Q 1 Explain the composition,objectives and functions and of

PTC in a hospital.
Introduction:
Introduction PTC is an advisory group of the medical staff and serves as the organizational
line of communication between the medical staff and the pharmacy department. The hospital
as an organization responds to rational use of drugs by creating a mechanism called the
Pharmacy Therapeutic which formulates policy regarding therapeutic use of drugs. 2
Composition of PTC:
Composition of PTC At least three physicians A pharmacist A representative of the nursing
staff A hospital administrator or his/her designated person and an ex-officio member of the
committee The physician may be appointed as the Chairman of P.T.C. The pharmacist is
designated as the Secretary of the committee.
Objectives:
Objectives Advisory: The committee recommends the adoption of (or) assists in the
formulation of the broad profession policies regarding evaluation, selection and therapeutic
use of drugs in the hospital. The committee serves in an advisory capacity to medical staff
and hospital administration in all matters pertaining to the use of drugs including the
investigational drugs.
Educational: The committee recommends or assists in the formulation of functions, designed
to meet the needs of the professional staff, the physicians, nurses, pharmacists and other
health care practitioners, for the complete current knowledge of the matters related to drugs
and their uses. The committee studies the problems related to the distribution and
administration of medication. It establishes or plans suitable educational scheme for the
hospital professional staff on the matters related to the use of drugs.
Drug Safety and Adverse Drug Monitoring: As the therapeutic agents are increasing, the
scope, knowledge and responsibility of the hospital pharmacist is also increasing. The safety
aspects are more or less taken for granted by pharmacy, medical and nursing staff.
Operation:
Operation PTC should meet regularly at least six times in an year and also as and when
necessary. The committee can invite its meetings and persons within or outside the hospital
who can contribute specialized or unique knowledge and skilled judgment. The agenda and
the supplementary materials should be prepared by the secretary and furnished to the
committee members sufficiently in time before the meeting.
Agenda:
Agenda Minutes of the previous meeting Reviews of the contents of the hospital formulary
for the purpose of bringing it up to date Information regarding new drugs Review of side
effects, adverse drug reactions, toxic effects and drug interaction Drug safety in the hospital
Review of investigated drugs currently under processing in the hospital
The minutes of all meetings held should be prepared by the secretary (pharmacist member)
and a permanent record of these minutes should be maintained in the hospital.

Functions:
Functions The PTC develops, compiles and ratifies the hospital formulary system sponsored
by the medical staff who adopts the formulary to the needs of the individual hospital. The
committee promotes rational therapeutics and prevents duplication and confusion. The
committee develops written policies and procedures for selection, procurement, storage,
distribution and use of drugs in the hospital
It also develops policies regarding drug safety. The committee recommendations are adopted
by the medical staff. The PTC minimizes the duplication of the drug. The PTC helps in the
development of training programmes for professional staff in drug use. The PTC studies
problems related to administration, distribution, drug reaction and drug stock. The PTC
advises the pharmacy regarding drug distribution and control procedure.
Role of PTC in Drug Safety:
Role of PTC in Drug Safety Following guidelines for the committee can be very suitable and
useful for ascertaining the adequate safety factor of the hospital pharmacy: Are the
pharmacists and his assistant adequately qualified? (Chief pharmacist should have a degree in
pharmacy and the rest must have diploma in pharmacy) Is there a practice of dispensing by
non-pharmacists? Is the man-power of hospital pharmacy adequate to do justice to the work
load? Does the hospital employ persons with proper regard with the pharmacy work load
Does the hospital provide adequate safety, work, space and storage facilities for the
pharmacy? Does the pharmacy has equipment necessary to carry out the modern practice of
pharmacy with adequate safety? Does the hospital has firm policy? Does the hospital has a
drug formulary? How are the poisons/non-poisons separated? How are the external/internal
use preparation separated? Are external used preparations separated from internal use? Does
the pharmacy manufacture product for patients use? Does the pharmacy has an adequate
reference library? Does the hospital has an Automatic stop order regulation for dangerous
drugs, e.g. narcotics, etc.
Role of PTC in Adverse Drug Reaction Monitoring:
Role of PTC in Adverse Drug Reaction Monitoring Adverse Drug Reactions can be tackled at
two levels: How to prevent the adverse reactions Once they occur how to treat them PTC
therefore develops a reporting system for this purpose The ADR reports consists of Name of
the drug Routes of administration Date of starting and ending treatment Indications for which
the drugs were used Adverse reactions noted for them and the steps taken to treat these side
effects 14 SHAIK ARIFA BEGUM
Role of PTC in Adverse Drug Reaction Monitoring
Role of PTC in Adverse Drug Reaction Monitoring ( Contd ) The ward/nursing station
transmits this report to the chairman, PTC. In the recommended procedure, the physician
places the ADR report before the chairman of PTC. The same is then ultimately placed within
the medical records room. The PTC also interacts with the bodies like FDA, government and
DTAB. 15 SHAIK ARIFA BEGUM
Role of PTC in Emergency Drug List:
Role of PTC in Emergency Drug List PTC of a hospital prepares box containing emergency
drugs which should be always available ready for use at the bed side. List of such drugs and
other supplies should be recommended by the committee, which should find their place in

