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3 | BILANGAN PERTANYAAN YANG DITERIMA | BILANGAN PENGAJU PERTANYAAN | |||||||||||||||||||||||||
4 | Keracunan / Ketoksikan [i] | Dos / Administrasi [ii] | Kesan Sampingan [iii] | Indikasi [iv] | Interaksi [v] | Kontraindikasi [vi] | Farmakokinetik [vii] | TPN [viii] | Pharmaceutical Availability [ix] | Pharmaceutical Compatibility [x] | Pharmaceutical Identification [xi] | Maklumat Am Produk [xii] | Lain-lain [xiii] | Profesional Kesihatan | Pesakit/ Orang Awam | ||||||||||||
5 | NUMBER | DATE | QUESTION | REQUESTOR | ANSWER | ANSWERED BY | SOURCE | KKM | Bukan KKM | ||||||||||||||||||
6 | JANUARY | 1 | 04/01/2016 | Augmentin dose for syrup | Dr Salwa ORL | 15-25mg/kg BD | Balqis | Frank Shann. | 1 | 1 | |||||||||||||||||
7 | 2 | 12/01/2016 | Stability of augmentin syrup once diluted | Dr Salwa ORL | Reconstituted suspensions should be stored in a fridge (2-8c) and used within 7 days. | Balqis | product leaflet | 1 | 1 | ||||||||||||||||||
8 | 3 | 13/01/2016 | What is the regime of Valganciclovir in CMV Retinitis? | Puan Zaiton | 900mg BD for the first 3 weeks, followed by 900mg OD thereafter. Treatment may be continued for months or lifelong. Discontinuation of prophylaxis may be considered in patients with a sustained (e.g., greater than three- to six-month) increase in CD4 cell count to greater than 100-150 cells/mm3 on HAART | Shiau Mei | Micromedex, Infectious Society of America | 1 | 1 | ||||||||||||||||||
9 | 4 | 14/01/2016 | What is the maximum infusion rate for aminophylline? | Jonathan Yee | 20-25mg/min | Shiau Mei | Product leaflet, Dilution Protocol Hospital Selayang | 1 | 1 | ||||||||||||||||||
10 | 5 | 15/01/2016 | Dose Cloxacillin syrup | Dr Salwa ORL | 15mg/kg qid | Balqis | Frank shann | 1 | 1 | ||||||||||||||||||
11 | 6 | 19/01/2016 | What time should Micardis OD be administered? Patient claimed feeling dizzy if taken in the morning but is comfortable when taking dose at night. | SN Ayu (MOPD) | According to Medscape,bedtime dosing of telmisartan was recommended. As opposed to morning dosing, bedtime dosing improved the sleep time-relative BP decline towards a more dipper pattern without loss in 24-h efficacy, and achieve significantly better nocturnal BP regulation. The findings indicate that the dosing time of telmisartan can be chosen according to the dipper status of a patient. Further studies are needed to address whether age status may influence administration time-dependent effects of telmisartan on BP control in hypertensive patients. However in Malaysia Hospital Settings, anti-hypertensives are still being adviced to be taken in the morning. If patient is more comfortable when taken at night, it can be administered at night. Do make sure the dose is taken consistently at the same time each day. | Shiau Mei | http://www.medscape.org/viewarticle/584529_5 | 1 | 1 | ||||||||||||||||||
12 | 7 | 19/01/2016 | What is the minimum administration duration for Betaserc? | Puan Shafinaz | There is no exact research or guidelines on how long should it be given. However according to the product leaflet, the improvement of symptoms may take up to 2 weeks and that the best results are sometimes obtained only after a few months. Dose will be adjusted according to patient's response to the medication. | Shiau Mei | Betaserc product leaflet | 1 | 1 | ||||||||||||||||||
13 | 8 | 19/01/2016 | What's the dose for Syp. Cefuroxime? | Dr Pua (ENT) | 10-15mg/kg BD | Shiau Mei | Frank Shann | 1 | 1 | ||||||||||||||||||
14 | 9 | 20/01/2016 | Why is hydrocortisone tablet given at 7am and 2pm? | Szee Sin | Our physiological cortisol secretion is the highest in the morning, intermediate in the afternoon and lowest at night. It is suggested that one-half or two-thirds of the daily dose is administered in the morning to mimic this diurnal secretion of cortisol. The second dose should be administered 6-8 hours following the first dose. | Shiau Mei | 1) Lennernäs, H., S. Skrtic, and G. Johannsson. "Replacement therapy of oral hydrocortisone in adrenal insufficiency: the influence of gastrointestinal factors." Expert opinion on drug metabolism & toxicology 4.6 (2008): 749. 2)Drug Information Handbook 3)BNF | 1 | 1 | ||||||||||||||||||
