goes in and says oh we'll see I
know because everyone that I've seen was
this way but just because you've only
seen white swans doesn't mean a Black
Swan can't exist just because you've
only seen grace whirls or black
squirrels doesn't mean that an albino
squirrel can exist and it does up and
aims about 25 minutes away so what I've
done is I've kind of created a
compendium but what I didn't have is
something to keep that in your memory
until the next exam and up until very
recently that next exam was the Netflix
but now that next exam is the p KOA and
the p KOA is a way of schools to assess
their own students but you're gonna see
that for whatever good intention it had
some bad things may come out of it the
first is that some schools will use it
to prevent you from going on your a P
rotation and I don't know if there's
some kind of grace period at some
schools there might be but other schools
you may have to wait a year and they're
saying that basically in the first three
years you didn't get as much as they
expected you to get and it has to be X
number of standard deviations from the
norm and that's pretty harsh to say okay
well you've been going along great with
these students your grades are okay but
unfortunately you're not passing the
tests that we need you to at a certain
level and this is especially difficult I
think for students that came into a
and they didn't have to take peek at but
now all of a sudden they're being told
yeah by the way this is a really
important test and I've also heard that
some people have monetary rewards if
they take the peak OA and they score
very well so there's other ways that
schools are trying to get people to care
about it because it is just another
thing it's like okay well do I review
all my notes from the last three years
what do i do how do I prepare for it
they give you some small exam but what
they're really trying to do by not
giving you test prep materials as
they're trying to say okay well we just
want to truly assess based across the
country where you are and we can now
rank and they're the distinctions would
be very slight but it's possible to rank
now every pharmacy school based on that
curricula based on those metrics from 1
to 140 whatever it is however many
pharmacy schools there are but you can
also rank people and that's where I
think it gets dicey because as we've
moved to 5,000 openings for residency
from 3500 it's a lot tougher to tell the
difference between people and having a
standardized score especially with great
inflation if you look at Princeton and
Harvard I think the numbers are that
more get more of those students that
graduate get academic honors then don't
so that's the magna cum laude and cum
laude and I don't summa cum laude those
those 3 so there's this tremendous grade
inflation you have to have certain
grades to get through so grades they're
not really much of a marker anymore of
success as much as they're a marker of
just a baseline you know competency so
I've heard this Beko may be used for
residency I don't have a definitive on
that I'm just not sure but a big part of
it was pharmacology and the issue is
pharmacology isn't that you didn't get
it you got it you passed the class it's
that you were never told how to remember
it for an extended period of time
and so as pharmacy schools are looking
for solutions so that they don't end up
at the bottom of this piccola because
the accreditation body can now see who
the worst pharmacy school in the country
is and then the second to the worst and
the third to the worst those numbers are
there they're protected in some way but
those numbers are there but they can
also tell you who the absolute worst
student is who are at the bottom 1% and
it's you know there are 7500 students
out there right now half of them that
are in the bottom 50% and that's a
really strange thing to say I think to
get into pharmacy school you needed X
grades and then Y peak at score if they
had the peak at but now all of a sudden
you have this new metric that can put
fully half of all pharmacy students in
the bottom 50% and no time in their
lives of many of those students ever
been in the bottom 50% so it's a very
unusual thing to see I understand it to
some extent that just like schools just
want another metric residency's one
another metric and certainly before they
hire you on to maybe get a predictor of
the NAP flex but I don't know that I've
seen any I don't know that I've seen
that this is a predictor of nap like
success because they've in the art
literature they don't say the peak OA is
a predictor of nap like success because
the Pico and Netflix are different
topics and many it's a certain extent so
it's not really the same thing it would
have been nice if they matched up but
that's not what they were doing so
anyway getting all back to the the book
and and so I wanted to be very
intentional about how to keep something
in and a mnemonic is not meant for you
to learn something I'm gonna say this
