Drug and therapeutic committee

A Group work as per curriculum of PGDHM.

1. THE DRUG AND THERAPEUTICS COMMITTEE SUBMITTED BY: Dr Aniket Desai S.Devi Prasad Yadav Indrani B Jisa Anna M Manisha Raturi

2. INTRODUCTION Many countries will spend 30 to 40 percent of their health care budgets on drugs and much of that money is wasted on irrational drug use and inefficiencies in procurement of drugs. Other serious problems that health care organizations face are the over use of antibiotics, increasing antimicrobial resistance, increasing adverse drug reactions, and considerably higher costs associated with drug use DTCs can provide the leadership and structure to select appropriate drugs for the formulary, promote rational drug use, and help reduce drug costs to acceptable level .

3. DEFINITION The pharmacy and therapeutics committee is a policy faming and recommending body to the medical staff and the administration of hospital on matters related to therapeutic use of drugs .

4. OBJECTIVE The pharmacy and therapeutics have three major roles to play. These are: ADVISORY EDUCATIONAL DRUG SAFETY AND ADVERSE DRUG REACTIONS MONITIORING

5. FUNCTIONS Advising medical, administrative, and pharmacy departments on drug related issues · Developing drug policies and procedures · Evaluating and selecting drugs for the formulary and providing for its periodic revision · Assessing drug use to identify potential problems · Promoting and conducting effective interventions to improve drug use (including educational, managerial, and regulatory methods) · Managing adverse drug reactions Managing medication error

6. COMPOSITION Composition of pharmacy and therapeutics committee (PTC) might vary from hospital to hospital. 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. MEDICAL STAFF HOSPITAL PHARMACIST CHAIRMAN ADMINISTRATORS DIRECTOR

7. OPERATION OF PHARMACY AND THERAPEUTICS COMMITTEE This committee should meet regularly at least six times in an year and also when necessary. The 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

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

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

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

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

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

13. 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 amphetamines 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, prevention and treatment, the PTC must assume the responsibility for the developing and instituting a procedure for the purpose of committee.

14. 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”

15. 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.

16. 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 Administration.

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

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

19. ETHICAL CONCERNS OF THE DTC The committee needs to operate in a manner that ensures transparency and avoids conflicts of interest with manufacturers and distributors of drugs or medical supplies. In order for the committee to maintain objectivity and credibility, it is necessary that a strict ethics policy be provided and rigorously enforced. There can be no relationships with the pharmaceutical companies other than a purely professional one that encourages the flow of unbiased information about their drug products.