Professional Documents
Culture Documents
Diploma in Pharmacy
By: Dr Mangeni Moses H. PharmD, MPS,
PGDME
1
Basic Definitions:
Law:
➢System of rules that govern a particular
country or community and may be enforced
by the imposition of penalties.
3.Regulation:
➢ A rule or order issued by a government
agency and often having the force of law.
2
Act:
➢ A bill which has passed through the various
legislative steps required and has become law.
Bye-law:
➢ A law that is made by a local authority and that
applies only to that area.
Rights:
➢ Are legal, social, or ethical principles of freedom or
entitlement
➢ Power, privilege, demand, or claim possessed by a
particular person by virtue of law
3
Ethics:
➢Are morals that guide people about what is
good or bad.
Ordinance:
An executive decision of a government which
has not been subjected to a legislative
assembly.
4
Torts:
➢The body of law which allows an injured
person to obtain compensation from the
person who caused the injury.
Felony:
➢A serious crime punishable by a term of
imprisonment of not less than one year or
death penalty.
5
TYPES OF LAWS
1. Criminal Law:
➢ Laws designed to protect the society as a whole from
wrongful actions.
2. Constitutional Law:
➢ The fundamental rules that determine how those who
govern are selected, the procedures by which they
operate, and the limits to their powers.
3. Civil Law:
➢ Law that helps solve problems which occur between
individuals or groups.
4. Statutory Law: Law written by the parliament or
congress
6
5.Common Law:(Judge declared Law)
➢ It’s a body of unwritten laws based on legal
precedents established by the courts
6. Administrative Law:
➢ refers to regulations from government agencies.
7. Customary law:
➢ A law consisting of customs that are accepted as legal
requirements or obligatory rules of conduct.
8. Labour law
9. Martial / military law
7
Sources of Law
The legal system of Uganda is based on law derived
from different sources. These sources include;
➢ Legislation
➢ Delegated Legislation ( statutory laws, Bye-
laws)
➢ Judicial precedents
➢ English Common Law
➢ Customs
➢ African customary law
➢ Ecclesiastical Law or Religion
8
Purposes/functions/relevance of laws
➢Maintains order in society
➢Source of penalties to law breakers
➢Settles conflicts and disputes
➢Promotes the welfare of people in the society
➢Protects the rights of citizens
➢Delivers justice in the community
➢Provide equality
9
Similarities of law & Ethics
➢ They are both an instrument of order in the society
➢ Both are concerned with preventing immoral and
unlawful acts in society
➢ Are both aimed at creating and having a better
society
➢ Both regulate the conduct & behaviour of individuals
in the society
➢ Both create guiding principles for professional groups
such as lawyers, pharmacist, doctors.
➢ Both work in hand to establish moral boundary for all
people in the society
10
Differences of Law VS Ethics
11
Differences of Law VS Ethics
12
Roles of Ethics to pharmacy professionals
Eases decision making by the professionals
Also help to assure clients that services offered
by a profession are of quality
Help to determine the expected level of
performance
Help to protect the practice of professionals
Also help to maintain the integrity of a
profession
Also regulates the behavior of members of a
profession
13
Code of ethics / Conduct
14
Code of Ethics/conduct for pharmacy
professionals:
1.should be concerned with the welfare of the
patient and the general public.
2. should apply professional competences to
enhance the health of the community and
society
3. should uphold the trust and rights of his/her
patients.
4. should at all times uphold reasonably
accepted standards of behavior.
15
Code of Ethics/conduct for
pharmacy professionals:
5. should maintain a level of competence sufficient
to provide his/her professional services effectively
and efficiently
19
Valid consent
The consent you obtain must be valid. For consent to
be valid the person must be:
1) Capable of making that particular decision.
2) Acting voluntarily, that is, they must not be
under pressure from anyone to make a
particular decision.
3) Provided with sufficient information to enable
them to make the decision.
4) Capable of using and weighing up the
information provided during the decision-
making process.
20
2. Beneficence
➢Beneficence means doing or promoting
good as well as preventing, removing
and avoiding evil or harm.
