Publications

Contraceptive Awareness, Knowledge and Attitude among Unmarried Young Adults in Malaysia

    DOI: 10.52494/RJMT2943
    by Mohd Hanif Zulfakar, Farida Islahudin and Nanthina Punniaseelan.
    Vol. 9 No. 1 (2023): Malaysian Journal of Pharmacy / Published: June 30, 2023
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    Abstract

    A lack of accurate sexual knowledge can lead to unwanted pregnancies, unsafe abortions, sexually transmitted diseases (STDs), substantial morbidity and social problems. The aim of this study was to determine awareness, knowledge and attitude toward contraceptives among unmarried young adults in Malaysia. A cross-sectional, survey-based study among unmarried young adults aged between 18-35 years was conducted. Of the 406 participants, male and female respondents were 20.4% (n=83), and 79.6% (n=323) respectively, with 406 (100%) aware of at least one contraceptive method. Overall, the mean total knowledge score obtained was 4.76 ± 2.90 (maximum knowledge score of 12). The total attitude score of the participants was 29.92 ± 4.12 (maximum score of 50). There was a significant positive correlation between knowledge and attitudes towards contraception (ρ=0.317, p=0.000). There is an urgent need to educate Malaysian youths about the importance of contraception for the prevention of unintended pregnancy and STDs.

    Focal Epilepsy in Pregnancy with Underlying Antiepileptic Drug Allergy: A Case Report

      DOI: 10.52494/ARGO7708
      by Ngah Kuan Chow, Lingeesh Balakirushnan and Vijayrama Rao Sambamoorthy.
      Vol. 9 No. 1 (2023): Malaysian Journal of Pharmacy / Published: June 30, 2023
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      Abstract

      Background: The first-line antiepileptic drugs (AED) approved for focal epilepsy are levetiracetam, carbamazepine, phenytoin, and zonisamide. Uncontrolled seizures can be caused by non-adherence, inadequate treatment, drug tolerance, or adverse drug reactions. In a resource-limited setting, a patient can run out of treatment options if having an AED allergy and is pregnant. Case presentation: A 24-year-old woman with temporal lobe epilepsy was admitted to the hospital due to a breakthrough seizure. Because of her allergy to carbamazepine, with contraindication of sodium valproate in pregnancy and women of childbearing age, clobazam was added to levetiracetam as her treatment regime for focal epilepsy. The patient has reduced seizure frequency since the commencement of clobazam treatment. Conclusion: Clobazam is feasible as an add-on treatment option for focal epilepsy in childbearing-age women with AED allergies. Future studies are needed to establish the safety and dosing adjustment of clobazam in pregnant women.

      PROCEEDINGS of 1st International Postgraduates Conference of Pharmaceutical and Health Sciences (IPCPHS) 2022

        DOI: 10.52494/YOXJ1358
        by Chan Siok Yee, Reem Abou Assi, Ibrahim M Abdulbaqi, Mohammed Zawiah, Nurzalina Abdul Karim Khan and Amer Hayat Khan.
        Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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        Abstract

        11th – 14th October 2022. Venue: Zoom Virtual Platform, School of Pharmaceutical Sciences, Universiti Sains Malaysia. Theme: 50th Anniversary of School of Pharmaceutical Sciences – Global Opportunities

        PROCEEDINGS of 28th Federation of Asian Pharmaceutical Associations, MPS-National Pharmacists Convention 2022

          DOI: 10.52494/JACT2738
          by Chan Siok Yee, Chua Siew Siang, Mai Chun Wai, Gan Siew Hua, Mohamad Haniki bin Nik Mohamed, Mohd Zulkefeli bin Mat Jusoh, Mohd bin Makmor and Bakry Paraidathathu Thomas A/L P.G. Thomas.
          Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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          Abstract

          10th – 12th November 2022, Venue: Kuala Lumpur Convention Centre, Malaysia
          Theme: Pharmacists Building a Better Healthcare System.

