Swine Influenza A (H1N1) Virus!! (2nd Edition)

This time its more on the pharmacist’s core business!!Drugs related to influenza A (H1N1) Virus….

RELENZA^® (zanamivir) Inhalation Powder

Indication	Dose
Treatment of Influenza	10 mg twice daily for 5 days (2 puff BD *5/7)
Prophylaxis: Household Setting Community Outbreaks	10 mg once daily for 10 days (2 puff OD *10/7) 10 mg once daily for 28 days (2 puff OD *28/7)

Note: The 10 mg dose is provided by 2 inhalations (one 5 mg blister per inhalation). Dosage Pack: Four 5 mg blisters of powder on a ROTADISK® for oral inhalation via DISKHALER®. Packaged in carton containing 5 ROTADISKs (total of 10 doses) and 1 DISKHALER inhalation device

Prior to prescribing and dispensing pls refer to the drug info leaflets for any special consideration.It is acessible at the site below
http://www.fda.gov/cder/drug/antivirals/influenza/default.htm

 

Add comment May 17, 2009 nazia-2141

Swine Influenza A (H1N1) Virus!! (1st Edition)

Got some basic info on this hottest creature in town..kalau rajin boleh baca

1.What is H1N1 (swine flu)?
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

2.Why is this new H1N1 virus sometimes called “swine flu”?This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe(1) and Asia(2) and avian genes(3) and human genes(4). Scientists call this a “quadruple reassortant” virus.

Influenza A virus strains are categorized according to two proteins found on the surface of the virus: hemagglutinin (H) and neuraminidase (N). All influenza A viruses contain hemagglutinin and neuraminidase, but the structure of these proteins differs from strain to strain due to rapid genetic mutation in the viral genome.

Influenza A virus strains are assigned an H number and an N number based on which forms of these two proteins the strain contains. There are 16 H and 9 N subtypes known in birds, but only H 1, 2 and 3, and N 1 and 2 are commonly found in humans. That’s why virus with H1N1 strain detected in human…hmmm..

3. Is this new H1N1 virus contagious?
CDC has determined that this new H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

Mexico, 2446 case (60 deaths), United States has reported 4298 cases (3 deaths), Canada 449 cases (1 death), Costa Rica 8 cases, (1 death).

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Belgium (1), Brazil (8), China (4), Colombia (10), Cuba (3), Denmark (1), El Salvador (4), Finland (2), France (14), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Malaysia (2), Netherlands (3), New Zealand (7), Norway (2), Panama (40), Poland (1), Portugal (1), Republic of Korea (3), Spain (100), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (71).

(Statistic as on 15May 2009.)

4. What are the signs and symptoms of this virus in people?The symptoms of this new H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting.  Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

5. How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

6. How does this new H1N1 virus spread? 
Spread of this H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

7. How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick.  Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.

8. Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of the novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

9. What can I do to protect myself from getting sick?There is no vaccine available right now to protect against this new H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Other important actions that you can take are:

• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
• Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

10.What should I do if I get sick?
If you live in areas where people have been identified with new H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people, except to seek medical care.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

·             Fast breathing or trouble breathing

·             Bluish or gray skin color

·             Not drinking enough fluids

·             Severe or persistent vomiting

·             Not waking up or not interacting

·             Being so irritable that the child does not want to be held

·             Flu-like symptoms improve but then return with fever & worse cough

In adults, emergency warning signs that need urgent medical attention include:

·             Difficulty breathing or shortness of breath

·             Pain or pressure in the chest or abdomen

·             Sudden dizziness

·             Confusion

·             Severe or persistent vomiting

·             Flu-like symptoms improve but then return with fever & worse cough

11. Are there medicines to treat infection with this new virus?Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with the new H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.

4 antiviral drugs currently approved by FDA to treat acute, uncomplicated influenza.  Two related drugs, amantadine (approved 1966; Trade Name Symmetrel, also available as generic Amantadine Hydrochloride) and rimantadine (approved 1993; Trade Name Flumadine, also available as generic Rimantadine Hydrochloride), are approved for treatment and prevention of influenza A, but many strains of influenza have now become resistant to these drugs as noted in the 2006 CDC Health Alert.  Two newer drugs, zanamivir (approved 1999; Trade Name Relenza; no approved generics) and oseltamivir phosphate (approved 1999; Trade Name Tamiflu; no approved generics), are approved for treatment of acute uncomplicated illness due to influenza A and B. Both zanamivir and oseltamivir are approved for preventive use.  Approved ages, doses, and dosing instructions in children are different for each drug, so the individual package inserts should be checked for this information. The anti-influenza antiviral drugs are not a substitute for vaccine and are used only as an adjunct to vaccine in the control of influenza.

