Schedule N Drugs and Cosmetics Rules, 1945

SCHEDULE N

LIST OF MINIMUM EQUIPMENT FOR THE EFFICIENT RUNNING

OF A PHARMACY

1.  Entrance. - The front of a pharmacy shall bear an inscription “Pharmacy” in front.

2. Premises. - The premises of a pharmacy shall be separated from rooms for private use. The premises shall be well built, dry, well lit and ventilated and, of sufficient dimensions to allow the goods in stock, especially medicaments and poisons to be kept in a clearly visible and appropriate manner. The areas of the section to be used as dispensing department shall be not less than 6 square meters for one pharmacist working therein with additional 2 square meters for each additional pharmacist. The height of the premises shall be at least 2.5 meters.

The floor of the pharmacy shall be smooth and washable. The walls shall be plastered or tiled or oil painted so as to maintain smooth, durable and washable surface devoid of holes, cracks and crevices.

A pharmacy shall be provided with ample supply of good quality water.

The dispensing department shall be separated by a barrier to prevent the admission of the public.

3. Furniture and apparatus. - The furniture and apparatus of a pharmacy shall be adopted to the uses for which they are intended and correspond to the size and requirements of the establishment.

Drugs, chemicals, and medicaments shall be kept in a room appropriate to their properties and in such special containers as will prevent any deterioration of the contents or of contents of containers kept near them. Drawers, glasses and other containers used for keeping medicaments shall be of suitable size and capable of being closed tightly to prevent the entry of dust.

Every container shall bear a label of appropriate size, easily readable with names of medicaments as given in the Pharmacopoeias.

A pharmacy shall be provided with a dispensing bench, the top of which shall be covered with washable and impervious material like stainless steel, laminated or plastic, etc.

A pharmacy shall be provided with a cupboard with lock and key for the storage of poisons and shall be clearly marked with the work ‘POISON’ in red letters on a white background.

Containers of all concentrated solution shall bear special label or marked with the words “To be diluted”.

A Pharmacy shall be provided with the following minimum apparatus and books necessary for making of official preparations and prescriptions:-

Apparatus: -

Balance, dispensing, sensitivity 30 mg.

Balance, counter, capacity 3 Kgm., sensitivity 1 gm. Beakers, lipped, assorted sizes.

Bottles, prescription, ungraduated assorted sizes. Corks assorted sizes and tapers.

Cork, extracter.

Evaporating dishes, porcelain. Filter paper.

Funnels, glass.

Litmas paper, blue and red.

Measure glasses cylindrical 10 ml, 25 ml, 100 ml and 500 ml. Mortars and pestles, glass.

Mortars and pestles, wedgwood.

Ointment pots with bakelite or suitable caps. Ointment slab, porcelain

Pipette graduated, 2 ml, 5 ml and 10 ml. Ring, stand (retort) iron, complete with rings. Rubber stamps and pad

Scissors

Spatulas, rubber or vulcanite Spatulas, stainless steel. Spirit lamp

Glass stirring rods. Thermometer, 0^oC to 200^oC. Tripod stand.

Watch glasses. Water bath.

Water distillation still in case Eye drops and Eye lotions are prepared. Weights, Metric, 1 mg. to 100 gm.

Wire Gauze.

*Pill finisher, boxwood.

*  Pill Machine.

*  Pill Boxes.

*  Suppository mould.

Books :

The Indian Pharmacopoeia (Current Edition).

National Formulary of Indian (Current Edition).

The Drugs and Cosmetics Act, 1940.

The Drugs and Cosmetics Rules, 1945.

The Pharmacy Act, 1948.

The Dangerous Drugs Act, 1930.

4. General provisions. - A pharmacy shall be conducted under the continuous personal supervision of a Registered Pharmacist whose name shall be displayed conspicuously in the premises.

The Pharmacist shall always put on clean white overalls.

The premises and fittings of the pharmacy shall be properly kept and everything shall be in good order and clean.

All records and registers shall be maintained in accordance with the laws in force.

Any container taken from the poison cupboard shall be replaced therein immediately after use and the cupboard locked. The keys of the poison cupboard shall be kept in the personal custody of the responsible person.

