oT TTT ADVERSE DRUG REACTION seta ae re yee op mae Seeder Date et meme vd mi she tds etn rg tacos Spontaneous ese reports an record ‘Apc sonst ave ag ston paring and management drogen ae ied a yan or nine ct of dr etn, ‘hi ea ad eon snd smi ay for pant a lo inchs exces Pherae masters drut Fr cmp antidiabetic drugs bene rh i, ot soca goa deed de 1. oc CLASSICATION OF ADVERSE DRUG REACTIONS Aen rei ogni hye ced Saen cag hc ‘erpa maton dw xs paracetamol pete Patent with Kidney dee parity tow who have ot more than 70% ey \ Hypossbuminemia which may be et ae of albumin preducon at nv ‘leas or albumin ean nephron sain atthe extemes ofthe ape range ce nant and neoates ‘Adve rescton in thee conditions can be minimized by dow adstnent afer hncwing ‘he pharnacolne bebo anniv ug ‘raps have sever pharmaccope actions a sua therapeu dose bute prsibed ‘oly for oe of the efi actions. For example anthaminc ar prs thar {taller hin ects r fr thr anita fe, but they abe produce drowanes def cetal nervous stm deprsionGncndary Phare! cles) scon may bite importacs or patients ing on bed bu tay have astrouseneequences ‘pain is motor iver, Ths tet ay be greatly exacted ithe pent ass ng hypnotics rangle cough suppressant at medicine or sconuming sea ‘he term ony ed for uns nepeced dg ef which ant be ed fphined er preiced. abo nes, 4 rug induced fetal aor ae other exposed 10 tame. Thaldorsse ‘Drug indo! cancers deen reactions For eample: ‘Yagil adenocrinco in gts with prolonged ua seater ‘amor inkiney pe with prolonged un ot sibero {snc jit wh ringed no gs “ymphnoi tames in patos cet long tern ieunesppreive therapy with ‘satopine eophomphamil and oe stage = Allerg: dr ection ange oo very id ‘arly ater export wie vat of gs (Characteristic allege adverse recone pea fos "Terao do notre tthe expected pharmacologic of dug scion to anaphylaxis and death may our— = - poner Manan PeAcTER = EE cnn gt vette ee Set ened nme Er spin nt ae em iy nd te Soi ie tee om ma a Ce a eT anh a te ee atc i tn tema ee se ea rng om cots ‘remem en sae allege drags stele drogrengon gaan a re a — Fe. pone gine ca cu hee Shiai Soph sg pct rare ie Pehiane map — Sst co oo cine pain nina Pas fected gest make yp rea hsp than average ik fr some ‘poi dup toss. Fer ample gcse php dehydrogenase valved i esd fhe poi eegy Cetin populate Ss ar defen in gla phphae dehyognae and theron tee ar stata SESS em: dene ater he wo nie dpa “i en otal my Dae tes ith pupa ae uceptie CNS deprive get epee agent ike baba. Indu eh ‘Sinha Tey may Sk pao MY susceptible dev palys an ate aprwe ee ou nto lee: i Many drag are det in er by acylation The bly of ctlation of many srs in vera in ini aw aeynors ve peter foi Teese dros ke unin, pron, yale, penne apd Sooone 4 Toy following drag withdeamal, Tolerance ecu aie prolong we of vary of rage nateote anlgo, hypnotic hy sled some hypotensive ape (Soins) and erie drop Suen witha ff suck drugs shows severe adver ects In patie abated t cent eros ‘eps uch a thy lcs and ne benzene, witha the Stal dove may produce marked apiatin, acy, conten deus and consis ‘Gonidne 6 wed in hypertension bt tan wham may cause severehyperesion Langton tapy i low common bce it maybe cae apy ‘pent nea nde, There, eden wharves sn peas am arte 2a {ts Adon dese which the pte become profounaly weak, hypertensive ‘ecole Sach cumstances can be vee by gradu enoval he costed overs pd of weeks depending pen the eg fee they hae ben conse 5. Drug interaction beneficial interactions averse in Noweardaya many drags rtd in combination pt rt lel Semen thes may Interact oper and cane adver ron ‘Adverse eatin digs [Adverse reaction dru take varying eng of tine to develo. Some become appren Imma whither ay soure wee or mont to develop. The seer may range frm ro catastophic Any bey sue o eran can be ae, Following table dtas the dootes due osome adverse dg reacons,a PONCPLES OF PHARMACY PRACTICE al [aint ih a o ay ‘Sees tact ‘poi ac iin y pay ‘nie eo os # supe sehen ei inn hence Stamens aE ony une ay epi se gn ews ct va Pent Onlenmapties poem oun ems z it pe ei el penne ae ere 3 ee a = —————— =< ee a a EL Acs eg eens Chaierpos petins a io “Aso habit Natotic rams 2 =~ =a eg nyse Be ADVERSE DRUG REACTION ia ves econ to drug tht hve wl erie forenend periods of te cn cut ‘ing change inthe ality the cent © metab or excrete the devo eso lnhercuret ines. The entation of cmon rents oa pei rp fen eres 10 en) yours of exprnce in hrapeutie ue’ Even ten sre risen tay hot De ‘ecognind a being drug ted For ample spin wae widely aed for dcr toe es devine efecs were akowiiges. The imgtance of cea sbcraton ad complete documento of chen reponse 1 eatin cnnthe serps ‘She eflects are the acon of rg tht re pcan ins etment cation, No drs eat single tet onthe body: aspect of pects osu subst adminiered in oo tance fos parc pupa be odin anther | ‘iferent fies: Which of he ator ate termed herpetic ad hah ave deemed ie ttt depends upon the stuton Side elect renal deinen, many ogy ae ‘hen fr presxpon in rere expat this deaiable wets or example diacepam (alum) & Botha angie nds Skeletal mc ela When sound