PRAISE BE TO THE ALMIGHTY GOD

by,

Dr. G Praveen Kumar

Assistant Professor,
Department of Pharmacy practice,
C.L. Baid Metha College of Pharmacy.
Incharge-Drug Information Centre & Patient Counseling,
VHS(voluntary health care) hospital, Adayar, Chennai

Definition
ADMIN
PHYSICIANS

PATIENTS

GPP is the practice of

pharmacy that responds to the
needs of the people who use
the pharmacists services to
provide optimal, evidencebased care.
NATIONAL
GUIDELINES

Requirements of good
pharmacy practice
The core of pharmacy activity is to help patients
make the best use of medicines, through;
the supply of medication and other health-care products
of assured quality
the provision of appropriate information and advice to the
patient
administration of medication
the monitoring of the effects of medication use
the promotion of rational and economic prescribing, as
well as dispensing

 GPP requires that the objective of each element of

pharmacy service is relevant to the patient, is clearly defined
and is effectively communicated to all those involved.
Multidisciplinary collaboration(TEAM WORK) among healthcare professionals is the key factor for successfully
improving patient safety.

ROLES OF PHARMACIST
IN GPP
Prepare, obtain, store, secure, distribute,
administer, dispense and dispose of medical
products
Provide effective medication therapy management
Maintain and improve professional performance
Contribute to improve effectiveness of the healthcare system and public health
...WE ALREADY DID/DOING IT..

PYHSICIAN & PHARMACIST

RELATIONSHIP

PHARMACIST

LOOKS SPECIAL BUT ACTUALLY NOT

PHYSICIAN

LOOKS SIMPLE BUT

SPECIAL
(SPECIALITY)

HOW TO OVERCOME THIS?

ANS: SPECIALITY PHARMACIST

A STEP FORWARD..
PHARMACIST(dispensing) MUST GETS SPECIALIZED IN;
Drug information services
Medication error
Patient counselling

DRUG INFORMATION
SERVICES
Services which cover the activities of specially trained
individual to provide accurate, unbiased, factual information
in response to patient oriented drug problems that are
received from health care professionals.
The Drug Information Centre is a service offered through
Pharmacy department which provides advice and act as a
referral service by directing the best available resource to
respond to query or concern.

Simple logic.

Knowledge is of two kinds. We know a subject

ourselves, or we know where we can find
information upon it.
-Samuel Johnson (1709-1784)

Resources of DI
Primary resources: Research papers/Journal articles/Case
reports.
Secondary resource: abstracts, review articles, indexing
services such as DRUGDEX, Drug Information Database
and abstracting MEDLINE, MICROMEDIX, etc
Tertiary resources: Text books on various aspects of drug
use & practical guidelines.

Updated resources

Micromedex
FDA website
Medscape
webMD
Drugs.com(drug interaction checker)
Who guidelines
EBSCO journal services

What kind of information?

1. New Drug or its Product Information/Identification
2. Contraindications/Safety
3. Adverse Drug Reactions/Drug Interactions
4. Efficacy/Treatment/Choice of drug
5. Pregnancy/Lactation/Pediatrics
6. Drug Profile/Indications/Dosage/Pharmacokinetic information
7. Toxicology
8. Counselling information

MEDICATION ERRORS...

 Almost everyone in the modern world takes medication at

one time or another
Most of the time medications are beneficial
But some occasion they do harmful effects (side effects)
which is adverse drug events
But sometimes the harm is caused by an error in prescribing
or dispensing or administration of medication

TYPES

PRISCRIBING ERRORS
TRANSCRIBING ERRORS
DISPENSING ERRORS
ADMINISTRATION ERRORS

PRISCRIBING ERRORS
PHYSICIAN

WRONG DRUG OF CHOICE

WRONG DOSE
WRONG UNITS
WRONG FREQUENCY
WRONG DURATION

TRANSCRIBING ERRORS
PHARMACIST
WRONG ENTRY
WRONG TIME OF ENTRY
MISSING INFORMATION

DISPENSING ERRORS
PHARMACIST

Wrong assumption of prescription reading

Wrong dispensing of drugs/dose/dosage form/quantity
Look alike and sound alike drugs
Fail to give proper information to patients
Time factor

ADMINISTRATION
ERRORS

Missing drugs
Wrong route of administration
Wrong entry
Wrong reporting

PATIENT COUNSELING..

