buletin farmasi 01/2013
DESCRIPTION
Buletin Farmasi JKN Kelantan edisi bulan Januari 2013 daripada Hospital Pasir Mas.TRANSCRIPT
@ HOSIM
Special Features:
Sepintas lalu:
* Mengenali Hospital Pasir
Mas (HOSIM)
* Unit Farmasi Hospital
pasir Mas
Diari Aktiviti Unit
Farmasi 2012
Album Kakitangan
Unit Farmasi HOSIM
Ubatan fast moving
Hospital Pasir Mas
2012
Food to save your
heart
DECEMBER 2012
Volume 1, Issue 1
PHARMACY
N E W S L E T T E R
* G6PD : safe & unsafe to take
Edisi : Disember Tahun : 2012
* Drug induced fever
* Oral dosages that should not be crushed
In this issue:
* FDA pregnancy categories for antiretroviral therapy
T E P A T S E L A M A T B E R K E S A N
Advisor
SABARIAH BT YUNUS
Editor
arifah nadiah bt ahmad
Contributors
nor aini bt ibrahim
salmi koh bt muhammad hashim koh
fadzilla bt badruddin
noni mazlina bt che soh
Editorial Board
Sepintas lalu : Hospital Pasir Mas
Pengarah Hospital Pasir Mas
DR. HJ MOHD SALLEH BIN MAT JUSOH
* Mempunyai 5 buah wad : wad perubatan lelaki (NILAM), wad perubatan perempuan (KRISTAL), wad kanak-kanak (ZAMRUD), wad prenatal (INTAN), wad post natal (MUTIARA)
KETUA UNIT FARMASI TAHUN 2000 - SEKARANG
PN. NAFISAH
SULAIMAN
(2000-2004)
Selamat datang ke Unit Farmasi & Stor Perubatan HOSIM
PN. NIK AZLEAN NIK
ISMAIL
(2004-2006)
PN. NOR AFIFAH
RAHIMI
(2006-2007)
PN. NONI
MAZLINA CHE SOH
(2007-2009)
PN. NOR AFIFAH
RAHIMI
(2009-2010)
PN. SABARIAH YUNUS
(2010-SEKARANG
PENCAPAIAN ANUGERAH UNIT FARMASI
1 ) 2002 - Naib Johan Pertandingan Kaunter Peringkat Negeri Kelantan
2 ) 2003 - Johan Pertandingan Kaunter Peringkat Negeri Kelantan
3 ) 2005 - Naib Johan Pertandingan Kaunter Peringkat Negeri Kelantan
4 ) 2006 - Johan Pertandingan Kaunter Peringkat Negeri Kelantan
5 ) 2008 - Unit Non Klinikal Terbaik Sempena Sambutan Minggu
2 ) 2010 - Perkhidmatan Kaunter Terbaik Anugerah Budaya Cemerlang HPM
KAUNTER PENDISPENSAN FARMASI PESAKIT
LUAR (KAUNTER TERBUKA)
BILIK KAUNSELING - MENJAMIN PRIVASI & KESELESAAN PARA PESAKIT
PELAKSANAAN PELABELAN
HARGA UBAT
PELABELAN UBAT DGN LABEL
“HIGH ALERT MEDICATION”
TELEFON @ SMS : +60105718048
DIREKTORI UBAT
HOSPITAL PASIR MAS
SELAMAT DATANG KE UNIT FARMASI
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Volume 1, Issue 1 Page 6
Oral dosages that should not be crushed
@ll about medicines
Medications which should not be crushed fall into one of the following categories
Extended Release Products
# The formulation of some tablets is special-ized as to allow medication within it to be slowly released into the body.
# This is sometimes accomplished by centering the drug within the core of the tablet, with a subsequent shedding of multiple layers around the core. Wax melts in the GI tract.
# Slow K is an example of this.
# Capsules may contain beads which have multiple layers which are slowly dissolved with time.
Medications Which Are
Irritating To Stomach
# Tablets which are irritating to
the stomach may be enteric coated
which delays release of the drug
until the time when it reaches the
small intestine.
# Enteric coated aspirin is an
example of this.
Foul tasting medication
# Some drugs are quite unpleasant in
their taste and the manufacturer, to
increase their palatability will coat the
tablet in a sugar coating.
# By crushing the tablet, this sugar
coating is lost and the patient tastes the
unpleasant tasting medication.
Sublingual medication
# Medication intended for use under
the tongue should not be crushed.
# Sublingual medications should indi-
cate on the package that they are in-
Effervescent tablet
# These are tablets which, when
dropped into a liquid, quickly
dissolve to yield a solution.