15 | 10 | 15/01/2016 | Is BCG supplied with diluent | Sister | Yes, BCG vaccine supplied with its diluent | Shiau Mei | Product Leaflet | 1 | 1 | ||||||||||||||||||
16 | 11 | 19/01/2016 | Dose of Ciprofloxacin for osteomyelitis | Dr Velman ortho | 500-75mg BD 4-6wks | Balqis | Drug Information Handbook | 1 | 1 | ||||||||||||||||||
17 | 12 | 19/01/2016 | Drug interaction between mefenamic acid and ciprofloxacin | Dr Velman ortho | the levels of ciprofloxacin will be increased, and the effects as well. Degree of interaction: not major. So can use together | Balqis | Drug Information Handbook, micromedex app | 1 | 1 | ||||||||||||||||||
18 | 13 | 22/01/2016 | Salbutamol syrup can be given for <2 yrs old? | Pn Zuhailah | Can, but preferred inhalation neb. Dose: 0.1mg/kg | Balqis | BNF for Children | 1 | 1 | 1 | |||||||||||||||||
19 | 14 | 22/01/2016 | Why need to monitor usage of Ketotop as JKUT ortho | Zaili | because need to know how much to charge under ortho budget and how many usage/month. Ketotop is under rehab as well. | Balqis | JKUT Meeting | 1 | 1 | ||||||||||||||||||
20 | 15 | 22/01/2016 | What is the antihistamine available for klinik warga and which one is better | En Shahrul Latihan | Chlorpheniramine and Cetirizine. Cetirizine is better since it doesn’t cause drowsiness | Balqis | 1 | 1 | |||||||||||||||||||
21 | 16 | 22/01/2016 | To double confirm DVT dose for S/C Enoxaparin for patient with 36.4kg | Dr. Karen Loo | 1mg/kg q12h or 1.5m/kg OD. Advised Dr. to supply 40mg BD. | 1 | |||||||||||||||||||||
22 | 17 | 27/01/2016 | Is Restasis Ophthalmic Suspension listed in KKMFU? How to bring it into HSAS formulary? | Dr Fariza | Restasis (Cyclosporine) ophthalmic suspension has been listed in KKMFU and it is a registered product. Can apply for JKTU item if the indication of usage is the same with the one listed in KKMFU. | Shiau Mei | KKMFU, Mims Gateway | 1 | 1 | ||||||||||||||||||
23 | 18 | 28/01/2016 | How to dilute IV GTN? | SN Liza (10B) | IV GTN can be diluted in NS or Dextrose BP (D5). 50mg of GTN should be diluted in 250-500mL (100-200mcg/mL) of diluent. Max concentration 100mg in 250mL (400mcg/mL). | Shiau Mei | Product leaflet, Dilution Protocol Hospital Selayang and HsgB. | 1 | 1 | ||||||||||||||||||
24 | 19 | 28/01/2016 | A 9-year-old patient (weigh 25kg) with UTI. What is the antibioitic in syrup that is available in HSAS for the treatment? | Dr Ili (9A) | Syrup Bactrim (Sulphamethoxazole 200 mg + Trimethoprim 40 mg/5 ml Syrup). Doses based on TMP 4mg/kg BD for 5-7 days. | Shiau Mei | Sanford antibiotic guidelines, Frank Shann Drug Doses | 1 | 1 | ||||||||||||||||||
25 | 20 | 28/01/2016 | How to dilute IV Phentoin 25mg for a 1-year-old patient? | SN Norashikin (Paeds Ward 7501) | Dilute 2.5 mL (125mg) of IV Phenytoin in 50mL of normal saline to get a concentration of 2.5mg/mL admixture. Then administer 10ml of admixture of patient in a rate not exceeding 1-3mg/kg/min. | Shiau Mei | Product Leaflet (Dilantin), Dilution protocol Hospital Selayang | 1 | 1 | ||||||||||||||||||
26 | 21 | 29/01/2016 | Dose for Venofer | Thaarani | Individualised dosage. ADULT and ELDERLY: Cumulative dose is to be administered in single doses of 100 - 200 mg of iron 2 - 3 times weekly depending on Hb level. By IV drip infusion, slow IV injection or directly into the venous limb of the dialyser. Total cumulative dose: 1000 mg | Balqis | MIMS Gateway. | 1 | 1 | ||||||||||||||||||
27 | 22 | 26/01/2016 | Dose Tamiflu for Kids | Zuhailah | Neonates: 2mg/kg od, Child 1-3mo: 2.5mg/kg od for 10 days. | Balqis | BNF for Children | 1 | 1 | ||||||||||||||||||
28 | 23 | 26/01/2016 | BCG Diluent supplied by EISAI company same like normal saline? | Pn Zaiton | Same. | Balqis | Email from DKSH pharmacist. | 1 | 1 | ||||||||||||||||||
