SuM 2024Community Pharmacy & Management [20222]

Give the characteristics of ideal pharmacy interior design. Ans.

Objectives of Layout Design:
(i) To attract a large number of customers.
(ii) To increase the sales of the store.
(iii) To reduce the selling expenses to a minimum.
(iv) To provide customers satisfaction.
(v) To project a professional image and improve general appearance.
(vi) To minimize the movement of customers within the premises of the drug store.
(vii) To provide surveillance in order to reduce the chances of pilferage and theft.
(viii) To have space for reserve stock, office and resting place for the employees.
(ix) To have a proper entrance for incoming goods
Pharmacy Designs and Interiors:
1. Generally, the drug stores, are located on the ground floor of the building. They are usually
constructed of cement concrete walls with mosaic tiles on the floor.
2. The internal fittings usually consist of racks or storage cupboards having glass doors, drawers
for storing strips, shelves and a proper place for placing the refrigerator.
3. The counters of the store are made from wood having white sunmica at its top.
4. The furniture includes a working table and wooden or steel chairs for the staff and
customers.
5. A modern drug store should fulfil all the minimum requirements as laid down in
Schedule 'N' of The Drugs and Cosmetic Rules, 1945.
6. To start a retail drug store a minimum of 10 sq. meter area is required. Similarly, to start a
wholesale drug store a minimum 10 sq. meter area is required.
7. The premises of a drug store must be separated from rooms for private use.
8. The outer front of the drug store should be very attractive and built with innovative
construction techniques.
9. The material used for constructing the drug storefront is normally glass, glazed tiles and
marbles which are easy to clean.
 10. The floor of the drug store should be smooth and washable. The walls should be plastered or
tiled or oil painted to maintain a smooth durable and washable surface, adequate lighting
should be provided, preferably tube lights which are concealed.
11. Good lighting system provides a cheerful atmosphere for the customers, and the merchandise
stored and displayed appears more attractive. It also helps in identifying the medicines etc.
quickly and easily and thus increases the efficiency of the store.

