Publications

Study of Aminoglycosides Use among In-patients at Hospital Kuala Lumpur

    DOI: 10.52494/TNSN1446
    by Endang Kumolosasi, Siti Aishah Mohamad Nor and Tengku Karmila Tengku Mohd Kamil.
    Vol. 1 No. 9 (2011): Malaysian Journal of Pharmacy / Published: October 1, 2011
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    Abstract

    Aminoglycosides are a group of antibiotics that have been widely used in treatment of infections especially caused by gram negative bacteria. The purpose of this research was to study the aminoglycosides use among in-patients. This study was carried out retrospectively which included the patients 18 years and above who had received aminoglycosides therapy from July 2008 until December 2008. Patients with incomplete data were excluded. A total of 104 patients were included in this study based on the inclusion criteria. The aminoglycosides were used in patients who had normal renal function and also in patients who were in end stage renal failure. Gentamicin was the most frequently used (44.2%), followed by amikacin (33.7%), netilmicin (13.4%) and the least frequently used was streptomycin (8.7%). The culture and sensitivity test had been performed only to 62% of patients. Indication was appropriate in 95.2% patients and was inappropriate in 4.8% patients (p<0.001). Appropriate doses were given to 59.6% patients and 37.4% patients had received inappropriate doses (p>0.05) and 5.8% patients were not assessable. Duration of therapy was appropriate in 87.5% patients and there were 12.5% patients did not received therapy in appropriate duration (p<0.001). A total of 77(89.5%) cases of pharmacodynamic and 9(10.4%) cases of pharmacokinetic potential drug-drug interactions between aminoglycosides and other drugs were identified. There were 3 cases had minor severity and the rest had moderate severity. Conclusion: The appropriateness of aminoglycosides use still needs to be improved in order to ensure their effectiveness and safety in clinical setting.

    Calculated 10 Years Risk of CHD: Primary Preventive Measures in Medical Ward PPUKM (University Kebangsaan Malaysia Medical Centre)

      DOI: 10.52494/RRJX5324
      by Semira Abdi Beshir and Rosnani Hashim.
      Vol. 1 No. 9 (2011): Malaysian Journal of Pharmacy / Published: October 1, 2011
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      Abstract

      Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally. Identification of common risk factors and risk stratification helps to prioritize primary preventive measures and hence can reduce this epidemic. This retrospective cross sectional study was carried out to assess the primary preventive measures according to 10 years CHD risk stratification. One hundred thirty (67 female and 63 female) middle aged (40-65 years) patients admitted to PPUKM’s medical ward with no prior diagnosis of CHD were selected. Patient diagnosed with diabetes or hypertension related to pregnancy was excluded. The patients’ medical record and order management system (OMS) were screened to obtain relevant demographic information, medical and medication history and related laboratory results. The Joint British Societies CHD risk prediction chart was used to calculate the 10 years CHD risk. Gender specific differences of 10 years calculated CHD risk, baseline measure of BP, cholesterol, weight, BMI, HbA1C level and number of patients who received primary preventive measures were used as outcome measures. Results showed that male patients had a significantly higher 10 years CHD risk than female (P < 0.05). Hypertension was the most prevalent risk factor followed by diabetes and dyslipidemia. About10% (n=6) of hypertensive patients with SBP≥160 mmHg and 32 (37%) diabetic patients did not receive antihypertensive therapy and lipid lowering therapy respectively. Hence, there is a need for further improvement in primary preventive measures for CHD.

      Predictors of Herbal Utilization by Multiethnic Secondary Care Patients in Malaysia: a Cross Sectional Survey

        DOI: 10.52494/LEML5968
        by Mohd Baidi Bahari and Saw June Tze.
        Vol. 1 No. 9 (2011): Malaysian Journal of Pharmacy / Published: October 1, 2011
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        Abstract

        This study was carried out to determine the extent to which demographic characteristic and disease variables are significantly associated with herbal use. This study was a cross sectional survey conducted by structured interview using a validated questionnaire. The subjects were selected using a convenience sampling of 250 patients attending medical wards in Penang Hospital. Univariate and multivariate analysis were performed to examine the predictors of herbal use. The result found 42.4% of participants (n=106) used herbal medicines, with more than one third used herbs and conventional treatments concomitantly (67.9%). A total of 76 patients (30.4%) used herbal medicines in the past 12 months, and 37 (14.8%) patients had ever been used herbs. Multiple stepwise selection logistic regression modelling identified two significant determinants (P<0.05) of herbal use. These were demographic factor, education attainment and disease variable, kidney problem. Study findings indicate that patients with higher education attainment are more likely to use herbal medicines. In contrast, those who suffer from kidney problems are associated with more than three times decreased odds.

