Buletin Farmasi 11/2013
Buletin Farmasi 11/2013
Buletin Farmasi 11/2013
PHARMACY BULLETIN
MTAC??
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While
known function of the pharmacist, pharmaciststhrough counseling, medication therapy management (MTM), disease -state management , and other meanscan play a pivotal role in patient care. There are opportunities in every type of pharmacy practice to improve patients adherence and therapeutic outcomes, and pharmacists must embrace and act on them. Many factors dictate a patients medication adherence, and each patient is unique. The pharmacist must approach each patient individually to determine the level of adherence and what barriers may exist that are preventing the patient from taking his or her medication appropriately. Education, while helpful, is usually not enough to persuade the patient to comply with the physicians drug orders. Information must be presented in clear, easy-to-understand language, and the patient must understand not only the benefits of adherence, but the repercussions of non-adherence. Also, positive reinforcement goes a long way; patients who feel empowered and cared for are more apt to play an active role in their treatment. Dosing simplification and minimization of
adverse effects are extremely successful strategies for improving adherence. When filling a prescription, the pharmacist should do a quick review to see whether the dosing schedule is as simple as possible. The pharmacist should inquire frequently about any adverse effects the patient is experiencing and then consult the physician regarding suggested alternatives. Preparing a dosing card containing only the most essential elements of the patients medications can be highly beneficial. Including the name of the pill, an image (if possible), the condition it is for, and time of day taken can be extremely helpful for patients who take many medications or who have cognitive barriers. Reminder calls, texts, or e-mails are helpful for many patients, especially those with busy lifestyles. Automatic refills are a useful strategy. Small details, like splitting a patients pills when necessary and providing easy-off caps, can be beneficial. Whatever the barriers to adherence may be, the only way to assess them is to talk to the patient. The pharmacist needs to be diligent about including the patient in the treatment experience. The more trust the patient has in the pharmacist, the more he or she will open up and disclose any apprehensions or difficulties about taking his or her medication. Only then can the pharmacist play an integral role in improving a patients adherence.
Among the types of MTAC offered are:
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P H A R M A CY B U L L E T I N
Re-educating
patients, further study of the effects of pharmacist communication, and updating pharmacy education curriculum are changes that can facilitate effective pharmacistpatient communication in the future. Several organizations emphasize the need to educate the public about the expanding role of pharmacists. Pharmacists surveyed for the Boehringer Ingelheim study noted the need to re-educate the public about the services pharmacies are providing, and to change their view of pharmacy from a pill dispensary to a source of medication information. And a 2006 policy brief from the Center for Health Improvement, based on surveys and studies of California pharmacists, stresses the need to educate patients about the changing practice of pharmacy so that patients will learn to rely on pharmacists for medication and health information. More data and documentation, as well as
updating pharmacy curriculum, can also provide pharmacists with information that will help them move communication and education efforts forward. Many organizations and researchers call for more studies to document evidence that pharmacist intervention does decrease rate of errors, and increase medication adherence. NCPIE calls on the federal government to begin collecting information on medication management and adherence intervention best practices. NCPIE also suggests that colleges of pharmacy and continuing education programs adopt curriculum on patient adherence management, train faculty apropriately, and include patient adherence management as a graduation competency.
Classification Of Contraception
Classification Oral Hormonal Combined OCP Progestrogen only pill (POP) Non Oral Progestrogen IM depo Depo Provera Progestrogen implant Implanon Levonorgestrel IUCD Copper IUCD Barrier methods Spermicide Lactational amenorrhoea Sterilisation Non Hormonal -
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P H A R M A CY B U L L E T I N
Role of Pharmacist
1. Make sure patient receive both verbal and written instructions on the chosen method of contraception. 2.Advice on dosage and administration (missed dose).
3. Educate patient on possible side effects, ways to identify and manage to improve compliance.
4.Advise for annual blood pressure monitoring & clinical problems possibly relating to the CHC (e.g., breakthrough bleeding, amenorrhea, weight gain, and acne).
Reference 1. 2. 3. Combined Oral Contraceptives, http://www.moh.gov.bh/PDF/MCHnewsLetter/English-OCP.pdf Contraception and Lactation, Joyce King , J Midwifery Womens Health. 2007;52(6):614-620. The Efficacy of Intrauterine Devices for Emergency Contraception, Kelly Cleland, Haoping Zhu, Norman Goldstuck, Linan Cheng, James Trussel Hum Reprod. 2012;27(7):1994-2000.
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Are health workers at risk from MERS-CoV? Yes. Transmission has occurred in health care facilities, including spread from patients to health care providers. WHO recommends that health care workers consistently apply appropriate infection prevention and control measures. Infection control measures & how to implement Standard precautions hand hygiene and use of personal protective equipment (PPE) to avoid direct contact with patients blood, body fluids, secretions (including respiratory secretions) and non -intact skin when providing care in close contact with a patient with respiratory symptoms (e.g. coughing or sneezing), use eye protection, because sprays of secretions may occur prevention of needle-stick or sharps injury safe waste management cleaning and disinfection of equipment Apply routinely in all health-care settings for all patients. Droplet precautions Use a medical mask if working within 1 m of the patient Place patients in single rooms, or group together those with the same etiological diagnosis. If an etiological diagnosis is not possible, group patients with similar clinical diagnosis and based on epidemiological risk factors, with a spatial separation of at least 1 m. Limit patient movement and ensure that patients wear medical masks when outside their rooms. Airborne precautions Ensure that healthcare workers performing aerosol generating procedures use PPE, including gloves, long-sleeved gowns, eye protection and particulate respirators (N95 or equivalent). Whenever possible, use adequately ventilated single rooms when performing aerosol-generating procedures. Is MERS-CoV like SARS? SARS is a coronavirus that was identified in 2003 and is distantly related to MERS-CoV. However, although both viruses are capable of causing severe disease, current information indicates that they have key differences. Most importantly, MERS-CoV does not appear to transmit easily between people whereas the SARS virus was much more transmissible. Are there any travel or trade restrictions related to this new virus? No. WHO does not recommend any travel or trade restrictions with respect to MERS-CoV. WHO will continue to review all recommendations as more information becomes available.
Reference: Source: http://www.who.int/csr/disease/coronavirus_infections/en/index.html (as of 17 July 2013).Information will be updated from time to time based on the WHO website.
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P H A R M A CY B U L L E T I N
A doctor is to give a speech at the local AMA dinner. He jots down notes for his speech. Unfortunately, when he stands in front of his colleagues later that night, he finds that he can't read his notes. So he asks, "Is there a pharmacist in the house?"
A customer gets a topical cream. Pharmacist : Apply locally two times a day. Customer : I can't apply locally, I'm going overseas."
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Authors Nur Shuhada Shamsuri Siti Najlaa Izzatie Mohammed Marzhuki Normala Harom Muhammad Azwann bin Ambak
CONTACT US Address: Pharmacy Department Hospital Jeli, 17600 Jeli, Kelantan. Tel: 09-9443300 Fax:09-9440014 Outpatient/Inpatient Ext: 3335/3336/3338 Store Ext: 3313/3316