The document provides an overview of a 250-bed general hospital in Pabna, Bangladesh, including: - Departments include surgery, medicine, obstetrics/gynecology, and pharmacy. Common medications administered include antibiotics, analgesics, and antihypertensives. - A SWOT analysis found strengths like affordable care and experienced physicians, but also weaknesses like an unhygienic environment and lack of technology. Opportunities for improvement include better infrastructure and digital records. - Four patient case summaries are presented, with recommendations to consider alternative medications that may cause intolerable side effects or interactions given patients' conditions.

1. Presentation on Hospital Training
at
250 Bedded General Hospital, Pabna
Submitted By
ID NO. : 161328
REG. NO. : 1135110
SESSION : 2015-2016
Department of Pharmacy
Pabna University of Science and Technology.

2. 2
CONTENTS
❑Introduction.
❑Hospital Overview.
❑Prescription Analysis.
❑SWOT Analysis.
❑Conclusion.
❑References.

3. CHAPTER 01:
INTRODUCTION
Content
❑Hospital Pharmacy.
❑Roles of A Hospital Pharmacist.
❑Objectives of the Training.

4. A hospital is a health care institution providing patient treatment with specialized medical,
nursing staff and medical equipment.
❑ Proper medical care.
❑ Patient Support.
❑ Preventive and promotive health care.
❑ Rehabilitation services (physiotherapy, occupational therapy etc.)
❑ Healthcare professionals.
❑ Clinical research.(1)
4
Hospital

5. Hospital Pharmacy is one of the key departments in hospitals that deals with
procurement, storage, compounding, dispensing, manufacturing, testing.
5
❖Form of medication best suits each patient.
❖Monitoring the effects of the medications.
❖Monitoring the outcomes of treatments.
❖Supporting other Healthcare professionals.
❖Route of administration.
❖Monitoring supply of medicines.
(2)
Roles of a Hospital Pharmacist

6. Objectives of the Training
➢ Hospital activities.
➢ Real life scenario.
➢ Interaction with other Healthcare Professionals.
➢ Prescription pattern.
➢ Polypharmacy.
➢ Drug induced harmful reactions.
➢ Prescription Errors.
➢ Critical condition management.
6

7. CHAPTER 02:
OVERVIEW of HOSPITAL
Content
❑Brief Introduction.
❑Departments.
❑Common Medications.

8. OVERVIEW OF HOSPITAL
Name: 250 Bedded General Hospital, Pabna.
Year Established: 1919
Ownership: Fully Government.
Health Care Level: Secondary.
Location: Shalgarhia, Pabna.
Manpower: Assistant Director: 01
Senior Consultant: 10
Junior Consultant: 10
Nurse: 180 Total: 384
8

9. Departments
Surgery
Department
Medicine
Department
Obstetrics and
Gynecology
Pharmacy
▪ Orthopedic Ward
▪ Male Ward
▪ Female Ward
• Male Ward
• Female Ward
• CCU Unit
• Diarrhea Ward
▪ Pediatric Ward
9

10. 10
Common classes of drug
Anesthetic
E.g. Lidocaine
Tranquilizers
E.g. Benzodiazepines
Miscellaneous
E.g. Salbutamol
Antibiotics
E.g. Ceftriaxone, flucloxacillin,
penicillin.
Antiprotozoal
E.g. Metronidazole
Antihypertensives
E.g. Amlodipine
Proton pump inhibitor
E.g. Esomeprazole
Anti-emetic
E.g. Domperidon, Ondansetron.
Analgesics and antipyretics
E.g. Paracetamol, Tramadol
Hydrochloride, Ketorolac.

11. CHAPTER 03:
Prescription Analysis
Content
01. Medicine.
02.Surgery & Orthopedics.
03.Labor and Gynecology.
04.Pediatrics.

12. 12 Name : Shanta
Age : 20 years
Sex : Female
Address :Gopalpur, Pabna
Date of admission : 21.05.22
O/E
 BP: 100/80 mm/Hg
 Pulse: 70 beats/min.
 Anemia: Absent
C/C
 SOB.
 Chest Pain.
Diagnosis
❖ Hb%: 9.9 g/dl
❖ Blood grouping & Rh typing
Management
Patient Profile
Management
21.05.2022
➢ Diet: Normal
➢ Inf N/S 1L, Iv stat 25 d/min
➢ Tab Deleta (1+1+0)
➢ Tab Propanolol 10 (1+1+1)
➢ Cap. Dexilend (1+1+0)
➢ Tab Rivo 0.5 (0+0+1)
P/A
➢ Tab. Cefixim 400 (1+0+1)
P/A 31.05.22
• Inj. Algin 1 amp I/M stat
P/A 01.06.22
• Tab Algin (1+1+1)
Medicine ward

13. Recommendation
❑ As the patient was prescribed cefixime there might be a chance of allergic conditions
happening or improper bowel movement. So, this had to be considered by the physician.
❑ Deleta is problematic for people undergoing therapy with MAOIs, which may cause intense
CNS depression.
❑ Algin is problematic to patients with glaucoma.
❑ Cefixime will not work for viral infections (such as common cold, flu). Using any antibiotic
when it is not needed can cause it to not work for future infections.(3)
13

