Issue 02/2015 PHARMACY UNIT, HOSPITAL SUNGAI SIPUT

PHARMACY BULLETIN
HOSPITAL SUNGAI SIPUT
Inside this issue: PHARMACY INFORMATION SYSTEM (PHIS)
Pharmacy Infor- 1-3 Pharmacy Information System (PHIS) supports end to end medication
mation System management to monitor the procurement and distribution, medication usage
(PHIS)
and safety, utilization of resources, and improve quality of patient care.

Antibiotic Aware- 4-6 The close loop medication management integrates both inventory and
ness Campaign clinical pharmacy services to ensure delivery of quality and efficient medica-
2015 tion management.

Amendment In 7
Drug Formulary
Hospital Sungai
Siput

Stability of Extem- 8
poraneous Prepa-
rations

Stability of com- 8-9

mercial syrups or
powder for recon-
stitutions

‘Letak dan Am- 10

bil’ (LASS) Service

Editorial Board:
Chief Editor:
Chang Siew Ting

Editor:
Teoh Lee Rhui

Contributors:

Koo Yoke See

Sharmini a/p
Tharumaseelan

Tan Keat Yee

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 PHARMACY BULLETIN

 Order Management
 Enables electronic medication order for inpatients, outpatients, emergen-
cy and daycare patients
 Interfaces to external drug database to provide drug alerts function
(drug interaction, contraindication, allergies, adverse drug effects, over-
dose and therapeutic duplication) while prescribing
 Maintaining patients’ complete medication profile
 Enables multilevel access for prescribing and authorization of list A / A*
type drugs
 Drug codes in compliance with Malaysian Drug Code (MDC) standards

 Outpatient and Inpatient Pharmacy Services

PHIS Life Run
Progresss: PHIS enables
Outpatient & Inpatiemt
 Monitoring of patient queue
Pharmacy Services
 Screening of medication orders
 Transcribing
 Preparation and filling of medication orders
 Verification
 Printing of labels and fill list
 Label  Dispensing of medication
 Preparation  Management and monitoring of Sistem Pendispensan Ubat-Ubatan Ber-
sepadu (SPUB) and value added services
 Dispensing
 Medication Administration Recording (MAR) for patients in the wards

Inventory  Clinical Pharmacokinetics Services (TDM)

 Budget manage-  Enables monitoring of patient with low therapeutic Index Drugs and in
ment poisonous cases
 Interfaces with Drug Knowledge database for advisory and references
 Procurement purposes
 Stock adjustment

 Distribution  Medication Therapy Adherence Clinic (MTAC)

 Provides documentation of MTAC services to allow monitoring of patient
 Indent
compliance to medication

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 Issue 02/2015

 Medication Counseling
 Provides documentation for medication counseling activity
 Enables scheduling for counseling appointment

 Pharmacy Inventory
 Provides functionality for finance management, procurement, stock management and
tracking of products movement from receiving up to the supply end point (close
loop)

 Ward Pharmacy Activity

 Assists in patient care by screening and monitoring of drug interactions, drug aller-
gies and other possible medication-related complications
 Provides clinical pharmacy documentation to allow medication profile retrieval and
reconciliation

 Drug Information and Consumer Education

 Allows healthcare providers and consumers to make inquiries on medication related
issues
 Provides portal for hospital community to share and acquires medical related infor-
mation and advisory knowledge based on content management features

 Adverse Drug Reaction

 Allows healthcare providers to report Adverse Drug Reactions cases and integrates
with Malaysian Adverse Drug Reaction Centre (MADRAC) system

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ANTIBIOTIC AWARENESS CAMPAIGN 2015

It has been recognized for several decades that up to 50% of antimicrobial use is inappro-
priate, where

 antibiotics are given when they are not needed

 antibiotics are continued when they are no longer necessary

 antibiotics are given at the wrong dose

 broad spectrum agents are used to treat very susceptible bacteria

 wrong antibiotic is given to treat an infection

Antibiotic misuse adversely impacts patients. In 2008, there were 142,000 visits to emergen-
cy departments for adverse events attributed to antibiotics. When misused, antibiotics will lost its ef-
fectiveness and cause antibiotic resistance.

