The community pharmacy sector in Malaysia has seen substantial growth in recent years. In 2021, there were 5,271 community pharmacists in the country, making up… Read More »The Distance Between Us and Community Pharmacies: A Commentary on The Needs of Zoning Policy in Malaysia
Introduction: Vancomycin is indicated for highly resistant gram-positive systemic infections. The targeted trough and 24-hour area under the concentration-time curve (AUC24) level of vancomycin must be achieved for efficacy and safety. Local population-based pharmacokinetic parameters including the elimination rate constant (Ke), half-life (t1/2), volume of distribution (Vd) and vancomycin clearance (Clvanco) can allow better vancomycin dosing determination. Objective: This study aims to determine the pharmacokinetic parameters in the Malaysian adult patients in Penang based on different kidney functions. Method: This was a retrospective, single-centered study conducted in the Clinical Pharmacokinetics Department, Penang General Hospital from 1 January 2016 to 31 December 2017. This study included adult patients who had been treated with intravenous vancomycin under therapeutic drug monitoring. The patients’ personalised vancomycin pharmacokinetic parameters were determined using a series of pharmacokinetic equations. Result: From the recruited 26 patients, 73.1% were male and 46.2% were above 50 years old. A total of 34.6% patients had the actual body weight / ideal body weight ratio of more than 1.0. The median total daily dose was 34.72 mg / kg. The median for Cmax (peak serum concentration) was 26.0 mg /L while Cmin (trough serum concentration) was 14.20 mg / L. The median for AUC24 is 412.08 mg*hr / L. The overall median for Ke and t1/2 were 0.091 hr-1 and 7.62 hours, respectively. The median Vd was 0.90 L / kg. It was found that with increasing creatinine clearance, the Ke and Vd increased while the t1/2 decreased. Conclusion: The vancomycin pharmacokinetic data from this study varied according to different degree of creatinine clearances.
This study was carried out to assess the prevalence of self-medication practice among Malaysian consumers who visit to community pharmacies. The data was collected using structured questionnaires which were randomly distributed to 500 consumers who visited to 10 conveniently selected community pharmacies in Sungai Petani, Kedah between August to October 2007. Out of the 500 questionnaire distributed, 105 responses were received for a response rate of 21.0%. Approximately 45% of the respondents have practiced self-medication in the preceding six months. The respondents mainly practiced self-medication for fever (35.2%), colds and flu (35.2%) and cough (31.4%). The most popular classes of medicines used by the consumers were analgesic/NSAIDs (32.4%), cold and flu medicines (23.8%) and antacids (18.1%). Only 27.6% of respondents were confident in self-managing medications or dietary supplements. The consumers mostly agreed that more advice on medications should be given by pharmacist (75.2%) and pharmacist has high level of professionalism on medication (65.7%). The study concluded that the practice of self-medication mostly involved management of minor ailments using non-prescription and over-the-counter medicines.
Tablet splitting practices have been shown to reduce the medication cost in many countries. This study was aimed to evaluate the tablet splitting practices among community pharmacists in Penang, Malaysia. A two-month cross-sectional descriptive survey was carried out in forty randomly chosen community pharmacies in Penang. The pharmacists were required to document all their tablet splitting recommendations during the study period. The data collected includes the appropriateness of the tablet splitting recommendations by pharmacists; the extent of communication between pharmacists and physicians when recommending tablet splitting; the physicians‟ and patients‟ acceptance towards the tablet splitting; and the documentation of cost-saving achieved from the tablet splitting. The result showed that the tablet splitting was recommended by 31.0% of the pharmacists who receives prescriptions eligible for this practice. Tablets of patent- protected innovator brands were more likely to be recommended for splitting. Majority (92.9%) of the splitting recommendations were appropriate except two cases which involve unscored combination tablet. The pharmacists requested consent from the physicians for 42.9% of the splitting recommendations and majority (91.7%) of the requests were accepted. Meanwhile, the patients‟ acceptance rate for splitting recommendation was 82.1%. Through acceptance of tablet-splitting, the patients‟ monthly expenses on drugs reduced by 36.5% and this correspond to a monthly saving of RM39.05 (US$10.30, US$1.00 = RM 3.80) per patient. The study concluded that the tablet splitting is not a common practice among the community pharmacists, however both the physicians and patients highly accept pharmacists‟ suggestion on splitting. The findings also revealed that tablet splitting can be used as a cost-containment measure for patient as well.