Download pdf - 204 1 KOLOKIUM fileEditor: Noor Aini Abu Samah Noor Shufiza Ibrahim Nik Azira Nik Ab. Ghani Dhamirah Mohd Razali ... Kata-kata Aluan oleh Timbalan Pengarah Kanan (Farmasi)

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K OLOKIUM PENYELIDIKAN

J A B A T A N | F A R M A S I

TEMPAT | Blok Pembelajaran &

Sumber Pelajar (BPSP)

TARIKH | 28 Oktober 2014 (Siri I) 29 Oktober 2014 (Siri II)

K O L O K I U M | P E N Y E L I D I K A N

Editor: Noor Aini Abu Samah Noor Shufiza Ibrahim Nik Azira Nik Ab. Ghani Dhamirah Mohd Razali Sakinah Mohamed Saat Aqilah Muhammad Nur Hidayah Zakaria Hak cipta terpelihara. Setiap bahagian daripada terbitan ini tidak boleh diterbitkan semula, disimpan untuk pengeluaran atau dipindahkan kepada bentuk lain sama ada dengan cara elektronik, mekanik, gambar, rakaman dan sebagainya tanpa izin pemilik hak cipta terlbih dahulu.

Diterbitkan oleh Jabatan Farmasi, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Rekabentuk buku oleh Wan Izzati Mariah Wan Hassan Dicetak oleh Percetakan Dian Darulnaim Sdn. Bhd.

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Kata-kata Aluan oleh Timbalan

Pengarah Kanan (Farmasi)

Objektif Program

Jawatankuasa Penganjur

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Program Saintifik 4

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6-15 Abstrak

Senarai Pembentang

Penghargaan 16

K O L O K I U M | P E N Y E L I D I K A N K

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Timbalan Pengarah Kanan (Farmasi), Jabatan Farmasi. Assalamualaikum w.b.t dan salam sejahtera, Saya ingin merakamkan setinggi-tinggi penghargaan kepada ahli jawatankuasa dan semua pihak yang terlibat dalam menjayakan Kolokium Penyelidikan Jabatan Farmasi yang diadakan buat julung kalinya. Sememangnya pemantapan perkhidmatan farmasi klinikal merupakan salah satu agenda jabatan dan aktiviti penyelidikan ubat-ubatan merupakan platform yang amat penting. Sesungguhnya, kolokium ini merupakan salah satu inisiatif kita semua dalam menzahirkan visi dan misi universiti. Syabas dan tahniah kepada semua pembentang dan kumpulan masing-masing di atas komitmen yang tinggi dalam menyiapkan kajian walaupun sibuk dalam mengendalikan rutin harian di unit. Justeru itu, telah menjadi hasrat kita semua agar kolokium ini dapat menjadi satu landasan yang dapat menghubungkan hasil kajian dengan praktis seharian dalam menambahbaik mutu perkhidmatan dalam penjagaan pesakit. Akhir kata, semoga kolokium ini telah dapat menyuntik semangat dan memberi kekuatan kepada semua penyelidik terutama penyelidik-penyelidik baru bagi meneruskan kajian-kajian berikutnya pada masa hadapan. Semoga kajian yang dilaksanakan mampu untuk terus memberi impak yang bermanfaat kepada pesakit, universiti dan negara. Terima kasih. Tuan Haji Zainol Abidin Hamid Timb. Pengarah Kanan (Farmasi) Jabatan Farmasi, Hospital USM

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K O L O K I U M | P E N Y E L I D I K A N Ja

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PENASIHAT PUAN NOOR AINI ABU SAMAH

PENGERUSI PUAN NOOR SHUFIZA IBRAHIM

SETIAUSAHA PUAN NIK AZIRA NIK AB. GHANI

AHLI-AHLI JAWATANKUASA EN. MOHD HASRUL HISHAM SEMAIL

CIK MAJDIAH MOHD YUNUS PUAN NORAINI OMAR

PUAN SITI NADIAH MOHD SUHANE

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Mendedahkan peserta kepada kepentingan kajian drug dalam perkhidmatan farmasi.

Memahami peranan penyelidikan dalam

memperkasakan amalan farmaseutikal. Memahami dan meningkatkan penglibatan

semua ahli farmasi dalam penyelidikan.

