Introduction to Hospital Pharmacy

Dr. Abdulrhman Akasha

Hospital Pharmacy
Lecture-1
Prof. Dr. Abdulrhaman Akasha
Professor
Department of Pharmaceutics
Faculty of Pharmacy, University of
Tripoli, Tripoli, Libya
 Introduction
Pharmacy is the science and technique of preparing and
dispensing drugs. It is a health profession that links health
sciences with chemical sciences and aims to ensure the safe
and effective use of pharmaceutical drugs.
The scope of pharmacy includes more traditional roles such
as compounding and dispensing medications, and it also
includes more modern services related to health care,
including clinical services, reviewing medications for safety
and efficacy, and providing drug information. Pharmacists,
therefore, are the experts on drug therapy and are the primary
health professionals who optimize use of medication for the
benefit of the patients
Pharmacists are healthcare professionals with specialized
education and training who perform various roles to ensure
optimal health outcomes for their patients through the
quality use of medicines. Pharmacists may also be small-
business proprietors, owning the pharmacy in which they
practice. Since pharmacists know about the mode of action
of a particular drug, and its metabolism and physiological
effects on the human body in great detail, they play an
important role in optimization of a drug treatment for an
individual.
Pharmacy technicians support the work of pharmacists
and other health professionals by performing a variety of
pharmacy related functions, including dispensing
prescription drugs and other medical devices to patients and
instructing on their use.
Pharmacy as profision can be divided into :

(1) Community pharmacy

(2) Institutional pharmacy (Hospital pharmacy)

(3) Clinical pharmacy

(4) Nuclear or Radio-pharmacy

(5) Industerial pharmacy

(6) Eductional pharmacy

(6) Pharmaceutical journalism

(7) Organizational pharmacy

Community pharmacy
A pharmacy (commonly the chemist in Australia, New Zealand and
the UK; or drugstore in North America; retail pharmacy in industry
terminology; or Apothecary, historically) is the place where most
pharmacists practice the profession of pharmacy.

Institutional pharmacy (Hospital pharmacy)

Pharmacies within hospitals differ considerably from community
pharmacies. Some pharmacists in hospital pharmacies may have more
complex clinical medication management issues whereas pharmacists in
community pharmacies often have more complex business and
customer relations issues
Hospital pharmacies can often be found within the premises of the
hospital. Hospital pharmacies usually stock a larger range of
medications, including more specialized medications, than would be
feasible in the community setting.
Most hospital medications are unit-dose, or a single dose of medicine.
Hospital pharmacists and trained pharmacy technicians compound
sterile products for patients including total parenteral nutrition (TPN),
and other medications given intravenously.

Clinical Pharmacy
Pharmacists provide direct patient care services that optimizes the use
of medication and promotes health, wellness, and disease prevention.

Clinical pharmacists care for patients in all health care settings, but the
clinical pharmacy movement initially began inside hospitals and clinics.

Clinical pharmacists often collaborate with physicians and other

healthcare professionals to improve pharmaceutical care. Clinical
pharmacists are now an integral part of the interdisciplinary approach to
patient care. They often participate in patient care rounds for drug
product selection.
The clinical pharmacist's role involves creating a comprehensive drug
therapy plan for patient-specific problems, identifying goals of therapy,
and reviewing all prescribed medications prior to dispensing and
administration to the patient. The review process often involves an
evaluation of the appropriateness of the drug therapy (e.g., drug choice,
dose, route, frequency, and duration of therapy) and its efficacy. The
pharmacist must also monitor for potential drug interactions, adverse
drug reactions, and assess patient drug allergies while designing and
initiating a drug therapy plan.
Nuclear or Radio-pharmacy
Radio pharmacy is a branch of nuclear medicine which deals with all
aspects of radioactive pharmaceuticals including compounding and
quality control.
 Industrial pharmacy
Compounding is the practice of preparing drugs in new forms. For
example, if a drug manufacturer only provides a drug as a tablet, capsule
syrup , injection and other dosage forms.

Educational pharmacy
Types of education necessary for creating a pharmacist
Basic science (Chemistry, Biology, Physics)
Clinical studies.
Technical Skills
Drug information and scientific knowledge
Economic knowledge
Psychological and sociological understanding
 Pharmaceutical journalism :As a pharmacist or pharmaceutical
scientist, can join the journal or magazine to report or writ aboute the
medicine and news on pharmaceutical-journal
Organizational pharmacy : Pharmacist must maintain & develop
good pharmaceutical practice by working with national and
international organizations.
International organizations:
World Health Organization (W.H.O): It is responsible for health care
all over the world.
Food and Drug Administration (F.D.A.): It is responsible for the
quality of food and drug in U.S.A
United Nation Division of Narcotic Drugs (UNND) responsible for the
regulations concerning the use and abuse of narcotic drugs.
Role of international organizations:
Development of protocols and methodologies
Development of materials and magazines
Exchange of in formations and experiences
Researches for evaluations of medications
Introduction:
A hospital pharmacy is concerned with pharmacy service to all types
of hospital and differs considerably from a community pharmacy.

Hospital pharmacies can usually be found within the premises of the

hospital. Hospital pharmacies usually stock a larger range of
medications, including more specialized and investigational
medications (medicines that are being studied, but have not yet been
approved

Hospital pharmacies typically provide medications for the

hospitalized patients only, and are not retail establishments. They
typically do not provide prescription service to the public. Some
hospitals do have retail pharmacies within them, which sell over-the-
counter as well as prescription medications to the public, but these are
not the actual hospital pharmacy.
Hospital pharmacists and trained pharmacy technicians compound
sterile products for patients including total parenteral nutrition (TPN),
and other medications given intravenously e.g. neonatal antibiotics and
chemotherapy. This is a complex process that requires adequate
training of personnel, quality assurance of products, and adequate
facilities. Some hospital pharmacies have decided to outsource high-
risk preparations and some other compounding functions to companies
that specialize in compounding. Every hospital has required ICU
facilities.
Goals of Hospital pharmacy:

(1) Teach the hospital pharmacists the policies and lows to assume
responsibility for professional practice

(2) Provides the adminstrative and tools essential to the hospital

pharmacist

(3) Provides the most advances and recent protocols of hospital

pharmacy to improve the profession.

(4) Improve the educational programmes to the hospital paractice

Responsiblities of Hospital pharmacist:

(1) Insures that established policies and procedures are followed

(2) Checks the accuracy of doses prepared
(a) Intravenous admixtures
(b) Unit dose
(3) Provides for proper drug control
(a) Insures that drugs are stored and dispensed properly
(b) Insures that all rules and lows are followed
(4) Insures that all good techniques are used in compounding of I.V
admixture and extamporaneous preparations
(5) Provides for proper record
(a) Patient medication record
(b) extamporaneous preparations record
(c) Investigational drug record
(d) Report (Monthly workload report)
(6) Insures that a new pharmacists are well trained in the policies and
and procedures of the dispensing area
(7) Provides drug information to the other staff as medical and
nursing staff
(8) Coordinates the overall pharmaceutical needs to the patient care
area with dispensing area.
(9) Communicates with nurses and physcains concerning the
medication adminstration problems
(10) Monitors patient‘s total drug therapy
(11) Advice the patient concerning drug therapy
(12) Periodically check the drugs in the nursing unit to maintain the
medication stock
(13) Provides good educations to all medical staff including nurses,
physcains, medical students, pharmacist.
(14) Assist the physcains to select the dosage and dosage regmin