Pharma Unit

Hospital & Clinical Pharmacy

Top 25 Most Important Questions with Answers
According to New Syllabus ER 2020-21

2nd Year D. Pharmacy

1) Define Hospital pharmacy write scope of hospital pharmacy?

Ans.
Defini�on: Hospital pharmacy is the department, service, or a domain in the hospital organiza�on, managed under the
direc�on of professionally competent legally qualified person.
Scope of Hospital pharmacy:
 To provide the right medicine to right pa�ent at right �me, in right quan�ty with minimum cost.
 To plan, organize and implement the policies of pharmacy.
 To implement the decision of PTC.
 To par�cipate in research work.
 To act as profit centre of the hospital.
 To act as a counselling centre to the pa�ent.
 To act as an informa�on centre about drugs.
 To manufacture large volume parenteral or suitable dosage forms.

2) Explain good pharmacy prac�ce in the hospital?

Ans.
Defini�on: Good pharmacy prac�ce is a prac�ce of pharmacy that responds to the needs of the people, who use the
pharmacist’s services to provide op�mal, evidence-based care.

WHO Recommenda�ons for GPP:

 Professional responsibility as main philosophy.
 Pharmacist's input crucial in medicine use decisions.
 Professional interac�ons as therapeu�c partnerships.
 Collabora�on among pharmacists for service improvement.
 Importance of providing pa�ent informa�on.
Elements of GPP:
 Promo�ng good health and achieving health goals.
 Ra�onal supply and use of medicines.
 Self-care ac�vi�es and advice.
 Influence on prescribing and medicine use.
 Collabora�on for community health promo�on.
 Involvement in clinical trials.

Major Roles for Pharmacists in GPP:

 Handling medical products.
 Providing effec�ve medica�on therapy.
 Maintaining and improving professional performance.
 Contribu�ng to healthcare system and public health effec�veness.

Requirements for GPP:

 Neat and iden�fiable pharmacy loca�on.
 Equipped with necessary tools, including refrigerator and basic medical equipment.
 Managed under pharmacist supervision with well-trained personnel.
 Proper storage and inventory management.
 Service strategies like home delivery and pa�ent care.
 Documenta�on for quality maintenance and compliance.

3) Define Hospital pharmacy and describe func�on of Hospital?

Ans.
Defini�on: Hospital pharmacy is the department, service, or a domain in the hospital organiza�on, managed under the
direc�on of professionally competent legally qualified person.
Func�on:
1. To take a care of sick and injured pa�ents.
2. Restoring and keeping up good health of community.
3. To promote good services to pa�ent for ge�ng relief from diseases and pains.
4. To lower the incidences of diseases through early detec�on and treatment.
5. To make trained and skilled physicians and nurses.
6. To maintain and distribute hospital formulary.
7. To promote research in medical, pharmaceu�cal, and other related fields.
8. To take care of pa�ent by using advanced knowledge and instruments.
9. To rise general standard of medicine for increasing quality of pa�ent care.
10. To contribute to preven�on of spreading of disease in the community.
11. To run the programmes like public educa�on and vaccina�on.
12. It serves as a link between community and official health agencies to improve community health.
13. The bigger hospitals co-operate with smaller hospitals. Thus, hospital performs co-opera�ve work.
14. Primary func�on is to take care of inpa�ents and outpa�ents.

4) Explain pharmacy and therapeu�cs commitee (PTC)? write composi�on and func�on of PTC?
Ans.
Defini�on: PTC is a policy framing and recommending body on maters related to ra�onal use of drugs in the hospital
and consists of members from various departments of the hospital.

Objec�ves:
A. Advisory Objec�ves:
 Assist in formula�ng policies for drug evalua�on and selec�on.
 Advise medical staff and administrators on drug maters, including inves�ga�onal drugs.
 Provide recommenda�ons for effec�ve drug distribu�on and control.
 Suggest drugs to be stocked in pa�ent care areas.
 B. Educa�onal Objec�ves:
 Help formulate policies to ensure professional staff have up-to-date drug knowledge.
 Review adverse drug reac�ons and establish a hospital formulary system.
 Arrange training programs for staff involved in drug use.

Composi�on:
 At least 3 physicians.
 One nursing staff.
 One pharmacist (secretary).
 Hospital administrator (chairman).