twice a mnemonic is not meant to help
you learn something it's meant to help
you keep something in memory for an
extended period of time and keep it in a
reasonably cognizant group so I'll give
you an example can you off the top of
your head name the SSRIs right
and my mnemonic for it is UPS effect so
ups ups paroxetine sertraline and then
effect okay so
fluoxetine fluvoxamine escitalopram
citalopram and then this is where you
can use the other letters to start
memorizing those pearls you know and I
use the T to say titrate up because you
don't want to give SSRIs too quickly or
you'll actually cause the anxiety that
sometimes the SSRIs are used for I know
their antidepressants as a class but
sometimes we see them for through that
titration we'll see them used for
anxiety but we'll also see a lot of
other medications used that have
clinical pearls so sertraline score
chillin that's the one that always you
know causes diarrhea quite a bit but if
we're talking about pregnancy that might
be the best choice right and then of
course we've got the data that shows
some other things about that as well so
this is not medical advice your clinical
advice I'm just telling you these are
the pearls that you're probably gonna
see which one has the longest half-life
you know fluoxetine should just roll off
the tongue you know and and so there's
you know fluvoxamine for OCD all of
these pearls need somewhere to attach to
and what I did was by creating the monic
UPS effect I said okay well make sure
you know all of them but also that
they're all in the same place in your
brain and when they're all in the same
place in your brain you can kind of go
to that small part of the closet that
has all of these on hangers like oh okay
here they are and then if I just need to
add something to it maybe I need to add
the pants to the you know vest in the
jacket then I've got a clothes hanger
that's marked SSRI I can do that so I
can put more information on there but
what you want is to have these 134 files
where you can just insert additional
material and put more details so the
mistake would be to say okay well I just
I'm going to go to pharmacy school I'm
going to start with memorizing
pharmacology mnemonics and that's
certainly not the case the other thing
is that how do you in a group
especially of multiple professionals
talk about different medications and
interprofessional Issei okay well we're
gonna talk about the SSRIs well which
one do you start with alright so how do
you start the conversation with a single
one and what you can do is if you have a
mnemonic like ups effect you can say
alright well let's just start with
paroxetine talk a little bit about paxil
and then paxil CR and see what the
differences are there talk about
sertraline a zoloft and so forth and you
have an organized way of having a
discussion between nurses and physician
assistants and physicians and everyone
that's in your smaller group so instead
of just hey let's talk about this as a
group and kind of picking one out of the
blue what you're doing is you're being
very intentional about where this fits
into the interprofessional space and I
never understood why we really didn't
study for our boards together if we're
gonna work together why don't we study
for our boards together I want to give
you an example of where nurses and and
pharmacists kind of come together my
daughter came in screaming she had
fallen down ended up that she had broken
her collarbone we took her in and so
here are two pharmacists calming the
daughter taking her to the ER to the
physician who will set the arm and the
nurse is taking care of him as well but
then in the aftercare you know we know
what to do with the medications for pain
and things like that but darn it that
stupid sling I would try to put it
together my wife would put together it's
like we were working on a car like as a
mechanic and there was just an extra
part every time we worked on it so we
tried to get the sling comfortable for
her she had some level of competence or
it looked sort of like it was right then
we would go I would take her to school
we passed the nurse's office and sure
enough the nurse be like oh that's
that's wrong and then well she wouldn't
be mean about it but she would just you
know put it back and then it was perfect
and you could see the smile on my
daughter's face oh that's how it's
supposed to be sure enough you know
later on the
the sling comes off again take it to my
mother-in-law oh yeah that's not how
it's supposed to be she's a nurse puts
it right back together then my
sister-in-law who's a nurse puts it
right back together so we have these
areas of phenomenal competence where
some of us might not have that
competence here my wife and I are with
you know our farm DS and we cannot get
this stupid sling to work right where a
nurse makes it look like tying your
shoes for the thousandth time and it's
just oh it's just so easy you know so I
never understood why interprofessional
