buletin farmasi hrpz
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If you have any queries with regards to drugs / health, feel free to con-
tact us at
Drug Information Service (DIS), Pharmacy Department HRPZ II
09-7452000 Ext: 2478 (Office hours) , HRPZIIDIS@gmail.com
We source the answers from:
Micromedex, Internet and our References
Medication safety Strive to enSure patient’S Safety
Edisi Mei 2013 Terbitan Jabatan Farmasi 2013
MOH/P/KEL/90.13 BUL)
HIGH ALERT MEDICATION :
PREVENTING ERRORS
Page 2 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Supervisor : Pn Fatimah
Chief Editor : Pn Sudarwaty
Cik Zaimawati
Pn Wan Najwa
Pn Wan Mahani
Cik Tg. Norfarhah Cik Balqis
Cik Suhaine
Cik Siti Noratiqah
Pn Sharina
Editor :
Page 3 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
trol of the healthcare pro-
fessional, patient or con-
sumer.
Types of medication error:
Prescribing error
Wrong time error
Dose error
Dosage form error
Drug preparation error
Omission error
Unauthorized drug error
Route of administration
Medication safety is one
of the major components
in patient safety but unfor-
tunately medication errors
do occur and often go
undetected.
Medication error is any
preventable event that may
cause or lead to inappro-
priate medication use or
patient harm while the
medication is in the con-
error
Administration tech-
nique error
Deteriorated drug error
With guidance and cooper-
ation of the Medication
Safety Technical Advisory
Committee, the Pharma-
ceutical Services Division
has embarked on a report-
ing system called the Med-
ication Error Reporting
One of the important missions of the healthcare providers is to help patients make the best use of
medications and very importantly, strive to ensure patient safety.
Medication Error Reporting System (MERS)
In Malaysia, medication
error reporting is at the
moment on a voluntary
basis.
Objectives of MERS:
To obtain information
on the occurrence of
medication errors
Maintain a database of
medication errors
Analyse reports
Propose remedial ac-
tions
Monitor the situations in
an effort to minimize
MEDICATION SAFETY Look alike drug
Example of error
http://mers.moh.gov.my/MERS/
Page 4 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
The consequences of an error associated with
use of these medications can result in significant
patient injury and special precautions must be
employed with their overall management.
CATEGORIES OF HIGH ALERT
MEDICATIONS
1. ADRENERGIC AGONISTS–
Adrenaline, Noradrenaline.
2. ADRENERGIC ANTAGONISTS–
Propanolol, Labetalol
3. ANESTHETIC AGENTS–
Propofol, Ketamine
4. ANTIARRYTHMIC—
Lignocaine, Amiodarone
5. ANTIFIBRINOLYTICS
6. ANTITHROMBOTIC AGENTS–
Warfarin, Heparin, Streptokinase
7. ANTIVENOM–
Sea snake, cobra, pit viper
8. CHEMOTHERAPEUTIC AGENTS
9. DEXTROSE, HYPERTONIC-
10. EPIDURAL & INTRATHECAL MEDICATIONS
11. GTN INJECTION
12. INOTROPIC MEDICATIONS–
Digoxin, Dobutamine, Dopamine
13. INSULIN
14. MAGNESIUM SULPHATE INJECTION
15. MODERATE SEDATION AGENTS
16. NEUROMUSCULAR BLOCKING AGENTS–
Pancuronium, Atracurium, Rocuronium
17. OPIATES & NARCOTICS
18. PARENTERAL NUTRITION PREPARATION
19. POTASSIUM SALT INJECTIONS
Institute for Safe Medication Practices (ISMP) in the United States has termed medications that have the highest risk of
causing injury when misused as ‘High-Alert Medications’. These are more likely to be associated with harm compared
to other medications, and the harm are likely to be more severe.
CONCLUSION High Alert Medications require a heightened
vigilance and a joint effort from all health-care
practitioners to improve patient safety with respect
to minimizing the errors and their consequences.
KEKUCHA AS SYURA JOHANAN FUTSAL
ANAN FUTSAL ANTARA JABATAN
COMMON RISK
FACTORS
1. Poor handwriting.
2. Incorrect dilution
procedure.
3. Confusion between route
of administration (IM, IV,
Intrathecal, epidural).
