Activity No 3,4,10

ACTIVITY NO. 3 DRUG PROCUREMENT AND INVENTORY CONTROL Objectives: At the end of the activity, the student should be able to: 1. Describe the procurement and inventory control systems utilized by the hospital pharmacy 2. Conduct actual drug inventory.

Discussion Outline A. Drug Procurement Purchasing Control on Purchase Procedures on Product Specifications, Contracts and Bidding Ordering Procedures Receiving, Checking and Coding B. Inventory Control Functions of Inventory Management Methods of Inventory Arrangement of Inventory Routine Stock Special Storage Areas C. Merchandise Return Policies and Procedures D. Product Recall Procedures

Activities 1. Write down the responsibilities of the pharmacist in terms of (a) requisition and procurement of drugs and medicines (b) detail men / med reps. (a) A pharmacist coordinates all activities relating to procurement of medicines in a pharmacy including storage, inventory and quality management of supplies. A pharmacist spends a lot of time interacting with people such as hospital staff and suppliers; good communication, interpersonal and organization skills are essential.

(b) Pharmacist should be able to understand the information, asked questions about the product, the disadvantage and advantages, and make a great deal with them. 2. Differentiate the process of purchasing drugs and medicines between government and private hospital pharmacy services. Government:  bidding for government contracts at all levels Private:  competitive bidding 3. Identify the advantages and disadvantages of using the Procurement Order in terms of inventory methods. A purchase order is a legally binding document between a supplier and a buyer. It details the items the buyer agrees to purchase at a certain price point. It also outlines the delivery date and terms of payment for the buyer. Advantages: -To control the acquisition of goods and services when price is a primary consideration. -An effective purchase order can move the purchase process forward from discussion to commitment by laying out products, prices, timelines and other critical terms and conditions. -The contractual nature of a purchase order protects both the buyer and the supplier in case of a dispute about the nature of the order; a great PO leaves no questions unanswered. -To create an "encumbrance" in the general ledger of accounts helping you manage your budget. -By using a Purchase Order, everyone involved in the purchase cycle can track the order by referring to the same number. -Utilization of a Purchase Order protects WHOI and includes WHOI’s Terms and Conditions. Disadvantages  Loosing tract of orders  Disloyalty of the buyer or seller 4. Enumerate problems encountered during procurement. How are these problems resolved? Problems:  Ordering items that are not needed

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Not checking the expiration date Losing records that is important Ordering incorrect items and quantities Ordering too much items Ordering less what is needed Not checking the quantities being delivered

Solutions:  Develop written procedures and assign responsibility for ordering.  Only order items your health facility needs and is authorised to keep.  Carry out a stock take before ordering more supplies.  Ask for quotations before placing orders. Use the same format as an order form, but state clearly that it is a quotation request. Also ask for a pro-forma invoice, which provides a complete breakdown of costs and which also makes ordering easier.  Keep records of past orders that show supplier contact details, code and catalogue numbers, and unit quantities, to help you make subsequent orders.  Fill in order or requisition forms clearly. Provide as much detail about requirements and specifications as possible to avoid supply of incorrect items or quantities or delays in filling your order.  Each supplier will have its own forms. It is particularly important to fill out the forms from your national supplier. For other suppliers, you may not need to fill out the form as long as you provide the relevant information.  Make sure that equipment is supplied with the necessary consumables, accessories and spare parts or, if not, order these at the same time.  For goods with expiry dates, specify in your order the minimum expiry dates required (i.e. the expiry date from the time of arrival of goods in-country).

ACTIVITY NO. 4 STORAGE AND PRESERVATION OF PHARMACEUTICALS

Objectives: At the end of the activity, the student should be able to: 1. Describe the proper methods by which drug and medicines are stored and preserved to maintain potency for expected therapeutic value. 2. Describe how unused pharmaceutical products and pharmaceutical wastes are disposed.

Discussion Outline A. Drug Storage and Preservation  Central Storage vs. Pharmacy Storage  Storage Conditions  Monitoring of Storage Conditions  Stock Rotations and Control  Containers and Container Labeling B. Requirements in Designing a Pharmacy Storage Area  Size  Shelves and Cabinets

Activities 1. What are the general principles of storage of pharmaceutical products?  Storage areas should be of sufficient capacity to allow the orderly storage of the various categories of materials and products, namely starting and packaging materials, intermediates, bulk and finished products, products in quarantine, and released, rejected, returned or recalled products.  Storage areas should be designed or adapted to ensure good storage conditions. In particular, they should be clean and dry and maintained within acceptable temperature limits. Where special storage conditions are required on the label

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(e.g. temperature, relative humidity), these should be provided, checked, monitored and recorded. Materials and pharmaceutical products should be stored off the floor and suitably spaced to permit cleaning and inspection. Pallets should be kept in a good state of cleanliness and repair. Storage conditions for pharmaceutical products and materialsshould be in compliance with the labelling, which is based on the results of stability testing. Recorded temperature monitoring data should be available for review. The equipment used for monitoring should be checked at suitable predetermined intervals and the results of such checks should be recorded and retained. All monitoring records should be kept for at least the shelf-life of the stored material or product plus 1 year, or as required by national legislation.

