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Title When Document / Link
PSHP meets CEO of Sindh Healthcare Commission
Aug 2023
Training of Safety Officers and Pharmacovigilance focal persons of Punjab, on “High Alert Medicines; in line with the National High Alert Medicines Guidelines (Pakistan)”.
Mar 2023
PSHP drafted "Minimum Standards of Hospital Pharmacy in Pakistan"
Feb 2023
Flood Relief-proper medicine storage and record keeping.
Sep 2022
Flood Relief-Safe medicine dispensing
Sept 2022
Training Need Assessment for Practicing Pharmacists (working in Pakistan).
Sept 2022
Basic First AID Medicine Supplies List
Sept 2022
Accepting and Handling Medicine Supplies & Donations; Guidelines for Relief Operations
Aug 2022
PSHP letter to DRAP notifying critical drug shortages
July 2022
PSHP developed National High Alert Medicine Guidelines Pakistan. Placed for stakeholders’
review (DRAP website)
June 2022
How pharmacist can help with medicine use during Ramadan
April 2022
PSHP helped DRAP to revise High Alert Medicine list for Pakistan
Dec 2021
PSHP congratulating Tabba Heart Institute – Pharmacy Department for ISMP Cheers Award 2021
Dec 2021
PSHP Celebrated MedSafety Week (WHO)
Dec 2021
PSHP Celebrated World Antibiotic Awareness Week (WAAW - WHO)
Nov 2021

Accepting and Handling Medicine Supplies & Donations; Guidelines for Relief Operations

The natural calamities as floods or earthquake etc. bring major disruption in the life and health of the people affected. To respond to the situation, several teams of professionals and volunteers start mobilizing resources to rescue the affected population, and medicines supplies constitute a big proportion of these resources. Their timely availability of medicines will save many lives on one side, on the other side their mismanagement, wastage, damage and expiry will lead to substantial loss to both the donors as well as the to the population it was intended for. Hence these guidelines will help all those organizations which are collecting, storing and distributing medicine supplies for medical camps and relief operations.

Core principles for medicine donations (Based on WHO guidelines):

1. Donations of medicines should benefit the recipient to the maximum extent possible. All donations should be based on an expressed need. Unsolicited medicine donations are to be discouraged.
2. Donations should be given in conformity with the government policies and administrative arrangements of the recipient.
3. There should be no double standard in the quality. If the quality of an item is unacceptable for the donor, it is also unacceptable as a donation.

Guidelines for accepting the medicine donations:

Applicable to:

 NGOs, welfare organizations, healthcare facilities, donor agencies, medical or relief camps etc.

1. The selection of medicines to be donated must be based on a sound analysis of needs. Distribution must fit with existing policies and administrative systems. E.g. do not accept an injectable medicine if the relief facility does not have a mechanism or staff to administer parenteral drugs See annexure 1 and 2 for sample medicine lists (refer to these lists in order to avoid unnecessary medicine stocking or wastage).
2. Those who are receiving the stocks, must check the shelf life (expiry) of the product.
3. It is advisable to receive the stock of more than a year shelf life.
4. Do not accept stocks in which lot # and expiry date are not visible, damaged or mutilated.
5. Do not accept the products if the packaging is damaged, seal is broken or if the product name and strength are not identifiable due to any reason.
6. Items requiring cold chain maintenance to be accepted only if the adequate storage and transport system exists from the donor site till the relief camp.
7. All cold chain items must be stored at 2-8⁰C with proper power backup and daily temperature monitoring and documentation. Do not use the cold chain medicines if they have a substantial exposure to high or freezing temperatures.
8. All medicine donations must be properly recorded as incoming and outgoing (dispensed) stocks (in manual or computerized record form) – see annexure 3 for sample issuance and receiving record for medicines.
9. Consumption patterns must be monitored in order to ensure the timely restocking of the products.
10. All dead (non-moving) stock items must be returned to the donor agency well before expiry date, in order to reduce the wastage.
11. Medicines must be stocked following FEFO rule (First Expire – First Out) and medicine expiry is monitored on regular basis (at least monthly).
12. All inventory management and dispensing process must be carried out under supervision of a qualified person i.e. a pharmacist.
13. The area where the medicines are stored must be neat, clean and clutter free.
14. Medicines should be accessible to authorized persons only and must be prevented from theft and damage.
15. Safeguard medicines from excessive heat, direct sunlight and moisture. Cartons must not be placed as directly touching the floor.
16. Pest control should be ensured to avoid damage and medicines wastage

References:

Basic/First Aid Supplies (Sample List)

1. Ciprofloxacin tabs and suspension (GI/UTI/SSTIs)
2. Doxycycline caps (GI; cholera, SSTI)
3. Cefixime caps, suspension (Dysentery)
4. Cephradine caps and suspension (SSTIs)
5. Metronidazole tabs and suspension (GI)
6. Amoxicillin (caps and syp) (URTIs and LRTIs)

1. Cough syrup (Dry cough)
2. Cough syrup (productive cough)
3. Anti-allergic tabs and syrup (e.g. Cetrizine or Loratidine)

