Basic Pharmacology

1. Pharmacology-1
Presentation: Group 1
Group members
1. Danial Nazir
2. M.Noman Sabir
3. Shehzad Hussain
4. Amjad Mushtaq
5. Farheen Tara
6. Sameer Jam Joom

2. Objectives
At the end of presentation learners will be able to:
• Drugs supply and functions
• Types of drugs distribution in hospitals
• Dispensing of controlled drugs
• Drugs card

3. Drugs Supply
• Drugs supply is defined as the system of drug procurement,
storage, and distribution .
According to WHO, an efficient drugs supply system should
undertake the following function
• Selection of Essential Medicines
• Quantification and Forecasting Demand for Medicines
• Procurement of medicines
• Storage of Essential Medicines
• Distribution of medicines

4. Drugs Distribution in the Hospitals
• Drugs distribution is defined as: “physical transfer of
medicines from storage area in the hospital to the patient’s
bedside.”
• This involves two types of drugs distribution. They are:
1. Inpatient
2. Outpatient

5. Cont……

6. Classification of Out-Patients
• The patients visiting the OPDs may categorized as
1. General Patients e.g. diabetic patients, hypertensive
patients
2. Emergency Patients e.g. heart attack, epilepsy patients
3. Referred Patients e.g. Patients suffering from eye, ear,
nose and teeth disorders

7. In–Patient Services
• The drug distribution to the inpatient department can be
carried out from the outpatient dispensing area.
• The staff involved in dispensing the drugs for outpatient can
dispense drugs for inpatients too.
• If the work load seems to be heavy then additional personnel
can be employed.

8. Types of Drugs Distribution Systems
There are 4 systems for inpatient drug distribution
1. Individual prescription order system
2. Complete floor stock system
3. Combination of above mentioned
4. Unit dose dispensing method

9. 1) Individual Prescription Order System
• In this system, the physician write the prescription and ask the
patient or the relative of the patient to get the medicine from any
licensed medical store or hospital dispensary by paying own
charge
• This system is mainly used in small or private hospitals because
of its economic consideration and reduced manpower
requirements
Advantages:
• Less numbers of staff is required
• All medication orders are directly reviewed by pharmacist
• It provides a closer connection among pharmacist, physician,
nurse and the patient
• It provides closer control of inventory

10. Disadvantages
• There may be possible delay in obtaining the required
medications for administration to the patient
• Emergency medicines are not quickly supplied
• Increase in the cost to the patient

11. 2) Complete Floor Stock System
• Drugs are stored at the nursing station and are administered
by a nurse according to the chart order of the physician
• Only commonly used drugs are stocked on the floor
Advantages Disadvantages

12. Drugs on the nursing station are known as
Floor Stock Drugs
NON-CHARGE
FLOOR STOCK
DRUGS
FLOOR STOCK
DRUGS
CHARGE FLOOR
STOCK DRUGS

13. 3) Combinations of Individual Prescription
Order and Floor Stock System
• It is a type of drug distribution system that uses individual
prescription or medication order system as their primary
means of dispensing but also utilize a limited floor stock
• This system is followed by in the governments and private
hospitals who run on the basis of no profit and no loss

14. 4) Unit Dose Dispensing
• Unit dose medication is defined as those medications which
are ordered , packaged, handled, administered and charged in
multiples of single doses units containing predetermined
amount of drugs or supply sufficient for one regular dose,
application or use.

15. Advantages
• Patient receives improved services and are charged for only
those doses which are administered
• Nurses get more time for direct patient care
• Medication errors are reduced
• More space is available in nursing station by eliminating
bulky floor stock
• It eliminates wastage of drug and pilferage

16. Disadvantages
• It requires separate man power for pre-packaging.
• It requires increased number of skilled personnel in the
pharmacy
• Separate containers, closures, machinery and also space is
required

17. METHODS OF
DISPENSING UNIT
DOSES
DUDD
CUDD

18. 1. Centralized Unit Dose Drug Distribution
System
• To operate the system, delivery devices such as medication
carts or pneumatic tubes are required
• PNEUMATIC TUBE SYSTEM

19. 2. Decentralized Unit Dose Drug
Distribution System
• This operates through small satellite pharmacies located on
each floor of the hospital
Procedure:
• Patient profile card is prepared upon admission to the
hospital
• Prescriptions are sent directly to the pharmacists

20. Cont…
• Pharmacists checks the medication orders
• Junior pharmacists picks medication order and place drugs in
cart
• Pharmacist check cart prior to release
• The nurse administers the drugs and make the entry in their
records
• Upon return to the pharmacy the cart is rechecked

21. Dispensing of Controlled Drugs:
• These drugs should kept under lock and key
• A separate register should be maintained to register them
PROCEDURE
• Medical superintendent is overall responsible for handling of
controlled drugs.
• Chief pharmacist procures, stores and dispense the drugs

22. Cont…
Prescription of narcotic drugs under Narcotics and psychotropic
substances act 1985 must include following information
• Patients full name
• Address
• Date
• Name and strength of drug
• Quantity of drug
• Signature of prescriber
• Dose and route of administration

23. Cont…
• If the required drug is not in the stock, the complete controlled
drug prescription must be written on hospital prescription
blank form by registered medical practitioner and signed
• Delivery of narcotic drugs from pharmacy to wards should be
carried out by reliable person
• After dispensing, nurses resume responsibility for
administration, control and auditing of the inventory
• If patient refuse or doctor cancels any dose , nurse should
destroy the drug in to sink and record “Refused by patient” or
“Cancelled by doctor”

24. Drugs card

25. Drug Recomm
ended
dose
Half life /T
max
Route
of
adminis
tration
Indication Contraindicat
ions
Adverse effects Toxic effects Route of
eliminati
on
Digoxi
n
0.25mg
IV
40
hours/1Hr
Oral/IV CHF, atrial
fibrillation
Digitalis
toxicity,
ventricular
tachycardia
Ventricular
fibrillation,
obstructive
cardiomyopat
hy
Dizziness, mental
disturbances,
diarrhea,
headache, nausea
and vomiting.
Bradyarrhyth
mias,
cardiac arrest
heart block
ventricular
fibrillation
ventricular
tachycardia
hyperkalemia
Kidneys
Digito
xin
1.5-2 ug
p/o
160
hours/1-3
Hrs
Oral/IV CHF, atrial
fibrillation,
ischemic
heart
disease.
hypersensitivity
reaction,
thrombocytopeni
a, confusion,
Liver
Ouaba
in
0.42
mg/kg
p/o,
0.004
mg/kg
i/v
20 hours/
0.5-1 Hr
Oral/IV CHF, atrial
fibrillation
Nausea, vomiting
and pulse
irregularities
Kidneys