PYQ\\\'s

• Define Hospital formulary and write about contents of hospital formulary Marking scheme: 1M for definition, 2M for content (Winter 2023)
• Write the composition and functions of PTC. (Summer 2024)
• Define PTC and write the function of PTC (Summer 2025)
• Define PTC and write the functions and scope of the committee. Marking scheme: 1M for definition, 2M for Function and scope (any 4 points) (Winter 2023)
• What are Reserved antibiotics? 1M (Winter 2023)
• Write in your own words, the actions required to be taken by the pharmacists to prevent antimicrobial resistance. 3M (Winter 2024)
• Define hospital formulary and write the uses of HF. 3M (Winter 2024)
• Describe the role of pharmacists in preventing antimicrobial resistance.3M for Any 6 roles (Summer 2023)

Pharmacy and Therapeutics Committee (PTC)

Definition (Model Answer):

PTC is a committee which formulates policies regarding evaluation, selection and therapeutic use of drugs.

The Pharmacy and Therapeutics Committee\\\'s main goal is to create a list of prescription drugs that are both good for the health of Plan members and don\\\'t cost too much. They also make sure that the medicines are high quality. The committee keeps an eye on any issues with the list and how the medicines are used.

Objective / Functions and Scope of PTC (Model Answer):

1. To advise medical staff and hospital administration in matters relating to use of drugs, prevention of waste and confusion.
2. Establish and develop suitable educational schemes to improve hospital’s professional staff on matters related to use of drugs.
3. Develop and compile a formulary of drugs.
4. To constantly review formulary and update if necessary.
5. To study problems related to drug administration, distribution, drug stocking and drug use.
6. To review ADR or interactions occurring in the hospital.
7. To recommend about drugs to be stocked in patient care areas.
8. To advise pharmacy in implementation of effective drug distribution and control procedures.
9. To develop written policies and procedures for selection, procurement, storage, distribution and use of drugs.
10. To develop policies regarding drug safety.

Composition of Pharmacy and Therapeutics Committee

The composition of a Pharmacy and Therapeutics Committee may vary depending on the institution and its specific requirements:

1. Medical Superintendent or Chief Medical Officer: Often serves as the chairman of the committee.
2. Clinical Pharmacists: Provide expertise in medication management and contribute to formulary decisions.
3. Physicians: Actively practicing physicians from various specialties who prescribe medications.
4. Pharmacists: Representing different areas of pharmacy practice, such as hospital pharmacy, clinical pharmacy, and drug information.
5. Nurses: Provide insights on medication administration and patient care.
6. Quality Assurance Officer: Ensures compliance with regulatory standards and quality improvement initiatives.
7. Therapeutics Specialists: Experts in specific therapeutic areas, such as cardiology, infectious diseases, or oncology.
8. Administrators: Representatives from hospital administration who oversee budgetary and operational aspects.
9. Patient Representatives: Advocates for patient perspectives and experiences.
10. Other Healthcare Professionals: Depending on the institution, other professionals such as dieticians, respiratory therapists, or social workers may be included.

Meetings

The Pharmacy and Therapeutics Committee meets at least quarterly. Minutes reflect the members in attendance, items discussed, and decisions reached. Minutes are forwarded to the Pharmacy Quality and Utilization Committee and to the Benefits Committee, and are maintained for at least 10 years in Pharmacy Administration.

HOSPITAL FORMULARY

Definition (Model Answer) :

Hospital Formulary is a continually revised compilation of pharmaceuticals (plus ancillary information) which reflects the current clinical judgement of medical staff.

