Hospital and Clinical Pharmacy

Hospital classification, pharmacy layout, staffing, Pharmacy & Therapeutics Committee (PTC), and hospital formulary.

• Organization, functions, and role of hospital pharmacy in Nepal
• Pharmacy and Therapeutics Committee (PTC): composition, duties, policies
• Hospital Formulary: development, contents, maintenance, and revision
• Hospital drug procurement and inventory control methods
• Safe storage and handling of narcotics and controlled substances in hospitals

Inpatient and outpatient drug distribution, unit dose dispensing, automated systems, and ward stock.

• Outpatient dispensing procedures and ambulatory care services
• Inpatient drug distribution: individual prescription order system
• Complete floor stock system and emergency drug kits
• Unit Dose Dispensing System (UDDS): centralized vs decentralized
• Distribution of controlled substances, hazardous drugs, and radio-pharmaceuticals

CSSD, sterile product preparation, IV admixture services, and total parenteral nutrition (TPN).

• Central Sterile Supply Department (CSSD): workflow, sterilization monitoring
• Intravenous (IV) admixture services and aseptic technique
• Total Parenteral Nutrition (TPN): composition, compounding, stability
• Safe preparation and handling of cytotoxic hazardous medications

Clinical pharmacy practice, medication history interview, chart review, and patient counseling.

• Concept, scope, and daily activities of clinical pharmacists
• Medication history interviewing and documentation (SOAP format)
• Inpatient chart review and identification of drug-related problems (DRPs)
• Patient counseling skills: chronic illnesses (hypertension, diabetes, asthma)
• Special patient populations: pediatrics, geriatrics, pregnancy, renal/hepatic impairment

TDM indications, drug interactions, adverse drug reaction (ADR) reporting, and pharmacovigilance in Nepal.

• Therapeutic Drug Monitoring (TDM): indications, narrow therapeutic index drugs (digoxin, phenytoin, aminoglycosides)
• Drug-drug, drug-food, and drug-disease interactions
• Pharmacovigilance: classification of Adverse Drug Reactions (ADRs)
• National Pharmacovigilance Centre (DDA Nepal) and yellow form reporting
• Medication errors: types, root causes, prevention strategies