Volume 3 | Issue 2 | June-Dec 2020 A BULLETIN OF PHARMACY DEPARTMENT | DRUG & POISON INFORMATION SERVICES SULTAN AHMAD SHAH MEDICAL CENTRE @IIUM الصيدليه F e a t u r e A r t i c l e s i n T h i s I s s u e Introducing MIMS Monsel’s Solution: A Classical Styptic Tips for Storing Your Medicine Safely Your Gateway to Clinical Knowledge Resources Did You Know? Page Page Page SASMEC @IIUM Staff has unlimited access to MIMS Gateway Website!
T A B L E O F CONTENTS 3 EDITORIAL TEAM Cover Story Introducing MIMS 5 Pharma Focus Monsel’s Solution: A Classical Styptic 6 Pharmacy Education Tips for Storing Your Medicine Safely 8 Pharmacy in Action Events from June – December 2020 9 Quiz! As-Saydaliah’s Quiz: Prizes to be won! Copyright Disclaimer and Fair Use Statement © 2018-2020 The Department of Pharmacy, Sultan Ahmad Shah Medical Centre (SASMEC @IIUM) all rights reserved. Copyright and other intellectual property rights in this bulletin belongs to the Department of Pharmacy, SASMEC @IIUM. This bulletin may contain copyrighted material, the use of which may not have been specifically authorised by the copyright owner. However, these material is included in an effort to explain issues relevant to the topic presented or to illustrate the content. There is no profit gain or commercial value intended in this publication. The SASMEC @IIUM also authorises healthcare organisations to reproduce any material in this bulletin for educational and non-commercial use only. The references is not included in this issue however, it is available if request is made to the editor. ADVISOR Che Rokiah Ismail Norhasila Hassim Raihah Bt Abd Rahim EDITOR Fatin Azzyati Pakururazi ASSISTANT EDITOR COLUMNIST DESIGNER Fatin Azzyati Pakururazi Ahmad Farhan Bin Ismail Noor Emilia Syakira Bt Azmirul Hazan Fatin Azzyati Pakururazi We are here to help you! Customer Care Form
The Monthly Index of Medical Specialities or MIMS is a pharmaceutical prescribing reference guide published in the United Kingdom since 1959. Initially, the guide contains information about branded and generic drugs in the UK formulary. The print title is published quarterly, freely available to all practice-based UK general practitioners, and on a paid basis to subscribers. Today, MIMS is offered globally and accessible through varieties of products. It has become one of the world’s leading providers of drug information and educational content to healthcare professionals, patients and consumers. We are extremely pleased to announce that SASMEC @IIUM has subscribed several products from MIMS. This subscription allows all SASMEC @IIUM staff to enjoy unlimited access to : Just log in to https://online1.mimsgateway.com.my/ or download the apps on Google Playstore and Apple Store Username: [email protected] Password: password1 Author: Fatin Azzyati Pakururazi Website & Mobile Apps &
MIMS Gateway MIMS Gateway unites essential clinical resources under one platform allowing for ease of searching and discovering related information from a variety of sources. Not only does this save time, but it also promotes usage of the resources which allows healthcare team to be better informed of local policies and guidelines as well as safety alerts. A website and mobile apps powered by MIMS Drug Information About MIMS Gateway MIMS Integrated Other Services Interface Overview Search Function Clinical Intelligence Dashboard Quick Links – Decision Support Modules Quick Links – Browse Categories Quick Links – Others Quick Search Panel We wish all SASMEC @IIUM healthcare professionals take advantage of this subscription and use this application as much as possible
MIMS Integrated Clinical Decision Support Tools About MIMS Gateway MIMS Integrated Other Services Interface Overview This module is exclusively subscribed for doctors. While human error is unavoidable, it can be prevented. MIMS Integrated is a clinical decision support modules that is embedded into SASMEC @IIUM’s i-pesakit system to assist healthcare professionals in making informed decisions at the point-of-care. It also provides comprehensive prescription screening tools for automatic detection of possible medication errors. An icon like this will pop-out if system detects potential errors. Module Information Drug Info Up-to-date prescribing information on pharmaceutical product Drug Alert Detects significant drug-drug interactions. Provides severity and documentation levels as filtering parameters Drug Duplicate Alert Detects therapeutic duplication against prescribed medications Detects if prescribed medicines have adverse effect on pregnant women and foetus, as well as women of childbearing age Drug Pregnancy Alert STEP STEP STEP STEP Drug Lactation Alert Drug Health Alert Detects if prescribed medicines have adverse effect on nursing mothers and infants Detects drugs and health issue interactions by comparing patient’s diagnosis profile against prescribed medications
