Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention &...
Transcript of Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention &...
![Page 1: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/1.jpg)
Overview of Poisoning Incidence and the
Pharmacists Role in Prevention
& Management of Poisoning
Prof. Rahmat Awang
National Poison Centre
Universiti Sains Malaysia
1st. National Poisoning Symposium 2016: Pharmacist’s Role in Poisoning Prevention and Management
5th-6th March 2016 St. Giles Wembley Hotel, Penang
![Page 2: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/2.jpg)
DRUG AND POISON INFORMATION
SERVICES
To function as the main resource centre in providing information on toxicity and risk of poisons
To assist in the management of poisoning cases.
To systematically disseminate drug and poison information and advice through the use of efficient, reliable and cost-effective methods
DRUG & POISON
INFORMATION
![Page 3: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/3.jpg)
24 hrs Service
After Office Hours
Including Weekends &
Public Holidays
Hrs
![Page 4: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/4.jpg)
94 119 133 231 231 288 278 291 387
859 1280
1501 1925
2595
3392
5022
6172
3556
4533
4996
0
1000
2000
3000
4000
5000
6000
7000
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Nu
mb
er
of
case
s
Year
Number of poisoning cases referred for enquiries
![Page 5: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/5.jpg)
Poisoning cases statistic
• There were more than 35,000 poisoning cases enquiries that has been reported to the poison centre since its establishment from the year 1995. These poisoning cases involve:
Phar Pharmaceuticals,
Drugs of abuse,
Pesticides,
Industrial chemicals,
Household products eg; cleaning agents personal care products
Natural toxins eg; mushrooms ,marine toxins
![Page 6: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/6.jpg)
0% 1% 0%
0%
Household product (8463, 25%)
2%
1%
3% Pharmaceutical
products (12084, 36%)
Pesticides (9609, 29%)
2% 1%
Distribution of poisoning cases by TYPES of agent(2006-2014)
Unknown function
Agricultural/Garden product
Environment contaminant
Food & Beverages
Household product
Industrial/Commercial product
Mixtures of agents
Natural toxin
Pharmaceutical product
Pesticide
Substance of abuse
Others
![Page 7: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/7.jpg)
1685 373
307 535
953 14
306 27
280 299
2510 386
2189 21
277 1038
253 581
50
0 500 1000 1500 2000 2500 3000
Analgesic
Antiinfective
Cough & cold
Gastrointestinal drug
Herbal remedies
Psychiatric drug
Topical agent
Vitamin/Mineral
Antidiabetic
Unknown medicine
Number of cases
Typ
e o
f p
har
mac
eu
tica
l pro
du
cts
PHARMACEUTICAL products poisoning ( 2006-2014)
![Page 8: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/8.jpg)
0
1000
2000
3000
4000
5000
3303
4166
957
54
923
30 159 17
Nu
be
r o
f ca
ses
Type of pesticides
PESTICIDE poisoning (2006-2014)
![Page 9: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/9.jpg)
0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000
Automotive
Cleaner/Bleach/Disinfectant
Cosmetic/Personal care
Electric/Electronic component
Solvents
Stationery/Art & Craft
Mixed household products
Other household product
Unknown household product
761
4558
611
49
1218
211
37
1013
5
Number of cases
HOUSEHOLD PRODUCTS poisoning (2006-2014)
![Page 10: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/10.jpg)
0 100 200 300 400 500
Snake
Spider/Scorpion/Centipede
Insect
Jellyfish
Other marine toxin
Plant
Bacteria/Fungi/Algae
Other natural toxin
Unknown natural toxin
418
119
36
30
54
74
157
23
4
Number of cases
Typ
e o
f n
atu
ral t
oxi
ns
NATURAL TOXIN poisoning (2006-2014)
![Page 11: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/11.jpg)
Intentional Incidents (Insiden sengaja)
Frequency Percent Valid
Percent
Suicidal (Bunuh diri) 15200 45.1 83.9
Abortion (Pengguguran) 18 0.1 0.1
Abuse (Penyalahgunaan) 722 2.1 4.0
Others (Lain-lain) 263 0.8 1.5
Unknown (Tidak diketahui) 1233 3.7 6.8
Misuse (Tidak patuh cara guna) 680 2.0 3.8
Total (Jumlah) 18116 53.8 100.0
Unintentional Incidents (Insiden tidak sengaja)
Frequency Percent Valid
Percent
Accidental (Kemalangan) 13426 39.9 90.9
Environmental (Alam sekitar) 35 0.1 0.2
Others (Lain-lain) 132 0.4 0.9
Therapeutic Error (Ralat terapeutik) 516 1.5 3.5
Unknown (Tidak diketahui) 152 0.5 1.0
Inapproriate Use (Tersalah cara guna) 173 0.5 1.2
Occupational (Pekerjaan) 331 1.0 2.2
Transport accident (Kemalangan kenderaan)
1 0.0 0.0
Total (Jumlah) 14766 56.1 100.0
Intentional 54%
Un-Intentional
44%
Adverse Reaction
1%
Unrecorded/
unknown 1%
Type of poisoning incidents (2006-2014)
(Jenis insiden keracunan)
![Page 12: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/12.jpg)
Poisoning in children
• More than half of poisonings occur in young children,
with those 1–3 years of age presenting the highest risk.
