Q.

1) Define and classify hospital ( 10 20 30 Or clinical and non-clinical)

Ans:-
I) Hospital
• “Hospital is very complex organization with an aim of restoration and
maintenance of good health.”
Or
• “Hospital is define as….institution that provides community health, where
diagnosis therapy, training and social services are provided.”

II) Classification based on type of patients Care

1) Primary hospital
2) Secondary hospital
3) Tertiary hospital

1) Primary Hospital
• Primary hospital focus on basic healthcare services
• Maintain health issues faced by individuals
• Care does not required specialist
• Health issues solve by general physician
• The goal is to make general health solution

2) Secondary Hospital
• Secondary hospital includes specialist like
i) Cardiologist
ii) Dermatologist
• Secondary hospital provide advance medical care
• Patients reach out by the reference Of primary healthcare professionals

3) Tertiary Hospital
• This includes highly specialized services
• Also includes super-specialist like
i) Neuro Surgery
ii) Plastic surgery
iii) Heart surgery
III) Classification Based on Clinical -Non-Clinical basis
Q 2) Explain organization Structure of hospital including functions of medical
staff in hospital.
Ans – I) Organization Structure of Hospital –
• The successful hospital is based upon good community oriented planning ,
good design and construction and good administration.
• A progressive hospital will build it’s services on certain knowledge of
community on its serve.
• The ultimate aim of the hospital is to provide optimum health care

II) Common categorical grouping –

1. Administrative services.
2. Informational services.
3. Therapeutic services.
4. Diagnostic services.
5. Support services
1. Administrative services –
• Plan and coordinate departmental activities
• Establish hospital policies and procedures
• Oversee budgeting and finance.
2. Informational services –
• Documents and process information
• Billings and collection department
• Medical record.
3. Therapeutic services –
• Provides treatment to patients.
• Physical therapy
• Occupational therapy
4. Diagnostic services –
• Determine causes of illness or injury
• Medical laboratory – study of body tissues is carried out in laboratory.
• Emergency medicine – provides emergency diagnosis & treatment for
accidental patients.
5. Support services – provide support to entire hospital
• Central supply • Housekeeping and maintenances
III ) Medical staff and their functions -
• Medical staff responsible for all medical care to be provided to the
patients.
• The key roles for staff in hospital categories into four areas being .
1. Doctors
2. Nurses
3. Allied health professionals
4. Support staff
1. Doctors -
• Doctors have different roles and responsibilities based on their level of
experience and their medical speciality.
✓The roles includes –
a) Senior consultant
b) Registrar’s
c) Residents
d) Student doctors
2. Nurses –
• Manage your ongoing care and treatment in hospital.
• They assess , plan and administer your daily treatment and manage your
general health.
• Specialist nurses , such as clinical nurse specialist, clinical nurse
consultants , emergency department nurses
3. Allied health professionals –
• Are University – educated practitioners who work as part of your
multidisciplinary health care team
• Example – occupational therapist , pharmacist , physiotherapist
4. Other hospitals staff –
• Clinical assistant
• Patients services assistant
• Volunteers
• Ward clerks
Q. 3) Hospital Pharmacy and its organization
( Responsibilities of Hospital Pharmacist)
Ans:-
I) Introduction to the Hospital Pharmacy
• Hospital Pharmacy is department which provides pharmaceutical services to
the outdoor and indoor patients
• This department handle by legally qualified pharmacist
Or
• Hospital Pharmacy is defined as department of hospital where storage
compounding , dispensing or distribution of medicine is done under qualified
pharmacist

II) objectives
• To Render services in professional manner
• To work with ethics
• To implement policies and standard given by PTC
• To ensure regular supply of medicine
• To appoint skilled and train pharmacist

III) function of Hospital Pharmacy

• To provide evaluate pharmaceutical services
• To draw plan for hospital Pharmacy administration
• Forecast of demand
• Selection of reliable suppliers
• Prescribing specifications of the required medicament
• Dispensing of medicaments to out-patients
• Drug information source in hospitals
• Centre for drug utilization studies
• Implement recommendations of PTC
• Patient Counselling
• Maintaining liaison between medical, nursing and the patient.

