Download HOSPITAL KUALA KUBU BHARU PHARMACY BULLETIN

HOSPITAL KUALA KUBU BHARU
PHARMACY BULLETIN
1st edition /June 2016
EDITORIAL BOARD
ADVISOR
 Ratna Suny bt Mohamed Esa
CHIEF EDITOR
 Noor Haslina bt Zainor Abidin
EDITOR
 Ainur Fadlina bt Mohd Nadzir
 Nur Shazwani bt Mokhtar
CONTRIBUTORS
 Mohamad Shafawie bin
Mohamad Sidik
 Murni bt Mohammed Ariffin
For further enquiries, please
contact us at :
PHARMACY RESOURCES
INFORMATION CENTRE
(PRIC)
Pharmacy Unit,
Hospital Kuala Kubu Bharu,
44000 Kuala Kubu Bharu,
Selangor
03-60641333 ext 279
HIGHLIGHTS:

Middle East Respiratory
Syndrome - Coronavirus (MERSCoV) : Page 1— 3

Immunisation Program in
Malaysia : Page 4-6
PHARMACY EDUCATION

Oral Contraceptive : Page 7- 9
Prepared by : Noor Haslina binti Zainor Abidin
MIDDLE EAST RESPIRATORY SYNDROME CORONOVIRUS (MERS– CoV)
INTRODUCTION
Middle East Respiratory Syndrome (MERS) is an
illness caused by a virus (more specifically,
a coronavirus). MERS affects the respiratory system
(lungs and breathing tubes). About 3-4 out of every
10 patients reported with MERS have died. Most of
the people who died had an underlying medical
condition. Some infected people had mild symptoms (such as cold-like symptoms) or no symptoms
at all; they recovered.
HISTORY
Health officials first reported the disease in Saudi Arabia
in September 2012. Through retrospective
investigations, health officials later identified that the
first known MERS cases occurred in Jordan in April
2012. So far, all cases of MERS have been linked
through travel to or residence in countries in and near the
Arabian Peninsula. The largest known outbreak of
MERS outside the Arabian Peninsula occurred in the
Republic of Korea in 2015. The outbreak was associated
with a traveler returning from the Arabian Peninsula.
SYMPTOMS




COMPLICATION
fever
cough
shortness of breath
gastrointestinal symptoms
(diarrhea, nausea, vomiting)


Pneumonia
Kidney failure
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WHO HAS HIGH RISK OF GETTING MERS-COV

people with pre-existing medical conditions (diabetes; cancer; and chronic lung, heart, and kidney
disease)

Individuals with weakened immune systems
** the incubation period for MERS (time between when a person is exposed to MERS-CoV and when they
start to have symptoms) is usually about 5 or 6 days, but can range from 2-14 days.
TRANSMISSION
Non-human to human transmission  Camels are likely to be a major reservoir host for MERSCoV and an animal source of infection in humans.
Human-to-human transmission  Spread from an infected person’s respiratory secretions and is
droplets. MERS-CoV has spread from ill people to others through close contact, such as caring for or
living with an infected person. Infected people have spread MERS-CoV to others in healthcare settings,
such as hospitals.
PREVENTION
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TREATMENT
There is no specific antiviral treatment recommended for MERS-CoV
infection. Individuals with MERS can seek medical care to help relieve
symptoms. For severe cases, current treatment includes care to support
vital organ functions.
TRAVEL ADVICE

Avoid any unnecessary contact with camels. Travelers should practice good general hygiene
measures.

Risk assessment of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) with soap and
water at all times, but especially before and after visiting farms, barns or market areas.

Avoid raw camel milk and/or camel products from the Middle East. More generally, travelers are
also advised to avoid consumption of any type of raw milk, raw milk products and any food that may
be contaminated with animal secretions unless peeled and cleaned and/or thoroughly cooked.