emergency kits. The same are then placed in the wards. The emergency box contains
different syringes, needles, ampoules, cutters, drugs like aminophylline, amyl nitrite, atropine
sulphate, calcium gluconate, digoxin, saline injection and ringers lactate. The list is
constantly reviewed by the PTC.
Role of PTC in Drug Product Defect Reporting Program:
Role of PTC in Drug Product Defect Reporting Program The drugs purchased by hospital
may not be of good quality. Therefore, PTC play an important role in Defect Report
Programming. The PTC may inform to the manufacturer or drug control department
regarding defective drug.
Role of PTC in Drug Utilization:
Role of PTC in Drug Utilization Drug utilization includes prescribing, dispensing,
administering and ingesting of prescribed drugs. Hospital pharmacist should take medication
history, including following information: Medication being taken at the time of admission,
during admission and home remedies. Drug-allergies and idiosyncrasy towards food
products.

Q.2 Define hospital and classify hospitals.Discuss the role of

hospital pharmacist.
A hospital is an institution which is scientifically & economically organized for
prevention, diagnosis & treatment of diseases. The teaching hospitals have facilities for the
teaching & training of medical & paramedical students & trainers, hospital may be operated
by the government or private agencies.

Classifications of hospital are given bellow:1.

According to servicea.
General hospital: - District hospital, Thana hospital.
b.
Special hospital: - Medical college hospital, mental hospital, cancer hospital.

a.
b.
c.

2.
According to ownership:Government hospital: - Unforced hospital, public health hospital.
Non Government hospital: - Private hospital.
Corporation hospital: - (I. Profitable, Ii. Non-profitable, Partnership hospital).

a.
b.
c.
d.
e.

3.
According to bed capacity:Fewer than 50 beds Thana label hospital.
51 to 100 beds district label hospital.
200 bed hospital Ex: - Khanpur hospital, Nariyongong. (Bangladesh)
200 -300 bed hospital Ex: - faridpur medical. (Bangladesh)
400-500 beds hospital an over. Ex: - Dhaka medical college hospital . (Bangladesh)

On the other hand, hospital is classified are as follows:.

Teaching hospital: - Medical college hospital.
2.
Specialist hospital: - TB hospital, cancer hospital.

3.
4.
5.
6.

General hospital: - District hospital.

Nursing home or clinic.
Secondary hospital.
Tertiary hospital.

RESPONSIBILITY OF HOSPITAL PHARMACIST :

Hospital Pharmacy : -:
Hospital Pharmacy : - Definition: Hospital pharmacy is the department , service or a domain
in the hospital organization managed under the direction of a professionally competent,
legally qualified pharmacist. Hospital pharmacist is responsible for the following: Dispensing
of drugs and medicines as per the prescriptions of the medical staff or the hospital for out
patients and inpatients.
2) Management of the stores which include: Purchase of drugs and medicines and other
allied stores as per the recommendations of the pharmacy and therapeutics
committee(PTC). Providing instructions for proper storage of such drugs and medicines.
Maintenance of proper records of the drugs purchased and the distribution thereof. Storage
and dispensing of narcotic and biological products. Supply and storage of ancillary products
and articles required in the hospital. www.revolutionpharmd.com
3) Manufacture and distribution of medicaments and products such as transfusion fluids,
tablets, capsules, ointments, stock mixtures as per the hospitals formulary.
4) Providing therapeutic drug monitoring services by studying effects of various drugs
administered to the inpatients.
5) Establishment and maintenance of drug information centre.
6) Patient counseling service while supplying drugs especially from the out-patient
department.
7) Maintaining liasion with the medical staff , nursing staff and the patients themselves.
8) To maintain the nursing department and the central sterile supply unit in the hospital.
9) Participate in the teaching programmers of nursing and the pharmacy students.
(1) INPATIENT (or)INDOOR PHARMACIST RESPONSIBILITIES:-:
:- CENTRAL DISPENSING AREA :- To ensure that all drugs are stored, dispensed correctly.
To check the accuracy of the dosages prepared especially of intravenous admixtures and
unit doses. To keep proper records and preparation of bills. He has also to maintain record of
all reports on drug used and/or issued from his section. To coordinate the overall
pharmaceutical needs of the patient care areas with the centrally dispensing areas. To
ensure that the established policies and procedures laid down are followed. To communicate
with all pharmacy staff regarding new developments in the area and assists in evaluations of
employees of his section. To coordinate the activities of the area with the available staff to
make the best possible use of the personnel and the resources. www.revolutionpharmd.com
b) Patient Care Areas:
To maintain a liasion with nurses who are involved in the drugs administration to the patients.
Reviewing of drug administration in each patient periodically to ensure that all doses are
being administered and charted accordingly. To provide instruction and assistance to the
junior pharmacists as needed in dealing with difficult patients and new procedures. To
coordinate the overall pharmaceutical services on the running unit level
www.revolutionpharmd.com
c) Direct patient care areas: -:

