Conference Papers
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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item A case series of duplication errors due to brand name confusion - experience from a Sri Lankan teaching hospital(Sri lanka Medical Association, 2015) Mamunuwa, A.M.V.G.N.; Jayamanne, S.F.; Coombes, J.; Lynch, C.B.; Perera, D.M.P.; Pathiraja, V.M.; Shanika, L.G.T.; Mohamed, F.; Dawson, A.H.INTRODUCTION AND OBJECTIVES: Confusion with drug names has been identified as a leading cause of medication errors. The majority of these errors result from look-alike or sound-alike drugs. This case series aims to provide examples of duplication errors due to brand confusion where there are no similarities in the names. METHOD: Information for this case series was extracted from a database prospectively collected from Colombo North Teaching Hospital as part of a study conducted to evaluate the impact of the addition of a clinical pharmacist to the standard inpatient care. RESULTS: Of 800 patients reviewed during the study period of 7 months, clinical pharmacist identified 8 cases of duplication errors due to prescribing both generic and brand names of the same drug, but with no similarities in names. Cases identified include a duplication of frusemide caused by the lack of awareness that 'Amifru' {a combination of frusemide and amiloride) contains frusemide. Similarly, a patient was prescribed 'H. Pylori Kit' plus the three individual drugs included in the 'Kif prescribed using their generic names. A patient was found to be taking two different brands of carbidopa plus levodopa not knowing the two contained the same drugs. CONCLUSION: Brand confusion does not necessarily arise from look-alike or sound-alike drug names. It can be due to numerous brands of generic ingredients and lack of awareness of drug names among the patients. Employing trained clinical pharmacists in the wards, educating patients on discharge drugs and appropriate labeling of medicines may prevent these errors.Item Importance of communicating medication changes to patients at discharge -a prospective case study(Sri lanka Medical Association, 2015) Pathiraja, V.M.; Jayamanne, S.F.; Lynch, C.B.; Coombes, J.; Perera, D.M.P.; Mamunuwa, A.M.V.G.N.; Shanika, L.G.T.; Mohamed, F.; Dawson, A.H.INTRODUCTION AND OBJECTIVES: Patients may inadvertently continue their previous medication regimen without understanding changes made by prescribers as part of in-patient care. Inadequate patient education at discharge can lead in some instances to readmission and increased morbidity. The objective of this study is to identify the importance of patient education with regard to changes to their medications. METHOD: This study was part of a prospective study carried out in two medical wards of Ragama teaching hospital to evaluate the effect of a clinical pharmacist's interventions on quality use of medicines. We identified cases from the control group of this study to illustrate the importance of patient education at discharge. RESULTS: From telephone follow-up (six days post discharge), only 89 of 337 patients in the control group reported being informed of changes to their pre-admission medications by a doctor or nurse. There were!24 cases where we have identified patients continuing at least one pre-admission medication which was stopped or changed while they were in hospital. A particular instance is a patient who continued to take sodium valproate post-discharge as per previous drug regimen after being diagnosed with valproate induced hepatitis. He was discharged on phenytoin. CONCLUSION: This study highlights the importance of ensuring patient education about changes made to existing medications whilst in hospital to ensure improved outcomes and reduce the risk of adverse events. The clinical pharmacist is well placed to assist medical teams by providing patients with appropriate education about medication changes and to provide appropriate educational material.Item Multidose activated charcoal in acute oleander poisoning - a longitudinal observational study(Sri Lanka Medical Association, 2009) Jayamanne, S.P.; Senarathna, L.; Dawson, A.H.BACK GROUND: Deliberate self-poisoning with yellow oleander seeds is associated with severe cardiac toxicity and a mortality rate of about 5%- 10%. Specialised treatment is expensive and not widely available. Multiple-dose activated charcoal (MDAC) binds cardiac glycosides in the gut lumen and promotes their elimination. There have been conflicting results on whether activated charcoal benefits patients with yellow oleander poisoning. METHODOLOGY: Patients who were admitted to Polonnaruwa General Hospital before September 2007 received single dose charcoal if they presented within two hours of poisoning. Patients who were admitted after September 2007 received MDAC (50 g 6 hourly for 48 hours). In this study, the clinical features and development of serious cardio toxic effects (2nd and 3rd degree heart block) following yellow oleander poisoning was assessed in patients who were admitted during a period of eight months prior to September 2007 and eight months afterwards. RESULTS: There were 254 patients before starting MDAC and 237 patients after starting MDAC. They were of comparable age and sex distribution. Proportion of patients who were transferred with 2nd and 3rd degree heart block for cardiac pacing in the pre MDAC group was 51 (20.1%) 95% CI (15.5%-25.5%). In the post MDAC group it was 30 (12.7%) 95% CI (8.9%-17.3%), the odds ratio was 0.58 (95% CI 0.35-0.94) for this relationship. There was no difference in deaths. Interpretation: The administration of multi dose charcoal in yellow oleander poisoning was associated with a 40% reduction in cardiac toxicity and the need to transfer for pacing.