Study on Role of In-patient Pharmacist in Prescribed Drug Handling, Mixing, Infusing and Spillage Handling of Chemotherapeutic Drug-Cisplatin in a Tertiary Hospital Pharmacy

The in-patient pharmacist in a cancer hospital plays a major role in patient care especially in patient taking chemotherapy and other narrow indexed drugs as a part of cancer treatment. The pharmacist works as one of the members of cancer treatment team along with physician, oncologist, nurse and other medical professionals. An oncology pharmacist has major role in chemotherapeutic drug handling, mixing, infusing and spillage handling in a disciplined manner. In order to get hands on training about ‘‘oncology-pharmacy’’, it is a mandatory novel pharmaceutical department where a hospital pharmacist who works in oncology will have to get training in handling of chemotherapeutic drugs. The pharmacists who are interested in cancer care will involve in various facets cancer care; from chemotherapeutic drug regimen preparation, mixing of dosage regimen, infusing and finally spillage handling. Hence, it is a mandatory criterion for a graduate pharmacist to get hands on training in specialty Centre to take the responsibility as oncology in-patient pharmacist. The inpatient pharmacist can also be a clinical investigator for various clinical trials involving chemotherapeutic medication usage in patients with cancer. Current study shows that an inpatient pharmacist can play a major role in handling, mixing, infusing and spillage handling of chemotherapeutic drugs in a cancer care centre. The pharmacists are also responsible for reducing drug waste, dealing with drug shortages and reducing exposure to hazardous cytotoxic drugs. The current study suggests that the pharmacist in a cancer care hospital should specially be trained for the handling of chemotherapeutic drugs, mixing and infusion, spillage handling and wastage handling in order to provide accurate treatment for patient and to avoid untoward damage to the person who is handling.

Leveraging a multidisciplinary oversight committee to ensure USP <797> and <800> compliance at a Veterans Affairs health system

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Producing compounded sterile preparations (CSP) of the highest quality and ensuring safe hazardous drug handling are well-established priorities for pharmacy departments. Maintaining compliance with United States Pharmacopeia general chapters 797 and 800 (USP &lt;797&gt; and &lt;800&gt;) must also be a priority for health-system leadership. This report describes how a pharmacy-driven multidisciplinary committee was created to provide USP &lt;797&gt; and &lt;800&gt; oversight within a multicampus Veterans Affairs health system and the facility and safety outcomes achieved. Summary The Veterans Health Administration required facilities to establish an oversight committee to ensure USP-compliant CSP procedures and the safe handling of hazardous drugs in all aspects of the medication-use process. Spearheaded by the pharmacy department, the VA Palo Alto Health Care System (VAPAHCS) chartered the CSP Advisory Committee to achieve this goal. The membership was composed of department heads in the areas of pharmacy, nursing, environmental management services, engineering, facility planning, safety, industrial hygiene, employee health, supply chain services, infection control, and quality management and the health system’s director’s office. The medication safety officer served as the executive secretary for the advisory committee and was responsible for agenda development, minutes, and coordinating timely follow-ups on action items; the VAPAHCS deputy director served as chair. Monthly meetings were conducted to receive updates on targeted sterile compounding and hazardous drug handling objectives: environmental controls and monitoring, compliance with regulatory requirements, staff competency, hazardous drug exposure event analyses, and development of well-defined health-system policy to guide practice. Conclusion Taking a multidisciplinary approach to USP &lt;797&gt; and &lt;800&gt; compliance facilitated communications, created engagement, and ensured completion of action plans.

Health professionals’ attitude and associated factors toward cytotoxic drug handling in University of Gondar specialized hospital: Institution-based cross-sectional study

Background Studies have shown that cytotoxic drugs are dangerous to health care workers. Health care professionals’ attitude to cytotoxic drugs is vital to apply safety protocols in the prevention of cytotoxicity. The current study aimed to assess health professionals’ desirable attitude and associated factors toward cytotoxic drugs handling in the University of Gondar Specialized Hospital. Methods An institution-based cross-sectional study was conducted on 412 health professionals from June to August 2019. Simple random sampling was used to select participants and a self-administered questionnaire was used to collect data. Epi Info and SPSS 20 were used for data entry and analysis, respectively. Variables with a p value < 0.05 were declared as determinants. Results The number of health professionals included was approximately 412. The mean age of participants was 29.9 ± 5.4 years. The proportion of participants with desirable attitude toward cytotoxic drugs handling was 224 (54.4%) (95% confidence interval: 51.95–56.85). Male (adjusted odds ratio = 1.69, 95% confidence interval:[1.08–2.65]), work experience of 5–8 years (adjusted odds ratio = 1.92, 95% confidence interval: [1.10–3.34]), weekly working hours of 44–55 (adjusted odds ratio = 2.25, 95% confidence interval: [1.02–4.96]), medium work stress (adjusted odds ratio = 1.67, 95% confidence interval: [1.01–2.69]), and good practice of cytotoxic drug handling (adjusted odds ratio = 1.67, 95% confidence interval: [1.04–2.67]) were significantly associated with the attitude of health professionals. Conclusion A significant proportion of health care workers did not have desirable attitude to handle cytotoxic drugs. Thus, strategies are suggested to improve the positive attitude of health professionals to cytotoxic drug handling. Female health professionals, those who had work experience of less than 2 years and those with higher work stress demand special attention.

