The Prevalence of Hypersensitivity Reactions to Snake Antivenoms Administered in Sultanah Nur Zahirah Hospital From 2013 To 2016

@#Introduction: Snakebite is an important medical emergency. Antivenoms remain the only proven treatment for snake envenoming. However, the use of antivenom is associated with hypersensitivity reactions. The aims of this study were to determine the prevalence and types of hypersensitivity reactions and types and outcomes of pharmacological and non-pharmacological treatments for antivenom reactions among snakebite patients that received antivenoms. Methods: This was a 4-year cross-sectional study of snakebite patients from January 2013 to December 2016 in Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. Data was extracted from the Pharmacy Record on the usage of antivenom and patients of snakebites treated with antivenom were identified. Data of patients were then obtained from the electronic medical records.’ Demographic details, clinical features and characteristics of antivenom reactions of patients were recorded in standardized data collection forms and analyzed using chi-square or MannWhitney U tests. Results: Of the 44 patients who received antivenom, 24 (54.5%) developed hypersensitivity reaction. All patients developed reaction early. No patient developed delayed (serum-sickness) reaction. Of the 24 patients, 14 (58.3%) had moderate to severe hypersensitivity reaction and 9 (37.5%) patients had mild reactions. Only one (4.2%) patient presented with bradycardia. Conclusion: The prevalence of early hypersensitivity reaction to snake antivenom in HSNZ was relatively high. Healthcare providers should be aware of the appropriate method of preparing and administering antivenom, and the management for acute hypersensitivity reactions. This will optimize the management of snakebite and ensure patient safety

Exploring the factors associated with the intention to assess customers’ herbal and dietary supplement use by community pharmacists in Kuala Lumpur, Malaysia

Community pharmacists (CPs) often stock herbal and dietary supplements (HDS) at their community pharmacies. Therefore, CPs should be held responsible for ensuring safe and appropriate use of HDS. The present study aims to investigate the factors associated with the intention (INT) of CPs to assess their customers’ HDS use. A crosssectional study using a self-completed questionnaire was employed. A questionnaire along with a cover letter and stamped envelope was sent to CPs at community pharmacies located in Kuala Lumpur, Malaysia. Only 70 out of 533 CPs responded to the survey (response rate = 13.13%). The results showed that 11.4% (8/70) of CPs always assess customers’ HDS use. The CPs, however, had positive and moderately high INT to assess customers’ HDS use (mean = 3.84 ± 0.70). Positive and significant correlations were noted between INT and belief about consequences, moral norms, belief of capabilities, and role and identity. The relationship between INT and social influences was statistically insignificant. Efforts to enhance the INT of CPs to assess customers’ HDS use should be warranted. This could be achieved by enhancing beliefs that are positively associated with the CPs’ INT to assess customers’ HDS use.