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8.10-8.30 pagi Pendaftaran

8.30-8.40 pagi Bacaan Doa

8.40-9.40 pagi Ceramah 1 oleh Puan Noor Aini Abu Samah

(Timb. Pengarah Farmasi)

9.40-10.10 pagi Pembentangan 1


10.40-11.00 pagi Persegaran



12.00-12.30 t/hari Pembentangan 5



1.30 t/hari Persegaran dan penangguhan

Siri 2: 29 Oktober 2014

2.00-2.10 ptg Pendaftaran

2.10-2.40 ptg Pembentangan 8



3.40-4.40 ptg Ceramah 2 oleh Tuan Haji Zainol Abidin Hamid,

Timbalan Pengarah Kanan (Farmasi)

4.40-4.55 ptg Penyampaian hadiah

4.55 ptg Persegaran


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1. Characteristics Of Drug Inquiries Asked To Pharmacist In Intensive Care Unit Hospital Universiti Sains Malaysia

Khairul Bariah Johan, Irfan Mohamad, Noor Aini Abu Samah

2. Pengesanan Lamotrigine Menggunakan Kaedah HPL Nurul Fatihah Mohd Amin, Dellemin Che Abdullah, Abdul Fatah Abdul Rahman, Tg Khairul Azhar Tuan Yahaya, Yunus Othman, Nor Adyani Khairuddin 3. Quality Control of Expired 99mTc-DTPA (Radpharm®) Nor Suriana Mohd Yusuf 4. A study of cancer pain and its treatment in Hospital Universiti Sains Malaysia Nur Amalina Che Rahim, Zalina Zahari 5. A survey on the knowledge and perceptions of prescribers towards generic medicines in HUSM Tuan Umar b. Tuan Ismail, Dellemin Che Abdullah, Norita Abdul Hamid, Nur Delaida Mohd Nawi, Noor Shufiza Ibrahim, Mohd Sabrie Mohd Nawawi. 6. Time Achieving Target Concentration: Intermittent Infusion vs Continuous Infusion of Vancomycin in ICU Noor Shufiza Ibrahim, Dellemin Che Abdullah, Yahaya Hassan, Mahamarowi Omar, Norizan Abdul Aziz 7. Pain Management Clinical Pharmacy Service in Hospital Universiti Sains Malaysia (USM) – Steps Forward Nur Aida Murni Mamamad, Zalina Zahari 8. Adverse Drug Reactions Reported in HUSM Noorhasliza Ramlee, Noor Shufiza Ibrahim 9. ‘Communication Issues Involving Medication Errors’ di Kalangan Pegawai Farmasi dan Penolong Pegawai Farmasi Nik Azira Nik Ab. Ghani, Noor Shufiza Ibrahim, Noorhasliza Ramlee, Asrul Akmal Shafie 10. Cold pressor pain responses among male opioid naive subjects in Malaysia Zalina Zahari

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Characteristics Of Drug Inquiries Asked To Pharmacist In Intensive Care Unit Hospital Universiti Sains Malaysia

Khairul Bariah Johan ¹ , Irfan Mohamad² , Noor Aini Abu Samah¹

¹ Dept. of Pharmacy, HUSM, ² Dept. of ORL-HNS, School of Medical Science, USM

Introduction Drug Information Service or Unit is available in most hospitals and is occasionally underuti-lized due to unawareness of its existence. The new approach of providing on-site pharmacist or participation of pharmacist in the ward round as a team member can contribute signifi-cantly to the patient care. Clinical pharmacists are dedicated to specific units which require a wide spectrum of treatment with antibiotics, drug dosing in immunocompromised patients such as high dependency unit (HDU) or intensive and criticical care units (ICU & CCU). Such information regarding utilization of clinical pharmacist in Malaysia is not sufficiently reported. The availability of clinical pharmacists in ward rounds is question-inviting as an inquiry would be spontaneously entertained with a response as compared to the conventional procedure that is via phone or e-mail. Objectives of the study To identify the characteristics (frequency, request category, inquirer) of questions asked by Intensive Care Unit (ICU) medical personnels, reflecting the utility of the availability of ICU pharmacist in HUSM. Methodology A cross-sectional study is conducted for a duration of one year beginning on the 1

st of Janu-

ary 2012 to the 31st December 2012 regarding the characteristics of questions asked. A