IV) Layout for Hospital Pharmacy

• Pharmacy must be on ground floor
• In multi story hospital, each floor should have pharmacy
• It must have enough space for outdoor patients
• Layout of pharmacy consist of
- Washing facility
- Storage for bulk solution
- Sufficient seating facility
- Storage of poison and narcotic drugs
- Fire control

V) Responsibility and functions of Hospital Pharmacist

• Dispensing for medication
• Hospital pharmacist is great source of advice for patients
• Quality testing of medicine
• Monitoring and reporting drug safety
• Preparing budget for medication
• Medicine management
• Monitoring drug charts
• Discharging patients
Q. 4) Define and classify Adverse Drug Reaction (ADR)
Ans:-
I) Adverse Drug Reaction
• Unwanted or harmful reaction experienced after the administration of a
drug or combination of drugs under normal conditions of use.

II) Classification of ADR

• Classified into 6 types
1) Excessive pharmacological Effect
2) Secondary pharmacological Effect
3) Idiosyncrasy
4) Allergic drug Reaction
5) Genetically determined toxicity
6) Toxicity following drug withdrawal

1) Excessive pharmacological Effect

• Effect of high dose is observed in
- Patients with CNS depressants
- Patients with 70% kidney failure
- Cardioactive patients

2) Secondary pharmacological Effect

• Observed in patients who consume OTC drug
• And self medicating patients

3) Idiosyncrasy
• This are unexpected drug Reaction
• It is qualitative drug Reaction
• Drug induced foetal abnormalities

4) Allergic Drug Reaction

• This are Common unpredictable Reaction
• Also called hypersensitivity Reaction
• Occurs when drug act as antigen
5) Genetically determined toxicity
• Drug produce toxic effects due to hereditary disorder
• Susceptible for specific Drugs e.g. Isoniazid
 6) Toxicity following drug withdrawal
• Group of symptoms occurs due to discontinuation or decrease in intake of
medication
• Withdrawal Symptoms depend on type of drugs
• Common withdrawal symptoms Are Change in appetite , nausea, muscle
pain, vomiting, sweating, changes in mood

III) Drug reactions may also be classified as :

1) Type A:
• Dose-related reactions
• adverse effects at either normal dose or overdose

2) Type B:
• Non-dose-related reactions
• any exposure is enough to trigger such a reaction

3) Type C:
• Dose and time-related reactions
• Due to dose accumulation, or with prolonged use

4) Type D:
• Time related reactions
• Due to prolonged use in a drug which doesn't tend to accumulate

5) Type E:
• Withdrawal reactions,
• the undesired effects of ceasing the drug (for example, opiate withdrawal)

6) Type F:
• Unexpected failure of therapy,
• where a drug undesirably increases or decreases in efficacy
Q.5) Drug interaction, pharmacokinetic drug interaction with example
Ans:-
I) Introduction
• Drug interaction is defined as….the pharmacological activity of one drug is altered by the
Concomitant use of another drug or by the presence of some other substance
• Occur inside or outside the body called as in-vivo and in-vitro drug interactions
II) Types of drug interaction :-
1) Drug-drug interactions.
2) Drug-food interactions.
3) Chemical-drug interactions.
4) Drug-laboratory test interactions.
5) Drug-disease interactions.
III) Pharmacokinetic Interaction:-
• Most drug interactions involve an alteration in the pharmacokinetics of the drug.
• Probably no 'overlap in the therapeutic effects of the two drugs.
IV) Classification of pharmacokinetic drug interactions
1) Absorption interactions
2) Distribution interactions.
3) Metabolism interactions.
4) Excretion interactions.
1) Absorption interactions
• In which absorption of the drug is altered.
• effect interaction is:
- Faster or slower drug absorption.
- More, or, less complete drug absorption.
2) Distribution interactions
• Distribution pattern of drug is altered
• alteration in protein-drug binding.
3) Metabolism interactions
• In which metabolism of drug is altered.
• Enzyme induction: increased rate of metabolism
• Enzyme inhibition: decreased rate of metabolism.
4) Excretion interactions
• In which excretion pattern of the object drug is altered.
• Alteration in renal flow
Q.6) write a Note on Adverse drug Reaction Reporting and Managements
Ans:-
I) ADR (Adverse drug Reaction)
• ADR is defined as any harm associated with the use of given drugs at a
normal dosage during normal use.
• ADRs may occur due to
- single dose
- prolonged administration of a drug
- combination of two or more drug

