pharmacy practice unit-3 B.Pharmacy 7th Semester 2021 (2020-2021) Previous Year's Question Papers/Notes Download - HK Technical PGIMS

A.PHARMACY AND THERAPEUTIC COMMITTEE:

Introduction:

➢ The pharmacy and therapeutic committee(PTC) is a standing medical committee of healthcare

professionals.

➢ This committee is composed of physicians, pharmacists ,nurses and other health professionals.

➢ In other words ,PTC are the group of medical staff who perform advisory functions for the safety of

patient’s health.

Scope and Functions of PTC:

• To serve in an advisory capacity to the medical staff and hospital administration in all matters

pertaining to the use of drugs.

• To develop a formulary of drugs acceptable for use in the hospital and provide for its constant revision.

• To establish programs and procedures that help ensure cost-effective drug therapy.

• To establish or plan suitable educational programs for the hospital’s professional staff on matters

related to drug use.

• To participate in quality-assurance activities related to the distribution, administration and safe use

of medications.

• To review adverse drug reactions and medication errors occurring in the hospital and recommend

corrective action.

• To advise the pharmacy in the implementation of effective drug distribution and control procedures.

Responsibility of PTC:

• Preparation of hospital formulary.

• Ensure patients safety regarding proper medication.

• Broadcasting of bulletin.

• Formation of automatic stop orders for dangerous drugs.

• Regulation on the use of investigational drugs.

• Involved in the preparation of kits or carts for a medical emergency.

• Program development for the reporting and assessing of the adverse drug reactions.

Role of PTC in Automatic stop orders for dangerous drugs:

➢ PTC has to set the policy for automatic discontinuation of all medication prescriptions after 48 hours

for sedative and hypnotics, narcotics ,anticoagulant and antibiotics containing drugs.

➢ Another way is prescription strictly indicates the dispensing of an exact number of doses to be

administered and if require more need to re-order the medications.

➢ There must be a policy for a rewrite of prescription order every 24 hours for narcotics and CNS active

drugs.

Role of PTC in developing of emergency Drugs list:

➢ Considering the time factor in an emergency ,the PTC of a respective hospital must get ready for the

availability of emergency kits/drug boxes/medicine for patients use at the bedside.

➢ Some emergency supplies likes syringes of various ranges such as 1,2,5,10 and 20 ml ,Needles of 16,18

,20,21 ,23 and 26, Airway equipment ,Tourniquets and files should maintained in emergency box.

➢ Some drugs like Aminophylline ,Atropine sulphate ,Caffeine, Calcium gluconate ,Digoxin, Epinephrine

,heparin, hydrocortisone etc should be maintained in emergency box.

Dispensing of drug to Inpatient:

➢ Inpatients are those who get hospitalized for treatment of disease ,surgery and rehabilitation.

➢ Dispensing of drugs to inpatient falls within four categories are as follows:

1. Individual prescription order system :This system is generally used by small or private hospital

because of the less manpower requirement and the appeal for individualised service .In this,

all the medication order are directly reviewed by the pharmacist and easily interaction of

pharmacist , Doctor ,nurse and patient in the medication matters .Medication errors could

avoid.

2. Complete floor stock system(charging policy):- Under this system, both pharmacy and

nursing are responsible for distribution to patients .According to this system the drugs are

stored at the nursing station and administered by the nurses according to the order of the

physician commonly used drug insignificant quantity are stocked on the floor station or in the

ward .It is categorised into two:

A.Charge floor stock drugs

B.Non-chargefloor stock drugs

3. Combination of individual prescription order system and complete floor stock system:

4. Unit dose dispensing system:- Unit dose medications are those which are ordered, packaged

and administered in single or multiple units containing a predetermined amount of drugs and

doses.

Advantages:

✓ Patients receive better health services and have to charge for those drugs and doses

which are administered to them.

✓ Nurses get more time for patient care.

✓ Reduce revenue losses.

Dispensing of drugs to outpatient:

➢ It is also called ambulatory services and refers to those patients who are not occupying beds in

hospital or in clinics, health centre, and other places when they come for consultation ,diagnosis,

and treatment.

➢ Categories of ambulatory services :

• Emergency Outpatient: For emergency outpatient, 24 hours services are given who require

immediate care for survival.

• Reffered Outpatient: These patients are referred to the hospital for a specific purpose due

to lack of facilities available with the private clinic practitioners or patient who needs extra

care.

• Special Outpatient: After compilation of general check-ups, the patients are asked to go for

accurate diagnosis by clinical, pathological, or radiological examination. After receiving the

test report of examination medicine is given to him.

• General Outpatient: This patients come for a general check-ups and medicines are

prescribed to them. They may either undertake minor surgery, superficial surgery, or

dressing at hospital. Outpatient decides the images of the hospital as per the service

received by them.

 

B. INFORMATION SERVICES:

Pharmacy Information System (PIS):

➢ Pharmacy information system (PIS) is a system that has many different functions in order to maintain

the supply and organisation of drugs. It can be a separate system for pharmacy usually only, or it can

be coordinated with an inpatient hospital computer physician order entry (CPOE ) system.

➢ It is used to reduce medication errors, increase patient safety, report drug usages, and track costs

➢ Inpatient PIS are used in hospital setting while outpatient PIS in home setting for discharged patients,

clinics, long term care facilities, and home healthcare.

Drug and Poison Information Service:

➢ Drug Information Service (DIS) are the critically, relevant, and currently examined data on the drug

and drug use for a given patients or situation . Many of the organisations run DIS and provide drug

information from any place to every kind or group of people.

➢ Major goal: “To improve patient care service and provide unbiased information for various drug

related questions.”