29 | 24 | 29/01/2016 | Patient has fever for 10/7 and was admitted yesterday. He has been diagnosed with dengue fever and trasaminitis (deranged AST and ALT). Can Azithromycin still be given to patient for atypical infection? | Dr Thasneem | Upon further investigation, no C and S test was done and patient is still having fever spike. Suggested doctor that Azithromycin can cause hepatotoxicy and is not recommended to be started in patient. If there is a really need of antibiotic for the suspected atpical infection, T. Doxycycline 100mg BD can be given to patient. However, it is reported that RARE cases of hepatotoxity have been reported for doxyclyline as well. Suggested to monitor patient's liver function closely and to discontinue the regime if there is further deterioration of patient's liver function. | Shiau Mei | Micromedex, Drug Information Handbook, Livertox.com | 1 | 1 | ||||||||||||||||||
30 | 25 | 29/01/2019 | Metolazone 2.5mg needs import permit? | Thaarani | Yes | Balqis | Pharmacy.gov.my | 1 | 1 | ||||||||||||||||||
31 | 26 | 30/01/2016 | How to administer inj tranexamic acid | SN 8A | By slow IV bolus over 10-15min | Zuhailah | Drug Information Handbook | 1 | 1 | ||||||||||||||||||
32 | 27 | 30/01/2016 | What is the stability of Frenin (Phenylephrine) injection after dilution and also when stored in syringe? | Jonathan Yee | According to Ms Yap, pharmacist from Evertrad (Supplier for Frenin to M.S. Ally), there is no stability studies regarding Frenin after dilution. Frenin contains sodium metabisulfite and EDTA as their antioxidant agents which do not possess antibacterial properties. Hence, it is recommended to use immediately after reconstitution/dilution. | Shiau Mei | Ms. Yap, pharmacist of Evertrad Sdn. Bhd (03-78034385) | 1 | 1 | ||||||||||||||||||
33 | 28 | 30/01/2016 | Regimen to administer inj sodium bicarbonate 160mEq (Pt weight 70 kg, acidosis) | Dr Jeremy | 160mEq administered over 4 hours (40mEq per hour x 4 hours) | Zuhailah | Drug Information Handbook | 1 | 1 | ||||||||||||||||||
34 | FEBRUARY | 29 | 01/02/2016 | Dose for chloral hydrate? | Dr Salwa ORL | CHILD : Neonate: 30-50 mg/kg; up to 100 mg/kg may be used with respiratory monitoring. 1 mth-12 yr: 30-50 mg/kg (max: 1 g); up to 100 mg/kg (max: 2 g) may be used; | Balqis | KKM Formulary | 1 | 1 | |||||||||||||||||
35 | 30 | 01/02/2016 | Strength of chloral hydrate | Dr Salwa ORL | 200mg/5ml | Balqis | KKM Formulary | 1 | 1 | ||||||||||||||||||
36 | 31 | 01/02/2016 | Interactions warfarin with calcium, folic acid, iron, lecithin, magnesium, phosphorus, sodium, vitamin A, Vitamin B complex, Vitamin C, Warfarin ,Zinc | Ching Szee sin | Adverse Effect: Warfarin sodium has its effect reduced by Vitamin C Actions to be Taken: 1. Use combination with caution. 2. Adjust dose of drug. 3. Monitor INR. Adverse Effect: Calcium may decrease the absorption of Iron Actions to be Taken: 1. Use combination with caution. Adverse Effect: Calcium may decrease the absorption of Zinc Actions to be Taken: 1. Clinical significance not established; be alert for evidence of interaction. 2. Administer drugs separately. 2. Administer drugs separately. | Balqis | Mims Gateway | 1 | |||||||||||||||||||
37 | 32 | 01/02/2016 | Stability of Actrapid vial once opened and then refrigeted? | Abez | The in-use shelf life is 6 weeks when stored below 25 degree or 4 weeks when stored below 30 degrees. | Balqis | Product leaflet | 1 | 1 | ||||||||||||||||||
38 | 33 | 01/02/2016 | How to bath baby with Chlorhexdine 4% Scrub? | SN Edaziana NICU | Wet Hands with water, apply 5 ml of Chlorhexidin e4 % soln, , wash for 3 min, then rinse and dry. | Balqis Abez | Product leaflet medscape | 1 | 1 | ||||||||||||||||||
39 | 34 | 01/02/2016 | Differences between modofied relase, extended relase and controlle drelease formulations: | Izzati | Modified release: Dosage forms can be designed to modify the release of the drug over a given time or after the dosage form reaches the required location. Extended-release systems allow for the drug to be released over prolonged time periods. Controlled-release systems also offer a sustained-release profile but, in contrast to sustained-release forms, controlled-release systems are designed to lead to predictably constant plasma concentrations, independently of the biological environment of the application site | Balqis | https://www.pharmpress.com/files/docs/FT_Pharmaceutics_Drug_Delivery_sample.pdf | 1 | 1 | ||||||||||||||||||
