1

The total number of dengue cases reported until 2/11/2013 was 1015 cases.

An increase of 619 cases or 156.31% compared to the same period in 2012 which was 396 cases.

Of the total cases for year 2013:

CHAIRMAN:

DR HJ JAMAL BIN ALI

JOHARI

ADVISER:

PN NUR ATIKAH YAAKUB

EDITOR:

JENNY SHUM

CONTRIBUTORS:

SIN QI, KAH YEE, PUI YEE,

IZATY, FAZRIN, AZMIR, IFZAD

High fever and at least two of the following:

Severe headache

Severe eye pain (behind eyes)

Joint pain

Muscle and/or bone pain

Rash

Mild bleeding manifestation (eg., nose or gum bleed, petechiae, or easy bruising)

Low white cell count

Dec 2013 Issue 1/2013

Issue 1/2013

1. Dengue

2. Dietary Supplement

Limits

3. Understand Lindane

Well

4. Family Day 2013

5. New & Old Staffs

6. Gout management

7. Stress in the Phar-

macy

8. Fun-Pharm Relax Zone

Issues

Pharmacy Unit PKD ALOR GAJAH

78000 ALOR GAJAH, MELAKA

EDITORIAL BOARD

Current Dengue Situation in Melaka

Contributed by Jenny Shum Reference: 1. 1.Laman Portal Rasmi Jabatan Kesihatan Negeri Melaka. 2.http://www.cdc.gov/Dengue/symptoms/ 3.http://www.cdc.gov/dengue/prevention/ 4.http://www.who.int/denguecontrol/control_strategies/en/

District Number of Cases

Melaka Tengah 859

Alor Gajah 91

Jasin 65

Symptoms of Dengue

Self-Prevention of Dengue Eliminate or clean frequently the places where the mosquito might lays her eggs:

Artificial containers that hold water in and around the home

Water containers like pet and animal watering containers

Flower planter dishes

Water storage barrels

Vases

Individual Protection:

Clothing that minimizes skin exposure

Repellents may be applied to exposed skin or to clothing

Mosquito nets

Household insecticide aerosol products, mosquito coils or other insecticide vaporizers

2

Dietary supplement is a product that: Is intended to supplement the diet

Contains one or more dietary ingredients (including vitamins; minerals;

herbs or other botanicals; amino acids; and other substances or their con-

stituents

Is intended to be taken by mouth as a pill, capsule, tablet, or liquid

Is labeled on the front panel as being a dietary supplement

Dietary Supplement Limits

Page 2

Issue 1/2013

NO. VITAMINS & MINERALS UPPER DAILY LIMIT

1 Vitamin A 5000 IU

2 Vitamin D 1000 IU

3 Vitamin E 800 IU

4 Vitamin B1 (Thiamine) 100 mg

5 Vitamin B2 (Riboflavine) 40 mg

6 Vitamin B5 (Panthothenic Acid) 200 mg

7 Vitamin B6 (Pyridoxine) 100 mg

8 Vitamin B12 (Cynocobalamin) 0.6 mg

9 Vitamin C (Ascorbic Acid) 1000 mg

10 Folic Acid 0.9 mg

11 Nicotinic Acid 15 mg

12 Niacinamide (Nicotinamide) 450 mg

13 Biotin 0.9 mg

14 Boron 6.4 mg

Beware health supplements with formulation that: Exceeds the new upper daily limit

Does not exceed the new upper daily limit but with recommended

dosage that exceeds the limit

The Updated Upper Daily Limits for Vitamins and Minerals (for Adults)

Contributed by Azmir Reference: Newsletter of the Drug Control Authority, Malaysia. (Volume 57, No. 35, ISSN 0128-0627)

3

Understand Lindane Well

Page 3

Issue 1/2013

Class: Scabicide & Pediculicide

Other name: Gamma Benzene Hexachloride

Dosing form and strength: Lotion/shampoo 1%

Introduction

INDICATIONS:

Topical application for treatment of Sarcoptes Scabiei (scabies),

Pediculosis Capitis (Head lice) & Phthirus Pubis (Crab lice).

Dosing & Uses:

Indication & Dosage

Scabies Apply (lotion) thin layer and massage on skin on entire body except

face, giving special attention to skin-folds and the finger/toe webs.

Bathe and remove drug 8-12 hours after application.