          Cyclosporine use in post haematopoietic stem cell transplant: Factors affecting the initial cyclosporine concentration and its association with acute graft-versus-host-disease

            DOI: 10.52494/RIPY4395
            by Choi Jing Herng, Nur Azrina Binti Muhamad Moosa, Suuria A/P Subramaniam, Lim V Co and Io Shir Hwa.
            Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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            Abstract

            Background: Cyclosporine (CSA) is required as a prophylaxis of graft-versus-host disease (GVHD) following allogeneic haematopoietic stem cell transplant (HSCT). However, subtherapeutic CSA concentration will increase the incidence of acute GVHD which is one of the major concerns. Objective: This study aims to identify the incidence of patients who achieved therapeutic initial CSA level with a standard intravenous CSA dose of 1.5 mg/kg BD, the occurrence of acute GVHD and factors associated with subtherapeutic CSA at the initial concentration in post-HSCT patients. Method: A retrospective single-centred study was conducted which involved 69 patients who underwent allogeneic HSCT between January 2020 and December 2020 in Hospital Ampang. The factors assessed were patients’ demographics, concurrent medications, liver and renal functions. Mann-Whitney test, Kruskal Wallis test and Spearman correlation test were used to identify the factors associated with sub-therapeutic CSA initial concentration. Result: 17.4% had therapeutic initial CSA level (200-400 ng/mL) and among 69 patients, 37.7% of them developed acute GVHD post-transplantation. Besides, only ethnicity and serum creatinine significantly affected the initial CSA levels. There was no significant association between the initial CSA level and the occurrence of acute GVHD. Conclusion: With the standard intravenous CSA dose of 1.5 mg/kg BD, only 17.4% were able to achieve a therapeutic initial CSA level due to the drug pharmacokinetic variability in different individuals. Hence, this study served as a baseline study for the future prospective clinical study to develop a population pharmacokinetic model in optimising the intravenous CSA dose to achieve the desired therapeutic range and improve the transplant outcomes.

            An Evaluation of Medication Adherence to Tyrosine Kinase Inhibitors Among Chronic Myeloid Leukemia Patients Underwent Medication Therapy Adherence Clinic in a Malaysian Tertiary Hospital

              DOI: 10.52494/maljpharmv8204
              by Stephanie Wai Yee Tan, Aisya Nabilah Abd Rahman, Chee Lan Lau, Dexter Van Dort, Farah Waheeda Tajurudin, Kiew Bing Pau, Lay Yen Gan, Mei Kuen Yin, Nur Jannah Azman, Nur Liyana Saharudin, Pooi Wan Mok, Poy Kei Lye, Rozita Mohd Idris, Sarah Anne Robert, Sheah Lin Ghan, Shue Hong Kong, Suet Yin Chin and Xin Yun Chua.
              Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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              Abstract

              Introduction: The treatment of chronic phase chronic myeloid leukemia (CML) has changed dramatically within the last two decades with the emergence of tyrosine kinase inhibitors (TKI). Treatment adherence to long-term TKI is pivotal to improving clinical outcomes in CML patients. Objective: To evaluate medication adherence to TKI and contributory variables affecting medication adherence among CML patients underwent Medication Therapy Adherence Clinic (MTAC). Method: This was a single-centre cross-sectional study conducted between January and December 2021. Malaysia Medication Adherence Assessment Tool (MyMAAT) was employed to assess medication adherence among CML MTAC patients. Descriptive statistics were used to summarise adherence information. Fisher’s exact test was performed to examine relationships between TKI adherence level, demographic and clinical variables. Result: Records of 41 patients (61% male, 39% female) at average age of 51 years old (range = 26 to 75) were analysed. They had been taking imatinib (48.8%) and nilotinib (51.2%) for an average of 6.3 years (range = 17 days to 18 years). Overall, 90% of the patients were adherent (MyMAAT score ≥ 54) to their TKI treatment (95% of patients on imatinib, 86% of patients on nilotinib). Medication adherence to TKI was not significantly influenced by demographic variables (i.e. age, gender) and clinical variables (i.e. years on TKI, number of TKI pills per day, type of TKI therapy). Conclusion: Majority of the CML MTAC patients (90%) were adherent to their TKI therapy. Adherence scores were not affected by the demographics and clinical variables investigated in this study. This affirms the role of pharmacists in implementing an individualised and comprehensive intervention strategy.

