pharmacy and therapeutic effect

1. UNIT-I
PHARMACY AND
THERAPEUTICS COMMITTEE
BY
J.JAYASUTHA
LECTURER
DEPT. OF PHARMACY PRATICE
SRM COLLEGE OF PHARMACY
SRM UNIVERSITY

2. DEFINITION
¾ THE PHARMACY AND THERAPEUTICS COMMITTEE IS A
POLICY FAMING AND RECOMMENDING BODY TO THE MEDICAL
STAFF AND THE ADMINSTRATION OF HOSPITAL ON MATTERS
RELATED TO THERAPEUTIC USE OF DRUGS.

3. OBJECTIVE OF PHARMACY AND
THERAPEUTICS COMMITTEE
The pharmacy and therapeutics have three
major roles to play. These are:
¾ ADVISORY
¾ EDUCATIONAL
¾ DRUG SAFETY AND ADVERSE DRUG
MONITIORING.

4. COMPOSITION OF PHARMACY AND
THERAPEUTICS COMMITTEE
¾ Composition of pharmacy and therapeutics
committee (PTC) might vary from hospital to
hospital. The following scheme is suggested for
general adoption:
The PTC may be composed of:
• At least three physicians from the medical staff
• A pharmacist
• A representative of the nursing staff
• An hospital administrator with his/her designated an
ex‐officio member of the committee one of the
physicians may be appointed as the chairman of PTC.

5. MEDICAL STAFF HOSPITAL
PHARMACIST
(CHAIRMAN) ADMINISTRATORS
(SECRETARY)
(DIRECTOR)
PHARMACY AND TERAPEUTICS COMMITTEE
SUB‐COMMITTEES

6. SUB‐COMMITTEE ‐1
¾ Neo‐plastics
SUB‐COMMITTEE‐2
¾ Anti‐infectives
SUB‐COMMITTEE‐3
¾ Cardio‐vascular dugs
¾ Diuretics
¾ Cardiac glycosides
¾ Hypotensives
¾ Vasodilators
¾ Anti‐coagulants

7. SUB‐COMMITTEE‐4
¾ Gastro‐intestinal drugs
¾ Autonomic
SUB‐COMMITTEE‐5
¾ CNS agents
¾ Analgesics
¾ Psychotherapeutics
¾ Respiratory & Cerebral Stimulants
¾ Sedatives & Hypnotics

8. SUB‐COMMITTEE‐6
¾ Endocrine agents
¾ Anti diabetic agents
¾ Anti‐inflammatory agents
¾ Hormones
¾ Thyroid Preparations.

9. OPERATION OF PHARMACY AND THERAPEUTICS
COMMITTEE
¾ This committee should meet regularly at least
six times in an year and also when necessary.
¾The agenda and the supplementary materials
should be prepared by the secretary and
furnished to the committee members well in
advance so that the members can study them
properly before meeting.
¾ A typical Agenda may consists of following:

10. ¾Minutes of the previous meeting
¾ Review of the contents of the Hospital
Formulary for the purpose of bringing it up to
date, and deleting of products not considered
for use
¾ Information regarding new drugs which may
have become commercially available.
¾ Review and/or adoption of investigational
drugs currently under processing in the
hospital.
¾ Review of side effects, adverse drug
reactions, toxic effects, drug interactions of
drugs reported by various units of hospital.

11. ¾ Review of “Drug Safety” in the hospital.
¾ Reports of various sub‐committees.
¾ Report of medical audit.
¾ Any other matter with the permission of
chair.
¾ Vote of thanks.

12. ROLE OF PHARMACY AND
THERAPEUTICS COMMITTEE (PTC) IN
DRUG SAFETY
• Drug safety is the moral, legal and professional
obligation of pharmacist in western countries.
• It includes responsibility from dispensing of drugs
to drug administration.
• Following guidelines may subserve the committee
in ascertaining the adequate safety factor of
hospital pharmacy:
¾ The hospital must employ a qualified, atleast, a
registered pharmacist with atleast B.Pharm degree
as ‘Chief Pharmacist’ and the rest are may be
atleast Diploma holders in pharmacist.

13. ¾ Should not permit non‐pharmacist personnel
to dispense drugs and allied materials.
¾ Must employ a sufficient members of
qualified considering the work load of a
pharmacist and allow for adequate
coverage(7days/week).
¾ Must provide adequate safe, work space, and
storage facilities.

14. ¾ Should have equipment necessary to safely
and adequately carry out the modern practice
of pharmacy.
¾ Must have an automatic stop order regulation
for dangerous drugs. e.g: narcotics,
anticoagulants etc.
¾ Should have a drug formulary which
periodically revised and kept upto date.

