BULETIN FARMASI BIL4/2016

FARMASI HSIJB DISEMBER ISSUE

Editorial Board Advisor

Pn Hjh Rohayah Binti Abd Ghani

Chief Editors

Pn Nur Hazalina Binti Md Salleh Pn Tan Pei LI

Pn Sim Shi Jia Pn Nurul Balqis Riza Binti Bakri Cik Sharifah Sadiqa Binti Syed Nur Azman

Editors

En Izzureen Bin Sumali Cik Farah Adilah Binti Taib Cik Thai Ru Way

2016

MTAC Warfarin

Insugen & Insupen

Antibiotic Awareness

Perhimpunan Bulanan

Welcome & Farewell

1

2

3

4

5

Cik Tuan Nurhafiza Binti Tuan Mat

Cik Tong Min

Frequently Asked

Questions

6

Warfarin Medication Therapy Adherence Clinic (MTAC) is a part of Medication Therapy Adherence

Clinic (MTAC) services provided by Pharmacy Department, Sultan Ismail Hospital, Johor Bahru.

OBJECTIVES:

To assist doctors in the management of patient prescribed with warfarin therapy.

To provide continuity and enhance patient care through education, monitoring, and close follow-

up to patients who require warfarin therapy.

To maximise the benefits of warfarin therapy and minimize the adverse effects and

complications resulting from warfarin therapy.

Warfarin MTAC Workflow Registration (CRC)

Blood taking for INR (at morning or 1 day before)

Obtain patient’s INR results and warfarin book

1. Document patient’s clinical progresses

2. Check INR

Sign & Symptoms of Bleeding / Thrombosis

*INR > 1 and < 3.5

Refer Doctor

Yes

No

No

INR within target range

Yes

General Counseling

1. Emphasis on compliance

2. Advice to maintain consistent diet

3. No dose adjustment

Yes

Checking & Counseling

1. Check Drug Interactions

2. Check on dietary changes

3. Advice to stabilize food type/intake

4. Emphasis on compliance & check for missed dose(s)

1. Do dose adjustment

2. Refer physician if necessary

1. Contact prescriber to order medication

2. Complete documentation in patient’s clinical

notes.

3. Schedule next appointment.

Dispense warfarin tablets

No

INSUGEN & INSUPEN

Insugen Insugen-R, Insugen-N and Insugen 30/70 are insulin product produced by Biocon Sdn Bhd.

Dec 2016

Name Insugen-R Refil Insugen-N Refil Insugen-30/70 Refil

Type of insulin Short-acting insulin Intermediate-acting insulin

Short-acting insulin (30%)

Intermediate-acting insulin

(70%) Volume 3mL 3mL 3mL Concentration 100IU/mL 100IU/mL 100IU/mL Onset of action Within 30 minutes Within 60 to 90 minutes Within 30 minutes Maximum Peak

effect Between 2 and 4 hours Within 4 to 8 hours Between 2 to 8 hours

Duration of

action 4 to 6 hours Up to 24 hours Up to 24 hours

Shelf life 2°C to 8°C - till expiry date

Room temperature - 6 weeks

2°C to 8°C - till expiry date

Room temperature - 6 weeks

2°C to 8°C - till expiry date

Room temperature - 6 weeks

Biosimilar

Actrapid

Insuman Rapid

Humulin R

Insulatard

Insuman Basal

Humulin N

Mixtard

Insuman Comb 30

Humulin 30/70

INSUPen EZ

Only fits with Insugen

Only available in white

Come with a pouch, a few needles and

stickers to differentiate different insulin

Return plunger rod by gripping plunger

return ring and rotate the pen body

INSUPen EZ by Biocon

Kempen Minggu Kesedaran Antibiotik dan

Keselamatan Pengubatan 2016

Tarikh : 14-20 November 2016 Objektif

Memberi pendedahan dan kesedaran

terhadap penggunaan antibiotik yang

rasional bagi mengatasi

masalah kerintangan antibiotik.

Menggalakkan peranan aktif staf

Hospital Sultan Ismail dalam

membendung penggunaan antibiotik

yang tidak rasional.

Membantu mengurangkan masalah

kerintangan antibiotik.

Tempat

Lobi Aras 3, HSIJB—Pameran dan booth

Bilik Seminar Aras 6, HSIJB - Bengkel

Kesedaran Antibiotik dan Medication Safety

Handle With Care

Bengkel Kesedaran Antibiotik dan Medication Safety

Booth dan Aktiviti

Booth interaktif.

Memberi penerangan maklumat tambahan

kepada masyarakat awam.

Penerangan yang diberi termasuklah mengenai

hand hygiene, jenis-jenis kuman yang dikulturkan

di dalam agar plate, mitos dan fakta tentang

antibiotik dan hangkitan, keperluan pengambilan

antibiotik yang betul, peratusan kerintangan

antibiotik, serta aktiviti Antimicrobial

Stewardship (AMS) Team.