Travelers returning from the Middle East with severe respiratory symptoms should seek medical
advice and must report their travel history so that appropriate infection control measures and testing
can be undertaken. People who are acutely ill with an infectious disease are advised not to travel.
REMINDER TO ALL HEALTHCARE STAFF
REFERENCES
1) https://www.cdc.gov/coronavirus/mers/
2) http://www.who.int/mediacentre/factsheets/mers-cov/en/
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Prepared by : Mohamad Shafawie bin Mohamad Sidik
IMMUNISATION PROGRAM IN MALAYSIA
Immunisation is the process of giving vaccine to the person with the intention of
stimulating the body own’s immune system against infectious disease. Immunisation
protects the individual and community from disease outbreaks
HOW DO VACCINE WORKS?
Vaccination Schedule by the Ministry of Health Malaysia
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Disease
Complication of the
disease
Vaccine product
Route of giving vaccine
Tuberculosis
Serious infections of the lung
(pneumonia), the membrane
covering the brain (meningitis) and
spread throughout the body
Weakened
bacterium (BCG)
Beneath the skin in the
arm
Diphtheria
Blockage of the airway and
pneumonia
Modified bacterial
toxin(D)
Tetanus
Stiffness of body muscles and
inability to open the jaws (lock jaw)
Modified bacterial
toxin(T)
Pertussis
Severe cough (whooping cough),
reduction of oxygen going to the
brain and pneumonia
Killed bacterium
(aP)
Haemophilus
influenza type B
Infection of the lungs (pneumonia),
airway and covering of the brain
(meningitis)
Bacterial
component (Hib)
Poliomyelitis
Infection of the brain (encephalitis)
and permanent weakness of the leg
muscles
Ruled virus
Hepatitis B
Acute and chronic liver damage and
predisposes the individual to liver
cancer in later life
Viral component
(Hep B)
Mumps
Infection of the brain (encephalitis)
and testis (orchitis) which can lead to
infertility
Weakened virus (M)
Measles
Infection of the brain (encephalitis)
and testis (orchitis) which can lead to
infertility
Weakened virus (M)
If the rubella virus circulates in the
community, an expectant mother,
especially in the first three months of
pregnancy may get the disease resulting in a baby with multiple birth
defects. The baby may have mental
damage, hearing and visual problems
and heart defect (usually a PDA
patent ductus arteriosus)
Weakened virus (R)
Rubella
Cervical Cancer
DTaP/ Hib/ IPV is given together into the
muscle of the thigh (if
less than 1 year old) or
arm (if more than 1 year
old)
Given as a liquid by
mouth
Given as MMR into the
muscle of the thigh
Reconcurrent virus
Into the muscle of the
arm / thigh
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HERD
IMMUNITY
Occurs when a sufficient proportion of the group is immune. The
decline of disease incidence is greater than the proportion of
individuals immunized because vaccination reduces the spread of an
infectious agent by reducing the amount and/or duration of pathogen
shedding by vaccines, retarding transmission.
References:
1. http://www.myhealth.gov.my/en/
2. Paeds Protocol 3rd Edition
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ORAL CONTRACEPTIVES
CHILDREN BY CHOICE, NOT BY CHANCE
Prepared by: Murni bin Mohamed Ariffin
WHAT ARE ORAL CONTRACEPTIVES?

Oral contraceptives or “the pill” are tablets taken once a day
to prevent pregnancy

Since 1960’s, the pill has been available and several changes
have occurred over time

One major change has been the reduction in the dose of the
hormones, estrogen and progestin.
ABOUT THE PILL

The pill is an oral contraceptive that is 99% effective when taken properly

There are 2 main types of pills :
1. Combined pill - contains 2 female
hormones; estrogen and progestin
2. Mini pill - contains only progestin

The difference between brands is the amount of
estrogens and the type of progestin used.
ORAL CONTRACEPTIVES AVAILABLE IN HKKB
DRUG
INDICATION, DOSE
Norethisterone 350mcg

Oral contraceptive: Progestin-only pill (POP)
(NORIDAY)

1 tab daily starting on the first day of
menstrual bleeding

Can be taken with or without food
Desogestrel 150mcg,
Ethinylestradiol 30mcg

Oral contraceptive: Combined oral
contraceptive pill (COC)
(DESOLON)

1 tab daily starting on the first day of menstruation without interruption for 21 days,
followed by 7 tab-free days.

Can be taken with or without food.
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HOW DOES THE PILL WORK?
One pill is taken every day for 21 days, followed by a 7-day break. When taken correctly
the hormones will cause the following changes in the body :

The ovaries stop releasing eggs. Without eggs, no pregnancy can occur.

The cervical mucus thickens to make the sperm more difficult to penetrate into the
cervix, making it difficult to reach the egg.

The lining of the womb (uterus) does not develop sufficiently for a fertilized egg to
implant

Reduces sperm transport in the upper genital tract.
WHAT DO YOU NEED TO KNOW ABOUT TAKING THE PILL?
1) When to start taking each pill
pack ?
3) Management of pills
 Your first pill pack is started on the
first day of your period.
 Each new pill pack be started on the
same day of the week, no matter when
your period starts or ends.
2) When to take your pills?
 Remember to take your pill at the
same time everyday.
 Choose the most convenient time,
when you first start taking the pill,
and then be sure to continue taking at
the same time.
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COMBINED ORAL CONTRACEPTIVES PILLS (COC) METHODS

Patient compliance is essential for best
protection

Missed pill period up to 12 hrs

Fertility usually returns quickly

Serious side effects are rare

Can be used by women of any age, whether
or not they have children

Help prevent anemia,menstrual cramps and irregular bleeding

Help to lower down risk of ovarian and endometrial cancers

Skin conditions such as acne can improve - has to be taken daily

In the first few months, some users may experiences side effects such as stomach
upset, bleeding between periods or spotting, mild headache, or moodiness.

Not suitable for women over 35 and smoke.
PROGESTIN-ONLY PILLS(POP/MINIPILL) METHODS

Mood of action : thickening of cervical mucus

Good choice for nursing mothers who want
pills beginning at 6 weeks after childbirth

Suitable for women who wants to avoid
estrogen

Effective during breastfeeding

Can be used as emergency method after unprotected sex

If used when not breastfeeding, bleeding changes are to be expected— especially
spotting and bleeding between period

Greater incidence of irregular bleeding & amenorrhea
REFERENCES:

Lippincott Williams & Wilkins, Koda Kimble and Young’s Applied Therapeutics: The
Clinical Use of Drugs, Tenth Edition.

MIMS Drug Dosage and Information at www.mims.com.
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