Hospital pharmacy today extends far beyond dispensing medicines. It plays a strategic role in inventory management, clinical research, and interpretation of laboratory data to support rational drug therapy. Unit 5 focuses on three crucial pillars of hospital pharmacy practice: efficient drug store management, safe handling of investigational drugs, and interpretation of clinical laboratory tests. Together, these areas strengthen patient safety, therapeutic effectiveness, and cost control within healthcare institutions.
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Drug Store Management and Inventory Control
Organization of the Drug Store
A hospital drug store functions as the backbone of pharmaceutical supply. It is systematically organized into receiving areas, quarantine zones, bulk storage, cold storage, and dispensing sections. Proper segregation of narcotics, psychotropic substances, high-alert medicines, and expired drugs is mandatory. Environmental controls such as temperature, humidity, and light protection ensure drug stability and compliance with regulatory standards.
Types of Materials Stocked and Storage Conditions
Hospital drug stores stock pharmaceuticals, surgical supplies, medical devices, disinfectants, vaccines, and emergency medicines. Special storage conditions are required for refrigerated items, light-sensitive drugs, cytotoxic agents, and biologics. Adherence to storage guidelines minimizes degradation, contamination, and therapeutic failure.
Purchase and Inventory Control in Hospitals
Principles of Purchase and Procurement
Efficient procurement ensures uninterrupted drug availability at optimal cost. Principles include purchasing the right quality, in the right quantity, at the right time, and from approved suppliers. Standard operating procedures govern vendor selection, tendering, and quality verification.
Purchase Procedure and Purchase Orders
The purchase process begins with indent generation based on consumption patterns and stock levels. Approved purchase orders specify drug name, strength, quantity, delivery schedule, and regulatory compliance. Proper documentation ensures traceability and accountability.
Inventory Control Techniques
Inventory control prevents overstocking, stock-outs, and financial losses.
Economic Order Quantity (EOQ) determines the most cost-effective purchase size.
Reorder Level indicates when fresh stock should be ordered.
ABC analysis classifies drugs based on cost significance, while VED analysis categorizes medicines based on criticality (Vital, Essential, Desirable).
These methods help prioritize monitoring and resource allocation.
Investigational Use of Drugs in Hospitals
Concept and Description
Investigational drugs are pharmaceutical products under clinical evaluation that are not yet approved for routine use. Their use is governed by ethical, scientific, and regulatory frameworks to protect patient rights and ensure data integrity.
Principles and Classification
Investigational drugs may include new chemical entities, approved drugs for new indications, or new dosage forms. Their use follows principles of informed consent, ethical approval, and strict protocol adherence. Classification is based on phase of clinical trial and therapeutic intent.
Control and Identification
Investigational drugs are clearly labeled, segregated from routine stock, and stored under controlled conditions. Detailed accountability records track receipt, dispensing, return, and destruction. This prevents medication errors and unauthorized use.
Role of the Hospital Pharmacist
The hospital pharmacist plays a central role in investigational drug management. Responsibilities include protocol review, storage compliance, dispensing accuracy, patient counseling, adverse event reporting, and maintaining trial documentation. Pharmacists also coordinate with investigators and regulatory authorities.
Advisory Committees
Institutional Ethics Committees and Research Advisory Committees oversee investigational drug use. They ensure ethical conduct, patient safety, and compliance with national and international clinical research guidelines.
Interpretation of Clinical Laboratory Tests
Importance in Drug Therapy
Clinical laboratory data provide objective evidence for diagnosis, monitoring therapy, and detecting adverse drug reactions. Pharmacists use laboratory values to optimize dosing, adjust therapy, and prevent toxicity.
Blood Chemistry Interpretation
Blood chemistry tests evaluate organ function and metabolic status. Parameters such as blood glucose, electrolytes, liver enzymes, and renal markers guide therapeutic decisions. For example, elevated serum creatinine may necessitate dose adjustment of renally excreted drugs, while abnormal liver enzymes may signal hepatotoxicity.
Hematology Interpretation
Hematological tests assess blood cell counts and coagulation status. Hemoglobin and hematocrit levels help diagnose anemia, while white blood cell counts indicate infection or immune suppression. Platelet counts and coagulation profiles are critical when prescribing anticoagulants or cytotoxic drugs. Pharmacists interpret these values to prevent bleeding risks and ensure safe therapy.
Urinalysis Interpretation
Urinalysis provides insights into renal function, urinary tract infections, and metabolic disorders. Parameters such as protein, glucose, ketones, and pH help assess disease status and drug effects. For example, acidic urine may enhance the effectiveness of certain urinary antiseptics, while proteinuria may indicate nephrotoxicity.
Integration of Pharmacy Services in Patient Care
Modern hospital pharmacists integrate inventory control, investigational drug management, and laboratory data interpretation into clinical decision-making. This holistic approach supports rational drug use, minimizes adverse effects, and improves therapeutic outcomes.