2. Description
Compounding & Dispensing :
The practice of Pharmacists regarding the process of compounding and
drug delivery
Good Pharmacy Practice as a Standard
Pharmaceutical Care
Extemporaneous dispensing
Prescription Handling
Specific aspects in the practice of compounding & dispensing such:
Prescription screening and address administrative, clinical and farmasetis
Dose Calculation
Labelling and determination of Beyond-use date
Medication error : Prevention and how to overcome it
Dosage Form and Patient specific drug delivery system
3. Objective:
Understand the role of compounding Pharmacists dispensing &
in practice
Able to resolve problems of making preparations-specific
preparations
Applying the techniques of solving problems related to the
administrative aspects, and clinical farmasetis in the giving of
drugs on patients
Apply the dose determination based on the patient's condition,
the disease and the presence of drug interactions
Apply the determination of beyond-use date of drugs given to
patients
Towards a rational treatment
4. Background:
Pharmaceutical care
Patient oriented
Comprehensive services → improve quality of life of the
patients
Assessment
Care Plan
Follow-up
Evaluation
Patient Care
Process
Pharmacotherapy
Workup
Practitioner
Medication
Experience
Patient
Therapeutic Relationship
Philosophy of Practice
Social Obligation
Responsibilities
Patient-centered approach
Caring
Today’s wants
and needs
Responsibilities
5. 5
Uniqueness of Pharmaceutical Care
Traditional Pharmacy Clinical Pharmacy Pharmaceutical Care
Primary focus Prescription order Physicians or other Patient
or OTC request health professionals
Continuity Upon demand Discontinuous Continuous
Strategy Obey Find fault or prevention Anticipate or improve
Orientation Drug product Process Outcomes
6. 6
Why is there a new concept and
whether it's Pharmaceutical Care?
7. 7
1960---------------1990
An explosion of drug
961: 656 type 1999: 8000 type
1971: 140,000 deaths & 1 million treated
20% of care due to medication errors
50% actually can be avoided
45-65% of patients using drugs not in accordance with the
advice of the prescribers
8. 8
Danger and risk can arise as a result of how
drugs are used, not because of its chemical
composition
Most of the problems are not inherent to
the cure, but in the way drugs are
Prescribed: tsb
And Fresh
Used/consumed
9. 9
Facts (1)
A fifth of in-patients undergoing drug therapy
problems even in the most advanced medical
institutions
76 billion dollar (US)
The patient's suffering?
Brigham and women's Hospital:
6.5% non-obstetric patients suffered an adverse drug event
(30% serius)
10. 10
Other studies:
Due to medication error LOS (Length of Stay) rose 5
days, it costs $ 6,000 increase $ 3 million/yearBedell
1991:
64% of cardiac arrest at a teaching hospital because of drug
use.
Other studies:
Medication Errors occurred on average 10-20% (although not all
serious)
13. 13
Pharmaceutical care
Is the direct responsible provision of
medication related care for the purpose of
achieving definit outcomes that improve
patient’s quality of life (ASHP)
Is a Practice in which the Practitioner
takes Responsibility for a patient’s drug
related needs, and is held Accountable for
this Commitment (Strand)
14. 14
Responsibility
The fundamental relationship of patient care
Trust and authority licensed
Commitment & competency
Responsibility (documentation)
Ensure that there was an indication for every item of drug therapy
Any drug used was the most effective & safest & that the patient
was compliant
15. 15
Medication Related
Drug therapy
The decisions of the
Drug usage
Consideration of the selection of doses, routes, methods
Therapeutic drug monitoring
Granting of the information
Provision of counseling
MedicationTherapy Management
16. 16
Care
The focus of care is the care ofWorking together
with other health staff in the:
Designing
Implement
Monitoring of the therapeutic plan
That improvement of patient's quality of life is for sure
17. Relationships individually Licensed must be:
Profesional
Personal
Commitment
Mutual respect
Honestly
Open communication
Cooperation
Empathy
Sensitivity
Promotion of patient independence
Seeing the patient as a person
18. 18
Patience, understanding,
attention,trust, comfort,
confidence, responsible,
accountable, competence
Putting the patient first
Offering reassurance, advocacy
Supporting the patient
19. 19
Outcomes
The assurance of improved quality of life
Cure disease
Elimination, reduction of symptoms
Termination/slowing the disease process
To achieve results
Identification Of DRP (Drug Related Problem)
Solve actual DRP
Prevent potential DRP
20. 20
Quality of Life
A comprehensive assessment of the quality of life
Objective assessment
Subjective assessment
Patients get involved
21. 21
BASIC SEVEN
7 elements in Pharmaceutical Care
1. Review all medications
2. Connect vs drug indication
3. DRP
4. Figured out, barring DRP
5. Care plan
6. Follow up/ monitor
7. Documentation
22. Good Pharmacy Practice
Standards for Quality of Pharmacy Services :
Recommendation against the required standard in
ensuring quality/quality of service kefarmasian
23. 23
Good Pharmacy Practice
Why GPP?