4. Confusion between differ-
ent strengths.
5. ‘Look-alike’ product.
6. ‘Sound-alike’ product.
STRATEGIES IN
PREVENTING ERRORS
1. Limit the drug’s strengths
available in the formulary.
2. Avoid frequent changes of
brand.
3. All HAM should be kept
in individual labeled-
containers. Avoid look-alike
and sound-alike drugs or
different strengths of the
same drug from being stored
side by side.
4. Use TALL-man letter to
emphasize differences in
medication names (ex: DO-
Pamine
and DOBUtamine).
5. Label all containers used
for storing HAM in red as
"HIGH ALERT".
6. All HAM must be coun-
ter-checked before dispens-
ing.
Page 5 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
An appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention or specific treatment, or alteration of the dosage regimen, or withdrawal of the product. –WHO-
website to refer :
www.pharmacy.gov.my
www.farmasiklt.moh.gov.my
www.bpfk.gov.my
Page 6 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Page 7 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
NO GENERIC NAME PRESCRIBER
CATEGORY
DETAILS
1. Amoxicillin 500 B As Amoxicillin 250 mg Capsule
2. Cloxacillin 500
mg Capsule
B As Cloxacillin 250 mg Capsule
3. Memantine HCl A* As Memantine HCL 10 mg Tablet
4. Quetiapine
Fumarate 100 mg
Immediate Re-
A* Indication
i) Schizophrenia, ii) Short term treatment of acute
manic episodes associated with bipolar I disorder,
either monotherapy or adjunct to lithium or divalpro-
ex, iii) Treatment of depressive episodes associated
with bipolar disorder
5. Quetiapine
Fumarate 200 mg
Immediate Re-
A*
6. Metformin HCl
750 mg Extended
A/KK As Metformin Hydrochloride 500 mg Extended Re-
lease Tablet
7. Benzydamine Hy-
drochloride 3.0
mg/ml throat
spray
A* Temporary relief of painful conditions of the mouth
and throat including tonsillitis, sore throat, radiation
mucositis, aphthous ulcers, pharyngitis, swelling,
redness, inflammatory conditions, post-orosurgical
and periodontal procedures. (For pediatric and oto-
rhinolaringology use. Restrict to patients who are not
8. Oxymetazoline
HCI 0.01% Nasal
A* Indication
i)Acute colds, ii)Paranasal sinusitis, iii)Otitis media
9. Calcipotriol mon-
ohydrate 50
mcg/g and Beta-
methasone di-
propionate 0.5
mg/g Gel
A* Indication
Topical treatment of scalp psoriasis
10
.
Ropinirole HCI 2
mg Extended Re-
lease Tablet
A* Indication
Treatment of idiopathic Parkinson?s disease. It may
be used as monotherapy or in combination with levo-
dopa 11 Ropinirole HCI 4
mg Extended Re-
lease Tablet
A*
NEW DRUGS IN MOH FORMULARY—3/2012
Page 8 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
NO GENERIC PRESCRIBER DETAILS
1 Amoxicillin 500 B As Amoxicillin 250 mg Capsule
2 Cloxacillin 500 B As Cloxacillin 250 mg Capsule
3 Memantine HCl A* As Memantine HCL 10 mg Tablet
4 Quetiapine
Fumarate 100
mg Immediate
A* Indication
i) Schizophrenia, ii) Short term treatment of
acute manic episodes associated with bipolar I
disorder, either monotherapy or adjunct to
lithium or divalproex, iii) Treatment of de-
pressive episodes associated with bipolar dis-
order
5 Quetiapine
Fumarate 200
mg Immediate
A*
6 Metformin HCl
750 mg Ex-
tended Release
Tablet
A/KK As Metformin Hydrochloride 500 mg Extended
Release Tablet
7 Benzydamine
Hydrochloride
3.0 mg/ml
throat spray
A* Temporary relief of painful conditions of the
mouth and throat including tonsillitis, sore
throat, radiation mucositis, aphthous ulcers,
pharyngitis, swelling, redness, inflammatory
conditions, post-orosurgical and periodontal
procedures. (For pediatric and otorhi-
nolaringology use. Restrict to patients who are
not able to gargle)
8 Oxymetazoline
HCI 0.01% Na-
sal Drops
A* Indication
i)Acute colds, ii)Paranasal sinusitis, iii)Otitis
media
9 Calcipotriol
monohydrate 50
mcg/g and Be-
tamethasone
dipropionate 0.5
A* Indication
Topical treatment of scalp psoriasis
10 Ropinirole HCI
2 mg Extended
A* Indication
Treatment of idiopathic Parkinson?s disease.