II) Adverse event reporting and management:-

• Adverse Event (AE) reporting involves:-
- receipt, triage, data entry, assessment, distribution, reporting and
archiving of AE data and documentation.
• Management:-
1) Confirmation of ADRs
2) Mention the criteria (regarding reaction as serious)
3) Mention any treatment given (after experiencing ADRs)

Q. 7) Genetically Determined Toxicity

Ans:-
• It is type of adverse Drug reaction
• This type of toxicity occurs in patients with hereditary disorder parents
• The drug produces toxic effects because of hereditary disorder
• The metabolic pathway in liver is altered, those patients of selected genetic
characters are susceptible for specific drugs e.g. Isoniazid.
• genetically determined toxicity includes
1) Patients with porphyria are susceptible to CNS depression agents like
barbiturates.
2) Individual with psuedocholinestrase deficiency is highly susceptible to
succinylcholine. They may develop paralysis and often apnoea.
Q. 8) Methods of Detecting Adverse Drug reaction and controlling them
Ans:- I) Adverse Drug Reaction
• Unwanted or harmful reaction experienced after the administration of
drug or combination of drugs under normal conditions of use.
• There are many factors responsible for adverse effects of drug in patients
receiving it
II) Methods of Detecting adverse drug reaction
1) Spontaneous Case Reports
2) Vital statistics and records linkage studies
3) Cohort Studies
4) Case control studies

Q. 9) Community Pharmacy
Ans:-
I) Community pharmacy –
• also known as retail pharmacy,
• it is the most common type of pharmacy
• Community pharmacy allows the public access to their medications and
advice about their health.
II) Scope of Community Pharmacy
• Advancement in research and Technology
• Population explosion – insufficient medical facilities
• Disease prevention
• Health promotion in society
• Drug information about their actions.
• Drug utilization
• Health care professionals

III) Structure of community pharmacy

1) Selection of pharmacy site -
• A needy town or city should be selected.
• The site available must be most suitable in city.
• Free parking facility.
2) Plant location
• Nearness to raw material
• Transport facilities
• Nearness to Market
2) Layout and design
• Layout for retail shop
• Layout for wholesale shop
Q. 10) Drug Distribution System in Hospital
Ans:- I) Drug Distribution
• Drug distribution is defined as, "Physical transfer of drugs from storage area in
the hospital to the patient's bedside".
• This involves two types of drug distribution. They are:
1) In-patient distribution
2) Out-patient distribution

1) In-patient Distribution
• The drug dispensing area is same for in-patient and outpatient
• The pharmacist involved in drug dispensing is also same for in-patient and
outpatients
• The pharmacist must be skilled and qualified
2) Out-patient Distribution
• Out patients are the patients who not occupying bed in hospital
• No medicine should be issue without prescription
• Out patients department also called as OPD

II) Types/ Methods of Drug Distribution System

1) Individual prescription order system
2) Complete floor stock system
3) Combination of individual and floor stock system
4) Unit Dose dispensing

1) Individual Prescription Order system

• It is a type of prescription System
• In which physician write prescription for individual patients
• Then patients purchase drug from medical store or hospital dispensary as per
prescription
• This system generally use in small hospital

2) Complete Floor stock System

• Drugs given to the patient through Nursing station
• And the pharmacy supplies from the drug store of hospital
• There are two types of complete Floor stock system
a) Charge floor stock system
b) Non floor stock system
 c) Drug Basket method
d) Mobile dispensary unit

3) Combination of individual and floor stock system

• This system followed by government as well as private hospital
• Runs on the basis of no profit no loss
• The dispensing is done under supervision of registered nurse

4) Unit dose dispensing

• In this system, the multiples of single dose administration of medication are
prepared by pharmacist or nurses
• single unit package is one which contains one complete pharmaceutical
dosage form.
• Pharmacist prepares every dose of medication ready for administration.
Example one Tablet, Capsule.
Q. 11) Explain in Details about Hospital Formulary?
Ans:-
I) Hospital Formulary
• Hospital Pharmacy is the….method by which physicians and pharmacists,
working through a Pharmacy and Therapeutics Committee of the medical staff
which evaluate and select medications for use in a hospital

II) objective
• Provide information on drugs which are selected for use in hospital
• provide basic information about each selected drug
• Provide information about the use of medicines
• Provide information about hospital policies and procedures