Lactulose syrup

1. Paracetamol tabs, suspension and drops
2. Ibuprofen tabs and suspension
3. Hyoscine butylbromide tablets
4. Cool gel packs for fever

1. Iron (ferrous sulfate) tabs
2. Folic acid tabs
3. Calcium/vit D tabs
4. Multivitamin tabs/syrup
5. Female sanitary pads

1. Antacid syrup, tabs or sachets
2. Omeprazole cap, sachet

1. Drops for ear pain (e.g. Lidosporin)
2. Gentamicin ear drops

1. Bandage roll
2. Gauze pieces
3. Cotton roll
4. Band aids (Saniplast)
5. Gloves
6. Alcohol Wipes
7. Surgical tape

3. Metoclopramide tabs and syrup
4. Ondansetron tabs and syrup

1. Loperamide capsules
2. Attapulgite tabs
3. ORS (sachet or liquid)
4. Zinc sulfate solution

1. Antibiotic eye ointment (e.g. Polyfax)
2. Gentamicin eye drops
3. Anti allergic eye drops

1. Antibiotic skin ointment (e.g. Polyfax).
2. Antifungal (ketoconazole or clotrimazole) cream.
3. Permethrin cream/lotion (scabicidal).
4. Hydrocortisone cream

1. Povidone-iodine solution 60ml
2. Hydrogen peroxide solution

1. Mosquito repellent lotion
2. Water purification tablets
3. Thermometer
4. Torch
5. Pair of scissors

Medicine Supplies for healthcare units (Sample List)

1. Ciprofloxacin tabs, suspension and infusion (GI/UTI/SSTIs)
2. Doxycycline caps (GI; cholera)
3. Cephradine caps and suspension (SSTIs)
4. Metronidazole tabs, suspension and infusion (GI)
5. Chloroquine tabs, syrup (malaria)
6. Artemether + Lumefantrine tabs, syrup
7. Artesunate injection (malaria)
8. Ceftriaxone inj. (IV)

1. Antibiotic eye ointment (e.g. Polyfax)
2. Gentamicin eye drops

1. Antibiotic skin ointment (e.g. Polyfax)
2. Antifungal (ketoconazole or clotrimazole) cream
3. Permethrin cream/lotion (scabicidal)
4. Hydrocortisone cream

1. Drops for ear pain (e.g. Lidosporin)
 2. Gentamicin ear drops

1. Paracetamol tabs, suspension and drops
2. Paracetamol injection
3. Ibuprofen tabs and suspension
4. Hyoscine butylbromide tablets
5. Drotaverine injection
6. Cool gel packs for fever
7. Baby colic drops / gripe water

1. Tetanus toxoid
2. Anti Snake venom
3. Anti Rabies vaccine

1. Normal saline 500ml
2. Normal saline 25ml
3. Ringer lactate 500ml
4. Dextrose 5% 500 ml
5. Dextrose 25% 25ml

1. Antacid syrup, tabs or sachets
2. Omeprazole cap, sachet

1. Iron (ferrous sulfate) tabs
2. Folic acid tabs
3. Calcium/vit D tabs
4. Multivitamin tabs/syrup

1. Metoclopramide tabs and syrup
2. Ondansetron tabs and syrup
3. Dimenhydrinate injection

1. Bandage roll
2. Gauze pieces
3. Cotton roll
4. Band aids (Saniplast)
5. Gloves
6. Alcohol Wipes
7. Pair of scissors

1. Cough syrup (Dry cough)
2. Cough syrup (productive cough)
3. Anti-allergic tabs and syrup (e.g. Cetrizine or
Loratidine)
4. Pheniramine Inj.
5. Dexamethasone inj.
6. Prednisolone tabs
7. Salbutamol nebulizer

1. Cannula
2. Syringes
3. IV sets
4. Surgical tape

1. Loperamide capsules
2. Attapulgite tabs
3. ORS (sachet or liquid)

1. Povidone-iodine solution 60ml
2. Hydrogen peroxide solution

1. Mosquito repellent lotion
2. Water purification tablets
3. Female sanitary napkins
4. Thermometer
5. Torch
6. BP apparatus
7. Tongue depressor

PSHP drafted "Minimum Standards of Hospital Pharmacy in Pakistan"

PSHP team drafted “Minimum Standards of Hospital Pharmacy in Pakistan” and sought stakeholders’ comments and review. Salwa Ahsan, Senior Vice President of PSHP handed over the draft and shared officially to CEO DRAP, Mr Asim Rauf in presence of Director Pharmacy Services Division (DRAP), Dr Obaidullah and his team on February 7th 2023, and stated that the aim of these guidelines/standards is to guide, help establish and upgrade the state of hospital pharmacy practice in Pakistan; thereby improving the:
• Medication Management & Use systems in the hospitals
• Patient safety and Medication Safety
• Pharmacovigilance system
• Hospital Formulary Management and
• Role of multidisciplinary committees such as Pharmacy & Therapeutic Committees etc.

These guidelines will help to setup a foundation of hospital pharmacy services in private and public sectors, and shall provide a guidance on how a hospital pharmacy leader could advance pharmacy services and role of hospital pharmacists for the ultimate patient benefit, and not just confining to the process of simple procurement and storage of medicines.