2. List down the storage requirements of pharmaceutical and biological products. Storage of Tablet Storage on label:  Store in a cool, protected from light and moisture.  Store in a cool and dark place, protected from light and moisture.  Keep in a dry dark place.  Store in cool dry and dark place. Storage of Capsule Storage on label:  Store in a cool and dry place, protected from light. Storage of Emulsion  An emulsion should be stored in air tight container, protected from light, high temperature or  freezing. The emulsions are required to be in cool place.

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Storage of Suspension Suspension should be stored in a cool place but not be kept in a refrigerator. Freezing at a very low temperature should be avoided which may lead to aggregation of the suspended particles. Storage on label: Store in cool and dry place, protect from heat and light. Store in a cool and dark place, protect from direct sun light. Keep in dry place at a temperature not exceeding 30 ºC. keep the bottle tightly closed.

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Store below 25 ºC, protected from moisture. Store at temperature not exceeding 30 ºC, protect from light. Storage of Ointment Ointment should be stored in well closed container so as to prevent the loss of volatile constituents. The ointment should be protected from high temperature or direct sunlight. Storage on label: Keep in a cool place. Storage of Paste The paste should be stored in well closed container and in a cool place so as to prevent evaporation of moisture present. Storage of syrup The syrup should be stored in well closed and stopper bottle in a cool dark place. The syrup should be stored at a temperature not exceeding 25 ºC. Storage on label: Store in cool, dry and dark place. Store in a cool and dry place, protected from light. Store in a cool place, protected from direct sunlight.

Storage of injection  Storage on label:  Store below 30 ºC, protected from light.  Store below 25 ºC, protected from light. Biological products  The vaccine temperature must be maintained in an insulated container between +2ºC to +8ºC at all times.  The optimum temperature for refrigerated vaccines is between 2°C and 8°C. For frozen vaccines the optimum temperature is –15°C  protection from light is a necessary condition for some vaccines. 3. How are unused pharmaceutical products and pharmaceutical wastes disposed? Unused pharmaceutical products

Wherever practical the possibility of returning unusable drugs for safe disposal by the manufacturer should be explored; particularly drugs which present disposal problems, such as antineoplastics. For unwanted, unrequested donations, especially those that arrive past or unreasonably near their expiry date it may be possible to return them to the donor for disposal.

Pharmaceutical wastes To landfill means to place waste directly into a land disposal site without prior treatment or preparation. Landfill is the oldest and the most widely practiced method of disposing of solid waste. Three types are recognized: Open uncontrolled nonengineered dump, Engineered landfill, Highly engineered sanitary landfill.

ACTIVITY NO. 10 QUALITY ASSURANCE PROGRAM FOR THE PHARMACY SERVICE

Objectives At the end of the activity, the student should be able to: 1. Describe the quality assurance program implemented by the hospital pharmacy. 2. Describe the pharmacy service effectiveness and efficiency standards.

Discussion Outline A. Definition B. Benefits Derived from the Quality Assurance Program C. Quality Assurance Activities D. Steps in Developing a Quality Assurance for Pharmacy Service E. Pharmacy Service Effectiveness Standard F. Pharmacy Service Efficiency Standard

Activities 1. As a pharmacist, how will you meet the challenge of the growing demand for assuring the quality of the pharmacy services that you provide? As a pharmacist, I will meet the challenge of the growing demand for assuring quality of the pharmacy service that I provide by continually learning new methods and technology that can meet the quality service that patients deserve. 2. What are the practice tools that you need to use to collect and analyze information regarding quality-related events, such as errors and omissions in prescription dispensing that may occur at the pharmacy? The tools that I need are books, references, pharmacopeia and newsletter.

3. What are the pharmacy functions that should be monitored using quality indicators? -identify potential adverse events that might need further study - provide the opportunity to assess the incidence of adverse events and in hospital complications using administrative data found in the typical discharge record; include indicators for complications occurring in hospital that may represent patient safety events -to track and improve inpatient quality and patient safety.