III) preparation of Hospital Formulary

• It is responsibility of Pharmacy and therapeutic committee
• Committee make all necessary decision regarding material include in
formulary
• It must be Visually pleasing, easily readable and professional in
appearance.
• A typical formulary must have the following composition;
1) Title page
2) Names & titles of the members of the PTC
3) Table of contents
4) Information on hospital policies & concerning drugs policies &
procedures
5) Products accepted for use at hospital
6) Appendix

IV) Content of hospital Formulary

1) Introduction
• List of abbreviations
• List of drugs used in the formulary

2) Basic information on each drug

• Efficacy for the treatment of specific conditions
• Safety profile of the item Interaction profile
• Adverse effects
 • Pharmacokinetic profile
• Availability of the item
• Available dosage form
• Cost
• Acceptability to patients
3) Supplementary information on each drug
• Storage guidelines
• Patient counselling information
• Labelling information
• Brand names and prices
4) Prescribing and dispensing guidelines
• Principles of prescription writing
• Reporting of ADR
• Prevention of ADR
5) General drug use and advice
• Use of IV drugs
• Special situations like pregnancy, breast feeding, liver/kidney disease
• Poisoning information and antidotes
• Treatment of snakebites and insect bites
6) Miscellaneous section
• Children’s dose
• Renal Adjustments
• Metric units
• Diagnostic aids
Q. 12) Factors Affecting Therapeutic Drug Monitoring ( TDM )
Ans:-
I) TDM
• Therapeutic drug monitoring (TDM) is defined as the management of a
patient’s drug regimen based on the serum, plasma, or whole blood
concentration of a drug.

II) Factors affecting Drug Monitoring (TDM)

1) Pregnancy
2) Age
3) Disease State
4) Free drug monitoring
5) Active metabolites
6) Dosage regimen
7) Use of saliva in drug monitoring
8) Cost effectiveness

III) Factors affecting Drug Monitoring are explain below

1) Pregnancy
• Pregnancy affects Pharmacokinetics and drug management
• Plasma drug levels of phenytoin is reduce during pregnancy.
2) Age
• Variability in response to drug in extremes age
• Elderly patients are more sensitive to CNS depressant effect of drug
• Young children are more sensitive to CNS depression effect of morphine
3) Disease States
• Acute or chronic disease alters drug clearance patterns
• Severity of disease affects the TDM
4) Free Drug Monitoring
• New filtration device make possible to measure free unbound drug level in
serum
5) Active Metabolism
• Many drug are bio transformed into compounds that are pharmacologically
active
6) Dosage regimen
• It is one of the important factors considering during TDM
Q 13) write a detailed note on term community pharmacy management
Ans
I) Community pharmacy –
• also known as retail pharmacy,
• it is the most common type of pharmacy
• Community pharmacy allows the public access to their medications and
advice about their health.
II) Community Pharmacy Management – ( CPM )
• represents all activities involved in the organization
• Also represent direction of getting people together
• Ans accomplish desired goals and objectives of pharmacy enterprisers

1) Financial management
• It involves capital investments
• Expenditure made during a particular time to improve long term assets
• Such as buildings , dispensing equipment
• It’s necessary for paying bills , making changes and other financial
transactions
#_Importance –
• Helps in successful development of business
• Helps in forecast of future funds
• Efficient direction of business .
2) Risk management
• Risk is the possibility of losing something of value.
• Types of risk – 1. market risk 2. Exogenous risk
• Common method - 1. Avoiding risk 2. Reducing risk
3) Insurances –
• Protection from financial loss
• Based on law of probability
• Types of insurance –
3) Life insurance.
4) General insurance
• Advantages – protection against risk of loss
• Makes secured , stable , and risk free business
• Insurance generates employment opportunities.
Q. 14) Described patients medication history interview.
Ans A) Introduction :-
• A medication history is a detailed , accurate and complete account of all prescribed and
non prescribed medication that taken by patients .
• Provides pharmacological and non pharmacological treatment.
• Interviewing a patient in collecting the data medical history is called medication history
interview.
B) Goals of patients medication history interview –
• Is obtained information on aspects of drug use that may assist in overall care of
patients.
• Compare medication profile with medication administration record .
• Examine the needs for medication aids
C) Data to be obtained –
1. Demographics information –
• Age / date of birth • Height and weight
• Types of residence • education • Occupation
2. Dietary information
• Dietary restriction. • Dietary supplement
• Dietary stimulants. • Dietary suppressant
3. Current prescription medications
• Name • Dose
• Dose schedule • Reason for taking medication
• Start date • Outcome of therapy
4. Past prescription medications
• Name • Dose
• Dose schedule. • Reasons for taking medication
• Start date • stop date
• Reason for stopping • Outcome of therapy
5. Allergies
• Drug name and description • Date of reaction
• Dose • Description of reaction
• Treatment of reaction
6. Adverse drug reactions
• Drug name and description. • Dose
• Date of reaction • Description of reaction
• Treatment of reaction
Q 15 ) Causes of medication adherence and role of pharmacist in it