12.How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.

13.What kills influenza virus?Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

 

 

 

 

Add comment May 16, 2009 nazia-2141

The Butterfly and The Flower

Once there was a man who asked ALLAH for a flower and a butterfly…

But instead Allah gave him a cactus and a caterpillar

The man was sad, he didn`t understand why his request was mistaken….

Then he thought…….

Oh well, Allah has too many people to care for and decided not to question….

After sometimes,the man went to check up on his request that he had left forgotten……

To his surprise , from the thorny and ugly cactus a beautiful flower had grown…

And the unsightly cater pillar had been tranformed into the most beautiful butterfly…..

ALLAH always does things right……

His way is ALWAYS the best way, even if to us it seems all wrong…

If you asked ALLAH for one thing and received another,

TRUST…….

you can be sure that ALLAH will always given you what you need at the appropriate time…..

what you want….. …………….is not always what you need !!

Allah never fails to grant our petitions, so keep on going for HIM without doubting or murmuring……

today`s THORN is tomorrow`s FLOWER!!

ALLAH gives the very best to those who leave the choice up to HIM….

MAY ALLAH BLESS US ALWAYS….

AAMINNN…

Add comment May 9, 2009 nazia-2141

Happy Birthday Daddy…

I was wondering if I should write on this…but I guess just wanna be brief…Daddy’s birthday 26^th April…usually when the clock strikes 12 midnight on 25^th April we would come rushing , knocking mom and dad’s door, trying to compete among ourselves who would be the first one to wish daddy happy birthday first…..But, this was the first time around where the practice has stopped..Dad’s birthday without dad being around….we did go check and instead wished Mom on dad’s behalf…we all share the same sorrow…but everybody pretends to be so strong and calming each other…deep inside we miss Dad a lot….There is no prayers where dad’s thought is not present….

Its very strange when sometimes I am driving on the road…it suddenly strucks me, the fact that how I used to be daddy’s little daughter….asking dad for this and that every time….How much I have change within this 1 year….how much our life has changed…it amazes me at times….When I recall those days when we used to talk about life and death…we used to always tell dad that we will live together and die together…so that we won’t have to cry over one….and Dad used to smile…and look at us having such innocent faces….I would never wanna even dream about it….but, I am living with my biggest nightmare since almost the past 1 year…

But, its strange I have learned to live with it….I used to wonder if I could ever smile, laugh, be able to get over it?? Strangely I have started walking on….But a Dad is always a Dad….no world’s treasure can ever replace his presence…..All those advice, comments, jokes and words of yours is always there…close to my heart…but I admit..I do forget at times…Wish I could get those daily doses of advice everyday….so that I would not have deviated without guidance

Ur birthday present from ur..little baby who used to fit into ur arms so nicely:- Al-Fatihah and Surah Yassin, and lots and lots of Doa. May Allah s.w.t. bless you and reward u with Janatul firdaus,Ameen! Love ya Daddy and miss ya lots!

Many..many happy returns of the day! 

2 comments April 26, 2009 nazia-2141

March !

Wah…its almost 2 months since I have written a blog…fuh..i guess it was a rule I made myself that ‘if you are working as a ward pharmacist…surely takde masa nak tulis blog’ It had proven to be very true for me…kalau ikutkan hati memang nak tulis blog sebaik shj habis posting ward pharmacy a week ago…tapi ada pulak CPE presentation that has to be dealt with sebaik sahaja habis posting ward pharmacy…Finally, yesterday I managed to present my first ever CPE presentation…and everything got settled well, Alhamdullilah. When I got back home after work…. after so long I felt so relieved, having no stress of work…no assignment for tomorrow…

‘March’…what an eventful month…so much to write…ward pharmacy’s sweet and sad memories…Kak Tanveer’s transfer to Jengka… Our ‘new SAGA’… Friend’s wedding…MPS Annual Grand Dinner…My forensic exam…and surely a lot more unsaid…

