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
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
Hospital Formulary - presentation gives the detail idea about Hospital formulary, its advantage, disadvantage, how to prepare Hospital formulary and much more. this will be useful for Pharm.D-IV YEAR students, which was in their Hospital pharmacy subject. regards APOLLOJAMES
Function of community pharmacy, Organization and structure of retail and wholesale drug store, Legal requirement for establishment, Maintenance of records
Drug distribution is one of the basic service provided by the hospital pharmacy.
Drug distribution system falls in to 3 categories -
1)Ward – controlled system
2)Pharmacy controlled imprest based system
3)Pharmacy controlled patient issue system
2. Hospital Pharmacy and its Organisation.pptxMangeshBansod2
Hospital pharmacy and its organization
Definition, functions of hospital pharmacy, Organization structure, Location, Layout and staff requirements, and Responsibilities and
functions of hospital pharmacists.
Definition, Types of drug distribution systems, Dispensing of drugs to ambulatory (outdoor) patients, Distribution of controlled drug, Novel drug distribution methods
Hospital Formulary - presentation gives the detail idea about Hospital formulary, its advantage, disadvantage, how to prepare Hospital formulary and much more. this will be useful for Pharm.D-IV YEAR students, which was in their Hospital pharmacy subject. regards APOLLOJAMES
Function of community pharmacy, Organization and structure of retail and wholesale drug store, Legal requirement for establishment, Maintenance of records
Drug distribution is one of the basic service provided by the hospital pharmacy.
Drug distribution system falls in to 3 categories -
1)Ward – controlled system
2)Pharmacy controlled imprest based system
3)Pharmacy controlled patient issue system
2. Hospital Pharmacy and its Organisation.pptxMangeshBansod2
Hospital pharmacy and its organization
Definition, functions of hospital pharmacy, Organization structure, Location, Layout and staff requirements, and Responsibilities and
functions of hospital pharmacists.
Definition, Types of drug distribution systems, Dispensing of drugs to ambulatory (outdoor) patients, Distribution of controlled drug, Novel drug distribution methods
The hospital formulary is a continuously revised compilation of pharmaceutical dosage agent and their forms etc. which reflects the current clinical judgment of the medical staff.
Introduction
Pharmacy & therapeutic committee (PTC)
Hospital formulary
Infection control committee
In these days of modern medicine, a large number of drugs are available for the treatment of a disease.
Considering the complexities surrounding their effective use, it is necessary for the hospital to establish a system to bring the best medicinal agents to the attention of the medical staff and help them in proper selection of therapeutic substances.
In order to ensure proper rationality in the use of drugs a “PHARMACY AND THERAPEUTIC COMMITTEE” need to be organized and constituted in a hospital.
It is an advisory group of medical staff and the administration of hospital on matters related to the therapeutic use of drugs.
FUNCTIONS
To advise the medical staff on usage of drugs.
To develop and compile formulary of drugs accepted for use in the hospital.
To plan/establish suitable educational programs.
To review adverse drug reactions.
To make recommendations concerning drugs to be stocked in hospital patient care areas.
To advise the pharmacy in the implementation of effective drug distribution and control procedures.
HOSPITAL FORMULARY
Hospital Formulary is defined as a list of drugs used in the hospital.
Formulary system is method whereby the medical staff of an institution, working through the PTC, evaluates, appraises, and selects from among the numerous available drug entities & drug products those that considered most useful in patient care.
A hospital exists mainly to provide therapeutic services to the patients.
Drugs are an integral part of patient care. In every hospital, medicines are crucial to the hospital services.
Appropriate use of medicines in the hospital is a multidisciplinary responsibility that includes doctors, nurses, pharmacists, administrators, support personnel and patients.
The availability of medicines in the hospitals depends not only on good supplies, but also on efficient use through good distribution system, rational prescribing, and dispensing practices.
"When a drug is required, the appropriate drug must be chosen. It must be available at the right time, at the right price. It must be dispensed correctly, must be delivered in a right dose, at the right intervals and for the right length of time".
