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Envelope-to: ghani@jack.ngo,
 hadi@jack.ngo,
 hafiz@jack.ngo,
 mirzaee@jack.ngo,
 musawy@jack.ngo,
 pharmacy@jack.ngo
Delivery-date: Tue, 19 May 2020 03:49:55 -0400
From: <pharmacy.kdz@jack.ngo>
To: <pharmacy@jack.ngo>
Cc: "'hafiz'" <hafiz@jack.ngo>,
	<ghani@jack.ngo>,
	<hadi@jack.ngo>,
	<musawy@jack.ngo>,
	<mirzaee@jack.ngo>
References: <005101d62d29$35ec0e60$a1c42b20$@jack.ngo> <20200518012305.Horde.V-aCAMYCQEm80OD5PxJBNkP@www.jack.ngo> <000301d62deb$ca5aa170$5f0fe450$@jack.ngo> <20200519031756.Horde.VC-CjGp9BIn_pn4fSCXUdRc@www.jack.ngo>
In-Reply-To: <20200519031756.Horde.VC-CjGp9BIn_pn4fSCXUdRc@www.jack.ngo>
Subject: RE: Emergency request of anesthesia medicine
Date: Tue, 19 May 2020 00:49:50 -0700
Message-ID: <005401d62db2$1651da60$42f58f20$@jack.ngo>
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Dear Dr sahib I got your recommendation and I will wait for their =
justification.

regards

-----Original Message-----
From: pharmacy@jack.ngo [mailto:pharmacy@jack.ngo]=20
Sent: Tuesday, May 19, 2020 12:18 AM
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

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 . =20
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;=20
> 'hafiz' <hafiz@jack.ngo>
> Subject: Re: Emergency request of anesthesia medicine
>
> Dear Jamal,
> The BPHS and EPHS determine the base for services and medicine=20
> 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=20
> medicines are not fulfilling their requirement such as morphine,=20
> tramadol, ketamine, spinal lidocaine), we will  check the market,=20
> please let us know the quantities required and health unit=20
> 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=20
>> 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 =E2=80=93 Metoprolol 5mg
>>
>> 4.       Vial =E2=80=93 Propofol 0.1%
>>
>> Please let us know the JACK policy regarding using and purchasing of=20
>> these items.
>>
>> Also we will send our revised and approved pharmaceutical request to=20
>> you ASAP, before that if you revised the pharmaceutical order based=20
>> on budget and our physical inventory please share that with us in=20
>> order both revised pharmaceutical order should be the same and there=20
>> should not be any delay from our side on procurement process.
>>
>>
>>
>> Best Regards,
>>
>>
>>
>>
>>
>>
>>
>> Mohammad Reza =E2=80=9CJamal=E2=80=9D
>>
>> Pharmacy/Warehouse Officer
>>
>> Just for Afghan Capacity and Knowledge       =D8=A8=D9=84=D9=86=D8=AF =
=D8=A8=D8=B1=D8=AF=D9=86 =D8=B3=D8=B7=D8=AD =D8=AF=D8=A7=D9=86=D8=B4 =
=D9=88
>> =D8=AA=D9=88=D8=A7=D9=86=D9=85=D9=86=D8=AF=DB=8C =
=D8=A7=D9=81=D8=BA=D8=A7=D9=86=D9=87=D8=A7 (=D8=AC=DA=A9)
>>
>> 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