Ans. A) Medication adherence –

• Medication adherence or taking medication correctly.

• Whether patients take their medications as prescribed (eg, twice daily), as
well as whether they continue to take a prescribed medication
• Determine therapeutic outcomes , specially patients suffering from chronic
disease.
B) role of pharmacist in it –

1. Show the medication to the patients and relate any information to the
medication itself.
2. Provide verbal education and written individualized information for the
patients.
3. The patients received both oral education and written instructions in
the local language about their disease

✓ The information that patients need to know pharmacist –

• Name and purpose of the drug

• When and how to take the medication
• Possible side effects
• Precautions
• Interaction with food or other drugs
• Duration of therapy
• Action to take if a dose is missed
Q. 16) pharmacy and therapeutic Committee (PTC)
Ans:-
I) Pharmacy and therapeutic committee
• It is a Group of medical staff
• Serve as Communication between medical staff and pharmacy department
• PTC is the body which has Responsibility to ensure the safe and effective
use of the drugs products.

II) Purpose of committee

1) Educational
• Provide knowledge about drug
• Which is helpful for medical staff
2) Advisory
• Helping in preparation of polices regarding
- Evaluation, selection and therapeutic use of drug

III) Structure of Organization

• Depend on size and location of hospital
• Vary from hospital to hospital
• PTC is composed of
3) Pharmacist
4) At least three physicians
5) Nurse representative
6) Hospital administrator
• Chairman appointed from physician
• Meeting of committee prepare by Secretary
• At least 6 meetings are conducted per year
• Maintain records of hospital

IV) Function and scope of PTC

• PTC develop and rectifies hospital formulary
• Advise medical staff in therapeutic use of drugs
• Study problem about administration of drug
• Study of adverse drug reaction observed in hospital
• To develop and assemble formulary of drug
• Study problem related to
- Drug Administration
 - Distribution
- Drug reaction
- Drug storage
- Drug uses
• PTC Advice to pharmacy regarding
- Drug distribution

V) Committee agenda
• A typical agenda consists of following:
1. Minutes of previous meeting.
2. Listing of new drugs which are commercially available.
3. Use of investigational drugs in hospitals.
4. Review of specific section of formulary
5. updating and deletion products.
6. Drug safety in hospital
7. Review of :-
- Adverse drug interactions
- Toxic effects of drug
- Side effects of drug
8. Reports of medical Audits
Q. 17) Drug Information Service and source Of Information
Ans:-
I) Drug Information Service
• Now a days new drugs are developed for treatment of disease like cancer and
HIV
• Physician must know about current knowledge of medicine
• This service provide knowledge of new and current drugs
• Helpful for physician and medical staff
• The information about drug is provided in the form of library
• “Drug information” First time introduced in early sixties
• Drug information centre provide following information
1) Dosing schedule, dosing and routes of drug administration
2) Drug product availability
3) Drug identification
4) Drug interactions
5) Drug stability and compatibility
6) Adverse drug reactions and side effects
7) Therapeutic alternatives
8) Investigational drug information
9) Pharmacokinetic information
10) General therapeutic information
II) Sources of Information
• Drug information centre possess good collection of source material
• This should be continuously updated and maintained
• Source of information are :-
1) Primary source of Information
2) Secondary source of Information
3) Tertiary source of Information
4) Other source
5) Computerised service

1) Primary source of Information

• Manufacturers and researchers materials
• Some journals report research, scientific journals, other information on
new development and express view points.
• This Information act as primary source of Information
2) Secondary Source of Information
• It includes Chemical abstract, Biological abstract, International
Pharmaceutical abstract, Index medicos, Medicinal and Aromatic Plant
abstract, etc.
• These abstracts are divided in three types:
a) Indicative abstract
b) Telegraphic abstract
c) Informative abstract

3) Tertiary Source of Information

• Dictionary and encyclopaedia are the tertiary source of Information
Q 18) Define patients Counseling and steps involved in patients counseling. OR
Discuss role of pharmacist in patients counseling.
Ans.
I) Definition –
• Patient counselling refers to the process of providing vital information,
advice and assistance to help you with your medications and to ensure you
take them properly.
• This also includes important information about the patient's illness and
lifestyle.