Hadiah berupa cenderahati turut diberikan

kepada peserta kuiz.

Tajuk-tajuk Perkongsian

Kerintangan antibiotik dan pengenalan perkhidmatan

Antimicrobial Stewardship Program : Dr Azmin Huda

(Head of Antimicrobial Stewardship Team) HSIJB.

Keselamatan Pengubatan : Pn.Ezazaya

Microbiology: Specimen Collection & Transportation : En.

Mohd Kamrul Ngah

Infection: Isolation Precaution and hand hygiene practical

session : Dr. Asma’ Md. Arif.

On 20th November 2016, pharmacy department of HSIJB was

selected to handle the Hospital Sultan Ismail’s monthly

meeting. The event was held at Auditorium Sri Selasih HSIJB

and almost all representative from each department

attended. As per usual, the tentative was started with three

obligatory songs “Negaraku, Bangsa Johor and Sihat

Sejahtera” and followed by oath taking ceremony from our

beloved companion pharmacists. Then, our dearest KPF,

Puan Rohayah gave a welcoming speech in which she

presented our pharmacy department activities across the

year. After that, HSIJB director Tuan Haji Arbain bin Lani also

joined the ceremony by delivering his routine speech.

The hallmark of the event was when Puan Rohayah officiating

the launch of Antibiotic Awareness Week that was held from

14th to 20th November 2016. Last but not least before the

event ended, the “Anugerah Senyum” award for those who

had the brightest smile among all was given to Miss

Logeswary from CDR department. For others, please wear

those curve on your face everyday and who knew next will be

your chance :)

Tan Siok Yean

PF UF44

Nur Jannah

PF UF41

Khairunnisa’

PF UF41

Salinda

PF UF41

Noorafinah

PF UF44

Tee Kok Chen

PPF U29

Faridah

PPF U36

Khairunnisa R.

PF UF44

Farizul

PRP

Siti Zubaidah

PPF U29

Ng Tzi Jia

PRP

Malini

PRP

Shangeeta

PRP

Frequently Asked Question IV CosmoFer® dose calculation and how to administer?

Ask DIS

Related images for CosmoFer®

CosmoFer® - Administration http://www.hsi.farmasi/AskDIS/CosmoFer/administration

IV CosmoFer® 50mg/mL solution for injection and infusion can be administered by intravenous drip infusion or by a slow intravenous injection. Alternative administration route is intramuscularly.

CosmoFer® - Administration: IV Infusion http://www.hsi.farmasi/AskDIS/CosmoFer/administration _IVi

Dilution can only be done using 100ml NS or D5 where 100-200mg iron shall be diluted in 100ml. Start infusion with 25mg of iron over 15 minutes. If no adverse reaction noted remaining dose may be administer at infusion rate not more than 100ml in 30 minutes.

CosmoFer® - Administration: IV Injection http://www.hsi.farmasi/AskDIS/CosmoFer/administration _IV

Dilution for slow IV injection in dose of 100-200mg iron into 10-20 mL NS or D5 with administration rate is at 0.2mL/min. Start with slow IV, 25mg of iron injected slowly over period of 1-2 minutes. If not adverse reaction occur within 15 minutes, remaining portion of injection may be given.

CosmoFer® - Administration: IM injection http://www.hsi.farmasi/AskDIS/CosmoFer/administration _IM

CosmoFer® is administered as a series of undiluted injections of up to 100mg iron (2.0 ml) each determined by the patient’s body weight. For moderately active patients, injection may be given daily into alternative buttocks. Lesser frequency among inactive or bedridden, once or twice weekly. CosmoFer® should be given by deep IM to minimize the risk of subcutaneous staining. It should be injected only into the muscle mass of the upper outer quadrant of the buttock– never into arms or other exposed area. The patient should be lying in the lateral position with the injection site uppermost, or standing bearing their weight on the leg or the injection site. To avoid injection or leakage into the subcutaneous tissue, a Z-track technique (displacement of the skin laterally prior to injection) is recommended. CosmoFer® is injected slowly and smoothly. It is important to wait for a few seconds before withdrawing the needle to allow the muscle mass to accommodate the injection volume. To minimize leakage up the injection track, the patient

CosmoFer® - Indication http://www.hsi.farmasi/AskDIS/CosmoFer/indication

IV CosmoFer® is indicated for the treatment of iron deficiency in following indications: - When oral iron preparations cannot be used. - Where there is clinical need to deliver iron rapidly.

CosmoFer® - Dose http://www.hsi.farmasi/AskDIS/CosmoFer/dose

Normal recommended dosage schedule 100-200mg iron, 2-3 times per week depends on hemoglobin level. However if clinical circumstances require rapid delivery of iron to the body iron stores CosmoFer® may be administered as total dose infusion up to a total replacement dose corresponding to 20mg iron/kg body weight.