Update from Hong Kong

Many people have asked for an update on my Hong Kong experience. It’s been just over five months since I moved with Joanna back to her home city. Given our many new priorities such as finding a permanent place to live and a new job, I’ve recently been absent from the blog.

Thank you for continuing to follow me. In no particular order, here is a brief update of the many professional and personal experiences since arriving in Asia on January 27, 2017.

  1. Celebrated my first Chinese New Year in Hong Kong.
  2. Spending lots of time visiting with my family and hosting friends from Canada.
  3. Successfully passed the Hong Kong Pharmacist Registration exam, and became a registered pharmacist on May 2, 2017.
  4. Started my new job at the University of Hong Kong (HKU) Centre for Safe Medication Practice and Research, on May 4, 2017.
  5. Completed my first elementary Cantonese class with the Chinese Language Center at the Chinese University of Hong Kong (CUHK). I will be starting the next level this week.
  6. Joined the South China Athletic Association fitness centre. Weight training is helping me get stronger and gives me more energy.
  7. Peer review one article and one Pharmacotherapy Self-Assessment Program chapter.
  8. Became a member of the Pharmaceutical Society of Hong Kong.
  9. Discussed pharmacist career opportunities with students at Island School.
  10. Joined the council of Pharmacists Connect, where I’ve made a lot of new pharmacist friends.
  11. Imbibed many local beers at Back to School Brewing, Hong Kong Beer Co. and Moonzen, some of Hong Kong’s great craft breweries.
  12. Attended the Hong Kong Pharmacy Conference and made some new friends.
  13. Discovered local fresh roasted coffee that is delivered to your door, from Coffee Roasters Asia.
  14. Attended my first Nerd Nite, Hong Kong edition, and learned about brewing beer and biodiversity.
  15. Attended Aging 2.0, hosted by Health Care Drinks, Hong Kong.
  16. Celebrated Canada’s 150th Birthday in style. The same day was the 20th Anniversary of the Hong Kong SAR handover to China.
  17. Joined HK Hiking Meetup, the globe’s most active Meetup group. We’ve completed a number of really beautiful hikes all over Hong Kong.
  18. Went sailing for the first time from the Royal Hong Kong Yacht Club, at Middle Island with Joanna’s uncle.
  19. As part of my work at HKU, our team met with an executive editor of The Lancet. This was a very enlightening experience on medical journal publishing and the role of editors and peer reviewers.
  20. Worked out twice with November Project Hong Kong.
  21. Was in the audience of BBC World Questions, which was asking about the future of Hong Kong.
  22. Visited Singapore for the first time. Can’t wait to go back for a second trip!
  23. Finally sold our car in Canada.
  24. Went swimming at Repulse Bay.
  25. Found a great 380 sq ft flat in Causeway Bay that has enough room for an Asian sized twin bed-we used to sleep in an American king bed in Canada. Plus the flat includes two small balconies.
  26. Reconnected with my inner child at Hong Kong Disneyland, my first ever Disney park experience!

Between work and enjoying what Hong Kong has to offer, the blog will continue with a renewed focus on drug related research, and on medications and clinical pharmacy in Hong Kong.

Prescription pancreatic enzymes in Canada

Everything you need to know about pancreatic enzymes

Pancreatic enzyme supplementation, or pancreatic enzyme replacement, is often needed in patients with chronic pancreatitis and cystic fibrosis. These medical conditions result in the pancreas either not producing enough pancreatic enzymes or the enzymes get blocked from reaching the digestive tract.

You need a sufficient amount of pancreatic enzymes to break-down your food so that it can be absorbed. Pancreatic enzymes can help avoid weight loss and may improve pain.

There are many prescription pancreatic enzyme products in Canada. Each has a different brand name and a unique dosage of enzymes. That’s why you need to know exactly which product and the dosage that you should be taking. Mistakes can occur in the prescribing, dosing, and dispensing of these medicines, particularly when you are admitted to or discharged from the hospital.

