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					Salt Lake Community College



Professional Portfolio
Pharmacy




Gabriel A Ruiz
4/24/2012
Contents

Cover Letter .................................................................................................................................... 2
Technical Definition ....................................................................................................................... 4
        Title: Pharmacology.
        Audience: Pharmacy Students.
        Purpose: I wrote this to help understand what Pharmacology is.
        Objective: To provide information about what Pharmacology is and what the two
branches are in order to be able to use the calculations that are made on it.
Technical Description ..................................................................................................................... 4
        Title: IV Room.
        Audience: Pharmacy Students.
        Purpose: I wrote this to give information about IV Rooms and how they work.
        Objective: To provide information about the infrastructure of the IV Room and what are
the different areas that exist on the IV Room.
Sample Writing ............................................................................................................................... 8
         Title: Antimicrobial Drug Resistance of Diarrheagenic E.Coli in Infants in Peru
        Audience: Biology Lab Teacher
        Purpose: I wrote this as a lab assignment on biology branches.
        Objective: To provide information about the results of a study made in Peru about
        Antibiotic Resistance of E.Coli in infants in Peru
Cover Letter

Gabriel A Ruiz
4882 S. Commerce Drive
Murray UT 84107
801-604-7224

Human Resources Director:

I am writing to demonstrate my interest in the pharmacy technician job at intermountain
healthcare, as a student I learned the basic skills required to be a Pharmacy Technician and now I
want to use the skills I obtain and learn from the Pharmacist and Pharmacy Technicians in your
facility to become an excellent healthcare provider.

As a waiter I learned to multitask and prioritize which can help me be a better employee and also
helped me develop better social skills to better interact with patients, as a customer service
representative I learned to be customer oriented while following the instructions of my
supervisors this also helps me provide good service to others, as a direct care associate I have
learned to work with patients and ensure to provide their medications on the right time, in the
right dosage and to the right patient.

I put my services in your hands.



______________________
Gabriel A. Ruiz, CPhT
Resume
Gabriel A Ruiz CPhT
4882 S Commerce Drive Murray, Utah 84107
Ph: 801-604-7224
Email: gara_coolman@hotmail.com

EDUCATION

Salt Lake Community College; Taylorsville, UT:
      AS Biology/Chemistry Expected Graduation August 2014
      Pharmacy Technician Certificate; August 2011; PTCB Exam August 18, 2011; License Number 7787986-
         1717

WORK EXPERIENCE

Pharmacy Technician Extern, Intermountain Medical Center Pharmacy; Murray, UT April-2011-May-2011
    Learned the Pharmacy Technician responsibilities in an Institutional Pharmacy.
    Became Proficient with Robot duties.
    Became Proficient with Central Pharmacy duties.

Direct Care Associate, Chrysalis; Salt Lake City, UT January-2011-Present
     Assist individuals in planning their daily activities
     Administer Medications on the right time, the right dose, and right patient.
     100% Integrity check on every check since the first month of employment

Waiter, K Rico Peru; Salt Lake City, UT June-2010 – November-2010
    Multi-tasked by serving up to 12 tables simultaneously
    Gained enhanced cashiering experience
    Helped trained other employees and provided feedback to manager

Interviewer, 2010 US Census; Taylorsville, UT May-2010 – June-2010
     Conducted phone surveys ensuring accuracy
     Succeeded the daily average of interviews per day
     Strengthened communication skills

Customer Service Representative, Deseret Industries; Murray, UT July 2009-April 2010
    Promoted to Team leader/trainer after 3 months
    98 % Productivity based on a 3 month period
    Sorted and organized clothes to maintain a clean store

ADDITIONAL SKILLS

       Proficient in Microsoft Suites
       Fluent in both English and Spanish
       HIPPA Compliance Training Certificate
Technical Definition
                                        Pharmacology
Pharmacology is the branch of biology and medicine that studies the action of medications in our
body. The word Pharmacology derives from the Greek words Pharmakon that means “Drug” or
“Poison” and Logia that means “Study of”.