40 | 35 | 02/02/2016 | Ranitidine tab to order mg in system. Can it be cut | Dr Lok | Can cut, asked IT to add mg in prescribing unit | Balqis | Leaflet, IT. | 1 | 1 | ||||||||||||||||||
41 | 36 | 02/02/2016 | How to know if a medicine needs KPK approval? | Zaili | Check if it is: a) registered b)in FUKKM c)different indication with FUKKM | Shiau Mei | KPK form (Pindaan 3.1) | 1 | 1 | ||||||||||||||||||
42 | 37 | 04/02/2016 | How to use alkaline nasal douche | Devi | 1/2 Table spoon mix with 1 glass of water. Syringe 20ml of water then flush inside the nose. Dinasihatkan tunduk dan bukak mulut | Balqis | Bottle labeled from manufacturing | 1 | 1 | ||||||||||||||||||
43 | 38 | 06/02/2016 | Loratadine pregnancy cateory? Can be used in pregnant lady? | Dr Ward 9B | Category B. Can be used in pregnancy | Balqis | Mims | 1 | 1 | 1 | |||||||||||||||||
44 | 39 | 06/02/2016 | Dilution for Amiodarone loading dose | SN 10B | Loading dose: Dilute into 50ml-100ml D5, run over 20 minutes to 2 hours (usually 1 hour). | Balqis | Dilution Protocol Selayang Hosp | 1 | 1 | ||||||||||||||||||
45 | 40 | 10/02/2016 | Does Perindoril cause postural hypotension? | Dr Jasmine | Symptomatic hypotension can occur with or witout syncope with ACE Inhibitors. Adverse drug reactions of Perindoril: rare but important; orthostatic hypotension. | Balqis | Drug Information Handbook | 1 | 1 | ||||||||||||||||||
46 | 41 | 15/02/2016 | How to order 10mL BD of sodium bicarbonate in eHIS? It is given for CKD. | Dr Husain (10B) | Need to be ordered according to grams and not mL. 1g of sodium bicarbonate powder equals to 12mEq of sodium and bicarbonate ions. For CKD patients, to start with 20-36 mEq in divided doses, titrate to bicarbonate level of 18-20 mEq/L. | Shiau Mei | Drugs. Com, Drug Information Handbook | 1 | 1 | ||||||||||||||||||
47 | 42 | 15/02/2016 | What is the renal adjusted dose of Cefotaxime for sepsis in neonates? Patient is Day 2 of life, Serum creatinine 138umol/L, 1.92kg, Length: 42cm. | Dr Kah Jin (NICU) | Calculated creatinine clearance using Schwartz equation, CrCl=11.8 ml/min. When CrCl<20ml/min, the dose should be reduced by 50%. From Micromedex, normal dose is 50mg/kg BD. Hence, suggest 25mg/kg BD. | Shiau Mei | Micromedex | 1 | 1 | ||||||||||||||||||
48 | 43 | 16/02/2016 | Neonates who mother positif Hepatitis B, what to inject during birth, duration of injection post exposure? | Sister Rukidah | Hepatitis B immune globulin (HBIG) should be administered (brand Hepabig). Should be injected within 12 hours post delivery. | Balqis | Product leaflet | 1 | 1 | ||||||||||||||||||
49 | 44 | 16/02/2016 | How is IV promethazine administered? | SN Lisa (10B) | IM: (preferred route) undiluted. If given IV: Dilute in 1 ampoule in 20mL NS over 10-15min. Administration rate must not exceed 25mg/min. Note: Severe tissue damage may occur with IV route | Shiau Mei | Dilution Protocol Selayang Hosp | 1 | 1 | ||||||||||||||||||
50 | 45 | 16/02/2016 | How is IV Tranexamic be given? | SN Azreena (9B) | It is administered by slow IV: Administer undiluted over 5-10minutes (1ml/min) | Shiau Mei | Dilution Protocol Selayang Hosp | 1 | 1 | ||||||||||||||||||
51 | 46 | 16/02/2016 | What is the dose of Acyclovir for a 5-year-old patient with chicken pox? Weight: 19kg | Dr. Gurjeet (ED) | 400mg QID x 5 days | Shiau Mei | Product leaflet, MIMS Gateway | 1 | 1 | ||||||||||||||||||
52 | 47 | 18/02/2016 | Do we have other volume for Lignocaine injection (Plastic ampoule)? Has the stock problem been solved? | Dr Syarifah ICU | There is only one volume available for Injection Lignocaine (plastic ampoule) and the stock issues have been resolved. | Shiau Mei | In patient pharmacy (Ward Supply), HSAS Drug Formulary | 1 | 1 | ||||||||||||||||||
