HOSPITAL FORMULARY

Definition: Hospital Formulary is a continually revised compilation of Pharmaceuticals (plus important ancillary information) that reflects the current clinical judgement of the medical staff. Formulary system is method whereby the medical staff of an institution, working through the PTC, evaluates, appraises, and selects from among the numerous available drug entities & drug products those that considered most useful in patient care. The need for Hospital Formulary: 1. 2. 3. 4. The increasing no. of new drugs manufactured and marketed by drug companies Increasing complexity of untoward effects of modern potent drugs Newer sales promotion strategies of pharmaceutical industry. The public interest in getting possible health care at lowest possible cost.

Disadvantages of a hospital formulary: 1. 2. 3. 4. Deprives the physician to prescribe and obtain the brand of his choice. Permits the pharmacist to act as the sole judge. Allows the purchase of inferior quality drugs (where there is no pharmacist). Does not reduce the cost though large volume purchases take place.

Guiding principles: 1. A multidisciplinary PTC outlines its purpose, organization, function 2. The formulary system shall be sponsored by the medical staff based upon the recommendations of the PTC. 3. The medical staff should adapt the principles of the system to the needs of the particular institution. 4. The PTC shall adopt written policies & procedures. 5. Non proprietary names should be included in the formulary. 6. The formulary system is informed to the entire medical and nursing staff. 7. The pharmacist shall be responsible for the specification as to the quality, & source of supply of all drugs, chemicals, biological & pharmaceutical preparations.

Pre requisites in developing a hospital formulary 1. 2. 3. 4. 5. Establish a formulary committee Establish and secure agreement on content ,structure and format of the formulary Appointing an editor Reviewing the draft Revise and produce new editions

Preparation of Hospital formulary:

guidelines for prescription writing Table of common Lab-values Posological tables Index of the drugs included in the formulary Tables for calculation % milliequalents & doses Formulas for varies diagnostic stains, diagnostic aids Poisons and their antidotes Pharmacological index Section on reagents

Formulary content: 1. General info: The hospital policies & procedures relating to the drugs. It includes (formulary, non- formulary, evaluation, investigational etc.) Brief description of PTC. Hospital regulations governing the prescribing, dispensing & administration of drugs. 2. Listing of drugs The drug list forms the main body of the formulary.

3. Description of the listed items Proper therapeutic information on medicines. Calculation of doses Abbreviations used in that hospital 4 Prescription writing Every prescription must furnish the following: Name and address of the patient The date Prescribed drug should be written in formulary terminology Strength of prescribed medication must be given in accepted metric system. 5 The total amount to be dispensed. The instruction to the patient should be clear, concise and in simple terms which can be understood by the patient. When repetition of the drug is desired, the no of times the drug is to be taken should be clearly written. 6. The Format It would be very good idea if the pharmacist decides its format etc before commencing work on printing and publishing in his own hospital. He has to collects formularies of some leading hospitals as well as their format.

Copies of finally published formulary may be sent to bodies liked central drug standard control organization, directorate general of health services, Govt of India, PCI.

7. Size

It is sufficiently small in size so that it could be easily carried by clinicians, nurses etc, in the pockets of their uniform or lab coats. The hospitals may determine their own size of the formulary.

8. Type of format Loose leaf or Bound Printed or Mimeographed Indexing and Assigning categories

Reference 1. 2. 3. 4. 5. William E Hassan, Hospital pharmacy, 124-140 H.P.Tipnis et al, Hospital Pharmacy 146-149 N.K.Jain, G.D.Gupta, Modern Dispensing and Hospital Pharmacy,386-391 S.H.Merchant and Dr. J.S.Quadry, A textbook of hospital pharmacy, 4th edition, 39-50 A.V.Yadav, B.V.Yadav, Hospital and clinical pharmacy, 2nd edition, 112-117