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Good pharmacy practice

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Good pharmacy practice

  1. 1. “PRAISE BE TO THE ALMIGHTY GOD” by, Dr. G Praveen Kumar Assistant Professor, Department of Pharmacy practice, C.L. Baid Metha College of Pharmacy. Incharge-Drug Information Centre & Patient Counseling, VHS(voluntary health care) hospital, Adayar, Chennai
  2. 2. Definition ADMIN PHYSICIANS PATIENTS GPP is the practice of pharmacy that responds to the needs of the people who use the pharmacists’ services to provide optimal, evidencebased care. NATIONAL GUIDELINES
  3. 3. Requirements of good pharmacy practice • 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 patient – administration of medication – the monitoring of the effects of medication use – the promotion of rational and economic prescribing, as well as dispensing
  4. 4. • 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.
  5. 5. ROLES OF PHARMACIST IN GPP • Prepare, obtain, store, secure, distribute, administer, dispense and dispose of medical products • 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……..
  6. 6. PYHSICIAN & PHARMACIST RELATIONSHIP
  7. 7. PHARMACIST LOOKS SPECIAL BUT ACTUALLY NOT
  8. 8. PHYSICIAN LOOKS SIMPLE BUT SPECIAL (SPECIALITY)
  9. 9. HOW TO OVERCOME THIS? ANS: SPECIALITY PHARMACIST
  10. 10. A STEP FORWARD….. PHARMACIST(dispensing) MUST GETS SPECIALIZED IN; •Drug information services •Medication error •Patient counselling
  11. 11. 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.”
  12. 12. Simple logic…. “Knowledge is of two kinds. We know a subject ourselves, or we know where we can find information upon it.” -Samuel Johnson (1709-1784)
  13. 13. Resources of DI • Primary resources: Research papers/Journal articles/Case reports. • 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.
  14. 14. Updated resources • • • • • • • Micromedex FDA website Medscape webMD Drugs.com(drug interaction checker) Who guidelines EBSCO journal services
  15. 15. What kind of information? 1. New Drug or its Product Information/Identification 2. Contraindications/Safety 3. Adverse Drug Reactions/Drug Interactions 4. Efficacy/Treatment/Choice of drug 5. Pregnancy/Lactation/Pediatrics 6. Drug Profile/Indications/Dosage/Pharmacokinetic information 7. Toxicology 8. Counselling information
  16. 16. MEDICATION ERRORS...
  17. 17. • 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
  18. 18. TYPES… • • • • PRISCRIBING ERRORS TRANSCRIBING ERRORS DISPENSING ERRORS ADMINISTRATION ERRORS
  19. 19. PRISCRIBING ERRORS • PHYSICIAN – – – – – WRONG DRUG OF CHOICE WRONG DOSE WRONG UNITS WRONG FREQUENCY WRONG DURATION
  20. 20. TRANSCRIBING ERRORS • PHARMACIST – WRONG ENTRY – WRONG TIME OF ENTRY – MISSING INFORMATION
  21. 21. DISPENSING ERRORS • PHARMACIST – – – – – 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 Time factor
  22. 22. ADMINISTRATION ERRORS • • • • Missing drugs Wrong route of administration Wrong entry Wrong reporting
  23. 23. PATIENT COUNSELING…..
  24. 24. “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”
  25. 25. 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.
  26. 26. • When a prescription is dispensed the pharmacist should be satisfied that the patient understands how to use the medication correctly. • 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.
  27. 27. Criteria… • • • • • • Language Time Knowledge Surrounding Terms/words used Communication – Appropriate – Voice tone – Volume
  28. 28. 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?”
  29. 29. Regarding drugs…. • Name of medication (brand/generic), dose, dosage form, schedule • 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)
  30. 30. Exercise… • Find the medication error on the following prescriptions ? • DYSLIPIDEMIA WITH HYPERTENSION SL NO 1. 1 1. 2 1. 3 1. 4 1. 5 1. 6 DRUGS T.ATORVA (Atorvastatin) T .ATEN (Atenolol) T. ENVAS (Enalapril) T.SORBITATE (Isosorbide dinitrate ) INJ. Rantac (Ranitidine) T.Dolo (Paracetamol) DOSE ROA FREQUENCY DURATION 10 mg iv 1-0-0 X 7 Days 50 mg P/O 1-0-0 X 7 Days 2.5 mg P/O 0-0-1 X 7 Days 5 mg P/O 1-1-1 X 7 Days 150 mg P/O 1-0-1 X 7 Days 650 mg P/O 1-0-1 X 7 Days
  31. 31. • • • • • 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.
  32. 32. Counselling regarding life style modification. • Do regular checkups – BP, Blood sugar level, ECG and Lipid profile • Have a brisk walking at least for 30min /day • Take more of fruits, carbohydrates, • Reduce salt intake. • Avoid fat containing food. • Etc…
  33. 33. 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 around you.
  34. 34. We TREAT But “GOD” Heals...
  35. 35. PROVE and then Proud to be a PHARMACIST Stay Tuned to the Developing Technology.
  36. 36. Thanks To the Almighty GOD (Jesus Christ) & to all….

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