• Serious poisoning is more likely when a child ingests an adult-strength, high-potency, sustained-release product
• Oral hypoglycemic agents,analgesics, sedative-hypnotics, and cardiovascular drugs account for the highest rate of hospitalization and injury rates in young children
![Page 13: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/13.jpg)
37
1
11
2452
64
4
53
2355
884
24
13
46
0 500 1000 1500 2000 2500 3000
Agricultural/Garden
Environmental …
Food and Beverages
Household/Leisure
Industrial/Commer…
Mixture of agents
Natural Toxins
Pharmaceutical
Pesticide
Substance of abuse
Unknown Function
Others
Children poisoning by type of agent (2006-2014)
5-14 yrs
1-4 yrs
4 weeks - 12 months
0-4 weeks
![Page 14: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/14.jpg)
Poisonings in Adolescents
• Though they are less frequent compared to young children, but they are often more serious.
• More than half are intentional (i.e. suicide or recreational drug abuse)
• Example of some commonly abused medications include dimenhydrinate, dextromethorphan
benzodiazepines.
![Page 15: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/15.jpg)
Poisonings in Adults
• In adults, intentional poisonings are more common than unintentional poisonings;
• Unintentional poisonings can result from therapeutic errors or drug interactions, or from taking more than one product containing the same ingredient or with similar effects.
• Common therapeutic errors in adults include repeat doses, taking the wrong medication, taking doses too close together, and incorrect dosing route
![Page 16: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/16.jpg)
0 1000 2000 3000 4000 5000 6000 7000 8000
Agricultural/Garden
Environmental contaminant
Food and Beverages
Household/Leisure
Industrial/Commercial
Mixture of agents
Natural Toxins
Pharmaceutical
Pesticide
Substance of abuse
Unknown Function
Others
247
8
54
4022
642
254
601
6792
7005
555
70
86
Teenagers and adult poisoning by type of agent (2006-2014)
>=75yrs
20-74 yrs
15-19yrs
![Page 17: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/17.jpg)
Unintentional poisoning
• Pharmacists can promote poison prevention by encouraging all consumers to use child resistant packaging and to keep all medications out of reach of children.
• Information can be targeted to those picking up prescriptions for opioids, cardiovascular medications, and sedative-hypnotic agents
Role of pharmacist in poisoning prevention & management
![Page 18: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/18.jpg)
Unintentional poisoning(cont)
• Parents, grandparents, and caregivers should keep the phone number of the local poison control centre with other emergency numbers, and know basic first aid in case a poisoning occurs.
• Pharmacists can increase awareness by distributing poison prevention pamphlets and poison control centre phone numbers.
Role of pharmacist in poisoning prevention & management
![Page 19: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/19.jpg)
Intentional poisoning • Intentional poisoning occurs when someone abuses medication for
recreational purposes. Patterns of drug abuse differ by region, vary with time, and are often inventive.
• Community pharmacists must be knowledgeable about local drug abuse trends to address adverse effects, potential interactions, drug diversion issues, and overdose management. Poison control centres, drug information centres, local law enforcement agencies, and internet sites can provide insight into local drug abuse patterns.
• Awareness of local drug abuse practices can also help pharmacists enhance patient care by identifying patients at risk for drug overdose and misuse.
Role of pharmacist in poisoning prevention & management
![Page 20: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/20.jpg)
Intentional poisoning (cont) • Anyone who expresses the hint of suicide should be taken
seriously. Poison prevention in this patient population will involve working with other healthcare professionals, agencies, and family members.
• The pharmacist can limit the number of pills provided at one time to a suicidal or depressed patient and monitor the intervals between refills to ensure appropriate use and prevent drug hoarding.
• Pharmacists must protect the patient’s right to confidentiality, but this may be breached when failure to disclose information could place the patient in serious danger.
Role of pharmacist in poisoning prevention & management
![Page 21: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/21.jpg)
![Page 22: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/22.jpg)
Sun
Buletin
Guidelines & Training Materials Books Articles in Magazine
Articles in
Newspaper
The NPC has
produced various health-related
educational materials since its
inception.
Brochure
![Page 23: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/23.jpg)
Interactive Multimedia Content
![Page 24: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/24.jpg)
INFORMATICS FOR COMMUNITY HEALTH
Integrate two important disciplines:
health (science)….
and literacy (arts)….
to form Health Literacy…..one of the pillar of health promotion
![Page 25: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/25.jpg)
Our Products
![Page 26: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/26.jpg)
![Page 27: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/27.jpg)
Examples of Products Developed
![Page 28: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/28.jpg)
![Page 29: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/29.jpg)
TOXICOLOGY IN THE CLASSROOM- TEST RUN IN MALAYSIA, ARGENTINA & GHANA
DISCUSSIONS WITH TEACHERS TEACHING IN ARGENTINA
LEARNING TOXICOLOGY IN ARGENTINA
LEARNING TOXICOLOGY IN GHANA
LEARNING TOXICOLOGY IN MALAYSIA
TEACHING IN GHANA TEACHING IN GHANA
VIPP IN LEARNING TOXICOLOGY
![Page 30: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/30.jpg)
LEARNING TOXICOLOGY IN MALAYSIA
CROSS WORD PUZZLE SELF- LEARNING
VISUALIZING CONCEPT SPIDER MAP GAME
COMPUTER COURSEWARE
GROUP WORK MATCHING
CAT-WALK PROTECTING ATTIRE
READING INFORMATION FROM PRODUCT CONTAINERS LECTURE
![Page 31: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/31.jpg)
VISUALISATION IN PARTICIPATORY PROGRAMME [VIPP]
![Page 32: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/32.jpg)
International Children Book Fair, Shanghai, China 1-3 Nov 2013
![Page 33: Overview of Poisoning Incidence and the Pharmacists Role ... · Pharmacists Role in Prevention & Management of Poisoning ... Buletin Guidelines ... ..one of the pillar of health promotion.](https://reader031.fdocuments.us/reader031/viewer/2022021916/5cd76bb788c993515c8ca4d3/html5/thumbnails/33.jpg)
Thank You
Transforming Higher Education For A Sustainable Tomorrow