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Volume 1, Issue 1 DECEMBER 2012

TEPAT

SELAMAT

BERKESAN
Edisi : Disember Tahun : 2012

PHARMACY
@
N E W

HOSIM
S L E T T

E R
Special Features:
Sepintas lalu:

In this issue:

* G6PD : safe & unsafe to take

* Drug induced fever

* 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

* Oral dosages that should not be crushed


* FDA pregnancy categories for antiretroviral therapy

Editorial Board

Advisor SABARIAH BT YUNUS

Editor arifah nadiah bt ahmad

Contributors

nor aini bt ibrahim noni mazlina bt che soh

salmi koh bt muhammad hashim koh

fadzilla bt badruddin

Sepintas lalu : Hospital Pasir Mas


Pengarah Hospital Pasir Mas DR. HJ MOHD SALLEH BIN MAT JUSOH

* Mempun yai 5 buah wad : wad perub atan lelak i (NILAM ), wad perub atan perem puan (KRISTA L), wad kanak -kanak (Z AMRUD), wad prena tal (INTA N), wad post natal (MU TIARA)

Selamat datang ke Unit Farmasi & Stor Perubatan HOSIM

KETUA UNIT FARMASI TAHUN 2000 - SEKARANG

PN. NAFISAH SULAIMAN (2000-2004)

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

SELAMAT DATANG KE UNIT FARMASI

KIT FARMASI PESA NDISPENSAN KAUNTER PE R TERBUKA) LUAR (KAUNTE

BILIK K AUNSEL ING MENJA MIN PR IVASI & KES ELESAA N PARA PE SAKIT

PELABELAN UBAT DGN LABEL HIGH ALERT MEDICATION

PELAKSANAAN PELABELAN HARGA UBAT

DIREKTORI UBAT HOSPITAL PASIR MAS

TELEFON @ SMS : +60105718 048

@ll about medicines


Inside Story Headline

Oral dosages that should not be crushed

Medications which should not be crushed fall into one of the following categories
Extended Release Products # The formulation of some tablets is specialized 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 # Capsules may contain beads which have multiple layers which are slowly dissolved with time.
Inside Story Headline

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.

Caption describing picture example or this. of graphic.

Sublingual medication

Effervescent tablet

# Medication intended for use under # These are tablets which, when the tongue should notwords. be crushed. dropped into earnings will show ness. Sales figures or a liquid, quickly This story can fit 100-150 dissolve to yield a solution. The subject matter that appearsshould indi-how your business is growing. # Sublingual medications in newsletters is virtually endless. You can Some newsletters include a column that cate on the package that they are in# Many effervescent tablets, when include stories that focus on current is updated every issue, for instance, an crushed, lose their ability to quickly
technologies or innovations in your field. You may also want to note business or economic trends, or make predictions for your customers or clients. If the newsletter is distributed interType nally, you might comment upon new procedures or improvements to the busiEnteric coated
Inside Story Headline

To catch the reader's attention, place an interesting sentence or quote from the story here.

advice column, a book review, a letter from the president, or an editorial. You can also profile new employees or top customers or vendors.

Drug Formulations That Preclude Crushing


Reasons for the formulation 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 Designed to release drug over an extended period of time. Such products include:

This story can fit 75-125 words. Selecting pictures or graphics is an release Extended important part of adding content to your newsletter. Think about your article and ask yourself if the picture supports or enhances Sublingual buccal the message youre trying to convey. Avoid selecting images that appear to be out of context. Microsoft Publisher includes thousands
Volume 1, Issue 1
Miscellaneous

of clip art images from which you can - Multiple layered tablets releasing drug as each layer is dissolved choose and import into your newsletter. - Mixed release pellets that dissolves at different time intervals There are also several tools you can use - Special symbols. to draw shapes andmatrixes that are themselves inert but slowly release drug from
the matrix

