Role of Pharmacist in Hospitals

Study Notes

Role of Pharmacist in Hospital

Hospitals and other facilities (drug treatment, information centers, long-term care) can be government- or privately-run.
Hospital pharmacists have more interaction with prescribers, allowing them to promote rational drug use.

Hospital Pharmacist vs. Community Pharmacist

Hospital pharmacists, in larger settings, usually have more opportunities to specialize and gain expertise.
They frequently have access to medical records, allowing them to impact drug selections, monitor patient responses, detect adverse reactions, and influence dosage regimens.

Hospital Pharmacist Responsibilities (cont.)

They can more easily assess and monitor drug usage patterns in hospitals, recommending necessary changes.
They are involved in policy-making committees (e.g., drug selection, antibiotic use, hospital infections).
Their role extends to influencing essential drug lists and formularies.

Hospital Pharmacist Responsibilities (cont.)

Hospital pharmacists are uniquely positioned to educate other healthcare professionals about rational drug use.
They can be part of studies to evaluate drug effects.
They control hospital drug procurement.
They plan and execute clinical trials.

Outpatient Services

Pharmacists supply the right drug, at the right dose, to the right patient.
Clarification of drug information, dosage, polypharmacy, and potential interactions is crucial.
Substitution of drugs and patient counseling are vital aspects.

Outpatient Services (cont.)

Effective communication between pharmacists, patients, and other staff is essential.
Pharmacists supervise staff and implement systems for appointment-based medication dispensing (SMART).

Inpatient Services

Hospital ward and satellite pharmacies distribute medications.
Discharge counseling ensures correct medication administration.
Unit dose system and unit of use packaging are key components of the process.
Monitoring of high-risk drugs is crucial in inpatient settings.

Prescription

Prescriptions vary in format.
Prescriptions often include patient information (name, identification number).
Prescriptions include drug information (name, quantity, frequency, administration route).

Manufacturing in Hospitals

Hospital pharmacies are not typically built for drug manufacturing and often have limited quantities available.
Compliance with Good Manufacturing Practices (GMP) is necessary.
Hospital settings may encounter contamination issues.
When large amounts of drug manufacturing are required, extemporaneous compounding is often done.

Clinical Pharmacy Services

Pharmacists often participate in rounds with doctors or as separate consultations.
Expertise in medication and patient conditions is crucial.
Pharmacists conduct medication reviews.
They identify potential drug-related illnesses (e.g., ICU, pediatrics, geriatrics, nephrology).
Pharmacists service surgical wards' medication needs.

Total Parenteral Nutrition

Pharmacists manage nutrition plans for patients who cannot eat.
Mixes are prepared carefully to limit contamination risks, and pharmacists use aseptic techniques.
Pharmacists ascertain the calorific value of foods and their compatibility with patient needs.

IV Admixture and Cytotoxic Drug Reconstitution

Handling very toxic drugs mandates safety precautions to protect staff.
Preventing contamination of IV mixtures is vital.
These services often require specialized facilities and expertise.

Therapeutic Drug Monitoring Services

Determining drug levels in the blood is part of patient care needs.
This is especially crucial for drugs with a narrow therapeutic index.
Specialized equipment is required.
Pharmacy departments or pathology labs perform related tests.
Pharmacists analyze test results to adjust medications as needed.

Blood Concentration

Blood concentration data is useful to determine minimum effective concentration (MEC) and minimum toxic concentration (MTC).
Cmax represents maximum drug level, and Cmin represents minimum level.
Data helps show medication effectiveness and potential toxicity when evaluating two different drug formulations.

Drug Information Services

Pharmacists provide answers to drug-related questions.
They prepare drug bulletins and reports.
They compile and maintain hospital formularies.

Medication Therapy Adherence Clinic (MTAC)

MTAC clinics provide services to improve medication compliance and better patient outcomes.
They identify issues patients encounter in taking medications, adhering to guidelines, and achieving therapeutic goals.

Hospital Administration

Pharmacists handle budgeting for medicines.
They participate in purchasing and supervising staff.
They contribute to the hospital's drug and therapeutics committee.
Pharmacists also deal with complaints from numerous stakeholders (management, public, press).

Description

Explore the key responsibilities and differences between hospital pharmacists and community pharmacists. Learn about their specializations, interactions with prescribers, and their critical role in ensuring rational drug use in healthcare settings.