# Many effervescent tablets, when
crushed, lose their ability to quickly
Drug Formulations That Preclude Crushing
Type Reasons for the formulation
Enteric coated
Designed to pass through the stomach intact with drug released in the intestines
to:
- Prevent destruction of the drug by stomach acids
- Prevent stomach irritation
- Delay onset of action
Extended release
Designed to release drug over an extended period of time. Such products include:
- Multiple layered tablets releasing drug as each layer is dissolved
- Mixed release pellets that dissolves at different time intervals
- Special matrixes that are themselves inert but slowly release drug from
the matrix
Sublingual buccal Designated to dissolve quickly in oral fluids for rapid absorption by the abundant
blood supply of the mouth
Miscellaneous
Drugs that:
- Produce oral mucosa irritation
- Are extremely bitter
- Contain dyes or inherently could stain teeth and mucosal tissue
Source: Drug Information Handbook
Drug induced fever is a serious & confusing problem. Of medications that cause the fever, the antibiotics are most frequent (esp beta lactamase antibiotics & penicillins) but also sulfonamides, nitrofurantoin & antituberculotics, drug induced fever doesn’t have characteristics features. Most often it occurs 5 to 10 days after the start of treatment
but it may also occur right after the first dose.most probably, the drug acts lilke an exogenic pyrogen. Although most patients are surprisingly well while febrile,some are
profoundly septic.
@ll about medicines
DRUGS INDUCED FEVER
Cause of fever:
Hypersensitivity reactions:
beta lactams,carbamazepine, phenytoin
Altered thermoregulatory mechanisms:
atropine
Directly related to the administration of the drug:
amphotericin b, biological agent
Direct extension of the pharmacologic action of the
drug :
chemotherapy
Idiosyncratic reactions:
malignant hyperthermia, neuroleptic malignant syndrome
Antibiotic Induced Fever
Erythromycin
Isoniazid
Penicillin
Nitrofurantoin
Procainamide
Quinidine
Atropine Captopril
Clofibrate Hydralazine Hydrochlorothiazide Methyldopa Nifedipine
Cardiovascular Medication Induced Fever
Miscellaneous Medications
Inducing Fever
Allopurinol
Antihistamines
Aspirin
Cimetidine
Heparin
Meperidine
Phenytoin
@ll about medicines
DO YOU KNOW ???
WHAT IS G6PD DEFICIENCY?
G6PD Deciency (G6PDD) is an inherited
genetic anomaly a-ecting the X chromosome.
Boys can only inherit G6PDD from their mothers,
but girls can get it from either or both parents.
When a girl inherits only one a-ected X chromosome,
she will be partially decient, but if she
inherits two affected X chromosomes, she will be
fully decient, as are all affected boys.
There are
over 420 known variants of G6PDD.
G6PD Deciency is a
genetic disorder
that is estimated to
a-ect more than
600 million people
world wide
OXIDATIVE STRESSORS ARE FOOD, DRUGS, AND OTHER CON-TRAINDICATED
SUBSTANCES THAT CAUSE HEMO-LYSIS IN PEOPLE WITH G6PD DEFICIENCY
Most people either don’t know they
have
G6PD Deciency, or have no idea
how to avoid the complications that can
lead
to life-long health problems, or even
death
source: www.g6pddeciency.org
@ll about medicines
G6Pd
DRUGS & CHEMICALS TO AVOID
Acetylphenylhydrazine
Antipyretics (Antipyrine,
Acetanilid)
Aspirin
Astemizole
Beta-Naphthol
Chloramphenicol
Chloroquine
Ciprooxacin
Dapsone
Dimercaprol
Doxorubicin
Ethanol
Furazolidone
Furosemide
Gadopentetate
dimeglumine
Glucosulfone
Glyburide
Pentaquine
Phenacetin
Phenazopyridine
Primaquine
Probenecid
Sulfamethoxazole
Sulfanilamide
Sulfapyridine
Sulfasalazine
Sulfathiazole
Sulfites (Sulfur dioxide,
sulphrous acid, etc.)
Sulfoxone
Tamsulosin
Toluidine Blue
Henna
Isobutyl Nitrite
Lamotrigine
Lawsonia inermis Linn.(henna)
Levofloxacin
Magnevist
Meoquine
Menadiol Sodium Sulfate
(Vitamin K4 sodium
sulfate)
Menadione
Menadione sodium
Menthol
Mesalazine
Methylene Blue
Moxioxacin
Nalidixic Acid
Naphthalene (Moth Balls)
Nimesulide
Niridazole
Nitrofurantoin
Nitrofurazone
Oxidase, Urate
Pamaquine
Pefloxacin
High Risk Medications
Low Risk Medications
G6PD
DRUGS & CHEMICALS TO AVOID
@ll about medicines
* Drugs above MAY be lower risk for hemolysis, but should not be administered without a doctor’s
supervision and
should not be taken at higher than normal doses.