Starting with ward pharmacy…which used to be my ‘dream career’ as a student. Anyhow as a PRP, it was a continuous 6 week ‘no life period’ filled with daily requirements of 5 CP1, 2 CP2 and 2 counseling…Fuh, memang penat bangat nak kejar quota… hari-hari balik lewat, almost everyday atleast till 8 pm and some days sampai 11pm pun ade! Esoknya still keje. I guess I memang slow, or being optimistic, my patient’s sayang me so much, sampai tak membenarkan saya balik awal…huhu. 2 weeks at CCU, 2 weeks at Medical and 2 weeks at Nephro.. So, much of exposure to the real pharmacy battle field…healthy relations with the healthcare team; Specialists, MO’s, HO’s, fellow pharmacists and nurses becomes so crucial to implement pharmaceutical care issues…But, Alhamdullilah, most of them were so co-operative and infact some really really appreciate our interventions. That’s the time when u realize that all that effort…was worth it. All in all, nephro was the my favourite.. Walaupun banyak kena tegur..tapi jauh lebih banyak yg dipelajari daripada teguran yg diberi….At the end of the day, more is gained and nothing lost…except for sleep…zzz

Next, my elder sister’s transfer to Jengka….sedihnye…baru nak merasa keje dgn MO kesayangan….boleh datang keje bersama…balik bersama…kalau malas nak drive adalah spare driver kat sebelah…huhu. If nak discuss case clinical…senang aje dapat jawapan,Alhamdullilah. Namun, manusia merancang, Allah s.w.t. yg menentukan..dan pastinya jalan pilihanNya untuk kita adalah jalan yg terbaik dan terindah…So, taking all that happened positively…Naz redha

Then, sempena nak move out to Jengka, Kak Tanveer decided to buy a new car and donate her old Saga to me…apa lagi…Naz terima ajelah. No problemo at all…Anyhow, bab nak beli kereta baru, surely the very dominant veto me, decided on which car and what colour…haha. Kak Tanveer got my dream car ‘SAGA baru’ colour granite grey. The car which I fall for, the first time I saw it…So, basically ‘my choice but she drives’ … so its sort of like ‘our’ SAGA  :)

Further, friend’s wedding. Congratulations to Mastura and Afzan…Alhamdullilah segalanya berjalan lancar dengan izin-Nya. So, 2 of my classmates, kini sudah bergelar isteri orang…huhu. Siapa sangka…things can speed up that fast. Cuma sorry to dearest Afzan coz I couldn’t make it to ur wedding dear, but my doa was and will always be with you

Then, the MPS Annual Grand Dinner on the 21^st, just two days before Forensic exam…kalau ikutkan hati memang tak nak gi…but then decided to go on that very day and balik malam tu juga..if not memang tak sempat lah buka buku forensic!!! For the honour I received there being from IIUM…Syukur to Allah s.w.t. and I wish to express my heartiest gratitude to my family and friends as well as to all my lecturers and teachers who have made me what I am today…‘Terima kasih kepada semua. Jasamu akan dikenang jua’…

23^rd of Mac, the big day, Forensic exam! For the first time in history it was fully open book..hurray! Alhamdullilah, tak yah hafal each and every word…Poison list pun boleh dirujuk if needed. But, soalan pertama pun ‘on appointment of pharmacist’…Naz dah pening dah…apa ke benda dia nak tanye ni.. tricky…? Tapi, pandai2 lah goreng… Whatever lah…Hopefully Naz dan rakan2 semua lulus….Insha-Allah,Ameen.

So, itulah alkisah bulan March penuh bersejarah…Glad to be back on blog!

 

2 comments April 8, 2009 nazia-2141

Penerbangan yang bertempah…

Bukankah anda sudah lama mendapat tiket free untuk satu penerbangan?

Yang mana?

Oh, sudah lupakah?

Alaa.. yang flight..

Di mana maklumat tentangnya tidak terdapat dalam sebarang brosur penerbangan tetapi dalam Al-Quran dan As-Sunnah.

Di mana penerbangannya bukan melalui Air Asia atau Air Jordan tetapi Al-Jenazah.

Di mana had kita bukan lagi beg seberat 23 kg, tetapi amalan yang tiada caj lebihan berat,atau tiada caj lebihan berat ianya atas kesudian Pencipta kita .

Dimana bajunya bukan Pierre Cardin, B.U.M. atau setaraf dengannya tetapi kain putih ‘cotton’.

