Unit I

1. Hospital and it’s organization
   Definition, Classification of hospital- Primary, Secondary and Tertiary hospitals, Classification based on clinical and non- clinical basis, Organization Structure of a Hospital, and Medical staffs involved in the hospital and their functions.
2. Hospital pharmacy and its organization
   Definition, functions of hospital pharmacy, Organization structure, Location, Layout and staff requirements, and Responsibilities and functions of hospital pharmacists.
3. Adverse drug reaction
   Classifications – Excessive pharmacological effects, secondary pharmacological effects, idiosyncra- sy, allergic drug reactions, genetically determined toxicity, toxicity following sudden withdrawal of drugs, Drug interaction- beneficial interactions, adverse interactions, and pharmacokinetic drug interactions, Methods for detecting drug interactions, spontaneous case reports and record linkage studies, and Adverse drug reaction reporting and management.
4. Community Pharmacy
   Organization and structure of retail and wholesale drug store, types and design, Legal requirements for establishment and maintenance of a drug store, Dispensing of proprietary products, maintenance of records of retail and wholesale drug store.

(10 Hours)

Unit II

1. Drug distribution system in a hospital
   Dispensing of drugs to inpatients, types of drug distribution systems, charging policy and labelling, Dispensing of drugs to ambulatory patients, and Dispensing of controlled drugs.
2. Hospital formulary
   Definition, contents of hospital formulary, Differentiation of hospital formulary and Drug list, preparation and revision, and addition and deletion of drug from hospital formulary.
3. Therapeutic drug monitoring
   Need for Therapeutic Drug Monitoring, Factors to be considered during the Therapeutic Drug Monitoring, and Indian scenario for Therapeutic Drug Monitoring.
4. Medication adherence
   Causes of medication non-adherence, pharmacist role in the medication adherence, and monitoring of patient medication adherence.
5. Patient medication history interview
   Need for the patient medication history interview, medication interview forms.
6. Community pharmacy management
   Financial, materials, staff, and infrastructure requirements.

(10 Hours)

Unit III

1. Pharmacy and therapeutic committee
   Organization, functions, Policies of the pharmacy and therapeutic committee in including drugs into formulary, inpatient and outpatient prescription, automatic stop order, and emergency drug list preparation.
2. Drug information services
   Drug and Poison information centre, Sources of drug information, Computerised services, and stor- age and retrieval of information.
3. Patient counseling
   Definition of patient counseling; steps involved in patient counseling, and Special cases that require the pharmacist
4. Education and training program in the hospital
   Role of pharmacist in the education and training program, Internal and external training program, Services to the nursing homes/clinics, Code of ethics for community pharmacy, and Role of pharmacist in the interdepartmental communication and community health education.
5. Prescribed medication order and communication skills
   Prescribed medication order- interpretation and legal requirements, and Communication skills- communication with prescribers and patients.

(10 Hours)

Unit IV

1. Budget preparation and implementation
   Budget preparation and implementation
2. Clinical Pharmacy
   Introduction to Clinical Pharmacy, Concept of clinical pharmacy, functions and responsibilities of clinical pharmacist, Drug therapy monitoring – medication chart review, clinical review, pharmacist intervention, Ward round participation, Medication history and Pharmaceutical care. Dosing pattern and drug therapy based on Pharmacokinetic & disease pattern.
3. Over the counter (OTC) sales
   Introduction and sale of over the counter, and Rational use of common over the counter medications.

(10 Hours)

Unit V

1. Drug store management and inventory control
   Organisation of drug store, types of materials stocked and storage conditions, Purchase and inventory control: principles, purchase procedure, purchase order, procurement and stocking, Economic order quantity, Reorder quantity level, and Methods used for the analysis of the drug expenditure
2. Investigational use of drugs
   Description, principles involved, classification, control, identification, role of hospital pharmacist, advisory committee.
3. Interpretation of Clinical Laboratory Tests
   Blood chemistry, hematology, and urinalysis

(07 Hours)

Unit VI

Definition of Antimicrobial resistance, overview on resistance mechanisms, AMR surveillance system , Introduction to GLASS, AMR burden in the global and national level, consequences of AMR, Strategies developed to overcome AMR, Concepts of GAP,NAP and KARSAP, WHO guidelines on AMR, Role of pharmacists in preventing AMR as per standard guidelines, Introduction to antimicrobial Stewardship, existing challenges for the containment of AMR

(02 Hours)

‘Pharmacy Practice – Theory’ is a course offered in the seventh semester of B. Pharm program at School of Pharmacy, Health Sciences campus, Amrita Vishwa Vidyapeetham.

Course Duration: 45 Hours

Scope:

In the changing scenario of pharmacy practice in India, for successful practice of Hospital Pharmacy, the students are required to learn various skills like drug distribution, drug information, and therapeutic drug monitoring for improved patient care. In community pharmacy, students will be learning various skills such as dispensing of drugs, responding to minor ailments by providing suitable safe medication, patient counselling for improved patient care in the community set up.

Objectives:

Upon completion of the course, the student shall be able to:

1. Know various drug distribution methods in a hospital
2. Appreciate the pharmacy stores management and inventory control
3. Monitor drug therapy of patient through medication chart review and clinical review
4. Obtain medication history interview and counsel the patients
5. Identify drug related problems
6. Detect and assess adverse drug reactions
7. Interpret selected laboratory results (as monitoring parameters in therapeutics) of specific disease states
8. Know pharmaceutical care services
9. Do patient counseling in community pharmacy;
10. Appreciate the concept of Rational drug therapy.

Recommended Books (Latest Editions)

1. Merchant S.H. and Dr. J.S.Quadry. A textbook of hospital pharmacy, 4th ed. Ahmadabad: B.S. Shah Prakakshan; 2001.
2. Parthasarathi G, Karin Nyfort-Hansen, Milap C Nahata. A textbook of Clinical Pharmacy Practice- essential concepts and skills, 1st ed. Chennai: Orient Longman Private Limited; 2004.
3. William E. Hassan. Hospital pharmacy, 5th ed. Philadelphia: Lea & Febiger; 1986.
4. Tipnis Bajaj. Hospital Pharmacy, 1st ed. Maharashtra: Career Publications; 2008.
5. Scott LT. Basic skills in interpreting laboratory data, 4thed. American Society of Health System Phar- macists Inc; 2009.
6. Parmar N.S. Health Education and Community Pharmacy, 18th ed. India: CBS Publishers & Distrib- uters; 2008.

Journals

1. Therapeutic drug monitoring. ISSN: 0163-4356
2. Journal of pharmacy practice. ISSN : 0974-8326
3. American journal of health system pharmacy. ISSN: 1535-2900 (online)
4. Pharmacy times (Monthly magazine)