Me, in front of the Community Pharmacy

I must apologize for my long absence of posts.  As the school semester has rapidly approached, I became extremely distant with all things remotely revolving work and have focused on soaking up my last beautiful days of summer.  And now that I have accepted my fate and classes have started (ok so they started almost 6 weeks ago!), it is time to get back to writing about Lithuania!

So what did I actually do in Lithuania?  I have been asked this countless times since I have arrived back in the states, so I figure it is about time to divulge such information… For starters, our days were busy.  Granted, when I explain to people that we only worked roughly 3 hours a day in the pharmacy, they laugh.  Rightfully so, it seems like nothing.  But honestly, our practice time worked out perfectly and enabled us to get an extremely thorough experience of the pharmacy and Lithuanian culture.  Let me explain-

Vials on display, filled with different chemicals/medications in the community pharmacy

Our practice started once all the other students arrived to Kaunas.  There were 8 of us from very different places (Portugal, Croatia, Egypt, Turkey and another student from the US).  We were divided into small groups of 2 for our practice sites and I was assigned to the community pharmacy initially.  At the pharmacy, there was little English spoken, and we relied on our host to translate (as well as the many, many sound effects from the head pharmacist which emphasized his hand motion explanations).  It was here we helped compound different types of creams and lotions – from salicylic acid to nitroglycerin formulations.  We weighed the drugs, mixed them with lanolin or vaseline and basically just followed the recipe on the prescription.

Ana and I working in the Community Pharmacy

Other days, we were to weigh out very specific dosages of drugs not normally found in pill formation and fold them into intricate origami papers.  (Believe me, after 3 hours of folding these papers, it becomes very tedious work).  It was interesting that for patient daily use of these packages, they are instructed to just open it up, dump the powder contents into their mouth, and then swallow- something I couldn’t imagine happening in the US (normally our compounded medications are usually mixed into a suspension to rid it of the poor taste).

A couple of my visits in the community pharmacy were spent bottling eye drops.  (Yup, they made their own eye drops – I am so used to all of our pre-packaged eye drop formulations, that the thought of actually making them had never occurred to me.)  We washed our hands (no gloves), sanitized the lab bench, measured out 10 mL per bottle, poured and then capped each and every eye drop prescription.  Another interesting aspect was how heavily the Lithuanian people rely on homeopathic healthcare.  Rather than running to the doctor for antibiotics to “cure any ailment” like what is common in the US, they initially rely on tea.  If that doesn’t work, they will then return to the doctor and find another remedy.  So what does that mean for the pharmacist?  They make tea!  Not brewed, made-to-order tea, but we measured out each individual plant/flower/herb and incorporated them into a bags of “loose leaf” prescription tea.

 Kaunas Clinicas

The groups switched during the second half of our stay and I was placed in the hospital setting (the Kaunas Clinicas – the largest hospital system in Lithuania).  Our first day in the hospital included a long descriptive tour of the pharmacy area, as well as readings on safety and other various regulations.  Again, no one spoke english but this time we had no host for translations.

 Medication Preparation room within the Hospital

The rest of our time in the hospital was interesting – one day we spent bottling water in the aseptic room.  It was extremely hot and amplified by the machinery in the room, including a giant autoclave, but we sat and took turns putting caps on glass bottles, and lined them on the tray to be autoclaved.  Once we de-gowned, we went and sorted medications in the supply room.  Almost everything in the pharmacy there was done on paper- no electronic prescriptions or orders.  We helped stock the medication shelves with assistance from the hand drawn map of the storage rooms and then helped retrieve medications for floor orders.

The other days in the hospital were much more directly related to pharmacy.  We were able to be in the prep room where we made more lotions/creams, packed powder into capsules and also were able to make suppositories.  At first the women in the room did not know what to do with us- we spoke no Lithuanian.  As soon as my friend started speaking Croatian, they beamed!  Apparently Russian (which many people speak as their second language in Lithuania) is closely related to Croatian.  And with that- down went the walls of our language barrier!  They throughly enjoyed being able to explain to us certain daily activities and prescription filling processes.

 Our student pharmacy team preparing medications within the hospital.

Once we completed our few short hours within the pharmacy settings, we hopped on the bus to have lunch (usually back in the dorm).  Our entire group would usually meet up around 3 pm and head out into town or the surrounding area to experience the culture, museums and various sites.  I’ll get to those adventures in future posts!