21
3. Non maleficence
➢Non-maleficence refers to non-infliction of
harm to others or doing no harm to a
patient
✓It guards against avoidable harm to subjects.
22
4. Justice / Equity
➢It means that everyone is entitled to the
same treatment or treating individuals
fairly.
▪ It encompasses the appropriate distribution of
limited resources; without discrimination, etc
6. Fidelity/ loyalty
▪ Do as you say you will do PLUS respect
confidentiality
24
Ethical Misconduct/ Professional
Misconduct
1. Over charging on products
2. Disclosure of patient’s information
3. Inappropriate behaviour e.g. drunkenness/
drug abuse.
4. Having a romantic relationship with patients
5. Asking for incentives from patients and
promoters
6. Giving wrong information to patients
7. Disrespecting co-workers
25
Laws and regulations that govern
pharmacy practice in Uganda are;
➢Pharmacy and drugs Act 1970
27
Roles of pharmacy laws and regulations
➢ They establish permitted and prohibited conduct for
pharmacy professionals and pharmaceutical outlets.
➢ Set the criteria that a pharmaceutical outlet must
satisfy to be licensed by a country .
➢ They set the criteria that pharmacy professionals must
meet to be registered/licensed .
➢ They establish the pharmacy professionals’
responsibilities for operating a pharmaceutical outlet &
offering pharmaceutical services.
➢ They establish the requirements for information that
must be on the prescription label, such as the name
and quantity of the prescribed
➢ They also Provide for discipline and penalties for
violations
28
Roles of Dispensers in health care .
Processing of prescriptions
Monitoring of drug utilization in health
centers
Making extemporaneous prescriptions
and small scale drug manufacture.
Providing drug information to other
healthcare professionals.
Participate in Primary Health Care
29
activities
Roles of Dispensers in health care
Carrying out health promotion.
Procure and receive drugs in the
health centers.
Sale and market drugs
Ensuring quality assurance of drugs.
Training of other health care
workers.
30
Process of registration of a Dispenser
31
Process of registration a Dispenser
➢Then submit the filled forms a long with the
following requirements;
▪ 4 recent passport size photographs (Must be
colored with a white background)
▪ Certified Final Academic transcripts/
Certificates of qualification
▪ Photocopy of identity card of school where
one trained from
▪ ‘O’ level and/ or A’ level certificates
32
Process of registration a Dispenser
➢ On submission of required documents, the registrar
shall enter the name of the applicant into the register.
➢ Then the registration number shall be issued to the
applicant.
➢ The registrar shall cause a list of all the pharmacy
Assistants whose names appear in the register to be
published in gazette after three months.
➢ If the council is satisfied that the applicant is of good
character, the registrar shall direct the applicant to
collect the certificate of registration.
33
National Drug Policy and Authority
Act
34
National drug policy and authority act,
1993
Commenced on 3rd December, 1993
It establishes the NDP and a NDA; to ensure
the availability at all times, of essential,
efficacious and cost-effective drugs to the
entire population of Uganda, as a means of
providing satisfactory health care and
safeguarding the appropriate use of drugs.
35
National drug authority
36
National drug authority (NDA)
➢It is established by the National drug
authority and policy act, 1993.
➢It is mandated by the law to regulate
products i.e medicines/drugs,
manufacturing Facilities, and Distribution
outlets (Importers, Wholesalers, Retailers)
37
Functions of the National drug authority.
1. Deals with the development and regulation of the
pharmacies and drugs in the country
2. Approves the national list of essential drugs and
supervise the revisions of the list in a manner
provided by the Minister
3. Estimates drug needs to ensure that the needs are
met as economically as possible
4. Controls the importation, exportation and sale of
pharmaceuticals
5. Controls the quality of drugs
38
Functions of the drug authority…
6. Promotes and controls local production of essential
drugs.
7. Encourages research and development of herbal
medicines.
8. Promotes rational use of drugs through appropriate
professional training.
9. Establishes and revises professional guidelines and
disseminates information to health professionals and
the public.
