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VOL 20 NO 3 Jul - Sep 2013 ISSN 1727-2874 EDITIORIAL COMMITTEE Editorial Editor-in-Chief CHEUNG, Hon-Yeung Cheung Hon-Yeung 97 Managing Editors CHENG, Mary TSANG, Warren Secretary WONG, Johnny News & Short Communications Treasurer TAI, Candy Business Manager KWAN, Wanda Boxed Warning on Increased Mortality and Severe Renal Injury and 99 KWOK, Ritchie Risk of Bleeding on the Use of Hydroxyethyl Starch Solutions Section Editors Pharmacy Education & Practice CHONG, Donald Updates on the Use of Codeine: Restrictions on Use of Codeine for 99 CHAN, Phoebe Drugs & Therapeutics CHAN, Esther Pain Relief in Children LEUNG, Wilson OTC & Health EWIG, Celeste Updates on the Use of Diclofenac 99 Pharmaceutical Techniques & Technology CHEUNG, HY TONG, Henry Canada: Important Changes to the Availability and Conditions of 101 Herbal Medicines & Nutraceuticals CHEUNG, HY Society Activities WONG, Helen Use for Drugs Containing Calcitonin New Products CHAN, Ivy LEUNG, Lucilla Increased Glucose Level May Increase the Risk of Dementia 101 PANG, Bobby EDITORIAL ADVISORY BOARD Singapore: Potential Interaction between Warfarin and Health 101 Prof. CHAN, Hak-Kim Prof. CHANG, Pong Supplements Containing Vitamin K Prof. CHERN, Ji-Wang Prof. CHIANANGG, Chiao-Hsi Dr. CHING, Wei-Mei Prof. CHO, Chi-Hin New Partner State Key Laboratory Pushes Frontiers in Metabolic 102 Prof. CHOW, SS Moses ProProf. HUI, SC Sarah Medicine Prof. LI, CH Paul Prof. LI, Wan-PoPo AlAlain Prof. LEE, An-Rong Prof. LEE, Hon-leung Vincent Dr. MORGAN, Rae MM. Proff. O’TTOOLE, Desmond K Canada: Association of Sutent (sunitinib malate) with Stevens- 102 Dr. TIAN, Hui DrDr. WORSLEY, Alan Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) Prof. YANG, Chih-Hsin David ThThe Hong Kong Pharmarmaceutical Journal, the publisher, the editorial Hong Kong Pharmacist Won the 2013 Royal Pharmaceutical 103 board and the resspective member societies are not responsible for the Society Leadership Award Recognizing Work in Elderly Homes completeeneness and accuracy of the articles and advertisements conttained in the Hong Kong Pharmaceutical Journal. The Journal will Medicines Safety nonot be liable to any damages to persons and properties. Readers are advised to approach the respective authors and advertisers for Erratum for Volume 20(1) January- March, 2013 103 information in case of doubts. Copyright © 2013 by Hong Kong Pharmaceutical Journal Pharmacy Education & Practice All rights reserved. No part of this publication or its supplement may be A Community Pharmacist Can Make a Difference - An Interview with 104 reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage Anita Chan and retrieval system, without permission in writing from the Publisher. LAI, Man-Chit; LI, Yuen-Yu; CHONG, Donald Wing-Kit All communications and enquiries should be directed to: The Secretary, Hong Kong Pharmaceutical Journal, Drugs & Therapeutics G.P.O. Box 3274, General Post Office, Hong Kong Cross Sensitivity Reaction of Different Drug Classes (2 CE Units) 107 For all enquiries regarding advertisement, please contact: KWOK, Ching-Chi Ritchie; MAK, Wai-Ming Raymond Ms. Wanda Kwan (Tel. 61086231) or Ms. Ritchie Kwok (Tel: 96457911) at the following email address: [email protected] Pharmaceutical Techniques & Technology No Improvement in Hand Skin Quality by Coenzyme Q10 Topical 116 INSTRUCTIONS FOR AUTHORS Formulation among Young and Old Healthy Female Volunteers The Hong Kong Pharmaceutical Journal iss a journal of the pharmacists, TONG, Henry H.Y. for the pharmacists and by the pharmarmacists. Submissiions are welcome for the following sections: Herbal Medicines & Nutraceuticals Pharmacy Education & PrPractice Drugs & Thherapeutics OTC & Health Pharmaceutical Techniques & Technology “Chinese Medicines are Toxic” is a Misconception 120 Medicatiotion Safety Herbal Medicines & Nutraceuticals LO, Wai-Man; CHEUNG, Hon-Yeung Society Activities New Products Comments on any aspects of the profession are also welcome as Letter Society Activities to the Editor. Hong Kong Pharmacy Conference 2014 124 TheThere is no restriction on the length of the articles to be submitted. They can be written in English or Chinese. The Editorial Committee may make editorial changes to the articles but major amendments will New Products be communicated with the authors prior to publishing. AFINITOR® (Novartis Oncology) 125 It is preferable to have original articles submitted as an electronic file, Edarbi® Tablets (Takeda Pharmaceutical) 127 in Microsoft Word, typed in Arial 9pt. Files can be sent to the following address: e-mail: [email protected] SPECIAL ISSUE ACPE Abstracts of 8th Asian Conference on Pharmacoepidemiology: 129 address: G.P.O. Box No. 32744, “Applying