              Evaluation of the Impact of Clinical Pharmacists’ Educational Intervention on the Knowledge of Patients with Chronic Kidney Disease

                DOI: 10.52494/KWQH7710
                by Roland Nnaemeka Okoro, Ibrahim Ummate, John David Ohieku, Sani Ibn Yakubu and Maxwell Ogochukwu Adibe.
                Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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                Abstract

                Introduction: Chronic kidney disease (CKD) is a progressive disease associated with high morbidity and mortality at all stages. Objective: To determine the impact of pharmacists’ educational interventions on the CKD knowledge and knowledge levels of patients with pre-dialysis CKD, and to identify potential predictors of good CKD knowledge. Method: Two main healthcare facilities in Maiduguri, Nigeria, were the study settings for this randomised, controlled, prospective study with a 12-month follow-up. Participants were randomised to the usual care (UC) and pharmacists’ intervention (PI) groups on a 1:1 ratio. The PI group was offered usual care plus face-to-face CKD education and self-management of CKD, an educational CKD infographic leaflet, and telephonic interventions. Categorical data were compared using Chi-square or Fisher exact tests where relevant, while an independent sample T-test was used to compare the mean values of the two study groups. A p-value of less than 0.05 was considered to be statistically significant. Result: Baseline characteristics were similar between the PI (n = 73) and UC (n = 74) patients, although participants in the PI group were significantly more female (71.2% vs. 52.7%; p = 0.021). The overall mean knowledge score of the PI group was significantly higher than the UC group at 6 months (18.9 ± 3.4 vs.14.6 ± 4.4, p < 0.001), and at 12 months (19.5 ± 3.8 vs.16.8 ± 6.0, p < 0.001), respectively. At 6 months, a significant proportion of the participants in the intervention group had high knowledge compared with those in the UC group (16.4% vs. 9.0%, p < 0.001). At the end of the study, the adjusted analysis revealed that those between 40 and 64 years of age (AOR 26.3, 95% CI 2.1 – 331.0) and 65 years of age or more (AOR 10.1 95% CI 1.1 – 89.7) were more likely to have good CKD knowledge. Also, participants in the intervention group (AOR 2.7, 95% CI1.0 – 7.2) had a higher likelihood of having good CKD knowledge. Conclusion: Educational interventions provided by pharmacy students/clinical pharmacists resulted in significant improvements in the CKD knowledge of patients with pre-dialysis CKD.

                Systematic Review of Population Pharmacokinetic Models of Isoniazid in Children and Adults with Tuberculosis

                  DOI: 10.52494/DJIQ7058
                  by Wen Rui Tan, Siti Maisharah Sheikh Ghadzi, Irfhan Ali Hyder Ali and Sabariah Noor Harun.
                  Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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                  Abstract

