Read All About It: Drug Control Authority Recalls a Cough Medicine!

WORDS LIM TECK CHOON

FEATURED EXPERT
LIM EN NI
Chief Pharmacist
Alpro Pharmacy

Recently, the Drug Control Authority under the Ministry of Health Malaysia issued a circular on the cancellation and product recall of pholcodine, an opioid medicine that is used in adults and children for the treatment of non-productive or dry cough. It is also used in combination with other active substances for the treatment of symptoms of cold and flu.

In Malaysia, you’ll need a doctor’s prescription to obtain pholcodine.

You can read more about the recall at the National Pharmaceutical Regulatory Agency website here (link opens at a new tab).

According to Lim En Ni, this recall is due to a possible drug interaction with neuromuscular blocking agents.

WAIT, WHAT ARE NEUROMUSCULAR BLOCKING AGENTS?

These are medications that are commonly used for general anaesthesia during medical surgeries.

There are a few types of neuromuscular blocking agents, but generally, they prevent normal transfer of information through nerves at your neuromuscular junction.

This keeps you from moving the skeletal muscles connected to the affected neuromuscular junction, hence the use of these medications as anaesthesia.

SO, WHAT DOES PHOLCODINE HAVE ANYTHING TO DO WITH THESE AGENTS?

Lim En Ni explains that people that take pholcodine-containing products in the past 12 months are at risk of experiencing anaphylaxis should they also receive neuromuscular blocking agents.

“Anaphylaxis is a serious, life-threatening allergic reaction,” she says.

ANAPHYLAXIS IS A SERIOUS MATTER
  • It can occur within seconds or minutes of exposure to something you’re allergic to.
  • When you experience anaphylaxis, your immune system will release chemicals that can cause your blood pressure to experience a sudden drop. Also, your airways to block and you will experience problems breathing normally. You will also typically experience weak blood pulse, skin rashes, nausea, and vomiting.
  • You will need an injection of epinephrine to stabilize your condition and then immediately proceed to an emergency room for quick treatment. Delays in getting treatment can lead to death!

WHAT YOU CAN DO ABOUT THIS MATTER

En Ni advises the following:

  • If you have purchased the medication but have not consumed it, you can return it to the pharmacy or healthcare facility that you obtained the medication from.
  • If you have used pholcodine in the last 12 months, visit a pharmacy and ask the pharmacist to help you prepare a medication list to show your surgeon or doctor should you need to undergo surgery. 
  • If you’re not sure whether you have taken pholcodine or your medicine contains pholcodine, consult a pharmacist for help.

Be Careful of This Viral Health “Advice”! Yes, Elon Musk Can Be Wrong Too!

WORDS LIM EN NI

FEATURED EXPERT
LIM EN NI
Chief Pharmacist
Alpro Pharmacy

A recent weight loss trend among TikTok users is the use of the diabetes medication Ozempic, which gathered over a million views—and counting!—using the hashtag #ozempic and #ozempicjourney. Even Elon Musk credited it as one of the reasons he shed 13 kg.

Ozempic is actually one of the many brand names for semaglutide, an anti-diabetic medication used for the treatment of type 2 diabetes and, in the United States, as anti-obesity medication for long-term weight management.

However, it is not the ultimate answer for obesity as it is a prescription medicine indicated for type 2 diabetes, which requires a patient to go get a complete medication review.

WHAT HAPPENS WHEN YOU MISUSE THIS MEDICATION?
  • Overdose of Ozempic or other similar prescription can cause low blood sugar or hypoglycaemia, which can lead to more health complications
  • Common side effects include gastrointestinal symptoms including nausea, vomiting, diarrhea, abdominal pain and constipation
  • Other possible side effects include pancreatitis, changes in vision, low blood sugar, kidney failure and gallbladder issues.
  • Furthermore, it is not suitable for people with medullary thyroid cancer or certain endocrine disorders
THE GO-TO OPTION TO REDUCE BODY WEIGHT SHOULD ALWAYS BE LIFESTYLE & DIET MODIFICATION

Diet is the key component in weight management. Many people are aware of this, but only a few succeeded in making changes to their diet in order to achieve a healthy body weight.