Func�ons
 Develops drug safety policies.
 Establishes hospital formulary system.
 Promotes ra�onal drug use.
 Reviews hospital formulary.
 Provides training to staff.
 Develops drug policies and procedures.
 Manages staff educa�on programs.
 Advises pharmacy on drug purchasing and storage.
 Manages hospital ac�vi�es through subcommitees.
 Inspects rou�ne hospital ac�vi�es.
 Par�ally oversees hospital library.
 Provides sugges�ons to hospital manufacturing.
 Decides on 'automa�c stop orders' for dangerous drugs.
 Compiles lists of emergencies, dangerous, and narco�c drugs.
 Interacts with FDA department.
 Promotes ra�onal drug use.
 Guides addi�on and dele�on of drugs in hospital.
 Reviews Adverse Drug Reac�ons (ADR).
 Sets quality norms for medica�on use.
 Advises pharmacy on drug distribu�on and control procedures.

5) Define inventory control and what are different inventory control technique?
Ans.
Defini�on: Inventory control is an effec�ve way to keep a watch over losses from misappropria�on, damage,
deteriora�on and carelessness and proper control over maintenance of stock.
Inventory control technique:
1. ABC analysis.
2. VED analysis.
3. EOQ method.
4. Recorder quan�ty level.
5. Inventory turnover.
6. Se�ng of various levels.
7. Perpetual inventory control system.
8. Input–output ra�o analysis.
9. Effec�ve purchase procedure.
10.Review of slow-moving and non-moving items.

6) Define radiopharmaceu�cals and describe dispensing and disposal of radiopharmaceu�cals?

Ans.
Defini�on: Radiopharmaceu�cals are medicinal formula�ons containing radioisotopes which are used in major clinical
areas for diagnosis and treatment.
Dispensing of Radiopharmaceu�cals:
 Dispensing area should be separate, secure, and hygienic.
 The dispensing room should be away from imaging and injec�on areas.
 All work surfaces should be smooth, impermeable, and easily cleanable.
  Radiopharmaceu�cals are dispensed as ready-to-use kits or cold kits.
 Chemical reagents are prepared in a sterile environment.
 Dosage levels are calculated based on pa�ent history, age, weight, etc.
 Dispensing follows applicable pharmacy laws and maintains accurate records.
 Policies ensure correct drug, dosage, pa�ent, �me, and route.
 Good radia�on prac�ces (GRP) should be followed to minimize unnecessary exposure.

Disposal Procedures of Radiopharmaceu�cals

 Disposal follows local regula�ons and considers environmental hazards.
 Large volume waste produc�on should be avoided.
 Waste includes syringes, vials, needles, etc.
 Waste bins are marked, dated, and stored.
 Methods of disposal include dilu�on, decay, burial, incinera�on, etc.
 Low-ac�vity solid waste can be disposed as ordinary hospital waste.
 Liquid waste with low ac�vity can be flushed into the sewer system.
 Radioac�ve waste is stored for decay before disposal.
 Some waste may be sent to approved disposal sites or incinerated.
 Waste with minimal radioac�vity can be treated as non-radioac�ve.
 Disposal methods include delay and decay, burial, incinera�on, etc.
 Some materials can be disposed of in sanitary sewers or sent to disposal sites.
 Sealed gauges and detectors may require specialized disposal.

7) Explain clinical pharmacy and write scope of clinical pharmacy in India?

Ans.
Defini�on: Clinical pharmacy is a part of hospital pharmacy which deals with the prepara�on of pa�ent drug profiles,
recording pa�ent drug history, advise about possible drug–drug interac�ons to trainees and drug effects on clinical
laboratory test results.
Scope of clinical pharmacy:
1. Prepara�on of history of pa�ent.
2. Prepara�on of drug history.
3. Par�cipa�on in management of medical emergency.
4. Par�cipa�on in drug inves�ga�on.
5. Par�cipa�on in the management of chronic diseases like diabetes, hypertension, arthri�s.
6. To control over drug u�liza�on.
7. To monitor drug therapy.
8. To counsel with pa�ent.
9. To help in selec�on of drug therapy to physician.
10.To communicate with physician and nurses through presenta�on and publica�on.
11.Detec�on and repor�ng of adverse drug reac�ons (ADRs).
12.To take part in educa�onal programme related with medical pharmacy and nursing profession.
13.To provide the formal and informal consulta�on to the physician.
14.To explain the direc�on of use, route of administra�on and other related informa�on to the pa�ents.
15.Collec�on of knowledge of drug therapy and pharmacokine�cs of drugs.
16.To take part in pa�ents educa�on, vaccina�on programme and other programmes related to social welfare
arranged by the hospital.

