Hospi lec m3

• Purpose of Pharmacy and Therapeutics Committee

  1. Drug safety and adverse drug monitoring

  2. This function is assigned to or taken up by the P&TC and it should be continuous scheme of exerting vigilance
• Purpose of Pharmacy and Therapeutics Committee

  1. Advisory

  2. The committee recommends the adoption of, or assists in the formulation of broad professional policies regarding evaluation, selection and therapeutic use of drugs in hospitals

  3. Serves in an advisory capacity to medical staff and hospital administration in all matters pertaining to the use of drugs, including the investigational drugs

  4. It makes recommendations concerning the drugs to be stocked in hospital patient care areas

  5. Advises the pharmacy in implementation of effective drug distribution and control procedures
• Functions and Scope of P&TC

  1. To serve in an evaluative, educational, and advisory capacity to the medical staff and organizational administration in all matters pertaining to the use of drugs

  2. To develop a formulary of drugs accepted for use in the organization and provide for its constant revision

  3. To establish programs and procedures that help ensure safe and effective drug therapy
• Organization of P&TC

  The P&TC is composed of: at least 3 physicians, a pharmacist, representatives of the nursing staff, A hospital administrator or his/her designated person and ex-official member of the committee
• Operation of P&TC

  1. A chairman from among the three physician representatives should be appointed

  2. A pharmacist usually is designated as secretary

  3. The committee should meet regularly at least six times per year and when necessary

  4. The committee should invite to its meeting persons within or outside the hospital who can contribute specialized or unique knowledge, skills and judgments

  5. An agenda and supplementary materials should be prepared by the secretary and submitted to the committee members in sufficient time before the meeting for them to properly review the material

  6. Minutes of the committee meetings should be prepared by the secretary and maintained in the permanent records of the hospital

  7. Recommendations of the committee shall be presented to the medical staff or its appropriate committee for adoption or recommendation

  8. Liaison with other hospital committee concerned with drug use (e.g. infection control, medical audit) shall be maintained
• Purpose of Pharmacy and Therapeutics Committee

  1. Educational

  2. The committee recommends or assists in the formulation of programs assigned to meet the needs of the professional staff (physicians, nurses, pharmacists and other health care practitioners) for complete current knowledge on matters related to drugs and drug use

  3. Evaluates the problems related to the distribution and administration of medication, including medication incident

  4. Develops and compiles a formulary of drugs and prescriptions of formulation accepted for use in the hospital

  5. It establishes suitable educational schemes for the hospital’s professional staff on the matters related to the use of drugs
• IV Orders

  Orders for intravenous medications must be written in the same manner as routine drugs and must include the following additional information: Exact quantity of the drug/s which must be added, Exact volume and name of the infusate solution, Specific directions for administration such as IV drip, IV bolus, IV push, etc., Specific times to hang infusate solution and drip rate, Specific directions for continuing or discontinuing any IV medications
• A new medication order must be written by the physician

  If a change is wanted in route of administration or in dosage
• Policies of Pharmacy and Therapeutics Committee (P&TC)

  • Proposal for a new drug for the hospital formulary shall be submitted on a Formulary Request Form
  • Drugs evaluated and approved by the Committee will be assigned to one of the four categories: Formulary Drug, Drug Approved on a Conditional Trial Period, Specialized Formulary Drug, Investigational Drugs
  • Non-Formulary Drugs are drugs which do not qualify for the four categories listed and will not be stocked in the pharmacy. If prescribed, the Pharmacy will obtain and dispense a limited quantity of the drug
  • Formulary system dictates that all drugs will be dispensed on the basis of generic names
  • Drug Recall may originate from manufacturers, regulatory agencies, or the Pharmacy Department, and may be of a general nature or a specific recall for one or more lot numbers
  • In-Patient Prescribing: Routine Drug Orders, IV Orders, Total Parenteral Nutrition (TPN) Ordering
  • Self-Medication
  • Automatic Stop Orders Policy serves as a protection against indiscriminate and indefinite open-ended drug orders that can be harmful to the patient and ensures continuous therapy if desired by the physician
  • A new medication order must be written by the physician if a change is wanted in route of administration or in dosage
  • Discharge Prescriptions– a separate prescription is required
• Total Parenteral Nutrition (TPN) Ordering

  The TPN mixture may only be prescribed by an authorized House Staff physician in conjunction with a dietician through consultation
• Functions of Pharmacy and Therapeutics Committee (P&TC)

  • Establish programs and procedures for safe and effective drug therapy
  • Establish programs and procedures for cost-effective drug therapy
  • Establish or plan suitable educational programs for the organization's professional staff on matters related to drug use
  • Participate in quality assurance activities related to distribution, administration, and use of medications
  • Monitor and evaluate ADRs in the health-care setting and make appropriate recommendations to prevent their occurrence
  • Initiate or direct drug use evaluation program and studies, review the results of such activities, and make appropriate recommendations to optimize drug use
  • Advise the pharmacy department in the implementation of effective drug distribution and control procedures
  • Disseminate information on its actions and approved recommendations to all organizational health-care staff
• A new medication order must be written by the physician if a change is wanted in route of administration or in dosage
• Contents of Emergency Kit or Stat Boxes