elu astern roperer te cosdeed ide efits When edo et ow beck pi teangullzaton i cnsered 9 side eect Inthe Inter inane these eft! tally nsiered pol Deus the cent often Ra ily ating othe obit and mastoid with order ‘Among common undesoble sg ees from droge are ntse,voming, skin ashes, leroy ibn, and changes inthe keel of oncousen emote alet Sle ‘cts ty be mo tey maybe weve and heating, Teles serous ses ae ‘ten ndignored, and in longterm drug therapy may pemist av voubeom a ‘isresing conditions tht ae reactor tent Tale blow Hastats the coment [cRNA pe hatee RRTR RET ese te omega wea eae eaea Terence pr eos) ‘ts heen ty ne Seton Sep ey aking op tig il) Gemini mei, ams cui eg oe ee ae eee ee ae a ee ee | Se a ecco ee oes Saeence ‘mthenew tom hema dass th peo mre rg tions ae rtgens. They eet eso cel entryoto duce shore Sone elaine tenes ek shee eesti Taleo rtp du ‘Soeeat eas nee ET palin sa : nie = Porn is a Fl mene see, ped ee ow tneab gar ce Peat ‘comme ) ‘ronan ed Neal papa Hal Bern OS eo [ADVERSE DRUG REACTION SSL Le Meet) FDA‘surd » warning about the posbity of developing chabdomysts, «condition rough combination treatment wth sims and ‘smlodaone, mir, clam chanel ctr wn approved y the FOA ie foe too ‘ri with from the mae shorty ater det potent! hire nts eo rug that prokong the Ciera 4 method was proposed that used the DDI Druglankdatbase along with molecular ‘loan or detecting DD ‘es ert pie ingest coils th known nso pater a ie a os binary vst of Tan Oe ‘wo deren interaction fingerprints can be compared sig th Tanimoto enfin (TC), ‘peer method foe comparing thesia to se Hypotheses flows: 1 droga dragjav sar acording 1 thet nteracton fgets ten dw Interact with the same drugs as dr jw a pratblty raed to the nary of tree Angry and vice ver Figure bw shows how the intachone af ob ee,PHARMACY PRACTICE su PRINCIPLES OF PHARMAC’ nya an ae bngepint a the in td ag ns oad wat te 1 core For ee ema pane rs pte operate Epi pene cae operon 0078 rein of te Esthet Drage nracin (DDI Datos (at MA 1h dnt tom Dr Bask ie calle rely. Only sal approved dros, not ning ‘astm and pps mere ited inthe males euling in DDI information rsp drogen ost 19454 qu DIS Une mores he ef cece’ DDI int 2925 binary marc M with value of reptsng av inert Seer wo droge and ato 0 representing no intracton ‘Te mel ide nfrmaton about the pamacologal ll of the ntacion ‘coin with pis of Sapa pa of te poss eg entry 9 Drogba or the DO! Feveen cxttryin and tpi i two anthers uy ease, 28 {hnchinene fics and enance ber advent), ADVERSE DRUG REACTION esto PieSil ty Mate ‘Toe interaction profile sanaty mats My casted inthe sep: ‘The conep of IPF sar to alc sre geri The scien nF isto repro the deg inact or pula Gg a eer ein th psec of Interacone in pei Paton Avance iar enero beech ‘buyin and al ther dps arc ctv pen 0. 22) 6 5 725 Oy hep whine ab ae ee epee xpi 1,102 25 14,729). Te normatn ete ces ne 10h cans compart “Tenino coef Jaa inde edt compte sre been al he ‘The TC between wo Aogepins A and find the ro tren Be mambo tation try tee figerints Cnt of te ari Mi 4 mt cot that he ows and cols represent ds and ech el psn the ntracton profe say Rae ont betwee the oping Piro is ‘Mase scmpatedy ing th MOE setae Predicin of New DD Mats Mi) To alate the matrix Miwith ew prod introns, we mui the mac sabished DDI date mat) by te mtr Me race poe inary as) Tris worth noting ht he vals in he gen he mats Mead Mt ie the nection oa drug with st natant account Although the moe cod prea ‘mull scores forthe te interaction tween smart fo eet pa, we ly onsite the predicted ineracton withthe phot TC val Fo thi feck el the prod the maton onthe ghee i he rayon ttn GeoFigive 2 We twtsormed the reuing math inthe symmetic mae conser th hight vale (Flor each pro drags ft ried De are thn genre fr Man the apa et prove by the nal DD seas ‘Mc scaptre and ced othe new DBI Asan ample figure shows how we wd ‘on iteractonBetrenhloperdl al dyeomine pred an sean Been leper an onybut. aon we aged the Kolo fit o the bensu rancmLs OF PHARMACY PRACTICE (Pret nero ti) ‘Re os nec gh hia he mac Mb Dorms by math dawson pags na Note ht ech cell shows he TC etre de A,B sd at wih oe sous mrmer ba ‘SPONTANEOUS CASE REPORTS AND RECORD LINKAGE STUDY ase repr an ihage sty has ee ae os yf MI Golde lin which be ‘ud soto and esc ‘he cas report and inage sty sows ‘+ Thee is contovesy stout whether itraption of pregnancy, paca i i Inde. ees tek bes cn ‘+ Motstudef ths sewn hve bon ct cont interview sae ‘Am imporant and mich dacined conan i wheter such sie are Inherent set voor bist women ih eet cnet maybe mae ely thin cont amen 10 Wl the interiewer hey have had ah ined shorn when qutionn abst heeds. 1+ Tere ae systema poring ine fn tei sais te posing of aa +The over ds rato cal in Bris et analy ld xan on ata from 2) acest ties + Byeantast prep cohort hs nl stds bed on nage of independent records canoe dese nhs way by reporing ae + Methods: A nese asecontol uy wing ned, anonyme dat fr the ‘Odor recede dataset was ahem by M) Gols ta 1+ Dat were aralynd fom 148-199 (hfe the Aberton Act f 1967 which ral abrtun and compre stati! seat of Naa Hel ‘Service (NES) hapa ado icing dy ces) and dest cert, + "Cases" were ears women with rant cancer n= 28616). 