JezK

Edit File: 1589872676.M838505P1475118.mocha3025.mochahost.com,S=5136,W=5277:2,S

Envelope-to: pharmacy.kdz@jack.ngo,
 hafiz@jack.ngo,
 ghani@jack.ngo,
 hadi@jack.ngo,
 musawy@jack.ngo,
 mirzaee@jack.ngo
Delivery-date: Tue, 19 May 2020 03:17:56 -0400
Date: Tue, 19 May 2020 03:17:56 -0400
Message-ID: <20200519031756.Horde.VC-CjGp9BIn_pn4fSCXUdRc@www.jack.ngo>
From: pharmacy@jack.ngo
To: pharmacy.kdz@jack.ngo
Cc: 'hafiz' <hafiz@jack.ngo>, ghani@jack.ngo, hadi@jack.ngo,
 musawy@jack.ngo, mirzaee@jack.ngo
Subject: Re: Emergency request of anesthesia medicine
References: <005101d62d29$35ec0e60$a1c42b20$@jack.ngo>
 <20200518012305.Horde.V-aCAMYCQEm80OD5PxJBNkP@www.jack.ngo>
 <000301d62deb$ca5aa170$5f0fe450$@jack.ngo>
In-Reply-To: <000301d62deb$ca5aa170$5f0fe450$@jack.ngo>
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Dear Jamal,
Till receiving feedback from surgeon or anesthesiat, the followings  
are our recommendation:
1-Pentazocine, not recommended at DH and CHC+. As we have already safe  
post operative analgesics for caesarian section such as morphine,  
tramadol , paracetamol and ibuprofen.
2- Ephedrine is required when patient may go hypotensive during spinal  
anesthesia specially with Bupivacaine. Though Bupivacaine it self is  
not in DH level, but Lidocaine + Dextrose spinal is not always  
available in the market and instead suppliers sending Bupivacaine. So  
ephedrine may be required in small quantities(DH and CHC+).
3-Metoprolol is not in essential medicine list and not recommended .  
Instead we have Hydralazine injection , to be supplied in CHC +s and  
DH.If additional quantity required, you can add.
4- Propofol is not recommended in DH and CHC +s. As it side effects  
management will be difficult at DH and CHC+ level. We have Ketamine  
and spinal Lidocaine or Bupivaicaie which can cover our services of  
Appendectomy or Caesarian section.
The contraindication of Ketamine  in pre)eclampsia can be covered with  
spinal lidocaine (or Bupivacaine)

With best regards

Quoting pharmacy.kdz@jack.ngo:

> Thank you very for your comment, I will share the needed quantities ASAP.
>
> -----Original Message-----
> From: pharmacy@jack.ngo [mailto:pharmacy@jack.ngo]
> Sent: Sunday, May 17, 2020 10:23 PM
> To: pharmacy.kdz@jack.ngo
> Cc: mirzaee@jack.ngo; musawy@jack.ngo; hadi@jack.ngo;  
> ghani@jack.ngo; 'hafiz' <hafiz@jack.ngo>
> Subject: Re: Emergency request of anesthesia medicine
>
> Dear Jamal,
> The BPHS and EPHS determine the base for services and medicine  
> required for each HF level. We can provide additional services when  
> it is required. The following medicine is not recommended for a CHC  
> + facilities. But only in DH level if surgeon and anesthetist  
> recommend and they have to provide justification(why current BPHS  
> medicines are not fulfilling their requirement such as morphine,  
> tramadol, ketamine, spinal lidocaine), we will  check the market,  
> please let us know the quantities required and health unit  
> justification.
> The review for your quarterly order will be shared soon.
> With regards
> KBL PHARMA TEAM
>   Quoting pharmacy.kdz@jack.ngo:
>
>> Dear KBL Pharmacy & Procurement Team,
>>
>>
>>
>> I received an emergency request regarding of anesthesia medicine from
>> Khan Abad DH and Archi CHC+ and I am sure we need these items to other
>> CHC+s and DH too, which are not based on BPHS manual such as:
>>
>> 1.       Amp - Pentazocine 30mg
>>
>> 2.       Amp - Ephedrine 50mg
>>
>> 3.       Amp – Metoprolol 5mg
>>
>> 4.       Vial – Propofol 0.1%
>>
>> Please let us know the JACK policy regarding using and purchasing of
>> these items.
>>
>> Also we will send our revised and approved pharmaceutical request to
>> you ASAP, before that if you revised the pharmaceutical order based on
>> budget and our physical inventory please share that with us in order
>> both revised pharmaceutical order should be the same and there should
>> not be any delay from our side on procurement process.
>>
>>
>>
>> Best Regards,
>>
>>
>>
>>
>>
>>
>>
>> Mohammad Reza “Jamal”
>>
>> Pharmacy/Warehouse Officer
>>
>> Just for Afghan Capacity and Knowledge       بلند بردن سطح دانش و
>> توانمندی افغانها (جک)
>>
>> Address: Kunduz,Kocha Sinama,First Region
>>
>> Beside Da Afghanistan Bank, House # 08
>>
>> Ph: +93 767 648 896
>>
>> Email:  <mailto:pharmacy.kdz@jack.ngo> pharmacy.kdz@jack.ngo
>>
>> Website:www.jack.ngo