question proforma which was designed by the Department of Pharmacy Hospital Universiti Sains Malaysia (HUSM) will be filled for each of every question asked by the medical person-als from ICU setting. The questions can be asked during clinical ward rounds or by telephone conversation to the dedicated ICU pharmacist of the hospital. The data obtained are divided into three categories namely frequency, inquirer and request category. A descriptive analysis is then performed. Results The highest number of questions was in September and the lowest was in December. Whereas most questions are asked by doctors and followed by staff nurses. For request category, drug dosing recorded the highest frequency. The average frequency of questions per month is 47 with the highest frequency was recorded in September followed by in May then in February. The most common inquirer is doctors namely medical officers ( Master of Medical Student ) and specialists (lecturer). The frequency is influenced mainly by the influx of new batch of medical officers, former medical officers leaving as well as exams week. Drug dosing is recorded as the category with the highest frequency followed by product infor-mation and product availability. Other questions asked include the dilution of drugs, antim-icrobial coverage, contents of TPN, how to get a non-standard drug, normal laboratory values and mechanism of action of drugs. Conclusion This study has emphasized the importance of preparation of pharmacists in clinical service.

Clinical service should also be emphasized during Provisional Registered Pharmacist ( PRP )

attachment and undergraduate clerkship. Pharmacists should also gain adequate knowledge

about and access to the hospital formulary. Result of this study is also potential for publica-

tion and dissemination of knowledge to pharmacists elsewhere.

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Pendahuluan Lamotrigine (LTG) tergolong dalam kumpulan ubat yang dipanggil antiepileptik. Ia boleh digunakan untuk merawat dua jenis penyakit: epilepsi dan gangguan bipolar. Pengesanan tahap LTG dalam darah adalah penting bagi tujuan perubatan kerana dos berlebihan LTG boleh menyebabkan pelbagai kesan sampingan. LTG juga mempamerkan farmakokinetik yang berbeza mengikut individu berdasarkan faktor-faktor seperti umur, penyakit, ubat-ubatan yang diambil, dan kehamilan. Kaedah pengesanan LTG masih belum ada dalam pasaran tetapi terdapat permintaan daripada pihak Klinik Psikiatri untuk menjalankan ujian pengesanan LTG. Objektif Untuk memperkembangkan teknik pengesanan LTG yang mudah dan murah dengan menggunakan ‘High Performace Liquid Chromatography’ (HPLC). Kajian ini akan merang-kumi perkembangan teknik pengesanan dan juga validasi kaedah tersebut. Metodologi Sistem kromatografi iaitu ‘Gilson HPLC System’ digunakan dan lengkok kalibrasi dis-ediakan menggunakan sampel darah dengan kepekatan LTG pada (0.5, 1,5,10, 15 dan 20) mg/L. Keputusan Dengan menggunakan methodology yang sesuai, pemisahan yang baik dapat dicapai dengan LTG berjaya dikesan pada ±5.8 minit dan internal standard dikesan pada ± 7.5 minit. Jumlah masa analisis ialah 15 minit bagi setiap ujian. Kajian sama diulangi untuk standard LTG dan LTG yang diekstrak daripada plasma dengan menggunakan kaedah yang divalidasi. Kedua-dua lengkung kalibrasi menunjukkan kelinearan yang baik dalam julat kepekatan antara 0.5 mg/ml - 16 mg/ml. Peratus pemulihan (recovery) LTG dalam plasma adalah 70.4%. Analisis standard LTG dijalankan selama 3 hari berturut-turut, dan purata kepekatan yang diperolehi adalah ±10%. Kesimpulan Kajian ini berjaya mengesahkan pengesanan LTG dengan menggunakan HPLC. Kaedah ini murah dan sesuai digunakan untuk analisis rutin LTG. Oleh itu, kaedah pengesanan ini boleh diperkembangkan untuk menganalisis sample pesakit yang mengambil lamotrigine untuk rawatan. Pengesanan LTG menggunakan kaedah automated (reagent) masih tiada dalam pasaran.

