Professional Documents
Culture Documents
HOSPITAL FORMULARY
It is a continually revised compilation of pharmaceuticals that reflects the current clinical judgment of the MS A Hospital formulary is useful to the Medical Staff since without this, they would become dependent on the exaggerated claims of the medical salesman.
2. ECONOMICAL Prevents unnecessary duplication, waste, confusion and thus, promote economy both to the hospital and to the patient 3. THERAPEUTIC Promote safe, intelligent and effective therapy in the hospital
HOSPITAL FORMULARY
Formulary service gives the hospital Pharmacist the following opportunities: 1. Time to work with the medical staff in the selective evaluation of new drugs. 2. Time to organize and plan for interesting and stimulating meetings of the PTC. 3. Time to work with the nursing staff in the elimination of practices and procedures, which may lead to medication errors. 4. Time to encourage the medical staff to undertake an objective audit of the discriminate use of the therapeutic agents and to enter other areas for promotion of rational drug therapy. 5. Time to cooperate with the medical staff and nursing staff in numerous areas involving broad policies concerning the use of drugs in the hospital.
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For specialized patient Investigational Drug BFAD approved for specific use by principal investigator Not commercially available
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Brief description of the PTC, including its membership, responsibilities and operations. Hospital policies governing the prescribing, dispensing and administration of drugs including policies to be followed by pharmaceutical company/ suppliers representative, standard administration, reporting of ADR and medication errors Pharmacy operating procedures such as hours of service, out-patient prescription policies, pharmacy charging system, prescription labeling and packaging practices, in-patient drug distribution procedures, the handling of drug information request and other services as patient education programs and pharmacy bulletins Information on using the formulary, including how the formulary entries are arranged, the information contained I each entry and the procedures for looking up a given drug product. Reference to source of detailed information on the formulary drugs should be included here.
2. Drug Product Listing This part is the heart of the formulary. It consists of one or more descriptive entries for each formulary items plus one or more indexes to facilitate use of the formulary. Formulary Item Entries can be arranged in several ways: 1. Alphabetically, generic name 2. Alphabetically, within therapeutic class 3. A combination of the two systems whereby the bulk of the drugs are contained alphabetically in a general section which is supplemented by several special sections such as ophthalmic/ otic drugs, dermatological and diagnostic agents. 4. Dosage form as oral tablets and capsules, oral liquids/ syrups/suspension/ parenteral injectables as ampules/ vials, etc. Each drug entry must include the following information: 1. Generic name of the basic drug entity or product/combination products. 2. Dosage form(s), strength(s), packaging (s) and size(s) stocked by pharmacy. 3. Formulation (active ingredients) of a combined product Indexes to the Drug Products Listing There are two indexes which can be included which will facilitate the use of the formulary: 1. Generic name of drug items 2. Therapeutic / Pharmacologic index
3|P age Lecture Notes in Internship 2 /G.G.G.
Index is a listing of all drug items within each therapeutic category. It is useful in ascertaining what therapeutic alternatives exist for a given situation such as patient allergy to a particular drug. 3. Specific Information The material to be included should be of general interest to the hospital staff not readily available in other sources such as: 1. List of Hospitals-approved abbreviations 2. Rules for calculating pediatric dosages 3. Table of sodium content of antacids 4. List of the contents of emergency cart/boxes/cabinets 5. Dosage guides for patients with impaired renal functions 6. Metric conversion scales and tables 7. Examples of formulary request forms and prescription blanks 8. Important provisions of the Generic act on prescribing and dispensing especially thorough erroneous, violative and impossible prescriptions 9. Tables of drug interactions 10. Poison antidote chart
Format
The format is extremely important since it will determine the practicality of daily use of the formulary as well as the publishing costs Experience has shown that a formulary which is sufficiently small in size to permit its being carried in a uniform or laboratory coat pocket will, in all probability, enjoy widespread use in the hospital. A small sized book also can be carried in the doctors bag along with his prescription. The most important of these is the ease by which a loose-leaf formulary can be kept current. A bound volume is difficult to keep up- to date and therefore requires more frequent revision A printed formulary is obviously more esthetic in appearance, easier to read and imparts to the user the impression that the hospital considers the formulary as an extremely important document and therefore of the cost printing
Size
Printed Vs Mimeographed
A typical formulary have this composition: 1. Title page 2. Names and titles of the members of the PTC 3. Table of contents 4. Information on hospital policies and procedures concerning drugs a. Objectives and operation of the formulary system. b. Hospital regulations and procedures for prescribing and dispensing drugs c. Hospital pharmacy services and procedures. d. Directions on how to use the formulary
4|P age Lecture Notes in Internship 2 /G.G.G.
5. Products accepted for use at the hospital a. Items added, deleted and requested for inclusion to PNDF consistent with the revision made by the NDF. b. Pharmacologic/ Therapeutic indexes. c. Description of FD products by pharmacologic/ therapeutic class 6. Appendix a. Rules for calculating pediatric doses b. Schedule of standard administration times c. Forms of addition to/ deletion from formulary and other important forms
2. Quality- each selected drug must be available in a form in which adequate quality, including bioavailability can be assured. 3. Relative Benefits applied to drugs which appear to be similar in the above respects. 4. Cost Benefit considers the cost of the total treatment and not only the unit cost of the drug. 5. Pharmacologic Advantages and Availability consider factors such as comparative pharmacokinetic properties or by local considerations such as availability of facilities for manufacture and storage. 6. Rational Formulation most essential drugs should be as single compound formulations. Fixed-ratio combination products are acceptable only when the dosage of each ingredient meets the requirements of a defined population group and when the combination has proven advantage over single compounds administered separately in therapeutic effect, safety and compliance.