II) Steps involved in patients counselling –

• Counselling is the two way communication process.
• And interaction between the patients and the pharmacist
• It includes four steps as..
1. Preparing for the session. 3. Counseling content
2. Openings the session. 4.closing the session
I) Preparing the session –
• The success of counseling depends on the knowledge & skill of the
counsellor.
• The pharmacist knows about patients and his treatment details.
II) Openings the session –
• The pharmacist should introduce him or herself to the patients
• The pharmacist should identify the purpose the session very clearly
• For ex. Hello Mr. XYZ I am mangesh , your pharmacist
• I would like to tell you about your medication.
III) Counseling content –
• Name and strength of medication
• How to take the medication
• Expected duration of the treatment
• Expected benefits of the treatment
• Possible adverse effects
IV) Closing the session –
• Cleared the new question and doubts
• Pharmacist can supply their telephone numbers to encourage the
patients to make contact if they need advice or information
Q19 ) write the role of pharmacist in the education and training program.
Ans.
I) Role of pharmacist in the education and training program

1) Role in Training program –

• Pharmacy is a great career of choice , therefore , pharmacist are the experts
on drug therapy.
• Pharmacist are also primary health professionals
• Use of medication for the benefit of the patients
• Patients can talk face to face , without an appointment
• Ask health related questions

2) Roll in Education program

• Offering continuous education CE program to pharmacist , physicians , nurses.
• Training pharmacy students ( internship)
• Providing residency program
• Hospital pharmacist participate in research conducted in the hospital

II) Education and training division –

1) Coordinate program of undergraduate and graduate pharmacy students.
2) Participate in hospital wide education program involving nurses , doctors
etc.
3) Train newly employed pharmacy department personnel .
4) Pharmacy profession plays main role in discovery , development production
and distribution of drug products and related knowledge.
Q. 20) Prescribe medication order and communication skill
Ans:-
I) Medication Oder
• A medication order is written by a practitioner for a medication that will be
administered
• Prescriber communicate with pharmacist by medication order
• Medication order is Similar to the prescription
• Medication order is a legal documents kept up to 2 years
• Medication Order Generally contain:-
1) Patients Name and location
2) Medication generic Name
3) Dosage and route of administration
4) Signature of physician
5) Date
II) Communication Skill
• Communication is sharing of ideas , thought , information, and feeling etc.
• Good Communication skill is require to communicate with patients
• Poor communications skill leads to
- Inaccurate patients medication history
- Wrong therapeutic decision
- Patients confusion
- Patients non compliance
• Types of Communication
1) Verbal Communication
o It includes ability to listen understand and respond to what people say
o Verbal Communication consists of
i) Active listening
ii) Observation and assessment
iii) Language
2) Non verbal Communication
• Communication done by body language
• This communication consist of
i) Eye contact
ii) Face expression
iii) Body posture
Q.21) write a note on Budget preparation and implementation
Ans:-
I) Budget
• Budget is define as… . Financial or quantitative statement prepared for the
purpose of attaining given objectives
• Budget preparation is important for management of hospital

II) objective of Budget preparation

• Analysis of deviation
• Development of standards
• Enhance efficiency of staffs
• Helps to focus on hospital priorities.
• manage financial aspects of hospital.
• Develop better financial planning.

III) Types of budget preparation

• it can be divided in to:
1) Short term budget (2 years)
2) Long term budget (5 - 10 years)

IV) division of budgets:

• It consists of three parts
1) Income accounts or revenue accounts
2) Expenditure accounts
3) Asking for capital investments

V) Implementation of budget:
1) Actual fund position
2) Utility of particular item
3) Cost of products
4) Quantity of products

VI) Advantages of planning the budget:

• Develop better financial planning.
• Manage Financial aspects of hospital...
• Helps to focus on hospital priorities
• Enhance efficiency of staffs and others.
Q. 22) Write short Note on Clinical Pharmacy
Ans:-
A) Introduction to clinical Pharmacy
• Clinical pharmacy is the branch of pharmacy that deals with the Care of patient using
medications to optimize health of patients
• Clinical pharmacy provide patient Care
• promoting wellness and preventing disease.