Pengesanan Lamotrigine Menggunakan Kaedah HPLC Nurul Fatihah Mohd Amin, Dellemin Che Abdullah, Abdul Fatah Abdul Rahman, Tg Khairul Azhar Tuan Yahaya, Yunus Othman, Nor Adyani Khairuddin Unit Permonitoran Drug Terapeutik, Jabatan Farmasi, Hospital USM

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Quality Control Of Expired Radiopharmaceutical: 99mTC-DTPA (RADPHARM) Nor Suriana Mohd Yusof

1, Rosaini Mohd Rosmi

1, Nur Ikhwani Daud

1, Zakiah Ahmad

1,

Ahmad Faizul Muhamad2

Hospital Universiti Sains Malaysia

1, MAHSA

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Introduction

99mTC-DTPA (Radpharm ) radiopharmaceutical stability would be stable for 5 hours

after its reconstitution. To obtain a good image result, quality control is performed to en-sure that the radiochemical purity of tagged radiopharmaceuticals is beyond 95%. Objectives This study aimed to determine whether the expired 99mTC-DTPA can be used after 5 hours tagging process in case of depletion of 99TmTcO4-, shortage of DTPA kit or in emergency case by obtaining a set of Quality Control (QC) data for radiochemical purity of 99mTC-DTPA within 1 to 3 hours after its expiry time. It was hypothesized that the ra-diochemical purity of 99mTC-DTPA after 5 hours are more than 90%. Methods In an observational, time series study, quality control procedures using paper chromatog-raphy were performed. Two control strip papers containing expired 99mTC-DTPA were put into two different solvents ie acetone and distilled water. The papers were cut into 4 strips and its radioactivity was measured using a dose calibrator at expiry, 1 hour, 2 hours and 3 hours after the expiry. Results Reconstitution of DTPA with sodium pertechnetate would result in the production of 99mTc-DTPA, free technetium and hydrolysed technetium. In this study, the radiophar-maceutical purity data obtained revealed that the radiopharmaceutical purity of 99mTC-DTPA within 1 to 3 hours after expiry were largely beyond 90%. Conclusion The expired radiopharmaceutical 99mtc-DTPA can be used after 5 hours tagging process

in case of depletion of 99TmTcO4-, shortage of DTPA kit or in emergency case.

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A study of cancer pain and its treatment in Hospital Universiti Sains Malaysia

Nur Amalina Bt Che Rahim¹ , Zalina Zahari ¹,Wan Mohd Nazri Wan Zainon² , ¹ Department of Pharmacy, Hospital USM, ²Department of Nuclear Medicine, Radiotherapy and Oncology, USM. Background Cancer pain is the most common symptom of cancer which could severely deteriorate a patient’s quality of life. Thus it is crucial to adequately control pain. The analgesic of choice usually comes from the opioid family . Despite being treated with opioids, pain is still preva-lent in patients with cancer. Choosing an appropriate opioid for patients is challenging due to many factors and may cause therapeutic failure. Objective Generally, the study aimed to study cancer-related pain and its treatment in Hospital Uni-versiti Sains Malaysia. In specific, this study aimed to describe the pain prevalence and severity and the impact of pain on patients daily functions among patients with cancer pain, the adequacy of cancer pain management among patients with cancer pain, the quality of life of patient with cancer pain, as well as patient satisfaction with pain treatment among patients with cancer pain. It was hypothesized that many patients with cancer have consid-erable pain and receive inadequate analgesia. Methodology This cross-sectional study was conducted at HUSM, whereby its target population was pa-tients with cancer-related pain in the clinics such as Oncology Clinic and Pain Clinic, and ward at HUSM using convenience sampling method. Inclusion criteria include cancer-related pain, and male and female patients ages 18 to 65. Results The results from this study are still in progress .Data were collected and were analyzed as statistical and descriptive using SSPS method which includes pain prevalence and severity and the impact of pain on patients’ daily functions, the adequacy of pain management, the quality of life of patients, and patient’s satisfaction with pain treatment. Conclusion This study is still in progress. Pharmacist’s involvement is crucial in carrying out interven-tions on patients’ drug dosing, drug of choice, preferable route and in ensuring patients ex-perience less side effects while on analgesic drugs. Pharmacist also plays a vital role in counseling patients on the administration, proper handling, side effects and disposal of drugs. In the future, pharmacist will also be producing one publication in a cited journal as well as delivering presentations as seminars or conferences. The limitations of this study are not all patients receiving analgesia are eligible and a large number of subjects are needed to meet with 83.2 % patients with cancer complained of pain.

