PHARMACY AND THERAPEUTIC

COMMITTEE(PTC)
 PHARMACY AND THERAPEUTIC
COMMITTEE(PTC)
The Pharmacy and Therapeutic Committee (PTC) is an advisory
group that considers essentially all the matters related to the
use of drugs in a hospital including evaluation of drugs &
dosage forms and safe use of investigational drugs.

It is a policy framing and recommending body to the medical

staff and the administration of hospital on matters related to
the therapeutic use of drugs.

It also serves as a means of communication between the

healthcare professional and pharmacy department …
 Composition and Membership
The decision to launch a Pharmacy and Therapeutics
Committee is made by the administrative head of the facility
(MS) who, together with the first deputy, appoints members of
the Committee. Normally, the Pharmacy and Therapeutics
Committee is composed of seven to eleven voting members
(odd number):
At least 3 physicians from the medical staff (one is the
chairman).
A chief pharmacist (secretary).
A representative from nursing staff.
A hospital administrator, who should be an ex-officio member
of the committee.
 OBJECTIVEs / PURPOSES

The main objective of PTC is to achieve optimal patient care

and safety through rational drug therapy.

Advisory:
It recommends the adoption of policies regarding evaluation,
selection and therapeutic use of drugs.
Educational:
It assists in the preparation of programs for healthcare
professionals to update their current knowledge on matters
related to drugs and its use.
 OPERATION OF PTC

The committee should meet at

least 6 times in a year and also
as & when necessary.

The committee should

invite persons from
inside or outside hospital
to its meetings, who can
contribute specialized or
unique knowledge, skills.
 Committee Agenda
A agenda should be prepared by secretary and submitted to
the committee members in sufficient time before meeting.

An agenda may consist of :

- minutes of previous meeting

- review of contents of hospital formulary

- new drugs, commercially available

- review of adverse drug reactions, drug

interactions, toxic effects reported in the hospital
Minutes of the meeting

Minutes of the meeting should be

prepared by the secretary and
maintained in the permanent
records of the hospital.

Recommendations of the
committee shall be presented to
the medical staff.
 FUNCTIONS

To provide advise to the medical staff on usage of drugs.

To develop a formulary of drugs accepted for use in the hospital.

To plan/establish suitable educational programs.

To review adverse drug reactions.

To make recommendations concerning drugs to be stocked in
hospital patient care areas.
To advise the pharmacy in the implementation of effective drug
distribution and control procedures .
 POLICIES OF COMMITTEE

In order to avoid misunderstanding amongst members and

medical staff, these policies were developed.

Policies should be reviewed periodically to ensure that they are

up-dated.Proposal of a new drug for the hospital formulary shall
be submitted to the pharmacy department by any medical staff.
Committee decides whether to accept or to reject.
 Policies Concerning Formulary
Drugs evaluated and approved by committee will be assigned to
one of the following categories :
1. Formulary drug
2. Drugs approved on a conditional trial period
3. Investigational drugs

4.Specialized formulary drugs

Drugs which cannot be placed under the above categories are
considered as Non-formulary drug.
The pre-signing of prescription blanks is prohibited
.

All drugs should be dispensed on the basis of generic names to

achieve cost-savings.
 Policies regarding In-Patient
Prescription order
Medication order must include :
a) Patient’s addressograph information
b)Name of nursing unit
c)Name and strength of each drug
d) Direction for frequency of drug administration
e)Route of administration
f)Signature of prescribing physician
g)Date and time at which order was written
Outpatient-prescribing

Outpatient prescriptions
should be written only on
hospital prescriptions and
should contain details of
patient, drug information
and name & signature of
physician.
 Polices Regarding controlled drugs
prescribing

