An adverse drug reaction is defined as any unusual or unexpected harmful reaction including acute poisoning by narcotics, barbiturates as well as industrial poisoning. Every case must be first reported by the attending physician to the chairman of PTC.
The hospital formulary system is a method whereby the medical staff of a hospital with the help of the pharmacy and therapeutic committee selects and evaluates medical agents and their dosage form which are considered to be most useful in patient care.
Formulary (pharmacy) at its most basic level, a formulary is a list of medicines. The main function of a prescription formulary is to specify particular medications that are approved to be prescribed at a particular hospital, in a particular health system, or under a particular health insurance policy.
Doctors use the formulary to find out which medications the hospital has available to treat a given symptom or condition. They also check it to make sure that they do not prescribe medications that can cause dangerous interactions with other medications. Doctors are accustomed to prescribing specific medications for specific conditions, but a hospital may choose to substitute similar drugs for those medications. For instance, a formulary may include a generic version of a widely used medication, which is usually less expensive than its brand-name counterpart. In addition, more than one doctor often treats a single hospitalized patient, and each doctor often orders different medications for the same patient.
Various systems are followed for in patient drug distribution in different hospitals. The systems have some advantages and disadvantages based on the same the hospital administration decided the systems to be implemented. The systems are as follows:
Individual prescription order system
This is usually followed in a small and private hospital for economic considerations and reduced manpower
Complete floor stock system
Under this system, the nursing station carries both charge and noncharge patient medication. according to this condition the nurses store the drug and administer them to the patient according to the physician’s order.
Only the commonly used drugs are taken
Combination of above mentioned
This system is used in those hospitals where patients pay for their hospitalization and hospitals used the individual prescription order system
Unit dose dispensing
Unit dose dispensing the multiples of single-dose administration of medication is prepared by pharmacist which is ready for the administration to the patient as prescribed by the physicians.
A single unit package is one which contains a complete pharmaceutical dosage form is used in this system
Two different methods used of dispensing unit doses are:
Centralized unit dose drug distributing system (CUDD)
Decentralized unit dose distributing system( DUDD).
Canes come in many different styles, designs, colors, and materials.
When choosing a cane, first consider the functionality. Choose a cane that best suits type of condition and the amount of support needed. Seek advice from doctor or a physical therapist.
The multitude of canes available that offer the functionality you. There are well-known
• Handle styles like sleek Fritz canes, elegant Derby canes
• Canes designed for travel like folding canes and umbrella canes, and
• Anatomic canes designed to fit your hand.
Stand up straight with your regular walking shoes on (the kind you will wear when using your cane) and your arms loosely at your sides.
Have the second person measure the length from the floor to the first crease of your wrist. The length you determined this way tells you the ideal length of your cane from the bottom to the top of its handle.
For ideal cane fit elbow should be bent at an angle of about 30° when you hold it in your hand while standing.
A minimum area of 10 square meters is required to start a medical shop or pharmacy or wholesale outlet. In case, the pharmacy business combines retail and wholesale, a minimum of 15 square meters is required.
• Storage Facility:
The store must have a refrigerator & air conditioner on the premises. According to the labeling specifications certain drugs like vaccines, Sera, Insulin Injections, etc., are required to be stored in the refrigerator.
• Technical Staff:
o Wholesale – The sale of drugs by wholesale shall be made either in the presence of a registered pharmacist or in the presence of a competent person who shall be a graduate with 1 yr experience in dealing in drugs or a person who has passed S.S.L.C with 4y ears experience in dealing in drugs, specially approved by the department of drug control for the purpose.
o Retail – The sale of drugs by retail must be made in the presence of a registered pharmacist approved by the department, Registered pharmacist is required throughout the working hours.
Classifications of the hospital are given below:-
According to service
a. General hospital: – District hospital, Thana hospital.
b. b. Special hospital: – Medical college hospital, mental hospital, cancer hospital.
According to ownership:-
a. Government hospital: – Unforced hospital, public health hospital.
b. Non –Government hospital: – Private hospital.
c. Corporation hospital: – (I. Profitable, Ii. Non-profitable, Partnership hospital).
According to bed capacity:-
a. Fewer than 50 beds Thana label hospital.
b. 51 to 100 beds district label hospital.
c. 200-bed hospital Ex: – e.g. Jupiter hospital Thane
d. 200 -300 bed hospital Ex: – Saifee hospital Mumbai
e. 400-500 beds hospital and over. Ex: – Hinduja hospital
The clinical basis of classification
a. Maternity hospital
b. Surgical hospital
• General hospital
• Pediatric hospital
• Mental hospital
• Dental hospital etc