In the study of Pharmacology you will learn about
drug composition and properties, interaction with
other medications as well as with our body,
toxicology, the medical applications, therapy and
antipathogenic capabilities.

Pharmacology has two main branches that you need to
understand Pharmacology are pharmacodynamics and
pharmacokinetics:

Pharmacodynamics that is the study of physiological
and biochemical effects of the drugs on our body or
on parasites and other microorganisms on the body or
within it, the mechanism of action of the drugs and the relationship that there is in between the
drug concentration and their effects. A formula that is used in Pharmacology is called The
equilibrium dissociation constant that is defined by the following L+RL∙R Kd =           where L
represents the ligand R represents the receptor and the brackets [ ] represent the concentration.

Pharmacokinetics that is the study of the outcome of substances that are administered on the
surface of a living organism. The substances that we are interested in studying are hormones,
toxins, nutrients and pharmaceutical agents.

To be able to understand Pharmacology there are two areas that you need to understand as well.

Pharmacognosy that means “Knowledge of Drugs” and is the branch of Pharmacy and Medicine
that studies medications that come directly or indirectly from plants animals and minerals, this
branch helps to understand how the drugs from natural origins work.

Pharmaceutical Chemistry that is the study of chemical uses for medications, their use, how to
prepare and preserve them and how to determine their purity and strength.

