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👑❤ | 💊 | @allday_sparkle |
#alldaysparkle

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Be kind.

[Abdulrahman @Rhamzy_]

@_saaroh @KnD_Etal @Allday_sparkle @__houmayrah Lol, well, she’s my precious gem 💎 and she deserves everything good 😊.

[leelee 🇵🇹 @liliisntit]

siblings when you’re on a call and you tell them they’re making noise:

[Paul Tobi, RPh @paultobi_]

The difference between DicloNa and DicloK is in the salt form and formulation and how it affects the pharmacokinetics.

On the one hand, DicloK is fast; you should feel the effect in minutes (typically 15-30 mins). On the other hand, DicloNa has a slower onset due to slower dissolution in the gastric fluid; you should feel the effect in >1 hour (typically 1-3 hours). This is different from the enteric-coated Diclo (mostly DicloNa) which has a slowest onset time compared to the previous two.

Both have a different onset time, the same elimination time, but a little difference in the onset time and the slower dissolution makes exposure a little different. So you will notice a lower Cmax and a slightly longer time for DicloNa. Or in simpler terms, you will notice that DicloNa has a broader and smoother concentration–time profile. Hence, it makes it better for chronic conditions where diclofenac is needed.

In short, you can see why and say that DicloNa is good for chronic conditions and DicloK is better for acute conditions.

Of course, the real issue is not the difference per se, but the clinical use and the context surrounding such a use. And from here, several questions come up.

A common question I get when I recommend a different one or try to optimize a treatment plan in terms of medication management as a rural pharmacist is "Can both be used interchangeably, like can we switch to the other?"

Not really a direct Yes/No answer, it depends on the clinical and supply chain context. But in many cases, it is possible, although there might be minor tweaks in the dosage regimen. For example, you can see clinicians switch to another diclofenac salt form but change the dose and/or the number of times they have to use it. Some will even add a different analgesic that is not an NSAID altogether or add another drug if gastric protection is or will become an issue. So it depends on the clinical context and the clinical dexterity of the clinician.

Another question is that, "which one is better for people with GI issues, let’s say ulcer?" While not recommended, in cases where both are the ONLY options available, DicloNa is better due to slow dissolution which reduces the peak and of course the side effects that come with a high peak that DicloK is known for. If you can consider the type of formulation itself, enteric-coated DicloNa can be better since it will dissolve in the small intestine. Fun fact, we don’t really have much enteric-coated DicloK because the main aim of DicloK is to work faster.

The more important question is the relation to cardiovascular issues, which many people say that DicloK is better than DicloNa, citing the issue of "sodium is in DicloNa and is already in salt." Another fun fact here is that, the total amount of sodium you will take per day in a guideline-adhering dosage regimen containing DicloNa is not significant clinically compared to the daily food's salt intake. That is me intentionally avoiding the other ways you can take in sodium as salt.

Same thing as DicloK in hyperkalemia, with some people wrongly thinking that hyperkalemia means too much potassium already, again the amount of potassium in DicloK is not really significant.

So generally, we DON'T RECOMMEND Diclofenac (whether K or Na) for patients with cardiovascular conditions or hyperkalemia because it is an NSAID, and NSAIDs have issues with renal function and heart, amidst other things. It is not due to the potassium or sodium content or whatsoever.

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It's been a busy and fruitful month

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@Muhsin2308 Annex>>>>>>>>>>>>>>>>>😂

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@Muhsin2308 😂😂

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This isn't solely about the patients, btw

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@TheAkandePeter Spent just 2 months and I almost ran mad.

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@TheAkandePeter Spent just 2 months and I almost ran mad.

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Gold and silver 😂

[Juls Oligbo @OligboJ]

What a moment between Adekunle Gold and Mensan on stage. ☺️🥹

#BBNaija

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Do you remember when you joined X? I do! #MyXAnniversary

[obito @thatboyobito]

All these nepo baby talks are useless to me, the only baby I'm concerned about is my baby❤️✨️

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This actually sums up the whole discourse 😅

[Aweni Peperemsz(i won’t marry a poor man IJN) @AweniOnibata]

Person wey make everybody die for inside her film and she no gree die😭😭😭

[Cynthia Ndidiamaka @CynthiaNdidiObi]

As a Pharmacist & Baker, I want to create #BakeToHealth so diabetics & health-conscious Nigerians can enjoy low-sugar, protein-rich, vitamin-packed pastries without guilt. 🧁🎂🥮

Let’s promote wellness through flavor. 🧁

#Myaccessbank #access_more #Access #Accesspreneur

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@CynthiaNdidiObi Rooting for you

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@Muhsin2308 @SirJarus Deleted 👀

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🤣I have a business. I can't talk🤐

[Dammy B 🎥 @_DammyB_]

Today on #vendornawa

[𝐌𝐚𝐲𝐨𝐫 @eccentric_mayor]

I don't know, man, I've just got this crazy confidence that everything will work out in the end.

[Mrs. PrettyASF ᥫ᭡⟡ @crystalbaee1]

a soft life with the man I love is all I want.