“PRAISE BE TO THE ALMIGHTY GOD”
Dr. G Praveen Kumar
Department of Pharmacy practice,
C.L. Baid Metha College of Pharmacy.
Incharge-Drug Information Centre & Patient Counseling,
VHS(voluntary health care) hospital, Adayar, Chennai
GPP is the practice of
pharmacy that responds to the
needs of the people who use
the pharmacists’ services to
provide optimal, evidencebased care.
Requirements of good
• The core of pharmacy activity is to help patients
make the best use of medicines, through;
– the supply of medication and other health-care products
of assured quality
– the provision of appropriate information and advice to the
– administration of medication
– the monitoring of the effects of medication use
– the promotion of rational and economic prescribing, as
well as dispensing
• GPP requires that the objective of each element of
pharmacy service is relevant to the patient, is clearly defined
and is effectively communicated to all those involved.
• Multidisciplinary collaboration(TEAM WORK) among healthcare professionals is the key factor for successfully
improving patient safety.
ROLES OF PHARMACIST
• Prepare, obtain, store, secure, distribute,
administer, dispense and dispose of medical
• Provide effective medication therapy management
• Maintain and improve professional performance
• Contribute to improve effectiveness of the healthcare system and public health
.…..WE ALREADY DID/DOING IT……..
LOOKS SIMPLE BUT
HOW TO OVERCOME THIS?
ANS: SPECIALITY PHARMACIST
A STEP FORWARD…..
PHARMACIST(dispensing) MUST GETS SPECIALIZED IN;
•Drug information services
• Services which cover the activities of specially trained
individual to provide accurate, unbiased, factual information
in response to patient oriented drug problems that are
received from health care professionals.
• “The Drug Information Centre is a service offered through
Pharmacy department which provides advice and act as a
referral service by directing the best available resource to
respond to query or concern.”
“Knowledge is of two kinds. We know a subject
ourselves, or we know where we can find
information upon it.”
-Samuel Johnson (1709-1784)
Resources of DI
• Primary resources: Research papers/Journal articles/Case
• Secondary resource: abstracts, review articles, indexing
services such as DRUGDEX, Drug Information Database
and abstracting MEDLINE, MICROMEDIX, etc…
• Tertiary resources: Text books on various aspects of drug
use & practical guidelines.
What kind of information?
1. New Drug or its Product Information/Identification
3. Adverse Drug Reactions/Drug Interactions
4. Efficacy/Treatment/Choice of drug
6. Drug Profile/Indications/Dosage/Pharmacokinetic
8. Counselling information
• Almost everyone in the modern world takes medication at
one time or another
• Most of the time medications are beneficial
• But some occasion they do harmful effects (side effects)
which is adverse drug events
• But sometimes the harm is caused by an error in prescribing
or dispensing or administration of medication
WRONG DRUG OF CHOICE
– WRONG ENTRY
– WRONG TIME OF ENTRY
– MISSING INFORMATION
Wrong assumption of prescription reading
Wrong dispensing of drugs/dose/dosage form/quantity
Look alike and sound alike drugs
Fail to give proper information to patients
“It is the pharmacist’s responsibility to ensure the patient
receives the required information for the quality use of
medicine. Counselling implies the communication of
information that would encourage therapeutic outcome”
When there is a need?
• The patient is new to the pharmacy
• The medication is new to the patient or there is a change in
strength from a previous prescription
• A prescription is for a child
• Where there is a lack of or inadequate directions for use
• A prescription for a drug with a narrow therapeutic index
(methotrexate, warfarin, digoxin, phenytoin) or a
prescription for a controlled drug.
• When a prescription is dispensed the pharmacist should be
satisfied that the patient understands how to use the
• Counselling provides an opportunity for the pharmacist to
discuss all aspects of the prescribed medicine with the
patient (or the patient’s carer) to ensure the desired
therapeutic effect is achieved.
– Voice tone
Counselling must be…
Listen to the patient
Speak distinctly and clearly (Tailor cut speech)
Use open ended questions
What is the need for using this medication?”
When are you going to take the medication?”
What side effects might you experience?”
What will you do if that occurs?”
What will you do if you miss a dose?”
• Name of medication (brand/generic), dose, dosage form,
• List precautions: e.g., use sunscreen, avoid milk
• How to administer (PO, IM etc.)(before/after food)
• Special directions (storage, dilution)
• Necessary lab tests
• GIVE WRITTEN INFORMATION TO PATIENT(if possible)
• Find the medication error on the following prescriptions ?
• DYSLIPIDEMIA WITH HYPERTENSION
(Isosorbide dinitrate )
X 7 Days
X 7 Days
X 7 Days
X 7 Days
X 7 Days
X 7 Days
T.ATORVA-EZ(ATORVASTATIN+EZETIMIBE): It is given to reduce the
cholesterol levels in the blood. It should be taken once daily in the night. It can
cause abdominal discomfort, nausea, vomiting and flatulence.
T.ATEN (ATENOLOL): It is given to lower the blood pressure. It is to be taken
once daily in the morning after food. It can cause bradycardia, tiredness, cold
extremities, dizziness, nausea and vomiting
T.ENVAS (ENALAPRIL): It is given to lower the blood pressure and cardiac risk.
Each drug should be taken once daily at bed time. It can cause headache,
dizziness, cough, abdominal pain and nausea.
T.SORBITATE (ISOSORBIDE DINITRATE): It is given to reduce cardiac risk.
The tablet has to be taken 3 times a day. If tingling sensation is experienced with
drug placed sublingually, the tablet should be holded under buccal pouch.
T.RANTAC (RANITIDINE): It is given to reduce gastric irritation caused by other
drugs. Take the tablet half an hour before food.
Counselling regarding life
• Do regular checkups – BP, Blood sugar level, ECG and
• Have a brisk walking at least for 30min /day
• Take more of fruits, carbohydrates,
• Reduce salt intake.
• Avoid fat containing food.
THE BEST TAILOR
• Three tailors came to a city on the same day and went to live on
the same street. The next morning one of them had a notice
outside his door: “The best tailor in the city”.
• The morning after that the second tailor hung a bigger notice:
“The best tailor in the world.”
• The third tailor was in a state of puzzle about what to do. How
could he beat the “best tailor in the world?”
• Then a thought occurred to him and he smiled, “Yes, that would
do!” The next morning a crowd gathered around the notice he
had hung on his door, that said, “The best tailor in the street.”
• All that matters is what you are doing NOW to help people