Pharmacy and Therapeutic Committee

Objective, Organization, Function and Policies of PTC

1. Pharmacy and Therapeutic Committee Dr. Subhash R. Yende Asst. Professor Gurunanak College of Pharmacy, Nagpur

2. Introduction The pharmacy and therapeutics committee is a policy framing and recommending body to the medical staff and the administration of hospital on matters related to therapeutic use of drugs It is responsible for framing policies and procedures for selection, procurement, dispensing, labeling, availability, administration, and control of drugs throughout the hospital. This committee is composed of physicians, pharmacists and other health care professionals selected with the guidance of the medical staff. It encourages rational use of drug in the hospital and also monitors issues relating to drug safety. 2 Dr. Subhash R. Yende, GNCP, Nagpur

3. Objective of the PTC: Advisory : Recommends the adoption of policies or assist in formulation of policies regarding evolution, selection and therapeutic use of drugs. Medical staff and hospital administration regarding use of drug including investigational drug. Drugs to be stocked in hospital patient care areas  Effective drug distribution and control procedures Dr. Subhash R. Yende, GNCP, Nagpur 3

4. Educational : Formulation of functions, for the complete current knowledge of the matter related to the drugs and their use to professional staff Evaluates the problems related to Distribution and administration of medications Develops and compiles a formulary of drugs and prescriptions of formulations Establishes or plans suitable educational schemes for the hospital’s professional staff on the matters related to the use of drugs Drug safety and adverse drug monitoring : PTC exert vigilance on safety aspect and ADR monitoring Dr. Subhash R. Yende, GNCP, Nagpur 4

5. Organization of PTC Composition of PTC might vary from hospital to hospital. It may composed of : 1. At least three physicians from the medical staff 2. A pharmacist 3. A representative of the nursing staff 4. An hospital administrator with his or her designated an ex-officio member of the committee. One of the physicians may be appointed as the chairman of PTC. The pharmacist is designated as the Secretary of the committee. Dr. Subhash R. Yende, GNCP, Nagpur 5

6. Dr. Subhash R. Yende, GNCP, Nagpur 6 PTC Sub Committees Neo-plastics Anti- infectives CVS drugs – Diuretics, Hypotensives Vasodilators, Spasmolytics , Antticoagulants GI drugs – Atonomic , Laxatives CNS drugs – Analgesics, Anticonvulsants, Respiratory Stimulants, Sedatives Endocrinology Agents – Antidiabetics , Hormones, Thyroid

7. PTC should meet regularly at least six times in the year, and when necessary. The committee should invite to its meetings persons within or outside the hospital who can contribute specialized or unique knowledge, skills and judgments. 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 the meeting Minutes of meeting should be prepared by Secretary and maintained in permanent record of hospital Recommendation of committee shall be presented to medical staff or its appropriate committee for adaptation or recommendation Dr. Subhash R. Yende, GNCP, Nagpur 7

8. A typical Agenda may consists of – Minutes of the previous meeting Review of the contents of the Hospital Formulary Information regarding new drugs which may have become commercially available. Review and/or adoption of investigational drugs currently under processing in the hospital. Review of side effects, adverse drug reactions, toxic effects, drug interactions of drugs reported by various units of hospital. Review of “Drug Safety” in the hospital. Reports of various sub‐committees. Report of medical audit. Any other matter with the permission of chair Dr. Subhash R. Yende, GNCP, Nagpur 8

9. Functions of PTC To advise the medical staff and hospital administrator in all matter related to use of drug (including Investigational drug) To recommend for adoption of suitable policies regarding selection, procurement, storage, prescription, dispensing and use of medicine To develop and prepare hospital drug formulary To develop norms and guideline for revision of formulary at regular interval and procedure for, addition of new drugs, deletion of old drugs, duplication of drug or its combination To suggest measures to evaluate clinical data regarding new drug or agent Dr. Subhash R. Yende, GNCP, Nagpur 9