8) Define pharmacovigilance write aim and scope of pharmacovigilance?

Ans.
Defini�on: Pharmacovigilance is defined as the science and ac�vi�es concerned with the detec�on, assessment,
understanding and preven�on of adverse reac�ons to medicines.

Aims of Pharmacovigilance:
1. Improve pa�ent safety and care with respect to the use of medica�on.
2. Early detec�on of unknown adverse reac�ons and interac�ons.
3. Detec�on of frequency of adverse reac�ons.
 4. Improve public health and safety with respect to use of medica�on.
5. Provide informa�on to healthcare professionals and pa�ents to op�mize safe and effec�ve use of medicines.
6. Contribute to assessment of effec�veness, harm, benefit, and risk of medica�on encouraging their ra�onal, safe,
and effec�ve use.

Scope and Objec�ves of Pharmacovigilance

1. To monitor adverse drug reac�ons (ADRs).
2. To monitor benefit–risk profile of medicines.
3. To create awareness among healthcare professionals about the importance of ADRs reported in India.
4. To generate independent evidence-based recommenda�ons on the safety of medicines.
5. To communicate findings with all stockholders.
6. To create a na�onal centre of excellence at par with global drug safety monitoring standards.
7. To build and maintain a vigorous pharmacovigilance system.

9) Define Drug related problem? write classifica�on of drug related problems?

Ans.
Defini�on: The drug related problem is an event or circumstance involving drug therapy that actually or poten�ally
interferes with desired health outcomes.

Classifica�on/Types of Drug Related Problems:

1. New drug therapy: Pa�ent has a medical condi�on that requires new drug therapy.
2. Unnecessary drug therapy: Pa�ent is taking the drug therapy which is not suitable for his present condi�on.
3. Use of wrong drug: Pa�ent has a medical condi�on as wrong drug is prescribed.
4. Too low dose: Pa�ent has a medical condi�on for which too low dose of a correct drug is taken.
5. Too high dose: Pa�ent has a medical condi�on for which too high dose of a correct drug is taken.
6. Adverse drug reac�on: The pa�ent has a medical condi�on that occurred due to adverse drug reac�on.
7. Non-compliance: The pa�ent has a medical condi�on for which the pa�ent is not receiving the drug.
8. Drug interac�ons: The pa�ent has a medical condi�on and there is a drug–drug drug–food or drug–lab test
interac�ons.
9. Lack of monitoring of effect and toxicity of drugs.
10.Lack of the drug chart/prescrip�on does not contain drug strength.

10) Define Pharmaceu�cal care & write objec�ve and purpose of pharmaceu�cal care?
Ans.
Defini�on: Pharmaceu�cal care is the responsible provision of drug therapy for the purpose of achieving definite
outcomes that improve pa�ent’s quality of life.

Objec�ve of pharmaceu�cal care:

 Op�mize pa�ent's health-related quality of life and achieve posi�ve clinical outcomes.
 Requires an established pa�ent-pharmacist rela�onship.
 Keep records of medica�on and collect pa�ent-specific informa�on with consent.
 Evaluate pa�ent-specific medical informa�on and develop a therapy plan with the prescriber.
 Ensure pa�ent has all supplies, informa�on, and knowledge for drug therapy plan.
 Review, monitor, and modify therapeu�c plan in collabora�on with pa�ent and healthcare team.

Purpose of pharmaceu�cal care:

 Pharmacy is the first point of contact to pa�ent a�er leaving doctor, hence pharmacist can take care of pa�ents.
 Only pharmacist can help and inform the doctors about the drugs and their ac�ons ul�mately it is involved in due
care of the pa�ent.
 A�er the doctor’s consulta�on, pa�ent visits the pharmacy frequently, so monitoring and correc�on of therapy, if
any, can be counselled by pharmacist.
 Most of the �me doctors are not available for the pa�ent care but pharmacists are always at any hour of �me.
 Mul�ple services and help under one roof can help the pa�ent to mo�vate and adhere to the plan.
 Visi�ng pharmacist is economical and easy as compared to doctor.
11) Define hospital formulary? Write aim of hospital formulary?
Ans.
Defini�on: It is con�nuously revised collected informa�on of pharmaceu�cal dosage forms which gives current clinical
judgement to the medical staff. It is con�nuously revised compila�on of pharmaceu�cal dosage forms.

