Pharmacy Unit

PEJABAT KESIHATAN DAERAH ALOR GAJAH (PKDAG)

78000 ALOR GAJAH, MELAKA

Issue 1/2017

Pharmacy Bulletin

Inside this issue:

Inside Story

1. PKDAG Pharmacy Family Day

2016Inside Story

2. Adverse Drug Reaction

ReportingInside Story

3. Medication Error ReportingInside Story

4. New Product in PKDAG Drug

FormularyInside Story

5. DiphteriaInside Story

6. Prenatal Vitamins Available in

PKDAG

EDITORIAL BOARD

CHAIRMAN:

Dr. Hazlinda Bt Datuk Hj.

Hamzah

ADVISER:

Pn. Azliah Bt Sakiman

EDITOR:

En. Chan Wei Jyh

CONTRIBUTORS:

Pn. Azliah Bt Sakiman

Cik Chong Pui Yee

Cik Fiona Benjamin

Pn. Khairunnisa Bt Ishak

Pn. Lim Sin Qi

Pn. Nor Aznida Bt Azizan Types of anemia during pregnancy include:

Iron-deficiency anemia

Folate-deficiency anemia

Vitamin B12 deficiency

Risks of Anemia in Pregnancy

Severe or untreated anemia during pregnancy can increase

risk of having:

A preterm or low-birth-weight baby

A blood transfusion (if you lose a significant amount of

blood during delivery)

Postpartum depression

A baby with anemia

A child with developmental delays

Baby with a serious birth defect of the spine

or brain (neural tube defects)

Treatment

Prenatal vitamins (with/without additional iron supplement

and/or folic acid supplement)

Foods high in iron and folic acid

All pregnant women are at risk for becoming anemic

because they need more iron and folic acid than

usual. But the risk is higher if:

Pregnant with multiples (more than one child)

Have had two pregnancies close together

Vomit a lot because of morning sickness

Are a pregnant teenager

Don't eat enough foods that are rich in iron

Had anemia before you became pregnant

Anemia in Pregnancy

REFERENCES:

• Website www.webmd.com (Anemia in Pregnancy: Causes, Symptoms, and Treatment)

Contributed by:

Cik Chong Pui Yee

Family Day Pharmacy PKDAG

Bora-Bora Chalet Kuala Linggi, 78200 Kuala Sg. Baru, Melaka

14 Jan 2017, 2pm - 7pm

Sukaneka

Cabutan bertuahKumpulan Johan

Sukaneka

Pemenang Bayi

Tercomel

Phamacy Bulettin PKD Alor Gajah 2

Contributed by:

Cik Fiona Benjamin

Number by Category

of Reporter

ADR Jan-Mac 2016 dan 2017

“A response to a

drug which is

noxious and

unintended, and

which occurs at

doses normally

used in man for

the prophylaxis,

diagnosis, or

therapy of

disease, or for the

modifications of

physiological

function”

Jan-Mac 2016 Jan-Mac 2017

Laporan Kesan Advers 24 41

24

41

0

5

10

15

20

25

30

35

40

45

Bilangan

70.8%

02468

10121416

KKMasjidTanah

KKDurian

Tunggal

KKLubukCina

KK Ibudan

AnakAlor

Gajah

KKMachap

Baru

KK KualaSungaiBaru

KKSimpangEmpat

KKHutanPercha

6

12

20

20

1 1

16

8 8

12 2

4

0

Jan-Mac 2016 Jan-Mac 2017

ADR Reported by Each Clinic in PKDAG

Jan – March 2017

Doctor 36

88%

Pharmacist5

12%

Drug No of

report

Adverse Reaction (Expected)

Perindopril 4mg

(Covapril ® )

5 Dry cough, dizziness

Amlodipine 5mg 4 Bilateral leg swelling, lip swelling, giddiness

Perindopril 8mg

(Covinase ®)

4 Dizziness, hand sweating, periorbital swelling,

cough and SOB

Metformin 500mg 3 Diarhoea, bilateral leg swelling, prolong

diarrhoea

Paracetamol 500mg 3 Eye oedema, facial puffiness, rashes, itchiness,

periorbital rash and itchiness

Adverse Drug Reaction (ADR) Reporting

Phamacy Bulettin PKD Alor Gajah 3

REFERENCES:

• Data of ADR Reporting 2016 & 2017 of PKDAG

Contributed by:

Pn Lim Sin Qi

Near misses and actual errors

involving:

• Prescribing

• Administration

• Dispensing

• Others

Examples:

• No prescribers stamp

• No countersignature for category A medicines

• Medicines not stocked

What to report?

How to report???

1. Medication Error (ME) Reporting Form

• Hospital & Health Care Pharmacy

• Medication Safety, Pharmaceutical Services Division, MOH

• www.pharmacy.gov.my

“Medication

Error (ME) is

any

preventable

event that may

cause or lead

to

inappropriate

medication

use or patient

harm while the

medication is

in the control

of the

healthcare

professional,

patient or

consumer.”

Medication Error Reporting

What not to report?

