UNIT-IPHARMACY AND
THERAPEUTICS COMMITTEE
BYJ.JAYASUTHA
LECTURERDEPT. OF PHARMACY PRATICE SRM COLLEGE OF PHARMACY
SRM UNIVERSITY
DEFINITION
THE PHARMACY AND THERAPEUTICS COMMITTEE IS APOLICY FAMING AND RECOMMENDING BODY TO THE MEDICALSTAFF AND THE ADMINSTRATION OF HOSPITAL ON MATTERSRELATED TO THERAPEUTIC USE OF DRUGS.
OBJECTIVE OF PHARMACY AND THERAPEUTICS COMMITTEE
The pharmacy and therapeutics have three major roles to play. These are:
ADVISORY
EDUCATIONAL
DRUG SAFETY AND ADVERSE DRUG MONITIORING.
COMPOSITION OF PHARMACY AND THERAPEUTICS COMMITTEE
Composition of pharmacy and therapeutics committee (PTC) might vary from hospital to hospital. The following scheme is suggested for general adoption:
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 HOSPITALPHARMACIST
(CHAIRMAN) ADMINISTRATORS(SECRETARY)
(DIRECTOR)
PHARMACY AND TERAPEUTICS COMMITTEE
SUB‐COMMITTEES
SUB‐COMMITTEE ‐1 Neo‐plastics
SUB‐COMMITTEE‐2Anti‐infectives
SUB‐COMMITTEE‐3Cardio‐vascular dugs DiureticsCardiac glycosidesHypotensivesVasodilatorsAnti‐coagulants
SUB‐COMMITTEE‐4
Gastro‐intestinal drugs
Autonomic
SUB‐COMMITTEE‐5
CNS agents
Analgesics
Psychotherapeutics
Respiratory & Cerebral Stimulants
Sedatives & Hypnotics
SUB‐COMMITTEE‐6
Endocrine agents
Anti diabetic agents
Anti‐inflammatory agents
Hormones
Thyroid Preparations.
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.
A typical Agenda may consists of following:
Minutes of the previous meetingReview of the contents of the Hospital Formulary for the purpose of bringing it up to date, and deleting of products not considered for useInformation 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.
Vote of thanks.
ROLE OF PHARMACY AND THERAPEUTICS COMMITTEE (PTC) IN
DRUG SAFETY
• Drug safety is the moral, legal and professional obligation of pharmacist in western countries.
• It includes responsibility from dispensing of drugs to drug administration.
• Following guidelines may subserve the committee in ascertaining the adequate safety factor of hospital pharmacy:The hospital must employ a qualified, atleast, a registered pharmacist with atleast B.Pharm degree as ‘Chief Pharmacist’ and the rest are may be atleast Diploma holders in pharmacist.
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.
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. e.g: narcotics, anticoagulants etc.
Should have a drug formulary which periodically revised and kept upto date.
The poisonous materials are separated from non‐poisonous materials in the pharmacy.
The external used preparations should be separated from internal used medications.
Must have adequate quality control measures and follow good manufacturing practices.
Should provide a teaching programme to teach students, nurses the basic course of pharmaceutical mathematics and pharmacology.
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.
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 amphetemines 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 as to the best type of prevention and treatment, the PTC must assume the responsibility for the developing and instituting a procedure for the purpose of committee.
AUTOMATIC ORDERS FOR DANGEROUS DRUGS
• “All Drug orders for narcotics, sedatives, hypnotic anticoagulants, and antibiotics (adminstered orally or parenterally) shall be automatically discontinued after 48 hours unless the order indicates an exact number of doses to be adminstered, or the attending physician, re‐orders the medication”.
• All orders for narcotics, sedatives and hypnotics must be re‐written every 24 hours.
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”.
• 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.
Following is the list of suggested drugs and other articles maintained in Emergency Box:
SUPPLLIES TO BE MAINTAINED IN EMERGENCY BOX:
Syringes of various range
Needles
Files for breaking the ampoule
Airway equipment
DRUGS FOR EMERGENCY BOX:
These may be selected in consultation with the physician.
Atropine sulphate 0.4 mg/ml
Digoxin 0.25 mg/ml
Heparin 10.000 units/ml
Neostigmine methyl sulphate 0.25 mg/ml
Mannitol injection 25%
Saline for injection 09% 30 ml
Water for injection 20 ml.
SUPPLIES FOR CABINET UTILITY ROOM
Oxygen catheters
Razor with blades
Resuscitation tube.
OTHER EMERGENCY SUPPLIES
Burn sheets
Dextran and tubing
Resuscitation carts.
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 Adminstration.
ROLE OF PHARMACY AND THERAPEUTICS COMMITTEE IN DRUG UTILISATION
REVIEW• Drug utilisation includes prescribing, dispensing, adminstering 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 (OTC drugs).
Drug allergies and idiosyncrosy 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.