This is because most people initiate the lifestyle and diet changes without proper planning and consultation from experts such as nutritionists and dietitians.

With proper consultation from nutritionist and dietitian, weight loss progression can be measured with a much higher success rate.

Dietitian can personalize weight management plan effectively and safely while taking into account the underlying contributing factor needs to be addressed for each individual.

THE RISK OF BUYING OZEMPIC FROM UNLICENSED OR ILLEGAL SOURCES WITHOUT A PROPER PRESCRIPTION

In cases where one requires Ozempic, it should only be used under a doctor’s prescription and purchased from a licensed pharmacy.

Members of the public should keep in mind to not purchase this drug online via illegal sources as this puts their health at risk health.

They will also subject genuine people with diabetes that need this medication to unnecessary distress, should the medication run out of stock due to the self-prescribing habit of the netizens.

Another issue of note is that this medication has to be handled with care under tight temperature control as it is a cold chain medicine. Once the cold chain is broken, the efficacy may be affected and may also cause unwanted side effects.

Highlights of the Safe Medication Disposal Practices Roundtable

WORDS LIM TECK CHOON

Alpro Pharmacy hosted an industry roundtable, called Safe Medication Disposal Practices in Malaysia–Past, Present & Future, on 15th December 2022 at Monash University Malaysia.

Highlight 1
THE NEED FOR PROPER DISPOSAL OF MEDICINES
  • According to Foon Hwei Foong from Malaysian Community Pharmacy Guild, unwanted medications disposed into landfills are reabsorbed by water streams. This means that these medications eventually leads back to the water that we drink.
  • Dr Saw Pui San, a lecturer from Monash University Malaysia’s School of Pharmacy, cited how irresponsibly discarded contraceptive medicines ended up in our waterways and caused the sterilization of fishes.
  • Antibiotics are strictly regulated prescription medication, and many efforts were made to prevent antibiotic resistance. However, another often overlooked possible cause of antibiotic resistance is the leakage of improperly discarded antibiotics into our water systems.
Highlight 2
THE POLICY IS THERE, BUT THE AWARENESS AMONG THE PUBLIC IS LACKING
  • Amrahi Buang, President of the Malaysian Pharmacists Society, stated that laws and policies are in place across all access points of medication distribution in this country, with the Malaysian National Medicines Policy (MNPP) clearly stating the measurements and governance in place for medication safety.
  • He opined that health and medication literacy is still lacking within the Malaysia public, hence the need for an pharmaceutical industry medium to act as an education platform for the public.
  • Furthermore, he stated that pharmacists are strongly encouraged to start working collaboratively with their colleagues as well as other key players in the pharmaceutical industry to educate on, implement, and practice safe medication disposal.
  • Ostwin Paw, the CEO of Alpro Foundation, called for leaders in the industry to kickstart the conversation on the impact and risks of unsafe medication disposal methods on the environment.
Highlight 3
ALPRO PHARMACY HELPS TO LEAD THE WAY 
  • Lim En Ni, the Chief Pharmacist of Alpro Pharmacy, shared that Alpro Pharmacy launched the Safe Medication Disposal campaign in 2021 in a joint effort with several key pharmaceutical companies in the country.
  • To date, the initiative has safely disposed more than 1,000 kg of medication waste as well as garnered more than 100,000 signatures from the community pledging their support within 3 months since July 2022.
One of the key initiatives of the Safe Medication Disposal campaign is the placement of dedicated medication disposal bins at all Alpro Pharmacy outlets nationwide to collect excess medicines for proper and ethical disposal. For more information on this as well as on proper medical disposal, click here to visit the Safe Medical Disposal Campaign webpage (link opens in a new tab).