pharmacoepidemiology to improve health care in Asia” General Post Office, Hong Kong Hong Kong For detail instructions for authors, please refer to the first issue of each volume of HKPJ. HKPJ VOL 20 NO 3 Jul-Sep 2013 95 Editorial Scientifi c Approach to the Vigilance and Risk Management of Medicines From the front cover and the thickness drugs, which may have advantages as well as disadvantages of this issue of the HKPJ, readers depending on their overall effect. Kwok and Mak reviewed some wouldn’t have diffi culty to fi nd that this is new evidences available and pointed out that cross sensitivity due a special issue devoted to the scientifi c to medication of different classes of drug should not be ignored. For meeting of the 8th Asian Conference on more details about cross sensitivity reaction of different classes of Pharmacoepidemiology, which will be drug, one should refer to page 107-114. held in Hong Kong from October 25-27.(1) As with many western pharmaceuticals, some herbal The goal of this meeting is to address, (5,6) discuss or exchange ideas relevant remedies have risk associated with their use. The fact that a to the vigilance and risk management botanical is completely natural does not necessarily make the of medicines. Around two hundred use of botanical substance risk-free. Several botanicals, when researchers and experts from the fi eld of consumed in their most natural form, can cause grave illness apply pharmacoepidemiology in different or even death in humans and animals. Although many of these countries will get together to report their discovery studies on drug botanical substances are routinely avoided by herbalists, scientists, adverse problems or solutions of medication with aim to improve and the general public because of their risks, yet hundreds of herbs health care in Asia. A list of these participants and the title of their and alternative medicines exist, and most of which have not been reports is shown in page 130-131, while abstracts of their report studied adequately, particularly in relation to their toxicology. A could also be found in this issue. This meeting is organized and large retrospective study of admissions to the casualty department hosted by the Department of Pharmacology and Pharmacy of of a Taiwanese hospital found that 4% of admissions were related the University of Hong Kong with the support from the Chinese to herbal drug use, ranking herbal remedies third among drug Pharmaceutical Association, the Hong Kong Pharmaceutical categories most responsible for adverse effects. Nevertheless, Society and the International Society for Pharmacoepidemiology. over reaction to the presence of some toxic components in Chinese Hence, it will certainly be a big event for all pharmaceutical medicines is unnecessary. As it is pointed out by some experts professions in Hong Kong. that excessive amount of a toxicant in some Chinese medicines is either a tactic to combat a disease or a misunderstood of its Although most therapeutics in use today have gone through effect. Many western drugs, in particular, chemotherapy drugs, premarketing study usually involves a few thousands of patients, it are extremely toxic yet they are still in use as long as they are has been found that it is not a reliable tool to discover uncommon used under proper monitoring by a doctor. For more details of this effects of a drug. A recent example was the worldwide withdrawal discussion, readers are encouraged to read an article written by of a synthetic antibacterial fl uoroqunolone derivative, temafl oxacin, Lo and Cheung in page 120-123. following postmarketing detection of hemolytic anaemia and other serious adverse reaction.(2,3) As defi ned by the medical faculty of False claim of effectiveness, whether deliberately or Johns Hopkins University in Maryland, pharmacoepidemiology is unconsciously, is another matter deserves people as well as the the study of the utilization and effects of drugs in large numbers of regulatory authority’s attention. Although it may not do immediate people; it provides an estimate of the probability of benefi cial effects harm to a patient, it is an economic lost, and may deprive the of a drug in a population and the probability of adverse effects. It right of receiving an expected effect or a proper treatment for the can be called a bridge science spanning both clinical pharmacology person. Tong reported that addition of Coenzyme Q10 into topical and epidemiology. Pharmacoepidemiology concentrates on clinical hand skin preparation failed to enhance skin barrier function in patient outcomes from therapeutics by using methods of clinical comparison to that of a placebo (page 116-119). Although the study epidemiology and applying them to understanding