Function of community pharmacy, Organization and structure of retail and wholesale drug store, Legal requirement for establishment, Maintenance of records
Function of community pharmacy, Organization and structure of retail and wholesale drug store, Legal requirement for establishment, Maintenance of records
hospital formulary is developed under the guidance of pharmacy and therapeutic commitee of the hospital.pharmacist working in a hospital should play an important role in the preparation of the hospital formulary
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hospital formulary is developed under the guidance of pharmacy and therapeutic commitee of the hospital.pharmacist working in a hospital should play an important role in the preparation of the hospital formulary
Pharmacy and therapeutic committee, PTC, Organization of PTC, Functions of PTC, Automatic stop order, Emergency drug list, ADR and safety monitoring, Role of Pharmacy and therapeutic committee
Definition, Types of drug distribution systems, Dispensing of drugs to ambulatory (outdoor) patients, Distribution of controlled drug, Novel drug distribution methods
Purchasing and Inventory control in drug store
by Mrs. Anjua Parkhe and Mrs. Priyanka Kalamkar
Assistant Professor
Sraaswathi Vidya Bhavans College Of Pharmacy, Dombivli
Drug Information Services, Drug information Sources, Illegal DIC, Drug Information Bulletin, Classification of scientific literature, services offered bu drug information services
Operations management is an area of management concerned with designing and controlling the process of production and redesigning business operations in the production of goods or services.
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
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ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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2. Organization of drug store
The pharmacist after attaining the required qualification, having an aptitude for
business and also willing to invest money in business can open a retail or wholesale
drug store.
Drug store is most essential for the proper functioning of the hospital.
It is sub-organization in any hospital where drugs are held till approval and then
stocked
DR. SUBHASH R. YENDE, GNCP NAGPUR 2
3. Objectives of drug store-
To stock all drugs and accessories required in hospital
To procure drug from different sources
To supply drug to consuming department
To store drugs require in research work
To preserve certain category of drug
To maintain record of drug and issue of drugs
DR. SUBHASH R. YENDE, GNCP NAGPUR 3
4. Success of a drug store is depends on factors such as-
Its location and proper layout design
Financial management
Qualified and experience staff
Honesty, sincerity and hard work
Behavior among staff member and with customer
DR. SUBHASH R. YENDE, GNCP NAGPUR 4
5. Selection of suitable site is depend on
Population Density
Number of physicians
Proximity of physicians & health care centres
Number of already existing drug store
Nearness to market
Nearness To A Packing Facility
Income group of people in the area
Age group of people in the area
Scope for expansion
Economic Factor
DR. SUBHASH R. YENDE, GNCP NAGPUR 5
6. FEATURES OF GOOD LAYOUT DESIGN
Proper ventilation
It must be located on the ground floor, close to pharmacy It must have 2 entries,
one for receiving and other for issuing of materials.
Proper illumination
Walls & roof should be painted with washable paint
Sufficient no. of wooden or steel racks should be provided
Movement of men & material should be minimized thus saving time, cost
Fast moving items should kept near the counter while slow moving items are kept
at back of shelves.
Bulky items should store at the bottom of shelve
Surgical instruments should store in separate racks
Cash counter ,wrapping counter should be located near entrance
DR. SUBHASH R. YENDE, GNCP NAGPUR 6
8. DR. SUBHASH R. YENDE, GNCP NAGPUR 8
Types of material stocked
Sufficient number od racks should be provide
Fire extinguishers should be provide at strategic points along with fire buckets
Material stocked are
Capsules, tablets, liquid dosage form and injections
Biological and antibiotics should store in refrigerator
Schedule X drugs, Narcotic and psychotropic substances should store under lock
and key
Poisons are store in separate rack, labeled as POISON
Stock of Alcohol and alcohol containing preparation should maintain in register
Large bulk items should be on bottom
11. DR. SUBHASH R. YENDE, GNCP NAGPUR 11
Inventory control is a scientific system which indicates as to what to order, when to
order, how much to order, and how much to stock so that purchasing costs and storing
costs are kept as low as possible.
Inventory Control is the process by which inventory is measured and regulated
according to predetermined norms such as economic lot size for order or production,
safety stock, minimum level, maximum level, order level etc.
Inventory control is the technique of maintaining the size of inventory at some desire
level keeping in view the best economic interest of an organization.
12. DR. SUBHASH R. YENDE, GNCP NAGPUR 12
Objectives of Inventory Control
To supply the materials in time.
To give maximum clients service by meeting their requirement timely, effectively,
smoothly and satisfactorily
To reduce or minimize idle time by avoiding stock out and shortages
To reduce loss due to changes in prices of inventory items
To avoid shortage of stock
To meet future demand
To average out demand fluctuations
13. DR. SUBHASH R. YENDE, GNCP NAGPUR 13
Functions of Inventory Control
To carry adequate stock to avoid stock-outs
To order sufficient quantity per order to reduce order cost
To stock just sufficient quantity to minimize inventory carrying cost
To make judicial selection of limiting the quantity of perishable items and costly
materials
To take advantage of seasonal cyclic variation on availability of materials to order the
right quantity at the right time.
To provide safety stock to take care of fluctuation in demand/ consumption during lead
time.
