GOOD PHARMACY PRACTICE VALENTINE U ODILI B.Pharm,MPharm. Dept. Of Clinical Pharmacy & Pharmacy Practice. University of Benin.

INTRODUCTION All practicing pharmacists are obliged to ensure that the service they provide to every patient is of appropriate quality. Good pharmacy practice is a means of clarifying and meeting that obligation.

UNDERLYING PHILOSOPHY Traditionally, the mission of pharmacy practice is to provide medications and other health care products and services. However in recent years the term “pharmaceutical care” has established itself as a philosophy of practice, with the patient and the community as the primary beneficiaries of the pharmacist’s actions.

UNDERLYING PHILOSOPHY Pharmaceutical care is a patient-centered practice in which the pharmacist assumes responsibility for a patient’s drug-related needs and is held accountable for this commitment.

UNDERLYING PHILOSOPHY Good Pharmacy Practice (GPP) guidelines are based on the pharmaceutical care given by pharmacists. The guidelines promote standards for: the promotion of health the supply of medicines, medical devices patient self care improving prescribing and medicine use by pharmacists' activities.

GPP standards for premises Aim: that there should be adequate premises from which to provide services Requirements: Clean, tidy and hygienic conditions Adequate space Appropriate conditions for storage, re-packing, dispensing and distribution of medicines, including security Adequate light

GPP standards for premises contd. Protection from exposure to excessive light and heat Availability of equipment appropriate to the tasks carried out Access to basic reference texts Direct access to patients for instruction, counseling, etc. (NO PIGEON HOLES)

GPP STANDARDS FOR DISPENSING. Aim: to ensure that the right patient receives the appropriate medicine in the correct dose and form Requirements: Read the prescription (Assessment) Is it legal Who is it for? Adult, child, Elderly What is the name of the preparation? What are the instruction for the patient? What quantity is to be dispensed?

GPP STANDARDS FOR DISPENSING contd Find out useful information about the prescription. -ASK How does the prescribed drug work and how is it used? Are the prescriber’s instructions correct? How is the medicine to be prepared? What advice does the patient require?

GPP STANDARDS FOR DISPENSING contd Make or assemble the preparation. Pack the drug into appropriate container Label the container Endorse the prescription Make appropriate records Handover the drug with appropriate advice Correctly dispose of the prescription

GPP STANDARDS FOR CONTAINERS. Aim: to preserve the integrity of the product Requirements: Tablets/capsules are dispensed in: STEP 1 An air-tight plastic wallet (this is considered to be the minimum requirement) STEP 2 An airtight, rigid container STEP 3 An airtight, rigid container with a child resistant closure STEP 4 The manufacturer's original pack Liquid preparations should be dispensed in "pharmaceutical" bottles so as to distinguish them from non-pharmaceutical preparations - such as drinks/foods/consumer products Poisonous products/products intended for external use should be packed in distinguishable bottles. Recycled containers may be used if adequately cleaned internally and externally.

GPP STANDARDS FOR LABELLING. Aim: to uniquely identify the contents of the container, to instruct the patient on the proper use of the medication and to protect the medication. The minimum requirements for a label are: Generic name & strength of medicine Dose, frequency & duration of course, if applicable Date of dispensing Name of patient Name/address of supplier Child safety warning auxiliary label Keep out of reach of children

GPP STANDARDS FOR INSTRUCTIONS TO PATIENTS. Aim: to ensure that the patient knows how and when to take/use the product Counseling is a professional responsibility and not an option for the pharmacist. Every pharmacist must develop this skill in order to ensure GPP and rational drug use. Counseling is imperative for the following reasons.

GPP STANDARDS FOR INSTRUCTIONS TO PATIENTS Patients need to be motivated to take their drugs Many patients do not read instructions on labels Advice on drugs is better appreciated if the drugs are before the patient, and this puts the pharmacist in a unique position to counsel since he has both the drug and the knowledge.

GPP STANDARDS FOR INSTRUCTIONS TO PATIENTS CONTD. Pharmacists’ active involvement in patient counseling will improve patient’s adherence and the following areas should be covered: Name of medication Indication in lay language e.g. this medicine is for blood pressure Removal of medicines from the pack, this should be demonstrated e.g. removal of suppository wrappings; opening of safety container, using cap to screw tubes and pressing of contents from the base of collapsible tubes.

GPP STANDARDS FOR INSTRUCTIONS TO PATIENTS CONTD. Dose, dosage interval and duration of therapy. Side effects to expect, what to do when the side effects occur Contraindications- state food, drinks or drugs to be avoided. Storage/disposal of left over drugs- patients should be advised not to use leftover drugs. The ideal is to return to the pharmacy for proper disposal.

GPP STANDARDS FOR RECORDS Aim: to facilitate patient care and provide an audit trail Requirements: STEP 1 A record of all medicines supplied should be kept detailing name of patient, name & strength of medicine, dosage, quantity supplied, date of dispensing STEP 2 Individual patient medicine records should be maintained in a system, manual or computerized, which allows for easy retrieval of patient information

STANDARDS FOR HEALTH INFORMATION AND PHARMACEUTICAL CARE. Aim: to promote good health and prevent ill health Requirements: All personnel should be trained and equipped in terms of literature and support material to give advice on general health matters as well as more specific information and services relating to medicines supplied by them. In terms of the provision of this service the steps would be as follows:

STANDARDS FOR HEALTH INFORMATION AND PHARMACEUTICAL CARE CONTD. STEP 1. Provide health promotion literature and support materials on general health STEP 2. Provide an area suitable for the delivery of basic information, counselling and pharmaceutical care STEP 3. Provide a separate, confidential room or facility for the above activities

STANDARDS FOR SELF MEDICATION. Where pharmacists are involved in giving advice on self medication and response to symptoms, protocols should be devised to ensure that the advice is accurate and appropriate. If the aforementioned standards are followed strictly the pharmacist can be sure that on the average he/she is providing services that comply with GPP.

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