Di mana pewanginya bukan Channel atau Paris Hilton, tetapi air mawar dan cendana.

Di mana passport kita bukan Malaysia, British atau American, tetapi Al-Islam.

Di mana visa kita bukan sekadar 6 bulan, tetapi Lailahaillallah.

Di mana pelayannya bukan si pramugari Michelle, tetapi Izrail dan lain-lain.

Di mana layanan di dalamnya bukan lagi kelas ‘bussiness’ atau ekonomi, tetapi sekadar kain yang diwangikan.

Di mana destinasi mendarat bukannya KLIA, Heathrow Airport atau Jeddah International, tetapi adalah tanah perkuburan.

Di mana ruang menunggunya bukan lagi bilik air-cond dan permaidani, tetapi bilik 6-7 kaki yang gelap gelita.

Di mana pegawai imigresen bukanlah pihak kastam, tetapi adalah Munkar dan Nakir. Mereka memeriksa kita sama ada kita layak ke destinasi yang diidamkan bukan Disneyland, Paris atau London tetapi sama ada Syurga atau Neraka.

Di mana tidak perlu alat pengesan untuk memeriksa ‘barang haram’ anda.

Di mana lapangan terbang transit adalah Al-Barzakh.

Di mana destinasi terakhir sama ada Syurga yang mengalir sungai di bawahnya atau Neraka yang merah menyala-nyala

Penerbangan ini tidak dinyatakan nilainya. Ia adalah percuma,jadi, simpanan (savings) anda tidak akan dihabiskan.

Penerbangan ini tidak akan dirampas, oleh itu anda tidak perlu bimbang.

Jangan risaukan ‘delays’, penerbangan ini sentiasa tepat pada waktunya,ia akan berangkat dan tiba tepat pada waktunya.

Jangan fikirkan tentang hiburan dalam penerbangan,anda telah hilang selera bersuka-ria.

Jangan bimbang tentang tempahan, ia telah siap ditempah sejak anda disenyawakan dalam rahim ibu anda lagi.

Ya! Berita baik!!

Jangan bimbangkan siapa yang duduk di sebelah anda. Anda adalah satu-satunya penumpang penerbangan ini. Oleh itu bergembiralah selagi boleh! (Sekiranya anda boleh!)

Hanya ingat!! Penerbangan ini datang tanpa ‘amaran’!!

Cuma perlu ingat! Nama anda telah ditempah untuk penerbangan!

Add comment February 17, 2009 nazia-2141

BELL’S PALSY

Well,this happen for the first time,i had 2 different patients on the same day coming in with a prescription for a diagnosis i wasn’t familiar with.Guess what? “Bell’s Palsy”??one was prescribed acyclovir and prednisolone and the other was prescribed prednisolone alone.Coincidently, both patient’s were so curious to know why the medication was prescribed and what’s the function….sadly,i wasn’t even sure with the “alien” diagnosis,so cam mana nak jawab soalan ptn tu…sigh..cuma sekadar explain acyclovir anti-viral dan prednisolone ,steroid yg untuk suppress immune…coz i wasn’t sure how to relate it to the diagnosis
I was quite sedih coz x dpt explain betul2 due to lack of ilmu about the diagnosis..so,came back home to search about it…This is what i have found, nak share di sini so that kwn2 yg maybe 1 day encounter this diagnosis tahu apake benda Bell’s Palsy ni…sekadar nak share ilmu…

Introduction

Bell’s palsy is a form of temporary facial paralysis resulting from damage or trauma to one of the two facial nerves (The facial nerve called the 7th cranial nerve).Each facial nerve directs the muscles on one side of the face, including those that control eye blinking and closing, and facial expressions such as smiling and frowning. Additionally, the facial nerve carries nerve impulses to the lacrimal or tear glands, the saliva glands, and the muscles of a small bone in the middle of the ear called the stapes. The facial nerve also transmits taste sensations from the tongue.

When Bell’s palsy occurs, the function of the facial nerve is disrupted, causing an interruption in the messages the brain sends to the facial muscles. This interruption results in facial weakness or paralysis.

Bell’s palsy is named for Sir Charles Bell, a 19th century Scottish surgeon who was the first to describe the condition. The disorder, which is not related to stroke, is the most common cause of facial paralysis. Generally, Bell’s palsy affects only one of the paired facial nerves and one side of the face, however, in rare cases, it can affect both sides.

