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lesson 5 Flashcards

1
Q

It is a continually revised compilation of
pharmaceuticals, which reflects the current clinical judgment of the medical staff and the relevant policies on medication.

A

Hospital Formulary

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2
Q

It is tailored to fit the particular
requirements of the hospital and reflects departmental consensus on first choice treatment from the national list essential drugs.

A

Hospital Formulary

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3
Q

A hospital formulary should be:

A

handy
complete
concise
easy to use

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4
Q

It is the process in which the list of drug products or formulary of the hospital is developed.

A

Hospital Formulary System

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5
Q

It is the method whereby the medical staff of an institution, working through
the Pharmacy and Therapeutics Committee, evaluates, appraises, and selects from among the numerous available medicinal agents and dosage forms those that are considered most useful in patient care.

A

Hospital Formulary System

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6
Q

It is a multidisciplinary process that is based on research and evidence to guide organizations on providing medications to patients.

A

Hospital Formulary System

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7
Q

The system provides the hospital pharmacists time to work with:

A
  • Medical Staff
  • Nursing Staff
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8
Q

The system provides the hospital pharmacists time to work with them in the selection, evaluation of new drug
products and critical use of therapeutic agents, and in the promotion of rational drug therapy

A

Medical Staff

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9
Q

The system provides the hospital pharmacists time to work with them to avoid practices and procedures
which may lead to medication errors

A

Nursing Staff

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10
Q

The system provides the hospital pharmacists time to work with them in the implementation of policies concerning the use of drug products in the hospital.

A

Medical and Nursing Staff

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11
Q

Objectives of the Hospital Formulary

A

 It serves to educate the physicians concerning the relative merits of the multitude of available medicines to provide rational therapeutics and promote quality patient care.

 It serves as a teaching aid to the interns and other medical staff
by providing essential information on a well-classified arrangement of therapeutically known medicines, which have been chosen after careful consideration by the medical staff.

 It prevents unnecessary duplication, wastage and confusion on prescribed medications thus promote savings both to the hospital and to the patient.

 It promotes safe, intelligent, and effective therapy in a hospital.

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12
Q

Potential Benefits of Hospital Formulary

A
  • Therapeutic
  • Economic
  • Educational
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13
Q

 It provides the greatest benefit to the patient and physician in that only the most efficient products are listed and available.

A

Therapeutic

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14
Q

 Merit a double benefit in that the formulary eliminates the duplication thus reducing inventory duplication and the opportunity for volume purchasing means lower charges to the patient.

A

Economic

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15
Q

 Significant for the resident staff, nurses and medical students because many good formularies contain various prescribing tips and additional drug information of educational value.

A

Educational

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16
Q

Guiding Principle Whether or not the local general and specialty staff considered the drug to be of proven clinical value based upon their experience with it.

A

First

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17
Q

Guiding Principle: May be that the drug must be recognized by the USP, NF, or their supplements.

A

Second

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18
Q

Guiding Principle: May be that the manufacturer of the drug must be
one of proven integrity and dependability as well as having the reputation of initiating and supporting
research activities of merit

A

Third

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19
Q

Guiding Principle: May be that no preparation of secret composition will be considered or admitted to the
formulary.

A

Fourth

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20
Q

Guiding Principle: May be deal with products of multiple composition.

A

Fifth

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21
Q

It is necessary to stock medicines listed in the _____, generic duplication should be eliminated.

A

Philippine National Drug Formulary

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22
Q

FACTORS to consider in preparing a Hospital Formulary (Part 1)

A

 A formulary list should be limited to conserve resources.

 It is necessary to stock medicines listed in the Philippine
National Drug Formulary, generic duplication should be
eliminated.

 Medicines should be selected based on disease and
conditions treated at the health facility.

 Medicines of choice should be selected comparing efficacy,
safety, toxicity, pharmacokinetic properties, bioequivalence,
pharmaceutical and therapeutic equivalence.

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23
Q

FACTORS to consider in preparing a Hospital Formulary

A

 Cost effectiveness should be a primary consideration.

 Once medicines of choice are selected, they form the basis
for standard treatment guidelines and for therapeutic substitution.

 Second line alternatives to medicines of choice may be included when necessary.

 The hospital formulary should correspond with the current
edition of the PNDF and to the approved standard treatment guidelines.

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24
Q

The Pharmacy and Therapeutics Committee of a hospital is responsible for ___, ____ and ____ its formulary.

A

compiling
maintaining
updating

25
Q

The committee consists of staff physicians, pharmacists, nurses and other health-care providers, as well as hospital administrators.

The committee chooses medications based on their effectiveness, their cost and the need for them at each particular hospital.

A
26
Q

The primary objectives of the formulary is to provide the hospital staff with the following:

A

 Information of what drug products have been approved for use by the Pharmacy and Therapeutics Committee.
 Basic therapeutic information about each approved item.
 Information on hospital policies and procedures governing the use of drugs.
 Special information about drugs such as dosing rules and nomograms, hospital-approved abbreviations, sodium content of various formulary items, etc.