Antibiotic awareness campaign aims to increase awareness of global antibiotic resistance

and to encourage best practices among the general public, health workers and policy makers to
avoid the further emergence and spread of antibiotic resistance. It was held in Hospital Sungai Siput
on 18 November 2015.

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 Issue 02/2015

Did you know that

most of fever and
sore throats are
caused by VIRUS
and DO NOT need
ANTIBIOTICS?

Antimicrobial Stewardship Programme promotes appropriate use of

antimicrobials by selecting appropriate indication, dose, duration and route of
administration. It has potential to improve efficacy, minimize drug-related ad-
verse events, limit the emergence of antimicrobial resistance and reduce treat-
ment-related costs.

Despite the public

knowing that
ANTIBIOTICS are
mainly meant for
BACTERIA and that
it can cause
RESISTANCE, some
(30%) still
REQUEST them
from their GPs and
half (48%) of them
would EXPECT it
for FEVER AND
SORE THROATS

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AMENDMENT IN DRUG FORMULARY HOSPITAL SUNGAI SIPUT
There are some amendments in Drug Formulary Hospital Sungai Siput from May till December
2015. The following is the list of medicines newly added into Drug Formulary HSS:
GENERIC NAME
Levodopa 100 mg, Carbidopa 25
mg and Entacapone 200 mg Tablet
(Stalevo)
Fenofibrate 145 mg tablet
(Lipanthyl)
Estradiol 1 mg with Dydrogesterone
5 mg Tablet (Femoston Conti)
Amantadine HCl 100 mg Capsule
Cefuroxime Sodium 750 mg Injection
Amoxicillin 1 g & Clavulanate 200
mg Injection
DuasorbTM (Dextran 70 0.1%, hy-
droxylpropyl methylcellulose 0.3%)
water-soluble polymeric system
(preservative free)
DuasorbTM (Dextran 70 0.1%, hy-
droxylpropyl methylcellulose 0.3%)
water-soluble polymeric system
Issue 02/2015
CATEGORY INDICATION
A* Idiopathic Parkinson's disease
A/KK As second line therapy after failed gemfibrozil in
patients:
i) Hypercholesterolemia and hypertriglyceridemia
alone or combined
[type IIa,IIb,III and V dysplipidemias] in patients
unresponsive to
dietary and other non-pharmacological measures
especially when
there is evidence of associated risk factors
ii) Treatment of secondary hyperlipoproteinemias if
hyperlipoprotenemia persists despite effective
treatment of
underlying disease
iii) Dyslipidemia in Type 2 Diabetes Mellitus
A* i) Hormone replacement therapy for the relief of
symptoms due to oestrogen deficiency
ii) Prevention of postmenopausal osteoporosis in wom-
en with a uterus
B Parkinson's disease
A Infections caused by susceptible organisms, surgical
prophylaxis
A Infections caused by susceptible organisms. Respirato-
ry tract, skin, soft tissue, GUT infection, septicaemia,
peritonitis, post-operative infection & osteomyelitis
Relief in both mucin & aqueous deficient dry eye syn-
dromes & symptoms of severe keratoconjunctivitis sic-
ca w/ associated ocular pain, disturbance in visual
acuity, stickiness discomfort & dryness
Relief in both mucin & aqueous deficient dry eye syn-
dromes & symptoms of severe keratoconjunctivitis sic-
ca w/ associated ocular pain, disturbance in visual
acuity, stickiness discomfort & dryness
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STABILITY OF EXTEMPORANEOUS PREPARATIONS

Drug Name Stability After Preparation Storage Condition
• Sy Folic Acid 1 month Refrigerate
( 2°C – 8°C )
• Pottasium Chloride 3 months Room Temperature

• Sy Ferrous Fumarate 1 month Refrigerate

( 2°C – 8°C )
• Sy Simplex 1 month Room Temperature

• Sy Ferric Ammonium Citrate 1 month Refrigerate

( FAC ) ( 2°C – 8°C )