Aims/Needs of Hospital Formulary:

1. To provide best possible treatment to the pa�ents in lowest possible cost is the aim served by a hospital
formulary.
2. It informs the physicians, nurses, and pharmacists about the new and more potent drugs available in the hospital.
3. It avoids the use of brand and therapeu�c duplica�on of drugs.
4. It promotes ra�onal use of drugs.
5. To provide guidelines for ‘procuring, prescribing, dispensing, and administering of drugs in a hospital.
6. It informs about availability of medicines, dosage forms and their quan�ty in the hospital.
7. To inform the staff about standard dosage regimen, adverse effects of the drugs.
8. It provides guidelines regarding emergency drugs in a hospital.
9. It contains list of physicians, their address, phone numbers, qualifica�on and available �mings in the hospital
which is useful for reference or in emergency condi�ons.
10.It informs the staff about reported ADRS in the hospital.

12) Write a note on the infec�on Control Commitee (ICC)?

Ans.
Defini�on: It is a process by which healthcare facili�es develop and implement specific policies and procedures to
prevent the spread of infec�on among the healthcare staff and pa�ents.

Objec�ves of ICC:
 Understand causes of nosocomial infec�on and basic infec�on control concepts.
 Minimize infec�on risk for pa�ents, healthcare workers, and visitors.
 Formulate local guidelines and standard opera�ng procedures (SOPs) for infec�on preven�on.
 Educate and train healthcare workers.
 Recommend ra�onal an�microbial policy and stewardship program.
 Ensure implementa�on and monitoring of programs.
 Prevent an�bio�c resistance.

Composi�on of ICC:
 Infec�on control officer (Chairman-Medical Superintendent).
 Infec�on control nurse (Secretary).
 Heads of departments from Microbiology, Pathology, Pharmacy, Surgery, Medicine, Paediatrics, Nursing.

Responsibili�es of ICC:
 Develop manual of policies and procedures for asep�c techniques.
 Conduct surveillance of HAIs, analyse data, and take correc�ve ac�ons.
 Advise staff on infec�on control, maintain safe environment.
 Supervise cleanliness, steriliza�on, and disinfec�on prac�ces.
 Oversee isola�on procedures for at-risk pa�ents.
 Inves�gate and control outbreaks of infec�on.
 Manage waste.
 Provide infec�on-related informa�on to management.
 Train new employees on infec�on control policies.
 Organize regular training programs for staff.
 Audit infec�on control procedures and an�microbial usage.
 Monitor healthcare worker safety programs.
13) Explain FEFO method of inventory control?
Ans.
Defini�on: FEFO stands for first expired, first out. FEFO is a term used in the field of inventory management to describe
the process of dealing with logis�cs of products that have limited self-life. FEFO is an inventory management technique
that permits for products with the earliest expiry date to be distributed first. FEFO is a simply highly effec�ve inventory
management technique that focuses on the handling and moving of date sensi�ve inventory.

Advantages of FEFO
 It helps to sell the products with shortest expiry date at the first.
 It reduces inventory, waste, and addi�on work.
 It helps to reach the ul�mate product before expiry date to the end user.
 It avoids unnecessary dumping/stock of certain items in the warehouse.
 It provides guarantee of the product towards customer sa�sfac�on.
 It avoids of dead stocking.

Disadvantages of FEFO
 An accurate product tracking system is required.
 Proper space should be planned for the storage.
 Higher taxes.

14) Explain FIFO method of inventory control?

Ans.
Defini�on: FIFO stands for first-in first-out. It is based on the principle that the materials which are purchased first are
sold first. It is simple and logis�c method because it takes into considera�on the normal procedure of u�lizing first
those materials which are received first.

Advantages of FIFO
 It reduces impact of infla�on.
 The change in cost price, lot wise will not affect the sale.
 Easy to apply.
 Produces higher income during infla�on period.
 This method is used for the products with stable prices and less frequency of purchase and sale.