53 | 48 | 18/02/2016 | Cloxacillin IV needs renal dosage adjustment or not | Dr Jazmine 10 B | No dosage adjustment necessary | Balqis | Drug Information Handbook, MIMS gateway | 1 | 1 | ||||||||||||||||||
54 | 49 | 19/02/2016 | Sodium Nitroprusside needs import permit? | Tharaani | Yes | Balqis | Pharmacy.gov.my | 1 | 1 | ||||||||||||||||||
55 | 50 | 22/02/2016 | Patient allergic to Naproxen, can give Promethazine and Pethidine? | Dr Vivian Og | Naproxen is NSAIDS, Pethidine is opiod, can be given. Promethazine(antihistamine) can be given. | Balqis | MIMS gateway. | 1 | 1 | ||||||||||||||||||
56 | 51 | 22/02/2016 | Atorvastatin and gemfibrozil can be used in breastfeeding mother? | SN Rahayu | infant risk cannot be ruled out. Usage is contraindicated. | Balqis | Micromedex. | 1 | 1 | ||||||||||||||||||
57 | 52 | 23/02/2016 | Does the use of Vitamin A powder need KPK approval? | Cik Josephine | Vitamin A powder is purchased under raw materials. So no KPK application is required. KPK applications are only required for finalised pharmaceutical products which are already ready in the market. | Shiau Mei | Cik Siti Fariza (BPF) | 1 | 1 | ||||||||||||||||||
58 | 53 | 23/02/2016 | How many mmol of potassium is in the potassium chloride solution and Slow K Tablet? | Pn Zahirah | The concentration of KCl solution that is available in HSAS is 1g/10ml. 1g = 13.4 mmol of K+ (solution). For Slow K Tablet, one tablet = 8mmol of K+. | Shiau Mei | Product leaflet, Sarawak Handbook | 1 | 1 | ||||||||||||||||||
59 | 54 | 23/02/2016 | Any patient monitoring form needed to be handed in for Phenylephrine Inj KPK Application (Ulangan)? | MA Idris | Informed Jonathan: Phenylephrine injection is for emergency stocks. Hence, no monitoring forms are needed. | Shiau Mei | Cik Siti Fariza (BPF) | 1 | 1 | ||||||||||||||||||
60 | 55 | 24/02/2016 | What is the dose of IV Augmentin for a 7-year-old child (20kg) in Pharingitis? | Dr. Salwa (ORL: 5407) | 30mg/kg TDS | Shiau Mei | Product leaftlet, MIMS Gateway | 1 | 1 | ||||||||||||||||||
61 | 56 | 24/02/2016 | What is the dose of Metronidazole for a 7-year-old child (20kg)? | Dr. Salwa (ORL: 5407) | 7.5mg/kg TDS | Shiau Mei | Frank Shann Drug doses, MIMS Gateway | 1 | 1 | ||||||||||||||||||
62 | 57 | 25/02/2016 | Is BCG Vaccine contraindicated in new borns receiving phototherapy? | Sister Thun (4508) | No evidence shown that it is a contraindication in newborns receiving phototherapy. | Shiau Mei | Product leaflet, http://extranet.who.int/ivb_policies/reports/contraindications.pdf (WHO) | 1 | 1 | ||||||||||||||||||
63 | 58 | 25/02/2016 | Is ampicillin delayed hypersensitivity common? Patient was previously treated with IV ampicillin. However, he develops rashes after changing to oral ampiciliin. | Cik Josephine | It is documented that some ampicillin allergic reactions may only be present after 6 hours following a dose and typically after days of treatment. However, it is also stated that the rashes may be due to the disease itself. | Shiau Mei | 1. http://adc.bmj.com/content/76/6/513.full#ref-5 ; 2. http://online.liebertpub.com/doi/abs/10.1089/pai.1996.10.197?journalCode=pai ; 3. http://www.uptodate.com/contents/penicillin-allergy-delayed-hypersensitivity-reactions ; 4. http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.1991.tb00560.x/abstract | 1 | 1 | ||||||||||||||||||
64 | 59 | 25/02/2016 | What is the dose of Lugol's solution for iodine, how is it administered and how long should it be given. | Pn Devi | Lugol's iodine 10-20 drops TDS, administration: mix with water or drop on bread. Duration of treatment is not stated in guidelines or references. However, according to Pharmacotherapy Handbook, symptoms improvements can be seen within 2 - 7 days after starting therapy. | Shiau Mei | Sarawak Handbook, BNF 70, Pharmacotherapy Handbook | 1 | 1 | ||||||||||||||||||
65 | 60 | 25/02/2016 | How to use Utrogestan (progesterone) Vaginal Tablet for threatened miscarriage? | Pn Devi | Dose: 2-4 cap (100mg per capsule) daily in 2 divided doses. Use this medicine by inserting it deep into the vagina. | Shiau Mei | Mims Gateway, Utrogestan Vaginal Product Leaflet | 1 | 1 | ||||||||||||||||||
