Hospital formulary pharmacy practice.pptx

Pharmacy practice

1. Hospital formulary Dr. Arpitha Anil George Assistant Professor Pharm.D , PGDM

2. Syllabus Relevant CO no Relevant LO no Learner Outcome(LO) learners will be able to…. Specific learner outcomes ( SlOs ) Learners will be able to ….. Bloom’s Level PO Hospital formulary CO703.4 CO703.2.2 Students will be able to differentiate between hospital formulary and drug list and explain the process of formulary management. 1. Define hospital formulary and its purpose. 2. Describe the contents of a hospital formulary. 3. Differentiate between hospital formulary and drug list. 4. Explain the process of preparation and revision of the formulary. Understand (BT-2), Analyze (BT-4 PO1, PO2 CO703.4 Learn the concept, management, and maintenance of hospital formulary

3. Introduction It is a list/manual of pharmaceutical preparations including important information which reflects the current clinical investigation for the medical staff. In every hospital, Hospital and Therapeutic Committee (HTC) prepares a list of drugs to be used in hospital It is a method whereby the medical staff of a hospital evaluates and selects agent from among numerous available medicinal agents and dosage forms that are useful in the patient care in the particular hospital. It assists in procuring, prescribing, dispensing and administrating drug.

4. Objectives To provide essential information about the drug which are approved by HTC to physicians and nurses. To update the knowledge/hospital guidelines and procedures to medical staff regarding drugs, its use, its merits and demerits. To avoid unnecessary use of medicine in hospitals during treatment. To reduce the cost burden on the patient. To prevent duplication and wastage of drugs in hospitals. To help the hospital pharmacist in procurement of new drugs.

5. CONTENTS AND ORGANIZATION OF HOSPITAL FORMULARY 1 . Information of Drug Product: It is the main and important part of the formulary (a) Entries in Formulary: Common names. Generic name or basic drug. Dosage strength, packaging and sizes stocked. Formulation (active ingredients) a combination of product. Adult or pediatrics dose. Route of administration. Special caution. Symbol of Controlled substance. Cost of drugs. ( b) Indexes to the Drug Product Listing: There are two ways for the indexing of the drug products and that can be the beginning or ending section: (1)According to generic name/brand name: The proper reference to page number should be included in each entry. (2)Therapeutic/ PharmacoIogical Index: This index is according to therapeutic category, e.g. anti-hypertensive drug.

6. 2. Information on Hospital Policies: Various policies and procedures of restrictions imposed by hospitals regarding drug use, and request to add the drug in its formulary. Brief discussion of Pharmacy and Therapeutic Committee, containing membership responsibilities and operations. Hospital rules and regulations in prescribing, dispensing, administration of drugs, generic drug names, drug orders, rules to be followed by medical representatives, emergency drug product, use of floor stock items, etc. 3.Pharmacy Operating Procedures: Hours of service, outpatient prescription policies, pharmacy charging systems, inpatient drug distribution procedures and patient education programs and pharmacy bulletins.

7. 4. Special Information: In hospital formulary, there is also indicating the information regarding list of nutritional products, equivalent dosage of similar drug, list of super free drug products, tables of drug interactions and adverse drug reaction reports, list of dialyzable poison, list of abbreviation, poison control distribution.

8. Formulary Drug List In the formulary there is listing of drugs according to their generic names followed by strength, dosage form, posology, adverse reactions, drug interactions, pharmacological uses and recommended quantity to be dispensed. In the drug list, listing of drugs according to their generic names followed by information on strength and dosage form. It is prepared by local clinical staff of hospital. Drug list is prepared by exceptional clinicians, pharmacologists and pharmacists of the country. Information which are given in formulary is subject to local requirements and needs Information which is given in drug list is based on the pharmacological properties.

9. PREPARATION AND REVISION OF HOSPITAL FORMULARY Preparation: Hospital formulary is prepared by identifying the most of the common diseases being treated in the hospital by referring all medical staff of the hospital. For each disease, there is suggested of first choice of treatment using standard treatment guidelines. The suitable committee who is preparing the hospital formulary brought together to identify appropriate treatment for each of the common health diseases. Another method is reviewing of WHO model listing of essential medicines. While during preparation, hospital and its staff should not forget to add the specific drug during selection process. Draft on the drug list must be prepared and given to each department for any comments on the drug list. The hospital and therapeutic committee must A draft of the list must be prepared and must be given to each department to comment on the list. The Drugs and Therapeutics Committee cautious check each comment given on the respective drug list and provide the feedback on it. The committee discussed all the information given in the formulary with the evidence-based review where possible. After the finalization of drug list, the monograph for each drug is prepared without comprising of any unbiased information.

10. Revision: There is needed to take help from various experts for the inclusion of new drug in the list. Reference books such as Indian Pharmacopeia, British Pharmacopeia, United State of Pharmacopeia and National Formulary are used while preparation of drug list for entry of new drugs. If there is no any information or whose formula is not disclosed in official Pharmacopoeia then the entry of new drug is not made in formulary. formularies need to be revised annually and there should be certain system for revision. One method for the revision is to attach supplementary sheets to the back covers of formulary books and the second method of revision is inclusion of sheet by different colour pages for the cover of each edition of the formulary, this method will help to reduce any confusion between current and past condition of formulary.

11. MANAGING A FORMULARY LIST (ADDING AND DELETING OF DRUGS) For addition of new drug into the hospital formulary: the hospital and therapeutic committee should consider the therapeutic potency and equivalency to existing drugs in terms of its safety, efficacy or suitability of administration. For the addition and deletion of drugs in the formulary, there is need to consider and compare the total cost for a course of the treatment with new medicine with the existing listed medicines.