Disadvantages of FIFO
 In FIFO inconsistent prices may be given to the customers.
 It may produce clerical errors.

15) Write defini�on advantages and disadvantages of individual prescrip�on order method?
Ans.
Individual Prescrip�on Order Method: Small and private hospitals adapt this system. According to this system
prescrip�on is received by pharmacist and medicines are dispensed for inpa�ents. The collec�on of prescrip�on is also
done by pharmacist. Here the drugs are dispensed and labelled for each individual pa�ent. Here medica�ons are kept in
nursing unit medica�on cabinet under the custody of nurse in-charge. Nurse is responsible for administering correct
medica�ons to each pa�ent in ward. The nurses are advised by the pharmacist about proper storage, labelling and
accoun�ng of drugs and unwanted effect produced by drug, etc. For faster dispensing, commonly used drugs can be
prepackaged.
Advantages
 Review of prescrip�on is possible by the pharmacist.
 Pharmacist can counsel the pa�ent.
 Control over inventory is easy.
 Purchasing cost, maintenance cost, space required are less in comparison with other systems.
 Maintenance of record is easy, and paperwork is minimized.
 Adjustment of cost of prescrip�on is possible by considering economical condi�on of the pa�ent.
Disadvantages
 Emergency medicines are not quickly supplied.
 Delay in receiving medicines.

16) Explain distribu�on of drugs to ICCU, ICU, NICU and emergency department?
Ans.
Distribu�on of Drug to ICCU/ICU/NICU/Emergency Ward: In hospitals, specialized units are dedicated for the pa�ents
who have life-threatening illness or injuries and need intensive care constant supervision.
The following are the specialized units:
1. ICU (Intensive Care Unit): It is a special department for cri�cal pa�ents who needs intensive treatment and
con�nuous observa�on. It is also known as cri�cal care unit.
2. ICCU (Intensive Coronary Care Unit): It is also known an intensive cardiac care unit. It is a unit which is focused on
intensive treatment for heart issues such as coronary heart disease, cardiac arrhythmia, heart atack, heart failure
and other cardiac condi�ons.
3. NICU (Neonatal/Newborn Intensive Care Unit): It is also known as intensive care nursery (ICN) It is an intensive care
unit specializing in the care of ill or premature newborn infants.
4. Emergency ward: These are also known as accident and emergency department, casualty department. It provides a
medical treatment facility specializing in emergency medicine, the acute care of pa�ents who present without prior
appointment, either by their own means or by that of an ambulance.
Distribu�on of Drugs:
 Pa�ent receives prescrip�ons in the ward while receiving treatment in the specialized ward.
 Specialized drug dispensing system is developed to emergency pa�ents in which uses a special cabinet having
medica�on bins that store selected and limited quan��es of medica�ons package in single unit containers.
 Intravenous solu�on, irriga�on solu�on, eye tray medica�ons, drugs for cardiopulmonary resuscita�on and
refrigerated drugs are kept in areas of ready access.
 The system provides for punched cards containing informa�on on the drug.
 These cards are stored with medica�on and are used for billing and reordering purposes.
 24 hours supply of medica�ons is required for these specialized units.
Common drugs used in the specialized units are:
A. ICCU: For example, aspirin, promethazine, heparin, hydrocor�sone, streptokinase, metoprolol, pentazocin,
frusemide.
B. ICU: For example, epinephrine, atropine, sotalol, lidocaine, adenosine, procainamide, vasopressin.
C. In NICU: For example, gentamicin, ampicillin, caffeine citrate, frusemide, dopamine, azithromycin, ibuprofen,
fluconazole.
D. In emergency ward: For example, adrenaline, salbutamol, atropine, aspirin, frusemide, hydrocor�sone, insulin,
lidocaine, and medical oxygen.