10. Provides advice and guidance to the Minister and
bodies concerned with drugs on the implementation of
the national drug policy
11. Performs any other function that is connected with the
above or that may be accorded to it by law.
39
Composition of National drug authority
The drug authority consists of ;
➢ The chairperson
➢ the director of medical services;
➢ the commissioner for veterinary services;
➢ the commissioner for commissioner for trade;
➢ the director, criminal investigation department;
➢ the chief of medical services, Ministry of Defense;
➢ the chief of pharmaceuticals and health supplies;
➢ the head of the Natural Chemotherapeutics
Laboratory;
➢ the director, Mulago Hospital;
40
Composition of National drug authority…..
A representative of each of the following;
the National Medical Stores
the Uganda Medical Association
the Pharmaceutical Society of Uganda
the Uganda Veterinary Association
the head of the School of Pharmacy, Makerere University;
the Uganda herbalists; (vii)
the Uganda Dental Association
the Joint Medical Stores
the director general of the Uganda AIDS Commission
two other persons appointed from the public
The chairperson and the members appointed from the public
are appointed by the Minister. The members appointed in
office serve for three years but are eligible for
41
reappointment.
THE NATIONAL DRUG AUTHORITY COMMISSION
➢One of the bodies of the NDA is the
National Drug Authority Commission
➢It consists of the chairperson and four
other members appointed by NDA from
among them.
➢The chairperson of NDA is the chairperson of
the commission.
42
The functions of the NDA
commission
to exercise the functions of the drug authority which
may require exercising when the drug authority is
not sitting
to monitor and supervise the implementation of the
decisions of the drug authority
to establish and revise from time to time, the
working procedure of the drug authority
To perform any other function relating to the
functions of the drug authority as the authority may
direct.
43
COMMITTEES OF THE NATIONAL DRUG
AUTHORITY
The committee on essential drugs
The committee on the national formulary.
Enrolled Nurse
Registered Nurse
Comprehensive Nurse
Enrolled midwife
Registered midwife
55
Procedure for opening a Human Drug shop business
Identify the location and premise where to locate
the business.
Approach DHO’s office or nearest NDA regional
office
Fill pre-inspection request form as directed (Forms
are free).
NDA team will schedule and carry out inspection as
per guidelines and provide formal feedback (
inspection is free).
If feedback positive , fill license application forms
and pay required fees to the bank
Submit complete application form to DHO’s office or
NDA regional office consisting of the following;
1.Duly filled in application form for certificate of
suitability of premises.
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2.Duly filled in application form for license to
operate a drug shop.
3.Proof of payment of prescribed fees.
4. A certified copy of certificate of qualification/
enrollment of full-time in-charge.
5. A letter of commitment from the full-time in-
charge
6. A sketch plan of the premises for a
Drugshop.
7. Two recent colored clear passport size
photographs of the full time in-charge
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8. A copy of in-charge’s national identity card
9. A copy of TIN certificate issued by URA
indicating the Drug shop as a registered
business with URA.
10. A copy of the National ID of the owner
Instill good dispensing practices e.g shelves,
reference books
Issuing of the operating License by NDA
58
Procedure for opening a pharmacy
business
Identify the location and premise where to locate the
business.
Approach the nearest NDA regional office
Fill pre-inspection request form as directed.
NDA team will schedule and carry out inspection as per
guidelines and provide formal feedback ( inspection is
free).
If feedback positive , fill license application forms . This
is done online via NDA – management information system
by the supervising pharmacist.
59
59
▪ Submit a complete application accompanied by the
following attachments;
1.Cetificate of incorporation of the company
2.Company Form 20 which shows that one of the
directors is a pharmacist
3.A copy of memorandum and Articles of Association of
the company
4. A sketch plan of the premises.
5.Certificate of registration of the supervising pharmacist
6.PSU Annual membership certificate of the pharmacist.
7.Commitment letter of the pharmacist
8.Certificate of registration/ enrollment of Auxiliary staff
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9.Commitment letter of the Auxiliary staff
10.TIN certificate of the company opening up the
pharmacy.
The application is then submitted
The application is then reviewed by the NDA.