Symptoms

Symptoms of Bell’s palsy, which vary from person to person and range in severity from mild weakness to total paralysis, may include :-

• twitching,
• weakness, or paralysis on one or both sides of the face,
• drooping of the eyelid and corner of the mouth,
• drooling,
• dryness of the eye or mouth,
• impairment of taste, and
• excessive tearing in one eye

Most often these symptoms, which usually begin suddenly and reach their peak within 48 hours, lead to significant facial distortion.

Other symptoms: may include pain or discomfort around the jaw and behind the ear, ringing in one or both ears, headache, loss of taste, hypersensitivity to sound on the affected side, impaired speech, dizziness, and difficulty eating or drinking.

Treatment

Bell’s palsy affects each individual differently. Some cases are mild and do not require treatment as the symptoms usually subside on their own within 2 weeks. For others, treatment may include medications and other therapeutic options.

Recent studies have shown that :-

·        Antiviral drug such acyclovir-used to fight viral infections  (Scientists think that a viral infection makes the facial nerve swell  or become inflamed)

·        Anti-inflammatory drug such as the steroid prednisone-used to reduce inflammation and swelling of the facial nerve-may be effective in improving facial function by limiting or reducing damage to the nerve.

·        Analgesics such as aspirin, acetaminophen, or ibuprofen may relieve pain.

·        Lubricating eye drops, such as artificial tears or eye ointments or gels, and eye patches are also effective.- keeping the eye moist and protecting the eye from debris and injury, especially at night, is important(eye protection). Bell’s palsy can interrupt the eyelid’s natural blinking ability, leaving the eye exposed to irritation and drying.

Because of possible drug interactions, patients taking prescription medicines should always talk to their doctors before taking any over-the-counter drugs.

·        Physical therapy to stimulate the facial nerve and help maintain muscle tone may be beneficial to some.

·        Facial massage and exercises may help prevent permanent contractures (shrinkage or shortening of muscles) of the paralyzed muscles before recovery takes place.

·        Moist heat applied to the affected side of the face may help reduce pain.

·        Other therapies that may be useful for some individuals include relaxation techniques, acupuncture, electrical stimulation, biofeedback training, and vitamin therapy (including vitamin B12, B6, and zinc), which may help nerve growth.

Decompression surgery for Bell’s palsy -to relieve pressure on the nerve-is controversial and is seldom recommended. On rare occasions, cosmetic or reconstructive surgery may be needed to reduce deformities and correct some damage such as an eyelid that will not fully close or a crooked smile.

Prognosis

The prognosis is generally very good. The extent of nerve damage determines the extent of recovery. With or without treatment, most individualsbegin to get better within 2 weeks after the initial onset of symptoms and most recover completely, returning to normal function within 3 to 6 months. For some, however, the symptoms may last longer. In a few cases, the symptoms may never completely disappear. In rare cases, the disorder may recur, either on the same or the opposite side of the face.

Panjang jugak lah ceritanya but its important facts to understand the diagnosis properly.Moga-moga dapat dimanfaatkan bersama,insha-Allah

1 comment February 3, 2009 nazia-2141

Methadone!

 

Hmmm..sempena 3^rd call naz yang pertama, teringin naz menyelidik sedikit about Methadone. So, just posting here some info for myself and friends who might wanna know a bit on Methadone…tapi mind you…not the high fi EBM source ye..ala kadar just to learn and share basic knowledge

Methadone is a synthetic opioid, used medically as an analgesic, anti-tussive and maintenance anti-addictive for use in patients on opioids. It was developed in Germany in 1937. Although chemically unlike morphine or heroin, methadone acts on the opioid receptors and thus produces many of the same effects. Methadone is also used in managing chronic pain owing to its long duration of action and very low cost. In late 2004, the cost of a one-month supply of methadone was $240, as compared to an equivalent analgesic amount of meperidine (pethidine) at $120, up to $500 and more for hydromorphone, morphine, fentanyl, and extended-release oxycodone.

Methadone’s usefulness in treatment of opioid dependence is the result of several factors.