        STARZ-DRP: A Step-by-step Approach for Pharmacy Triage Services

          DOI: 10.52494/BGQU2795
          by Azmi Sarriff, Nazri Nordin and Mohamed Azmi A Hassali.
          Vol. 1 No. 9 (2011): Malaysian Journal of Pharmacy / Published: October 1, 2011
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          Abstract

          This article highlights the importance of structured and systematic processes in triaging patients with minor illnesses. The main aim is to describe a model or protocol for organizing a community pharmacist’s knowledge in a manner that allows him/her to begin identifying the actual and potential drug-related problems (DRPs). We consulted standard reference textbooks and key pharmacy journals looking for common mnemonics which has been promoted as a decision aids for the supply of non-prescription medicines. Our focus was to examine each method in terms of the collecting relevant information with respect to detection of DRPs associated with self-medicating patients. The positives and negatives attributes of each method were assessed. We noticed that each of the mnemonics examine were incomplete in some area. Even for an established and popular aide-memoire, WWHAM, which is an easily remembered mnemonic to obtain a general picture of the patient’s presenting compliant does not provides adequate information for triage and recognize patient-specific medication related problems. Although other mnemonics are more comprehensive than WWHAM, they are still limited. Moreover, by no means these methods were universally use and apply in the community pharmacy practice. Alternatively, the proposed approach provides a platform for triaging a self-medication patient as well as identifying DRPs for collaborating with other health care professionals. Therefore, the STARZ-DRP is an alternative approach for conducting self-care consultation. In depth study is needed to determinate whether it is more effective than other methods for pharmacy triage service when studied in a controlled, systematic manner.

          Influences of Patient-Related Factors in Diabetes Management Among Non- Insulin-Treated Type 2 Diabetics

            DOI: 10.52494/EVKR8069
            by Yap Li Swan.
            Vol. 1 No. 6 (2008): Malaysian Journal of Pharmacy / Published: December 1, 2008
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            Abstract

            Study was conducted to investigate the influences of patient-related factors in diabetic management among non-insulin-treated type 2 diabetics in Outpatient Department, Hospital Kemaman. Convenience interview has been conducted, followed by further review of outpatient cards. Data collected from 29 subjects was analyzed by using SPSS Version 11. The inclusive criteria were patients diagnosed with diabetes for at least one year and on oral hypoglycemic agent. Patients on insulin treatment were excluded. The efficacy parameter was the fasting blood glucose level. 86.2% of study population were non-smokers. 41.4% consumed alternative medicines concurrently with antidiabetic medications. Majority of the subjects practiced lifestyle modifications, 62.1% in the form of routine exercise and 79.3% dietary modifications. 24.1% and 20.7% received counseling before being put on diabetic medications and on lifestyle modifications respectively. Many diabetics have poor understanding on their medications. Only 27.6% have their fasting blood glucose level ≤ 7mmol/L during the study duration. 72.4% patients claimed to have good compliance to the medications prescribed. Study revealed that patients had better glycaemic control if they had better understanding/knowledge about the medications, had better compliance, practice lifestyle modifications and had been counseled before. Other variables (age, smoking and concurrent use of alternative medicines) failed to demonstrate significant effect on glycaemic control. This study revealed problems such as non-optimal glycaemic control, insufficient patients’ knowledge about the disease and medications, and inadequate compliance in diabetic population. Pharmacists can help the community to manage diabetes better. This information is expected to be useful for pharmacists in improving their roles.