- Identification of drugs brought in to hospitals by the patients. Obtaining patients medication

history and communicating all the information to the attending physicians. To assist in the
selection of drug products and their identities. To monitor patient drug therapy for
1.Effectiveness 2.Sideeffects 3.Toxicities 4.Allergic drug reactions 5.Drug interactions etc.
www.revolutionpharmd.com
Counseling patients on: -:
- Medications which are to be self administered in the hospital. Regarding the use of
discharge medicines. Participating in cardiopulmonary emergencies by 1. Procurement
and/or preparation of drugs needed. 2.Charting all medications given. 3.performing cardiopulmonary resuscitation if necessary. www.revolutionpharmd.com
d) General responsibilities: :
d) General responsibilities: Pharmacist is expected to provide in service and education for
the Pharmacists , Pharmacy students, Nurses, Nursing students, Physicians and Medical
students www.revolutionpharmd.com
-:
(2).OUTDOOR PHARMACISTS RESPONSIBILITIES : - The Central Dispensing Area:- The
pharmacist ensure that proper techniques are used in extemporaneous compounding .
provides for adequate record keeping and billing in respect of patient medication particulars,
records of investigational drugs , records of out patient bills for the charges of services and
material , furnished by the department. Correctly maintaining the prescription files. Keeps the
outdoor pharmacy in a neat and tidy manner. www.revolutionpharmd.com
b) Patient Care Area:- :
b) Patient Care Area:- To periodically inspect the medication areas on the nursing unit and to
make sure that they are always adequately supplied with other articles required. To identify
drugs brought in to the clinic by the patient and record the patients medication history.
Monitoring of drugs as explained earlier. To counsel the patients on the proper use of their
medication and prepare the medication for the intravenous administration
www.revolutionpharmd.com
C) General Responsibilities: - :
C) General Responsibilities: - To co-ordinate overall pharmaceutical needs, of the outdoor
service area and exercise adequate control over such drugs. To ensure that all drugs are
handled properly such as storage of investigational drugs. To participate in cardio pulmonary
emergencies. To provide for in service education and training for the pharmacists, pharmacy
items i.e. the pharmacy students sent for practical training as a part of diploma or degree
courses, nurses

Q.3 Describe the hospital control procedures for narcotics and

other controlled substance.
Q 4. Explain the location and layout of CSSR.
Q 5 Define the Hospital Formulary and mention its contents
.Differentiate between hospital formulary and National
formulary of India .
Q 6 Write a short note on Pharmaceutical ethics.
Q 7 Disscuss prepackaging of medicines in hospitals.

Q 8 Disscuss the method of sterilisation of scissors,rubber

gloves and glass sringes
Q 9 Give the role of community pharmacy in development of
health services in India.
Community pharmacists are the health professionals most accessible to the
public. They supply medicines in accordance with a prescription or, when legally
permitted, sell them without a prescription. In addition to ensuring an accurate
supply of appropriate products, their professional activities also cover counselling
of patients at the time of dispensing of prescription and non-prescription drugs,
drug information to health professionals, patients and the general public, and
participation in health-promotion programmes. They maintain links with other
health professionals in primary health care.
Today, an increasingly wide range of new and analogous products are used in
medicine, including high-technology biological products and radiopharmaceuticals. There is also the heterogeneous group of medical devices,
which includes some products analogous to medicines, some of which demand
special knowledge with regard to their uses and risks (e.g., dressings, wound
management products, etc.).Pharmacists have progressively undertaken the
additional task of ensuring the quality of the products they supply.
The main activities of community pharmacists are described below.