B) History
• The term clinical pharmacy was First used in 1953.
• The concept of Clinical pharmacology Started in 1960
• Two major incidences.
1) Thalidomide tragedy
• Happened in 1962
• Consumption of Thalidomide leads to birth of babies with sealed limbs
2) phenytoin toxicity.
• Reported in Australia in 1968
• Occurs due to change in formulation
• Switching of calcium sulphate to lactose

C) Concept of Clinical pharmacy

• Clinical pharmacy grabe huge place in developed countries like
- United States of America
- Canada
• India posses top ranked in the world in pharmaceutical market
• So there is need of concept of clinical pharmacy

D) Qualities Of Clinical pharmacist

• Good communication skill
• Good clinical skill
• Honest about his work
• Good relationship with medical and paramedical staff
• Must help on therapeutic drug monitoring

E) Function and responsibilities of Clinical pharmacist.

1) Taking medication history of patient
2) Patient care
3) Patient education
4) Education of medical and paramedical Staff
5) participation in drug utilization Studies
6) Formulation and management Of drug policies
7) Drug information
8) Research and Development
Q23 ) Short note on drug therapy monitoring .
Ans
I) drug therapy monitoring –
• Therapeutic drug monitoring (TDM) is testing that measures the amount
of certain medicines in your blood
• Directly influence drug prescribing procedures
• Use of drug concentration measurements in body fluids to the
management of drug therapy for prevention of disease.
• TDM is based on drug relationship between plasma level of drug and it’s
clinical effects.
• To decrease the toxicity of drug
• With narrow therapeutic index
II) clinical applications –
1. To avoid drug toxicity
2. Maintaining drug therapeutic range
3. Help to minimize the risk of toxicity
4. To assess medication compliance
III) role of pharmacist –
• Initial selection of drug about drug choice, dosing interval, route of
administration
• Provide a safe, efficacious, and accurate dose
• Dose adjustment for patients in peritoneal dialysis
• Provision of poisons information.
Q 24 ) Write a note on OTC medicine

Ans I) Introduction –

• Over the counter (OTC) medication are defined as safe and effective drugs
available to use by general public without a doctors prescription .
• Purchased without a prescription from doctors .
• OTC labels should be more detailed as compared to prescription drug
labels.
II) significance –

1) Comparatively cheaper
2) Time saving medication
3) Less no. of side effects
4) Chemist himself may prescribe OTC
III) some examples of OTC drugs –

1) Antibacterial and antifungal OTC drugs –

Ex. Bacitracin , clotrimazole , Miconazole
2) Pain reliever OTC drugs –
Ex . Acetaminophen , Aspirin , ibuprofen
3) Anti histamine –
Ex . Cetrizine tab , cetrizine D tab
4) Proton pump inhibitors –
Ex . Omeprazole laxative
5) Other drugs –
Ex . Nasal spray
Q. 25) Write short Note on drug store
managements. II) Interior layout of a Warehouse
Ans:- • Interior layout of a Warehouse
A) Organization of drug store Consists of
1. Shelves and pallets
I) Site selection for a drug store. 2. stocking areas
• population density 3. Receiving Areas.
• Number of physician 4. Distribution Areas.
• Health Care Centres 5. Work space
• No. of Already existing drug store 6. Desk
• Nearness to market
• Traffic Count. B) Types of Materials Stock
• Scope of expansion • No of Drugs available in the drug
• Economic factors. store
• They are classified as
1) Oral drug
II) Layout of pharmacy 2) Injectable drug
• Premises should be designed in 3) Infusions
order to ensure 4) Drug for external use
✓ Safe keeping of stock 5) Antiseptic
✓ Rational and easy management 6) Disinfectant
✓ Correct Storage of drugs and • Products are classified alphabetically
Supplies • Expiry date are clearly mentioned on
boxes
III) Requirement of Good layout design
• Proper Ventilation C) Storage Condition
• Located on ground floor. • Storage conditions is essential to
avoid drug expiring during storage
• Close to pharmacy
• Temperature control :-
• It must have 2 entries.
1) cold temperatures:- 20C – 80C
• Proper illumination.
• Use of Washable paint 2) Cool temperatures :- 80C-250C
• Cash counter near to entrance 3) Room temperature :-
• Surgical item store in separate racks. 4) Warm :- 300C- 400C
5) Excessive Heat :- Above 400C
Q.26 ) describe the Techniques of Inventory Management? (EOQ)
Ans:-
I) Inventory Management
• In Inventory management tracking of inventory from manufacturers to
warehouses is done
• The aim of inventory management is to place right product in right place in
right time
II) Three techniques:-
1. ABC analysis
2. Economic Order Quantity (EOO)
3. VED analysis
1) ABC analysis:-