1 scone” were records of women With a wide range of thr, mainly mine, soll nvr sais (n= 32548). + Records were aad, comparing caves and conta, t eit plor hata ‘minions coded” a ‘duced aborton, sponaneow abortion or sborion “espectida induced spontaneous. It was cormen er aoron 9 be coded thou qualfcation of whether ey were ince porta 1+ Cases and cons were sified by ape Gn ive yar ands yar focuenc of ‘ae econo vet nd plano iden. «Lined stein for sol cs an posible although therein ch due dat wasincomplete «esuls- Ove previous abortion was sigh les common in women with beast ‘ce thn in coms. Mj Galore eal wondered the wer te ight eat fom confounding wth cl hut twa ound in ech acl cl a 4 The aio of obneed to expected aes id nt irene oer ire eer fo all ‘horton or orindu abn, x wou Be expected if abortions wera auc offy PRINGPLES OF PHARMACY PRACTICE ean tt ao mtn nt an Seon reat ne 1+ Ute she Seth kage sto ed «sll wer am e=PSi ae of | Sei cnt wth ar rae Simcsatienmsiccar "rn + ape et ane rae | eer en yy ne occa atone nee ee ae =< oe ears Sees oc ee eee oe eee ‘Table ow shows Pir ron n women wth ent cancer: observed numbers of open hte can nd rare expt nts the reer © ‘pec a conde nerdy cada) syne and Cae Foe Sm Sepa ar ae os ples 7 | wo aw ityees ba ied ae ADVERSE DRUG REACTION oe vary adverse ft oecued or may ecu by new dre and rigs of cues, (Documentation of vaous drags hat used ADR, which nde deh bethrsenng cendtons, daily, hopializton nd congenial abnormal, ADR monitoring incades ferent suis fo the dentition of averse events By tis method, he unpredictable Giza) ees Le TYPE adverse drug reactions ae pore Anecdotal porting 1 comes tough reports of individual dctrs when patent sles om the pra Fe keto mt oft mth Mot, al ADR sporting programmes foow th mth Her, th fc re corded pontaneuyBath usual nd ace ADRS cone ora ‘on and montana hs mete Heath care member consnaculy watch he patel and record al the events observed when drag o different drags are adnate. In ths, dtined groupe of pains ae serene to delet ADRs. The main advantage of th stoi i hat the populationinto tone Period Of ting nh patent i SET a ins meen oy eat me oe eons panning sir ue ef nd ea toast Nap mst soda at niu pent acd end np Tenge pce crn eet caine > ee sen acer sn nme 1s ew sen pi wh he is de df he wf # dng ‘ronda thy heen hg Ten hn compre rt ‘ect gy a slr nnn bet ee ses te srs ‘eb tne ub rh neon ree ag has od ‘Sreeroret Howey al er AD cme i ‘Tho sud ic tt prospect cart ay ad epee case-control ste inet words. the cambtn fh ds 1 mt ee ah ‘0 rp mrp hd np ‘econ are studied oideny the less with drugs. i: a ct a acer in m0 rnd io determine the rel 13 rapide vet ery fet a ay hem, caeco perimental cert se salle iniang Pm i or ce tO tents uh a children een or pst eth elo haat yscion, With these tasty rte ol aver vet can be epoted Ansa sade: Analy tear peso ost read outcomes ofthe ‘exponre to the drug. Thy can tke the form of cheereaonal ar well as Interventional expernentl stan. Thre are fur main types of analytes suds namely eclogcaloereconal cor and cate contrl ‘Obert tis: Observational satis provoke wipes drug flecvenes in ‘stents ring teatnent Ths i conta with expernenty sch at random ‘oti ri, where each subject is iniacriminately aad to a eaten group ot ‘cont poupe en AevVIEW guesToNnNs LONG ANSWER QUESTIONS. 1. linea lasy adver dra rections on diferent basi in dtl 2% Desrbe the meio of detain drug ntractons, spontaneous che reports and rece inkae sade ‘Das th concep of adverse drug rection reporting and managementCOMMUNITY PHARMACY Ta Sam nia oon SSS eae LAND WHOLESALE DRUG STORE ‘The main factor responsible for the success of a drug store its location and proper layout design. An ideal plan for proper layout design of areal drug store and whole sale drug store ‘The main objectives of layout design are 1 tshould attract large numberof customers should increase the sale of store ld reduce the selling expenses toa minimum, ould provide the customer satisfaction. should have pace for reserve for stock, office and resting place for the employees. ‘A modern drug store should fulfil all the requirements in schedule cosmetic rules, 1M5. To start a retail drug store a minimum of 150 sq, meter similarly to wholesale drug store a minimum of 200 sq, meter area is required + 1082 Fea —+ Sem pene i) a" = Ws 1550 Feat —> a COMMUNITY PHARMACY eS — Fl ) | a | Zk, Sep department where selt service is not~~ 990q, $190 ‘Od ‘OS ‘WI‘AI: e1NOY Uwonyewstju0> sHnadezayy ‘uoypexayu Sep aiqusso,, Axprxo1 papadsns rene1 xed eu) {9ne} esoperd 30 yBno1y Od S173 ONG SIHL — bay '3800 1S¥1 JO 3.va. GNV ANIL 18 un "OO, 4 uum Pepeeu sane] ueyM aEn/pU! asead ‘esuodses ojnadesaig jo eoussqy eoueyd.w09, fq paepig Wi reg NH Uonewuyuoo synadevouy, ‘Avor.0, peyradsng 4san03u Hod Nosvay “aaus3nosy vaAzT onwa ‘ON @U0ud pieM ™ by re ‘WeN one WL 40 WO 1s3NAy SNIMOLINOW ONG SINaaVESHLSE MEDICATION ADHERENCE Cmca ps, est ‘plete een of