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Prescribers’ Knowledge And Perceptions Towards Generic Medicine Utilization In Hospital Universiti Sains Malaysia Abdullah CD

1, Hamid AN

1, Nawi MND

1, Ibrahim NS

1, Ismail TTU

1, Nawawi MSM

1, Hassali

MA2, Saleem F

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1Department of Pharmacy, Hospital Universiti Sains Malaysia

2School of Pharmaceutical Sciences, Universiti Sains Malaysia

Introduction: Most countries are facing escalating health-care expenditures. A recent trend to control these staggering increases in costs is to encourage the use of generic medicines. Physi-cians are at the centerpiece of the medication use process as they are the dominant pre-scribers in all clinical settings. Physicians play a pivotal role in promoting and implement-ing the practice of generic prescribing and substitution. It is therefore prudent to examine what they perceive about generic medicines. Objective The current study attempts to identify physicians’ knowledge and perceptions on the use of generic medicines in Hospital Universiti Sains Malaysia. Methodology A cross-sectional study was conducted between March to April 2012 where the question-naire survey forms were distributed to all medical prescribers. The collected data was analyzed using SPSS software, version 16.0. Results A total of 1083 practicing physicians of Hospital Universiti Sains Malaysia were targeted for the study, however 90 responded to the survey with a response rate of 8.3%. The re-spondent was dominated by females (n=48, 53.3%) with majority at age group of 30-40 (n=61, 67.8). Forty two (47.1%) had an experience of more than 6-10 years. Only 19 (21.1%) knew the corrects regulatory limits of bioequivalence of generics versus branded medicines. Forty four (48.8%) of the respondents disagreed that a generic medicine is bioequivalent to innovator medicine. Fifty one (56.6%) also believed that generic medi-cines are less effective than their innovator counterparts and reported that innovator drugs are required to meet higher safety standards than generic medicines. Majority were in fa-vor of brand substitution guideline and patient educational activities towards generic medi-cines. Eighty two (91.1%), therefore agreed that this can be achieved with the collabora-tive efforts of physicians and pharmacists. Conclusion Healthcare practitioners should be educated and reassured about generic products ap-proval system in Malaysia concerning bioequivalence, quality, and safety. Professional bodies also should declare their views from generic practices in their policy statements; and consumers’ associations through demanding to be informed about the drugs they will pay for, especially in cases of out-of-pocket payments can also play their respective role.

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Time Achieving Target Concentration of Vancomycin: Intermittent Infu-sion versus Continuous Infusion of Vancomycin in Intensive Care Unit

Noor Shufiza Ibrahim

1, Yahaya Hassan

1, Noorizan Abdul Aziz

1, Mahamarowi Omar

2,

Dellemin Che Abdullah3

1 Clinical Pharmacy Department, School of Pharmaceutical Sciences, Universiti Sains Ma-

laysia, 2 Department of Anesthesiology, School of Medical Sciences, Universiti Sains Ma-

laysia, 3

Therapeutic Drug Monitoring (TDM) Unit, Department of Pharmacy, Hospital Uni-versiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Background: The most suitable way to dose vancomycin is still been debated. This study compared the standartd clinical practice of giving intermittent infusion of vancomycin ( IIV) and the po-tential alternative mode; continuous infusion of vancomycin (CIV) in terms of clinical out-come, pharmacokinetics and nephrotoxicity event. Method This was a descriptive, observational study based on retrospective review. It was single-center study in Intensive Care Unit (ICU), Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia. The patients included in this study were patients admit-ted to ICU from January 1

st, 2008 to December 31

st, 2009 and treated with vancomycin

intravenously as a prophylaxis MRSA or suspected of MRSA or after confirmation of MRSA infection. Vancomycin was administered intermittently or continuously depending on the preference of supervising ICU physician. The ICU case notes for selected patients were reviewed. All selected patients Results Forty-three patients were evaluated (IIV = 19, CIV = 24). There were significant difference between the age and baseline CrCl of patients who received IIV or CIV. For CIV patients, the use of concurrent antibiotics were higher (IIV =73.7%, CIV = 95.8% ;p = 0.049). Beside, patient on CIV mode tend to receive lower initial dose and shorter duration of therapy with vancomycin. The white blood cell (WBC) count were much improved among patients re-ceiving IIV. No significant different was seen in terms of clinical outcome between both groups. Although, no significant different in nephrotoxicity occurrence, the use of nephro-toxic agents was high in CIV patients (CIV =79.2% , IIV= 68.4%). Conclusion No significant advantage was observed with respect to clinical outcome between IIV and CIV but this warrant further investigation as a consequence of significantly differences in demographic data. The therapeutic range was achieved faster and easily be maintained constantly throughout therapy with CIV. Nephrotoxicity in CIV patients were high in the presence of other factors ; older patients, declining in renal function and concomitant used of nephrotoxic agents

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Pain Management Clinical Pharmacy Service in Hospital Universiti Sains Malaysia (USM) – Steps Forward

Nur Aida Murni Mamamad, Khairul Bariah Johan Dept. of Pharmacy, HUSM

Background Pain is a global healthcare problem.