Technical Description
                                            IV Room
         An IV Room also known as a clean room is a room where the concentration of particles
on the air is controlled to meet specific air cleanliness and it is used to prepare Sterile Solutions
and compounds.
         To ensure cleanliness of the air there are air particles regulations called ISO Class, this
ISO Class are based on the amount of air particles that are 0.5 μm (micrometer) or larger in a
cubic feet (ft3).
         The ISO Class that are approved to be in an area of the IV Room Range from ISO Class 3
to ISO Class 8 each ISO Class increases 10 times the amount of particles per square feet on the
following way:
         ISO Class 3 is the cleanest air available containing only 1 particle that is 0.5 μm or bigger
                                                                   by ft3.
                                                                    ISO Class 4 contains 10 particles
                                                                   that are 0.5 μm or bigger by ft3.
                                                                   ISO Class 5 contains 100 particles
                                                                   that are 0.5 μm or bigger by ft3.
                                                                    ISO Class 6 contains 1,000
                                                                   particles that are 0.5 μm or bigger
                                                                   by ft3.
                                                                    ISO Class 7 contains 10,000
                                                                   particles that are 0.5 μm or bigger
                                                                   by ft3.
                                                                   ISO Class 8 contains 100,000
                                           3
particles that are 0.5 μm or bigger by ft .
         These ISO Class are very important in an IV Room because this helps ensure the sterility
of the compounds and solutions that are prepared, to help ensure that the ISO Class is maintained
the IV Room is divided on 3 different areas, the Ante Area, the Buffer Area and the Primary
Engineering Control (PEC), each area provides a lower amount of particles by filtering and other
specialized techniques, some IV rooms have a separate Chemo room that is used to prepare
radioactive drugs as a fourth room in order to avoid contamination from the radiation.
         Ante area is the first are in the IV Room this has an ISO Class 8 or better, this is the area
where the personnel do hand washing and garbing procedures, receive order entries, label
compounded sterile products and perform other activities that generate high amounts of particles,
this is considered a low particle room, this means that it should not contain boxes, paper or any
other material that release high amounts of particles, for safety reasons food and drinks are not
allowed in this room, this room has a positive pressure to keep the Air Quality constant.
         One of the most important activities that occur on the Ante Area is the Scrubbing and
Garbing procedures that are required before accessing other areas of the IV Room, the process of
Scrubbing and Garbing occur simultaneously this process is called Aseptic Technique.
         Aseptic Technique starts by changing from
your street clothes into Scrubs since they shed less
particles than street clothes, following the scrubs
you put on shoe covers, following you will put on
hair covers, if you have a beard you will be required
to use a beard cover, the next step is to put on a face
mask, the next step is to put on goggles if you need
them.
         After you have covered the areas of your
body that shed the most particles it is time to scrub
using a specialized soap and a small sterile brush
that will be disposed after using the proper way of
scrubbing requires at least 45 seconds and to wash
your hands all the way to the elbow, after you finish
scrubbing you can only dry your hands with lint
free cloths to avoid contaminating your hands, after
you have dried your hands you put on a Non shedding gown with cuffs that will cover most of
your body.
                                                     After this it is always good to clean your hands
                                             with an alcohol lotion or other cleaning solution
                                             before you put on your sterile gloves, when you put on
                                             your gloves there are some things that are very
                                             important that you have to do, first of all you need to
                                             make sure that you do not touch the outside of the
                                             glove because it will be contaminated and you will
                                             have to use a new pair of gloves, to help the gloves are
                                             going to have a fold that is from the inside of the
                                             glove, as you put on the first glove grab only the
folded area and put your glove on and then turn the fold in, the second glove you grab it from the
sterile area as you put the glove on and pull from the corner of the glove or underneath the fold
to expose only the sterile area of the glove.
         Buffer Area As you have completed the Aseptic Technique you are ready to enter the
Buffer area that is the area where the PEC is located, this area is required to have an ISO Class 7
or better.
         Primary Engineering Control (PEC) is the area of the IV room where the Sterile
Solutions are prepared; the PEC has an ISO Class 5 or better to ensure the amount of particles is
                                                                  at a minimum to be considered
                                                                  sterile, there is a variety of PECs
                                                                  that can be used in an IV Room
                                                                  some of the most common ones
                                                                  are:
                                                                           Biological Safety
                                                                  Cabinet this type of hood is used
                                                                  to compound chemotherapy and
                                                                  other radioactive drugs, this
                                                                  Cabinet has a Negative pressure
                                                                  to avoid any residues to escape
                                                                  and contaminate the environment
                                                                  and is usually on a Chemo Room
                                                                  but they can be located on the
                                                                  buffer area as well.
         Laminar Airflow Hood is a specialized apparatus that is used in the preparation of
sterile drugs, it contains a HEPA filter (High-efficiency particulate air) that is a filter that is
capable of 99.97% of particles that are 0.3 micron or larger of diameter this provides a work-
space that is pathogen free and pyrogen free.
         This HEPA filter is so effective because the size of fungi is 0.5 micron while the size of
bacteria is 0.3 micron and even
though virus size ranges from 0.1 to
0.2 micron they need a host to
reproduce.
Sample Writing
            Antimicrobial Drug Resistance of Diarrheagenic E.Coli in Infants in
                                      Peru
            This research was to determine of antimicrobial drug resistance of infants in their first
year of life with diarrhea caused by Escherichia coli in low socioeconomic communities in
Lima, Peru, and to determine if the organism’s resistance occurs in an early stage in life.

          The prediction for the study stated that due to the abuse of antibiotics use in Lima
there would be a high antimicrobial resistance in strains of diarrheagenic E. coli that was isolated
from infants with diarrhea or the control group without diarrhea.

           The scientist took a group of 1034 infants in Peru that varied in age from 2 months to
12 months and their parents were advised for a treatment using oral rehydration solutions and
antibiotics only as needed, as well as dietary management. The group was required to give stool
samples, at the same time there were 20 to 30 stool samples taken from randomly selected
healthy infants from the controlled group that had not have diarrhea 7 days before or 7 days after
the stool sample was taken.

          The samples were analyzed for the presence of E. coli, the positive strains where then
analyzed for their antimicrobial drug susceptibility, the antimicrobials analyzed were ampicillin,
amoxicillin, azithromycin, cefotaxime, ceftazidime, chloramphenicol, ciprofloxacin,
cotrimoxazole, gentamicin, nalidixic acid, nitrofurantoin and tetracycline.

           The presence of the different types of E. coli in gastroenteritis and in control samples
by their age group and their antibiotic resistance were compared and the differences were
evaluated by Fisher's exact text that is a 2 by 2 test.