For control In case of schedule 2 drugs(narcotics),

drug are limited to 30-day supply, no refills
prescriptions, schedule 3 drugs(barbiturates) and
it requires schedule 4 drugs(benzodiazepines),
physician’s limited to 30 day supply, refilled up to 5
DEA number.
times within 6 months of issue date.
 ROLE OF PTC IN DRUG SAFETY
• Drug safety includes responsibility from dispensing of
drugs to drug administration and to observe possible
adverse effects.
• Following guidelines can help in inducing drug safety:
 a qualified, registered pharmacist should be employed
for supervision of pharmacy.
 non-pharmacist should not be permitted to dispense
drugs.
 sufficient number of qualified staff should be employed
for adequate coverage of pharmacy.
 the hospital should provide adequate, safe work space
and safe storage facilities.
 the hospital must have an autonomic stop order
regulation for dangerous drugs.
 the hospital should have a drug formulary, periodically
revised and updated.
 the poisons and poisonous materials should be
separated from non-poisonous materials, similarly
external and internal preparations.
 the hospital should permit pharmacist to engage in a
teaching program to medical staff.
 all nursing drug stations should be periodically inspected
for the purpose of removing deteriorated and outdated
drugs.
 AUTOMATIC STOP ORDERS FOR
DANGEROUS DRUGS
All drug orders for narcotics, sedatives, hypnotic,
anticoagulants and antibiotics should be automatically
discontinued after 48 hours unless a)order indicates
a) exact number of doses,
b) exact period of time,
c)attending physician reorders

All P.R.N(pro re nata) and standing order medications shall

expire as determined by the pharmacy and therapeutic
committee in consultation with concerned medical staff and
recommend the hospital administration.
 ROLE OF PTC IN ADVERSE DRUG
REACTION MONITORING
An adverse reaction is defined as any unusual
or unexpected harmful reaction from a drug.
Every case of adverse reaction must be first
reported by attending physician to chairman
of PTC.
The attending physician should complete the
‘Adverse drug reaction report form’.
 ROLE OF PTC IN DEVELOPING
EMERGENCY DRUG LIST

• It is absolutely necessary for the PTC of a hospital to

prepare “emergency drug boxes or stat boxes” containing
emergency drugs, readily available at bed-side for use.
• It should be checked daily either by pharmacist or
nursing supervisor responsible for the ward.
A. Supplies to be maintained in emergency box:
syringes- 1, 2, 5 ml; 10,20ml
needles- 16’, 18’, 20’, 23’, 26’
files for breaking ampoules
B. Drugs for emergency box:
These are selected in consultation with physician.
examples-aminophylline, atropine sulphate, heparin,
epinephrine, nalorphine, pentazocine, pentobarbitone,
digoxin, mannitol, saline for injection, water for injection.
C. Supplies for cabinet utility room:
venous cannulation set, venous catheters, oxygen catheters,
razor with blades.
D. Other emergency supplies:
oxygen equipments, resuscitation carts, tracheotomy sets,
burn sheets.
 ROLE OF PTC IN DRUG UTILIZATION
REVIEW
• Drug utilization includes prescribing,
dispensing, administering and ingesting of
prescription of drugs.
• Hospital pharmacist should take medication
history, that should include following
information:
1) medication being taken at time of
admission, during admission and OTC drugs
2) any drug or food related allergies.
Patient medication profile will serve for following
purposes:
a) to help improved drug prescribing practices by
promoting safe and rational use of drugs
b) to detect and prevent drug-interactions,
adverse reactions
c) to detect drug induced diseases
d) it helps to detect potential drug toxicities
Within patient medication profile, patient history
and laboratory procedure, pharmacist is in an
excellent position to monitor proper drug
utilization.
 ROLE OF PTC IN DRUG PRODUCT
DEFECT REPORTING
• The drugs purchased by hospital can have the following
defects like deteriorated, contaminated, inferior or
defective quality drugs, inadequate labeling, inaccurate
filling of product or faulty delivery.
• It is the responsibility of committee to get information
about the defective drug products and to inform it to
the manufacturer or supplier for appropriate action.
• If satisfactory answer is not obtained from
manufacturer or supplier then it should be reported to
Food & drug control administration.
 REFERENCES

1)A Textbook of Hospital Pharmacy; Dr.J.S.

Quadry, Dr. Ramesh K. goyal, Dr. Parikh; 8th
edition; page no. 28-38.

2)Hospital Pharmacy ; William E. Hassan; 4th

edition; page no.85-96.