Pain, particularly chronic pain is a major threat to the

quality of life worldwide and will become more so as age increases. Inspired by Saint John Health Center in Santa Monica, California, which started pain management service in 1999, HUSM started its own Pain Management Pharmacy Service in 2010. After 3 years, the services had been expanded apart daily ward rounds, pharmacist rounds , doing inter-ventions and answering drug enquiries. Objective To describe the expand of services provided by clinical pharmacist in pain management in Hospital USM in the year of 2013. Methods A descriptive analysis was carried out. Documentation references include Record of Pa-tient Care Round, Pharmacotherapy Review in Pharmacy Pain Service, Record of Patient Monitored in Pharmacy Pain Service, Medication Error (ME) Report Form, Report on Sus-pected Adverse Drug Reaction Form, Drug Information Request Form, and Bedside Coun-seling Form. Results The highest number of interventions done by PMP was recorded in April with 50 interven-tions whereas the highest number of interventions done by PMP accepted by physician was recorded in April, May and November with 46 interventions. A hundred percent accep-tance of interventions was recorded in January, February, June, September, October, No-vember, and December. The highest percentage of daily round was recorded in January (90.4%), whereas the lowest in August and September (65%). Only 2 ADR reports were compiled and that was in March. A total of 28 medication error reports were compiled with the highest number of reports in November (8) and the lowest in both September and Oc-tober (1). A total of 11 pharmacist rounds were held; the highest in April and none in May and December. The highest number of bedside counseling was done in January, March, and August (8) and the lowest was in February, July and October. Apart from that, PMP also involved as a presenter in 3 different programmes. Conclusion The services provided by PMP pharmacist has expanded tremendously.

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Adverse Drug Reactions Reported in HUSM

Noorhasliza Ramlee, Noor Shufiza Ibrahim Dept. of Pharmacy, HUSM Introduction Malaysian Adverse Drug Reaction Advisory Committee (MADRAC) has provided data on adverse drug reaction (ADRs) across the nation but little information about hospital-based study on ADRs in Malaysia have been published. Objectives To evaluate the ADR reports submitted to the Research and Drug Information Unit, Depart-ment of Pharmacy, Hospital Universiti Sains Malaysia with regard to the types of reporter, demographics of patient affected, drugs involved and ADR characteristics. Methodology A retrospective study was conducted by reviewed all ADR report forms received by the unit from January 2004 until June 2012. The pharmacological groups of drug associated with ADRs and the clinical manifestations of the ADR were classified in accordance to British National Formulary system organ class. The suspected ADRs were analyzed for casualty using the Naranjo ADR Probability Scale or clinical judgment by the doctors. Data were analyzed using SPSS for Window Version 19. The 95% confidence interval (CI) was calcu-lated and the limit of significance was set at 0.05. A p-value of <0.05 was considered sig-nificant. Result A total of 90 reports were evaluated. Majority of the reports were received from doctors (67.8%), which involved mainly male patients (58.9%) at age ranged 25 to 64 years (63.3%). Anti-infective agents were recorded as the highest drug class related to ADR (34%). The most common organ system affected with ADRs was dermatology (32.8%) followed by central nervous system (15.3%) and cardiovascular system (12.2%). There is significant association between extent of reaction (i.e: mild, moderate and severe) and pharmacological group of drug related to ADR (p=0.029). About half of ADR reports were categorized as probable (46.7%).Severe reaction was significantly associated with anti-infective. Common anti-infective agent involved was cephalosporin groups. The most af-fected organ system was dermatology. Most ADR cases were recovered after discontinua-tion of suspected drugs. We had performed assessment using Naranjo ADR Probability Scale and the doctors relied on their clinical judgment. Causality based on clinical judg-ment was the reason why ‘probable’ was the highest causality in our study. Conclusion ADR reporting in HUSM remains low due to lack of awareness among healthcare profes-sionals. Creating awareness about ADR reporting among the healthcare professionals is very important, we suggest the need of more clinical pharmacists who would educate the prescribers, identify, report and help to manage ADRs. Anti-infective agents represent as the highest drug causing ADRs thus, need more attention while in use.

