The Pharmaceutical Department of the Tamale Teaching Hospital (TTH) has described as mischievous and outlandish a claimed by some doctors of the hospital that the department had issued an expired anaesthesia drug to them for use.
In a letter dated on February 13 2017, the chief Anaesthesia of TTH threatens to withdrawn their services alleging that, they have been using expired drugs to treat patients, an allegation the Pharmaceutical Department vehemently refuted.
According to the Pharmacists, the allegation label against their department is unfounded and absurd, saying, there have never been a situation where they issued expired drugs.
The pharmacists in an interviewed with savannanews24.com said, they are professionals and will not compromise their professionalism, adding that, they have a conscience that will not allow them to administer expired drugs to their patients.
When our team visited the medical stores of the hospital, there were drugs, most of the essential drugs are available in the stores and the drugs are of quality and not expired.
Officials of the Food and Drugs Board in Tamale upon their investigations has also confirmed the quality and validity of the drugs.
According to Mr. Bugri Amos, the Senior Pharmacist and Pharmacist in-charge of the Pharmacy stores at the Tamale Teaching Hospital, the allegations is a smear-attack on the hard working pharmacists at the hospital, wondering the motive of those making the allegations.
He said, “we do not have any expired drugs especially anaesthetic drugs that are expired and have been issued to any unit from the pharmaceutical department at all and I’m surprise that some expired drug are been use at the theatres, it is very strange”.
Mr. Amos said, the Pharmacy Department has a process in handle expired drugs, saying, there is a place in the unit where all expired drugs are quarantine and also all pharmacy units at the hospital are supposed to return drugs that are expired back to the pharmacy stores for a proper disposal.
“There are processes of disposing medications, so you come to the store, you pick your medications and take them to your various units and eventually if you are not able to use all and they are expired it is your duty as the unit head to return the expired drugs at the pharmacy store for onward disposal, so we do not keep expired drugs at the stores”.
The Senior Pharmacist in-charge of the stores hinted that, anaesthetic drugs such as Vecuronium, Suxamethonium chloride and Neostigmine are not expired as alleged by the Chief Anaesthesia of the hospital, adding that, Etomidate which was alleged to be expired has also never be in stock of the hospital stores.
Savannanews24 can also confirm upon our checks that, the Etomidate has never been in stock at the pharmacy stores and has never been procured according the Deputy Supplier Chain Manager/Procurement Officer of the Hospital, Mr. Paul Senyo-Gawu.
In an interviewed with Mr. Samuel Sinikan, a pharmacy at the accident and emergency unit of the hospital , there is no way a pharmacist can issued expired drugs, adding that, there are check and balances in issuing drugs to patients.
He reiterated that, the system that they use will not allow expired drugs to be dispensed, saying that, the allegations is not only an indictment to the pharmaceutical department but also the nurses and doctors as well who are supposed to check expired dates of drugs before they administer to patients.
Mr. Samuel revealed that, for some time now the pharmaceutical department has become the center of excellence of the hospital due to the innovative ideas of the Director of Pharmacy Mr. Hamidu Abdulai.
He therefore described the allegation as bizarre and pure sabotage towards the hard won reputation of the Director of Pharmacy who have work so hard to transform the pharmaceutical department of the hospital.
Our investigations revealed that, the Director of Pharmacy Mr. Hamidu Abdulai has initiated a satellite pharmacies at all units of the hospital to ease the hassle of patients in dispensing drugs.
Again, the Tamale Teaching Hospital now runs a twenty four hour pharmacy services to their clients.
Meanwhile, some of these doctors according to our investigations who have launched this smear-attack on the Pharmaceutical Department of the TTH have their own Clinics and pharmacies where they refer patients to.
Some of the doctors alleged to have devise ways of smuggling expired drugs, from their private clinics and pharmacies into the hospital stores, a practice the pharmaceutical department is currently investigating.
Meanwhile, the hospital is currently under investigations on various managerial issues as various political groups are calling for immediate removal of the CEO, Dr. Prosper Akambong and disbandment of the Hospital Board led by Dr. Abdullah Tinorgah.
Dr. Prosper Akambong was appointed the substantive Chief Executive Officer of the TTH in 2014 after acting as CEO for one year when the then CEO of the hospital Dr. Ken Sagoe went on compulsory retirement from the public service in September 2013.
The anaesthetic agents
Etomidate is a short-acting intravenous anaesthetic agent used for the induction of general anaesthesia and sedation for short procedures such as reduction of dislocated joints, tracheal intubation, and cardioversion.
Etomidate suppresses corticosteroid synthesis in the adrenal cortex by reversibly inhibiting 11β-hydroxylase, an enzyme important in adrenal steroid production; it leads to primary adrenal suppression. Using a continuous etomidate infusion for sedation of critically ill trauma patients in intensive care units has been associated with increased mortality due to adrenal suppression. Continuous intravenous administration of etomidate leads to adrenocortical dysfunction.
The mortality of patients exposed to a continuous infusion of etomidate for more than 5 days increased from 25% to 44%, mainly due to infectious causes such as pneumonia.
Suxamethonium chloride, also known as suxamethonium or succinylcholine, is a medication used as part of general anesthesia for short-term paralysis to help with tracheal intubation or electroconvulsive therapy. It is given either by injection into a vein or muscle. When used in a vein onset of action is generally within one minute and effects last for up to 10 minutes.
Common side effects include low blood pressure, increased saliva production, muscle pain, and rash. Serious side effects include malignant hyperthermia and allergic reactions. It is not recommended in people who are at risk of high blood potassium or a history of myopathy. Use during pregnancy appears to be safe for the baby. Suxamethonium is in the neuromuscular blocker family of medications and is of the depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles.
Neostigmine, sold under the brand name Prostigmin among others, is a medication used to treat myasthenia gravis, Ogilvie syndrome, and urinary retention without the presence of a blockage. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type. It is given by injection either into a vein, muscle, or under the skin. After injection effects are generally greatest within 30 minutes and last up to 4 hours.
Common side effects include nausea, increased saliva, crampy abdominal pain, and slow heart rate. More severe side effects include low blood pressure, weakness, and allergic reactions. It is unclear if use in pregnancy is safe for the baby. Neostigmine is in the cholinergic family of medications. It works by blocking the action of acetylcholinesterase and therefore increases the levels of acetylcholine.
Vecuronium bromide, sold under the brand name Norcuron among others, is a medication used as part of general anesthesia to provide skeletal muscle relaxation during surgery or mechanical ventilation. It is also used to help with endotracheal intubation; however, suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.
Side effects may include low blood pressure and prolonged paralysis. Allergic reactions are rare. It is unclear if use in pregnancy is safe for the baby. Vecuronium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles
By: Hamza Lansah Lolly, Tamale