PEJABAT KESIHATAN DAERAH

JASIN In 2008, RM1.5 billion

was spent by Ministry

of Health (MOH) on

purchasing drug as

compared to RM 206

million on 1995. De-

spite spending billions

of Ringgit, many pa-

tients still fail to

achieve the targeted

goal of treatment. Na-

tional Health and Mor-

bidity Survey 2006

(NHMS III) reported

that only about 26.3%

of patients who re-

c e i v e d a n t i -

hypertensive treat-

ment were able to

reach the targeted

blood pressure. Failure

to achieve treatment

goals might be contrib-

uted by under-

utilization of medica-

tions and treatment

non-adherence. A sur-

vey done by Pharma-

ceutical Service Divi-

sion, MOH on medica-

tion returned by pa-

tients showed that the

value amounted to RM

200,000 in 2008 and

RM 700,000 in 2009

respectively. There-

fore it is vital to in-

corporate Home Med-

i c a t i o n R e v i e w

(HMR) into current

health care system to

improve health out-

come and reducing

expenditure. HMR is

basically an exten-

sion of services from

health facilities to pa-

tient’s home. It in-

volves systematic re-

view of all prescrip-

t ion and non-

prescription medi-

cines (including nu-

tritional supple-

ments, herbal medi-

cine, vitamins and

other remedies) and

assessment of medi-

cal storage at home.

Throughout the pro-

cess, health care pro-

vider will be able to

identify, resolve and

prevent drug-related

problems at home.

Pharmacist’s roles in

HMR will be channel-

ing information and

advising patient or

caregivers with re-

gards to medication

and therapeutic de-

vices to ensure better

therapeutic outcomes

in the overall man-

agement of the pa-

tient.

By: Nur Syahrina Yunus

Editorial board Advisor:

Pn Fatimah bt Othman

Editor:

Nur Syahrina bt Yunus

Contributor:

Nur Farhana bt Ismail

Tan Chong Seng

Tan Suet Ting

Amreet Kaur Gill

Tan Siong Guan

Azura bt Kasim

Melissa Joan Anbalagan

Team Building 2

Coaprovel 3

Tenvir-EM 5

Heat Stroke 8

Antifungal 9

Psoriasis 10

New staffs in PKDJ 13

Inside this issue:

HOME MEDICATION REVIEW (HMR)

PHARMACY BULLETIN

Edition 1/2016 Volume 1, Issue 1

On 9th April 2016 pharmacy unit

held a Team building Programme

placed at Dewan Kenyalang, Pejabat

Kesihatan Daerah Jasin (PKDJ).

There are about 30 participants

joined including clinic and pharmacy

staff. The program started from 8.00

am until 5.00 pm including many activ-

ities hosted by our invited speakers.

The objective are to strengthen rela-

tionship and integration among work-

ers. To increase the involvement, com-

mitment and motivation among work-

ers, thus creating a harmonious at-

mosphere in the organisations.The

invited speakers, Pn Hanani Osman

and Pn Norzahira Mohd Osman are-

from Counselling Unit, Jabatan

Kesihatan Negeri Melaka (JKNM). She

delivered few talks and activities

throughout the day.

TEAM BUILDING

character, their strengths and pro-

vides opportunity for immediate cor-

rection, guidance and affirmation. It

is a fun and interactive style of team-

building programme.

The activities were divided into

3 parts which involved a few small

groups training such as “Acapella ac-

tivities”, “Peribahasa & Simpulan Ba-

hasa Challenge” and “Straw Team”.

Lastly the advantages of this

program are the participants can

learned new experiences in each ac-

tivities. Furthermore, it reveals their

By: Nur Farhana bt Ismail Page 2

CoAprovel is under FDA Pregnancy category D.

This means that CoAprovel should only be used in

life-threatening emergencies when no safer drug

available.

There is positive evidence that CoAprovel imposes

human fetal risk. The use of drug that affects ren-

in-angiotensin system may result in

fetal injury or death.

NEW DRUGS ON THE block

CoAprovel is a cardiovascular drug that is used to

treat hypertension. It is the combination of an An-

giotensin Receptor Blocker (ARB) irbesartan and a

thiazide diuretic hydrochlorothiazide given as once

daily (OD) dosing.

It is currently sold under the brand of CoAprovel

by Sanofi-Aventis.

INTRODUCTION TO COAPROVEL

Presentations:

CoAprovel 150/12.5

CoAprovel

300/12.5

CoAprovel

300/25

Page 3

Te

nv

ir

-e

m

CO

AP

RO

VE

L

28’s/

box

By: Tan Chong Seng

COAPROVEL GENERAL

COUNSELLING

POINTS

If you are pregnant and is pre-

scribed with CoAprovel, please

inform your doctor immediately

so that this drug can be stopped

as soon as possible.