Upon satisfaction , an invoice is sent by NDA via
NDAMIS, which can be downloaded by the pharmacist.
Make payment in the Bank.
Instill good dispensing practices e.g shelves, reference
books, etc
NDA will schedule for re-inspection and the
notification is received online.
The inspecting NDA officer will generate a report after
inspection, which approves the premises for Licensure.
License is then issued by NDA
61
Classification of Drugs
Classified drug
Means a class A, B, or C drug.
Restricted drug
Means a classified drug or any other drug
which is not an exempted drug.
Exempted drug
Means a drug in the fourth schedule of the
NDP & A
62
Schedules of the NDP/A act, 1993
1. First Schedule; Class A drugs or narcotics.
2. Second Schedule; Class B drugs or controlled drugs.
3. Third Schedule; Class C licensed drugs.
4. Fourth Schedule; Exempted drugs and articles.
5. Fifth Schedule; Diseases as to which publication of
descriptive matter is restricted or prohibited.
6. Sixth Schedule; Preparations that may be
manufactured by, or under the supervision of, a duly
qualified medical practitioner.
7. Seventh Schedule; Requirements as to the storage of
classified drugs.
8. Eighth Schedule; Consignment and transportation of
classified drugs.
63
First schedule
Also called Class A drugs or narcotics
➢They may be sold by retail only on the
prescription of a duly qualified medical
practitioner, dentist or veterinary surgeon, but
only for medical, dental or veterinary purposes
and may be supplied only by a registered
pharmacist or licensed pharmacy.
They include; Cocaine, Codeine, Heroin,
Opium, Pethidine, Morphine, Fentanyl, etc.
64
Second Schedule
Also called Class B drugs or controlled
drugs
➢These drugs may be supplied by retail only
on the prescription of a duly qualified medical
practitioner, dentist or veterinary surgeon,
but only for medical, dental or animal
treatment respectively.
They include: majority of antibiotics,
antineoplastic agents, barbiturates, CNS
drugs, antihypertensive agents, steroid
drugs, antidiabetic drugs, phenothiazines,
65 antiarrhythmic drugs, etc.
Third Schedule
Also Class C or licensed drugs.
67
Fifth schedule
It Lists diseases as to which publication
of descriptive matter is restricted or
prohibited.
These diseases include: gonorrhea,
syphilis, cancer, hernia, goiter, etc.
68
Sixth Schedule
It lists Preparations that may be
manufactured by, or under the
supervision of, a duly qualified
medical practitioner.
These include: preparations containing
extracts of pituitary, suprarenal,
thyroid, liver, pancreas or
parathyroid glands, or stomach.
69
Seventh Schedule
It lists Requirements for the storage of
classified drugs.
The drugs should be kept in a place accessible only
to the person in charge of the drugs, or to some
person under his or her immediate supervision.
All class A drugs and preparations should be stored
in an immovable $ lockable place/locker.
Class A, class B and class C drugs should be kept in
a part to which the general public does not normally
have access.
70
Eighth Schedule
❖Describes Consignment and transportation of
classified drugs.
Outside package of classified drugs should be
labelled conspicuously with the name or description
of the drug and a notice indicating that it is to be
kept separate from food and from empty food
containers.
Classified drugs should be prevented from
contaminating foods if transported in the same
vehicle.
71
The Allied Health Professionals Act.
72
The Allied Health Professionals Act.
Chapter 268 of the constitution
74
The functions of AHPC………..
6. Supervises the registration of allied health professionals
and the publication of the names of registered allied
health professionals in the Gazette.
7. Advises and makes recommendations to the
Government on matters relating to the allied health
professions.
8. Exercises general supervision and control over the
allied health professions and performs any other
function relating to those professions or incidental to
their practice.
9. Performs any other functions conferred upon it under
the Act or referred to it from time to time.
75
Composition of the AHPC
1. a chairperson who should be a senior allied health professional
appointed by the Minister.
2. a representative of the director general of the health
services.
3. the assistant commissioner of health services responsible
for allied health professionals.
