What is antibiotic resistance?

1

Antimicrobial resistance is the ability of a microbe to

resist the effects of medication that once could

successfully treat the microbe. The term antibiotic

resistance is a subset of AMR, as it applies only to

bacteria becoming resistant to antibiotics.

Advisor:

Pn Nur Shazrina Ahmad

Editor:

Cik Yee Chiou Yann

Co-editor:

Meera Kalaiselvan

Nurain Shafiqah binti

Hassim

In this issue

Antibiotic resistance 1-3

Drug Safety Update 4

Product Brand

Changes

5-6

New Drugs in

Hospital Segamat

7

ADR Cases 8

Medi Kit 9-12

Pharmacy Activities 13-14

PHARMACY BULLETINHOSPITAL SEGAMAT, ISSUE 03/2019

2

3

COMMUNITY

HOSPITAL

Take antibiotics only as directed by your doctor

Take the whole dose of antibiotics even when you are feeling well

Do not use any previous antibiotics

Do not share antibiotics with others

Prevent infections by regularly washing hands, avoiding close contact

with infected people and regularly taking vaccine doses.

Get culture before starting antibiotics

Antimicrobial prescribing must be reviewed no later than the 72 hours

after it has been initiated

REFERENCES

1) Antibiotic resistance. (2019). Retrieved 8 October 2019, from https://www.who.int/news-room/fact

sheets/detail/antibiotic-resistance

2) What Exactly is Antibiotic Resistance?. (2019). Retrieved 8 October 2019, from

https://www.cdc.gov/drugresistance/about.html

3) WHO releases list of world's most dangerous superbugs. (2019). Retrieved 8 October 2019, from

https://www.statnews.com/2017/02/27/who-list-bacteria-antibiotic-resistance/

4) Newsmax Media, I. (2019). Superbugs List: World Health Organization Names Top 12 Threats. Retrieved 8

October 2019, from https://www.newsmax.com/TheWire/superbugs-list-world-health-

organization/2017/02/27/id/775845/

5) Antimicrobial stewardship - APIC. (2019). Retrieved 8 October 2019, from https://apic.org/Professional-

Practice/Practice-Resources/Antimicrobial-Stewardship/

Disclaimer: While all care is taken to ensure that the information presented in this bulletin is accurate, the board of editors and authors of this bulletin disclaim all

responsibilities for any liability, loss or harm incurred as a result of misinterpretation or inaccuracies within this bulletin. The content of this bulletin is provided for

general informational purposes only and is not intended as, nor should it be considered substitute for professional medical advice.

Deferiprone: Risk of neurological disorders in children

4

Background of Safety Issue

NPRA has received information from Health

Canada regarding a safety alert on the potential

risk of neurological disorders in children receiving

deferiprone at recommended doses.

Previously, the package insert of deferiprone has

already documented this risk occurring in children

who received deferiprone at 2.5 times more than

the recommended dose. However, a safety review

was initiated by Health Canada when two

published cases of neurological disorders

including difficulty walking or difficulty with the

coordination of movement were observed in

children treated with deferiprone at recommended

doses. Health Canada has concluded that these

neurological adverse events may occur with

deferiprone even at recommended doses.

Following this, product manufacturers of

deferiprone are required to update the package

insert with this information.

Upon further investigation, it was noted that the

package insert of deferiprone in Europe was

approved by the European Medicine Agency

(EMA) to be updated with safety information on

the risk of neurological disorders in children

receiving standard doses of deferiprone. Among

the neurological disorders observed with the

standard dose are hypotonia, instability, inability

to walk, and hypertonia with inability of limb

movement. These neurological disorders were

found to gradually subside with discontinuation of

deferiprone.

Adverse Drug Reaction Reports

NPRA has received 351 ADR reports with

721 adverse events suspected to be related

to deferiprone. To date, no report related to

neurological disorders such as difficulty in

walking or difficulty in coordination of

movement has been reported

Advice for Healthcare Professionals

•Monitor for any signs and symptoms of

neurological disorders in patients taking

deferiprone at any dose.

•Please report any adverse events suspected

to be related to deferiprone to NPRA.

Adapted from NPRA Safety Alerts, 12 June 2019

PRODUCT BRAND CHANGES

FOLIC ACID 5MG TABLET

Previous brand: Royce

Manufacturer: ROYCE PHARMA

MANUFACTURING SDN. BHD.

Current brand: Upha Folic

Manufacturer: UPHA

PHARMACEUTICALS MFG

FRUSEMIDE 10 MG/ML INJECTION

Previous brand: Fusix

Manufacturer: SM PHARMACEUTICALS

SDN. BHD.

Current brand: Akoset

Manufacturer: DUOPHARMA (M) SDN.

BHD.

DIOSMIN 450MG AND HESPERIDIN 50MG TABLET

Previous brand: Davmorid

Manufacturer: HOMECARE

Current brand: HemoRid

Manufacturer: UPHA

PHARMACEUTICALS MFG

5

PRODUCT BRAND CHANGES

LOSARTAN 50MG TABLET

Previous brand: Zyltan

Manufacturer: TROIKAA

Current brand: Zylovaa

Manufacturer: XEPA

AMIODARONE 200MG TABLET

Previous brand: Eurythmic

Manufacturer: UNIMED SDN BHD

Current brand: Amiohexal

Manufacturer: IMEKS PHARMA SDN.