Medicaments when supplied shall have labels conforming to the provisions of laws in

force.

Note: - The above requirements are subject to modifications at the discretion of the licensing authority, if he is of opinion that having regard to the nature of drugs dispensed, compounded or prepared by the licensee. It is necessary to relax the above requirements or to impose additional requirements in the circumstances of a particular case. The decision of the licensing authority in that regard shall be final.

* These items are to be provided only by those who intend to dispense pills or suppositories, as the case may be.]

Reference: 

http://indianhealthservices.in/schedules/Schedule_N.pdf

Maintenance of various registers in community pharmacy:

Maintenance of various registers (records) in community pharmacy:

For various reasons it is very important to maintain various legal, financial and professional records in a community pharmacy. 

Type of records required in a community pharmacy may be classified as following:

(1) Legal records (registers):

According to federal and state law, the pharmacy owner (manager) is responsible for maintenance of accurate up-to-date records of specific classes of drugs and poisons according to Drugs and Cosmetic Act 1940. Rules 1945 and The Poison Act 1919, the pharmacist is responsible for maintaining accurate records related to acquisition and disposition of certain drugs that are supposed to be subject to possible misuse or abuse. According to law it is required to maintain a record on the distribution of poison and hazardous substances. Improperly maintained or incomplete records can bring legal action and penalties. 

(2) Patients records:

To include patients drug histories those type of records are maintained, although the format of records may vary according to basic ideas of establishing a record. Records may be based on family unit basis that allows the pharmacist to monitor the drug usage of each member of family. It provides basic information about kinds and amounts of drugs being taken by average patients, which helps in reducing the problems associated with drug interactions and individuals idiosyncrasies to drugs. These records also serve in economic purposes, as source of information for insurance claims and for income tax deduction of the patients. 

(3) Financial records:

Properly collect and organized accounting data serves various important uses as :

1.Serves as a basic tool for efficient management and measuring its effect. 

2.For making sound decisions regarding future money needs, inventory requirement, personnel matters and expansion of facilities. 

3.In evaluation of past operations, controlling current operations and providing information for planning and forecasting. 

4.Analyzing revenues and expenses & Measuring return on investment. 

5.Providing the required information to potential granters credit and loans as well as to federal, state, and local governmental agencies regarding income and business taxes. 

6.Helping to ensure a profitable operation.

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Explore more topics:

• Retail Drug Store Design Whole sale Drug Store layout/Design

• Role of pharmacist in patients health care

• Code of Pharmaceutical Ethic

• Pharmacist OATH

• Community pharmacy

Retail Drug Store Design Whole sale Drug Store Design

Objective of layout design:

1.To attract large number of customers.

2.To increase the sale of store.

3.To have proper entrance of coming goods and space for reserve stock, office and resting place for employees.

4.To reduce the selling expenses and provide customer satisfaction.

5.To project a professional image and improve general appearance.

6.To minimize the movement of customer with in the premises of the drug store.

Design of retail and wholesale drug store:

A modern drug store should fulfill all the requirements in schedule “N” of drug and cosmetics rules. To start a drug store a minimum of 150 sq. feet area is required similar to whole sale drug store a minimum of 200 sq. feet.

Types of a drug store:

On the basis of design, it is classified as:

1.Traditional Drug Stores:

These types of drug stores are designed in such a manner that the entire area of Drug store is exposed to customers.

-Such a design has pleasing and professional appearance and is convenient for both workers and customers. It provides opportunity for maximum sales but there are good chances of theft in such design.

2. Personal Service Drug Stores:

In this type of design, the whole of the area is not exposed to the customer but the customer is required to interact with the drug store personnel at the service counter. During the purchasing process the customer demands an article and the personnel provide the articles. This service and design facilitates maximum interaction between drug store employee and the customers. The success of the drug store depends upon the convenience and friendly service of the personnel at the service counter.

3. Prescription Oriented Drug Store:

These types of drug stores provide a comfortable waiting area where the customers are expected to wait while his prescription is proceeding. In this type of design health related items, drugs and prescription accessories are displayed in the vicinity while orthopedic and surgical appliances are kept in a separate room. Cosmetics and gifts are arranged in a suitable area in the store.