To ensure optimum level of inventory holding to minimize the total inventory cost.
14. DR. SUBHASH R. YENDE, GNCP NAGPUR 14
Purchasing is basic function in inventory management
The basic purpose of purchasing is to ensure continuous flow of raw material of
right quality, right quantity, and right price from right source at right time.
With an objective of avoidance of duplication and wastage with respect to
various items purchase
15. DR. SUBHASH R. YENDE, GNCP NAGPUR 15
Purchase Procedure
It involve different steps for procurement of goods
1. Determination of requirements
◦ Through purchase requisition prepared by departmental head including types of
material, time and quantity required
2. Sources of supply
◦ Medical store depot
◦ DGS&D
◦ From wholesaler or manufacturer
◦ By inviting tenders
◦ Emergency drug from local market
16. DR. SUBHASH R. YENDE, GNCP NAGPUR 16
3. Purchase order
It is a contract between buyer and supplier
4. Receipt of acknowledgement
5. Receipt of drug
6. Distribution of drug to wards
17. DR. SUBHASH R. YENDE, GNCP NAGPUR 17
Inventory Analysis
Three level of analysis-
Overall analysis,
Category analysis
Individual item analysis
Economic order Quantity (EOQ)
Economic Order Quantity or Fixed Order Quantity system is the technique of
ordering materials whenever stock reaches the reorder point.
It includes ordering cost and carrying cost
18. DR. SUBHASH R. YENDE, GNCP NAGPUR 18
Ordering Costs-It is the cost of ordering the item and securing its supply.
It Includes Expenses from raising the indent, Purchase requisition by user
department till the execution of order, Receipt and inspection of material
Inventory Carrying Costs- Costs incurred for holding the volume of inventory and
measured as a percentage of unit cost of an item
It includes Capital cost, Deterioration cost, Taxes on inventory, Insurance cost,
Storage & handling cost
Can be calculate by tabular method,
graphical method or algebraic formula
19. DR. SUBHASH R. YENDE, GNCP NAGPUR 19
Techniques or methods of inventory analysis
1. Always Better Control (ABC) Analysis
This technique divides inventory into three categories A, B & C based on cost of
material and annual consumption value.
A item- 10% of total items (costly) which have the highest rupee percentages
(aprrox. 70%). Require proper storage and handling, over stocking should be
avoided.
B item - 20% of all items (neither costly nor cheaper) with the next highest rupee
percentages (20%).
C item- 70% of all items (cheaper) with the lowest rupee percentages (10 %)
20. DR. SUBHASH R. YENDE, GNCP NAGPUR 20
Advantages of ABC Analysis
Gives rewarding results quickly
Helps to point out obsolete stocks easily
In case of “A” items careful attention can be paid at every step such as estimate of
requirements, purchase, safety stock, receipts, inspections, issues, etc. & close
control is maintained
Helps better planning of inventory control
Provides sound basis for allocation of funds & human resources
Disadvantages of ABC Analysis
Proper standardization & codification of inventory items needed
Considers only money value of items & neglects the importance of items for the
production process or assembly or functioning
21. DR. SUBHASH R. YENDE, GNCP NAGPUR 21
2. VED (Vital, Essential & Desirable ) Analysis
It is based on utility of material, importance of item and its effect on the
functioning and efficiency of a hospital
Vital items – Its shortage may cause havoc & stop the work in
hospital/ward/patient care. They are stocked adequately to ensure smooth operation.
Essential items - Here, reasonable risk can be taken. If not available, the work does
not stop; but the efficiency of functions in hospital/ward/patient care is adversely
affected due to expediting expenses. They should be sufficiently stocked to ensure
regular flow of work
Desirable items – Its non availability does not stop the work because they can be
easily purchased from the market as & when needed. They may be stocked very low
or not stocked.
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3. FSN (Fast moving, slow moving & non moving) Analysis
Classification is based on the pattern of issues from stores & is useful in controlling
obsolescence
Date of receipt or last date of issue, whichever is later, is taken to determine the no. of
months which have lapsed since the last transaction
It helps to avoid investments in non moving or slow items.
N item- If there are no issues of an item during the period (1 – 2 yr)
S item- up to certain limit, say 10-15 issues in the period
F items- The items exceeding limit of no. of issues during the period
The period of consideration & the limiting number of issues vary from organization to
organization.
23. DR. SUBHASH R. YENDE, GNCP NAGPUR 23
4. Perpetual Inventory System
Recording of store balance after receipt and issue of item to facilitate regular
checking
After every receipt or issue the entry is made in bin card and balance is adjusted
Bin card is a document maintained by store keeper to keep record of all items
Bin card is used for each material
Each receipt, issue or returns are recorded on bin card in chronological order and
latest balance is maintained
24. Reference
AB Budhrani, R. Usman, M Sharma, P Kumar. Concise Course in
Pharmacy Practice. S. Vikas and Company.
https://www.slideshare.net/gayathrijayakumar4/drug-store
https://www.slideshare.net/friendsalways0102/cdocuments-
and-settingscromamy-documentssem-ivpminventory-control
DR. SUBHASH R. YENDE, GNCP NAGPUR 24