           The antimicrobial drug resistance tests occurred in between September 2006 and May
2007 during this time there were 557 stool samples that came from children with diarrhea and
195 controlled samples that came from children without diarrhea, during this time frame several
children suffered from diarrhea more than one time and some didn't have a single episode. The
mean +- SD (Standard deviation) age of the children that were studied was 5.2 +- 1.8 months of
age with the oldest infant being tested was 10 months.

           This study determined that the presence of diarrheagenic E. coli was 29% (161 of 557)
in the study group and 30% (58 of 195) in the controlled group, of this both groups the test
showed the percentage of various E. coli strains giving the following results EAEC
(enteroaggregative E. coli) 14% (78 of 557) vs. 18% (35 of 195), EPEC (enteropathogenic E.
Coli) 7% (37 of 557) vs. 7% (13 of 195), DAEC (diffusely adherent E. coli) 4% (21 of 557) vs.
3% (6 of 195), ETEC (enterotoxigenic E. coli) 4% (20 of 557) vs. 2% (3 of 195) and STEC
(Shíga toxin-producing E. coli) 1% (5 of 557) vs. 0.5% (1 of 195).
                                          E.coli Strains
     90
             78
     80
     70
     60
     50
                          37                                                     Study Group
     40           35
                                                                                 Controlled Group
     30                                 21             20
     20                        13
     10                                        6            3        5
                                                                         1
      0
             EAEC          EPEC          DAEC           ETEC         STEC




           Besides the E. coli the tests found the presence of Campylobacter ssp. 14% (78 of
557) vs. 8% (16 of 195), Salmonella ssp. 0% vs. 0.5% (1 of 195). Rotavirus was also found in
the diarrhea samples in a 7% (37 of 548).

           The children from the study group used more antibiotics than the controlled group in
the 3 months before the study with a ratio of 1.0 +- 1.3 courses of antibiotics for the study group
vs. 0.6 +- 0.8 the most commonly used antibiotics were amoxicillin 31% vs. 42, macrolides 32%
vs. 19%, and cotrimoxazole 15% vs. 23%.


                                          Antibiotic Use
                  45%          42%
                  40%
                  35%      31%           32%
                  30%
                  25%
                                                               23%
                   20%                         19%                           Study Group
                   15%                                  15%                  Controlled Group
                   10%
                    5%
                    0%
                         Amoxicillin
                                       Macrolides
                                                     Cotrimoxazole


          For diarrhea episodes were macrolides 26% (erythromycin 20%, azithromycin 6%),
furazolidone 8%, amoxicillin 5% and cotrimoxazole 2%.
          There was a very high resistance to all the antibiotics in the diarrhea samples even
higher than the control group in the following antibiotics ampicillin 85% vs. 70%, and
cotrimoxazole 79% vs. 61%.

                                 Single Antibiotic Resistance

                   100%         85% 79%
                    80%                        70% 61%
                    60%
                                                                                Ampicillin
                    40%
                                                                                Cotrimoxazole
                     20%                                        Cotrimoxazole
                      0%                                     Ampicillin
                           Study Group
                                          Controlled
                                            Group

           There was also a multidrug resistance in the study group being the results 63% vs. the
control group 53% with the most common resistance being to ampicillin-cotrimoxazole-
tetracycline, where it was found present in a 24% of the strains and ampicillin-cotrimoxazole that
was found in 19% of the strains.

       From the different strains that showed multidrug resistance it was found the following
DAEC 100%, EAEC 70%, ETEC 47%, and EPEC 44%.

                     Resistance to 3 or more Antibiotics
            120%
                             100%
            100%

             80%                                       70%                        DAEC

             60%                                                                  EPEC
                                         44%                     47%
                                                                                  EAEC
             40%
                                                                                  ETEC
             20%

              0%
                                                1

           The results showed us that the inappropriate use of antibiotics caused resistance from
the strains causing the need to find different medications to cure microbial diseases. This also
showed how the lack of proper information about antibiotics causes abuse and inappropriate use.

				
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