            Serum Trace Elements and Immunoglobulin Profile

              DOI: 10.52494/ZFSU7894
              by A F M Nazmus Sadat, Md. Iqbal Hossain, Md. Khalid Hossain, Md. Selim Reza, Zabun Nahar, Md. Nazrul Islam Khan, SK. Nazrul Islam and Abul Hasnat.
              Vol. 1 No. 6 (2008): Malaysian Journal of Pharmacy / Published: December 1, 2008
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              Abstract

              The aim of this study was to determine the serum concentrations of trace elements (Zn, Cu, Mn, Pb) and immunoglobulins (IgG, IgA & IgM) in lung cancer patients. The study was conducted among 45 lung cancer patients and 50 age and gender-matched healthy volunteers. Flame atomic absorption spectroscopy method was employed to analyze the serum trace element concentrations, and turbidimetry method using immunoglobulin kit was used for the estimation of serum immunoglobulin levels. Results showed that the majority of the patients were literate and older married patients were smokers. Compared to the control volunteers, they had significantly (P<0.05) lower BMI. Serum concentrations of trace elements and IgG were found to be significantly (p<0.05) lower in the lung cancer patients. In the cancer patients, the concentration of zinc, copper, manganese and lead were 0.028±0.007 mg/L, 0.029±0.027 mg/L, 0.011±0.15 mg/L and 0.053±0.049 mg/L respectively, while these were 1.14±0.27 mg/L, 1.15±1.09 mg/L, 0.44±0.59 mg/L and 2.209±1.885 mg/L, respectively in the healthy controls. IgG concentration was found to be 14.96±3.92 g/L in lung cancer patients and 20.56±8.02 g/L in healthy volunteers. The concentrations of serum IgA and IgM were found to be unchanged. Correlative analysis suggested that serum lead value had a significant correlation with age in the lung cancer patient (r ═ –0.369, p ═ 0.013). The decreased concentration of trace elements and IgG may have a prognostic significance for the detection of lung cancer.

              The Study of Alfuzosin and Finasteride in the Treatment of Benign Prostatic Hyperplasia

                DOI: 10.52494/XPJG8847
                by Lee Sau Yong, Tan Meng Wah and Wan Noor Hayati.
                Vol. 1 No. 6 (2008): Malaysian Journal of Pharmacy / Published: December 1, 2008
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                Abstract

                Benign Prostatic Hyperplasia (BPH) is a hyperplasia process where there are an increased number of cells from the transition zone of the gland. The goals of the study were: (1) to compare the effectiveness of finasteride 5mg (Proscar) versus alfuzosin 10mg (Xatral XL) for the treatment of BPH; (2) to compare the treatment costs of both drug; (3) to compare the side-effect profile of both drug. All patients who have been diagnosed with BPH and have been receiving the treatment in SOPD Hospital Tuanku Ja’afar were reviewed. The inclusion criteria were: (1) male more than 45 year old; (2) patients who are not suffering from recurrent or rebound BPH. Subjects were evaluated using the International Prostate Symptom Score (IPSS) questionnaire The score and side effects occurrence were analysis by SPSS. Only 66 men were analyzed in the study as 6 men (8.3%) were excluded. 36 of them (55%) are taking Finasteride 5mg once daily whereas the other 30 men (45%) are taking the extended released form of Alfuzosin 10mg once daily. The distribution of subject’s age is even. Subjects with Finasteride 5mg have higher score (mean = 22.18) than Alfuzosin 10mg (mean = 18.87) (p<0.05). However, the total side effect score of both drug showed no significant different (p>0.05). Finasteride group (mean = 0.52 case) has experienced a slightly more side effect than the Alfuzosin group (mean = 0.50 case). This study concluded that both Alfuzosin and Finasteride provide symptomatic relief to BPH patients. Alfuzosin with its faster onset of action could be very useful for patients who were diagnosed with BPH and carry moderate IPSS scores.