2. Hospital Formulary.pdf unit 2 sem 7 b.pharmacyVedika Narvekar
Hospital formulary
Definition, contents of hospital formulary, Differentiation of hospital formulary and
Drug list, preparation and revision, and addition and deletion of drug from hospital
formulary
The P&T committee is generally the medical staff committee responsible for managing the formulary system. The P&T committee provides an evaluative, educational, and advisory service to the medical staff and organizational administration in all matters pertaining to the use of available medications. The P&T committee should be responsible for overseeing policies and procedures related to all aspects of medication use within an institution.
This committee assists in the formulation of broad professional policies regarding the evaluation, selection, procurement, distribution, use, safety procedures and other matters relating to drugs use in the hospital.
fetal movements of the baby is the best sign to acess the health condition of the fetes,During your pregnancy, feeling your baby move gives you reassurance of his or her well being.
If you notice your baby is moving less than usual or if you have noticed a change in the pattern of movements, it may be the first sign that your baby is unwell and therefore it is essential that you contact your midwife or local maternity unit immediately so that your baby’s wellbeing can be assessed.
evidence based practice is a important tool in clinical practice.everything we do in our life can also correlated to evidence based practice. PICO is used to frame a answerable question
cluster headaches are also called as
Familial cluster headaches
Histamine cephalalgia
Vasogenic facial pain
Horton’s Syndrome
Cluster headache (CH) is a neurological disorder characterized by recurrent, severe headaches on one side of the head, typically around the eye.
A cluster headache commonly awakens paitent in the middle of the night with intense pain in or around one eye on one side of head.Cluster headache often accompanied with eye watering, nasal congestion, or swelling around the eye, on the affected side. These symptoms typically last 15 minutes to 3 hours.
The starting date and the duration of each cluster period might be consistent from period to period. For example, cluster periods can occur seasonally, such as every spring or every fall.
Most people have episodic cluster headaches. In episodic cluster headaches, the headaches occur for one week to a year, followed by a pain-free remission period that can last as long as 12 months before another cluster headache develops
Amyloidosis is the term used for a group of diseases characterized by extracellular deposition of insoluble protienaceous substance called “Amyloid”.Amyloidosis was first described by Rokintansy in 1842.
Virchow named it as amyloid under the mistaken belief that the material was starch like.
The medical term for tumor (or) cancer is Neoplasm, Which means a relatively autonomous growth (or) un corodinated cell proliferation of body tissue.The branch of medicine which deals with the excessive study of neoplasm (tumor) and its development diagnosis and treatment is called “Oncology.”
The term cancer was translated from a Latin word carcino i.e. Crab by celsus.
For the first time Hippocrates coined the Greek word Karkinos i.e. (crab/cray fish) for malignant breast cancer
Agents used to treat such abnormal cell productions are known as anti neoplastic agents.they are 1.Alkylating agents:-
Nitrogen mustards
Cyclophosphamide
Meclorethamine
2.Antimetabolites:-
purine antagonist:-6-mercaptopurine
Folic acid antagonist:-methotrexate
Pyrimidine antagonist:-5-flurouracil
3.Plant products:-
Vinca alkaloids
Vincrystine
vinblastine
4.Anti biotics:-
Doxorubicin
Actinomycin
5.Hormonal agents:
Tamoxifen
Glucocorticosteroids
6.Miscellaneous:-
Hydroxy urea
Asparginase
Public education campaigns are important in highlighting the dangers of smoking, because possibly as many as 30% of cancers are caused by smoking, excessive drinking, and hazardous solvents, as well as promoting healthy diets and lifestyles.
30% of cancers are diet related that’s why everybody should take healthy diets and lifestyles.
The benefits of eating high-fibre foods, fruit, and vegetables are clear.
Infact, there have been various research projects aimed at identifying the specific chemicals in these foods which are responsible for this protective property.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
3. The hospital formulary is a continuously revised compilation of
pharmaceutical dosage agent and their forms etc. which reflects
the current clinical judgment of the medical staff.
Hospital formulary provides information for
Procuring
Prescribing
Dispensing
Administration of drugs
3
4. ORIGIN IN INDIA
• The first hospital formulary in India was published in 1968 by
the Department of Pharmacy ,CMC,Vellore.
