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Poison and Drug Information
Center
800 424
Yasser Sharif MD, MS
Head, Medication & Medical Product Safety
Head, Poison & Drug Information Center
Primary Functions
Answering patient-specific and general inquires regarding all
aspects of medication use & overdoses with medications or
chemicals from general public and HCP
Contact Information:
• Toll Free Number: 800-424
7:00 am – 3:00 pm, Sunday through Thursday. Voice mail for
after working hours.
• Email Us: [email protected]
• Ask PDIC & interactive chat window on haad.ae
PDIC Services
• Poison Prevention and
Management
• Drug Information
• Weekly Medication Safety
Alerts
• Surveillance
• Training Center
• Antidotes List and
Stockpile
• Publications
• PDIC Website
• Consumer Product
Surveys
• Quality Assurance
• Working with other
governmental agencies
• Role of PDIC in Chemical
Disaster
Other Activities
• Injury & Poison Notification System (IPNS) 2013
• Toxicology Lab Screening
• Working with AD QCC to regulate the use of
pesticides
• Role of PDIC in Chemical disaster
• National strategic stockpile
Safe Use of Medicine
Provide current accurate unbiased information on
• Dosage
• Administration to children
• Side effects and adverse drug reactions
• Medication storage, traveling with medicine..etc.
• Drug Identification
• Drug in pregnancy and lactation
• Interactions:
• Drug-Drug
• Drug-Food
Staffing and Resources
• Staffing: Medical Toxicologist and 5 pharmacists
Resources:
• Protocols for treatment of major poisoning
• SOPs for enquiry handling
• Databases: Drugdex ,Poisondex through MicroMedex
,Toxbase, Medicines complete, IDIS , Medical letter.
• On-line periodical access: Full access to on-line and print
holding of medical and pharmacy periodicals
Toxicall
Number of Drug Information Enquiries
2500
2217
2000
2004
1760
1609
1500
1000
865
931
935
Year 2008
Year 2009
668
500
0
Year 2006
1
Year 2007
Year 2010
Year 2011
Year 2012
Year 2013
1200
Enquiries By The Public Across The Years
1034
968
1000
800
800
602
600
362
400
200
142
173
214
7
0
Y05
2
Y06
Y07
Y08
Y09
Y10
Y11
Y12
Y13
Distribution Of Enquiries By Category (2013)
Number of Enquiries
300
250
269
275
247
245
200
161
150
100
84
57
50
0
3
276
34
34
24
12
26
16
Number of Poison Information Provided
130
119
94
85
59
Year 2009
4
Year 2010
Year 2011
Year 2012
Year 2013
Number Of Medication Safety Alerts That Were
Communicated To HCP
300
250
247
230
209
200
166
153
150
159
100
50
0
46
5
Year 2006
5
Adulterated Dietary Supplements
Year 2007
Year 2008
Year 2009
Year 2010
Year 2011
Year 2012
Year 2013
After Working Hours Missed Calls 2013
100
94
90
80
82
80
75
70
60
50
75
69
58
54
51
43
40
48
45
30
20
10
0
Jan
6
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Next Day Follow Up for the Missed Calls 2013
49
94
Irrelevant
219
149
No answer
Wrong number
Poison Case
86
7
123
Drug Enquiries
Hospital (Caller not identified)
Customer Satisfaction 2013
7
Total number of respondents 38
Customer Satisfaction 2013
7
Total number of respondents 38
Customer Satisfaction (2013)
Medication Safety Alerts
Was the medication safety information of benefit to your clinical practice?
7
Total number of respondents 79
Customer Satisfaction
Trends
Customers Evaluation of the Service
97%
100%
90%
98%
94%
87%
84%
80%
70%
60%
50%
40%
30%
20%
14%
10%
12%
2%
1%
3%
6%
0%
0%
2%
0%
year 2009
year 2010
year 2011
Very good to Excellent
7
year 2012
Average
Poor
year 2013
0%
HAAD Antidote Survey
Antidote
Atropine sulfate
(US/UK)
Calcium gluconate
gel (US/UK)
Calcium gluconate
INJ (US/UK)
Cyanide antidote kit
(US/UK)
Diazepam (UK)
Flumazenil(UK/US)
Number of hospital has
Antidote
adequate antidote (n
=20)
3(15%) Glucagon(UK/US)
0(0%) Methylene blue(UK/US)
20(100%) N-Acetylcysteine
(UK/US)
2(10%) Naloxone(UK/US)
14(70%) Phentolamine mesylate
(UK/US-Illinois)
6(30%) Sodium
bicarbonate(US/UK)
Number of hospital has
adequate antidote (n
=10)
2(10%)
9(45%)
8(40%)
4(20%)
4(20%)
14(70%)
Antidote Stock Standard
Phase 1: Survey the availability of antidotes in AD hospitals;
Antidote availability analysis in AD. Completed and submitted 2010 .
Phase 2: Standard finalized. Two lists has been created, basic and
advanced for private and public hospitals respectively (Nov. 2010).
Phase 3: Launching the antidote stock reporting and conduct
workshops started early 2011.
