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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
Hi, I am
Azmya Reisha
Bt Fahros Faiz
Baby of Pn
Anida Daud Hi, I am
Haisha Delisha
Bt Mohamad
Hairy
Baby of En
Hairy
Hi, I am Ayra
Hazinah Bt
Azrul Effendy
Baby of Pn Nur
Huzaimah
D.O.B 070417
D.O.B 241216
Hi, I am Wan Izz
Aaeron Danish
Bin Wan Nor
Mu’izzuddin
Baby of Pn Nur
Syafinaz
En. Muhammad Amirul Haziq bin Abu Bakar
Penolong Pegawai Farmasi U29
Klinik Kesihatan Padang Sebang
D.O.B 100417
Hi, I am Nur
Zhufairah Bt
Mohd Hamizan.
Baby of Pn
Norlizawati
D.O.B 020417
En. Taufek Bin Ajeh
Penolong Pegawai Farmasi U29
Berpindah ke Klinik Kesihatan Membiak (PKD Kuala Krai)