DIC workshop for staff nurse students.pptx

Slide note on Drug information and workshop for nursing student

1. Drug Information center, Nepal (DIC, Nepal) Presented by:- Trilochan Panday Drug Information officer

2. Public Health Concern Trust, Nepal (phect-NEPAL) was founded in 1991. It is a secular, non-political, not-for-profit, national level non-government organization committed to health development. DIC is supported by: Kathmandu Model Hospital Institute of Health Science, Bagbazar Kirtipur Hospital, Kirtipur

3. Drug Information Center Nepal (DIC, Nepal) DIC was established on 31 st Ashad of 2078 as an integral unit of phect-NEPAL Began its in-house(within phect-Nepal) services from 1 st Shrawan 2078 Nationwide opening was held on 29 th Poush 2078 by former Health Minister Mr. Birodh Khatiwada .

4. Working Modality Office Time: 9:00 am to 4:00 pm (However, queries can be placed any time via toll-free number & social media. Response will depend on urgency of request.) Human Resource: Full Time Pharmacist 2 Consultant Pharmacist 5 Office Location: Budhabudhi complex (phect-Nepal central building), Bagbazar, Kathmandu.

5. Drug Information Center The Drug Information Centre (DIC) provides authentic, unbiased, well referenced and up-to-date information on any aspect of drug use to healthcare professionals, research scholar and patients. In addition, DIC also publishes periodic health bulletin, newsletter and organizes workshop to enhance the skills of healthcare professionals.

6. History of DIC 1960s Development of the term “Drug Information” 1962 First drug information center at the university of Kentucky medical center, USA 1964 Conference on drug information services 1967 The “drug information specialist” 1975 The Millis commission report, American Association of Colleges of Pharmacy (AACP) described the main function of pharmacists as providers of drug information.

7. History of DIC in Nepal

8. Need of DIC Increase in number of drugs and formulations in pharmaceutical market. Easy access of haphazard information (biased/unauthentic). Increase of patient flow, clinicians might lack time to get updated drug information. Increase in irrational drug uses & antimicrobial drug resistance. Increase in overall health care expenses due to poly pharmacy & irrational drug use.

9. Goal To enhance overall drug-related knowledge of health care personnel as well as the general population. To minimize adverse drug reactions, misuse, and abuse of drugs. To promote patient care through the rational use of medicines.

10. Objectives To provide authentic, individualized, accurate, relevant, unbiased and well-referenced medication information  to health care professionals(HCP), patients and general public. To conduct research activities in different health and medicine related areas like adverse drug reaction, patient compliance, drug utilization etc. To organize public awareness, training program and CMEs. To participate in ADR reporting and prepare for pharmacovigilance centre. To prepare and disseminate periodic, and online-based newsletters and bulletins. To prepare counseling aids related to different drugs and dosage forms.

11. Services Query Handling Counseling services. Continuing medical education(CME) & Seminar. Video presentation of medical devices. Public awareness. Publications (Newsletter, Bulletins & leaflets)

12. Query Handling Regulatory Registration Status Availability Therapeutic Use Adverse Drug Reactions Contraindications, Warning & Precautions Dosage/Administration Drug Interactions Drugs in pregnancy/lactation Stability/Compatibility Pharmacodynamics and Pharmacokinetics Drug/Therapeutic Efficacy and Comparison Pharmaceutics Identification Pharmacoeconomics Overdose/Poisoning (Immediate Referral) Literature Retrieval Other Rejected Education and counselling

13. Query handling flow chart

14. Continuing Medical Education (CME)

15. CME on Medication error Pharmacovigilance and importance of ADR reporting

16. World patient safety day and overview of CVP line

17. CME on polypharmacy in elderly patient

18. Public awareness

19. International day against drug abuse and illicit trafficking

20. World Pharmacist day celebration

21. Participated in a health camp organized by KMH-IHS to aware public about proper use of antibiotics

22. "Visit of MMIHS B.Pharm 4th Year Students to DIC, Nepal as per TU curriculum "

23. Promotional activity

24. Video promotion by our PATRON Madan Krishna Shrestha and Hari Bansha Acharya. https://www.youtube.com/watch?v=aOMT7tHtZ3o

25. Counselling aids Preparation of counseling aid (Video, pamphlets, flex etc.) Revolizer (Video) Rotahaler (Video)

26. INSULIN PEN

27. Research S.N. Research 1. Drug Information Services in Nepal: An Overview, Present Scenario and Future Perspective 2. Antibiotic Consumption Pattern in Intensive Care Unit and Internal Medicine Departments of Kathmandu Model Hospital 3. Evaluation of the different types of drug-related inquiries received in a drug information center (DIC), Nepal

28. How to place query at DIC, Nepal? Toll free number:16600121500 Social media: Viber/ Whatsapp : [phone] Gmail: [email protected] Website : www.dicnepal.org/query-placement/

29. Medical devices in COPD/Asthma

30. Introduction. Asthma/bronchial asthma is a Chronic inflammatory disorder of the airways . Asthma is now considered as inflammatory condition which is trigger by various factors such as infection, irritants, pollution exercise, exposure to cold air etc Disease characterized by increased responsiveness of trachea and bronchi to various stimuli result in inflammation and bronchospasm. COPD : It is chronic obstruction of airway due to chronic bronchitis and/or pulmonary emphysema Common symptoms include wheezing, coughing, chest tightness, and shortness of breath. Symptoms can range from mild to severe .