Today I’m reviewing the pancreatic enzyme products that require a doctor’s prescription. You will find a variety of “natural health product” enzymes that you can purchase over-the-counter. I do not recommend these products since they are unregulated and may be of questionable quality.

Source of pancreatic enzymes

All of the prescription enzymes are derived from pork (pig) pancreas that is used for human consumption. If you are allergic to pork you should not consume these medications.

How to correctly take pancreatic enzymes

Do not crush or chew your pancreatic enzyme products. The capsule products can be opened and sprinkled on food as required or administered down a feeding tube.

Take your pancreatic enzymes just before the first bite of every meal or snack. Swallow the product whole with sufficient fluid. If you forget to take your enzyme take it as soon as you remember if you are still eating. Otherwise, resume your regular dosing with your next meal or snack.

How to store pancreatic enzymes

Store your enzymes in their original container at room temperature (20-25°C). Don’t store in the fridge.

Helpful notes

Each pancreatic enzyme product has a particular brand name. They frequently have a number that refers to the quantity of lipase contained in the product.

Ask your pharmacist to dispense an entire bottle of your enzymes in their original container. Always double check to ensure you have been prescribed and dispensed the correct product.

Enteric coating and gastro-resistant mean the same thing. These terms refer to is the fact that the medication is not released in your stomach, but released only once it passes into your small intestine. The small intestine has a basic pH, which allows for the enzymes to be active in breaking down your food.

For non-enteric coated products (ViokaceTM or Cotazym® capsules), you should also be taking a medication called a proton pump inhibitor, which reduces the level of stomach acid. Examples of proton pump inhibitors include lansoprazole, omeprazole, pantoprazole, esomeprazole, rabeprazole, and dexlansoprazole.

The Drug Information Number (DIN) will help you identify each unique product on the Health Canada website or with your insurance company. It can also serve as a double-check when you pick-up your pancreatic enzymes from the pharmacy.

Regular release capsule

Cotazym® Capsule (lipase 10,000 units/ amylase 40,00 units/ protease 35,00 units), DIN 00263818.

Enteric coated microsphere capsules

Cotazym® ECS 8 (lipase 10,800 units/ amylase 42,000 units/ protease 45,000 units), DIN 00502790.

Cotazym® ECS 20 (lipase 25,000 units/ amylase 100,000 units/ protease 100,000 units), DIN 00821373.

Gastro-resistant granules for infants and children

Creon Minimicrospheres® Micro (lipase 5,500 units/ amylase 5,100 units/ protease 320 units), DIN 02445158.

Capsules containing gastro-resistant granules

Creon Minimicrospheres® 6 (lipase 6,000 units/ amylase 30,000 units/ protease 19,000 units), DIN 02415194.

Creon Minimicrospheres® 10 (lipase 10,000 units/ amylase 11,200 units/ protease 730,000 units), DIN 02200104.

Creon Minimicrospheres® 25 (lipase 25,000 units/ amylase 30,000 units/ protease 19,000 units), DIN 01985205.

Delayed-release capsules with enteric coated microtablets

Pancrease® MT 4 (lipase 4,200 units/ amylase 17,500 units/ protease 10,000 units), DIN 00789445.

Pancrease® MT 10 (lipase 10,500 units/ amylase 43,750 units/ protease 25,000 units), DIN 00789437.

Pancrease® MT 16 (lipase 16,800 units/ amylase 70,000 units/ protease 40,000 units), DIN 00789429.

 

 

Regular release tablets

ViokaceTM (lipase 10,440 units/ amylase 56,400 units/ protease 57,100 units), DIN 02230019.

ViokaceTM (lipase 20,880 units/ amylase 113,400 units/ protease 112,500 units), DIN 02241933. Note this product contains double the quantity of each enzyme. Your prescriber should specify the product or dose in units of lipase.

 

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