• Sy Trimethoprim 1 month Refrigerate

( 2°C – 8°C )

• Mixt Ammonium & Ipecacuanha 3 months Room Temperature

STABILITY OF COMMERCIAL SYRUPS OR POWDER FOR RECONSTITUTIONS

Drug Name Stability After Un- Storage Condition Notes

sealed
• Sy Albendazole Don’t have data Don’t have data The patient is expected to fin-
• Sy Chlorpheniramine ish consuming the contents be-
tween 3 – 6 days as the rec-
ommended dosage.

• Sy Bromhexine 1 month in good environ- Refrigerate

• Sy Salbutamol ment ( 2°C – 8°C )
• Sy Prednisolone
• Sy Carbamazapine Same as the recom- Room temperature The cap must be closed tightly
• SySodium Valproate mended expiry once open

• Sy Benadryl (Paeds) Same as the recom- May or may not refrig-

mended expiry erate

• Sy Hyoscine 1 month in the fridge - 1 month in the fridge

- 2 months in the room
2 months in the room temperature
temperature

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 Issue 02/2015

Drug Name Stability After Un- Storage Condition Notes

sealed
• Sy Lactulose Same as the recom- Room temperature Materials in the syrup are sta-
mended expiry ble in normal condition

• Mist Carminative ↓ 30 °C Room temperature In general, syrups better to be

• Magnesium Trisilicate Use within 3 months refrigerate once the cap has
• Potasium Citrate been opened.
• Sy Multivitamin
Fresh spoon should be used
every time consuming the syrup
to avoid contamination.

Avoid Syrup Multivitamin from

sunlight and heat.

• Sy Nystatin 30 days ↓ 30 °C

• Oral Rehydration Salt Take immediately after None The drug company never done
dilute the powder any studies on stability after
the powder has been diluted

• Sy Paracetamol 1 week Refrigerate The patient is expected to finish

• Sy Benadryl (Adult ) ( 2°C – 8°C ) consuming the contents between
3 – 6 days as the recommend-
ed dosage.

Under the stipulated storage

conditions on the bottle, the
product is expected to be sta-
ble for the duration as men-
tioned above.
• Sy Metronidazole Same as the recom- ↓ 30 °C The cap must be closed tightly
mended expiry once open

• Sy Bactrim 12 days Room temperature Assuming the contents should be

finished within the period as
prescribed.

• Sy Promethazine 1 week Refrigerate

( 2°C – 8°C )

• Sy Cloxacillin 1 week after dilution Refrigerate

• Sy Amoxcycillin ( 2°C – 8°C )
• Sy Penicillin V
• Sy Erythromycin

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PHARMACY BULLETIN
‘LETAK & AMBIL’ (LASS) SERVICE
“Perkhidmatan Letak & Ambil”
provides flexibility for patients
to collect next partial medica-
tions supply on the prefer date,
especially for patients who are
unable to come and collect their
medications during working
hours.
It was created to ease the pa-
tients on collecting their next
partial medications supply with-
out long waiting time for medi-
cation and ensure continuous
medication supply to patients.
1. Take number ticket
4. Staple one of the number tick-
et on prescription & keep the
other one
ETAK & MBIL
All registered patients are able The following are medica-
to choose their prefer date for tion collection time period
next partial medications collec- for LASS service:
tion. Patients need to drop their
Monday-Thursday:
prescription into the LASS box
1300-1700
beside pharmacy counter 1 week
1800-2100
earlier, according to the date
chosen.
Friday:
Medications will be prepared 1445-1700
early before the appointment 1800-2100
date set by patients. Thus, pa-
tients are able to get their medi- Weekends & Public Holi-
cations without long waiting time days:
on that chosen date. 1800-2100
2. Fill the prefer date for medica- 3. Split the number ticket
tion collection on both number
ticket
5. Drop the prescription into LASS 6. Bring the number ticket and
box according to the date chosen LASS registration card on the cho-
sen date to collect medication
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