Patients shouldbe monitored for hemolysis during treatment.
Proguanil
Pyrimethamine
Quinidine
Quinine
Streptomycin
Sulfacytine
Sulfadiazine
Sulfaguanidine
Sulfamerazine
Sulfamethoxypyridazine
Sulfonylurea
Trihexyphenidyl
Trimethoprim
Tripelennamine
Vitamin K1
Acetaminophen
Aminophenazone
Analgesics
Antazoline
Ascorbic Acid
Colchicine
Diphenhydramine
Dopamine
Ibuprofen
Isoniazid
Mirtazapine
Norfloxacin
Phenylbutazone
Phenytoin
Procainamide
G6PD:
FOODS, HERBS, &
SUBSTANCES TO AVOID
LEGUMES: All legumes: Fava Beans (and any other kind of beans), Soy (and food additives made from soy), peas, lentils, mesquite, carob, and pea-nuts... most any plant that contains a seed from a pod
BITTER GORD: Also known as garden egg. This is a common food in some parts of Africa and Asia.
ALCOHOLIC BEVERAGES:
Ethenol interferes with the
production of G6PD; Wine contains sulfites
MOTH BALLS: Contains Naphthalene
SULFITES:
Sultes are used in a wide variety of foods
such as packaged fruits, vegetables, meats, mixes,
wine, condiments, etc.,
MENTHOL: This can be difficult to avoid as tooth paste, candy, breath mints, mouth wash, and many other products have menthol added to them.
Mint from natural mint oils is NOT contraindicated.
ACSORBIC ACID:
It is commonly put in foods and
vitamins and can cause hemolysis in large doses and
should be avoided.
Research also shows that it increases the absorption of
iron, which could be dangerous for G6PDD patients
because hemolysis already raises iron to unhealthy
levels.
SOME CHINESE HERBS:
Particularly RHIZOMA
COPTIDIS (huang lien),
CALCULUS BOVIS (neu huang),
FLOS CHIMONANTHI I PRAECOCIS (leh mei hua),
FLOSLONICERAE (kam ngan fa)
MARGARITA
@ll about medicines
FDA Pregnancy Categories
for Antiretroviral Therapy
FDA Pregnancy Categories
FDA Pregnancy Categories for Antiretroviral Therapy
There are several antiretroviral agents that are used to treat HIV, including nucleoside and nucleotide
analogue reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, protease inhibi-
tors, cellular chemokine receptor (CCR5) antagonists, fusion inhibitors, and integrase inhibitors.
Category A:
Adequate and well-controlled studies of pregnant women fail to demonstrate a risk to the fetus during the
first trimester of pregnancy (and no evidence exists of risk during later trimesters)
Category B:
Animal reproduction studies fail to demonstrate a risk to the fetus, and adequate, but well-controlled,
studies of pregnant women have not been conducted
Category C:
Safety in human pregnancy has not been determined; animal studies either are positive for fetal risk or
have not been conducted, and the drug should not be used unless the potential benefit outweighs the po-
tential risk to the fetus
Category D:
There is positive evidence of human fetal risk that is based on adverse-reaction data from investigational
or marketing experiences, but the potential benefits from the use of the drug in pregnant women might
be acceptable despite its potential risks
Category X:
Studies in animals or reports of adverse reactions have indicated that the risk associated with the use of
the drug for pregnant women clearly outweighs any possible benefit
FDA Pregnancy Categories for Antiretroviral Therapy
(source:www.medscape.com.my)
Nucleoside and nucleotide analogue reverse transcriptase inhibitors
Antiretroviral therapy FDA pregnancy category Abacavir (ABC) C
Didanosine (ddI) B
Emtricitabine (FTC) B
Lamivudine (3TC) C
Stavudine (d4T) C
Tenofovir DF (TDF) B
Zidovudine (ZDV) C
Nonnucleoside reverse transcriptase inhibitors
Antiretroviral therapy FDA pregnancy category Delavirdine (DLV) C
Efavirenz (EFV) D
Etravirine (ETR) B
Nevirapine (NVP) B
Rilpivirine (RPV) B
Protease inhibitors
Antiretroviral therapy FDA pregnancy category Atazanavir (ATV) B
Darunavir (DRV) C
Fosamprenavir (f-APV) C
Indinavir (IDV) C
Lopinavir/ritonavir C
Nelfinavir (NFV) B
Ritonavir (RTV) B
Saquinavir (SQV) B
Tipranavir (TPV) C
Fusion inhibitor
Antiretroviral therapy FDA pregnancy category Enfuvirtide (T-20) B
Cellular chemokine receptor (CCR5) antagonist
Antiretroviral therapy FDA pregnancy category Maraviroc (MVC) B
Integrase inhibitor
Antiretroviral therapy FDA pregnancy category Raltegravir (RAL) C
Foods To Save
Your Heart
Black Beans
Mild, tender black beans are packed with heart-healthy nutrients
including folate, antioxidants, magnesium, and fiber -- which
helps control both cholesterol and blood sugar levels.