BHD.

PROLASE TABLET

Previous brand: Prozyme tab

Manufacturer: ROYCE

Current brand: Noripapain tab

Manufacturer: NORIPHARMA

6

NEWLY APPROVED DRUGS

Tablet Vortioxetine 10mg Tablet Rivaroxaban 20mg

Injection Iron Dextran 50mg Fe/ml Tablet Levodopa 100mg & Carbidopa 25mg

Tablet Empagliflozin 25mg Tablet Amantadine 100mg

7

Adverse Drug Reaction (ADR) Cases In Hospital Segamat

8

2019 ADR Cases by Pharmacological Group

2019 ADR Cases:Cutaneous Reaction

Nutrition & blood disorder 1 %

Anti-Infective 32 %

Ear, Nose and Oropharynx

3%

Supplement 1%Rheumatology 7%

Gastro-intestinal 8%

Endocrine 5%

Analgesic25%

Cardiovascular 18%

1 1

8

1311

17 16

24

11

25

17

9

21

8 8

15 16

8

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

2018 : 153, 2019 (Jan-Jun) : 76

2018 2019

Non Cutaneous Cutaneous

Non-cutaneous

32%

Cutaneous 68%

KONVENSYEN INOVASI & KREATIVITI FARMASI (KIKF) 2019

5 - 7 OGOS 2019

Berjaya Waterfront Hotel, Johor Bahru

9

MEDI-KIT, HASIL KUMPULAN MATRIX, HOSPITAL SEGAMAT TELAH

MENDAPAT JOHAN (KATEGORI INOVASI PRODUK) DALAM KIKF 2019

MEDI KIT

Home Medication Review (HMR) merupakan

satu perkhidmatan lawatan ke rumah

pesakit Psikiatrik yang berkonsep

pembekalan Pharmaceutical Care yang

optima kepada pesakit

Masalah-masalah yang dihadapi:

Pendispensan ubat dalam sampul: Ubat

didapati telah dikeluarkan daripada

sampul ubat dan blister asal yang

mengakibatkan kekeliruan pengambilan

ubat.

Pendispensan ubat dalam pillbox:

Pillbox yang digunakan oleh pesakit

hanya dapat menyimpan bekalan ubat

selama 2 minggu dan identiti ubat, tarikh

luput dan kelompok ubat tidak dapat

dikenalpasti.

Objektif Medi-kit:

• Meningkatkan

kepatuhan pesakit

terhadap ubat

• Mengurangkan

kesilapan pengubatan di

kalangan pesakit

• Meningkatkan

produktiviti pegawai

farmasi HMR

10

Inovasi baru untuk memberi ubatkepada pesakit HMR dalam bentuk

album di mana ubat disediakan dalambentuk Unit Dose.

CIRI-CIRI PRODUKBersifat kalis air, tahan lasak dan

boleh digunakan berulang-ulang kali

Ubat tidak perlu dikeluarkan dari

blister asal mengelakkan

masalah ketidakstabilan ubat

Bahan yang digunakan murah,

senang didapati dan boleh

direplikasi di fasiliti lain.

Fleksibiliti berbanding pillbox dari

segi mengubahsuai kekerapan

pengambilan ubat

FAEDAH-FAEDAH

>Penjimatan kos penghantaran ubatapabila kekerapan lawatan dapatdikurangkan & bahan Medi-kit lebihmurah daripada pillbox

>Penjimatan masa pengisian ubat

>Penyediaan pillbox melibatkanpencucian, pengeringan dan pengisian.Penyediaan Medi-kit hanya melibatkanpengisian ubat bentuk UOD sahaja.

>Peningkatan produktiviti PegawaiFarmasi apabila lawatan HMRdikurangkan.

>Nilai tambah kepada pengguna dimana peningkatan kepatuhan pesakitterhadap ubat dan kekerapan pesakitterlupa mengambil ubat telahdikurangkan.

>Patient empowerment di mana Medi-kitmengandungi maklumat pesakit,preskripsi ubat, cara pengambilan ubat,indikasi, nama ubat, durasi.

11

12

Butiran

pesakit

Panduan

Ubat diletakkan

mengikut waktu

pengambilan ubat.

OD, BD, TDS, QID

Preskripsi

Kalender untuk

merekodkan tarikh injeksi

MAJLIS PERPISAHAN PRP

PERTANDINGAN BOWLING

ANJURAN BADAN KEBAJIKAN DAN SOSIAL JABATAN FARMASI

HOSPITAL SEGAMAT

13

PERTANDINGAN BOWLING TELAH DIADAKAN PADA 20 APRIL 2019 DI

BOWLING ALLEY, BANDAR SEBERANG, SEGAMAT. ACARA TERSEBUT

DIMENANGI OLEH UNIT FARMASI LOGISTIK.

SAMBUTAN HARI RAYA 2019 PERINGKAT JABATAN

DAN HOSPITAL

14