econ Peatem inode oes uot ret [CAUSES OF MEDICATION NON ADHERENCE ‘Tey i hn rn ent oe meat ghee edn fy ht ens + Repaorpgtn mip eas he Ug toes coe pte ‘Poor coping skills Pe Schone done ttm mi poe ero dats pepe) resi ste ket seals tes MEDICATION ADHERENCE 7 Sc nar ype the mance of i peur treatment te ot oe trany Pernt moming dang ant ofen meat thee Imeicaton th aki and ye pate phys enhp wh rnerem F priv ctr and et. Reton rence were gate ate ewan dre im gua ver dr weg, sipping re Pong tecut hy) mr der ad ek spe [ROLE OF THE PHARMACISTIN THE MEDICATION ADHERENCE AND MONITORING OF PATIENT MEDICATION ADHERENCE edn x presenting ing ena sory nce nv me am evel on any es, ggg ‘rw eh rou ar ch ee ey ‘CAUSES OF MEDICATION NON ADHERENCE ‘hmptmat deste eg Pypetersion bees ype) jt depen ses, ck ofl upju PRINGIPLES OF PHARMACY PRACTICE the main cause of uncontrolled blogg ing adherence included perceive, fe disease requiring, lifl and often. associated thee planning OF PHARMACIST IN pharmacist, management, in every type of MEDICATION ADHERENCE rect observed therapy such as measurement of the level of a drug ‘detection or measurement ofa biological marker added to the rug formulat jpproaches are one of the most accurate methods of measuring adherence but foreover in these methods variations in metabolism andl “white coat adherence” an pivea false impression of adherence. 3D Indirect methods inchide patient questionnaires, patent self reports, pill counts, rates of prescription refills, assessment 's clinical response, electronic medication monitors, ‘measurement of physiologic markers, as well as patent diaries Each method has its own advantages and disadvantages and no method is considered asthe best standard, The simplest way of measuring adherence i from te patient’ set report For example assessing children’s adherence can be done by ashing the help of a care giver (school nurse or teacher), The various methods questioning the patient, patient diaries and assessment of patient can be susceptible to misrepresentation and tends to res ‘overestimating the patieEE Tee RS TE PATIENT MEDICATION HISTORY REVIEW OBJECTIVES Upon completion of this chapter, the student should be able to: 1 Understand the need of patient medication history interview. 2. Obtain the medication interview forms, PATIENT MEDICATION HISTORY INTERVIEW A medication history is a detailed, accurate and complete account of all prescribed and non- Prescribed medications that a patient had taken or is currently taking prior to a newly initiated institutionalize or ambulatory care. It provides valuable information about patients’ allergic tendencies, adherence to pharmacological and no pharmacological treatments, social drug use and probable self- medication with complementary and alternative medicines. Interviewing a patient and collecting the data medical history is called medication history interview. NEED FOR PATIENT MEDICATION INTERVIEW Importance of accurate drug history * Prescription errors can be prevented and consequent risks to patients. Can be avoided Accurate medication histories are also useful in detecting drug-related pathology or changes in clinical signs that may be the result of drug therapy. A good medication history should encompass all currently and recently prescribed drugs, previous adverse drug reactions including hypersensitivity reactions, any over- the counter medications, including herbal or alternative medicines, and adherence to therapy for the better health care plan. * A full medication history Identifies patients’ needs |Explores the patient's perspective of illness and its treatment (needs and concerns) The aim of medication history interview is to obtain information regarding drug use that may assist in over all care of patient. The information gathered can be utilized : 1 To compare the medication profiles with the medication administration record and investigate the discrepancies. 2 To verify medication history taken by other staffs and provide additional information where appropriate. For documentation of allergies and adverse reactions. For screening of drug interactions, To assess patient medication compliance. To assess the rationale for drug prescribed. @1 Ripmitctepeheme nae eae re se —— Fone pre n Pac MEDICATION INTERV FOROS 1M een og 1 Mi hott pact aun cent eda tin chart ‘Sta “aacae 1 Extn Pcmacy + D1N ror Pega ae ew Wacom ama oyu Tenmeetgemeaaas = 5 Reamoure city do) tov mye? eye rere dine ou + tein etree AMMEN Ar oa ede? PATIENT MEDICATION HISTORY REVIEW mee PATIENT HISTORY INTERVIEW FoRM ‘dentify @ patient for you to monitor throughout the IPFE and get the patients hist by conplatng soc nr aetry t PASENT MEDICATION STORY REVIEW hoes —=—_ Rete ape Maen Compliance | stp matin alin fr Pet? Do rt har ty | =e ty weaning of [Sev th eden tuts? Bare | Te od epaeney fener | he con | A cond Actes of daly z ine ab cst Say ‘ela c Medication History Pefomedby: ate. neview guesTONS: [MULTIPLE CHOICE QUESTIONS 21" Prsipn eran preted an sei ha tpt canbe eed 1 “ese maser so rt net oad pablo change leincal sp tne be