The Role of Pharmacist in Hospital PDF

The role of pharmacist in hospital Tuan Mazlelaa Tuan Mahmood, PhD Faculty of Pharmacy, UKM  Introduction Hospitals and other institutions and facilities (e.g. drug- dependency treatment facilities, drug information centers, and long-term care facili...

The role of pharmacist in hospital Tuan Mazlelaa Tuan Mahmood, PhD Faculty of Pharmacy, UKM  Introduction Hospitals and other institutions and facilities (e.g. drug- dependency treatment facilities, drug information centers, and long-term care facilities) may be operated by the government or privately. Activities: hospital pharmacist VS community pharmacist?  The hospital or institutional pharmacist has more opportunity to interact closely with the prescriber therefore, to promote the rational prescribing and use of drugs in larger hospital and institutional pharmacies, is usually one of several pharmacists thus has a greater opportunity to interact with others, to specialize and to gain greater expertise having access to medical records to influence the selection of drugs and dosage regimens, to monitor patient compliance and therapeutic response to drugs, and to recognize and report adverse drug reactions  The hospital or institutional pharmacist (cont) can more easily than the community pharmacist assess and monitor patterns of drug usage thus recommend changes where necessary serves as a member of policy-making committees, including those concerned with drug selection, the use of antibiotics, and hospital infections (Drug and Therapeutics Committee) thereby influences the preparation and composition of an essential-drug list or formulary  The hospital or institutional pharmacist (cont) better position to educate other health professionals about the rational use of drugs easily participates in studies to determine the beneficial or adverse effects of drugs can control hospital manufacture and procurement of drugs to ensure the supply of high-quality products takes part in the planning and implementation of clinical trials  Outpatient services } Supply of the right drug, at the right dose, to the right patient } Clarification ◦ Drug ◦ Dose ◦ Polypharmacy ◦ Interaction } Substitute } Patient counseling  Outpatient services (cont) Communication with patient & other staff Supervision of staff Sistem mendispens ubat secara temujanji (SMART) Ubat melalui pos 1 Malaysia (UMP1Malaysia)  Inpatient services Ward pharmacy/satelite pharmacy Discharge counseling – discharge Rx Unit dose Unit of use Monitoring of drug usage – dangerous drugs Prescription Prescription Prescription Prescription  Manufacturing in hospitals Not built for manufacturing Compliance with GMP Contamination “Extemporaneous” Limited quantities  Clinical Pharmacy Services Do “rounds” together with doctors or separately Good knowledge of medicines and patients’ condition Skill and confidence Medication reviews Identify drug-related illnesses Services provided in ICU, paediatrics, geriatrics, nephrology, surgical wards  Total Parenteral Nutrition Patients who cannot eat Careful preparation of mixtures Patients very ill Food is good media for microbial growth Intravenous solutions of fats, amino acids, sugar, electrolytes, trace elements Special technique for preparation – aseptic technique Good knowledge of calorific value of foods and miscibility IV admixture and cytotoxic drug reconstitution Very toxic drugs To protect the person administering the drug Prevent contamination of the mixture Very useful service Requires special facilities  Therapeutic Drug Monitoring Services } Determination of the levels of drug in the blood } Useful for drugs with a narrow therapeutic index } Requires specialised equipment } Tests done by pharmacy department or the pathology laboratory } Analysis of data done by pharmacist  Blood concentration Blood concentrations to demonstrate MEC Identify Cmax Identify Cmin  Blood concentrations } Blood concentrations of 2 drugs to demonstrate MEC & MTC.  Drug Information Services Answering questions about drugs Preparing reports and drug bulletins Preparing the hospital formulary  Medication Therapy Adherence Clinic (MTAC) } Services to improve compliance } To get better outcomes } Identify problems patients have with their medications } In line with the concept of pharmaceutical care } MTAC for diabetes, warfarin, asthma etc  Hospital Administration } Preparing the budget for medicines } Purchasing for the hospital } Supervision of staff } Hospital drugs & therapeutics committee } Dealing with complaints – from management, from public, from the press Thank you!