10. To establish or plan suitable educational programme for hospital professional matter related to drug use To review reported adverse drug reaction to drug administered to the patients in the hospital To evaluate problem related to the procurement, storage, distribution and administration of drug in hospital To develop and establish generic and therapeutic substitution guideline for the hospital To advise pharmacy regarding drug distribution and control procedure, Developing Drug Information System, Maintenance of drug standard and quality control, maintenance of records and disposal of Expiry Drugs Dr. Subhash R. Yende, GNCP, Nagpur 10

11. Policies of PTC The use of drug in hospital is controlled by different policies, which includes- 1. Proposal of new drug for hospital formulary shall be submitted on Formulary request form to pharmacy department. 2. Drug evaluated and approved by committee will assigned to one of the following categories- Formulary Drug Drug approved on conditional trial period Specialized formulary drug Investigational drug 3. Non Formulary drug will not be stocked in pharmacy 4. Rules and regulation which governs pharma representatives activity 5. Pharmacy dept authorized to dispense drug as per policies and procedure of PTC Dr. Subhash R. Yende, GNCP, Nagpur 11

12. 6. Pre signing of blank prescription or drug order is prohibited 7. Drug recall 8. Inpatients prescription: Routine drug order IV orders Total Parenteral nutrition (TPN) Self medication Medication brought to hospital by patients Automatic stop order Discharge prescription 9. Outpatients prescription: Hospitalized patient at discharge, clinic patients and employees prescription may only be written on hospital prescription form Information required Special requirement for cotrol drug Dr. Subhash R. Yende, GNCP, Nagpur 12

13. All Drug Orders for narcotics, sedatives, hypnotic anticoagulants, and antibiotics shall be automatically discontinued after 48 hours unless the order indicates an exact number of doses to be administered, or the attending physician, re-orders the medication. All orders for narcotics, sedative and hypnotics must be rewritten every 24 hours. Dr. Subhash R. Yende, GNCP, Nagpur 13 Automatic stop orders for Dangerous Drugs :

14. Role of PTC in Developing “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”. 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. Dr. Subhash R. Yende, GNCP, Nagpur 14

15. Aminophylline 0.25 g/ml Amylnitrite glass capsules for inhalation Atropine sulphate 0.4mg/ml Caffeine sodium benzoate 0.5g/2 ml. Calcium Gluconate 1 g/10 ml Digoxin 0.25 mg/ml Diphenylhydantoin sodium 50 mg/ml Epinephrine Hcl /1 mg/ml Heparin 10.000 units/ml Hydrocortisone 100mg Magnesium sulphate injection 10%, 50% Isoproterenol 1:100 Mannitol injection 25% Nalorphine Hcl-10 mg/2ml Neostigmine methyl sulphate 0.25mg/ml Norepinephrine Injection 0.2%   Pentobarbitone 50mg/ml Pentzocine Phenylephrine Hcl 10mg/ml Pheomethazone inj Picrotoxin Inj. 3mg/ml Procainamide 100mg/ml. Protmine sulphate 20mg/ml Saline for Injection 09% 30ml Sodium molar lactate solution Water for injection 20ml Dr. Subhash R. Yende, GNCP, Nagpur 15 Drugs for emergency box :

16. Supplies To Be Maintained In Emergency Box: Syringes of various range Needles Files for breaking the ampoule Airway equipment Supplies for cabinet utility room Oxygen catheters Razor with blades Resuscitation tube. Other emergency supplies Burn sheets Dextranand tubing Resuscitation carts. Dr. Subhash R. Yende, GNCP, Nagpur 16

17. Reference William E Hassan, Hospital Pharmacy, Fourth edition, Philadelphia: Lea & Febiger . RK Goyal & RK Parikh. Text book of Hospital Pharmacy, B S Shah Prakashan Ahmedabad . AB Budhrani , R. Usman , M Sharma, P Kumar. Concise Course in Pharmacy Practice. S. Vikas and Company. https://www.slideshare.net/apollojames/pharmacy-and-therapeutic-committee-81224362 https :// www.slideshare.net/rameshganpisetti/pharmacy-and-therapeutic-committee-134693292 17 Dr. Subhash R. Yende, GNCP, Nagpur