• It has cross-tolerance with other opioids including heroin and morphine.
• It has a long duration of effect, with the result that oral dosing with methadone will stabilize the patient by stopping the opioid withdrawal syndrome.
• It also blocks the euphoric effects of heroin, morphine, and similar drugs. As a result, properly dosed methadone patients can reduce or stop altogether their use of these substances. (Anyhow, it is not intended to reduce the use of non-narcotic drugs such as cocaine, marijuana, methamphetamine, or alcohol.)

Methadone’s main route of administration is oral. Methadone has a slow metabolism and very high fat solubility, making it longer lasting than morphine-based drugs. Methadone has a typical elimination half-life of 15 to 60 hours with a mean of around 22. However, metabolism rates vary greatly between individuals, up to a factor of 100, ranging from as few as 4 hours to as many as 130 hours, or even 190 hours. This variability is apparently due to genetic variability in the production of the associated enzymes CYP3A4, CYP2B6 and CYP2D6. A longer half life frequently allows for administration only once a day in heroin detoxification and maintenance programs.

Adverse effects of methadone include:-

Hypoventilation, constipation, miotic pupils, nausea, vomiting, headache, hallucination, hypotension, cardiac arrhythmia, anorexia (symptom), weight gain, stomach pain and many more.

Withdrawal symptoms:-

Lightheadedness, lacrimation, rhinorrhea, sneezing, nausea, vomiting, diarrhea, fever,chills, tremors, tachycardia, suicidal ideation, depression and many more (the withdrawal can be much more prolonged than with other opiates, spanning anywhere from two weeks to six months).

Methadone clinics are a way to provide methadone to ex-opioids addicts trying to quit on the substance. Patients are required to visit the clinic daily so that they may be observed taking their dose by the pharmacist, but may be allowed to leave the clinic with increasing supplies of “take home doses” or “take away” after several months of adherence to the clinic’s regulations, including consistent negative drug-screen results.

Role of methadone clinic

• Stabilizes the patient by stopping the opioid withdrawal syndrome by blocking the euphoric effects of heroin, morphine, and similar drugs.
• It reduces and/or eliminates the use of heroin, and criminality associated with heroin use, and allows patients to improve their health and social productivity.
• In addition, it has potential to reduce the transmission of infectious diseases associated with heroin injection, such as hepatitis and HIV.

Methadone maintenance has been found to be medically safe and non-sedating. It is also indicated for pregnant women addicted to heroin.

Hmmm…itu aje kut for now…banyak jugak info yg naz dapat tahu bila search tentang Methadone ni…hopefully kwn2 pun sama.Ok…mengantuk ni,esok kena dispense methadone!!! Moga segalanya lancar dengan izin-Nya, Ameen.

6 comments February 1, 2009 nazia-2141

Lagu untuk Palestin!

Balada Seorang Gadis Kecil

( MENGINGATKAN 17 SEPETMBER 1982 DI BUMI SABRA DAN SATILA)

Gadis kecil itu telah bertahun

Dicengkam derita

Di khemah pelarian

Yang menjanjikan duka cita

Munir tak mengenal erti cinta

Telah kering airmata

Menangisi kematian

Ayahbonda dan saudara

Pada suatu senja Langit Syatila

Menyaksikan pembunuhan

Anak kecil dan wanita

Munir ditembak Penuh luka

Tapi ajalnya belum tiba

Kerna Tuhan mengasihi dia

Peristiwa hitam 17 September Telah menjadi bukti

Sempurnalah kekejaman

Suatu bangsa yang sombong dan hina.

berapa banyak lagi

 

**********

 SATU BANGSA YANG HINA

Tatkala menyaksikan satu demi satu

tragedi penuh tragis,

seakan hampir dan terlalu hampir

ianya berlaku di sisiku

saat anak-anak kecil dan ibu tua

serta perempuan tua mengandung

sarat dengan penderitaan

manusia apakah engkau

lagikan binatang sayangkan anaknya

bukan kekuasaan menjadi ukuran

manusia adalah manusia

kebahagiaan adalah

tatkala kehidupan ini

dapat menghirup nafas lega

mampu mengukir senyum

melihat anak-anak berlari

serta menyaksikan keindahan bumi warisan anbia

Hari ini bangsa bangsatlah Engkau

megah pada kehebatan

rakus dengan kegilaan

berani kerana bersamamu

adalah syaitan dan iblis laknatullah

Apakah tidak ada

sekelumit insan

dan rasa kasih pada anak-anak kecil

sedang ibu meraung kepedihan

lelaki dengan darah yang menyimbah bumi

berlari di celah-celah himpitan kemusnahan

demi menyelamatkan ibu tua.