17) Define computer? Explain advantages, disadvantages, and applica�on of computers in

hospital pharmacy prac�ce?
Ans.
Defini�on: It is the electric device performing the several complex and complicated func�ons and can store the
informa�on.
Advantages
 High speed
 Storage capacity—so�ware, floppy disc, hard disc
 Easy retrieval of data
 Accurate results
 Can perform complicated, several arithme�cal and logical func�ons.
 Time saving
 Space saving
  Economic
 Can work for 24 hours.
Disadvantages
 Cannot correct itself.
 Lack of common sense.
 Depends upon human instruc�ons.
 Electricity is required.
 Skilled person is required for opera�on.
Applica�on of Computers in Hospital Pharmacy
 In drugstore for billing, purchasing, stocking, ordering, etc.
 In hospital pharmacy to record prescrip�ons.
 In pathological laboratory.
 In manufacturing sec�on of hospital pharmacy.
 In maintenance of pa�ents’ records.
 In data storage and retrieval.
 In inventory control. 8. In medica�on order entry.
 In drug therapy monitoring.
 In repor�ng ADRs.
 In purchasing and accoun�ng.
 In billing of charge floor stock.

18) Define medica�on error. Explain types of medica�on errors?

Ans.
Defini�on: Medica�on error is any preventable event that may cause or lead to inappropriate medica�on use or pa�ent
harm while the medica�on is in the control of healthcare professional, pa�ent, or consumer.
Different types of medica�on error:
1. Prescribing error: It means those errors which occur due to improper drug selec�on dose, dosage form or route
of administra�on. Examples of this type of error include Prescribing a dose of drug, i.e. too high or too low.
Wri�ng a prescrip�on illegibly. Ordering duplicate therapies
2. Omission error: It occurs when a pa�ent does not receive scheduled dose of medica�on.
3. Wrong �me error: It occurs when a dose is not administered in accordance with a predetermined administra�on
interval.
4. Wrong dose error: This type of error occurs when a prescriber orders an inappropriate dose of medica�on. It
occurs due to wrong calcula�ons or wrong units of measurement or not measured properly.
5. Wrong dosage form error: It occurs when a pa�ent receives a dosage form different from that prescribed.
6. Wrong route of administra�on: This type of error occurs when an agent meant for intramuscular administra�on is
given intravenously.
7. Wrong drug prepara�on: This type of error occurs when a medica�on requires some prepara�on before its
administra�on such as recons�tu�on of solu�on by adding water for injec�on in the vial.
8. Unauthorized drug error: This type of error occurs when a pa�ent receives the drug which is not prescribed to
him.
9. Deteriorated drug error: This type of error occurs when a pa�ent receives an expired drug or deteriorated
prematurely due to improper storage condi�ons.
10.Monitoring error: This type of error occurs when the pa�ent is not properly monitored before or during the
therapy, e.g. In warfarin therapy, not conduc�ng the pa�ent’s response by doing adequate blood tests, life-
threatening haemorrhage may happen.
11.Compliance error: This type of error occurs when the pa�ent use medica�on inappropriately due to improper
educa�on of pa�ent by the pharmacist or physician or both.
19) Explain ward round par�cipa�on?
Ans.
Defini�on: A ward round is a visit made by a medical prac��oner, alone or with a team of health professionals and
medical students to hospital inpa�ents at their bedside to review and follow-up the progress of their health.
Goals and Objec�ves
 To improve understanding of pa�ent’s clinical progress and status, current therapeu�c goals, and planned
inves�ga�ons.
 To provide relevant informa�on on various aspects of the pa�ent’s drug therapy such as pharmacokine�cs,
pharmacology, drug avail ability, adverse reac�ons, drug interac�ons.
 Op�mize therapeu�c management by influencing drug therapy selec�on, implementa�ons, follow-up, and
monitoring.
 Inves�gate unusual drug doses or orders.
 To provide addi�onal informa�on about the pa�ents such as comorbidi�es, medica�on compliance or alterna�ve
medicine use that might be relevant to their management.
 To detect drug interac�ons and adverse drug reac�ons.
 To par�cipate in pa�ent discharge planning.
Procedure of Ward Round Par�cipa�on
 Ward round par�cipa�on provides many learning opportuni�es for pharmacists.
 It allows pharmacists to see firsthand how drugs are prescribed and used and to see the effects of these drugs on
pa�ents.
 With �me, pharmacists develop an apprecia�on of how the pa�ent’s own wishes and their economic, social, and
cultural circumstances may influence therapeu�c choices.
 Even for experienced clinical pharmacists in teaching hospitals, it is very rare to finish a ward round without
gaining new perspec�ves on some aspect of pa�ent care or therapeu�cs. For those involved in academia and
research, ward rounds allow iden�fica�on of cases for clinical publica�on and teaching.
 Ward round par�cipa�on strengthens the inter-professional rela�onship among various health professionals,
leading to beter healthcare research and prac�ce.