4. one person representing each of the following professions
i) Dentistry ii) Pharmacy
iii) Clinical medicine iv) Physiotherapy
v) Public health vi) Radiography
vii) Medical laboratory technology viii) Orthopaedic
technology
5. a representative of the Medical and Dental Practitioners
Council;
6. a representative of the Nurses and Midwives Council;
7. one representative of all faculties of medicine of all
universities established in Uganda by law
8.
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a representative of the National Drug Authority.
Advisory boards of AHPC
❖ They include;
A pharmacy board, catering for dispensers;
A dentistry board catering for public health
dental officers and dental technologists.
A medical clinical officers board, catering for
medical clinical officers, anesthetic clinical officers,
ophthalmic clinical officers and psychiatric clinical
officers.
A medical laboratory technology board,
catering for laboratory technologists and laboratory
technicians.
77
Advisory boards of AHPC……
An orthopedic technology board, catering
for orthopedic clinical officers and orthopedic
technicians.
A physiotherapy board, catering for
physiotherapists and occupational therapists.
A public health board, catering for health
inspectors, health assistants and assistant
field officers for entomology.
A radiography board, catering for
radiographers.
78
Functions of the registrar.
The registrar shall be the chief executive officer of the AHPC
and the head of the secretariat and as such shall;
(a) keep and maintain the registers of the allied health
professionals
(b) make necessary alterations and corrections in the
registers in relation to any entry as may be directed by
AHPC from time to time
(c) remove from the register;
➢ the name of any person ordered to be removed under AHP
Act.
➢ the name of a deceased professional.
➢ any entry which may have been incorrectly or fraudulently
made in the register.
79
Functions of the registrar
(d) reinstate a name removed from the
register for a specified period and at the
request of the person concerned, after
payment of the prescribed fee;
(e) inspect and have full access, on behalf of
the council, to all allied health units licensed
under AHP Act;
(f) implement the decisions of the council;
(g) perform any other duty or function that
may be required AHPC
80
Removal from the register
The council may, after inquiry, cause to be
removed from the register the name of any
person;
➢who is convicted by a court of law of a
criminal offence involving moral turpitude
➢who is found guilty of professional
misconduct by the council
➢who is suspended from practice.
➢Who is deceased.
81
Establishing Suitability of Premises
and Locations
PHA-3204
82
Types of pharmaceutical premises
1. Premises for pharmaceutical
manufacturing
2. Premises for wholesale pharmacy
3. Premises for retail pharmacy
4. Premises for sale of class C drugs
83
Criteria for choosing a location for a
pharmaceutical premise
Type of pharmaceutical premise to be set up.
Availability of raw materials or supplies
Proximity to target market
Supply of labour
Transportation networks
Local regulations(NDA and NEMA regulations)
Environmental impact, waste disposal and safety
requirements
Future plans (is there a possibility for expansion?)
Capital
Competition
Cost of utilities
84 security
Characteristics of a good pharmaceutical
premise
The Pharmaceutical premise should have adequate
space to ensure proper storage and better work climate
The layout and fittings in respect of the storage of
medicinal products must facilitate their appropriate
storage and supervision of their sale or supply
Adequate heating, lighting and ventilation/air
conditioning should be provided to ensure the correct
storage and safe dispensing of medicinal products
within the pharmacy.
A suitable waiting area with seating option should be
provided for patients, giving consideration to the privacy
of others.
85
Characteristics of a good pharmaceutical
premise……………..
Pharmacies should have a separate, designated,
conveniently located patient consultation area to ensure
privacy.
All floors within the registered premises should be
undamaged, intact and with an even surface
It must be easily identifiable as a healthcare facility and
must reflect the professional nature of the premise.
Any signage used on the exterior of the pharmacy must
be clear, legible and not misleading
Must be secure
86
Importance of having a suitable
location for a pharmaceutical premise
A suitable location of a Pharmaceutical
premises ensure low operating and capital
costs
Clients can easily access the premise
Increase of profits for pharmaceutical
enterprise.
Creates a good relationship with the clients
A suitable pharmaceutical enterprise can
motivate the employees to work better to
87
achieve better outcomes
Importance of having a suitable
pharmaceutical premise ………
There is reduction in length of hauls and motions
between operations, which minimize production
time as well as the activities of workers.