➢ The Poisons Information Centre (PIC) is a specialised service or centre dedicated to involving in

providing information on the prevention, diagnosis, and management of poisoning. In most of the

developed countries, there is an established facility of the poison control centre , analytical laboratory

with poison information service, and facility of patient management. In India , AIIMS, New Delhi has

established National Poisons Information Centre (NIPC) which provides toxicological information as

well as guidance on the management of poisoned patients.

Poison Control Centre(PCC):

➢ A Poison Control Centre (PCC) is rapid access and immediate medical facility centre. The centre can

provide free and immediate export opinion on the telephone for assistance and management in case

of exposure to poisonous substances . The centre also provide information on medicines, domestic

products, pesticides, bites and stings, food poisonings, and fumes. It also covers the information

about the body , health, or diseases to better utilization of the drug Information.

Sources of drug Information:

1. Primary Sources: The primary sources of drug information is undertaken by the authors without

access by a second party. Such types of source provides current drug information. Examples: Articles

published in journals.

2. Secondary Sources: In this source, the originality of drug information has been evaluated by a second

party other than the publisher. This type of information is modified and in rearranged form. Example;

review articles such as Lexis, Nexis, medline, etc.

3. Tertiary Sources: In this source, the drug information is collected from primary and secondary sources

and organised in a manner to represent a composite of the available information. Example ;

Encyclopaedia, dictionaries, textbook, guides, official pharmacopoeia such as BP, USP, IP, BNF, etc.

Information Storage And Retrieval System (ISAR):

 

➢ ISAR is an organized process of collecting and classification of data so that the information can be

easily located and displayed on request. The user of computers and data processing techniques has

made this possible to assess a large amount of information for academic, government, and

commercial purposes.

➢ Types of storage media includes hard drive , floppy disc, CD and DVD, USB flash drive.

➢ Major components of information retrieval includes database, search mechanism, language and

interface.

C . PATIENT COUNSELLING :

Introduction:

➢ Patient Counselling is defined as delivering the medication information to the patients or their

representatives either orally or in written form regarding how to use the medical prescription on

possible side effects, precautionary measures, storage conditions, consumption of diet, and

modification of lifestyle if any requires.

➢ In other word, Patient Counselling is a two way communication methods in which interaction

between the pharmacist and patient is essential for effective counselling.

➢ Four major steps to be used during patient Counselling:

I. Preparing for the session.

II. Opening of the session.

III. Counselling content.

IV. Closing the session.

Special cases require for the pharmacist:-

1. Patient care: There is a significant and positive impact of pharmacists on patient care and therapeutic

outcome through effective patient Counselling.

2. Understanding of the Therapy: Pharmacist can provide better information and effectively understand

the patient on the drug therapy.

3. Proper use and management of adverse effects of the medication: Pharmacist has more information

and knowledge about the proper uses and adverse effects of the medicine. so he can provide

information effectively to the patients.

4. Improving patient adherence and motivating to take an active role in health: Pharmacist has a great

role in the improvement of patient adherence. He plays an active role in health education. During the

dispensing of the drug, the pharmacist provides behaviour and emotional support. Sometimes

pharmacist also collaborates with patient to incorporate the medication regimen in their daily

schedule particularly when there is complex therapeutic regimen and elderly patients.

Outcomes of Patient Counselling:

• There may be better patient sympathy for their illness and the role of medication in its treatment.

• There is enhancing in the professional relationship between the patient and the pharmacist.

• There is improved medication compliance.

• There is more effective drug treatment.

• There is a reduction in the incidence of medication errors, unnecessary medical costs.

• There are better managing approaches to the adverse effect of medication.

 

D. EDUCATION AND TRAINING PROGRAM IN THE HOSPITAL :

Introduction:

➢ It is scientific process of improving the knowledge and skills of employee for doing a particular job.

➢ The main purpose of training is to mould the behaviour of new recruits so that they can do their job

in a more efficient way.

➢ In hospitals education and training activity includes undergraduate and graduate programme in

medicine, teaching student nurses, training of technologist, physiotherapist, dietician, administrative

residents, social service worker and pharmacist.

Role of pharmacist in the education and training program:

• Educating the medical and allied health professional as well as the patients about medicine.

• Participate in education program related to different medical area such as psychiatric, physical,

rehabilitation, special education program like diabetic or cardiac patient.

• To instruct on all medicine including; pharmacokinetic properties, adverse drug reactions, and drug

interactions.

• To monitor products sold directly to the public, prescription trends, and the selection management,

and procurement of drugs by government and local purchasing agents.

• Educate general public through lecture or demonstration about the rational use of drugs and their

dosages.

Internal training program:

➢ This program are generally carried out in hospital by hospital staff which is associated with the use

of the hospital’s resources and expertise to develop and deliver the specific type of training .

➢ This type of program is generally provided to the entire newly recruited employees at the time of

their joining of the hospital and a session of introductions to the hospital‘s quality policy, Vision,

Mission and other policies and procedures, job description and responsibilities etc are taught to

employee.

➢ The purpose of such training in hospital is to make the employee familiar with the normal working

condition such as handling of the patient, cleaning of machinery, storage of materials, sterilization

etc.

External Training Program:

➢ The external training program are generally conducted by someone from the outside of the hospitals.

➢ External training programmes are sometimes also named off-the-job training which is organized at a

site, which is away from the hospital work environment for a particular periods. In this program,

various case studies, conference, audio-visuals, seminars, simulations, role play and lecture are

conducted by an external expert.

➢ This training also include advancement/ introduction/ changing technology/ equipment training to

upgrade them according to situation.

Services to the nursing home/clinics:

➢ Nursing homes delivered the services of residential care for elderly or disabled people.