Salmon: Super Food A top food for heart health, it's rich in the omega-3s EPA and
DHA. Omega-3s may lower risk of rhythm disorders and reduce
blood pressure. Salmon also lowers blood triglycerides and re-
duces inflammation. The American Heart Association recom-
mends two servings of salmon or other oily fish a week.
Tuna for Omega-3s Tuna is a good source of heart-healthy omega-3s; it generally
costs less than salmon. Albacore (white tuna) contains more
omega-3s than other tuna varieties. Reel in these other sources
of omega-3s, too: mackerel, herring, lake trout, sardines, and an-
Tofu Make soy protein the main attraction more often at dinnertime
by cooking with tofu instead of red meat.
You gain all the heart-healthy minerals, fiber, and polyunsatu-
rated fats of soy --
and you avoid a load of artery-clogging saturated fat.
Ubat-ubatan ‘fast moving” Unit Farmasi Hospital Pasir Mas
2012
Bil Item
1 Nacl 0.9 % 500 ml Inj
2 Haemodialysis Conc Bicarb 1B
3 Recombinant Erythropoeitin (EPREX)
4 Heparin Sodium 5000iu/ml Injection
5 Haemodialysis Conc Bicarb 2A
6 Isosorbide Dinitrate 10 % Injection
7 Paracetamol 120mg/5ml syrup
8 Salbutamol Inhaler 200 doses
9 Metformin 500mg Tablet
10 Diphenhydramine adult
11 PDS 1.5 % Dextrose Injection
12 Recombinant Biphasic Insulin (Mixtard & Humulin 30/70)
13 Perindopril 4 mg Tablet
14 Magnesium Tri & Aluhydro Tab (Gelusil)
15 Lovastatin 20 mg Tablet
16 Paricalcitol 5mcg/ml Injection
17 Alfacalcidol 2mcg/ml Injection
18 Benzylpenicillin 5MU Injection
19 Celecoxib 200mg capsule
20 Finasteride 5mg Tab
Antara Aktiviti yang disertai oleh kakitangan Unit Farmasi
Hospital Pasir Mas bagi tahun 2012
Diari aktiviti 2012
09092012 Berjalan kaki
10,000 langkah peringkat daerah
Diari aktiviti 2012
03092012 Majlis Sambutan Hari Raya Peringkat
Hospital Pasir Mas Pertandingan Sketsa Antara Unit
Pelakon Wanita Terbaik: Roshilawani Zain (Unit Farmasi)
Sambutan Hari Kemerdekaan Peringkat Hospital Pasir Mas
Pertandingan Sajak Kemerdekaan Peserta : rokman zakaria & rezali
Diari aktiviti 2012
MAJLIS HARI RAYA UNIT FARMASI
Diari aktiviti 2012
Sambutan hari kemerdekaan peringkat Hospital Pasir Mas
MEMENANGI TEMPAT KE-2 PERTANDINGAN KECERIAAN
UNIT
Diari aktiviti 2012
Sambutan hari kemerdekaan peringkat Hospital Pasir Mas
PERTANDINGAN KAD HARI RAYA ANTARA UNIT
Diari aktiviti 2012
Ceramah & Pameran Kenali Ubat Anda di
Majlis Pemimpin bersama rakyat, Kg. Atas Pinggir Tendong
17.11.2012
Diari aktiviti 2012
KURSUS FARMASI
20.11.2012
Tempat:
Dewan Permai,
Hospital Pasir Mas
Waktu:
0830 - 1630
Majlis Berkhatan Perdana Hospital Pasir Mas 24.12.2012 & 25.12.2012
Urusetia Ubatan:
Pn.Sabariah Yunus
Pn. Roshilawani Zain
Pn. Fatimah Haron
Pn. Siti Sulaili
Urusetia Pendaftaran:
Cik Arifah Nadiah Ahmad
ALBUM UNIT FARMASI 2012
SABARIAH BT YUNUS KETUA PEGAWAI FARMASI U54