4. Pharmaceutical Centre:
These types of centre sell medicines, convenience articles, orthopedic and surgical appliances. The store has sufficient floor space and is properly decorated. 

5. Super Drug store:
Such types of drug stores have a huge floor area ranging from 5,000 to 10000 with a square design. The customers have access to all-most-all the area in the drug store and can inspect, handle and select articles themselves. The design is on self service pattern except for the prescription department where self service is not possible.

The legal requirements for the establishment of retail drug store:
Licenses:

a). General Licenses:

These licenses are granted to person who have the premises for the business and who engage the services of a qualified person to supervise the sale of a drug store. License for retail sale of drug store are issued in form 20 for drug specified in schedule C1 C1 excluding those specified in Schedule X in form of 21 and for Schedule X in 20F. Conditions for general licenses:-

1.The license should be displayed in prominent place in a part of premises open to the public.

2.The license should comply with the provision of drug and cosmetics act and rules. 3.Any change in the staff should be reported to the licensing authority within one month. 4.Precaution prescribed by the licensing authority for the storage of Schedule C and C1 should be observed.

5.For the sale of additional categories of drug listed in Schedule C1 C1 excluding X the license must take prior permission of the license authority. 

b). Restricted Licenses:

The licenses for the restricted sale of drug other than those specified in Schedule C1 C1 and X and those specified in Schedule C1 C1 not in X are issued in the form 20A and 21A respectively. Conditions for restricted licenses:

1.Drug should be sold in their original container.

2.License should be complying with the provision of drugs and Cosmetics Acts and Rules.

3.Drug only purchased from a duly licensed dealer.

4.The licenser must have adequate premises equipped with facilities for the proper storage of drug.

Staff (Personnel):

Personnel or staff selection is one of the most important aspects of developing an efficient operating community pharmacy. Success of a community pharmacy depends upon proper selection training, and maintenance of employees (staff).

Selection of staff:

Following criteria should be followed during the selection of the staff for community pharmacy:

1. Minimum standards for qualification of employees should not be allowed to fall below the minimum standards under here for a given position will result in fall in reputation of pharmacy.

2. Over hiring means superior people should not be hired for inferior jobs; this type of selection may result in an adverse effect on staff moral and efficiency.

3. For the proper selection of staff for a specific job, the manager should develop a job description and a job specification for each position in pharmacy. This job description should contain such detail as scope of job, its relation to other jobs, working hours, and pay scale, etc. It prevents misunderstanding about the nature of the duties of a particular job.

4. Promotion within a pharmacy staff may be appropriate. But in most of the cases external source must be used such as employment agencies, placement offices of schools and universities or classified news paper advertising. Orientation and training of staff:

After proper selection needs to be followed by adequate orientation and training of the employee, which results in increase productivity and reduced employee turnover. Compensation:

Retaining good employees is one of the most difficult problems faced by the community pharmacy manger. Many factors decides keeping of employees but most important factor is the compensation plan. Adequate compensation is necessary, not only to retain employee but also to encourage them to work toward the over all goals and objectives of the pharmacy.

IMPORTANCE OF CODING AND STOCKING

Importance of coding for drug store:

Coding is the process of assigning f code symbol or a number to a particular material for easy identification.It is important for a drug store because;

1. Coding of various items of materials is essential for good system of store keeping.

2. Ambiguity in description is avoided.

3. The length in description is minimized.

4. The codes ensure of item lying in the store.

5. Each stored item is easily identified, particularly, where the same item is known by more than one name.

Importance of stocking for drug store

1. Drugs are stored in alphabetical order.

2. It provides a channel for distribution of drugs.

3. It provides space for storage of drugs or materials and supplies.

4. Drugs are readily available for administration.

5. Vaccine and antibiotic drugs are stored in refrigerator.

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Explore topics:

• Maintenance of various records in community pharmacy

• Role of pharmacist in patients health care

• Code of Pharmaceutical Ethic

• Pharmacist OATH

• Community pharmacy

Community health, Public health, Dimension of health

Community health

Community health refers to the healthy status of the member of the community to solve the problems affecting their health and to the totality of a health care provided for the community. Community health broadly encompasses the entire gamut of community efforts for maintaining, protecting, improving the health of the people. Modern community health seeks to bring together all the available health services (e.g. medical care, mother & child care, family planning services, environmental sanitation, laboratory services, disease control programme, health education).