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Communication Issues Involving Medication Errors Among Pharmcists and Pharmacy Technician Nik Azira Nik Ab. Ghani, Noorhasliza Ramlee, Noor Shufiza Ibrahim, Asrul Akmal Shafie Dept. of Pharmacy, HUSM Background Medication process is complex and involves a number of different individuals, disciplines & phases thus increasing the risk of error. In Malaysia, from 2010 until March 2011, a total of 2572 medication error (ME) have been reported. Starting end of the year 2011, Unit Kajian dan Maklumat Drug (UKMD), Deparment of Pharmacy has started to implement ME re-porting in Hospital USM. Objective To assess pharmacy staff knowledge, attitude and practice on medication error in Hospital Sains Universiti Malaysia (HUSM). Methods This was a cross sectional survey using validated questionnaire form that was distributed during Medication Error Roadshow to pharmacists and pharmacy technicians. The survey questions comprised of demographic data, general communication attitudes, training com-munication about ME, communication regarding ME and experiences with ME. Descriptive analysis was used to analyze the responds. Results A total of 65 pharmacists and pharmacy technicians involved in this survey. More than half agreed that between pharmacist-patients communication does exist (69.2%) and be-tween pharmacist-other pharmacy staff (55.4%). agree for in our setting. Despite high per-centage of respondents had no training on how to communicate with patients about ME (95.4%), respondents agreed that they know how to handle ME and observe at least one pharmacy they have worked manage ME very well. This is probably due to the mean age of respondents is 37.1 years old which means more than 10 years of working experience and higher percentage of respondent also have experience working in UFS(67.7%) and UFPL (80%).The findings showed approximately same percentage of reporting self error either to a peer or a supervisor (67.7% and 69.3% respectively) rather than other staffs’ errors. This showed that staffs are not comfortable being the ‘whistleblower’ which might affect other person’s career. More than 10 years of working experiences at UFS (in-patient pharmacy) and UFPL (out-patient pharmacy), causing the staffs to have high confi-dence level in dealing with problems including ME even without formal training.

Conclusion Sufficient and formal staff training should be provided to improve knowledge and communi-cation in preventing and handling medication error in the future. It is important for us to develop preventive measures to avoid the same mistake being repeated. Thus, it is impor-tant for pharmacy department to find ways to establish better communication among staffs in order to improve patients care.


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Cold Pressor Pain Responses among Opioid Naive Subjects in Malaysia

Zalina Zahari

Dept. of Pharmacy, HUSM Background Cold pressor test (CPT) is a standardized and naturalistic tonic pain model that has been used to study human pain perception. It is well-recognized that pain sensitivity is influ-enced by race and ethnicity. Objectives The present study investigated CPT over a 24 hour period to provide pain sensitivity data among Malay males subjects in order to analyze if healthy individuals exhibit any diurnal variations in their pain sensitivity. Methods This was an observational cross-sectional study. Participants comprised 152 healthy Malay male opioid naive subjects (mean age (SD) = 27.46 (10.10) years). Excluded were indi-viduals with chronic or ongoing acute pain and individuals with a history of analgesics in-gestion within 3 days before the CPT. Result Pain responses (i.e. pain threshold, pain tolerance and pain intensity) to cold pressor test (CPT) were evaluated at 0 hour, and at 2, 4, 8, 12, and 24 hours after the first CPT. The mean difference of CPT responses among opioid naive were analysed using repeated measure analysis of variance (RM-ANOVA). Pain threshold and pain tolerance were lowest in the afternoon at 1600 and increased at night (2000) and early morning (0800). Pain intensity score was highest in the morning at 0800 and lowest at noon (1200). However, there were no significant differences in pain threshold, pain tolerance and pain intensity scores among opioid naive subjects based on time (p > 0.05). Conclusion The results indicated that healthy adults do not display significant diurnal variations in cold pressor pain sensitivity. The results provide further evidence of the important role of pain as a physiological protection.


Sekalung penghargaan kepada:

Timbalan Pengarah Kanan (Farmasi)

Timbalan-timbalan Pengarah (Farmasi)

Ketua-ketua Penolong Pengarah (Farmasi)

Semua Ahli-ahli Jawatankuasa Kolokium Penyelidikan Jabatan Farmasi 2014

Semua staf Jabatan Farmasi

Unit Pengurusan Sumber Manusia, Hospital USM

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