It may be used as monotherapy or in combina-
tion with levodopa 11 Ropinirole HCI
4 mg Extended
A*
ADD STRENGTH/ FORMULATION—3/2012
Page 9 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Page 10 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Indication
Long-acting β2-agonist indicated
for maintenance bronchodilator
treatment of airflow obstruction in
adult patients with chron-
ic obstructive pulmonary dis-
ease(COPD).
Dosage
Recommended Dosage: Once-daily
inhalation of one 150 mcg cap
Maximum Dose: 300 mcg once-daily.
Elderly: No dosage adjustment is
required in elderly patients.
Contraindications
Hypersensitivity to
indacaterol maleate, to
lactose or to any of the
other excipients of
Onbrez Breezhaler.
Mechanisme of
Action
Relaxes bronchial
smooth muscle by
selective action on β2-
receptors with little
effect on heart rate ;
acts locally in the lung
Storage
Store capsules at controlled
room temperature of 25°C ;
excursions permitted to 15°C
to 30°C.
Protect from direct sunlight
Administration
For inhalation using
Brezehaler. Do not swallow
capsules. Do not use remove
capsules from blister until
immediately before use. Use
at the same time everyday.
Do not wash mouthpiece.
How To Manage Missed Dose
If missed a dose, take the
dose as soon as possible as
long as it is 12 hours before
the next dose
If it is less than 12 hours to
the next dose, do not take the
dose that was missed
Do not take a double dose to
make up for the dose missed
Common Side Effect
Throat Irritation
Head pain
Cough
Page 11 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
8. Before placing the mouthpiece in your mouth, breathe out fully.
12. Open the mouthpiece again, and remove the empty capsule.
10. As you breathe in through the inhaler, you should hear a whirring noise.
You will experience a sweet flavour as the medicine goes into your lungs.
7. Release the side
buttons fully.
11. Hold your breath for at least 5-10 seconds while taking the inhaler out
of your mouth.Then breathe out.
4.With dry hands, re-
move one capsule
from the blister.
5. Place the capsule
into the capsule
chamber. Close the in-
haler until you hear a
“click”.
1. Pull off the cap.
3.Hold the base of the
inhaler firmly and tilt
the mouthpiece.
2.Opens the inhaler
9. Hold the inhaler as shown in the picture. The side buttons should be fac-
ing left and right.Place the mouthpiece in your mouth and close your lips
firmly around it. Breathe in rapidly but steadily and as deeply as you can.
6. Pierce the capsule
by firmly pressing
together both side
buttons at the same
time. You should
Page 12 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Presenter Pn Nor Azura Mohd Noor giving a detailed ex-
planation & guide on the reporting of medication errors
through the Medication Error Reporting System (MERS)
MEMORY LANE 2012
Page 1
Tajuk Kajian:
“Meningkatkan Tahap Kepatuhan Ubat Di
Kalangan Pesakit Hipertensi di HRPZII”.
Pencapaian:
-Johan QAP Peringkat Hospital, HRPZII
-Naib Johan QAP Peringkat Negeri Kelantan
Fasilitator: Pn. Hasnah
Ahli: Pn. Nor Azura Mohd Nor
Pn Masnor Mat daud
Cik Fitriah Cahyani Che Will
En. Wan Mohd Khairul Wan Mahmud
QAP 2012
HARI KELUARGA JABATAN FARMASI HRPZII Date: 28-29 SEPTEMBER 2012 Venue: PCB BEACH RESORT
Page 13 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
KEKUCHA AS SYURA
JOHANAN FUTSAL
ANAN FUTSAL ANTARA JABATAN
Misi Kemanusiaan ke Kg. Chhnang, Kemboja anjuran Persatuan Pekerja Islam, HRPZ II.
Bertarikh 24/10/2012 sehingga 29/10/2012.