we didn't come together but this way the
conversation can make a lot more sense
you know let's use another one like
ulcer developer how do you talk about
the different PBIS right so you want to
talk about you know the difference is
you want to talk about what are some of
the clinical pearls why you would pick
one over the other you know are there
parenteral forums versus entró forums
and then what in the world is with this
deck sling so Brazil vs. land so Brazil
s omeprazole vs. bow met resolve and by
putting it in the mnemonic ulcer
developer D Ford excellent so result s
for us a map result skip the V then L
freelancer Brazil o for omeprazole p4
temp Anto Brazil and R for Rebecca's oh
and I don't have anything in front of me
I'm just doing this from memory then you
have a conversation piece that you can
now talk about these and you're all on
the same page in the same order so I
think that because mnemonics have been
publicized as the shortcut to getting
this quick quiz or something like that
done what mnemonics are is there the
shortcut to remembering something so you
can build on it but it's also the
shortcut to getting right to the answer
because you can't go back on the NAP
flex you can go back on the picot uh but
it's inefficient but you can't go back
on the nap flex that means that you need
if it's an if it's you know PPI is front
and center on the nap Lex you need to be
able to go okay I need to know the six
proton pump inhibitors and that
presenting isn't going to save you every
time because you've got arrow peppers
all and you've got
Breck's pippers ole that also have the
Brazil ending and it's really pip Rizal
at both of them and those are
antipsychotics so you can't exactly rely
on that but you can rely on this
mnemonic to get you to those six and
then you think about the clinical pearls
that you've attached to them and now you
have a very very quick lightning fast I
got to where it needs to be in my brain
and then I'm back okay so going on and
and talking about how you would use this
I am busy
I have my daughters are gonna be turning
seven I have three seven year olds that
I'm gonna have in a week they're you
know their birthday is coming up in a
couple weeks and I just find that
running the car those are two places
that I love to get additional
information and it is expensive to make
an audiobook and it is incredibly long
and difficult to make an audiobook when
you are translating nonfiction
dictionary type information into enough
of a narrative that it's not like oh my
gosh this is just going on and on so
it's not a lecture it's a quick hit just
like a flashcard here's what you're
trying to memorize here are some details
about it here's how you can add to it
let's go on to the next one and I didn't
actually even count the drugs but I know
there's well over 450 drugs that you
would have then in your memory and it
doesn't even include really you know
talking about the stems and and so forth
so maybe I'll put up a video that shows
how many drugs I can do for memory and
it might just be a fun exercise
all right well on to the audiobook codes
I think we'll just do this just like we
did the Facebook challenge for a the
APHA meeting I'll do that again this
year coming up for Seattle I'll have
those free travel stipends but we'll
just say through Sunday this Sunday
whoever has the most likes on just all
you're gonna do is just attach to this a
comment and you just say hey can you
just like my comment and then you can
get a free audiobook the first 24 will
go to the people that are
u.s. or that want the u.s. one and then
if you want it I can give you the UK one
I'll I'll contact you but it'll take me
a little time to get through all the
names so hopefully this will be fun and
kind of an engaging way something to to
do at the barbecue or something to do
while you're hanging out so again if you
have any questions about the book or you
have any questions about pharmacology if
you are struggling or the top 200 if
you're struggling how do I learn it
quickly I've really really focused on
this part
Eric Christensen I know has some free
materials for you as well on his med ed
101 and he has also got a great new
podcast real life pharmacology where
he's got some case studies so we're
working together to try to kind of
create a continuum where I've really
worked on the p1p2 year he's worked p3
through BCPs and hopefully this material
is helpful for you but again have a
great fourth of July if you're in the
United States and if you're in the UK
hey you know just let me know I'll be
happy to send you a code as well support
for this episode comes from the audio
book memorizing pharmacology a relaxed
approach with over 9,000 sales in the
United States United Kingdom and
Australia it's the go-to resource to
ease the pharmacology challenge
available on audible iTunes and in print ebook and audiobook
thank you for listening to the pharmacy
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