• The first hospital formulary for the development of
government hospital teachings was published in 1997 at
Government Medical College, Trivendrem,Kerala
4
5. OBJECTIVES
To Set standards for best practice, promoting
high quality, evidence based prescribing.
To ensure rational drug therapy and control drug
cost.
To precise use by the physician and nursing staff.
To continually revise compilation of
pharmaceuticals and some important ancillary
information that reflects the current clinical
judgement of medical staff.
5
6. TYPES OF FORMULARY
An open formulary serves merely as a guide; a physician
may prescribe any drug, but is encouraged to use the
formulary list in prescribing decisions.
OPEN FORMULARY
An closed or restricted formulary lists the drugs that will
be reimbursed by the health care provider; non-formulary
drugs will be reimbursed only if they are authorised prior
to prescribing.
CLOSED OR
RESTRICTED
FORMULARY
An incentive-based formulary represents a hybrid between
the open and closed formularies; patients pay a higher
price for non formulary drugs
INCENTIVE BASED
FORMULARY
6
8. MEMBERS INVOLVED IN THE
PREPARATION OF HOSPITAL FORMULARY
A representative clinician
from each major specialty
A clinical
pharmacologist
A nurse, usually the senior
infection control nurse, or
sometimes the matron.
A pharmacist (usually
the chief or deputy chief
pharmacist)
A clinical
microbiologist or a
laboratory technician
where there is no
microbiologist.
A member of the
hospital records
department.
An administrator, ,
representing the hospital
administration and finance
department
8
9. The governing body of the hospital shall appoint a pharmacy and therapeutic
committee composed of physician and pharmacist which will prepare the hospital
formulary system.
The medical staff in the governing body shall sponsor and outline the purpose,
organization function and scope of the hospital formulary system. It should adopt
the principle as per the need of particular hospital.
The pharmacy and therapeutic committee shall develop policy and procedure
governing the hospital formulary and the medical staff shall adopt these policies
and procedures subject to administrative approval
The policy and procedure shall afford guidance in the appraisal, selection
,procurment, storage,distribution, use, safety procedures and other matter relating
to drug in the hospital and shall be published in the hospital’s formulary
To ensure the maintenance of the responsibility and procreative of the physician in
the exercise of his professional judgment.
The medical staff shall adopt the policy formula, and procedure for including drugs
in the formulary by the non proprietary name even though proprietary names
continue to being use in the hospital physicians
9
10. In the absence of written policies approved by the medical staff related to
the operation the hospital shall make it certain that the nursing personnel
are in formed in writing though its system of news of communication that
there exits the formulary system in the hospital and the procedure
governing its operations
In the formulation of policies and procedure the term substitute or
substitution should be avoid since these term have been used to imply the
unauthorized dispensing of entire different drug, neither of which takes
place under a properly operated hospital formulary system.
It shall be made known to the medical staff about the changes in the
working in the hospital formulary system or in the content of the hospital
system.
Provision shall be made for the appraisal of the member of the medical staff
for the use of the drug not include in the formulary or the investigational
drugs.
The pharmacist with the advice and guidance of the pharmacy and
therapeutic committee ,shall ascertain the quantity and source of supply of
all drugs, chemical, biological and pharmaceutical preparation used for
diagnosis and treatment of patient.
10
11. STEPS INVOLVED IN THE PREPARATION
OF HOSPITAL FORMULARY
Identify the most common diseases being treated in the
hospital by consulting all medical departments. For
each disease, an appropriate first choice of treatment
should be identified using standard treatment
guidelines
An expert committee can be brought together to
identify the appropriate treatment for each of the
common health problems.The alternative method is
reviewing the WHO model list of essential medicines
may also be used as a starting point
A draft of the list must be prepared and must be
given to each department to comment on the list
11
12. STEPS INVOLVED IN THE PREPARATION
OF HOSPITAL FORMULARY
The Drugs and Therapeutics Committee must
deliberate on their comments and provide feedback
All information should be discussed with evidence
based reviews where possible.