Previous allergic reaction from

sulfonamide-containing drugs

(i.e Bactrim) and is prescribed

with CoAprovel, might cause

cross-hypersensitivity to

hydrochlorothiazide.

If you are on both ACE inhibi-

tors (-pril) and CoAprovel,

please inform your doctor imme-

diately to stop either one of the

drugs.

Please consult your doctor or

pharmacist before starting to take

any potassium supplement.

By: Tan Ch ong Seng Page 4

INTRODUCTION TO TENVIR-EM

Page 5

Tenvir-em is the combination of Tenofovir Disoproxil Fumarate 300mg and Emtricitabine 200mg.

Description

Blue colored capsule shaped biconvex film coated tablet plain on both sides.

Indication

Tenvir-EM is indicated for combination

with other antiretroviral agents (such as

NNRTI or PI) for the treatment of HIV-1 infec-

tions in adults.

How to take Tenvir-EM?

Usual dose:

Adult : One tablet each day with or without

food.

Not for children and adolescents.

RM154.00/30 tabs

CO

AP

RO

VE

L

Te

nv

ir

-e

m

NEW DRUGS ON THE BLOCK

By: Tan Suet Ting

Possible side effects

Very common side effects

1. Dizziness, headache, diarrhea, nausea & vomiting.

2. Muscle pain and weakness (if creatinine kinase levels in

the blood increased).

Common side effects

1. Abdominal disturbance

2. Difficulty in sleeping, abnormal dreams

3. Flatulence

4. Rashes

Pregnancy Category : B

Lactation : excreted in breast milk and should not be

used while nursing.

*If you have difficulty swallowing, you can use the tip of a spoon to crush

the tablet, then mix the powder with about 100ml (half a glass) of water,

If you forget to take Tenvir-EM, what should you do?

If you do miss a dose of Tenvir-EM : take it as soon as you can, and then

take your next dose at its regular time.

If it is almost time for your next dose : forget about the missed dose. Wait

and take the next dose at the regular time. Do not take double dose to make

up for the forgotten tablet.

If you throw up less than 1 hour after taking Tenvir-EM : take another

tablet. You do not need to take another tablet if you were sick more than 1

hour after taking Tenvir-EM.

Page 6 By: Tan Suet Ting

Page 7

It is the most severe form of heat illness wherein the body overheats and can’t cool down by sweating because of dehydration

Page 8 By: Amreet Kaur Gill

Antifungal cream How to use Antifungal Cream effectively?? The effectiveness of the cream is best achieved by follow-

ing these steps: Clean and thoroughly dry the affected ar-ea. Apply the cream to the affected area (skin surface),

usually twice a day or, as directed by your doctor. Be sure to apply enough amount of cream to cover until the sur-roundings of the affected area. Continue to use this medication for 1 MORE WEEK after

the symptoms disappear. (Stopping the medication too early may allow the fungus to continue growing, which may result in re-infection)

Miconazole and Clotrimazole

are antifungal creams com-

monly used in Klinik

Kesihatan. These antifungal

creams are used to treat skin

infections such as athlete's

foot, jock itch, ringworm, and

other fungal skin infections

(Candidiasis).

By: Tan Siong Guan Page 9

:

Topical Rx Phototherapy Systemic Rx

Coal Tar

Keratolytics

Topical steroids*

Vit D3 analogues

Dithranol (anthralin)

Emollients

NB-UVB

Oral PUVA

Bath PUVA

Topical PUVA

Methotrexate

Acitretin (retinoid)

Sulphasalazine

Ciclosporin

Hydroxyurea

Systemic steroids*

Safe Still safe Potential risk

Psoriasis is a noncontagious skin condition that produces plaques of thick-ened, scaling skin. The dry flakes of skin scales are thought to result from the excessively rapid proliferation of skin cells that is triggered by inflam-

matory chemicals produced by specialized white blood cells called lympho-cytes. Psoriasis commonly affects the skin of the elbows, knees, and

scalp.There are many effective treatment choices for psoriasis. The best treatment is individually determined by the treating physician and depends,

in part, on the type of disease, the severity, and the total body area in-volved. Here are treatments given to patient with psoriasis.

Areas usually af-

fected

Psoriasis on

hands

Psoriasis on

legs

By: Azura Kasim Page 10

Topical Treat-

ment Types of Tar Counseling points

Tar Polytar Shampoo Used twice a week on the scalp. Rub in gently and do not scratch the

scalp as it will worsen the condition

Coal Tar bath Ideally add into a bathtub of water and soak for 15-20 minutes.