Once you have chosen an image, place it close to the article. Be sure to place the for rapid absorption by the abundant Designated to dissolve quickly in oral fluids Caption describing picture or blood supply of the mouth caption of the image near the image.
graphic.
Drugs that: - Produce oral mucosa irritation - Are extremely bitter - Contain dyes or inherently could stain teeth and mucosal tissue

Page 6

Source: Drug Information Handbook

@ll about medicines

DRUGS INDUCED FEVER


Antibiotic Induced Fever
Erythromycin Isoniazid Penicillin Nitrofurantoin Procainamide Quinidine

Cardiov

ascular Medica tion Induced Fever

Drug induced fever is a serious & conf using problem. Of medications that cause the fever, the antibiotics are most frequent (esp beta lactamase antibiot ics & penicillins) but also sulfonamides, nitrofurantoin & anti tuberculotics, drug induced fever doesnt have characte ristics 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 exog enic pyrogen. Although most patients are surprisingly well whil e febrile,some are profoundly septic.

Atropine Captopril Clofibrate Hydralaz ine Hydrochlo rothiazid e Methyldo pa Nifedipin e

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
edications Miscellaneous M Inducing Fever

Direct extension of the pharmacologic action of the drug :


chemotherapy

Allopurinol Antihistamines Aspirin Cimetidine Heparin Meperidine Phenytoin

Idiosyncratic reactions:
malignant hyperthermia, neuroleptic malignant syndrome

@ll about medicines

YOU KNOW ??? DO


iency.o source: www.g6pddec rg

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.

y is a G6PD Decienc r genetic disorde d to that is estimate a-ect more than ople 600 million pe world wide

IVE ST RESS FOOD, ORS ARE DRUGS , AND OTH TRAIN ER CONDICAT SUBST ED ANCES THAT C LYSIS AUSE HEMO PEOPL IN E WIT H G6PD DEFIC IENCY

OXIDA T

t know they ople either don Most pe have ve no idea eciency, or ha G6PD D ations that can id the complic how to avo lead ms, or even g health proble to life-lon death

@ll about medicines

G6Pd
DRUGS & CHEMICALS TO AVOID
High Risk Medications

Acetylphenylhydrazine Antipyretics (Antipyrine, Acetanilid) Aspirin Astemizole Beta-Naphthol Chloramphenicol Chloroquine Ciprooxacin Dapsone Dimercaprol Doxorubicin Ethanol Furazolidone Furosemide Gadopentetate dimeglumine Glucosulfone Glyburide

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

Pentaquine Phenacetin Phenazopyridine Primaquine Probenecid Sulfamethoxazole Sulfanilamide Sulfapyridine Sulfasalazine Sulfathiazole Sulfites (Sulfur dioxide, sulphrous acid, etc.) Sulfoxone Tamsulosin Toluidine Blue Henna Isobutyl Nitrite Lamotrigine

@ll about medicines

G6PD
DRUGS & CHEMICALS TO AVOID
Low Risk Medications

Acetaminophen Aminophenazone Analgesics Antazoline Ascorbic Acid Colchicine Diphenhydramine Dopamine Ibuprofen Isoniazid Mirtazapine Norfloxacin Phenylbutazone Phenytoin Procainamide

Proguanil Pyrimethamine Quinidine Quinine Streptomycin Sulfacytine Sulfadiazine Sulfaguanidine Sulfamerazine Sulfamethoxypyridazine Sulfonylurea Trihexyphenidyl Trimethoprim Tripelennamine Vitamin K1

* Drugs above MAY be lower risk for hemolysis, but should not be administered without a doctors supervision and should not be taken at higher than normal doses. Patients shouldbe monitored for hemolysis during treatment.

@ll about medicines

G6PD: FOODS, HERBS, & SUBSTANCES TO AVOID


MES: All legum es: Fava Beans (an kind of b d any oth eans), So er y (and fo od additiv es made from soy ), peas, len tils, mesq uite, caro b, and nuts... m peaost any plant tha t contain s a seed fr om a p od LEGU
: ACSORBIC ACID ods and in fo It is commonly put ge doses and use hemolysis in lar vitamins and can ca should be avoided. e absorption of s that it increases th Research also show tients erous for G6PDD pa which could be dang iron, to unhealthy already raises iron because hemolysis levels.