  • Contains drugs and supplies readily available in case of emergencies
  • Medications and related accessories are standardized and approved by the medical staff through the Pharmacy and Therapeutics Committee
• Formulary supplies essential information to the medical/nursing staff on the available therapeutic agents, prevents unnecessary duplication and confusion
• Formulary includes, but is not limited to: a list of medications & medication associated products or devices, medication-use policies, important ancillary drug information, decision-support tools, organizational guidelines
• Hospital formulary is a continually updated list of medications and related information, representing the clinical judgment of physicians, pharmacists, and other experts in the diagnosis, prophylaxis, or treatment of disease and promotion of health
• Detailed Parts of the Formulary: Hospital policies and procedures concerning drugs, Categories of Hospital Formulary Drugs - Formulary Drugs: FDA Approved, Essential for Good Patient Care, Well established usage
• Emergency (STAT) Orders
• Continuous therapy


  If desired by the physician
• Purpose of Hospital Formulary: educates physicians on the relative merits of the drugs available, serves as a teaching tool to interns, residents, and other healthcare professionals, promotes safe, intelligent, and effective drug therapy
• Roles of Pharmacists in the P&TC

  1. Plan future agendas

  2. Gather data to create drug monographs and other necessary documents

  3. Evaluate medications for formulary adoption or deletion

  4. Prepare and conduct quality assurance programs

  5. Prepare policies and procedures

  6. Create hard copy and electronic versions of the formulary

  7. Communicate P&TC decisions to other healthcare professionals

  8. Follow up with research when necessary
• Formulary system is an ongoing process through which a healthcare organization establishes policies regarding the use of drugs, therapies, and drug-related products
• Primary objective of the formulary is to provide hospital staff with information on approved drug products, basic therapeutic information, hospital policies and procedures governing drug use, special information about drugs
• Discharge Prescriptions require a separate prescription for each medication the patient is to take home
• Drugs approved on conditional trial period

  1. FDA Approved

  2. For general use

  3. Evaluated for 6 or 12 months period
• Formulary item entries arrangement

  1. Alphabetically, generic name

  2. Alphabetically, within therapeutic class

  3. Combination of the two systems whereby the bulk of the drugs are contained alphabetically in a general section which is supplemented by several special sections such as ophthalmic/otic drugs, dermatological and diagnostic agents

  4. Dosage form as oral tablets and capsules, oral liquids/syrups/suspension/parenteral injectable as ampules/vials, etc.
• Specific Information

  • List of Hospitals-approved abbreviations
  • Rules for calculating pediatric dosages
  • Table of sodium content of antacids
  • List of the contents of emergency cart/boxes/cabinets
  • Dosage guides for patients with impaired renal functions
• Investigational Drug

  1. FDA Approved for specific use by principal investigator

  2. Not commercially available
• Detailed Parts of the Formulary

  • Hospital policies and procedures concerning drugs
  • Drugs approved on conditional trial period
  • Specialized Formulary Drug
  • Investigational Drug
  • Brief description of the P&TC including its membership, responsibilities and operation
  • Hospital policies governing the prescribing, dispensing and administration of drugs including policies to be followed by pharmaceutical company/suppliers representatives, standard drug administration tome and the reporting of adverse drug reactions and medication errors
  • Pharmacy operating procedures such as hours of service, outpatient prescription policies, pharmacy charging system, prescription labeling and packaging practices, in-patient drug distribution procedures, handling of drug information requests and other services as patient education programs and pharmacy bulletins
  • Information on using the formulary including how the formulary entries are arranged, the information contained in each entry and the procedure for looking up a given drug product
  • Drug Product Listing
  • Specific Information
• Indexes to the Drug Products Listing

  • Generic name of the drug items
  • Therapeutic/Pharmacologic index
• Specialized Formulary Drug

  1. FDA Approved

  2. For specialized patients
• Each drug entry

  Must include the generic name of the basic drug entity or product/combination products, dosage forms, strengths, packaging and sizes stocked by pharmacy, formulation (active ingredients) of a combined product
• Specific Information in the Formulary

  • List of Hospitals-approved abbreviations
  • Rules for calculating pediatric dosages
  • Table of sodium content of antacids
  • List of the contents of emergency cart/boxes/cabinets
  • Dosage guides for patients with impaired renal functions
  • Metric conversion scales and tables
  • Examples of formulary request forms and prescription blanks
  • Important provisions of the Generic act on prescribing and dispensing especially thorough erroneous, violative and impossible prescriptions
  • Tables of drug interactions
  • Poison antidote chart
• Formulary Updates, Revisions and Distribution

  1. A process to continually update the formulary must be established

  2. Such a process should include a method for making additions and deletions to the formulary

  3. This process typically involves the submission of a request for formulary addition or deletion from the pharmacy or medical staff

  4. Agent to be considered for addition or deletion

  5. Rationale for request. This should include the impact on the cost and quality of patient care

  6. Alternative agents currently on the formulary

  7. Some organizations require or permit the requesting individual to attend the P&T committee to support their request

  8. Size: A formulary which is sufficiently small in size to permit its being carried in a uniform or laboratory coat pocket will enjoy widespread use in the hospital

  9. Loose-Leaf vs Bound: The ease by which a loose-leaf formulary can be kept current

  10. Printed vs Mimeographed: A printed formulary is more aesthetic in appearance, easier to read and imparts to the user the impression that the hospital considers the formulary as an extremely important document

  11. Keeping the formulary: Generally, the formulary will need to be revised annually

  12. Keeping the formulary: Additions and deletions to the formulary, changes in the drug products, removal from/ addition to PNDF of current edition and changes in DOH policies, laws, rules, and regulations related to drugs, hospital policies and procedures will necessitate periodic revision of the hospital formulary

  13. Keeping the formulary: Any changes in the current sheets can be attached to the inside back covers of the formulary
• End of Presentation: '-'