task 1 pharmacy practice

8/14/2019 Task 1 Pharmacy Practice

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20/11/08

Martin King

Pharmacy Practice

Task 1: Receipt and storage of medicines

Introduction

Whilst visiting a retail pharmacy, and a hospital pharmacy, I observed and recorded the differentmethods and procedures involved for ordering, receiving and the storing of pharmaceuticalsubstances.

Outcome

The ordering of drugs tended to be done via modem, although orders via telephone wereapparently not uncommon. One of the largest suppliers for retail and hospital pharmacy is thecompany AAH. In the retail pharmacy I visited, AAH owned the computer system. When an itemis dispensed, the computer records, and puts it down for automatic reorder. This order can beadjusted manually as needed. Both pharmacies I visited had two deliveries per day from AAH,one at around 9am (items must have been ordered the previous evening) and another at around4pm (items must have been ordered by 12.30pm). In the hospital I visited, the stores departmentwas managed by a senior technician, and they were in charge of ordering. The pharmacistoverlooked all drug orders at the retail pharmacy.

When the pharmacy orders were received the boxes were signed for. Included with each box wasa receipt and a picking ticket stating what the box contained. All items on each picking ticketwere to be checked to assure that the correct item was present, and that each had an acceptableexpiry date. In retail pharmacy controlled drugs must be signed for, and recorded in the ‘CD’ book by a pharmacist. A senior technician was able to do both of these in the hospital pharmacy.

In both pharmacies I visited, the items were manually put away into the correct place; ensuringstock rotation is carried out to reduce the likelihood of a box expiring on the shelf. I was also

informed that many hospital pharmacies have a robot which can hold 10’s of thousands of individual drug skillets. Each individual box is put onto a conveyor belt and the robot scans, putsaway and dispenses each item as requested.



Some items have different storage requirements

For example:

1 Freezer items: gemeprost pessaries, botulinum toxin2 Fridge items: latanoprost eye drops, liposomal cytarabine, vaccines3 Light sensitive items: glucose 25% IV solution, TPN’s

It is very important to take note of storage requirements for 2 reasons.

1 The patient could receive an inactive or harmful product.2 Drugs are very expensive (liposomal cytarabine is approximately £1223 for one 50mg

vial)

Vaccines are particularly vulnerable to warm and very low temperatures. Therefore it is vital to

refrigerate them as soon as possible to keep the temperature of the product within therecommended range. This tends to be between 2 degrees Celsius and 8 degrees Celsius. Anauditable ‘cold chain’ has to be kept from manufacturing to dispensing to assure quality. Thefridge in which they are stored must have a monitor to indicate the temperatures in which it hasranged.

Other items requiring special handling include cytotoxic drugs. Cytotoxic means cell destroying,so the reasons for special handling are obvious. They are much more widely used in hospital pharmacy, and generally used to treat cancers. The only cytotoxic drug that was stored at theretail pharmacy was methotrexate 2.5mg tablets. This group of drugs have the potential to causeharm if not handled correctly e.g. burns, and even cancer. This is why gloves should be wornwhen handling cytotoxic products at all stages from delivery, reconstitution and dispensing. Inthe hospital pharmacy, cytotoxic spill kits were at hand and standard operating procedures wereto be followed in case of any accidents.

Some items have to be specially ordered for a patient. Reasons could include the pharmacy nothaving the item in stock. As each pharmacy has two or more deliveries a day this isn’t alwayssuch a problem as the patient would get an owing slip and come back when the item was in. Thiscould be a more troublesome problem if the item wasn’t commercially available as a specialslaboratory would need to make the item and this takes around a week.

The hospital pharmacy had a production unit which regularly made extemporaneous products intheir non-sterile area. An example is clobazam suspension 1mg in 1ml for an epileptic infant.The product was made on a weekly basis and sent from the hospital to the named patient’sdoctor’s surgery.

task 1 pharmacy practice

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