Phase 4: Receiving reports started on July 2011 (compliance with
first report ~100%)
Phase 5: Automation of reporting process
launching end of March 2012 (compliance ~100%)
Phase 6: Revision of standard (March 2013- Ongoing)
Facility Designation (total 33)
Advance List
13 HCFs
41%
Basic List
20 HCFs
59%
Automation of Antidotes
Stocking Reporting
Antidote Stock Deficiency 2011
40%
30%
Advance
20%
Basic
10%
Overall
0%
Jul-11
Aug-11
Sep-11
Oct-11
Nov-11
Dec-11
Percentage
Antidotes Stock Deficiency 2012
6%
5%
4%
3%
2%
1%
0%
Advance
Basic
Overall
Antidote Stock Defciency Graph 2013
Percentage Deficiency
Basic List
6.30%
Advanced List
6.00%
5.00%
4.00%
4.30%
5.00%
4.00%
5%
4.00%
5.00%
4.00%
3.60%
3.00%
2.70%
3.00%
2.70%
3.00%
2.80%
1.50%
1.13%
Jan
0.90%
Feb
1.00%
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Basic List Feedback
•
8/15 (53%) of the antidotes have other uses other than
just as antidote
•
Total cost of expired antidotes in all hospitals in
emirate of Abu Dhabi: 155,505 AED
•
Total Cost for Basic List: 20, 683 AED
Advanced List Feedback
• 16/34 (47%) of the antidotes have other uses other
than just as antidote.
• Total cost of expired antidotes in all hospitals in
emirate of Abu Dhabi: 545,229 AED
• Total Cost for advance list: 154,444 AED
• Revision of antidote standard.
• Publishing guidelines for antidote use on PDIC
website.
• Lectures for antidote use and common poisoning
situations.
Cough & Cold Product
Safety Survey
Child Resistant Cap
Child resistant
Non Child resistant Cap
23%
77%
Alcohol Content
Two products are recommended for children by the manufacturer despite of the high
alcohol content
Alcohol free
20%
Present and
not specified
7%
Present and
specified
12%
No mention
61%
Availability and convenience of
Dose measurement devices
Dose measuring device
Present: not well defined
30%
Present: clear
29%
Absent
41%
Household Product Survey
Household Product Survey
Child Resistant Package
Present
Absent
60%
16%
24%
Corrosive
Corrosive products
(not child resistant)
Household Product Survey
Product Labeling in English and Safety Measures
Available
46%
54%
26%
74%
Purpose of use Directions for
is clear
the proper use
and storage
50%
50%
Provide all
cautionary
information
necessary
Not available
32%
68%
15%
46%
75%
85%
54%
25%
Keep away
First aid
Child-resistant
from children Information in
container
statement
case of
exposure
Contact
information
PDIC & Adulterated Products
Enquiries 2010-2013
(Total # = 7383)
Other Medicines Enquiries
Weight Reduction Products
Body Building
Sexual Enhancement
General Health Natural Products
HAAD Weight-Loss Supplements
Survey
• The survey identified 82 products containing 516
separate ingredients.
• The mean number of ingredients per product was
7.45± 6.2
HAAD Weight Reduction Survey
HAAD Weight Reduction Survey
% of Products Containing Top 10 Ingredient
50
43.9
39
40
31.7
30.5
30
18.3
20
10
0
15.9
15.9
13.4
12.2
11
11
8.5
Adulterated Virility Products
•
•
•
•
None of confiscated products (101) passed all criteria
for general sales items.
Active ingredients not listed in 35% of the products.
Lack of concentration of active ingredients in 93%.
Lack of safety data in (88%) such as cautions,
contraindications, adverse effects
Adulterated Virility Products
Adulterated Virility Products
• Early 2000: Satibo®
• Analysis for the content of the capsules were
negative for undeclared ingredients.
• The soft gelatin capsule shells were heavily
impregnated with sildenafil.
Adulterated Virility Products
Adulterated Virility Products
Unusual active ingredients in (13%) such as
•
•
•
•
Camel’s horn extract
Jinnee’s tail extract
Turtle’s shell
yak’s testicles
Adulterated Products Alerts
Worldwide
90
80
70
60
UAE
50
FDA
40
MHRA
30
Health Canada
20
10
0
2004
2005
2006
2007
2008
2009
2010
2011
Bodybuilding Products
Bodybuilding Products
Bodybuilding Products
Bodybuilding Products
Outreach Program
– Workshops: on poisoning and medication
• HCPs through HAAD CME: more than 2000 HCPs
• General public
– Poison Prevention week campaign: shopping malls at Al
Ain and Abu Dhabi, combining educational and fun
activities, Campaign website.
– PDIC Website: www.pdic.haad.ae
– Publications :
• Brochures (32): Arabic and English
– 132,180 brochures distributed to 529 locations in Abu Dhabi
and UAE
• Abu Dhabi MED-TOX UPDATE Newsletter
– Soft and hardcopies distributed to HCPs in UAE
Abu Dhabi Poison Prevention Week
Abu Dhabi Poison Prevention Week
Abu Dhabi Poison Prevention Week
Abu Dhabi Poison Prevention Week