b) Mention the causes of dispensing errors. Give strategies to minimize dispensing errors.
Ans.
COMMON DISPENSING ERRORS:
1. Dispensing medication for a wrong patient
2. Dispensing wrong medicine
3. Dispensing wrong drug strength (dose)
4. Dispensing the wrong quantity
5. Dispensing wrong dosage form
6. Dispensing with wrong information on label
7. Dispensing at wrong time
8. Failure to dispense
9 Dispensing medicines of inferior quality
10. Dispensing expired or almost expired drugs.
OR
1. Poor handwriting of the prescriber
2. Retrieval of wrong drug from the stock
3. Dose interpretation: Dose error/ Wrong dose
4. Incorrect interpretation of abbreviation.
5. Expiry error
STRATEGIES FOR MINIMISING DISPENSING ERRORS
1) Confirm contents of prescription- Any doubts & uncertainties should be clarified with the
prescriber
2) Beware of LASA (Look alike sound alike) – The name should be read carefully
3) Organize workplace- proper lighting, adequate counter space, and proper temp. & humidity
of the workplace
4) Reduce distraction – Avoid multitasking
5) Reducing stress & balance workload- Give regular breaks & freedom from
secondary responsibility to the employee
6) Thoroughly check all prescriptions
7) Thorough patient counselling
8) Educating the patients about safe & effective use of their medicines
c) Define patient counselling. Discuss the patient counselling points for hypertensive
patients.
Ans.Definition: Patient counseling is a process wherein pharmacists have face-to-face interaction
with the patient to provide oral or written information on directions of use and advice on side
effects to help them use their medications appropriately.
Patients Counselling in Hypertension:
 Patients should be counselled about the nature of the disease and the management of
hypertension, before being subjected to laboratory evaluation and drug treatment.
 Hypertension (systolic blood pressure 140 mm/Hg or diastolic pressure 90 mm/Hg) Risk
increases with age: those who are normotensive at age 55 have a 90% lifetime risk of
developing hypertension.
  Counselling hypertensive patients requires insight, creativity and ingenuity because fixed
messages will fall flat.
 Effective counselling covers following essential themes:
(a) Improving health status with adherence.
(b) Providing information on adverse effects.
(c) Contraindications.
(d) Promoting healthy behaviours.
 Always begin by asking patients what prescribers told them previously, in order to save
time and to identify information related to their disease quickly.
Emphasizing Medication Adherence:
 Because patient adherence is lower for symptomless conditions, it is crucial to emphasize
controlling blood pressure and to list the risks of medication non- adherence.
 Inform patients about what to do if they miss a dose. Repeat the name of the medication
frequently so that patients become familiar with it.
 Make suggestions that incorporate multiple daily doses into the patient's routine.
 Be cautious, however, about pairing medications with meals because some patients eat
only 2 meals a day, others may have 4. Instead, specify the number of times per day to
take the medication.
 Ask specific questions about the patient's ability to follow directions, such as "This
medication must be taken twice; when in your day do you think you would take it?"
Adverse Effects and Contraindications:
 Make adequate counselling ideal by offering tips for coping with common adverse
effects. Not rare but serious side effects and describe the circumstances under which
patients should contact their physician.
 Warn patients about drug, food or OTC product interactions and other contraindications.
 Highlight transient side effects, such as orthostatic or gastrointestinal complaints are
temporary.
 Counsel patients about the dangers of stopping the medication before talking to their
physician. Sudden termination of many antihypertensive may lead to rapid, dangerous
blood pressure escalation.
 Tell patients to keep enough medicine to last through weekends, holidays or vacations.
Suggest carrying an extra prescription in a billfold or purse in case of an emergency.
 Always encourage patients to call the pharmacy whenever needed help with medications.
Promoting Healthy Behaviors:
 Effective changes in health behaviors help the patient set realistic, achievable goals.
 Suggest small changes that elicit firm commitments. Patients may balk at 30 minutes of
exercise but be willing to commit to 10 minutes a day. They may roll their eyes at a 10%
weight reduction but commit to losing 5 lb. Sometimes adding new behaviours (e.g.
exercising) is easier than eliminating old habits (e.g. eating salty chips).
Patient Self-Monitoring:
 Many patients monitor their own blood pressure.
 They should be told to keep a log and to record their B. P. at the same time each day.
 Additionally, they should take their cuff with them when they visit their doctor to ensure
that they are taking readings correctly and that the machine is calibrated accurately.
 Building confidence begins with demonstrating a genuine interest in what happens to the
patient, and communicating your concern by saying "See you next month, OK?"
d) Explain the role of pharmacist in OTC medication dispensing. Ans.
Definition: Over-the-counter (OTC) medicines are the drugs which are available to the patients
without a prescription. These medicines are called non-prescription medicines.
Role of pharmacists in OTC medication dispensing: -
 Effective treatment - Pharmacists can help in effective treatment and reduce its cost
 Public health- Pharmacists can help improve public health by screening patients’ health,
providing information on drug safety, and deciding on rational use of OTC products.
  Rational use of medicines- Pharmacists need to check regarding interactions of OTC
medications with herbal and dietary supplements or prescription drugs.
 Education and counselling - Pharmacists need to counsel patients regarding appropriate
use of OTC products like dose, dosage form, route of administration, duration of action,
special directions, precautions, side-effects, interactions and contraindications
 Keeping check - Pharmacists need to check OTC medicines interactions with other
drugs, prescription drugs or with food.
 Preventing drug abuse and misuse - Pharmacists need to keep check on drug abuse and
misuse by the patients.
 Referral to doctor - The community pharmacists need to identify whether OTC products
are appropriate for the patient or the case needs to be referred to a doctor.
e) What factors need to be considered while selecting a site for setting up a community
pharmacy?
Ans.The following factors should be considered while selecting a site for a new community
pharmacy.
Various factors are:
1. Physicians
2. Clinic/ Hospital
3. Other drug store
4. Flow of traffic
5. Parking
6. Business Locality
7. Residential areas
8. Developing areas
9. Near hotel, school, playground, cinema hall etc.
10. Visibility & accessibility