It is the pharmacists responsibility to ensure the patient

receives the required information for the quality use of
medicine. Counselling implies the communication of
information that would encourage therapeutic outcome

When there is a need?

The patient is new to the pharmacy
The medication is new to the patient or there is a change in
strength from a previous prescription
A prescription is for a child
Where there is a lack of or inadequate directions for use
A prescription for a drug with a narrow therapeutic index
(methotrexate, warfarin, digoxin, phenytoin) or a
prescription for a controlled drug.

 When a prescription is dispensed the pharmacist should be

satisfied that the patient understands how to use the
medication correctly.
Counselling provides an opportunity for the pharmacist to
discuss all aspects of the prescribed medicine with the
patient (or the patients carer) to ensure the desired
therapeutic effect is achieved.

Criteria

Language
Time
Knowledge
Surrounding
Terms/words used
Communication
Appropriate
Voice tone
Volume

Counselling must be
Listen to the patient
Speak distinctly and clearly (Tailor cut speech)
Use open ended questions

What is the need for using this medication?

When are you going to take the medication?
What side effects might you experience?
What will you do if that occurs?
What will you do if you miss a dose?

Regarding drugs.
Name of medication (brand/generic), dose, dosage form,
schedule
List precautions: e.g., use sunscreen, avoid milk
How to administer (PO, IM etc.)(before/after food)
Special directions (storage, dilution)
Necessary lab tests
GIVE WRITTEN INFORMATION TO PATIENT(if possible)

Exercise
Find the medication error on the following prescriptions ?
DYSLIPIDEMIA WITH HYPERTENSION
SL NO

1. 1

1. 2
1. 3

1. 4

1. 5
1. 6

DRUGS
T.ATORVA
(Atorvastatin)
T .ATEN
(Atenolol)
T. ENVAS
(Enalapril)
T.SORBITATE
(Isosorbide dinitrate )
INJ. Rantac
(Ranitidine)
T.Dolo
(Paracetamol)

DOSE

ROA

FREQUENCY

DURATION

10 mg

iv

1-0-0

X 7 Days

50 mg

P/O

1-0-0

X 7 Days

2.5 mg

P/O

0-0-1

X 7 Days

5 mg

P/O

1-1-1

X 7 Days

150 mg

P/O

1-0-1

X 7 Days

650 mg

P/O

1-0-1

X 7 Days

T.ATORVA-EZ(ATORVASTATIN+EZETIMIBE): It is given to reduce the

cholesterol levels in the blood. It should be taken once daily in the night. It can
cause abdominal discomfort, nausea, vomiting and flatulence.
T.ATEN (ATENOLOL): It is given to lower the blood pressure. It is to be taken
once daily in the morning after food. It can cause bradycardia, tiredness, cold
extremities, dizziness, nausea and vomiting
T.ENVAS (ENALAPRIL): It is given to lower the blood pressure and cardiac risk.
Each drug should be taken once daily at bed time. It can cause headache,
dizziness, cough, abdominal pain and nausea.
T.SORBITATE (ISOSORBIDE DINITRATE): It is given to reduce cardiac risk.
The tablet has to be taken 3 times a day. If tingling sensation is experienced with
drug placed sublingually, the tablet should be holded under buccal pouch.
T.RANTAC (RANITIDINE): It is given to reduce gastric irritation caused by other
drugs. Take the tablet half an hour before food.

Counselling regarding life

style modification.
Do regular checkups BP, Blood sugar level, ECG and Lipid
profile
Have a brisk walking at least for 30min /day
Take more of fruits, carbohydrates,
Reduce salt intake.
Avoid fat containing food.
Etc

THE BEST TAILOR

Three tailors came to a city on the same day and went to live on
the same street. The next morning one of them had a notice
outside his door: The best tailor in the city.
The morning after that the second tailor hung a bigger notice:
The best tailor in the world.
The third tailor was in a state of puzzle about what to do. How
could he beat the best tailor in the world?
Then a thought occurred to him and he smiled, Yes, that would
do! The next morning a crowd gathered around the notice he
had hung on his door, that said, The best tailor in the street.
All that matters is what you are doing NOW to help people
around you.

We TREAT
But
GOD
Heals...

PROVE and then Proud to

be a PHARMACIST

Stay Tuned
to the
Developing
Technology.

Thanks To the Almighty GOD

(Jesus Christ) & to all.