Kebencian dan kebencian

tertanam utuh

pada sebuah bangsa sehina itu

biar menjadi warisan sejarah

namun untuk mengaku kalah

bukan kita bangsa yang demikian

kerna dan demi Allah

di sisimu para mujahid biar

menjadi pegangan

sekalipun kematian

adalah penyudah pada perjuangan.

Add comment January 20, 2009 nazia-2141

2 weeks journey at enforcement!!

Alhamdullilah, I’m done with my 2nd station,the enforcement training at BPF, Pahang. My pre-emtive thoughts of enforcement as a student have been proven wrong. I used to think it would not be a suitable working place for females coz of the risk involved with its activities. But, i believe i was wrong. Being posted there i manage to see a wider picture of their activities and even manage to ask on the experiences of the female FRP’s posted there which seems very positive about the job there.

First day at work, we hardly had anything to do..Well what can u expect on the 2nd day of the new year! But,i guess that was the only day where we didn’t had anything to do…this 2 weeks we have covered quite a lot of task and at the end of the day we end up enjoying ourself to the extent that we are already considering to join enforcement as FRP as one of our options…My friend eizera and i find it some how “lain daripada yg lain” and preparing investigation paper and the prosecution part seems to have caught our interest the most…

A brief review of  Bahagian Perkhidmatan Farmasi (BPF) Kuantan and our task there for 2 weeks…Well,BPF has 2 main components,management and enforcement…being attached there for enforcement, we deal more into enforcement than management.Under enforcement u have licensing, pintu masuk(shipping port and airport), precursor,  pendakwaan, siasatan, risikan and Pelindungan Pengguna.

Each PRP would usually get a chance to follow the officer to the port.As a student,i used to think that we would go to ground level, check kontena and do detailed inspection of chemicals that are imported at the port…But, nothing as such is required….At the port,there will be a special office,more or less like a room, where you sit and wait for the agent of any importing company to come in,show legal papers and if  all the documents are there,then, we will just put a stamp on the release order and the chemicals can be released from the port by the agent.So,its quite simple.Duties to port is 9-12 tghr on monday,wed,fri.

Besides going to the port, we went to few premises for inspections…looking for any fishy items or illegal ones as well as asking for the basic formalities like SSM (business registration) and MPK License documents. We were also briefed on how to differentiaite between the registered products and the fake one via their security features i.e hologram or MAL no. It was really fun and we learned a lot..

Next, we were briefed on investigations, prosecutions and steps till Orang Kena Saman (OKS) pleads guilty! Macam lawyer plak…But, this one was the most interesting, as we learn how investigations are carried out and the legal requirments that comes with it..

We also manage to learn on basic Pharmacy Law related procedures i.e Licensing. Ada license A,B and Permit NaOH.Do you know what’s the difference between License E and Permit NaOH…?its quite similar but yet with a bit of difference…Well, to friends and juniors, check out law book for the answer..

Last but not least, there we were briefly briefed on Precursor and Pelindungan Pengguna… Precursor is more on illicit drugs manufacturing..whereas Pelindungan Pengguna comprises activities to educate the general public on drug related issues…i.e. Kempen Kenali Ubat Anda, etc. They will be setting booths for Pharmacy Day kali ini juga as part of their activity.Hopefully adik2 kat UIAM tu, can get some useful info through the booths setup…and may the event goes fine by His Mercy! Ameen.

I guess that’s it on enforcement. Just wished we had peluang to join a raid, but x dapat.Never mind better luck next time.Now, at 3rd Station Farmasi Makmur plak.Oh..i’m being overdosed with outpatient task…2 months at FKP (outpatient) now 1 month lagi di FM (almost like outpatient gak..). But FM is a lot more lighter than FKP…Bestlah juga 1st day at FM with my PRP friend Joo Ean.Dia banyak memberi tunjuk ajar bagi apa-apa yg patut.Good to have good friends around, makes your job fun and life..Easy! Lepas ni, 4th station: Farmasi Ward! Creepy…May Allah help me. Adios for now!

P/s: Mummy is finally coming back home after 3 months being in India.Rindu mama…Hope can get cuti on 23rd untuk gi receive mama kat airport,insha-Allah

1 comment January 16, 2009 nazia-2141