Drug Distribution System PDF

**DRUG DISTRIBUTION SYSTEM** = Method by which medications are supplied to patients provided that medications given safely and efficiently Process: 1. **Ward stock system** - Storing bulk quantity or frequently used medications (pain relievers, antibiotics, emergency drugs) in a unit or d...

**DRUG DISTRIBUTION SYSTEM** = Method by which medications are supplied to patients provided that medications given safely and efficiently Process: 1. **Ward stock system** - Storing bulk quantity or frequently used medications (pain relievers, antibiotics, emergency drugs) in a unit or department - There is pharmacy per ward or unit - Pharmacist are doing inventory - Nurse are dispensers - Advantages and Disadvantages **Advantages** **Disadvantages** --------------------------------- ---------------------------------------------------------------------------------------------- Immediate access to medications Lack of control Efficient for high volume drugs Increase waste and medication error Increase risk of error (mistakes in dosage, selection of drugs without pharmacist oversight) Inventory management issues 2. **Individual patient specific dispensing system** - Medication dispense for RPh, prepared by the RPh and distribute individually - Advantages and Disadvantages **Advantages** **Disadvantages** ---------------------- ------------------------------------------------------------------------- Patient specific Delayed administration (pharmacist has to prepare the medication order) Quantity specific Pharmacist oversight Less waste 3. **UDDS (Unit Dose Dispensing System)** - Preparation and delivery of individual doses by the pharmacist for a 24 hour period - Packaged and labeled by the pharmacist, give to the nurse and administer to the patient - Advantages and Disadvantages **Advantages** **Disadvantages** --------------------------------------------------------- -------------------------------------- Reduces medication errors Potential for delays Medications are prepackaged and labeled Labor intensive (manpower is needed) Improved safety Better control, RPh retains control over the medication 4. **Centralized Drug Distribution System** - Medications are delivered from central pharmacy **Advantages** **Disadvantages** -------------------------------------------------------- ---------------------------------- Cost effective Delay in medication delivery Enhanced control of RPh Limited flexibility (for nurses) Efficient resources use (optimize usage of pharmacist) 5. Decentralized Drug Distribution System - Multiple satellite pharmacies located throughout the hospital - Services specific unit - Enables dispensers of medication locally from the central pharmacy **Advantages** **Disadvantages** ---------------------------------------------- --------------------------------- Reduces delay Costly or not cost effective Clinical involvement (give clinical support) Require more staff Improve efficiency Inventory management challenges 6. Automated Dispensing System - No pharmacist involvement - Used by high end hospital especially abroad - Uses computerized and robotic system **Advantages** **Disadvantages** ------------------------------------------- ------------------- Improved safety Human error Real time inventory tracking Technical issues Controlled access by authorized personnel High initial cost **Compounding of non-sterile preparation** Compounding -- mixing and preparing medication for the patient -- mixing and preparing medication that doesn't require sterile or aseptic condition. For oral and non-injectable/parenteral medication. - Solution (suspension and syrup) - Topical preparations (creams, ointments, lotions, gels) - Suppositories (pre-packaged individually) - Capsules and tablets Document Compounding Preparations 1. Master Formulation record -- detailed recipe for preparing a compounded drug It has: Name, strength, dosage form, generic name of ingredients and quantity (write it) 2. Compounding record -- step by step instruction. Real time record of prepared compounded drug - Date of preparation - Name of ingredient and quantity - Identification of person who compounded - Change anything in the master formulation - Beyond use date 3. Quality assurance record - Document to adhere - Equipment calibration - Signed by the person prepared the whole country **Packaging and Labeling** - Ensure safe and effectivity og compounded medication ***Packing*** - Appropriate container - Choice of container depends on the nature of preparation - Solution = amber bottles - Creams, ointments = tubes, jars, pump - Capsule and tab = air tight containers to avoid mositure - Tamper evident seal = ensure integrity of the product ***Labeling*** - Product info of the healthcare provider and the patient - Drug name, strength, dosage form, patient's name, instruction for use, storage conditions, pharmacy contact info **Waste Disposal** **Waste management** = environmental inspection of all hospital, prevent contamination and protect healthcare **Types of waste** **Pharmaceutical waste** = expired and unused pharamcetuical ingredient; excess compounded medication **Hazardous waste** = listed by environment protection agency **Non-hazardous waste** = non toxic ingredient **Proper Disposal method** 1. Segregration 2. Sharp disposal - dispose in designated sharp disposal/ container (syringes, needles) 3. Incineration of hazardous waste -- at approved facilities to avoid contamination provided in complete PPE 4. Return program -- pharmaceutical takeback program, unused are returned to suppliers 5. Compliance with regulation -- adhere to disposal practices of regulating bodies