27
Q

In accordance with these objectives, the formulary should consist of three (3) main parts:

A

I. Information on Hospital Policies and Procedures concerning drugs
II. Drug Product Listing
III. Special Information

28
Q

Information on Hospital Policies and Procedures concerning drugs

A

• Categories of drugs
• Brief description of the PTC
• Hospital Policies governing the Prescribing, Dispensing and Administration of drugs
• Pharmacy Operating Procedures
• Information on using the formulary

29
Q

Categories of drugs include:

A

Formulary Drugs
Investigational Drugs

30
Q

Brief description of the PTC, including its:

A

 Membership
 Responsibilities
 Operation

31
Q

Hospital Policies governing the Prescribing, Dispensing and Administration of drugs including:

A

 Policies to be followed by pharmaceutical company/supplier
representatives
 Standard drug administration times
 Reporting of adverse drug reactions
 Medication errors

32
Q

Pharmacy Operating Procedures such as:

A

 Hours of service
 Out-patient prescription policies
 Pharmacy charging system
 Prescription labelling and packaging practice
 In-patient drug distribution procedures
 Handling of drug information requests and other services
 Patient education programs
 Pharmacy bulletins

33
Q

Information on using the formulary, including:

A

 How the formulary entries are arranged
 Information contained in each entry and the procedures for
looking up the drug product
 Reference to sources of detailed information on formulary
drugs

34
Q

This part is the heart of the formulary. It consists of one or more descriptive entries for each formulary item plus one or more indexes to facilitate use of the formulary.

A

Drug Product Listing

35
Q

Drug Product Listing includes:

A

 Formulary Item Entries
 Indexes to the Drug Product Listing

36
Q

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;

A

Formulary Item Entries

37
Q

Dosage forms, as oral tablets and capsules, oral liquid/syrups/suspension, parenteral injectables as ampules/vials, etc.

A

Formulary Item Entries

38
Q

The type of information to be included in each entry will vary. At a minimum, each entry must include the following:

A

 Generic name of the basic drug entity or product/combination products;
 Common Synonyms and Brand Names;
 Dosage form(s), strength(s), packaging(s) and size(s) stocked by
Pharmacy;
 Formulation (active ingredients) of a combined product.

39
Q

Additional Information which may be part of the drug entries includes:

A

 Usual adult dose/pediatric ranges, or both;
 Special caution and notes such as “do not administer I.V.” or “refrigerated”;
 Controlled substances symbol;
 Cost information; this generally will be most useful where the therapeutic classification system is used or, alternately, lists of similar drugs (oral steroids) may be presented showing relative cost

40
Q

There are two indexes which can be included at the beginning
or end this section which will facilitate the use of the formulary.

A

 Generic Name-Brand/Synonym Cross index
 Therapeutic/Pharmacologic index

41
Q

The material to be included should be of general interest to the hospital staff not readily available in other sources

A

Special Information

42
Q

The material to be included should be of general interest to the hospital staff not readily available in other sources such as:

A

 List of Hospitals - approved abbreviations
 Metric conversion scales and tables
 Table of sodium content of antacids
 Rules for calculating pediatric dosages
 Dosage guides for patients with impaired renal functions
 Table of drug interactions
 Poison antidote charts
 List of content of emergency cart/boxes/cabinets
 Examples of formulary request forms and pediatric blanks
 Important provisions of the Generics Act on prescribing and
dispensing especially thorough erroneous, violative and
impossible prescriptions.

43
Q

 The formulary should be visually pleasing, understandable, and must appear professional.
 The need for proper grammar, punctuation, correct spelling and neatness is obvious. There is no one
single format or arrangement which all formularies must follow.

A
44
Q

A Typical Appearance might have this Composition:

A
  1. Title page
  2. Names and Titles on the members of the PTC
  3. Table of Contents
  4. Information on hospital policies and procedures
    concerning drugs
  5. Products accepted for use at the hospital
  6. Appendix
45
Q

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 worthy
of the cost of printing.

A
46
Q

In many institutions, a non-formulary drugs will not be dispensed from the out-patient pharmacy.

The patients are
instructed to obtain the medication from their local pharmacy.

With respect to in-patients, a physician is allowed to order a non-formulary drug for a specific patient by the use of a special non-formulary drug request form.

A
47
Q

It usually consists of listing of therapeutic agents by their: Generic names, strength, form, posology, toxicology, use, recommended quantity to be dispensed

A

Formulary

48
Q

It usually consists of listing therapeutic agents by their: Generic names, strength, form, recommended quantity
to be dispensed.

A

Drug List

49
Q

It can be kept current and can be
revised at will simply by printing, distributing and inserting the
necessary page or pages.

A

Loose-leaf Formulary

50
Q

It is difficult to keep up-to-date and therefore requires more frequent revision.

A

Bound Volume

51
Q

With respect to in-patients, a physician is allowed to order a non-formulary drug for a specific patient by the use of a:

A

special non-formulary drug request form

52
Q

It should be limited to conserve resources.

A

formulary list

53
Q

Medicines should be selected based on ____ treated at the health facility.

A

disease and conditions

54
Q

It should be a primary consideration in preparing hospital formulary

A

Cost effectiveness

55
Q

Once medicines of choice are selected, they form the basis for ___ and for ——.

A

standard treatment guidelines

therapeutic substitution

56
Q

_____ to medicines of choice may be
included when necessary.

A

Second line alternatives

57
Q

The hospital formulary should correspond with the ___ and to the approved standard treatment
guidelines.

A

current edition of the PNDF

58
Q

include such items as restrictions on
use and procedures for requesting that drug should be added
to the formulary

A

Investigational Drugs

HP (11 decks)

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