Drug distribution is defined as, "Physical transfer of drugs from storage area in the hospital to the patient's bedside". This involves two types of drug distribution. They are: In-patient distribution Out-patient distribution The drug distribution to the in patient department can be carried out from the out patient dispensing area. The pharmacists involved in dispensing the drugs for out patient can dispense drugs for in patients too. The pharmacist employed for drug distribution to the in patient wards should be well skilled and qualified staff. Out patient refers to the patients not occupying beds in hospital or in clinics, health centers and other places where out patients usually go for health care. No medicaments should be issued without the prescription. After the issue has been made the quantities supplied must be recorded. In short form the out patient department was called as OPD. CLASSIFICATION OF PATIENTS EMERGENCY TERTIARY CARE PRIMARY CARE AMBULATORY.

1. BY: ARCHANA B CHAVHAN
DRUG DISTRIBUTION SYSTEM IN HOSPITAL

2.  Drug distribution is defined as, "Physical
transfer of drugs from storage area in the
hospital to the patient's bedside".
 This involves two types of drug distribution.
They are:
In-patient distribution
Out-patient distribution
DEFINATION
1

3. IN PATIENT
DISTRIBUTION
 The drug distribution to the in patient
department can be carried out from the out
patient dispensing area.
 The pharmacists involved in dispensing the
drugs for out patient can dispense drugs for in
patients too.
 The pharmacist employed for drug distribution
to the in patient wards should be well skilled
and qualified staff.
2

4. OUT PATIENT
DISTRIBUTION  Out patient refers to the patients not
occupying beds in hospital or in clinics,
health centers and other places where out
patients usually go for health care.
 No medicaments should be issued without
the prescription.
 After the issue has been made the
quantities supplied must be recorded.
 In short form the out patient department
was called as OPD.
3

5. CATEGORIES OF OUT PATIENT
 EMERGENCY
 TERTIARY CARE
 PRIMARY CARE
 AMBULATORY.

6. TYPES OF DRUG DISTRIBUTION
SYSTEMS
Individual prescription order system
Complete floor stock system
Combination of individual prescription
and floor stock System
Unit dose system
Non-floor stock system
4

7. INDIVIDUAL PRESCRIPTION ORDER
SYSTEM
 It is a type of prescription system where the
physician writes the prescription for individual
patient who obtains the drug prescribed from any
medical store or hospital dispensary by paying own
charges.
 This system is generally used by the small and/or
private hospitals because of the reduced man
power requirements and desirability for
individualized service.
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8. ADVANTAGES
*All medication orders pharmacist.
are directly reviewed by
pharmacist
*It provides closer liaison among
pharmacist, physician nurse and
the patient
*It provides closer control of
inventory
DISADVANTAGES
*Wrong errors, illegible writings
of the physicians.
*Physician may write high
economic drugs in the
prescription or cost effective
drugs.
6

9. FLOOR STOCK
SYSTEM
Under this system, the
drugs are given to the
patient through the
nursing station and the
pharmacy supplies from
the drug store of a
hospital.
7

10. The way of floor-stock distribution includes 2 types
They are:
Charge
Floor Stock
Drugs
Non-Charge
Floor Stock
Drugs
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11. Charged floor stock system
 In this method medicines which are
stocked in the nursing stations all the
times& charged to the patients
account after administered to them.
 The patient is charged for every single
dose administered to him.
 Once the floor-stock list is prepared it
is the responsibility of the hospital
pharmacist to make the drugs
available.
9

12. Non charged floor-stock system
 These system includes the
medicaments placed in the nursing
station that are used by all the
patients on the floor.
 There shall be no direct charge
from the patients account.
10

13. Method of Dispensing non-
charge floor stock drug
 This method is adapted where
nurses verify the availability of
medicines in all rooms as well as in
the refrigerator and accordingly
prepare a master list of pharmacy .
 Nurses fill demand form for delivery
of drug at the floor. When there is
empty container , the nurses take it
in the drug basket .
 ones the procedure is completed ,
the drug basket containing empty
container and demand from for floor
stock supplies sent to pharmacy
Drug
Basket
Method
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14.  It consists of specially
constructed stainless- steel
trolley which is mounted on
bottom tiers .
 Accordingly to requirement
, patients get the medicine
via this unit
Mobile
Dispensary
Unit
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15. ADVANTAGES:
 The drugs are readily available for
administration
 Minimum return of drugs
 Reduced in-patient prescription orders
 Reduction in number of pharmacy
personnel required
DISADVANTAGES:
 Increase in chance of medication
errors
 Increase in drug inventory
 Increase chances of drug
deterioration due to lack of proper
storage facilities and due to
unnoticed drug degradation
 Increased workload on nurses
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16. COMBINATION OF INDIVIDUAL PRESCRIPTION
AND FLOOR STOCK SYSTEM
 This system is followed by all government
hospitals and also private hospitals those run on
the basis of no -profit and no loss.
 Surgical items are given to the patients, who
purchases and deposit those items in a hospital
wards on rooms under the supervision of
registered headness
14