Ensure more labor productivity
There is more safety and security to workers
from accidents.
Better working conditions resulting in improved
efficiency
Can act as form of advertising for the medical
drugs
88
Premises for pharmaceutical
manufacturing
89
Premises for pharmaceutical
manufacturing
Definition:
➢These are premises that deal in the
production of pharmaceutical products
on large scale.
90
Premises for pharmaceutical manufacturing:
Legal Requirements
❖Premises should be located in a place where
they can not be contaminated from the
external environment.
❖Premises should be of a permanent nature;
91
Premises for pharmaceutical manufacturing:
Legal Requirements
❖Premises to be in good repair and decoration.
93
Premises for a wholesale pharmacy
Definition:
➢These are premises that deal in the
sale of all classified drugs and other
pharmaceutical products to retail
outlets in large quantities
94
Premises for a wholesale
pharmacy: Legal Requirements
❖Premises should be of a permanent nature;
❖Premises should have sufficient space for the
carrying out and supervision of the necessary
operations;
❖Premises should have floors and walls made of a
washable and impervious material.
❖The dispensary must be a separate lockable area
with no access to the public
❖There should be a separate office or
administrative area for the pharmacist
95
Premises for wholesale pharmacy:
Legal Requirements
❖Premises should have at least one toilet not
shared with any other premises;
❖Pharmacy-only drugs should be separated from OTC
drugs;
❖Narcotic and psychotropic drugs should be kept in a
secure, fixed and lockable storage place.
❖The minimum floor area shall be at least 41 square
metres
96
Premises for a retail
pharmacy
97
Premises for a retail pharmacy
Definition:
➢These are premises that deal in the
sale of classified drugs and other
pharmaceutical products to final
consumers in small quantities
98
Premises for a retail pharmacy –legal
Requirements
❖Premises should be of a permanent nature;
❖Premises should have sufficient space for the
carrying out and supervision of the necessary
operations;
❖Premises should have floors and walls made of a
washable and impervious material.
❖The dispensary must be a separate lockable area
with no access to the public
❖There should be a separate office or
administrative area for the pharmacist
99
Premises for a retail pharmacy:
Legal Requirements
❖Premises to be in good repair and
decoration.
❖All materials and finished products should
be protected from light, heat and moisture,
❖Premises should have at least one toilet not
shared with any other premises;
100
Premises for a retail pharmacy…..
❖Premises should have at least one toilet
not shared with any other premises;
❖Pharmacy-only drugs should be separated
from OTC drugs;
❖Narcotic and psychotropic drugs should be
kept in a secure, fixed and lockable
storage place.
❖The minimum floor area shall be at least 20
square metres
101
Premises for sale of class C drugs
102
Premises for sale of class C drugs
Definition:
➢These are premises that deal in the
sale of only class C drugs to final
consumers in small quantities
103
Premises for sale of class C drugs:
Legal Requirements
❖Premises should be located in a place where they
cannot be contaminated from the external
environment.
❖Premises should have floors and walls made of a
washable and impervious material
❖Premises to be in good repair and decoration.
❖The minimum floor area shall be at least 20
square metres
❖
104
Premises for sale of class C drugs:
Legal Requirements……………..
❖Premises shall be of a permanent nature with
direct access to the public.
❖Premises shall not be shared with similar business.
105
Advertising new products / promotion
Drug promotion: refers to all informational and
persuasive activities by manufacturers and distributers
of drugs to induce the prescription, supply, purchase
and use of medicinal drugs. Its intent is to create
awareness among health professionals.
108
108
Advertising new products
Type of information that such advertisements should usually
contain, among others:
The name(s) of the active ingredient(s) using either
international nonproprietary names (INN),
The brand name;
Content of active ingredient(s),
Approved therapeutic uses;
Dosage form or regimen;
Side-effects and major adverse drug reactions;
Precautions,
Contra-indications and warnings;
Major interactions;
Name and address of manufacturer or distributor;
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END
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