Pediculosis Capitis (Head

lice) or Pediculosis Pubis

(Crab lice)

Apply 30-60ml of shampoo (not exceed 60ml) into the scalp and

the hair, leave on 4 minutes, lather, rinse, remove nits with fine-

toothed comb. (One time application usually sufficient; may use

other pediculicide in 1 week if necessary).

Premature neonates (<28do) due to their skin

maybe more permeable and liver enzymes not

sufficiently developed

Uncontrolled seizure disorder

Norwegian (crusted) scabies

Hypersensitivity to the product or any of its com-

ponents

Skin conditions that may increase systemic ab-

sorption

Contraindication

Pregnancy Cate-

gory:

C

Lactation:

Distributed in breast milk, do not nurse for 24 hours post-application (express milk & discard)

Pregnancy & Lactation

Contributed by Pui Yee References: 1. Gamascab ® Lotion Product Leaflet

2. Micromedex Drug Information: Lindane

3. http://reference.medscape.com/drug/lindane-topical-343501

4

Page 4

Issue 1/2013

Changing of Drug Brand

Previous

Current

Contributed by Jenny Shum

Generic Name: Mist. Magnesium Trisilicate

Brand Name: Hovid

Generic Name: Mist. Magnesium Trisilicate

Brand Name: KCK

Generic Name: T. Amlodipine 5 mg

Brand Name: Ranbaxy

Generic Name: T. Amlodipine 5 mg

Brand Name: Hovid

Generic Name: T. Amlodipine 10 mg

Brand Name: Ranbaxy

Generic Name: T. Amlodipine 10 mg

Brand Name: Hovid

5

Page 5

Issue 1/2013

Contributed by Jenny Shum

Changing of Drug Brand (Con’t)

Previous

Current

Generic Name: Losartan 50 mg

Brand Name: Cozaar

Generic Name: Losartan 50 mg

Brand Name: Winthrop

Generic Name: Salbutamol 100µg/dose inhalation

Brand Name: Ventolin

Generic Name: Salbutamol 100µg/dose inhalation

Brand Name: Asthalin

Generic Name: Finasteride 5 mg

Brand Name: Proscar

Generic Name: Finasteride 5 mg

Brand Name: Finaintas

6

Page 6

Issue 1/2013

On 25 August 2013, a Family Day was held by pharmacy staffs in Akar Beach Resort, Teluk Kemang

Port Dickson. It is just one hour away from the town and we get a good chance to come across with the

sight of the beautiful blue ocean and white capped waves. Several activities and games were carried

out at the beach side and grand prizes were given to the winners. Everyone of us did enjoy very much

and looking forward for the next gathering.

Coconut Bowling

Blowing Balloons

Ping-Pong Game

Contributed by Izaty

7

Tug of War

Page 7

Issue 1/2013

Contributed by Izaty

Wet War

Sugar in the powder

Prize Giving

Prize Giving Prize Giving

8

Farewell Parties

Page 8

Issue 1/2013

Farewell parties were held as a token of appreciation to Ms.

Chin Yee Ling, Ms. Tan Aie Yen, and Pn. Anis Haswani Binti

Othaman for their commitment and contribution to the Phar-

macy Department of PKD Alor Gajah. Ms. Chin Yee Ling has

her new placement in KK Jinjang, Ms .Tan Aie Yen in KK

Taman Universiti and Pn. Anis Haswani Binti Othaman in

BPFK. Wishing three of them all the best and success in their

future undertaking.

Bye! Ms. Chin Yee Ling

Bye! Ms. Tan Ai e Yen Bye! Puan Anis

New Staffs

Meanwhile, we would also like to welcome new staffs Mr. Chew Chun Siang (KKMT)

and Fiona Benzamin (KKSE) for joining the pharmacy team PKD Alor Gajah..

Hi! Mr. Chew Chun Siang

Hi! Fiona Benzamin

Contributed by Sin Qi

9

Page 9

Issue 1/2013

Changing of Drug Category

DRUG OLD CATEGORY NEW CATEGORY

Bisoprolol Fumarate 2.5 mg

A B

Bisoprolol Fumarate 5 mg A B

Carvedilol 6.25 mg A* A/KK

Carvedilol 25 mg A* A/KK

Budesonide + Formeterol 160 mcg/4.5 mcg Turbu-

haler

A A/KK

Budesonide + Formeterol 320 mcg/9 mcg Turbu-

haler

A* A/KK

Contributed by Jenny Shum

10

Gout Management

Page 10

Issue 1/2013

Introduction

Acute Gout Chronic Gout

Severe joint redness, pain, and

swelling.

