02.C Core Competency: Handle and control pharm products

• Handle and Control of Pharmaceutical Products

  ELEMENTS: • Comply with drug storage requirements • Monitor inventory • Dispense of waste
• Storage Temperatures of Pharmaceutical Products

  
• cold place 


  not exceeding 8C
• cold place (freezer)


  -25C - -10C
• cold place (refrigerator)


  2C - 8C
• cool


  8C - 15C
• room temp

  20C - 25C
• controlled room


  20C - 25C or 15C - 30C
• warm


  30C - 40C
• excessive heat


  40+ C
• Zoning: 


  the most basic way in which supplies are arranged
• Zone:

  can be a building, or a room, locked cupboard, a ref, freezer, or a cold room
• Zoning Stock within the Store

  Combination of Temperature and Security
• Temperature and Security Zones


  Each storage zone should at least have 1 thermometer; temperatures should be recorded daily at the hottest time of the day

  
• Secure storage


  Narcotics, controlled substances, frequently stolen non-narcotics, expensive products (e.g., antiretrovirals)
• Secure storage


  Room should be equipped with red warning light or warning bell when door is unlocked
• Secure storage


  Not more than 2 assigned officers should have access (Senior RPh/senior store keeper and director of store)
• Controlled Drugs

  Narcotics (e.g., Pethidine injection, Morphine preparations)
• Controlled Drugs Security measures in the pharmacy


  A safe and reinforced double lock cabinet w/ light (red) • A special register recording details of each receipt or issue (with 2 signatures, physical counting after each entry and signatures at “handover-takeover”) • Independent audit
• Attractive Items

  Expensive items ( e.g., cimetidine, PZQ, ARVs) • Antibiotics • Psychotropics • Equipment (scissors, safety razors, hypodermic needles, rolls of cotton)
• Attractive Items Security measures:

  • Stored in a separate area and locked • Audits • Embossing
• Storage that is at uncontrolled room temp: most of the products (unless specified), some can even be stored at +40 ºC in temperate climates
• Hot climates →

  air conditioned
• Humid →

  use dehumidifiers
• Cold climates →

  heated stores
• Items Needing Storage in a Controlled Environment

  Injectable products • Suspensions • IV fluids • Suppositories, pessaries, creams, ointments • X-ray films and chemicals • Products containing rubber, latex, cellulose or some plastics
• Cold storage consists of:


  Vaccines, sera, test kits • Cold chain: +4 ºC cold room: twin refrigeration units, recording thermometer, alarm • -20 ºC freezer recording thermometer, alarm • Ice packs and cold boxes • Standby power supply
• Cold chain equipment


  should meet WHO standards
• Cold chain equipment


  Top-loading refrigerators and freezers are the most appropriate choices
• Electric refs of the ice-lined type


  good “hold-over” in the event of power failure
• Front loading types 


  used in areas with stable supply of electricity
• Top-loading refrigerators and freezers

  most appropriate choices
• cold box


  use for transport of vaccines, fully frozen ice packs placed at the bottom and sides
• vaccine carriers


  used to carry small quantity of vaccines (16-20vials), for out of reach sessions, 4 icepacks are used
• Items needing Freezing or Refrigeration

  Vaccines • Biologicals • Blood Products
• Temperature Monitoring sheet


  indicates safe temperature range and measured at least once a day
• Flammables


  • ROH, ether • Separate building • Well ventilated, fireproof • Explosion hatch • Fuels must never be stored near a medical store
• Flash point of -18 ºC 


  (Acetone, Ether)
• • Flash point of -18 ºC to +23 ºC


  (ROH before dilution)
• • Flash point of +23 ºC to +61 ºC 


  (kerosene)