@ 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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