Often affects one joint in 90%

of patients.

Lower limbs’ joints are more

common affected than upper

limbs.

Last from few days to weeks

with inflammatory signs gradu-

ally resolved.

Characterized by polyarticular

arthritis and formation of to-

phi.

Tophi, deposit of monoso-

dium urate usually appear

painless, firm, nodular or fusi-

form swelling.

Digits of hands and feet are

the most common site for to-

phi.

Elderly are more prone to de-

velop polyarticular arthritis.

Treatment

Colchicine Allopurinol

Indication:

Acute attacks of gout or short-term prophylaxis of

gout.

Dosage:

Indication:

Chronic gouty arthritis.

Dosage:

Initial dose: 100-300 mg daily

Maintenance: 300-600 mg daily

Maximum: 900 mg daily Acute Attacks Short-term prophy-

laxis

1 mg initially then 0.5 mg every 2 to

3 hours until pain relief is obtained

or gastro-intestinal adverse effects

occur (diarrhea). Total daily dose

≤10 mg. At least 3 days should elapse before another course is

given.

0.5 or 0.6 mg one to

three times daily.

Contributed by Kah Yee Reference: 1. Oxford Handbook of Clinical Medicine 7th edition (page 534). 2. Product leaflet for T, Colchicine 0.5 mg. 3. Blue Book.

11

Page 11

Issue 1/2013

In the Pharmacy???

1. Listen to Music Take a break and listening to relaxing clas-

sical music. Playing calming music has a

positive effect on the brain and body, can

lower blood pressure, and reduce cortisol,

a hormone linked to stress.

2. Call a Friend Take a break to call a friend and talk about

your problems. Good relationships with

friends and loved ones are important to any

healthy lifestyle. A reassuring voice, even for

a minute, can put everything in perspective.

3. Talk Yourself Through It If calling a friend is not an option, talking calmly to yourself can be the next best thing.

Don’t worry about seeming crazy. Just tell

yourself why you’re stressed out, what you

have to do to complete the task at hand, and

most importantly, that everything will be OK.

4. Eat Right Stress levels and a proper diet are closely related. Fruits and vegetables are always

good, and fish with high levels of omega-3

fatty acids have been shown to reduce the

symptoms of stress. A tuna sandwich really

is brain food.

5. Breathe Easy For an easy 3 to 5 minute exercise, sit up in

your chair with your feet flat on the floor

and hands on top of your knees. Breathe in

and out slowly and deeply, concentrating

on your lungs as they expand fully in your

chest. Deep breathing oxygenates your

blood, helps center your body, and clears

your mind.

6. Laugh It Off Laughter releases endorphins that improve

mood and decrease levels of the stress-

causing hormones cortisol and adrenaline.

Laughing tricks your nervous system into

making you happy.

7. Try Tea A large dose of caffeine causes a short-

term spike in blood pressure and may

cause your hypothalamic-pituitary-

adrenal axis to go into overdrive. Instead

of coffee or energy drinks, try green tea.

It has less than half the caffeine of coffee

and contains healthy antioxidants, as well

as theanine, an amino acid that has a calming and soothing effect on the nerv-

ous system.

8. Be Mindful There are also many lifestyle changes that

can be more effective in the long run. From

yoga and tai chi to meditation and Pilates,

these systems of mindfulness incorporate

physical and mental exercises that prevent stress from becoming a problem in the first

place.

9. Exercise (Even for a Minute) Exercise doesn't necessarily mean power

lifting at the gym or training for a mara-

thon. A short walk around the office or

simply standing up to stretch during a break at work can offer immediate relief in

a stressful situation. Getting your blood

moving releases endorphins and can im-

prove your mood almost instantaneously.

10. Sleep Better Everyone knows stress can cause you to lose

sleep. Unfortunately, lack of sleep is also a

key cause of stress. Make it a point to get the doctor-recommended seven to eight hours of

sleep. Turn the TV off earlier, manage your

time, and do your best to get into bed.

Contributed by Ifzad References: http://www.healthline.com/health-slideshow/10-ways-to-relieve-stress#11

12

Page 12

Issue 1/2013

Fun-Pharm Relax Zone

Contributed by Fazrin Reference: http://www.offthemark.com/cartoons/pharmacy/pg/5