Czech Republic Finale

Hey everyone-

I'm back in Ann Arbor after a hellish day of multiple 5 hour layovers, an incessantly screaming toddler on my 10 hour flight, and nursing a bad cold. But it's the 4th of July, and I'm happy to be back in the States celebrating it.

I visited Prague my last weekend in Czech Republic. I was told to expect great things from the city. After all, out of the many Czech travel books I looked at, Prague took up at least 50 pages of them while Brno got maybe 4 pages.

Our hostel was in an ideal location, just minutes outside of Wenceslas square, the traditional setting of demonstrations and celebrations and named after St. Wenceslas, the patron saint of Bohemia (Prague is located in Bohemia, Brno is in Moravia). Emily and I got acquainted with the city by hitting up the Lonely Planet's Top 14 Things To Do in Prague. Prague is smaller than I had previously thought and everything was fairly close, but we were nevertheless proud of our accomplishments. My favorites were the Charles Bridge and Mala Strana (shown below). Mala Strana is a quaint and charming section of Prague that sits on the other side of Charles Bridge. We also had breakfast at Cafe Louvre, where Albert Einstein used to sit and have coffee. At night we found ourselves at a 80's and 90's dance party. I think it was Will Smith's Men in Black that drew us in. Speaking of dance clubs, the playlist at a "disco" club in Brno included Dirty Dancing, Grease, and Uptown Girl and all the locals were very excited about the songs. I explained that American clubs play a lot of hip hop, which they thought was weird.


Prague has these excellent pastries called trdlnk (once again, the consonants). Trdlnks are essentially dough that's wound around a metal pole, roasted, and covered with cinnamon and sugar. I got mine with nutella on the inside and it was heavenly.


During our last week or so in the pharmacy Emily and I were shuttled back and forth between coworkers who were back from summer vacation. In Czech, everyone gets a 5 week vacation per year - with 2 weeks vacation taken during the summer and 3 weeks at a later time. We were taken to visit the University of Veterinary and Pharmaceutical Sciences for the pharmacy school graduation (shown below), which was pretty cool. Watching the graduation ceremony made my own graduation seem more attainable.


Pharmacy school in Czech Republic uses more of a pass/fail grading system. They do have A, B, C, D, E, and F, however students I spoke with seemed simply excited to have passed their course. Students take 5 classes per semester but if ambitious, can take up to 7. There aren't exams during the semester, just an oral exam at the end. Students schedule their own finals sometime during the month following the end of their courses.

Some other differences between American and Czech pharmacies: OTC ibuprofen only comes in 400 mg and you need a prescription for ranidine. Prescriptions are called receipts in Czech. Vitamins are for the most part in the form airborne effervescent tablets, which I don't mind because I think it makes it more fun to take.

Čau,
Kristin

Czech Republic Part III

Ahoj! Dobrý den!

I spent this past weekend in Berlin, which is about 8 hours away by bus. The city is bustling with people, many of whom are presumably tourists because they look as excited about being in the city as we do. Emily's friend coaches the men and women's USA lacrosse team and had a tournament in Berlin, so we braved the complicated subway station and went on a quest to find them. When we did, we relaxed by watching the Germany World Cup game with a bratwurst in one hand and a German pilsner in the other. All the bratwursts in the city use small baguettes instead of buns so they cover only a small midsection of the brat. Makes it difficult to pour on the ketchup.

We spent our days in Berlin sightseeing the whole city. My favorite site was the Brandenburger Tor (aka, Brandenburg Gate, shown below). This majestic gate is the last existing gate that formerly divided East and West Berlin.


The night we got back to Brno, I went to the cafeteria at the dorms to get pizza. I asked a student to translate a few kinds of pizza for me. I got the usual "cheese and ham" and "margherita pizza" but then he paused and said "cheese and fruit". I assumed he meant vegetables so I ordered the pizza ovocna, which really turned out to be mozzarella smothered on peaches, tangerines, hazelnuts, and jam. I took one look at the pizza and put back the chocolate hazelnut pudding I was planning on having for dessert. The pizza wasn't bad ... it just wasn't what I was expecting. Sweet meals aren't uncommon in the Czech Republic. In fact, there are sweet Fridays where lunch consists of fruit filled buns, which are really good.

The pharmacy where I am interning is one of the largest in the Czech Republic. They make sterile eye drops in bulk once or twice a week and sell it for a minimum profit to other pharmacies in Moravia. The "sterile"environment is less stringent in the Czech Republic, where the pharmacists making the eye drops were working in a laminar flow hood wearing their normal clothing with open-toed shoes, without gloves, and hair not pulled back. I even got to pour a few bottles but I didn't even have to wash my hands before I did it! We tested the batch of eye drops by checking for correct mass, antimicrobial activity, and concentration of boric acid using — the titration method. I never thought I would use that outside of Med-Chem lab! The eye drops turned out to be within the correct range for all three factors.


This is the room where most of the compounding takes place.

When compounding, Czech pharmacies just weigh everything directly on the electric balance in grams. At first I wondered why they didn't measure liquids in graduated cylinders but I realize that it's much easier keeping everything in grams and not having to convert to milliliters. And instead of using a water bath to heat solutions in beakers, the pharmacy here uses a shallow pot filled with paper and water and sits the beaker on top of the paper water mixture. It looks similar to the consistency of mushy oatmeal and prevents the glass from breaking while being heated.