Be ek cog apy (©) gpol meat a shld eng cae ad ey psi dap Prous ave do einen Pps ann sy Ce he outer este ucang hea srs um, a er ey eer hath care LONG ANSWER QUESTIONS | Dace th ned ptt edit ity oe 2 Din tint ev oe “Ananens)—=——— INFORMATION SERVICES pom amples chap, he nde shold ae Te ga oom nflormaton cnt > Coens ag orm Peeierempunan rer ard HoTg =n PE eee error so min ras et an ae ape eS ee hg ap Ry woes Ce a Se ad Sarg ae Stearn Sree ae et ail fe reece ee aed See ed Fas herp hgh bpeaphat epee Sait Fee apna ne Sine Sou et oe as ete ceo ni reeva of infrmation Sorbet aceon peter rien “Stier mm ag oa @ Incrmaton centre i to repond to enqus & Provide servis 10 health presinas a very enuiry i handled within a masrable pri of ine ant eve appropiate 8 ‘Benue of te enquire Re I aaion Atsossment f herp drag an ipo! action of 2 ation cnt The cove mast hive cece fo the primal meal a ‘Rrmacetcal ourals The staf shold capi of realy ssi te mesial [ature te intonation mindy ad ca unc tac advice nls fcr fac wfc, opium done, intercon, ee and inciade mes of aveatty rm, ot rage ar SA. edn nd Teining: Educational ahi ar mpatan to appt he quay Se Psote Adu infomation cent an lo wpprnaboal and repoal suerte Sopot for drug une programs «eeeNtation of Intrmaten: Dr information cents can deni information Aol o rug monoyraph, dete an wees Edi silane portant or oan Dr information cote sould be invalid in search act ining, [hurmaco-epidemisogy eg ru tiation uses and phamaccvgdane eee inne Brag information cetes en have 2 vale in programs which ee mae ag waco Engi st potential adverse action ca od © ‘Thor of urpectel reactions and resnch maybe requ o snes the contusion ok ‘Topo. recon or for ebeeqoe! patent nape aoe onknogy series prindeinkrmation and vice the dgnoss and "wenn of pong Drug information centres shouldbe organised 2 coperave mal involving # mat ancl ct snd here parle ising sources sch rare compute an ‘tataser should ews 1. Femonnel ‘The sumber of pertnne required depend our of service A ene shoul am 0 prove # bermand by i ons eno tengo aii fe and heINFORMATION SERVICES Prt ca be mth grogaphi ro ot pec al iporance The appropriate orn tk cortmanaatie ‘al prac and nase or drag information cntes weg ‘hth iret seni or aes to recurs ae ier Sontag ge amt gt whine foie te tn is of hei pei, haus meters oa re tet meng mc nal ns ana 1 Me eiay faction of din Se tne ea ee i ee sro lth profess snd {ato pode tag noon wh dein mon rater ma hae sda ae cst he ara a i TY nal ag and expr @ le ferme pum The al hl ‘rome adhere in hens condone re Mont ther ene wil ate pharmaceutical preparations include tue wstntyematn cos storage td way 1 Eincon gd Twining: Edueona cette ar important to support the quality de ‘deus Ada norman cence suppor satoal snd feponal ulhores ‘opener drag ne programe 10, Remarc.” Dragnrmaton centres shoul be invaved in research activites including [Pherrac-epldemislopy, eg Sr wlaton states and pharmacopance ce Dg inrmaton center ier have ae Im prose wg reasons Enis shut potential aver reaction can lead 6 ‘Rpors of suposed eatin and ech ny be requied o ane the contrition of ‘rug toa reaction ofr tbmequn pat management. 12. Toney Tonclogy trie provide infrmaton and vie on the dlagnosts and treatment of poserings ‘Dag information cenies shuld be organ on cooperative model inelving 3 mul MEDLINE edu erin) 5 NEMatonal ary of edi) 4 MIcRODDC Isa lcocompuer bse reveal sytem that wis ser dik at She otnrgs fa Intemational ParrceotclAbsrcPA is aval nine pit version ‘© Phurmacrueal Nev Index I it Gon cent news abut devices, come {deste bah nds 1 provi evar which eno pining in abst Rilo oped wey Adana “The an advantage ire Singin condcing eau sachs. A pharacst ay 3 ‘ever hour fo eseuch pasa thenpeae qin fm a hraar serch ne en sonar stncen bag qavaorsna aaa . Name and address of the manufacturer 8 Batch number ESTABLISHMENT OF AN OTC MEDICATION COUNTER Factors tobe considered for establishing medical store: 1. Site selection Premises may be owned oF rented for depends on the locaton Site should be on super market ara, near toa hospital Ste 2 Layout of the store ‘prea of medical store should fulfil the requirement according tothe schedule N in Drug and canoer Aer lt should have a big and attractive front door for easy approach drinking ther tcity, public telephone facity. Availability of enough space for keeping prescripson wea nom presenption drugs is necessary requirement. I is preferred fo have the separate Counter for OTC medication to attract the costumers 3. Equipments and facilities “There should be good working faites as wel as equipments forthe personnel working and patients. Medical store generally contains: + Adequate sale counter + Adequate dispensing section + Sufficient waiting area {Drinking water facility + Cash counter {Sutficient glass apparatus 1 Store rooms for storing the raw and finished materials tease for certain period of time. Cost of premises round floor and ina good business area ike ina Jrould also have a good parking area 4. Pemonnel Tr includes adequate number of registered pharmacists, assistant pharmacist attendants a%4 cashiers. 