14. Attachment
14

15. 15
➢ Diet-NPO TFO
➢ Inj. Flucloxacillin 500 mg-1vial I/V stat & 6
hourly.
➢ Inj. Ketorolac 30 mg- 1 amp I/M stat &
TDS
➢ Inj. Esomeprazole 40 mg- 1vial
I/V stat & BD
➢ Inj. Ceftriaxone 1g- 1vial I/V stat
& BD
➢ Inj. Emistat 8mg 1amp iv stat &
BD
➢ Tab. p/c 500mg (1+1+1)
➢ Inj. N/S (1L) +5% DNS
(1L) I/V stat 20d/min
Name: Asad
Age: 45 years
Sex: Male
Address: Ataykula,
Pabna
Admission date:
23.05.2022
C/C
Cell injury to mouth
Hx
RTA
Diagnosis
CT scan of head
CBC
Patient Profile Management
Surgery ward

16. 16 Recommendation
❑ Flucloxacillin, Ceftriaxone should be given with caution to patients with a history of
hypersensitivity reactions.
❑ As antibiotics are very powerful and destroy normal flora, this combination of two
antibiotics may cause intolerable abdominal distress.
❑ Ketorolac should not be used for longer than 5 days, it may cause serious side effects,
especially when taken improperly.

17. 17
Attachment

18. 18
o Name: Julekha
o Age: 26 years
o Sex: female
o Address: Kumarpur, Pabna
C/C
• Amenorrhea for 29 wks
• Abdominal pain
• Fever for 2 days
H/O
• Para: 1 NVD+ 1 Abortion
• Gravida: 3rd
• E.D.D: 29.07.2022
O/E
▪ BP: 120/80 mmHg.
▪ Absence of anemia.
Management
21.05.2022
• Diet: Normal
• Cap. Esomeprazole 20
• (1+0+1)
• Tab. P/C 500 mg
(1+0 +1)
• Tab. Hysomide 20
(1+1+1)
Patient Profile Management
Labor ward

19. 19 Recommendation
❑ Hysomide is problematic for patients with benign prostatic hyperplasia, urinary
retention, closed-angle glaucoma, tachycardia.
❑ Hysomide also seems to lower CNS activity which may lead to respiratory depression
and ultimately lead to coma.
❑ Should avoid other medications that also have anti-cholinergic effects./
❑ It is permissible in pregnancy only if the potential benefits outweigh the potential
risks.(3)

20. 20
Attachment

21. Name: Kawsar
Age: 5 years
Sex: Male
Address: Ataikula, Pabna.
C/C
Poisoning (diesel oil).
Vomiting.
H/O
Para: 1 NVD+ 1 Abortion
Gravida: 3rd L.M.P?
E.D.D: 08.09.2022
O/E
BP: 100/60 mmHg
Weight: 20 kg
Diagnosis
Chest X-ray.
➢ Diet NPO. TFO
➢ Inf. APN 500ml+ 5% DA
500 ml - I/V stat @ 8
drops/min
➢ Inj. Ceftriaxone 1 gm – 1
vial I/V stat, bd
➢ Inj. Esotid 40 mg (I/V stat
12 hourly)
➢ Inj. Lasix 1 amp. I/V stat
P/A.
➢Syp. Napa-
1 TFS TDS
21
Patient Profile Management
Pediatric ward

22. 22 Recommendation
❑ As the patient is of very little age, ceftriaxone’s hypersensitivity reactions may cause
severe fatal conditions which may be intolerable for the child.
❑ Ceftriaxone is problematic for patients with gallbladder disease, kidney disease, liver
disease, intestinal disease. So, physician should always check for this before prescribing.
❑ Forced diuresis may cause the patient severe dehydration so, dextrose solution should be
continually administered.(3)

23. 23
Attachment

24. CHAPTER 04:
SWOT Analysis
Content
❑ Strength
❑ Weakness
❑ Opportunities
❑ Threats

25. SWOT
SWOT Analysis Findings
Strengths Affordable, Highly accessible, Internship Program, Experienced
physicians ,Reputation, Trained staffs.
Weaknesses Unhygienic environment, Old and inefficient building structure, Lack of
technological advancements, Low doctor to patient ratio, Inefficient
Patient monitoring.
Opportunities Improved medical procedures, Research and innovation, therapeutic
data monitoring, Digitalized records, Infrastructure facilities.
Threats Budget constraints, Salary issue , Hospital acquired infection (HAI),
Patient satisfaction , Rising cost.

26. CHAPTER 05:
Conclusion

27. CONCLUSION
Pabna General Hospital is a public hospital ,funded by govt. It’s obvious
that we won’t get quality treatment compared to high-end private
hospital. There is no A grade pharmacist working in the hospital, low
technology usage , inadequate physician and staff, lack of patient
monitoring, inefficient patient medication history checking. However, it
is a heaven for poor people, they can come here and get well with a low
cost. There are a lots of area where improvements can be done. People
involved are trying hard to improve the total service with best effort &
team spirit. 27

28. References
1. Vedantu. Hospital [Internet]. VEDANTU. Vedantu; 2022 [cited
2022Nov12]. Available from: https://www.vedantu.com/biology/hospital
2. Hospital pharmacist [Internet]. Hospital Pharmacist - an overview |
ScienceDirect Topics. [cited 2022Nov12]. Available from:
https://www.sciencedirect.com/topics/nursing-and-health-
professions/hospital-pharmacist
3. Ketorolac: Medlineplus Drug Information [Internet]. MedlinePlus. U.S.
National Library of Medicine; [cited 2022Nov12]. Available from:
https://medlineplus.gov/druginfo/meds/a693001.html
28

29. 29