15. ¾ The poisonous materials are separated from
non‐poisonous materials in the pharmacy.
¾ The external used preparations should be
separated from internal used medications.
¾ Must have adequate quality control measures
and follow good manufacturing practices.
¾ Should provide a teaching programme to
teach students, nurses the basic course of
pharmaceutical mathematics and
pharmacology.

16. ¾ Should be periodically inspected in order
to remove deteriorated and outdated drugs
as well as to check all labels for legibility.
¾ Should have an adequate reference library
which contains texts on pharmacology,
toxicology, posology, and journals
containing information on newer
developments in the pharmaceutical world.

17. ROLE OF PTC IN ADVERSE DRUG REACTION
MONITORING PROGRAMME:
• An adverse drug reaction is defined as any usual
of unexpected harmful reaction including acute
poisonings by narcotics, barbiturates, and
amphetemines as well as industrial poisonings.
• There is a proportionate increase in the drug
reactions. In order to gain an understanding of
these problems and to formulate competent
opinions as to the best type of prevention and
treatment, the PTC must assume the
responsibility for the developing and instituting
a procedure for the purpose of committee.

18. AUTOMATIC ORDERS FOR DANGEROUS DRUGS
• “All Drug orders for narcotics, sedatives,
hypnotic anticoagulants, and antibiotics
(adminstered orally or parenterally) shall be
automatically discontinued after 48 hours
unless the order indicates an exact number of
doses to be adminstered, or the attending
physician, re‐orders the medication”.
• All orders for narcotics, sedatives and
hypnotics must be re‐written every 24 hours.

19. ROLE OF PTC IN
“EMERGENCY DRUG LISTS”
• The Time Factor is necessary for the
Pharmacy and Therapeutics Committee of a
hospital to get prepared boxes containing
emergency drugs which should be always
available readily for use at the bed‐side. List of
such drugs and other supplies should
compiled by Committee, and it should find
their place in “Emergency Kits”.

20. • After the emergency boxes have been
placed in the wards, it is very essential and
compulsory that a system is developed
whereby they are checked daily either by
the hospital pharmacists or by nursing
supervisor responsible for the ward.

21. Following is the list of suggested drugs and
other articles maintained in Emergency Box:
SUPPLLIES TO BE MAINTAINED IN
EMERGENCY BOX:
¾ Syringes of various range
¾ Needles
¾ Files for breaking the ampoule
¾ Airway equipment

22. DRUGS FOR EMERGENCY BOX:
These may be selected in consultation with the
physician.
¾ Atropine sulphate 0.4 mg/ml
¾ Digoxin 0.25 mg/ml
¾ Heparin 10.000 units/ml
¾ Neostigmine methyl sulphate 0.25 mg/ml
¾ Mannitol injection 25%
¾ Saline for injection 09% 30 ml
¾ Water for injection 20 ml.

23. SUPPLIES FOR CABINET UTILITY ROOM
¾ Oxygen catheters
¾ Razor with blades
¾ Resuscitation tube.
OTHER EMERGENCY SUPPLIES
¾ Burn sheets
¾ Dextran and tubing
¾ Resuscitation carts.

24. ROLE OF PHARMACY AND THERAPEUTIC
COMMITTEE IN DRUG PRODUCT DEFECT
REPORTING PROGRAMME
• The drugs purchased by hospital may be
defective in quality.
• It is for the committee to get information about
the defective drug products and to inform it
first to the manufacturer for appropriate action.
• If satisfactory answer is not obtained from the
manufacturer , it should be reported to the
Food and Drug Control Adminstration.

25. ROLE OF PHARMACY AND THERAPEUTICS
COMMITTEE IN DRUG UTILISATION
REVIEW
• Drug utilisation includes prescribing,
dispensing, adminstering and ingesting of
prescription of drugs.
• Hospital pharmacist should take medication
history that should include following
information:
¾ Medication being taken at the time of
admission, during admission, home remedies
(OTC drugs).

26. ¾ Drug allergies and idiosyncrosy towards food
products etc.
Patent medication profile to be maintained for
each patient. This will serve the following
purposes:
¾ To help improved drug prescribing practices by
promoting the safe and rational use of drugs.
¾ To detect and help prevent drug‐interactions.
¾ To detect and prevent adverse drug reactions
in sensitive patients.
¾ To detect and prevents IV additive
incompatibilities.

27. ¾ To detect drug‐induced diseases.
¾ To help detect and potential drug‐toxicities.

28. Thank You