20) Define drug interac�ons and explain the role of pharmacist to avoid drug interac�ons?
Ans.
Defini�on: The drug interac�on is a reac�on in which the effects of one drug are altered by prior or concurrent
administra�on of another.
Role of pharmacist to avoid drug interac�ons:
 Pharmacist should do pa�ent counselling to make the pa�ents aware about drug interac�ons.
 Pharmacist should provide vital informa�on about the drugs to pa�ents regarding drug selec�on and
administra�on.
 Pharmacist working in hospitals should maintain drug history and medical record of the pa�ent.
 Pharmacist can educate the public for safe and effec�ve use of medica�ons through verbal communica�on as
well as by writen materials and use of computers.
 Pharmacist should warn the pa�ents not to use OTC drugs without consulta�on of physician.
 Pharmacist should tell the pa�ents to strictly follow the instruc�ons given by the physician regarding
administra�on �ming and dosage.
 Pharmacist should guide the pa�ent, not to take the treatment from mul�ple physicians.
 Pharmacist should tell the pa�ent not to consume excess drug than prescribed dose.
 Pharmacist should tell the pa�ent not to take different drugs at once.
 Pharmacist should inform the pa�ent about drug–food interac�ons and specific food during use of certain
medica�ons.
21) Explain Outpa�ent in detail?
Ans.
Defini�on: The pa�ent which is not admited in hospital but receiving general or specific treatment is called outpa�ent.
Classifica�on of Outpa�ent:
• General outpa�ent: The outpa�ents which are not receiving emergency or specific treatment are called general
outpa�ents, e.g. diabe�c pa�ent, hypertension pa�ent.
• Emergency outpa�ent: The outpa�ents if receiving emergency treatment or an accident care are called
emergency outpa�ents.
• Referred outpa�ents: If outpa�ents are receiving specific treatment, then those are called referred outpa�ents,
e.g. pa�ents suffering from eye, ear, nose, teeth disorders.
• Ambulatory pa�ent: An ambulatory pa�ent can walk and since outpa�ents receive primary healthcare and walk
off, they are wrongly called ambulatory pa�ents. Majority of outpa�ents are ambulatory pa�ents, e.g. cancer
pa�ent.
Drug Distribu�on or Dispensing to Outpa�ent Department:
 Whenever the outpa�ent visits for the first �me, he should register his name at the registra�on counter.
 Then he will be directed to specialist physician for the consul�ng and take the prescrip�on from them.
 The prescrip�on would bear, the name, age, registra�on number and diagnosis of the pa�ent.
 Pa�ent should produce this prescrip�on to dispensing counter where pharmacist checks the prescrip�on and
assembles the materials for compounding.
 The specific medica�ons given in the prescrip�on are dispensed properly in the packets/containers, etc. and
labelled.
 Pa�ent counselling can be done during the dispensing regarding dose, route, and use of the drugs.
 The prescrip�on along with the bills are issued to the outpa�ent.

22) Define poisoning and explain different types of poisoning?

Ans.
Defini�on: It is defined as a substance which when administered, inhaled, swallowed, applied locally, causes toxic
effects on the body.
Types of Poisoning
A. According to purpose of poisonings it is classified as
• Suicidal poisoning: Person consumes poison to kill himself.
• Homicidal poisoning: Poison is used to kill another person.
• Accidental poisoning: The poison is consumed by mistake.