                  Introduction: Isoniazid (INH) is one of the first-line anti-tuberculosis (anti-TB) drugs that have both bactericidal and bacteriostatic properties depending on the rate of mycobacterial growth. Several population pharmacokinetic (PPK) models of INH were established. This systemic review aims to summarise published PPK parameters of INH in the models and to identify covariates influencing the INH pharmacokinetic parameters of models. Method: A search of publications for PPK analyses of INH in volunteers or TB patients from 2011 to 2021 was conducted in PubMed and Scopus databases. Reviews, methodology articles, non-compartmental analysis, in vitro, and animal studies were excluded. Result: Twelve studies were included in this review. Most of the included studies described the pharmacokinetics of INH as two-compartmental with first-order absorption and elimination in most of the included studies. Eleven studies reported N-acetyltransferase 2 (NAT2) genotype polymorphism as the most common significant covariate affecting the pharmacokinetic parameters of INH. Other common significant covariates reported include body weight (n = 2) and body mass index (BMI) (n = 1). Conclusion: The variability of population clearance parameters of INH was explained mainly by the NAT2 genotype polymorphism. This indicates that to optimise and rationalise the dosing regimen of INH, a patient’s NAT2 genotype should be considered. At the same time, body weight and BMI values should be considered when making dosing adjustments for INH to achieve the therapeutic range.

                  The Paradigm shift of Pharmacy Profession at Post-COVID-19 Era in Malaysia

                    DOI: 10.52494/TIOG4999
                    by Long Chiau Ming and Chan Siok Yee.
                    Vol. 8 No. 2 (2022): Malaysian Journal of Pharmacy / Published: December 31, 2022
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                    Abstract

                    Malaysia currently has a total 19,260 registered pharmacists with active practising certificate which is regulated by the Pharmacy Board of Malaysia and relevant pharmacy laws and regulations. In tandem with the evolvement of medicine, pharmacists are responsible for ensuring the safe and effective use of medications, and they play a key role in providing healthcare to the public as a frontliner, educator and clinician. For instance, in community pharmacies, pharmacists dispense prescription and over-the-counter medications, compound extemporaneous preparation, provide medication, immunization, travel medicine and disease advice to patients, and offer other value added services such as medication adherence tool, blood pressure and blood glucose monitoring. It is worth noting that with the implementation of Regulation 23 of Poison Regulation as early as year 1952, dispensing separation have been fully implemented in all public hospitals whereby all supply of medications should be solely on prescription and the supply to be recorded, labelled and dispensed at the pharmacy. With medication dispensing as the core professional duties, hospital pharmacists are also responsible for the procurement, storage, and distribution of medications, as well as the preparation of radioactive diagnostic, cytotoxic drug and sterile products. They also actively involved in patient care, such as pharmacokinetics, pharmacotherapy services, medication therapy adherence clinic, medication reconciliation, reviewing medication orders and providing drug and poison information to healthcare professionals.

                    Price Variation Among Registered Brands of Anti-Cancer Medicines Available in Pakistan

                      DOI: 10.52494/EXVW6975
                      by Fiza Ayub, Kah Seng Lee, Khang Wen Goh, Muhammad Faisal Nadeem, Imtiaz Rabbani, Amal K Sulaiman and Tahir Mehmood Khan.
                      Vol. 8 No. 1 (2022): Malaysian Journal of Pharmacy / Published: June 30, 2022
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                      Abstract

                      The current study aims to explore the number of registered anticancer medicine in Pakistan and the price variation of these single-ingredient medicines. A data-based study was conducted between March 2021 and May 2021. Pharmaguide (Mobile Version 2020 – 2021), Druginfosys.com and Medicialstore.com.pk were used to derive the price of anticancer medications sold in Pakistan. The difference in minimum and maximum costs of each formulation was calculated, and the price variations in 81 anticancer medicines belonging to 14 different categories were analysed. There were 115 formulations registered for these 81 anticancer medications. Estimations in price difference revealed that topotecan (4mg / ml) had the highest price variation, while the lowest price variation of 4.01% was observed for abiraterone acetate (250mg). Price variations among different anti-cancer brands marketed in Pakistan are noticeable and substantial, therefore necessitating action from the drug regulatory authority of Pakistan, not only to gain awareness on this issue, but also to set pricing thresholds to make the prices of anti-cancer medications more affordable. In addition, external reference pricing and reimbursement programs partially sponsored by the government or insurance companies can be a possible way to control the price variation of anti-cancer drugs.