Processing of prescriptions
The pharmacist verifies the legality, safety and appropriateness of the
prescription order, checks the patient medication record before dispensing the
prescription (when such records are kept in the pharmacy), ensures that the
quantities of medication are dispensed accurately, and decides whether the
medication should be handed to the patient, with appropriate counselling, by a
pharmacist. In many countries, the community pharmacist is in a unique position
to be fully aware of the patients past and current drug history and,
consequently, can provide essential advice to the prescriber.

Care of patients or clinical pharmacy

The pharmacist seeks to collect and integrate information about the patients
drug history, clarify the patients understanding of the intended dosage regimen
and method of administration, and advises the patient of drug-related
precautions, and in some countries, monitors and evaluates the therapeutic
response.

Monitoring of drug utilization

The pharmacist can participate in arrangements for monitoring the utilization of

drugs, such as practice research projects, and schemes to analyse prescriptions
for the monitoring of adverse drug reactions.

Extemporaneous preparation and small-scale manufacture of

medicines
Pharmacists everywhere continue to prepare medicines in the pharmacy. This
enables them to adapt the formulation of a medicine to the needs of an
individual patient. New developments in drugs and delivery systems may well
extend the need for individually adapted medicines and thus increase the
pharmacists need to continue with pharmacy formulation. In some countries,
developed and developing, pharmacists engage in the small-scale manufacture
of medicines, which must accord with good manufacturing and distribution
practice guidelines.

Traditional and alternative medicines

In some countries, pharmacists supply traditional medicines and dispense
homoeopathic prescriptions.

Responding to symptoms of minor ailments

The pharmacist receives requests from members of the public for advice on a
variety of symptoms and, when indicated, refers the inquiries to a medical
practitioner. If the symptoms relate to a self-limiting minor ailment, the
pharmacist can supply a non-prescription medicine, with advice to consult a
medical practitioner if the symptoms persist for more than a few days.
Alternatively, the pharmacist may give advice without supplying medicine.

Informing health care professionals and the public

The pharmacist can compile and maintain information on all medicines, and
particularly on newly introduced medicines, provide this information as
necessary to other health care professionals and to patients, and use it in
promoting the rational use of drugs, by providing advice and explanations to
physicians and to members of the public.

Health promotion
The pharmacist can take part in health promotion campaigns, locally and
nationally, on a wide range of health-related topics, and particularly on drugrelated topics (e.g., rational use of drugs, alcohol abuse, tobacco use,
discouragement of drug use during pregnancy, organic solvent abuse, poison
prevention) or topics concerned with other health problems (diarrhoeal diseases,
tuberculosis, leprosy, HIV-infection/AIDS) and family planning. They may also
take part in the education of local community groups in health promotion, and in

campaigns on disease prevention, such as the Expanded Programme on

Immunization, and malaria and blindness programmes.

Domiciliary services
In a number of countries, the pharmacist provides an advisory as well as a supply
service to residential homes for the elderly, and other long-term patients. In
some countries, policies are being developed under which pharmacists will visit
certain categories of house-bound patients to provide the counselling service
that the patients would have received had they been able to visit the pharmacy.

Agricultural and veterinary practice

Pharmacists supply animal medicines and medicated animal feeds.

Q 10) Define HOSPITAL AND hospital pharmacy ?

Explain functions of hospital Pharmacist in purchase of quality drugs .
Hospital The hospital is a complex organization utilizing combination of intricate,
specialized scientific equipment, and functioning through trained people educated to the
problem of modern medical science. These are all welded together in the common purpose
of restoration and maintenance of good health
Hospital Pharmacy
The department or service in a hospital which is under the direction of a professionally
competent, legally qualified pharmacist, and from which all medications are supplied to the
nursing units and other services, where special prescriptions are filled for patients in the
hospital, where prescriptions are filled for ambulatory patients and out-patients, where
pharmaceuticals are manufactured in bulk, where narcotic and other prescribed drugs are
dispensed, where injectable preparations should be prepared and sterilized, and where
professional supplies are often stocked and dispensed.
The computerization of the pharmacy department makes it possible for the staff to
participate in patient education programs, poison control center activities, preparation of
patient drug use profiles, parenteral nutrition program participation, cooperating in the
teaching and research programs of the hospital, communicating new product information to
nursing service and other hospital personnel and dispensing radiopharmaceuticals Hospital
Pharmacy

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