2) Economic Order Quantity (EOO):-

• it is defined as the quantity of the material to be Ordered at one time.
• This quantity is fixed in such a manner as to minimize the cost of ordering
and carrying the stock so that only correct quantity of the material is to be
purchased.
• There should be no over stock or under stock and balance should be made
between the cost of carrying and the cost of carry out.
• EOQ formula is widely used for computing the minimum annual cost for
ordering and stocking each item.
3) VED analysis :-
• The stores when subjected to analysis based on their criticality can be
classified into vital, essential and desirable stores.
• This analysis is termed as VED analysis.
➢ V = Vital
➢ E = Essential
➢ D= Desirable

Q 27) Described investigation use of drug

Ans. I) Definition –
• Investigational use drugs are defined as those , which are being
considered for , but not yet received , approval by the federal food
and Drug administration / legal authority of the respective country for
human use
II) Basic principles –
• Proper handling of investigational drug in overall care of hospital.
• Nurses responsible for administering investigational drug of the
patients.
• Drug used under the supervision of principal investigator
• Investigational drug must be completely and correctly labelled.
III) Control & Identification of investigational Drugs –
1. Control -
• All investigational drugs should be registered with the pharmacy
Therapeutic committee.
• Letter from principal investigator provides following information
1. New drug number
2. Generic name
3. Manufacturer chemical name
4. Pharmacology
5. Toxicology
6. Dose range
7. Method of administration. 8 . Therapeutic use
2. Identification –
• In addition to commonly required information are
1. Patients name
2. Data
3. Prescription number
4. Doctors name
5. Research drug number
Q 28) Discuss interpretation of clinical laboratory tests

Ans interpretation of clinical laboratory tests –

• Clinical laboratory tests results are very important parameters in diagnosis

monitoring and screening .
• 70 – 80 % of decisions in diagnosis are based on laboratory results .
• Medical procedure involves testing sample of blood , urine or other sub.. of
the body .

I) Haematological parameters –
a) Erythrocytes ( red blood cells )
• The RBC count of blood as number of cells per mm³.
• Pathological conditions like chronic heart disease
b) Leucocytes ( white blood cells )

II) WBC differential analysis gives the distribution of various types of

leucocytes.
✓ Basophils - chickenpox , viral hepatitis , tuberculosis
✓Eosinophils – allergic disorder bronchial asthma , skin allergy
✓ Monocytes – malaria and various bacterial infection
a) Thrombocytes – ( platelets)
• Increase number of thrombocytes , Iron deficiency
b) Haemoglobin –
• transferring oxygen in your blood from the lungs to the tissues
c) Clotting time of blood –
• Clotting time is 4-9 minutes at 37°C

III) Urine analysis –

• A urinalysis is a test of your urine. It’s used to detect and manage a wide
range of disorders, such as urinary tract infections .
• A urinalysis involves checking the appearance, concentration and content
of urine
1) Hospital (Classification) ( 1°, 2°,3°)
2) Organizational Structure of Hospitals
3) Hospital pharmacy
4) Adverse drug reactions (ADR)
5) Drug interactions
6) ADR reporting & management
7) Genetically Determined Toxicity
8) Method detecting ADR
9) Community pharmacy
10) Drug Distribution In Hospital
11) Hospital Formulary
12) Therapeutic drug monitoring (TDM)
13) Community pharmacy
14) Patients medication history interview
15) Medication Adherence
16) PTC ( pharmacy Therapeutic committee)
17) Drug information services
18) Patients counseling
19) Role of pharmacist – Training & Education
20) Medication order
21) Budget
22) Clinical pharmacy
23) Drug therapy monitoring
24) OTC
25) Drug store management
26) Techniques inventory management
27) Investigation use of drug
28) Interpretation Of Clinical Laboratories