Kristin

Czech Republic Part II

Dobry den (good afternoon/good morning/good day/hello...basically an all encompassing greeting),

I've been in Brno almost a week and am feeling increasingly more acquainted with Czech Republic's second largest city and the culture that surrounds it.

Czech has this soda called Kofola that was introduced while it was a communist country and did not import Coke or Pepsi. Kofola looks like Coke but takes more sour and has hints of lemon/lime. I was excited to try it when a few people told me that they prefer it to Coke, but I think I'm good after trying it once. Another thing, they have multivitamin flavored soda here, but multivitamin just means mixed fruit. It threw me off when I first read it on a menu.

Emily and I have been making ourselves useful at work by putting away the daily medication order from the distributor. That's our main contribution, I would say. We also do a lot of observing...observing the compounding process, observing interactions with patients.

Other major differences between pharmacy here and pharmacy in the US are that here, upon receiving large stock bottles from the distributor, they must open and smell each one to make sure it the label matches what is in the bottle. All orders from the distributor are rubber banded together which makes it much easier to find the same medication. Inventory is done once or twice a year while CIIs are checked every month. Two copies of the CII prescription are made. The original copy is sent to insurance, one copy goes to the doctor, and one stays in the pharmacy. All medication labels (pills, ready made creams and ointments, anything compounded) are hand-written except if they are special order allergen vaccines directly from the distributor - those have the labels pre-typed. I didn't even know allergen vaccines existed before yesterday. So far I've seen dog/cat hair and grass allergen vaccines.

Emily and I have been watching the World Cup, although being in Europe you would think that any European city would partake in fotbal festivities, but Brno is big on ice hockey so it's been a challenge to find bars to watch the games and to encounter people that are excited. You would think I was in the US with the soccer apathy I've encountered. (In case you haven't been watching, the US tied England!)

Emily, our coworker Basia, and I took a day trip to Vienna (or Wien as the Austrians call it). It took an hour and 45 minutes by bus to get there. The city looked pretty desolate when we arrived because it was before 8 am on a Sunday morning. We visited the Natural History Museum in its entirety before making it to the Schonbrunn Palace, home to the rulers of the Austro-Hungarian Empire. We took an informative guided tour which was actually really interesting but confusing with all the inbreeding and who's related to who. We spent the rest of the day walking around, sitting at cafes (we also went to Starbucks because Basia had never been there and insisted that we go) and tourist watching. Vienna is chock full of tourists from all over the place. Vienna is known for its coffee, chocolate, churning out of classical composers (Mozart, Schubert, Haydn, Strauss, etc.), and of course wiener schnitzel. Wiener schnitzel is nothing like the American fast food chain. It's usually pork or veal that's been pounded into a thin slab of meat, fried, and served with a lemon wedge. It doesn't sound very appetizing, but it's surprisingly good.

Emily and I took a trip to the laundromat today. The laundromats here are also bars. I didn't understand why til I saw it for myself. It took 3 hours to do one load of laundry so it would make sense to give customers the option of getting drinks while they waited.

Till next time,
Kristin

Czech Republic Part I

Ahoj! (Ajoi is pronounced “ahoy” and it means hi)

I arrived in Brno, Czech Republic after a few delayed flights and finally made it back to my Brno University of Technology dorm room. The University of Veterinary and Pharmaceutical Sciences is a small university, so we were given dorms elsewhere.

I went to my first day of work this morning. The Czech word for pharmacy is "lekarna". Work begins at 8 am and ends around noon (for me at least: everyone else works the full day). The pharmacy is much larger than it appears from the outside. It consists of three floors, not including storage space. The basement contains a laminar flow hood and other equipment to make sterile ophthalmic solutions, which the pharmacy sells to smaller pharmacies. The main floor is where all OTC products and prescription medications are stored and where interactions with patients occur. Instead of the standard white shelves we have in the US, this pharmacy contains beautiful dark wooden cabinets, drawers, and counters. The second floor of the pharmacy has a break room for employees, two compounding rooms, a locker room, and offices.

There are so many differences between pharmacies in the US and pharmacies here. For one, Czech pharmacies do not count pills because everything is prepackaged from the manufacturer. Pharmacies here are primarily compounding pharmacies. Secondly, controlled drugs are rarely dealt with in community pharmacies because they are mainly provided in hospitals. Thirdly, OTC products are not available for patients to peruse because they are kept behind the counter. The patient must state what he or she needs and is then handed the product to purchase. These are just a few of the differences I have seen thus far.

I have been doing a lot of walking through Brno, getting to know my way around the city while visiting historical landmarks and places of interest such as the Cabbage Market, a farmer's market that has been here since the 13th century.

Brno's namesti Sovbody, or Sovbody Square, is filled with people walking the cobble-stoned streets with an ice cream cone in hand (ice cream is zmrzlina in czech...check out those consonants). The architecture is old and intricate and the city is filled with history like the Augustinian Monastery, where Gregor Mendel formulated his theory of genetics.

Cau (pronounced chau)!