Public health

Public health is the science and arts of—

1) Preventive disease

2) Prolonging lifespan

3) Promoting health and efficiency through organized community efforts for—

i) the sanitation of the environment.

ii) the control of communicable diseases

iii) the education of the individual in personal hygiene

iv) the organization of medical and nursing services for the early diagnosis and preventive treatment of disease. v)the development of the social machinery to ensure everyone a standard of living for maintenance of health.

A recent definition of public health, which meets the criteria of modern public health is as follows — “Public health is the planning carrying out an evolution of health measures and system services that both maintain and improve the health of a population group, prevent and control diseases within the population group”.

Dimensions of health

There are four major dimensions of health included in the WHO definitions of health—

1. Physical health

2. Mental health

3. Social health

4. Spiritual health


Besides these, many more can be cited e.g. 1. Emotional 2. Vocational 3. Philosophical 4. Cultural 5. Socio-economical 6. Environmental 7. Political 8. Educational 9. Nutritional


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Explore topics:

• Maintenance of various records in community pharmacy

• Role of pharmacist in patients health care

• Code of Pharmaceutical Ethic

• Pharmacist OATH

• Community pharmacy

Pharmacist OATH

• I Swear by the code of Ethics of Pharmacy Council of India in relation to the community and shall act as an integral part of health care team. 
• I shall uphold the laws and standards governing my profession. 
• I shall strive to perfect and enlarge my knowledge to contribute to the advancement of pharmacy and public health. 
• I shall follow the system, which I consider best for pharmaceutical care and counseling of patients. 
• I shall endeavor to discover and manufacture drugs of quality to alleviate sufferings of humanity. 
• I shall hold in confidence the knowledge gained about the patients in connection with professional practice and never divulge unless compelled to do so by the law. 
• I shall associate with organizations having their objectives for betterment of the profession of Pharmacy and make contribution to carry out the work of those organizations. 
• While I continue to keep this Oath inviolate, may it be granted to me to enjoy life and the practice of pharmacy respected by all, at all times! 
• Should I trespass and violate this oath, may the reverse be my lot!

Community Pharmacy

Definition

The main responsibilities of a community pharmacy include compounding, counseling, and dispensing of drugs to the patients with care, accuracy, and legality along with the proper procurement, storage, dispensing and documentation of medicines. The community pharmacist must be a qualified and pertinent with sound education, skills and competence to deliver the professional service to the community.

A community pharmacist should

(i) have a sound background of pharmaceutical care, pharmacotherapy, and health promotion.

(ii) have good communication skills with patients and other healthcare providers.

(iii) maintain a high degree of standard in products, services, and communication.

(iv) record and maintain his documents in order.

“In short community pharmacy is the drug use, control and effective application of knowledge of ethics, that assures optimal drug safety in the distribution and use of medicines and hence, it ensures maximum well-being of patients while they are on drug therapy.”

Community Pharmacy is defined broadly to include all those establishment that are privately owned and whose function, in varying degrees is to serve societies needs for both drug product and pharmaceutical service. It is the branch of pharmacy that deals with different aspects of patient care, dispensing of drugs and advising patient on the safe and rational drug use.

Patient conseling

Dialogues between patients and physicians regarding the indication, proper use and potential adverse effects of non-prescription drugs (NPDs) should be different as compared, when if the physician has written the prescription. In the era, the cost considerations are greater than ever, NPDs should be considered and referred when appropriate, as alternatives to prescription drugs.

Topics comes under community pharmacy:

• Maintenance of various records in community pharmacy

• Retail Drug Store Design Whole sale Drug Store layout/Design

• Role of pharmacist in patients health care

• Code of Pharmaceutical Ethic

• Pharmacist OATH

Code of Pharmaceutical Ethics

As adopted by Pharmacy Council of India under chapter-I: General Introduction, The profession of pharmacy is noble in its ideals and pious in its character. Apart from being a career for earning livelihood it has inherent in it the attitude of service and sacrifice in the interests of the suffering humanity. In handling, selling, distributing, compounding and dispensing medical substances including poisons and potent drugs a pharmacist is, in collaboration with medical men and others, charged with the onerous responsibility of safeguarding the health of people, as such he has to uphold the interests of his patrons above all things. The lofty ideals set up by Charaka, the ancient Philosopher Physician and Pharmacist in his erunciation : "Even if your own life be in danger you should not betray or neglect the interests of your patients" should be fondly cherished by all Pharmacist.

