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Hospital formulary

Hospital Formulary - presentation gives the detail idea about Hospital formulary, its advantage, disadvantage, how to prepare Hospital formulary and much more. this will be useful for Pharm.D-IV YEAR students, which was in their Hospital pharmacy subject. regards APOLLOJAMES

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Hospital formulary

  2. 2. DEFINITION The hospital formulary is a list of pharmaceutical agents with its important informations which reflects the current clinical views of the medical staff. The hospital formulary system is a method whereby the medical staff of a hospital with the help of pharmacy and therapeutic committee selects and evaluate medical agents and their dosage form which are considered to be most useful in the patient care. The hospital formulary system provides the information for procuring, prescribing, dispensing and administering of drugs under non- proprietary or proprietary(brands)names in instances where drugs have both names. 2 AJ
  3. 3. origin The first scientific hospital formulary in India was published in 1968 by the pharmacy department of CMC Vellore. The first HF for a Government teaching hospital in India was published in 1997 at Govt.Medical College Hospital, Trivandrum. 3 AJ
  4. 4. ADVANTAGES: Therapeutic Economic Educational Rational drug use 4 AJ
  5. 5. DISADVANTAGES: Deprive the physician of his right and privilege to prescribe and obtain the brand of his choice. Permits the pharmacist to act as the sole judge of which brands of drugs are to be purchased & dispensed. 5 AJ
  6. 6. GUIDELINE FOR HOSPITAL FORMULARY The governing body of the hospital should appoint a pharmacy and therapeutic committee composed of physician and pharmacist which will prepare the hospital formulary system. PTC shall sponsor and outline the purpose, organization function and scope of the hospital formulary system, it should adopt the principle as per the need of particular hospital. PTC develop policies and procedures - medical staff adopt these - subject to administrative approval. The policy and procedures shall afford guidance in the appraisal, selection, procurement, storage, distribution, use, safety procedures and other matter relating to drug in the hospital and shall be published in the hospital’s formulary or other media available to the member of medical team 6 AJ
  7. 7. Prescribers should be strongly encouraged to prescribe drugs by their nonproprietary names. Generic equivalents & therapeutic equivalents. a.Pharmacist is responsible for selecting from available generic equivalents. b.That the prescriber has the option, to specify the brand for that particular prescription. c. PTC is responsible for determining those drug products and entities. medical & nursing staffs are informed about the changes in the HF system. Labeling of medicine with non-proprietary names, followed by decided formats. 7 AJ
  8. 8. To develop an effective formulary system, PTC has to consult various references on a drug regarding its pharmacokinetic profile, interactions, ADR, etc.,,, 8 AJ
  9. 9. FORMULARY CONTENT & ORGANIZATION Primary objectives: a)Information on drug b)Information on hospital policies & procedures c)Special information about drugs In accordance with these objectives, the formulary should consist of three main parts: A.Information on hospital policies & procedures concerning drugs. B.Drug products listing C.Special information 9 AJ
  10. 10. A. HOSPITAL POLICIES AND PROCEDURES Drug use Description of PTC Hospital regulations about prescribing, dispensing & administration of drug, rules for Medical Reps, emergency drug products, Pharmacy operating procedures Information on using formulary 10 AJ
  11. 11. B. DRUG PRODUCTS LISTING Formulary item entries: Alphabetically by generic name Alphabetically within therapeutic class Type of information: Dosage form, strength, packaging Active ingredients Adult/pediatric dose Route of administration Cost Indexes to the drug products listing: Generic name/brand name Therapeutic /pharmacological index 11 AJ
  12. 12. C.SPECIAL INFORMATION: Equivalent dosages of similar drugs Hospital approved abbreviations Rules for calculating pediatric dosages List of sugar free drugs List of dialyzable poisons Metric conversion tables Poison control information Table of drug interactions 12 AJ
  13. 13. PREPARATION OF FORMULARY Visually pleasing, easily readable and professional in appearance. A typical formulary must have the following composition; 1. Title page 2. Names & titles of the members of the PTC 3. Table of contents 4. Information on hospital policies & procedures concerning drugs 5. Products accepted for use at hospital 6.Appendix 13 AJ
  14. 14. CONTENTS a. Introduction  List of abbreviations  List of drugs used in the formulary b. Basic information on each drug  Efficacy for the treatment of specific conditions  Safety profile of the item  Interaction profile  Adverse effects  Pharmacokinetic profile  Availability of the item  Available dosage form  Cost  Acceptability to patients 14 AJ
  15. 15. c. Supplementary information on each drug  Storage guidelines  Patient counselling information  Labelling information  Brand names and prices d. Prescribing and dispensing guidelines  Principles of prescription writing  Reporting of ADR  Prevention of ADR 15 AJ
  16. 16. e. General drug use and advice  Use of IV drugs  Special situations like pregnancy, breast feeding, liver/kidney diseases  Poisoning information and antidotes  Treatment of snakebites and insect bites f. Miscellaneous section  Children’s dose  Renal adjustments  Metric units  Diagnostic aids 16 AJ
  17. 17. YOUR RESPONSIBILITY Drug selection Promoting formulary adherence Review and take action on all non-formulary drug use in the hospital. Provide a copy of the hospital formulary to all doctors in the hospital. Involve the medical staff in various formulary- implementing programs. Give much advertisement and publicity regarding formulary. -Revision of formulary 17 AJ
  18. 18. FORMULARY Vs DRUG LIST FORMULARY DRUG LIST (e.g. I.N.F) Listing of drugs by their generic names followed by information on strength, form, posology, toxicology, use & recommended quantity to be dispensed. Prepared locally by its own clinical staff. Information provided is subject to local needs and desires. Generic names followed by data on strength & form. Prepared by country’s outstanding clinicians, pharmacologists and pharmacists. According to their pharmacological properties. 18 AJ
  19. 19. REFERENCES 1. Hospital pharmacy by William E. Hassan, JR 5th edition. Pg no.124-153. 2. A textbook of pharmacy practice by K.G. Revikumar, B.D.Miglani . 1st edition.pg no.82. 3. Remington –The science and practice of pharmacy 21st edition volume 2, pg no.2259. 4. Merchant and Qadry’s-A text book of Hospital Pharmacy. Pg no.39-50 19 AJ