5. Quality control Procedure In India at the medical store level quality control is not established. Quality is observed by seeing the label of the drug, manufacturer name, batch number -and expiry dat Dispensing of OTC Mediation is done by the qualified pharmacist and it documented Documented record should contain: 1 Name ofthe patient, age {Master Formula and source LP. of BP) a _— OVER THE COUNTER sates nt a Me any ach nein volved np resi the OT C Med tbe given bythe pharma POT Bian ing sufcent surete paren formation Yo guide a forthe right indication fective ight intervals and forthe right duration of te comes asker of Grass commonly used as OTC Drugs inde Cough suppressents NsAIDs Antibiotics Decongestans Antacids Antifungal Antihistamines Smoking cessation drugs ANALGESICS /PA\ Pain relieving medi Analgesics act on the body’ Sensitivity of pain. Others act by inhibit These relieve the minor aches and pain associ ‘old, menstrual cramps et. ee= OF PHARMACY PRACTice “Thee arto types fC pan ent tio" ‘Aetaminophen is a ace ge respon medines cdg pai found 9 mare tha $00 OTC drags and man preset tnd cod meas Fe ba ed to obere fever aches and pi. They inde aan, re ant many hr cies dicted o Od ergs. They {Toylnnbring an entye tt hp mas spot chemicals How to Use Analgesics Pam mediation re sf ar ftv when aed as etd Misuse ofthese prods cn Tne of hath ars profesional mst be lowed {toate dou mons ochange be dose of your medion 1) Bovnor shure pan rec! medion with oer Only health ere profesional an tec whee it se for tameone cot Points ob remembered while taking ncetaninophen “ak the dose as rcommended, nat te Rgh desedt may be dangerous mach ow can ed tang uae «Becton wie ging acetaminophen chlden Points ob remembered while taking NSAIDS “= Too machcon ce mach og, risk nasi peopl king blood thine for neris or ens having ie + Use of NSAIDS can lead ohne damage Th rk crass in peopl who ae ove years ofage aking diuretic o having highbod pressure ints tobe remembered wl taking Opis ‘Use of pois can kao drowsiness, When ou fit stat the medication dono sry machinery that may ire you ‘Use dose that sate more dn can ven ado death ‘Cough sepprements Agente which peo pps coh nh te body comes at | “hace busi ype OTC Cough matinee ee ner NS CEE pesto Sepprenen Cntinaton cough products VER THE COUNTER sates RATIONAL USE OF ANTiBionCs col ‘flowing idles wil, th pre sib oe es SEP FP of rss eras and oY Wh ide the . nie the cy an and ther rou tt ag elton vetenge Fp tint Sormotectmae a ry ed tonto oa Ee el antic tergy stl te bed we pe ot bal ‘Pele das a pop een i ‘name cbs shy oer ded “Toes apc cninset te = Tomb aye: cer dt Tope emipe ce me Tepe tins a ee sw poe nin came soccer Tale tilts fr dt whe sls ie Mv ate tubs rst ecm tera uit OTC ge ‘in gy ug ert ont itn ports Tht a ie Sy hs mdr oa le OCS ye ae ene mrp et ae yng Sie Wie OFC ds ae gos pe from pharmacies with prescription. the lhe etic tis whee as en Speci ori shu cle the mos efecie, tov ad narove pci ot ae py ed in reece opener py whence 7 reece parenteral ry whenever cinaly ee ae saattsattesaasstsaansteaniaeesnesesentePte PY PRINCIPLES OF PHARMACY PRactice diagnosis is uncertain or requires highly potent drugs/agents. Dispensing few tablets fo, headache or minor ailments is acceptable Vitamins and tonics, Iron preparations, analgesics, NSAIDs and cough mixtures are useg widely in the community. Frequently, community pharmacist sell and recommend these products without considering whether there is genuine need for treatment or not. Two important factors are the patient's desire for treatment a and the pharmacist’s desire to please the patient and to sale the drug. Vitamin preparations are promoted for conditions which often have nothing to do with the vitamin deficiency. This includes fatique, anxiety, lethargy, stress, indigestion, menopause symptoms etc. Rational use of OTC Drugs require the systematic approach Care must be taken to ensure that the recommended OTC products are not contraindicated in a particular patient. Care must also be taken to enquire about other drug therapy so that the potential drug interactions can be avoided. Review guesTloNs MULTIPLE CHOICE QUESTIONS 1. Use of an appropriate, efficacious, safe and cost effective drug given for the right indication in the right dose and formulation, at right intervals and for the right duration of time is: a) Rational use of drugs b) Over the counter sale TDM 4) Clinical pharmacy 2. Which one of the following are not independent contractors? a) Community pharmacists b) Hospital pharmacists ©) Opticians d) Dentists LONG ANSWER QUESTIONS 1. Define OTC medicines and discuss the factors to be considered in establishment of OTC met store (2 Explain the concept of rational use of medicine over the counter medications ANSWerRsS MULTIPLE CHOICE QUESTIONS 1 a) and b) both‘by PRINCIPLES OF PHARMACY PRACTICE RELATIONSHIP BETWEEN CUSTOMER, MANAGEMENT AND ADMIN ae pRUuG STORE MANAGE 2 Cot involved in carrying of inventories can be minimized, such a location should! be