31. Classification of drug Bronchodilators: β Sympathomimetics ((β 2 agonist) : Salbutamol, Terbutaline, Bambuterol , Salmeterol , Formoterol , Methylxanthines : Aminophylline ,, Theophylline , Doxophylline . Anticholinergics / antimuscuranic : Ipratropium bromide, Tiotropium bromide. Leukotriene antagonists : Montelukast , Zafirlukast . Mast cell stabilizers: Sodium cromoglycate Ketotifen . Corticosteroids : Systemic (oral/IV: Hydrocortisone, Prednisolone Inhalational: Beclomethasone dipropionate , Budesonide, Fluticasone propionate, Flunisolide , 5) Anti- lgE antibody: Omalizumab

32. ROTAHALER

33. REVOLIZER

34. INHALER

35. Inhaler with spacer पहिले हात राम्रो संग साबुन पानिले धुनुहोस र हात सुक्न दिनुहोस्। अब, इनहेलर र स्पेसरको दुबैको मुखमा लगाएको बिर्को निकालनुहोस्। यदि तपाईले यो पहिलो पटक प्रयोग गर्दै हुनुहुन्छ भने वा लामो समय देखि यसलि प्रयोगमा ल्याउनु भएको छैन भने, वा इन्हेलर भुइमा खस्यो भने; इन्हेलरलाई हल्लाएर पहिलो एक पफ आफ्नो आनुहार भन्दा टाढा हावामा फ्याक्नुहोस्। अब, इन्हेलरलाई स्पेसर संग जोड्नुहोस। ईन्हेलरलाई करिब ०५ सेकेन्ड सम्म राम्ररी हल्लाउनुहोस्। अब, इन्हेलरलाई सिधा ठाडो पारेर समात्नुहोस्; जस्मा तपाईको माहिलि औला क्यानेसटरको माथिल्लो भागमा र बुढी औला तल्लो भागमा राखी समात्नु पर्ने हुन्छ। अब, मुख बाट बिस्तारै श्वास बाहिर फ्याक्नुहोस सकेसम्म सबै सास बाहिर फाल्ने कोसिस गर्नुहोस। भिडियोमा देखाए जस्तै जिब्रोलाई स्पेसरको माउथ पिससंग नछोइने गरि दांत र ओठको बिचमा च्याप्नुहोस् (तर दातले टोक्ने चाहि होइन)। (यदि स्पेसरमा मास्क जोड्नु भएको छ भने, मास्कले लाक र मुख पुर्ण रुपमा ढाक्ने गरि राख्नुहोस्।) अब क्यानेस्टरलाई माहिली औलाले दबाऊनुहोस्, र बिस्तारै श्वास भित्रै सम्म लिनुहोस्। यो प्रक्रियालाई ०४ देखि ०५ सेकेन्ड लाग्न सक्छ। अब,औषधिलाई फोक्सोमा रहनदिनका लागि श्वासलाई सकेसम्म ०५ देखी १० सेकेन्ड सम्म वा सक्ने जाति रोकि राख्नुहोस् ( मनमनै १० सम्म औलामा गन्नुहोस्। यदि तपाईले पुर्ण रुपमा श्वास लिन सक्नु भएन वा श्वासलाई लामो समय सम्म रोक्न सक्नु भएन भने फेरि एक पटक स्पेसरमा भएको औषधि तान्नुहोस् र श्वासलाई सकेसम्म ०५ सेकेन्ड संम्म रोक्नुहोस्। (शिशु तथा बालबालिका वा अन्य जो कोहिले पनि राम्रो संगश्वासलिन वा रोक्न सक्नु भएन भने स्पेसरमा भएको औषधिपर्ण रुपमा लिनका लागि ०५/०६ पटक सामान्य तरिकाले श्वास लिन सकिन्छ।) यदि दिश्रो पफ पनि लिनु पर्ने छ भने अन्दाजि १५ देखि ३० सेकेन्ड पछि मात्रै दोश्रो पफ लिनुहोस र तयसका लागि बुदा न. ०५ देखि १० सम्म पुनस्च: दोहोर्याऊनुहोस्। तर २ पफ एकै पटक स्पेसरमा भने नहाल्नुहोस्। औषधिको मात्रा लिई सके पछि इनहेलरको बिर्को लगाऊनुहोस्। यदि तपाइले लिनु भएको इन्हेलरको औषधिमा स्टेरोइड जस्तै Beclomethasone, betamethasone, fluticasone जस्ता औषधिहरु समावेष गरिएका छन भने ,( औषधी लिएको २-५ मिनेट पछि ) सफा पानिले मुख कुल्ला गरि त्यो पानि बाहिर फ्याक्नुहोस। हजुरले एऊटै स्पेसरबाट एक वा एक भन्दा बढि औषधिको प्योग गर्न सक्नु हुन्छ तर त्यसका लागि एऊटा इनहेलर प्रयोग गरिसके पछि बल्ल त्यो निकालेर अर्को इनहेलर औषधि प्रयोग गर्नु पर्दछ।