66 | 61 | 26/02/2016 | Is Xylocaine 2% viscous solution injectable? | Cik Josephine | No. It is only for oral use. | Shiau Mei | Product leaflet | 1 | 1 | ||||||||||||||||||
67 | 62 | 26/02/2016 | Can KPK-approved Syrup Furosemide and Nevirapine by OPD and SPUB patients? | Cik Heng | Both of these can be used by IPD and OPD after authorized by paeds doctor. SPUB patients are not allowed to use these two items. | Shiau Mei | 1 | 1 | |||||||||||||||||||
68 | 63 | 27/02/2016 | What is the dose and test dose for IM Cosmofer (Iron Dextran) in patient with Iron Deficiency Enemia (Cannot tolerate orally). | Dr Loges (4614, O & G) | Test dose: 0.5 mL (25mg) test dose should be administered on the first day of therapy; patient should be observed for 1 hour for hypersensitivity reactions, then the remainder of the total daily dose (dose minus test dose) should be given; Dosage: (According to Drug Information Handbook): Dose (mL) = 0.0442 (desired hemoglobin - observed haemoglobin) x LBW + (0.26 x LBW) with Hemoglobin in g/dL, LBW= lean body weight in KG. To calculate LBW: (Reference: Medscape): LBW[kg] = (0.65 * Height[cm]) - 50.74; Administration: Total dose should be given in divided doses. Administration: It is administered as a series of undiluted injections of up to 100mg iron (2.0mL) each determined by the patient's body weight. If the patient is moderately active, injections may be given daily into alternate buttocks. In inactive or bedridden patients, the frequency of injections should be reduced to once or twice weekly. | Shiau Mei | Cosmofer product leaflet, Drug Information Handbook | 1 | 1 | ||||||||||||||||||
69 | 64 | 29/02/2016 | Dose of Raltegravir | Areena | 400mg BD for 1month | Shiau Mei | 1 | 1 | |||||||||||||||||||
70 | 65 | 29/02/2016 | How long can Locabiotal (Fusafungine) last after opening? | Hamizah | Spoken to product specialist, Mr. Brian. One canister can last up to its expiry date stated on the box after opening (shelf life 18 months). However, since the dose is one puff every 4 hours and one canister contains 100 doses, there will be minimal doses left after a course of treatment (Usually a week). | Shiau Mei | Product leaflet, Product specialist Mr Brian | 1 | 1 | ||||||||||||||||||
71 | 66 | 29/02/2016 | What anti-emetics which does not cause oculogyric crisis that is available in HSAS? | Dr Natasha (10B) | Antiemetics that are available in HSAS: Domperidone, promethazine, prochloperazine, veloxin. However, Veloxin is indicated for nausea and vomiting in pregnancy according to FUKKM. Oculogyric crisis cases are documented in all three agents mentioned above. However, only promethazine has been used to treat oculogyric crisis as well. If promethazine is to be prescribed, the dose is IV promethazine 12.5 - 25mg 4 - 6 hourly as needed. | Shiau Mei | 1 | 1 | 1 | ||||||||||||||||||
72 | MARCH | 67 | 01/03/2016 | How much of elemetal iron in 1ml of FAC? | Dr Achana (Paeds) | 1ml of FAC = 16mg of elemental iron. C/w Kak Yati: 172mg FE in 10ml FAC Syrup (17.2mg of Fe in 1ml) | Shiau Mei | Hospital Sungai Buloh | 1 | 1 | |||||||||||||||||
73 | 68 | 02/03/2016 | What are the available drugs for migraine/headache in HSAS? Can flunarizine be given? | Dr Nazrul (Medical, 4111) | Flunarizine is an ENT item. Other departments can prescribe T. Pizotifen 0.5mg OD initially, then titrate up slowly to a total daily dose of 1.5mg TDS or given as a single dose ON. Max:4.5mg/day. | Shiau Mei | FUKKM, Mims gateway, Formulary HSAS | 1 | 1 | 1 | |||||||||||||||||
74 | 69 | 03/03/2016 | What is the storage condition for the snake antivenom (Cobra, Pit Viper, Hemota, Neuro) | IPD | informed RC, the storage condition is below 25 degree celcius. No need to store in fridge. For those which are already stored in the fridge, can continueing storing it there but once new batch arrives, may store at room temperature. | Shiau Mei | Product leaflet. | 1 | 1 | ||||||||||||||||||