Pengalaman bertugas:
Hospital Kuala Terengganu (1993-1995),Hospital Machang (1995-2004)
Klinik Kesihatan Ketereh (2004-2005), Hospital Besut (2005-2007)
KK Pengkalan Chepa (2007-2008), KK Ketereh (2008-2009)
KKB Kota Bharu (2009-2010), Hospital Pasir Mas (2010-sekarang)
NOR AINI IBRAHIM
PEGAWAI FARMASI U48
Pengalaman bertugas:
KKB Pasir Mas (2004-2011)
Hospital Pasir Mas (2011-sekarang)
NONI MAZLINA BT CHE SOH
PEGAWAI FARMASI U48
Pengalaman bertugas:
Hospital Pasir Mas (7 Tahun)
SALMI KOH BT MUHAMMAD HASHIM KOH
PEGAWAI FARMASI U44
Pengalaman bertugas:
HRPZ II (2007-2008)
KK Wakaf Baru (2008-2011)
Hospital Pasir Mas (2011-sekarang)
ARIFAH NADIAH BT AHMAD
PEGAWAI FARMASI U44
Pengalaman bertugas:
HRPZ II (2008-2009)
Hospital Pasir Mas (2009-sekarang)
NOOR FADZILA BT BADRUDDIN
PEGAWAI FARMASI U41
Pengalaman bertugas:
HRPZ II (2010-2011)
Hospital Pasir Mas (2011-2012)
MOHD NASIR B. CHE ABDULLAH
PENOLONG PEGAWAI FARMASI U 32 (KUP)
Pengalaman bertugas:
Hospital Kuala Lipis (01.09.1984-30.08.1985)
Hospital Pasir Mas (1985-1997)
KKB Pasir Mas (1997-2005)
KK To’ Uban (01.06.2005-30.11.2005)
KKB Pasir Mas (01.12.2005-04.10.2008)
Hospital Pasir Mas (05.10.2008-sekarang)
FATIMAH BT HARON
PENOLONG PEGAWAI FARMASI U 32 (KUP)
Pengalaman bertugas:
Klinik Kesihatan Petaling, Selangor
Klinik Kesihatan Puchong, Selangor (15.07.1984-30.06.1985)
KKB Ayer Lanas (01.07.1985-15.04.1986)
KK Tendong (16.04.1986-10.09.2005)
Hospital Pasir Mas (11.10.2005-sekarang)
MIGAWATI BT MUSTAFA
PENOLONG PEGAWAI FARMASI U 32 (KUP)
Pengalaman bertugas:
KK Pengkalan Kubur (01,08.1993-31.08.1995)
Hospital Pasir Mas (01.09.1995-1997)
KKB Pasir Mas (1997-14.09.2005)
Hospital Pasir Mas (15.09.2005– sekarang)
ROSHILAWANI BT ZAIN
PENOLONG PEGAWAI FARMASI U32 (KUP)
Pengalaman bertugas:
KK Gual Ipoh
KK Ibu & Anak
KK Rantau Panjang
Hospital Pasir Mas
ZURAINI BT YIM
PENOLONG PEGAWAI FARMASI U29
Pengalaman bertugas:
KK Lintang, Sg. Siput (16.03.2005-18.05.2006)
Hospital Gerik (19.05.2006-23.08.2009)
KK To’ Uban (18.03.2011-sekarang)
SITI SULAILI BT MOHAMAD
PENOLONG PEGAWAI TADBIR N27
Tempoh bertugas:
4 tahun
ELLY AZLINA BT MOHAMED
PEMBANTU TADBIR N17
Tempoh bertugas:
8 tahun
AHMAD ZAHID B. MOHD YUSOFF
PEMBANTU TADBIR W17
Tempoh bertugas:
4 tahun
MOHAMMAD KHAIRUL ANUAR B. ABDUL HAMID
PEMBANTU TADBIR N17
Tempoh bertugas:
Mula bertugas 2012
MOHD REZALI MOHAMAD
PEKERJA AWAM KHAS R4
Tempoh bertugas:
16 tahun
MOHD NIZAM B. ARIFFIN
PEMBANTU PERAWATAN KESIHATAN U12
Tempoh bertugas:
23 Tahun
ROKMAN B. ZAKARIA
PEMBANTU PERAWATAN KESIHATAN
Pengalaman bertugas:
Hospital Hulu Kinta Perak
Hospital Ipoh (02.02.2002-02.03.2003)
Hospital Pasir Mas (03.03.2003-sekarang)
ROSPAZILAH BT HANAFI
PEMBANTU PERAWATAN KESIHATAN
Pengalaman bertugas:
Hospital Pasir Mas (April 2003-sekarang)
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