Phamacy Bulettin PKD Alor Gajah 4

0

2

4

6

8

10

12

KK Kuala

Sungai Baru

KK Masjid

Tanah

KK Durian

Tunggal

Medication Error Report

(Jan – Mac 2017, n=16)

REFERENCES:

• Data of ME Reporting 2017 of PKDAG

Contributed by:

Pn Azliah Bt Sakiman

Tablet Lamivudine 150mg and Zidovudine 300mg

Change of Generic Brand from DUOVIR to LAMIZIDO

New Product in PKDAG Drug Formulary

Phamacy Bulettin PKD Alor Gajah 5

Levemir Flexpen®

(Insulin Detemir)

Tablet Enalapril 20mg

Losartan 50mg & 100mg

Contributed by:

Pn Nor Aznida Bt Azizan

Diphteria

Complications

“Diphteria is an

infection caused

by the bacterium

Corynebacterium

diphtheria.

Usually spreads

between people by

direct contact or

through the air.”

Figure: A pseudomembrane,

characteristic of diphteria

Sign & Symptoms

• Sign and symptoms may vary from mild to severe.

• Usually start two to five days after exposure

• Symptoms often come on fairly gradually, beginning

with sore throat and fever

• In severe cases, a grey or white patch develops in

the throat. This can block the airway and create

barking cough as in croup.

• The symptoms are due to a toxin produced by the

bacteria.

• Include myocarditis, inflammation of nerves, kidney

problems, and bleeding problems due to low blood

platelets.

• Myocarditis may result in abnormal heart rate.

Preventions

Treatment

Phamacy Bulettin PKD Alor Gajah 6

• Treatment is with the antibiotics erythromiycin or

benzylpenicillins. These antibiotics may also be used

for prevention in those who have been exposed to

the infection

• A surgical procedure known as tracheotomy is

sometimes needed to open the airway in severe

cases.

• A diphtheria vaccine is effective for prevention and

available in a number of formulations.

• Three or four doses, given along with tetanus

vaccine and pertussis vaccine, are recommended

during childhood.

• Further doses are recommended every ten years

• Protection can be verified by measuring antitoxin

level in the blood

REFERENCES:

• Website https://www.cdc.gov/diphtheria/about/causes-transmission.html

Contributed by:

Pn Khairunnisa Bt Ishak

Hb Level Suggestion of Vitamin Dose Recommendation

≤10 Iberet Folic-500 tab. 1 tab OD to BD (max)

10.1 – 11.9 Zincofer cap. 1 cap OD

≥12 Obimin tab. 1 tab OD

Prenatal Vitamins available in PKDAG

Suggestion Of Administration

*May switch to separate hematinics if non-tolerable

Phamacy Bulettin PKD Alor Gajah 7

REFERENCES:

• Website www.webmd.com (Anemia in Pregnancy: Causes, Symptoms, and Treatment)

• Product leaflets of Iberet Folic-500, New Obimin & Zincofer

New Obimin (Westmont)

Vit A 3,000 IU

Vit D 400 IU

Vit C 100mg

Vit B1 10mg

Vit B2 2.5mg

Vit B6 15mg

Vit B12 4mcg

Niacinamide 20mg

Pantothenic acid 7.5mg

Folic acid 1mg

Fe 30mg

Ca 32.5mg

Copper 100mcg

Iodine 100mcg

Zincofer (Apex)Ferrous Fumarate (providing 115mg iron) 350mg

Cyanocobalamin 5mcg

Folic acid 1mg

Ascorbic acid 75mg

Pyridoxine HCl (providing 1.23mg pyridoxine) 1.5mg

Zinc Sulfate (providing zinc 19.8mg) 55mg

Iberet Folic-500 (Abbott)Fe sulfate controlled release 525mg

Vit B1 6mg

Vit B2 6mg

Vit B6 5mg

Vit B12 25mcg

Vit C 500mg

Cobalamin 25mcg

Niacinamide 30mg

Ca pantothenate 10mg

Folic acid 800mcg

Contributed by:

Cik Chong Pui Yee

Preventing Anemia

Enough iron

Eat well-balanced meals and foods that

are high in iron

E.g. foods high in iron:

o Lean red meat, poultry, and fish

o Leafy, dark green vegetables

(such as spinach, broccoli, and

kale)

o Iron-enriched cereals and grains

o Beans, lentils, and tofu

o Nuts and seeds

o Eggs

Foods high in vitamin C can help body

absorb more iron. E.g.

o Citrus fruits and juice

o Strawberries

o Kiwis

o Tomatoes

o Bell peppers

Phamacy Bulettin PKD Alor Gajah 8

Jalan Hospital,

78000 Alor Gajah

Melaka .

Phone : 06-5566235

ext. 237

Fax : 06-5566236/

06-5566249

Hi, I am Nur

Mahya Bt

Mazwan

Baby of Pn Nur

Laili

D.O.B 060417D.O.B 260117

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Baby of Pn

Anida Daud Hi, I am

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Bt Mohamad

Hairy

Baby of En

Hairy

Hi, I am Ayra

Hazinah Bt

Azrul Effendy

Baby of Pn Nur

Huzaimah

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D.O.B 241216

Hi, I am Wan Izz

Aaeron Danish

Bin Wan Nor

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Syafinaz

En. Muhammad Amirul Haziq bin Abu Bakar

Penolong Pegawai Farmasi U29

Klinik Kesihatan Padang Sebang

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Mohd Hamizan.

Baby of Pn

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En. Taufek Bin Ajeh

Penolong Pegawai Farmasi U29

Berpindah ke Klinik Kesihatan Membiak (PKD Kuala Krai)