Monsel’sSolution: A CLASSICAL STYPTIC Monsel’s Solution is a drug that acts as a styptic or hemostatic agent to control haemorrhage, usually after superficial skin biopsies. It was discovered by a pharmacist in the French army, Leon Monsel who pioneered the use of ferric subsulfate for its styptic qualities in the late 1840s. His discovery soon became a standard in the French Corps, which saved many lives during battles of the French Army. The United States Pharmacopeia soon included his solution in 1863. Monsel prepared his solution by oxidizing ferrous sulfate with nitric acid in the presence of additional sulfuric acid, and thus remains very acidic. Later in the 19th century, a pharmacologist, W. Proctor developed a less acidic Monsel’s solution and coined the term ferric subsulfate, which has survived to date. Nowadays, Monsel’s solution is made up to 20% aqueous ferric subsulfate, and it has subsequently gained popularity. It remained useful to gynaecologists, in which they consider it indispensable in most colposcopy clinics due to its excellent and rapid haemostatic qualities. Besides, it is also used during cervical biopsies and excisional procedures, dermatologists for punch biopsies and topical hemostatic agent for minor surgical procedures. The haemostasis action of Monsel’s Solution is depend on the oxidation capacity of the subsulfate group and the agglutination of blood proteins. When the solution was brought into contact with a small amount of blood, it triggers coagulation, favours fibrin formation and thus develop plugs. The membrane of the coagulated protein and the superficial crusts then seal the small blood vessels. However, the relatively superficial crust produced by styptic solutions does not arrest bleeding from larger vessels. Author: Ahmad Farhan Bin Ismail
The steps on how to apply Monsel’s solution is easy and simple: 1. Clean bleeding site and apply local pressure 2. Insert cotton swab into Monsel’s solution and stir to mix 3. Apply cotton swab to the bleeding site Monsel’s solution has several advantages over more commonly used haemostatic agents/methods. Unlike electrocautery, silver nitrate, and suture, its application is usually painless, even when no anaesthetic is used. Jetmore et al. reported that its use in haemostasis after clot extraction from thrombosed external haemorrhoids, is as effective, less painful, and less expensive than either silver nitrate or electrocautery. They also note that not only the application of Monsel’s is faster and simpler than stitching, but postoperative haemorrhage is decreased, and patient experienced less cervical stenosis and have less secondary surgery performed for menstrual disorders or inadequate follow-up colposcopy when Monsel’s solution alone is used. However, the use of Monsel’s solution is not without drawbacks. It may lead to deposition of ferric salts (ferrugination) within fibrin, dermal collagen and striated muscle, which may cause refractory pigmentation of skin following its usage and an inflammatory reaction that may persist for weeks at the site of damage. This solution also produces artifacts which can be troublesome if re-biopsy of a lesion is necessary. Histologically, it is associated with ferrugination of fibrin, dermal collagen, and striated muscle fibers. In conclusion, most evidence for the efficacy of Monsel’s solution is still anecdotal. A well-designed, specialty-specific trials regarding the use of topical haemostatic agents remain scarce, but a growing body of pivotal support exists in many literature.
Tips for Storing Your Medicine Safely In this issue, I wanted to talk to you about something that literally only takes five minutes, but has the potential to save your child’s life. Lots of us are not always storing our medicine safely. And that is not an exaggeration. Every year, 60,000 kids go to the U.S. emergency room due to accidental medicine ingestion1 . That is FOUR bus loads of kids every day! All medicines have the potential to be dangerous regardless of whether they are purchased over-thecounter (OTC) or obtained by prescription. Always check the labels from the leaflet of medication or the medicine’s packaging. If medication products are not stored properly, the potency and expiration time of the product may be affected. According to SafeKids1 , “half of the 2 million calls to poison control centers in 2011 were for exposures and ingestions among kids 5 and under.” We want those numbers to be much lower! Author: Noor Emilia Syakira Bt Azmirul Hazan
5. Never hesitate to ask your pharmacist about any specific storage instructions. 1. Read the label for any storage instructions. 2. You must understand that heat, air, light, and moisture can harm your medicine. 3. Store your medicine at a room temperature and at dry place. 4. Always keep medicine in its original container.
Staff Competency Exam 11 August 2020 Stock Take Briefing/Quiz 04 December 2020 SIRIM Stage 2 External Audit 09-13 November 2020 1 st Prize for Smile & Salam Video Competition 14 September 2020
“ 11 Pharmacy QUIZ! Ans w e r t h e s e qu e s t io ns a n d s ta n d a c h a n c e t o w i n w o n d e r f u l pr ize s ! Scan to answer the QUIZ! MIMS is an abbreviation for? What are the 2 types of MIMS product that SASMEC @IIUM has subscribed? What is the content of today’s Monsel Solution? Heat, oxygen, sunshine and water can harm your medicine. Yes or No? Treat yourself to a cookie break with Famous Amos®!
DRUG & POISON INFORMATION SERVICES (DIS) PHARMACY DEPARTMENT, SULTAN AHMAD SHAH MEDICAL CENTRE @IIUM Phone: +609 - 59112672 / 2558 Email: [email protected] We'd love to hear your thoughts! To err is human; to edit, divine.