17. UNIT DOSE SYSTEM
 Those medications ordered, stored, packed,
handed, administrated and charged in multiples of
single does units containing a predetermined
amount of a drug or supply sufficient for one
regular dose.
 A single unit package is one which contain one
complete pharmaceutical dosage form.
 Ex- 1 tablet or 1 capsule.
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18. TWO METHODS OF DISPENSING
UNIT DOSES ARE
Centralised
unit dose drug
distributing
system
(CUDD)
Decentralised
unit dose drug
distributing
system
(DUDD)
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19. Centralized
unit Dose
system
• In this system, all the drugs
are stored in central area of
pharmacy and the drugs are
dispensed
• To all inpatients in unit doses.
To operate the delivery system
effectively, various medication
• Carts are used to transport unit
doses to the patients and to
forward a copy of the
physician
• Original medications order to
the pharmacy for the direct
explanation and filling
17

20. Decentralized
unit Dose system
• Unlike the centeralized
system,decenteralized unit
dose system function through
small Satellite pharmacies
which are located on each
floor of the hospital.
• In this system , the core
Pharmacy becomes a
procurement , manufacturing
,storage and packaging center
which Provides all medicine to
all the satelites pharmacies.
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21. • Better financial control
• It prevents loss of
partially used
medications.
• Does not require
storage facilities at
nursing stations.
• Irregular dosage
• skill physician is
required for
administration of
drug.
• Regular monitoring is
required.
ADVANTAGES DISADVANTAGES
19

22. Distribution of drugs to
ICU/ICCU/NICU/Emergency wards.
Intensive care units cater
to patients with severe or
life-threatening illnesses
and injuries, which
require constant care,
close supervision from
life support equipment
and medication in order
to ensure normal bodily
functions.
Intensive care units(ICU)
20

23. Distribution of drugs to
ICU/ICCU/NICU/Emergency wards.
ICCU is a hospital ward
specialized in the care of
patients with heart attacks,
Cardiac dysrhythmia and
various other cardiac
conditions that require
continuous monitoring and
treatment.
Intensive Coronary Care unit(ICCU)
21

24. Distribution of drugs to
ICU/ICCU/NICU/Emergency wards.
NICU specializing in the care of
ill/premature newborn infants.
The NICU is divided into
several areas, including a
critical care area for babies who
require close monitoring and
intervention, an intermediate
care area for infants who are
stable but still require
specialized care,
Neonatal Intensive Care Unit (NICU)
22

25. Distribution of drugs to
ICU/ICCU/NICU/Emergency wards.
Emergency wards
is a medical treatment facility
specializing in emergency
medicine, the acute care of
patients who present without
prior appointment; either by
their own means or by that of
an ambulance.
Emergency wards
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26. Drugs distributed to these
departments are packed in a
single unit container and
location are fixed for storage of
IV solutions
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28. Automated dispensing is a pharmacy
practice in which a device dispenses
medications and fills prescriptions.
ADCs, which can handle many
different medications, are available
from a number of manufacturers such
as BD, ARxIUM, and Omnicell.
26

29. BD Pyxis™ MedStation™ ES, Automated Dispensing System - BD
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30. Automated drug dispensing ARxIUM
28

31. Automated drug dispensing omnicell for dispensing of
controlled substances
29

32. “
”
Distribution of Narcotic
and Psychotropic
substances and
their storage
30

33. 31

34. DISPENSING OF CONTROLLED
DRUGS
• A separate register is maintained for controlled drugs.
• Various steps involved are as follows:
• Medical super indent is over all responsible for handling of controlled
drugs, chief pharmacist procures , stores and responsible for proper
dispensing of drugs within the hospital.
• Required information:
 Full name of the patient
 Address
 Date
 Name and strength of drugs
 Quantity of drug
 Signature of the prescriber
 Dose and route of administration.
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