Aspects of legal competency, and ethics in practice
Control of the regulation
Rational use of drugs
Treatment of high quality,safe and cost-effective
Optimise patient outcomes
System and Infrastructure Support
24. 24
Good Pharmacy Practice
Standard that is used to:
Health promotion
Provision of medicines and health equipment
Patient self care
Prescribing and drug use
25. 25
Contoh elemen GPP dalam :
Pelayanan Obat Resep
Medication records
Kompetensi dari Personil yang terlibat dalam Dispensing
Sumber pengadaan sediaan farmasi
Penyimpanan dan mutu sediaan farmasi
Penyiapan dan penjaminan mutu sediaan – sediaan yang
diracik
Advis tertulis dan penyampaian secara lisan
Patient follow up and monitoring
Documentation of professional activities
Disposal/ pemusnahan
26. 26
Contoh elemen GPP dalam :
Influencing prescribing and medicines use
Formularies and treatment guidelines
Generic substitution
Evaluation of use of medicines
Adherence support
Assessment of drug promotion materials
Medicines information sources
Reporting of adverse effects, errors, defects in medicine
quality, counterfeits
32. When a prescription is received for an extemporaneous
product, there are a number of considerations to be prior
to dispensing.
1. Use of the product
2. Is it safe and suitable for the intended purpose?
3. Calculation of formula for preparation
4. Method of preparation
1. Solubility when applicable
2. Vehicle/ diluent
3. Preservative
4. Flavouring when appropriate
33. 5. Choice of container
6. Labelling considerations
Title
Quantitative particulars
Product specific cautions (additional labelling requirements)
Directions to patient – interpretation of Latin abbreviations
when necessary
Recommended BNF cautions when suitable
Discard date
Sample label
7. Advice to patient
34. Extemporaneous Preparation
Suatu produk dapat diformulasikan secara
extemporaneous hanya jika tidak ada produk sesuai
dengan dikehendaki yang beredar di pasaran
Example:
Captopril syrup
Captopril powder (puyer)
Omeprazole for NG administration
35.
36.
37. An awful lot of events in the field of enteric tablet preparations with a salute also
crushed.
Please note that the material of a tablet that was overlaid with a particular purpose
such as that controlled drug release, or that the drug is not damaged by stomach
acid and can be diabsorpsi in the intestine.
Mixing antibiotics (e.g. amoxicillin) and drugs NSAIDS (e.g. paracetamol, ibuprofen,
mefenamic acid, etc) in the form of a preparation headache is not ideal because the
prescribing of antibiotics is a drug taken to run out while the NSAID drugs are
medicines that are taken only when necessary.
We need to know that antibiotics such as amoxicillin should not be crushed because
it can cause shock anafilaktik that can endanger the patient or the officer making the
drug.
The real headache-making sometimes don't pay attention to hygiene, humidity of the
room, the room temperature, the use of tools that are not clean, compounding
preparations headache while joking, chatting-chat and the don't m. ..
38. Mixing several kinds of drugs in dosage form of headache without
considering the possibility of interactions between the drugs that affect the
interaction of both farmokinetika as well as farmakodinamik drug.
No need denying also that the condition of our society actually need these
supplies, headache because it still has a number of advantages and
advantages: easy to dose adjustment according to the age and weight of the
patient.
Still at least drug preparations that are specific to children so that should
be made in the form of headache preparations.
Treatment costs become cheaper.
Preparations can help and ease the headache patient kids who have
difficulty taking the medication in the form of preparations in tablets.
39.
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42.
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44.
45.
46.
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48.
49. 5/31/2018LISA ADITAMA
Prescription Medications
ONLY CERTAIN PEOPLE CAN WRITE A
PRESCRIPTION:
Doctor of Medicine or osteopathy
Nurse Practitioner
Dentist
Optometrist
Naturopathic physician
51. 5/31/2018LISA ADITAMA
A Little More on Prescriptions
Written Instruction from a physician (prescription label
will meet this requirement)
Original Pharmacy container
Verbal doctors orders can only be taken by a licensed
nurse
59. 59
9. Pharmaceutical Expiration Dates,
Http://www.amaassn/.org/ama/pub/category.html
10. Guidance Expiration Dating of Unit-Dose Repackaged Unit:
Compliance Policy Guide,
http://www.fda.gov/cder/guidance/index.html
11. The United States Pharmacopoeia
12. Clark,T.R., 2002, Beyond Use Dating Of Repackaged Oral Solid,
www.ASCP.com
13. Kupiec,T., 2003,Analitycal Research Laboratories, www.arlok.com
14. A To Z Drugs Facts Comparissons
15. Drug information handbook
16. Langley C, Belcher D, 2008, Pharmaceutical Compounding &
Dispensing