75 | 70 | 03/03/2016 | How to use glucose in glycerin nasal drop? | Nethiya | Spoken to Dr Maliana from ENT clinic, their practice is to use as douche or nasal drop, OD/BD/TDS. The duration may vary from patient to patient. There is no definite dose for it. It is used in the management of atopic rhinitis to humidify the nasal environment and to reduce foul smelling for the nose. | Shiau Mei | Dr Maliana, ENT Clinic | 1 | 1 | ||||||||||||||||||
76 | 71 | 07/03/2016 | Is IV dexamethasone and human normal globulin compatible? | Hafizza | According to the product (IV Globulin SN Inj) insert, due to the absence of compatibility studies, this product must not be mixed with other medicinal products. | Shiau Mei | Product insert. | 1 | 1 | ||||||||||||||||||
77 | 72 | 08/03/2016 | What is the dose of promethazine for paeds? | Dr Kala (ED) | 0.2-0.5 mg/kg TDS | Shiau Mei | Frank Shann | 1 | 1 | ||||||||||||||||||
78 | 73 | 08/03/2016 | What is the options for migraine besides pizotifen? | Dr Nazrul (Medical, 4111) | T. Propranolol 40mg BD - TDS initially, increase weekly to a total daily dose of 160mg daily. Flunarizine ENT item | Shiau Mei | Drug Information Handbook, FUKKM | 1 | 1 | ||||||||||||||||||
79 | 74 | 08/03/2016 | Doctor has prescribed 50mg elemental iron of FAC. How much ml to give? | Nethiya | One ml of FAC = 16mg of elemental iron. Therefore, the dose is 3.1mL OD. | Shiau Mei | Hospital Sungai Buloh | 1 | 1 | ||||||||||||||||||
80 | 75 | 08/03/2016 | How to dilute IVI Frusemide? Doctor prescribed 3mg/hr | SN Shakilah (10A) | IV Frusemide concentration: 20mg/2mL. Dilute one ampoule in 20mL of NS to get a concentraion of 1mg/mL. To infuse 3mL/hour. | Shiau Mei | Micromedex, Dilution Protocol Hospital Selayang | 1 | 1 | ||||||||||||||||||
81 | 76 | 10/03/2016 | What is the administration rate for IV Globulin SN Injection? (Human Normal Immunoglobulin) | Miss Josephine | According to the agent which imported the product from Green Cross Corp., the suggested administration rate is 0.01-0.02 ml/kg/min (first 30 min) then increase the rate up to 0.06 ml/kg/min (If the patient seems normal). | Shiau Mei | Bonnie Chung (Pharmacist/Head of Regulatory and QA of Propharm (M) Sdn. Bhd. 019-3221718) | 1 | 1 | ||||||||||||||||||
82 | 77 | 14/03/2016 | Dose adjustment of cefuroxime in renal failure <30ml/min | 10B | 500mg OD | Balqis | Drug Information Handbook | 1 | 1 | ||||||||||||||||||
83 | 78 | 16/03/2016 | Magnesium sulphate availability for topical? | Dr Nazrul Medical | Magnesium sulphate paste | Balqis | 1 | 1 | |||||||||||||||||||
84 | 79 | 16/03/2016 | Tranexamic acid indication for gargle? | Izyan | Follow indicaiton in blue book | Balqis | 1 | 1 | |||||||||||||||||||
85 | 80 | 16/03/2016 | Nystatin suspension with alcohol? Permissible limit for kids? | Izyan | 1 | ||||||||||||||||||||||
86 | 81 | 16/03/2016 | Max dose for Slow K tab | Dr Nazrul Medical | 9-12 tabs /day | Balqis | KKM Formulary | 1 | 1 | ||||||||||||||||||
87 | 82 | 17/03/2016 | What other options are availble for antifungal ear drop in FUKKM | Pn. Balqis | Only Clotrimazole ear drop is available in FUKKM | Shiau Mei | KKM Formulary | 1 | 1 | ||||||||||||||||||
88 | 83 | 17/03/2016 | Is there any interaction between colchicine and anti-TB medications? | Puan Zuhailah | There is no documented drug-drug interaction between colchicine and anti-TB mediations | Shiau Mei | MIMS Gateway, Medscape | 1 | |||||||||||||||||||
89 | 84 | 17/03/2016 | Is lindane safe to use to paediatrics? | Pn Areena | For paediatrics, extreme precautions is needed for patients weighing less than 50kg. Safer options: Permethrin 1% which is currently in the process of getting KPK approval. According to FDA, gamma benzene hexachloride is reserved for second line thrapy in head lice management. | Shiau Mei | Micromedex, FDA | 1 | 1 | ||||||||||||||||||
90 | 85 | 17/03/2016 | Is solcoseryl dental paste halal? | Dr Sharifah / Ms Jocin | Solcoseryl oral dental paste contains ingredients derived from bovine and porcine. | Shiau Mei | Sococeryl dental paste packing, Ms ReAnn Tan 012-9166218 | 1 | 1 | ||||||||||||||||||