Alternatively, dilute with water and apply on the skin using a cloth or

sponge, leave for 15 minutes then rinse off with water

Ung Cocois Rub onto the scalp thoroughly at night, wrap with a towel or shower cap

to avoid staining the pillowcase. Leave for 6-8 hours and rinse off the

next morning

Liquor Picis Car-

bonis (LPC) Applied at night on lesions after applying emollient. May cause skin irri-

tation and therefore if not well tolerated, steroids may be reconsidered

Keratolytics 2% Salicylic acid

cream Can be used in combination with steroid (1%HCT, BVC 1:2 or BVC 1:4)

on the scalp

Salicylic acid oint-

ment (2%, 4%, 10%,

20%, 40%)

Apply onto thick areas

Topical Steroid

Topical steroids

should be ap-

plied 5 minutes

after the applica-

tion of emollient

and should be

used twice daily

Very potent

Clobetasone propio-

nate 0.05%

(Dermovate)

To be applied on thick lesions on hands and feet

Potent

Betamethasone val-

erate (0.1%, 1:2, 1:4,

1:10)

Mometasone furoate

0.1% (Elomet)

To be applied on itchy and reddish areas on the body, limbs or scalp (1:2,

1:4)

Moderate

Clobetasone butyrate

0.05% (Eumovate)

Can be used on the face, hairline, ears and neck

Mild

Hydrocortisone (1%,

0.5%)

Can be used on the face and scalp

Page 11 By: Azura Kasim

Vit D3 analogues Daivobet ointment

(Calcipotriol + Betame-

thasone diproprionate)

Apply only to the psoriatic plaques and gently rub in. If u accidentally

put some of the ointment on the normal skin, wash it off as soon as pos-

sible. Avoid using on the face and body folds.

Daivonex lotion Apply drop by drop only to the areas of the scalp that have psoriasis.

Use twice a day. If any accidentally gets on the face, wash off immedi-

ately.

Xamiol gel Soak on the scalp overnight then wash off the next morning with nor-

mal shampoo

Dithranol Anthralin Test with a small area on the skin first as it may not be well tolerated

by certain individuals (may cause skin irritation).

Apply on very scaly and thick lesions using a cotton bud and followed by

Vaseline ointment along the margin of the affected area.

After 10-15 minutes, rinse off with liquid paraffin.

Initially to be applied 2-3 times a week and then on a daily basis, pref-

erably at night, until the lesions clear off.

Emollients

Administration of

emollient is by

smoothing them

along the line of

hair growth (top

to bottom and one

direction) to avoid

folliculitis. Do not

rub them in. Fre-

quency of admin-

istration depends

on the condition of

the skin and in-

structions from

prescriber

Aqueous cream May be used as a soap

Aqueous cream + 25%

Glycerin

Has higher moisture content than aqueous cream (effect lasts longer)

Emulsificant ointment

(UE)

Less oily hence suitable to be used on palm and sole. If used as a soak,

scoop into warm water, soak for 15 minutes. (the skin will soften and

peel off easily)

White soft paraffin Oily, usually used at night

50% Liquid paraffin +

50% White soft paraf-

fin

Oily, usually used at night

Urea cream For strengths 5% and 10% (20% is used as a keratolytic)

Liquid paraffin

To be used on the scalp

for very scaly areas (to

soften crusts and blis-

ters)

Soak on the head for 30 minutes, then rinse off with Cetavlon shampoo

Page 12 By: Azura Kasim

By: Melissa Joan Page 13

By: Melissa Joan Page 14

Nama: Julia bt Shamsuddin

Umur: 33 tahun

Asal: Perak

Perkhidmatan: Hospital Melaka (4 tahun)

Klinik Kesihatan Umbai (terkini)

Impian: Menceburi perniagaan dalam bidang kesihatan

bersama suami

Nama: Izzura Akmal bt Mohd Shoib

Umur: 28 tahun

Asal: Melaka

Perkhidmatan: Hospital Banting, Hospital Melaka (4 tahun)

Klinik Kesihatan Kemendor (terkini)

Impian: Melanjutkan pengajian dalam bahasa Korea & menjelajah seluruh dunia

Nama: Melissa Joan Anbalagan

Umur: 26 tahun

Asal: Selangor

Perkhidmatan: Klinik Kesihatan Jasin (terkini)

Impian: Melanjutkan pengajian ke peringkat doktor falsafah & menjadi seorang pensyarah.

Nama: Tan Chong Seng

Umur: 25 tahun

Asal: Perak

Perkhidmatan: Klinik Kesihatan Umbai (terkini)

Impian: Melancong ke luar negara & meluaskan

ilmu pengetahuan dalam semua bidang.

‘FAMILY DAY’

KM CHALET KUALA LINGGI

23 APR 2016

MAJLIS PERPISAHAN

STAF

28 JAN 2016

MAJLIS PERSARAAN

EN OW ENG KAR & EN

SHAFIE

14 MEI 2016

MAJLIS

SAMBUTAN

HARI JADI

1

2

3

4

‘’GAME

BOWLING’

FARMASI PKD

JASIN

30 OGOS 2016

KEMPEN

KENALI UBAT

ANDA (QUMC)

KURSUS

TEAM BUILDING

& SOFT SKILL

7

5

6