Government restricts the practice of Pharmacy to those who qualify under regulatory requirements and grant them privileges necessarily denied to others. In return Government expects the Pharmacist to recognise his responsibilities and to fulfill his professional obligations honorably and with due regard for the well being of Society.

Standards of professional conduct for pharmacy are necessary in the public interest to ensure an efficient pharmaceutical service. Every pharmacist should not only be willing to play his part in giving such a service but should also avoid any act or omission which would prejudice the giving of the services or impair confidence in any respect for pharmacists as a body.

The nature of pharmaceutical practice is such that its demands may be beyond the capacity of the individual to carry out or to carry out as quickly or as efficiently as the needs of the public require. There should, therefore at all times, be a readiness to assist colleagues with information or advice.

A Pharmacist must, above all be a good citizen and must uphold and defend the laws of the state and the Nation.

Pharmacist in relation to his job

Scope of pharmaceutical service: 

When premises are registered under statutory requirements and opened as a pharmacy, reasonably comprehensive pharmaceutical services should be provided. This commonly required medicines of this nature without undue delay. It also involves willingness to furnish emergency supplies at all times.

Conduct of the pharmacy:

It should be clear to the public that practices of Pharmacy are carried out in the establishment. Signs, notices, description, which do not or imply pharmaceutical qualifications, should be limited to those of which the use is restricted by law. A notice stating that dispensing under employees by government is carried out may be exhibited at the premises. In every pharmacy, there should be a pharmacist in personal control of pharmacy that will be regarded as primarily responsible for the observance of proper standards of conduct in connection with it.

Handling of prescriptions:

A prescription is presented for dispensing; it should be received by a pharmacist without any discussion or comment over it, regarding the merits and demerits of its therapeutic efficacy. In case of any error in it, due to any omission, incompatibility or over dosage, the prescription should be referred back to the presciber.

Fair trade practice: 

No attempt should be made to capture the business of a contemporary by cut throat competitions that are by offering any sort of prizes or gift. Label trade marks and other signs and symbols of contemporaries should not be imitated or copied.

Purchase of drug: 

Drug should be purchased from genuine and reputable source and a pharmacist should always be on if guard not to aid or abet, directly or indirectly.

Hawking of drug: 

Hawking of drugs and medicinals should not be encouraged, not should any attempt be made to solicit orders for such substances from door to door.

Advertising and display

(a) Any wording design or illustration reflecting unfavorably on pharmacist collectively or upon any group of individual.

(b) Misleading or exaggerated statements or claims.

(c) A guarantee of therapeutic efficacy.

(d) An appeal to fear.

(e) A prize competition or similar scheme.

(f) For correction or approval of the change suggested.

Handling of drug: 

All possible care should be taken to dispense a prescription correctly by weighing and measuring all ingredients. Incorrect proportion by the help of scales and measures, visual estimation must be avoided. A pharmacist should always use drugs and medicinal preparations of standard quality. He should never fill his prescription with spurious sub-standard and unethical preparation.

Apprentice pharmacist: 

While incharge of a dispensary, drug store or hospital pharmacy where apprentice pharmacist are admitted for practical training. A pharmacist should see that the trainees are given full facilities for their work, so that on the completion of their training they have acquired sufficient technique and skill to neck themselves dependable pharmacist.

Pharmacist in relation to his trade

Price structure: 

Price charged from customers should be fair and in keeping with the quality and quantity of commodity supplied and the labor and skill required in making it ready for use.

Pharmacist in relation to medical profession

Limitation of professional activity: Whereas it is expected that practitioners in general would not take to practice of pharmacy by owing drug stores as this ultimately leads to coded prescriptions and monopolistic, detrimental to the pharmaceutical profession and also to the interest of patients; it should be made a general rule that pharmacist under no circumstances, take to medical practices that is diagnosing diseases and prescribing remedies, therefore even if requested patrons do so.