91 | 86 | 18/03/2016 | Why is there a tablet encapsulated in Carinox (Loratadine and Pseudoephidrine) capsule? | Sajitha | For Carinox delivery system, a measured amount of immediate release granules are encapsulated with a sustained release tablet. The brand leader for this product is Clarinase Repetabs (Schering-Plough). Their formulation is divided into two portions; 1. Immediate release coating which contains 5mg Loratadine and 60mg Pseudoephedrine Sulphate 2. Sustained release core which contains 60mg Pseudoephedrine Sulphate This technology was at that time protected by patent. Thus, our company had developed such formulation (tablet/s in a capsule) to not infringe the patent but still matching the drug release as per brand leader. | Shiau Mei | Puan Noramalina, Executive, quality assurance & pipeline department CMM | 1 | 1 | ||||||||||||||||||
92 | 87 | 18/03/2016 | What is the drug classification of flunarizine? What is the dose and maximum duration that it can be given for migraine? | Dr Salwa ORL | Flunarizine is a calcium channel blocker. It can be given as 5-10mg ON. If symptoms do not improved after 3 months, therapy should be discontinued. It is recommended to have 2 consecutive drug-free days in a week to reduce risk of adverse effects (eg. extrapyramidal effects, fatigue, CNS effects) | Shiau Mei | Drug Information Handbook | 1 | 1 | 1 | |||||||||||||||||
93 | 88 | 22/03/2016 | Salbutamol dose for 1 yrs 8 months old 7.5kg. | Dr Siti | 0.1mg/kg, 2mg/5ml= 2ml | Balqis | BNF for Children | 1 | 1 | ||||||||||||||||||
94 | 89 | 22/03/2016 | What is the identity of green antibiotic capsule? | SN Izzati | Based on MIMS Gateway, cephalexin capsule is green in colour. The photo has been emailed to her. However, the identity cannot be 100% confirmed due to availability of other brands in the market and the lack of further details regarding the medication. | Shiau Mei | MIMS Gateway | 1 | 1 | ||||||||||||||||||
95 | 90 | 22/03/2016 | Is there any case reports on cefuroxime delayed hypersensity ? | Cik Josephine | It is stated that cephalosporins can cause a range of hypersensitivity reactions, from mild, delayed-onset cutaneous reactions to life-threatening anaphylaxis in patients with immunoglobulin E (IgE)-mediated allergy. There is a delayed hypersensitivity case reported: An 80-year-old man developed generalized pruritus and erythema 2-3 days after starting treatment with cefuroxime. | Shiau Mei | 1. UpToDate (Cephalosporin allergy: Clinical manifestations and diagnosis). 2. Gonzalo G, Rodríguez N, de AD. Patch tests for diagnosis of delayed hypersensitivity to cephalosporins. Allergol Immunopathol (Madr) 2006 Jan-Feb;34(1):39-41. | 1 | 1 | ||||||||||||||||||
96 | 91 | 23/03/2016 | Metoprolol conversion dose to bisoprolol | Dr Jeremy | No exact conversion, but can start titrate from lower dose for UA indication: 2.5mg od. | Balqis | http://www.swmit.nhs.uk/pdf+/CIOS/cios2010709.pdf | 1 | 1 | ||||||||||||||||||
97 | 92 | 24/03/2016 | Renal dosage for IV Erythromycin and IV Benzylpenicillin | Dr Kalai | No dosage adjustment necessary for IV Erythromycin. For Benzylpenicillin: dose adjustment is necessary. Since dr decided for erythromycin, IV Dose: 15-20mg/kg/Day in divided doses.Max dose: 4g/d. Recommended 1g qid for IV. For oral: 400md bd. | Balqis | Drug Information Handbook. | 1 | 1 | ||||||||||||||||||
98 | 93 | 24/03/2016 | Dilution of antivenom: polyvalent, cobra,pit viper. | Pn Syahidah | Balqis | 1 | 1 | ||||||||||||||||||||
99 | 94 | 24/03/2016 | Max dose for sodium valproate tab | Dr Nazrul | 10-45mg/kg/day. Patient: 130kg. Recommended dose: 600mg/600mg/400mg day. =12.3mg/kg/day. | Balqis | 1 | 1 | |||||||||||||||||||
100 | 95 | 25/03/2016 | Can pneumococcal vaccine and meningoccal vaccine be injected together? | Puan Zaiton | Both of them are inactivated vaccines. Hence, they can be injected silmutaneously at different site of injections and different syringes. | Shiau Mei | Andrew TK, Ciro VS, Larry KP, Willian LA. General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) 2011. Accessed online on 28 March 2016 via http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm | 1 | 1 | ||||||||||||||||||