Category: Education

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PHARMACY&THERAPEUTIC COMMITTEE The pharmacy &therapeutic committee is a policy framing& recommending body to the medical staff & the administration of the hospital on matters related to therapeutic use of drugs. this committee is composed of physicians, pharmacists & other health professionals selection with the inclusion of medical staff. Objectives: 1.Advisory : it recommends the adoption of policies or assists in the formulation of broad professional policies regarding evolution, selection & therapeutic use of drugs in the hospital. -- serves in an advisory capacity to medical staff& hospital administration in all matters like use of drugs The committee advices the pharmacy in the implementation of effective drug distribution & control procedures

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2.Education : It recommends or assists in the formulation of functions, designed to meet the needs of professional staff i.e., physicians ,nurses ,pharmacists & other medical practitioners, for the complete current knowledge of the matters related to the distribution & administration of medications, including medication incident, it reviews adverse drug reactions occurring in the hospital & to initiate & direct the drug activity study finally review & study the results of such activities It also develops & compiles a formulary of drugs & prescriptions of formulations accepted for use in the hospital It establishes or plans suitable educational schemes for the hospital’s professional staff on the matters related to the use of drugs. 3. Drug safety & adverse drug monitoring : With the advent & increase of each new class of therapeutic agents, the scope, knowledge & responsibilities of the hospital pharmacist increases proportionately.


COMPOSITION: 1. At least 3 physicians from the medical staff. 2. A pharmacist 3. Representative of the nursing staff & 4. An hospital administrator ` OPERATION of PTC: It should meet six times in a year The committee can invites its meetings persons within or outside the hospital who can have knowledge, skills & judgments The agenda & the supplementary materials should be prepared by secretary & furnished to the committee members well in advance so that members can study properly before attending meeting Agenda : -- Minutes of meeting -- Review of the contents in hospital formulary for the purpose of bringing up to date & deleting products not considered as necessary.

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-- Information about new drugs which may have commercially available -- Review of investigational drugs currently under processing in hospital -- Review of side-effects, adverse drug reactions, toxic effects, drug interactions of drugs reported by various units of the hospital -- Review of drug safety in the hospital -- Reports of various sub-committees -- Report of medical audit -- Any other matters -- Vote of thanks Minutes of meeting –maintained by Secretary & record maintained in the hospital.

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ROLE OF PTC IN DRUG- SAFETY : Drug-Safety is the moral, legal & professional obligation of the pharmacist in western countries. Drug – Safety includes responsibility from drug dispensing –drug administration—side effects Our Country pharmacist duty is to dispensing the drug prescribed by doctor PTC play a major role in drug safety Guide lines: Hospital must appoint a qualified person - B.pharm-chief pharmacist - D.pharm –pharmacist Hospital should not permit non-pharmacist person to dispense the drugs Hospital must employ sufficient no.of qualified people—7 days Hospital must provide adequate safe,work space,& storage facilities in for the pharmacy

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Hospital must have an automatic stop order regulation for dangerous drugs like narcotics, hypnotics, anticoagulants etc., Hospital should have firm policy regarding the use of research drugs in the hospital The hospital should have drug formulary which periodically revised & kept upto date The hospital should not permit any person other than a registered pharmacist into the pharmacy The poison & poisonous materials should be adequately separated from non-poisonous materials in the pharmacy & in the wards The external use preparations should be separated from internal use preparations in pharmacy & in the wards The hospital should provide sufficient help to pharmacist in a teaching program to familiarize the nursing with new drugs & also to teach the student nurses the basic course of ph.calculations & pharmacology

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Hospital pharmacy should have an adequate reference library, that should have books like pharmacology, toxicology, posology & journals containing adequate information on new developments. ROLE OF PTC IN ADVERSE DRUGREACTIONS MONITORING PROGRAMME : Adverse reaction –unexpected or unusual harmful reaction including acute poisoning by narcotics, barbiturates etc.,

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PROFORMA FOR MONITORING OF ADVERSE DRUG REACTIONS(ADR) IN INDIA 1. Do not leave any item blank. 2.Mark tick in appropriate box. 3.Type or write in BLACK LETTERS Center name: Type of patient: In patient (1) Out patient (2) Serial No: Name of the patient: Address (complete) : pin code: Age : years Sex : male (1) female(2) Occupation : Hospital Record No : Dietary Habit : Veg. (1) Non-veg. (2) Smoking habit : No (1) Yes (2) if yes, duration (yrs) Alcoholic habit : No (1) Yes (2) if yes, duration (yrs)

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Relevant medical history : If yes, details Allergy No (1) Yes (2) Environmental exposure No (1) Yes (2) Occupational exposure No (1) Yes (2) Previous drug reaction No (1) Yes (2) Pregnancy 0/1/2/3 TRIMESTER Family history of ADR No (1) Yes (2) Background signs / symptoms : Provisional diagnosis : Treatment Schedule (including traditional medicines) Drug name Trade & (diagnosis) Generic Indication Total daily dose Route Duration

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Date of end of treatment : Outcome of Management : Recovered (1); Still under R x (2); Died (3); Lost to follow up (4); ADR suspected (5) If ADR is suspected fill in the PROFORMA – 11 No (1) Yes (2) -- This proforma prepared by committee & made available to wards, nursing station - Every case of adverse reaction must be first reported by attending physician to the chairman of the PTC. - If any patient having adverse reactions the attending doctor should complete the adverse drug reaction report form. - Medical record room upon the patient discharge, remove this report from the medical record & forward it to the chairman of the committee AUTOMATIC STOP ORDERS FOR DANGEROUS DRUGS: All drug orders for narcotics, sedatives, etc,. Shall be automatically discontinued after 48 hrs. All orders for this type of drugs must be re-written every 24 hrs.

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In India this type of system is not practiced except for hospitals like CMC,Vellore, Jaslok Hospital, Mumbai ROLE PTC IN DEVELOPING EMERGENGY DRUGS LIST: Time factor is very important in emergency situations, so it is necessary for the PTC of a hospital to get prepared boxes containing emergency drugs which should be always available for use at the bed-side containing label emergency kit. After the emergency boxes have been placed in the wards, it is very essential to check daily by the hospital pharmacist or nursing supervisor Following is the list of things in emergency boxes: Syringes of various range, needles two each of 16,18,20,21,23 & 26 Files for breaking the ampoules, airway equipment etc., Drugs: aminophyllin,atropine caffeine, calcium gluconate, digoxin, ephedrin, heparin,salines for injection,wfi etc., Others like venous canulation set,oxygen catheters,sterile suction catheters,razor with blade,burn sheets,oxygen equipment etc.,

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ROLE OF PTC IN DRUG PRODUCT DEFECT REPORTING PROGRAMME: ROLE OF PTC IN DRUG UTILIZATION REVIEW: utilization includes prescribing, dispensing, administration &ingestion of drugs this is very important function of PTC in the hospital. review is useful in to detect & help prevent drug interactions to detect & prevents additive incompatibilities to detect drug induced disease to detect possible drug induced diseases to help detect & potential drug toxicities

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