After the preparation of final list, monographs for
each drug should be prepared and it should contain
unbiased information
12
14. CONTENTS
Introduction
polices and procedures
list of abbrevations
List of drugs
monographs
Additional information of drugs
storage guidelines
patient counseling information
prescribing and dispensing guidelines
dose adjustments
poison information and antidotes
14
15. CONTENTS OF DRUG MONOGRAPH
• Non-proprietary name of drug
• Synonyms
• Available brands
• Cost
• Reconstitution
• Administration
• Dosage forms
• Indications
• Contraindications
• Precautions
• Dose
• Pregnancy risk factors
• Adverse effects
• Interactions
15
16. Formulary may become a collection of older, less effective drugs.
The entire formulary should be reviewed every 2–3 years.
This can be done by evaluating all the formulary medicines within
each therapeutic class in a systematic way on a regular basis and
comparing them to other new non-formulary medicines within that
class
Requests for the addition of new medicines and deletion of old
medicines.
Systematic review of a therapeutic class of medicines.
Review of programmes to identify and resolve medicine use
problems.
All decisions of the DTC should be documented (minuted).
16
17. For a new medicine to be added into the hospital formulary, the
committee should consider the therapeutical equivalency to existing
drugs in terms of efficacy, safety, or convenience of
dosing/administration.
For the addition and deletion of drugs the total cost for a course of
treatment with new medicine should be compared with the already
listed medicines
If a new medicine is added to the list for reasons of improved
efficacy, safety or lower price, serious consideration should be
given to delete the medicine which was previously on the formulary
list for the same indication, for two reasons:
17
19. FORMAT AND APPERANCE
SIZE:
The formulary which is sufficiently small in size to fit in apron is
acceptable and convenient 4” x 7” or 10cm x 18cm
APPERANCE:
use of different colors to differentiate different categories of drug.
Attractive designing of the cover page
It should be visually pleasing, easy to read and have a professional
appearance
19
20. DISTRIBUTION
All doctors
Wards of the hospital
Head od the departments of paitent care
Outpatient departments and casualities
Drug information centers
Administrative office
20
21. IMPROVING ADHERENCE TO A FORMULARY
Reviewing and taking action on all non-formulary medicine use; action may
include adding the medicine to the formulary, educating the prescriber about
the nonformulary status of the medicines or banning use of the medicine
within the hospital.
Prohibiting the use of non-formulary drug samples in the hospital.
Establishing procedures and approved drug product lists for therapeutic
interchange or substitution.
Providing easy access to the formulary list, with copies at each drug ordering
location and in pocket manuals for staff.
Involving medical staff in all formulary decisions.
Advertising and promoting all formulary changes.
Establishing agreed procedures for clinical trials with non-formulary
medicines
21
22. ADVANTAGES AND DISADVANTAGES
●It is very handy for use by the
physician and nursing staff.
●It helps physicians to know about
the available drugs in the hospital
pharmacy and also helps in better
inventory control.
●Evidence based treatment
guidelines.
●It is complete, concise, updated
and easy to use.
●Improves clinical practice of
health care professionals.
●Reduces the variation in the level
of treatment provided to the
patients and controlling drug cost.
It deprives the physician of his right
and prerogative to prescribing and
obtained the brand of his choice.
pharmacist act as the sole judge of
which brands of drugs are to
purchased and dispensed.
The system allow for the purchase of
inferior quality of drugs particularly
in institutions where there is no staff
pharmacist.
The system does not reduce the cost
of drug to the patient or the third
party payer
22
23. ROLE OF
PHARMACIST
IN HOSPITAL
FORMULARY
Pharmacist in the DTC has a key role in
developing policies and procedures
governing the hospital formulary.
The chief pharmacist has the primary
responsibility for the preparation of
hospital formulary.
Pharmacist with the advice and guidance
of DTC shall as certain the quantity and
source of supply of all drugs, chemicals,
biological and pharmaceutical
preparations used for the diagnosis, and
treatment of patients.
Pharmacist should ensure that quality of
drugs is not compromised by economic
considerations
23