Question

Explain how to organize the pharmacy laboratory; mention the instruments and chemical substances usually used in a pharmacy laboratory and their storage conditions.

please write the refernces is important

Answer 1

A pharmacy laboratory must be organized keeping the following things in mind:

1) Drug designation

All active ingredients have an international nonproprietary name (INN). The INN should also be mentioned in standard therapeutic regimens and management documents, so as to avoid confusion, since drugs which are sold under tINN or a variety of brand names, depending on the manufacturer (e.g. ampicillin may be sold as Britapen®, Penbritin®, Pentrexyl®, Totapen®, etc.).

Generic drugs are copies of drugs whose patents have expired. They can therefore be made by any pharmaceutical laboratory and are most often sold under their INN or occasionally under a new brand name.

Selection of essential medicines

Most countries have a national list of essential medicines. If there is no national list, refer to the latest WHO list.

The use of such a list presents several advantages:

– it simplifies supply and reduces costs: most drugs on the WHO list are available in generic forms at affordable prices;

– it facilitates co-ordination of international aid and obtains approval from organizations which subsidise projects (United Nations, European Union, etc.).

The list of selected drugs is drawn in accordance with pre-established standardised therapeutic regimens. This offers two major advantages:

– better treatments due to more rational use of a restricted number of essential drugs;

– economic and administrative improvements concerning purchasing, storage, distribution and control.

Proposing the same drug in many different strengths or forms should be avoided. In most cases, one form/strength for adults and one paediatric form/strength are sufficient. This facilitates management and avoids confusion in prescriptions.

At times, local prescription usages should be taken into account, e.g. in French-speaking Africa, 500 mg aspirin tablets are used; in English-speaking Africa, 300 mg tablets.

Note: medical supplies (dressing, injections, sutures, etc.) should be limited to essentials and the object of a standardised list.

Drug classification

In the WHO list, drugs are classified according to their therapeutic action. This classification presents a certain pedagogical advantage but cannot be used as the basis of a storage arrangement system (e.g. a drug may appear in several classes).

Médecins Sans Frontières recommends a storage arrangement system according to the route of administration and in alphabetical order.

Drugs are divided into 6 classes and listed in alphabetical order within each class:

– oral drugs

– injectable drugs

– infusion fluids

– vaccines, immunoglobulins and antisera

– drugs for external use and antiseptics

– disinfectants

This classification should be used at every level of a management system (order forms, stock cards, inventory lists, etc.) in order to facilitate all procedures.

Levels of use

More limited lists should be established according to the level of health structures and competencies of prescribers. Restricted lists and the designation of prescription and distribution levels should be adapted to the terminology and context of each country.

Quantitative evaluation of needs when launching a programme

Once standard therapeutic regimens and lists of drugs and supplies have been established, it is possible to calculate the respective quantities of each product needed from the expected number of patients and from a breakdown of diseases.

Several methods have been suggested (see Estimating drug requirements, WHO). Quantities calculated may differ from those corresponding to true needs or demands (this can be the case when the number of consultations increases or when prescribers do not respect proposed therapeutic regimens).

In an emergency situation (especially with displaced population), the Emergency Health Kit, developed in collaboration with the WHO, UNHCR, MSF, etc., is designed to meet the care needs of a displaced population of 10,000 people for 3 months. Afterwards, specific local needs should be evaluated in order to establish a suitable supply.

Routine evaluation of needs and consumption allows verification of how well prescription schemes are respected and prevents possible stock shortages.