B. Based on onset of ac�on poisoning is classified into two groups

• Acute poisoning: It is generally due to consump�on of a large amount of poison. It may be accidental, inten�onal,
or non-inten�onal. The symptoms develop very rapidly in severity. The aggrava�on of symptom is fast, therefore,
treatment should be given quickly otherwise death may occur. The malfunc�oning of respiratory and cardiac
func�on. General symptoms of acute poisoning are vomi�ng, diarrhoea, convulsions, coma, respiratory or
circulatory failure. It requires suppor�ve, symptoma�c, and specific treatment.
• Chronic poisoning: The symptoms are observed very slowly. It is due to consump�on of small amount of poison
but with definite period of interval. The aggrava�on of symptom is very slow. The death due to chronic poisoning
is rarely observed because more �me is available for the treatment. General symptoms of acute poisoning are
GIT irrita�on, confusion, insomnia. Usually, symptoma�c treatment is given if required.
23) Explain Unit dose dispensing system (UDDS)?
Ans.
Defini�on: It is the system which consists of dispensing unit doses to the pa�ents containing a predetermined amount
of drug
Types of Unit Dose Dispensing System
A. Centralized unit dose dispensing system (CUDDS): If the unit doses are dispensed from pharmacy department, it
is called centralized unit dose dispensing system.
B. Decentralized unit dose dispensing system (DCUDDS): If the unit doses are dispensed from nursing sta�ons, it is
called decentralized unit dose dispensing system.
Advantages of Unit Dose Dispensing System
 Avoids misuse of medica�on.
 Review of prescrip�on is possible; therefore, medica�on errors are reduced.
 Time required for dispensing is reduced.
 Pa�ent should pay the cost of medicines which are consumed by him.
 Purchasing cost and budget of hospital is decreased.
 Accoun�ng becomes easier.
 Paperwork is less at nursing unit as well as at the pharmacy.
 Beter financial control.

Disadvantages of Unit Dose Dispensing System

 Separate manpower is required for pre-packaging.
 Separate containers, closures, machinery, and space is required.
 Unit dispensing should be handled by skilled person and supervised by pharmacist only.

Benefits of UDDS
 The pa�ents are charged only for those medica�ons which are consumed by them.
 It reduces the medica�on error since the pharmacist checks a copy of physician’s original order.
 It avoids wastage of drug.
 Less space is required as compared to bulky floor stock.
 It allows the nurses more �me for direct pa�ent care.
 Pa�ent receives the nursing service 24 hours a day.
 It avoids the duplica�on of orders and extra paperwork.
 It increases more efficient u�liza�on of personnel.

24) Explain satellite pharmacy?

Ans.
Defini�on: The main pharmacy centre is called satellite pharmacy and sub pharmacy centres are located at each floor
and working as substa�ons for satellite. Satellite pharmacy service is developed with an advanced view of clinical
pharmacy programs. These sub pharmacies are located on wards. They receive their supply from main pharmacy and
distribute them to the pa�ents on current basis. These pharmacies are managed by clinical pharmacist who is available
in his professional capacity for pa�ent counselling.
Advantages
 Review of prescrip�on is possible by pharmacist.
 Wai�ng period is decreased.
 Emergency medicines are quickly available for administra�on.
 Drug therapy can be monitored by pharmacist.
 Pharmacist may counsel the pa�ent.
Disadvantages
 Inventory is increased therefore, budget is increased.
 Paperwork, maintenance cost are increased.
  Separate space is required for keeping the stock.
 Number of pharmacists required for dispensing are more.

25) Explain pulmonary func�on tests in details?

Ans.
1. Spirometry: Measures breathing paterns. Iden�fies condi�ons like asthma, pulmonary fibrosis, cys�c fibrosis,
and COPD. It measures Peak expiratory flow rate (PEFR), Forced expiratory volume in 1 second (FEV1)
2. Diffusion Capacity Test: Measures gas transfer from alveoli to blood. It is Called DLCO (diffusion capacity of lungs
to carbon monoxide). Useful in pulmonary oedema, asthma, pulmonary fibrosis, and sarcoidosis.
3. Body Plethysmography: Measures lung volume a�er deep breath. Provides various lung volumes at different
stages of lung infla�on.
4. Exercise Challenge Tes�ng: Confirms exercise-induced bronchospasm (EIB). Evaluates medica�on effec�veness.
Typically done using treadmill or cycle ergometer. Spirometry post-exercise indicates abnormal response if FEV1
decreases by 10% or more.
5. Six-Minute Walk Test (6MWT): Measures walking distance in six minutes. Assesses oxygen needs during exer�on.
Oxygen satura�on ≤88% indicates need for supplemental oxygen.
6. Maximal Inspiratory/Expiratory Pressure: Measures strength of inspiratory muscles (maximal inspiratory
pressure). Assesses ven�latory failure, restric�ve lung disease, and respiratory muscle strength. Non-invasive and
quick test.
Notes:
1) Please Read All the Topics & All the Chapters of Hospital & Clinical Pharmacy Very Carefully.
2) This Pdf Notes/Questions & Answers Are Only for Reference Purpose.