selected asa store area 3. Store location also depends on nature, value of materials and frequency of material Decentralised storage system should be followed for the big organizations. i MENT AND INVENTORY, CONTROL, tt an advan ‘aayzing the | | Goa ana mance || oS — snvirorment || sommaiten [+] Smart | Sultans | |” vag “ing mix “control 1 ete | pe 10a Feet S100 Frazer | ae Hy a) dl |) te Waiting Area 8 e a sows] | Retail drug store design DRUG STORE OBJECTIVES: The main objectives of drug ore Procure, supply drugs of allypesand to matali ieee> pRuG STORE MANAGEMENT AND INVENTORY CONTROL TYPES OF MATERIALS STOCKED AND STORAGE CONDITIONS principle type containers and their appropriate use Cement, Barites Material stocked Paints, spirit, oils Greases Barrels / Liquid and solids Bottle | Liquids 7 Cupboard | Small articles tequiring more protection than open shelves Casks Miscellaneous goods Carboys Liquid chemicals and acids in large quantities oI Cylinders | Gases 1 Floors Tubing piping fittings manufactured goods Tanks Spiritoils 7 | Tins Certain materials required to be kept damp and air proof ] Vats Oil and greases Grease,paints white lead Dry goods readymade upon standard weight in large quantities, Hardware STORAGE CONDITIONS Reduction in storage space and handling cost ensures maximum return on capital invested. following points are taken into consideration: LWhere to store Factors gover eee ning the layout are shown as below:a $V PRINCIPLES OF PHARMACY PRaCTice Similarity Items such as medicine, hardware ete are treated as similar items and stored together Popularity Most used items should be stored near point of issues Size Large size items to be stored near point of issue Capacity Location, size of door to be considered ,two way doors preferred Characters of | Hazardous, sensitive materials require great consideration materials Turn over 2.How to store To store the material following methods may be adopted Unit pilling Certain materials tends themselves easily adaptable to this system where each shelf, tray is given a number Aisles Should be adequate for easy access Pallestisation Where frequent handling of heavy material is the case Slotted angle | Provides greater flexibility in storing shelving Special storing Required for inflammable materials STORAGE CONDITIONS : Drug stores are used to store all kind of materi like capsules, tablets, liquid dosage forms, injections. Cold storage for antibiotics, biologist! Lock and key system for narcotics and psychotropic substances, separate tracks for poisons ) Cold Storage -2-8°C 2 Cool Temperature - 8-25°C. © Room Temperature RT--Temperature prevailing in working area. 4 Warm Temperature - 30-40" C 5 Excessive Heat - Above 40°C STORAGE AT COOL TEMPERATURE: LIST A: Drugs that require storage at 2-8 °C includes Sera, Vaccines, Whole human Ble normal human plasma, thrombin, thromboplastin , cobra and viper in solution, oxyteci®™ lit vasopressin , insulin preparations ,porterior pituitary injection, human gamma gl injection etc eee eC eaee aa eHeEe oaEES INTERPRETATION OF CLINICAL LABORATORY TESTS Pui Ce ‘omecrves, Upon completion of thi ape the ten soul beable 2 tery sce ratory rv oftood and une rays in pee dine ste 1.000 CHEMISTRY, HEMATOLOGY, AND URINALYSIS Thee re vats pyc co fr haa oy wih a dae i he 181000 cHEMISTRY/HEMATOLOGY ‘Yrs parameters mci wih lod dy are Clog tine of od "este enh of tine ete the momen he nape of od ote the ves mt themmentof development of Bn Wakes rund 34 minute node for aloo lt Stance Below ding any major sue operation, detection of dating tne of Blood 6 of mostra. Is wed Inthe gro na he hmopi, Mermage, unde, anemia, ‘ood Preeure Measurement of Blood prewure is done by mans of an inirument named 28 sphygmanomett 8 ‘Nora bod presiei 120/80 me Spt lo presen 8 mig Dasa lod prenutanges tom sc eqroen th man BF and so penpals he 1+ Syma Bis deemed cons Re shock. sly fod ve tl nag Ie arcs, ag ppl te Sse 8 cori ontHacmoglbin count ‘Normal stgein male fre and infants slows Maeisse25¢% Female 1425 6% Inf 16558095 ‘Phe count of haemoglobin dares in anaemia and leakeniae increases in dehydration and pjeytbemit ‘Norma angen male and infants a flows Malet mions/ mm? Infant 405 mion/ a? RC. Count inceiesin the condtons rch fang, sweating, vomiting iho, fori, severe burns congenial heat dere. The count decreases nl Sper of (hom euenia end hennerage. Nora cunt in adit dren nan Adit 00 0 per ac ae iden 8001000 perce men Infant 10000200 pe ebi mn + Coun below 4.0 per cube mm inate leeopeia Count inrestes to 1.00020000 pe cube mince yo Count fbeyond 200-100 praia bod cancer ‘Proportion of pet ccys i lows Newtophile 6070 Eminophile 24% Busphile 2 Uymphoiee 20508 Monocytes S10 ‘Acute Dicer inecons the peeumens, wiping cough spend, ppedein 2 Neutops ppns in ine of tens, ne nay Ta ncn 1 Windle comiton nd pot ena prater 2 intron atin oust ceee 2 Ince in ber ected nee so 4. Bosnopena esente in nop) oxy i iris, burs or re of dreamer adn cle openiinons Lyphocytots Incas of ph cr fae cans eens apn reece enece phat eka, cl whooping cough how