Content of hospital formulary (Model Answer):

PTC will take the decision regarding content of hospital formulary, but it generally contains 3 parts -

1. Information of hospital policies and procedures regarding drugs. This will include following items:
   • a) Formulary policies and procedures
   • b) Brief description of PTC
   • c) Hospital regulations governing prescribing, dispensing and administration of drugs.
   • d) Pharmacy operating procedures
   • e) Information on using formulary
2. Drugs product listing. This includes information on drug products which have been approved by PTC
   • a) List of approved drugs
   • b) Information about each approved drug

   This section is the heart of formulary and consists of one or more index to facilitate use of formulary, e.g. 1) Generic brand name, cross-reference list 2) Pharmacologic-therapeutic index

3. Special information. This section includes:
   • a) Prescription writing - This section is to guide young physicians who are appointed as trainee staff. This gives information about parts of prescription, systems of measurement, abbreviations used, essentials of narcotic prescription, etc.
   • b) Other data -
     • i) Normal laboratory values
     • ii) Calculation of doses for children
     • iii) Weights and measures
     • iv) Toxicology section
     • v) mEq calculations
     • vi) Diagnostic and pathological reagents in common use.

   And other such data that PTC considers useful is included in formulary.

Procedure for How to Use Hospital Formulary

By following these procedures, healthcare providers can effectively utilize the hospital formulary, promote standardized medication use, and ensure patient safety and quality of care.

1. Familiarize Yourself with the Formulary: Review the hospital\\\'s formulary, which is typically available in a document or electronic format. Understand the structure and organization of the formulary, including the categories and classifications of medications.
2. Follow Formulary Guidelines: Adhere to the guidelines and policies established by the Pharmacy and Therapeutics Committee regarding medication selection, procurement, and utilization. This includes using medications listed in the formulary for prescribing purposes.
3. Check for Formulary Status: Before prescribing a medication, verify its formulary status to ensure it is included in the approved list. This can be done by consulting the formulary document or using electronic resources provided by the hospital.
4. Consider Therapeutic Alternatives: If a specific medication is not listed in the formulary or is restricted, consider therapeutic alternatives that are included in the formulary. This helps ensure compliance with the hospital\\\'s medication management policies.
5. Seek Approval for Non-Formulary Medications: If there is a clinical need to prescribe a medication that is not included in the formulary, follow the hospital\\\'s procedures for seeking approval. This may involve obtaining prior authorization or submitting a request for an exception.
6. Stay Updated: Stay informed about any changes or updates to the formulary. The Pharmacy and Therapeutics Committee regularly reviews and updates the formulary based on new evidence and changes in therapeutic guidelines. Stay updated through communication channels, such as newsletters or meetings.
7. Collaborate with Pharmacists: Work closely with pharmacists who are knowledgeable about the formulary and can provide guidance on medication selection and alternatives. They can help ensure that prescribed medications align with the formulary and are appropriate for the patient\\\'s condition.
8. Document Medication Use: Maintain accurate documentation of medication use, including the specific medications prescribed and their formulary status. This helps with tracking and monitoring medication utilization within the hospital.

Infection Control Committee (Model Answer):

Reserved antibiotics:

Reserved antibiotics are drugs that are accessible but reserved for treatment of confirmed or suspected infections caused by multi-drug-resistant micro-organisms.

Pharmacists have a key role in avoiding misuse of antibiotics to prevent antimicrobial resistance. Following are the roles of pharmacist in AMR:

1. Infection prevention and control is an essential strategy to reduce infection and the subsequent increased use of antimicrobials.
2. Immunization is an important part of any infection control strategy. It helps reduce the misuse of antimicrobials.
3. Advise the hospitals about the selection, safe and appropriate use of antibiotics, disinfectants and sterilant.
4. Pharmacists maintain records of antibiotics distributed to the medical staff & also participate in monitoring of patient lab. report of microbial sensitivity & advice to physicians on selection of antibiotics.
5. Select correct route of antibiotic administration.
6. Pharmacists help in dose adjustment of antibiotics in renal disorder for better result.
7. Carry out periodic prescription audits by an expert and give suggestions to optimize the use of antibiotics
8. Arrange the review program for accessing and improving the quality of antimicrobial therapy.
9. Quantitative data on antimicrobial drug use should be routinely generated and used.
10. Offer effective medication therapy management.