Important Advice to Stay Prepared During the Monsoon Season

WORDS LIM EN NI

FEATURED EXPERT
LIM EN NI
Chief Pharmacist
Alpro Pharmacy

The Malaysian Meteorological Department (MetMalaysia) recently announced that Malaysia will experience continuous heavy rainfall from mid-November, leading to probable major flash floods in several states, and the monsoon season will last until early next year.

We would like to outline several precautionary measures for residents in flood-prone areas, from a community pharmacist’s point of view, to proactively mitigate flood damages ahead of the period and in the aftermath.

BEFORE A FLOOD
  • Closely monitor your surroundings and stay up to date on weather forecasts and warnings
  • Assemble disaster supplies, including long-term medications and first aid kits in water-proof bags in case of evacuation.
  • People, especially the elderly, with chronic diseases, are advised to visit their nearest pharmacy and bring along with their chronic medications, in order to keep a record in the pharmacy and have an up-to-date medication list; this will be useful should one lose the hard-copy of their prescription and face difficulties in retrieving their medication
AFTER A FLOOD
  • Due to poor sanitation and hygiene in flood areas, there is a high risk of flood-borne diseases such as leptospirosis, cholera, and dengue fever. Keep an eye out for general symptoms such as fever, headache, diarrhoea, muscle aches, and vomiting. In the case of any such symptoms, please visit the nearest healthcare centres immediately.
  • Alpro Pharmacy and DOC2US have launched the Life-saving Medication Care Programme, which provides a one-time supply of medications for up to 7 days for free. Those with contaminated or lost chronic disease medications can visit an Alpro Pharmacy outlet and speak to the pharmacist for more details. Note that a police report copy of the flooding is required for verification purposes.

Empowering Pharmacists to Better Serve The Nation

WORDS LIM EN NI

FEATURED EXPERT
LIM EN NI
Chief Pharmacist
Alpro Pharmacy

For the longest time, the role of a pharmacist has been seen by many, even among those in the profession, as retailer of supplements and other healthcare products. However, due to the COVID-19 pandemic, the general public have come to recognize the values community pharmacists bring.

MEDICATION SAFETY

Very often, patients with multiple non-communicable diseases (NCDs) were prescribed with medications by different doctors, they might not be aware of possible medical contradictions. They brought these medications to community pharmacists like me, and we helped them review and explain the dosage and possible side effects of each medicine. Most importantly, pharmacists ensure the safety of patients from medication errors.

ACCESSIBILITY

Pharmacies are usually open for long hours and pharmacists offer informal, appointment-free consultation. At the height of the pandemic when clinics and hospitals required COVID-19 screening prior to consultation with doctors and patients avoided going to high-risk places, community pharmacists filled the gap by offering advice on COVID-19 and other health related matters including basic health screening and re-filling much needed chronic prescriptions through collaboration with telemedicine providers.

SOLUTION-BASED SERVICES

In recent years, many product-based retail pharmacists have transited to community pharmacists with solution-based services, such as wound-care, smoking cessation service, and diabetic-care.

THUS, COMMUNITY PHARMACIES INFLUENCE NATIONAL HEALTH CARE PROGRESSION IN POSITIVE WAYS

It is high time for the Government to endorse community pharmacists as an integral part of community health and wellness by allocating funding for programmes in support of the Government’s efforts in creating a smoke-free generation, battling against NCDs and providing preventive care for the ageing population.

The inclusion of community pharmacists in the Government’s outreach plan will benefit the country as a whole, as it will ultimately reduce medical costs, improve population health, increase the quality of healthcare in Malaysia and contribute to the country’s GDP.

This year, The International Pharmaceutical Federation announced the theme of World Pharmacist Day 2022 as “Pharmacy United in Action for a Healthier World”. This theme invites comrades from all sectors of the pharmacy profession to take part in the campaign. Regardless of culture or point of view, the core duty of every pharmacist remains—to safeguard medication safety for everyone.