No pharmacist should recommend particular medical practitioner unless specifically ask to do so.

Clandestine arrangements:

 No pharmacist should enter into any secret arrangements or conduct with the physician, to offer him any commission or any advantage by recommending his dispensary or drug store himself to the patients.

Liaison with public: Being a liaison between medical profession and people, a pharmacist should always keep himself abreast with the modern developments in pharmacy and other periodicals.

Pharmacist in relation to his profession

It is not sufficient for a pharmacist to be law abiding and to deter from doing things derogatory to the society and his profession, but it should be his duty to make others also fulfill the provisions of the pharmaceutical and other law regulations.

Law-abiding citizen: 

A pharmacist is a unit whole and his life cannot be divided into compartments. A pharmacist, engaged in profession has to be an enlightened citizen endowed with a fair knowledge of the law of the land and he should be particularly conversant with the enactments pertaining to food, drug, pharmacy, health, sanitation and the like and endeavor to abide by them in every phase of his life.

Relationship with professional organizations

In order to inculcate a corporate life in his own professional colleagues, should join and advance the cause of all such organizations, the aims and objects of which are conducive to scientific, moral and cultural well-being of pharmacists and at the same time are in no way contrary to the code of Pharmaceutical ethics.

Decorum and proprietary:

A pharmacist should always refrain from doing all such acts and deeds which are not in consonance with the decorum of pharmaceutical profession and are likely to bring discredit or upbraid to the profession or to him.

Role and Responsibilities of Pharmacist

Role and Responsibilities of Pharmacist

(I)      Central Pharmacists Responsibilities

 A. Dispensing area

1.    Ensures that established policies and procedures are followed.

2.    Checks for the accuracy of doses prepared

(a)      Intravenous admixtures

(b)     Unit dose

3.    Provides for proper drug control

(a)      Ensures that drugs are stored and dispensed properly (eg. Investigational drugs)

(b)     Ensure that all state and federal drug laws are followed

4.    Ensure that good techniques are used in compounding intravenous admixtures and extemporaneous preparations

5.    Provides for proper record keeping and billing

(a)     Patient-medication records

(b)     Extemporaneous compounding records

(c)     Intravenous admixture records billing

(d)     Investigational-drug records

(e)     Reports (eg. Monthly workload report)

6.    Maintains professional competence, particularly in knowledge of drug stability and incompatibilities.

7.    Ensures that new personnel are trained properly in the policies and procedures of the dispensing area.

8.    Co-ordinates the activities of the area with the available staff to make the best possible use of personnel and resources.

9.    Keeps the dispensing area neat and orderly.

10.    Communicates with all pharmacy staff regarding new development in the area and assists in employee evaluations.

11.    Provides drug information as necessary to the pharmacy, medical and nursing staffs.

12.    Co-ordinates the overall pharmaceutical needs of the patients care areas with the dispensing area (eg. Delivery schedules).

B.   Patient-care area

1.     Supervision of drug administration.

(a)     Reviews and interprets each unit doses and intravenous (IV) admixture medication order to ensure that it is entered accurately into the unit-dose or IV- admixture system.

(b)     Reviews each patients drug administration form periodically to ensure that all doses are being administered and charted correctly.

2.     Reviews all doses missed, reschedule the doses as necessary and signs all drugs not given notices.

3.     Ensures that new drug administration forms are transcribed accurately for continuity of drug therapy and that drug charges are assessed correctly.

(a)     Confirms periodically that administered doses are noted correctly on the patient chart.

(b)     Ensures that records for administered narcotics are kept correctly and that the physician is informed of all automatics stop orders.

(c)     Ensures that proper drug administration techniques are used.

(d)     Acts as liaison between the pharmacist, the nursing and medical staffs.

(e)     Communicates with nurses and physicians concerning medication administration problems.

(f)     Periodically inspects the medication area on the nursing units to ensure that adequate levels of floor stocks drugs and supply are maintained.

(g)     Ensure that order supportive services performed from the dispensing area as required.

