Pharmacist in Transplantation – the OT

Adlin Nadia Zakaria
Pharmacist, Selayang Hospital

In the ever increasingly complex world of Transplantation, a transplant pharmacist could be providing clinical services such as Medication-Use Management, Medication Regimen Review, Medication Use Evaluation, Drug Information, Formulary System & Adverse Drug Reaction to the Transplant Team. In Selayang Hospital, pharmacist is involved in the preparation of the drugs used pre-, intra & post transplant via a list. This minimizes preparation time and maximizes patient safety through limiting the selection of drugs, quantities and dosage forms. The trends in drug use or disappearance could also be easily identified, noted and reconciled, thus, reducing wastage. Pharmacist could keep track of the drug inventories and facilitate in the matter of drug expiration dates.

In specialized situation such as G6PDH Deficiency or other metabolic disorder, the pharmacist could provide a suitable regimen. It is also beneficial to have a specified member of the team who could help screen for drug allergies and review potential drug-disease, drug-drug interaction and able to communicate these pertinent information's to the relevant personnel. The services provided could be further enhances by developing pharmaceutical practice guidelines. Throughout the operation procedure, the pharmacist should be able to provide timely and accurate drug information in response to known needs or random inquiries, including issues pertaining to dose, administration, dilution, time of administration, cost or even the availability of the items. In cases requiring prompt action, having a pharmacist in the OT, the urgency can be easily translated and immediately responded upon. In Selayang Hospital experience, where the majority of the liver transplant recipients are children. We have to find out a way to ease these children medication regimen. Most of the immunosuppressant drugs in the market are made for adult and it is difficult to procure formulations, other than capsules @ tablet into the country. With the pharmacist network, we were able to find suitable formulas and procure the necessary materials to provide these children the medications.

In conclusion, we believe that every transplant program should include a dedicated clinical pharmacist to contribute towards optimizing patient outcome as the contribution of pharmacist enables the transplant team to have a more in depth and comprehensive perspective when designing and implementing drug regimen.