ANSWER SCHEMES FOR PP3 PHARMACY DISPENSING ACTIVITIES AT HOSPITAL QUESTION NUMBER 1 a) Describe the pharmacy dispensing activities

at a public hospital (6Marks) Pharmacy dispensing activities involves in the areas of below: - Drug storage and distribution: receiving drugs , storing and distribution of drugs and other health related items. Pharmacist in charge of hospital store. - Outpetient dispensing: receving prescriptions from outpatients daily, sorting, verifying, filling, counselling and education to the patients. - InPatient dispensing (Ward Pharmacy): usually divided into several Satellite Pharmacy that is attached to wards nearby. Involves in distribution of drug supplies to the wards such as floor stock management, unit dose distribution etc. Pharmacist also involve in dispensing drugs to discharged patient or so called bedside dispensing. - Drug Information Services: this department headed by pharmacist in disseminating drug information services like: 1. Entertain drug related enquiries from doctors or other health care professionals 2. Setting up Drug and Therapeutics Committee,which invloves in selecting new drug usage for the hospital. 3. Publish monthly Drug Information Newsletter or any arising important memo regarding drug related matters. b) Explain the dispensing workflow of an outpatient pharmacy department. (4Marks) This is the workflow of an outpatient pharmacy department: Registration (patient get que number) - verifying -- allocating - filling -- counter checking - dispense the medications to patients. Any errors in the prescriptions will be checked thoroughly by pharmacists, drug-drug interactions, poly pharmacy issues etc. Allocating : to allocate duration and quantity to supply. Part supply for long term medications. Filling: done by pharmacy technicians or pharmacist Counter checking done by pharmacist to ensure all correct drugs, dose, duration and quantity supplied, labelling and instruction of use. Dispensing: patient is called upon and if need be, counselling or education to attend any arising matters by the patient this is to ensure compliance (concordance) to therapy. Follow up date or Refill date is given if needed.

c) Describe the specialised pharmacy services in a hospital. (6Marks) Choses any one of these specialised pharmacy services: 1. TDM Therapeutic Drug Monitoring: specialised pharmacy drug monitoring on narrow theraputic drugs such as Gentamicin, Amikacin, Digoxin and Warfarin. Blood sample from patients are taken after introduction of drugs and, blood measurements are measured using HPLC at TDM unit. Pharmacist will recommend to adjust therapeutic dose if needed to the doctor/s involve. 2. CDR Chemotherapeutics/Cytotoxis Drug Reconstition is a specialised services provided by pharmacists in supplying anticancer drugs. Cytotoxic drugs are
potentially hazardous to Health Service Staff, who are involved in their handling, preparation, distribution, administration, and to patients receiving them. Trained Pharmacists only can handle this services.

Pharmacist is responsible for checking the: Compliance with CDR Protocols Compliance with environmental and aseptic protocols Formulary : Drug doses, Cumulative doses, Intervals between treatments Dose modifications to previous treatments are maintained if appropriate The administration details are correct for the protocol chosen The pharmacist is also responsible for ensuring accuratecompounding Determining and allocating the correct expiry and storage conditions for cytotoxic dose. All Chemotherapy prescription must be checked and signed by an oncology trained pharmacist. 3. TPN Total Parenteral Nutrition is part of pharmacy services and has developed specialized programs in Nutritional Therapies for patients who are severely malnourished, paediatrics, geriatrics, oncology patients, HIV patients and pregnancies. Trained pharmacists provide careful monitoring of patient response to treatment, therapy specific information. 4. Extemporaneous Dispensing : preparation of extemporaneous preparations for paediatrics,