                Adherence To Antihypertensives Among Haemodialysis Patients At Five Non-Governmental Organisation Centres In Malaysia

                  DOI: 10.52494/LKHP5701
                  by Hui-Lin Saw, Yoke-Lin Lo, Chae-Miang Cher and Sean-Hau Chang.
                  Vol. 1 No. 6 (2008): Malaysian Journal of Pharmacy / Published: December 1, 2008
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                  Abstract

                  Background: Uncontrolled hypertension is associated with increased cardiovascular mortality among haemodialysis (HD) patients. Poor adherence to antihypertensive regimens was found to contribute to inadequate control of blood pressure. The study is aimed to investigate the adherence to antihypertensives and factors affecting adherence among HD patients at non-governmental organisation (NGO) dialysis centres at the vicinity around Kuala Lumpur Methods: Cross-sectional surveys using questionnaires were conducted in five NGO dialysis centres and Statistical Package for the Social Sciences (SPSS) was employed to conduct all statistical analyses. Patients who took at least 80% of the prescribed antihypertensives were considered as adherent. Results: Two hundred and thirty-one respondents were interviewed; of which, 68% of patients were adherent. Patients’ socio-demographic characteristics did not show any correlation to their adherence (p>0.05). On the other hand, the setting of dialysis centres did influence drug adherence significantly (p=0.033). Medication cost influenced adherence in a way that those who received medication for free and who had no difficulty paying for their medications were more adherent when compared to their counterparts (p=0.004 and p=0.016, respectively). The number of prescribed medications also showed significant relationship with adherence (p=0.032). Furthermore, patients who did not experience major side effects from antihypertensives revealed better adherence (p=0.019). Conclusions: Adherence to antihypertensives was suboptimal among HD patients at the NGO dialysis centres studied. Thus, all potential barriers to adherence should be taken into consideration in the treatment of hypertension among these patients.

                  Outpatient Prescription Intervention Activities by Pharmacists in a Teaching Hospital

                    DOI: 10.52494/HJPB1043
                    by Chua Siew Siang, Kuan Mun Ni and Mohamed Noor bin Ramli.
                    Vol. 1 No. 3 (2003): Malaysian Journal of Pharmacy / Published: April 1, 2003
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                    Abstract

                    Prescriptions with prescribing errors received by an outpatient pharmacy of a teaching hospital were sampled. The types of pharmacist interventions on problematic prescriptions and its outcome were identified and documented. From a total of 6340 prescriptions processed by the outpatient pharmacy in a one-week period, 43 prescriptions (0.68%) required interventions by the pharmacy staff. These included 54% of the prescriptions that were incomplete or inadequately written (errors of omission) and 46% that contained the wrong drug, dose regimen, strength and dosage form (errors of commission). A total of 62 types of action were taken by the pharmacy staff to resolve the 43 problematic prescriptions. These include contacting the prescribers concerned (24.2%), clarifying with the patient or his/her representative (19.4%), contacting the prescriber’s nurse (17.7%) and checking the patient’s appointment or identity card (4.8%). Of the 43 problematic prescriptions, 48.8% were clarified without any change and dispensed while 32.6% were changed and dispensed. The study reinforces the importance of prescription screening and interventions by pharmacists in minimising preventable adverse events attributed to medication errors. It also emphasizes the necessity of interdisciplinary communication and cooperation in identifying and resolving prescribing errors and irregularities in order to achieve optimal therapeutic outcomes for the patient.

                    Awareness of Hepatitis A and Hepatitis B among Residents in Kuala Lumpur and Selangor

                      DOI: 10.52494/TQWM8592
                      by Ho Chiew Lim and Hesham Rashwan.
                      Vol. 1 No. 3 (2003): Malaysian Journal of Pharmacy / Published: April 1, 2003
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                      Abstract

                      A survey was carried out to assess the level of knowledge and vaccination coverage of hepatitis A and B among 753 subjects (>12 years of age) from rural areas, town areas, undergraduates and healthcare workers. The main objective of the study was to assess the relationship between the extent of hepatitis A and B knowledge and vaccination status of the participants. A questionnaire was distributed and completed by the subjects. The results showed that the overall level of knowledge among the public was low compared to healthcare workers and undergraduates. The hepatitis A vaccination coverage was very low among all the groups (<8%). The hepatitis B vaccination coverage was generally low among the groups of non- healthcare workers (<35%) and higher among healthcare workers (65.6%). There was a strong correlation between the extent of knowledge of hepatitis A and B and the status of vaccination among the participants (p<0.01). The study concluded that health education on hepatitis A and B should be provided and vaccination programmes should be held more frequently among the public, especially in rural areas.