ey Hh cane condi he abe never ako sows gh on Monee Tncraaen ona tees manos . a Tr lcm prea tos, mony ikem nd Hoh Te= snes rranucr scree ERYTHROCYTE SEDIMENTATION RATE (E.R) 1 ie iter fc plan orm the top he ert column i pe Waseem © — “Te ESR determination afl 9 aig of duets the tbe teamatc it in which the paraneternceaes ESR ah increased anemia and ‘pce ESR dessin ale conto ating Mood separ 5012 mp/100 ml. Ine in Noe sugar Se termed a ypernyemia nd deca ld ga termed ype Santee oo mga vel aay ese 30 mene nbn, Hypogicemin ithe ren of ‘81000 eHOLESTEROL Ahn ont cite po 0 mg + Becerra CS URINE ANALYSIS ‘Vasous physic We chal microscale perm ne analyte Te enue| PRINCIPLES OF PHARMACY PRACTICE DTeRPRETAON OF CUNEAL LABORATORY TESTS _ ies | enstwent | ___| a i ami “iva Aint pe rome rN ‘ewilendamesinton (eomourt) iter cae vik dts real aenmeige may er Rivera | acre den gears RS Dncn og sor : come cs ‘natn es al] wae sur | se) ——*| cA on ol | Sioertecr ‘Som eas bang tet) [ yp oat | | ete a merophags pa inet a LL sty rey 7 as - Pato Pon eds Raa aE —] oe Seton ‘retort na Clon Bea |__| | maces se cn af Pier ‘xetans) [Ament [Aone wes Pu PI 7 ce | coe [tice | fee | 1 bags [amt | Paco as cn on a }See }\ PRINCIPLES OF PHARMACY PRACTICE Poseuts Type of Significance - constituent Bile salts abnormal jaundice (sodium taurocholate, | sodium glycocholate) "Bile pigments abnormal jaundice | (bilirubin, biliverdin) | Ketone bodies abnormal Hypoglycemia, haematuria | "Blood cells abnormal ‘Acute inflammation of urinary organs, cancer, Kidney stone, haemolysis due to poison Calum abnormal | Hyperparathyroidism neview ouesTIoNS LONG ANSWER QUESTIONS Explain the complete chemistry of blood. + Interpret laboratory results of blood and urine analysis in specific disease states{4 PRINCIPLES OF PHARMACY PRACTICE [ECONOMIC ORDER QUANTITY “The model was developed by Ford W. Hariin 1913 but RH. Won,» constant who {pple it evtensively, and K Ander ae creditors fot omomic ender guantty (COQ) f the oder quantity that min cents and ordering costs ‘Two mont important categorie of inventory cons ar crderng com and arying ot ‘Ordering cnt are cont hat are incared b obtaining atonal inventors, They ince ous incurred on commuting the eer, rarsportation cs {Carrying cos represent the cots icured on ling invertor in Rand, They ice the opportunity conto money held pn ewentoris, storage cents, pag cots ‘Seenng cos and crying ents ce quite oppose each ther, I we nee 0 minimize “crying cans we have wo place sl der whch scenes the ordering cons we want atte ur ordering cots we have to place ew odes inayat and his requires placing Tiege ors which in turncoat th ttl carving cot fo the period Wrest to minimize the tal inventory cots and EOQ mode eps jus dota Toul ivenny cons = Ordering cots + Holding css Dy king the fe derivative ofthe funtion we fd th following sation for minima 1200 SQRT 2» Quantity «Cet per Onder / Carrying Cos per Oder) Bangle “ABC Ld engaged Ins falls cot per order $400 and its carrying com ut $10 ‘pean pes aanum. The company has # demand fr 20000 units pe yar. Calute the jc ntl ders requ ring yer, al cayng cost and tal ordering cet oF the year ‘Sotton BOO » SORT 220000» 40/10) = 1265 units [Anvual depund is 20000 nite 20 the company wil have to place 16 orders (= anna mand of 20000 divided by oder ne of 1255, Total ordering ot hence $4000 A mali by 18. “Rrerge inventory held is 6825 (0265/2) eich means lal arin costs of $5305 it (25% S10. REORDER QUANTITY LEVEL/REOROER POINT Reorder Level implies the quay 04 Stock em in hand ter eching which you = ‘Hheverdes for our eps Theiporanc of ere evel arses fom he eed HY Fement mocks to tree ester ores ad, a the same time, aot to wanes) ‘secumulate stook seca considered while deciing the reorder eves area flows pe ea ie for pple dellverthe stock izes the tt oling seermmemicemroewercome fig conn. + The deliver in psy + Thestckintundt cone in hand toate Te purpose of specifying rier ei ‘och em hat you mat der Ibe ane sin eet a rh indice be any de i ects bay tine he Si hese sper oe man a mei le or Be mamta proce 0 pro the ‘ay ovetg gt unto ch iy Af business slg ey sec asta level would ccs by hele ys Satay sck sth scat ten ney on hd ‘ec oe espe em ney A daly wage acer he der Reorder Level = Lead Tine in Daye Dlly Ante Lage Sly Sock ely orders shou be lal pri ine at wich ses ring tho time wil ust have depleted alla heey or ant shat uy sk edd, amples ‘Example I: ABC Li. rte of oben Hel ait foe of ons rand days supplier aes werk dle ore Se laventry mang sud cen rr reeves ep ew 3:00 us (CO ut of Say une lp wih? dyson ere boas sample 2 ABC Ld sds old a slay sc equakt vege wae ofS age, Cae the ordered Sey steck whch ABC is ied ll qs 250 ait Dunit aly ape mule by 5 49 1 ths scenario rode lee woud based on 7 ays fd ti), Method sed forays oo Par shoal cn traci ans Mae ‘Parmay anager ctl ane en NG Tee taney me acorn ie vietanintercignie “simak te 0 ais 250 of key tk las 00 ute The analysis ls Fst 105% ofthe items axon *, 205% category Bits hat cl Remaining 65 70% are catego He 20 ———— ath ating |