(h)     Ensure that the other supportive services performed by the department of pharmacy are carried out correctly.

(i)      Co-ordinate all pharmacy services on the nursing unit level.

(j)      Ensure that the medication area is neat and orderly.

(k)     Ensure that proper security is maintained in the medication area to prevent pilferage.

C.  Direct patient care

Identifies drug brought into the hospital by patients.

Obtain patient medication histories and communicates all pertinent information to the physician.

1.    Assists in drug-product and entity selection.

2.    Assists the physician in selecting dosage regimens and schedules and then assigns drug administration times for these schedules (pharmacokinetic service).

3.    Monitors patient s’ total drug therapy for-

(a)     Effectiveness/ ineffectiveness

(b)     Side-effects

(c)     Toxicities

(d)     Allergic drug reactions

(e)     Drug interaction

(f)  Appropriate therapeutic outcomes

4.    Counsels patients on

(a)     medication to be self administered in the hospital

(b)     Discharge medications

5.    Participates in cardiopulmonary emergencies by

(a)     Procuring and preparing the drug required.

(b)     Charting all medications given.

(c)     Performing cardiopulmonary resuscitation, if necessary.

D. General responsibilities

1.    Provides education to

(a)     Pharmacists, pharmacy externs, clerks, students, residents and other students.

(b)     Nurses and nursing students.

(c)     Physicians and medical students.

2.    Provides drug information to physicians, nurses and other health-care personnel.

(II)    Ambulatory Pharmacists Responsibilities

 A. Dispensing area

1.    Ensure that established policies and procedures are followed

2.    Checks for the accuracy in the work of supportive personnel

3.    Ensure that proper techniques are used in extemporaneous compounding

4.    Maintenance of adequate record keeping and billing

(a)     Patient medication records

(b)     Investigational drug records

(c)     Outpatients billing

(d)     Reports

(e)     Prescription files

5.    Maintains professional competence

6.    Ensure that new personnel are trained properly in the policies and procedures of the ambulatory pharmacy.

7.    Co-ordinate the activities of the area with available staff to make the best use of personnel and resources.

8.    Keeps the ambulatory pharmacy area neat and orderly at all times.

B.  Patient care area

1.    Inspects the medication areas in the nursing unit periodically to ensure an adequate supply of stock drugs and their proper storage.

2.    Identifies the drugs brought into the clinic by patients.

3.    Obtains patients medication histories and communicates pertinent information to the physician.

4.    Assists in drug-product entity selection.

5.    Assists the physician in selecting dosage regimens and schedules.

6.    Monitors the patients total drug therapy for:

(a)     Effectiveness

(b)     Side-effects

(c)     Toxicities

(d)     Allergic drug reactions

(e)     Drug interactions

(f)     Appropriate patient outcomes

7.    Counsels patients on the proper use of their medications.

8.    Prepare medications for intravenous administration.

9.    Provides medication and/or supply for patient home care.

C.  General responsibilities

1.    Provides drug information necessary to pharmacy, medicals and nursing staffs.

2.    Co-ordinates overall pharmaceutical needs of the ambulatory service area.

3.    Provides adequate drug controls

(a) Ensures that the drugs are handled properly (eg. Investigational-drug storage).

(b)  Ensures that all state and federal laws are followed

4.    Maintains professional competence in area.

5.    Participates in cardiopulmonary emergencies by

(a)  Procuring and preparing the drug required.

(b)  Charting all medications given.

(c)  Performing cardiopulmonary resuscitation, if necessary.

6.    Provides in-service education to

(a)     Pharmacists, pharmacy externs, clerks, students, residents and other students.

(b)     Nurses and nursing students.

(c)     Physicians and medical students.

In a small hospital with only one pharmacist it is a challenge to be knowledgeable in all the activities of the hospital pharmacy. In large hospital with a number of pharmacists who specialize in certain areas of practice, each may become expert in one or more fields.

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Explore more related topics:

• Maintenance of various records in community pharmacy

• Retail Drug Store Design Whole sale Drug Store layout/Design

• Role of pharmacist in patients health care

• Code of Pharmaceutical Ethic

• Pharmacist OATH

• Community pharmacy