E HERBS: SOME CHINES OMA Particularly RHIZ lien), COPTIDIS (huang VIS (neu huang), CALCULUS BO hua), ECOCIS (leh mei ONANTHI I PRA FLOS CHIM E (kam ngan fa) FLOSLONICERA MARGARITA

icult to avoid as tooth paste, candy, breath m ints, mouth was h, and many othe r products have m enthol added to them. Mint from natural mint oils is NOT contrain dicated.

This can be diff

MENTHOL:

RD: garden egg. T his is a common food in some parts of Africa and
Also known as

BITTER GO

SULFITES:
Asia.

Sultes are used in a wide variety of foods such as packaged fruits, vegetables, meats, mixes, wine, condiments, etc.,

RAGES: ALCOHOLIC BEVE th the Ethenol interferes wi es ; Wine contains sulfit production of G6PD

MOTH BALLS: Contains Naphtha lene

FDA Pregnancy Categories for Antiretroviral Therapy


FDA Pregnancy Categories
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 potential 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


There are several antiretroviral agents that are used to treat HIV, including nucleoside and nucleotide analogue reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, protease inhibitors, cellular chemokine receptor (CCR5) antagonists, fusion inhibitors, and integrase inhibitors.

FDA Pregnancy Categories for Antiretroviral Therapy


(source:www.medscape.com.my)

Antiretroviral therapy

Nucleoside and nucleotide analogue reverse transcriptase inhibitors

Antiretroviral therapy
Delavirdine (DLV) Efavirenz (EFV) Etravirine (ETR) Nevirapine (NVP) Rilpivirine (RPV)

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 C D B B B

FDA pregnancy category

FDA pregnancy category

Atazanavir (ATV) Darunavir (DRV) Fosamprenavir (f-APV) Indinavir (IDV) Lopinavir/ritonavir Nelfinavir (NFV) Ritonavir (RTV) Saquinavir (SQV) Tipranavir (TPV)

Antiretroviral therapy

Protease inhibitors

FDA pregnancy category


B C C C C B B B C

Antiretroviral therapy

Fusion inhibitor

Antiretroviral therapy
Maraviroc (MVC)

Enfuvirtide (T-20) B Cellular chemokine receptor (CCR5) antagonist B

FDA pregnancy category

FDA pregnancy category

Antiretroviral therapy
Raltegravir (RAL)

Integrase inhibitor

FDA pregnancy category


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 reduces inflammation. The American Heart Association recommends 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 polyunsaturated fats of soy -and you avoid a load of artery-clogging saturated fat.

Ubat-ubatan fast moving Unit Farmasi Hospital Pasir Mas 2012


Bil 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Item Nacl 0.9 % 500 ml Inj Haemodialysis Conc Bicarb 1B Recombinant Erythropoeitin (EPREX) Heparin Sodium 5000iu/ml Injection Haemodialysis Conc Bicarb 2A Isosorbide Dinitrate 10 % Injection Paracetamol 120mg/5ml syrup Salbutamol Inhaler 200 doses Metformin 500mg Tablet Diphenhydramine adult PDS 1.5 % Dextrose Injection Recombinant Biphasic Insulin (Mixtard & Humulin 30/70) Perindopril 4 mg Tablet Magnesium Tri & Aluhydro Tab (Gelusil) Lovastatin 20 mg Tablet Paricalcitol 5mcg/ml Injection Alfacalcidol 2mcg/ml Injection Benzylpenicillin 5MU Injection Celecoxib 200mg capsule Finasteride 5mg Tab

Diari aktiviti 2012

Antara Aktiviti yang disertai oleh kakitangan Unit Farmasi Hospital Pasir Mas bagi tahun 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)

Diari aktiviti 2012 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

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 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)

MOHD REZALI MOHAMAD PEKERJA AWAM KHAS R4


Tempoh bertugas: 16 tahun

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