Drug-Handling Problems and Expectations of the Ideal Pediatric Drug — Reported by Children and Their Parents

Experienced drug-handling problems and inadequately considered expectations for drug therapy have an unfavorable influence on therapy. We performed a questionnaire survey in (i) parents of 0–5-year-old children and (ii) 6–17-year-olds and their parents. We assessed (A) experienced drug-handling problems and (B) expectations for drug therapy. (i) 46 parents and (ii) 103 children and their parents participated in the study. Experienced drug-handling problems were described by (i) 100% of parents and (ii) 62% of children and 70% of parents. Problems concerned the preparation of the drug, dosing, compliance with the time interval, and acceptance. (i) 65% of parents preferred a peroral route of drug administration, while (ii) 74% of children and 86% of parents did so. Preferred characteristics of peroral drug formulations, e.g. liquid versus solid drug formulations or flavor, were highly heterogeneous. Preferences of 6–17-year-old children and their parents matched in 43% to 66%. Conclusion: Most children and their parents had already experienced drug-handling problems. Preferences concerning the ideal pediatric drug were highly heterogeneous and in about half of cases, preferences of children and their parents differed. Thus, the children should be approached directly. If information is solely gained from parents, the children’s needs might remain unmet.

Creation of a regional hazardous drug handling task force

Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose A regional task force of health-system pharmacy leaders was created to assist with successful adoption of United States Pharmacopeia (USP) general chapter &lt;800&gt;. Summary A group of pharmacy leaders in the Kansas City region identified potential benefits to healthcare personnel and patients if hazardous drug handling procedures were standardized. A task force was created, a preimplementation survey was distributed, and meetings were held monthly to discuss sections of USP &lt;800&gt; identified as the most challenging to implement. The task force focused on an assessment of risk tool, hot topics, cleanroom design, and a detailed analysis of controversial medications. After the first year of meetings, a postimplementation survey was distributed, and the results were analyzed. The task force created significant value for the participants and achieved the goal of facilitating efficient USP &lt;800&gt; implementation resulting in greater compliance and consistency across the multiple health systems represented. Over 5,100 beds and 200 clinic sites were affected by this task force’s efforts. Nearly three-fourths (73%) of respondents reported that the task force was “extremely helpful,” and the majority (64%) of respondents adopted most or all (81%-100%) of the task force’s assessment of risk choices. Prioritization of tasks, information sharing, and decision-making were areas where the individual leaders were most supported. Conclusion Creating a structure to eliminate barriers and facilitate collaboration among regional pharmacy leaders provided a framework for successful implementation of USP &lt;800&gt; requirements. This interdependent leadership model produced innovative and standardized solutions and should be considered when addressing complicated initiatives that impact the profession.

Drug interactions

Administration of multiple drugs within a short period of time is inevitable in anaesthesia practice, increasing the likelihood of drug interactions with each drug or with patients’ chronic medication. Drug interactions can be described as the pharmacological effect of one drug on another drug when administered simultaneously. The principles of these interactions may be divided into pharmaceutical, which relates to the physicochemical structure or pharmaceutical preparation of a drug; pharmacokinetic (PK), which relates to changes in drug handling in the body; or pharmacodynamic (PD) where drug activity is affected.

Study of Inventory Management in Pharmaceuticals: A Review of COVID-19 Situation

The study uses the inventory audit procedure to improve the inventory status of pharmaceuticals by selective inventory control techniques. Pharmaceuticals are vital sectors of medical industry, but because of the current situation, of COVID-19 Pandemic, there is a lot of reduction in capsule production, many of the pharmaceutical industries have rejected orders due to shortage of medicinal products during lockdown. This study uses systematic evaluation, statistical methods, Fuzzy logic, ABC-VED, EOQ, JIT etc. based on these methods the classification of various models for pharmaceutical inventory are incorporated. This also summarizes some of the case studies conducted based on the annual expenditure with ABC classification in the pharmaceuticals. The basic aim is to identify and improve the problems of inventory management by proposing a timely correct analysis. In this study, all methods that are primarily used in the inventory management of drug handling are reviewed and the best methods have been suggested that, when combined and applied in an automated environment, they can help to keep the inventory at an optimum level.