Pada 13 Disember 2012 ‘Hari
Kucha As-Syura” peringkat
HRPZ II telah diadakan di
pe rka rangan Kuar t e r s
HRPZII. Jabatan Farmasi
telah muncul sebagai Johan
bagi kategori Kebersihan.
Perlawanan futsal peringkat Hospital telah diadakan di MASA Sport Centre , Panji Kota Bharu pada 10 November
2012. Pasukan futsal wanita telah menyertai pertandingan ini buat julung-julung kalinya dan berjaya muncul sebagai
Johan Peringkat Hospital dan mengharumkan nama Jabatan Farmasi.
NEWS FROM CAMBODIA
KUCHA AS SYURA
KEJOHANAN FUTSAL ANTARA JABATAN
Page 14 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Cik Ong Huey Chin Pharmacist U 41 Grad : International Medical University 2011 Date of report duty: 1/9/2013
Cik Siti Nurul Zuliana Bt Abdullah Pharmacist U 44 Grad : Universiti Islam Antarabangsa 2006 Date of report duty 17/2/2013
En Muhamad Tohiri Bin Mohd Zulkifli Pharmacist U 41 Grad : Universiti Islam Antarabangsa 2011 Date of report duty: 29/11/2012
Cik Hanan Hayati Bt Mamat Pharmacist U 41 Grad : Universiti Islam An-tarabangsa 2010 Date of report duty: 17/2/2013
Pn Nazmi Liyana Azmi Pharmacist U 48 Grad : Universiti kebangsaan Malaysia 2004 Date of report duty: 17/2/2013
En Shafei Ahmad Pharmacist Assistant U 36 Grad : Sekolah Latihan Pen.Pegawai Farmasi 1985 Date of report duty :03/09/2012
En Ahmad Nashriq Bin Setapa@Mustapha Pharmacist U41 Grad : UITM 2009 Date of report duty: 17/2/2013
Page 15 Buletin Farmasi HRPZ II Edisi Jan—Mac 2013
Left : Pn Nor Sharina Bt Mohamed Nor Pharmacist U 41 Grad : UITM 2011
Right : Cik Wan Mastura Bt Wan Mohd Azlan Pharmacist U 41 Grad : UITM 2011
Middle : Pn Nur Husna Ibrahim Pharmacist U 41 Grad : UITM 2011 Date of report duty :20/11/2012
From Top Left : Tee Eng Chun, Liew Zhan Yit, Eddy Lim, K.Heygaajivan From Left : Chee Shu Wen, Wan Karen, Yusra, Nabilah, Ilmi Najwa, Yap Sze Yin, Shahratul Hafizan From Bottom Left : Chu Ee Wen, Tham Szhe Woon, Syuhidatun, Hidayah Awang, Hidayah Ghazali, Zulaikha, Azleen, Sarah Tan Not in the picture : Intisar, Hasanah, Khalifah, Tan Jing Rou, Wee Joo Lie, Syamimi, Qalif, Tg Norfarhah, Siti Noratiqah, Nadwanie,
Puan Nik Marahhan Nik Jaafar Pharmacist Assistant U 32 ( kup)
Pension Date : Januari 2013 Working experiences: 1979: petaling jaya makmal perubatan 1980: KK Pasir Putih 1981: Hosp Marchang 1982-2013: Hosp Raja Perempuan Zainab II ( 30th services)
SPECIAL THANKS TO:
Joke #2 Customers gets a topical cream. Direction : apply locally two times a day. Customer says to the pharmacist: "I can't apply locally, I'm going overseas."
Joke #1 (Just for laugh and not related to any real situation) Every morning during ward round, there will be a Specialist, a Medical Officer, a Houseman, a Nurse and a Pharmacist will see and discuss the patient in ward. One day when a pharmacist is not around during ward round : Specialist : Can anyone tell me what I wrote for PLAN on the case note yesterday? MO : Ermmm... I think is Pantoprazole 40mg stat, and....ermmmm...errr.... HO : Yesterday I gave Frusemide 40mg stat...So is frusemide!!! Nurse : I think you write KIV discharge if peak low improve 75%? Specialist: OMG!! You all don't simply guess my writing if you don't know!!! Please call the pharmacist to help us interpret what I write yesterday...
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