1. Physicians: - If a location is having a good practice of more than three physicians, then 70%
of business will come through prescriptions. But if physicians are dispensing their own
medicines, they will prove to be competitors for the drug store.
2. Hospital: - If a hospital or clinic has a good practice of doctors without its own pharmacy,
then it is considered to be a very good location.
3. Other drug stores: - The area where no other pharmacies exist should be selected, but if the
potential is very high and already a number of pharmacies are existing then this area may be
selected. This area may become a major business centre for drugs. People in large numbers
may visit the area thinking that all types of medicines are available and in turn the sales
increase
4. Flow of traffic: - A pharmacy should be in an area, where there is no traffic congestion. A
pharmacy should not be opened near traffic signals or road circles as it may lead to traffic
jams. It should be opened on that side of road which people take to reach their homes because
people prefer to buy goods while returning home from their jobs
5. Parking: - Enough parking space is always advisable when selecting a location.
6. Business Locality: - Number of people coming to business locality is high. In this case, if
shop is made attractive people may visit to purchase drug simultaneously. The disadvantage
is that the shop is not easily available and the price of shop is very high. Huge investment is
required to maintain the standard of pharmacy.
7. Residential areas: - Thickly populated areas should be selected for a pharmacy. People
prefer to buy medicines from nearby areas
8. Developing area: - Nowadays in cities new areas are developing fast. It is a good location to
serve the needs of customers initially providing all types of services. Competition is not a
problem in this area.
9. Near hotels, schools, playground, cinema halls: - These locations are not preferable for
starting a drug store because generally people live at a distance from schools, playgrounds, hotels
 etc. If a site is near a restaurant, it may create a problem of maintaining cleanliness in the
neighborhood of the drug store. In case cold drinks or Ice-cream facilities are also extended then
it is preferable to open a pharmacy near cinema halls.
10. Visibility & accessibility: - The pharmacy should be easily visible & accessible to the
customers. It should be on a ground floor & near the footpath
f) Define Diarrhea. Describe the causes, symptoms and self-care advice for management of
Diarrhea.Ans.
Define: Diarrhea is an increased frequency and decreased consistency of fecal discharge as
compared with an individual's normal bowel pattern.
Causes:
 Allergies to certain foods
 Diseases of the intestines (such as Crohn's disease or ulcerative colitis)
 Eating foods that upset the digestive system
 Infection by bacteria (the cause of most types of food poisoning) or other organisms like
parasites
 Laxative abuse or a reaction to medications like antibiotics and certain cancer drugs
 Running (Some people get “runner’s diarrhea” for reasons that aren’t clear.)
 Some cancers
 Surgery on your digestive system
 Trouble absorbing certain nutrients, also called “malabsorption”
 Overactive thyroid (hyperthyroidism)
Symptoms:
 Bloating in your belly
 Thin or loose stools
 Watery stools
 An urgent feeling that you need to have a bowel movement
 Nausea and throwing up
 Leaking stool, and you can't control your bowels (incontinence)
Self-care Advice:
Drink Liquids:
Drink clear fluids or oral rehydration to replace lost fluids:
 Clear liquids such as water or broth are the best choices.
 Don't have drinks with a lot of sugar in them, such as juices and sodas. These can make
diarrhoea worse.
 If you have severe vomiting, don't drink sports drinks, such as electrolyte solutions. These
don't have the right mix of water, sugar and minerals.
 They can also make the symptoms worse. In this situation, commercially available Oral
Rehydration (ORS) solutions are best.
 Suck on ice chips if the thought of drinking something makes you queasy.
When you're able to eat again:
Tips include the following:
 As your appetite comes back, you can resume your normal diet.
 Avoid eating unhygienic food.
Medicines:
Know the following about medicines:
 Vomiting and diarrhea are ways your body uses to rid itself of harmful substances such as
bacteria. Don't use antidiarrheal or anti-vomiting (antiemetic) medicines unless your
healthcare provider tells you to do so.
 Aspirin, medicine with aspirin and many aspirin substitutes can irritate your stomach. So
don't use them when you have a stomach upset.
 Certain prescription and Over-The-Counter medicines can cause vomiting and diarrhea. Talk
 with your healthcare provider about any medicines you take that may be causing these
symptoms.
 Certain Over-the-Counter antihistamines like Dimenhdinate can help control nausea. Other
medicines can help soothe stomach upset. Ask your healthcare provider which medicines may
help you.
g) Enlist various inventory control techniques useful for community pharmacy. Explain any
two techniques in detail.
Ans.
Is defined as a continuous process that involves planning, organizing, & controlling
inventory to minimize the investment in inventory while maintaining an optimum level stock of
the items.
Techniques of inventory control:
1. ABC analysis
2. Economic order quantity (EOQ)
3. Perpetual inventory system
4. VEN/VED analysis
5. Setting of various levels
6. FIFO and LIFO
7. Establishing an effective purchase procedure
ABC analysis: (Always Better Control): In this, the materials are divided into three groups – A,
B and C according to the cost of material and money value of consumption.
A items B items C items
1 It covers 10% of total inventories It covers 20% of total inventories It covers 70% of total
inventories
2 It consumesabout 70% of total budget It consumesabout 20% of total It consumes about 10% of
budget total budget
3 It requires very strict control It requires moderate Control It requires light or loose
control
4 It needs minimum follow up It needs periodic follow up It needs close follow up
5 It requires more effort to reduce lead time It requires moderate effort to reduce It requires minimum
lead time effort to reduce lead time
6 It requires low safety stock It requiresmoderate safety stock It requires high safety stock

Q.2 Answer any TEN of the following: 30

a) What are the factors to be considered while selecting the vendors to supply the
medication material in community pharmacy?
Ans.
The wholesaler or distributor is the vendor for community pharmacies.
A vendor audit is a useful tool which can be used while selecting vendors for supplies.
Vendor audit should take into account the following:
 Vendor has a drug license for wholesale.
 Vendors should ensure quality, uninterrupted supply, at a competitive price of
medicines.
 Has good stocking and transport facility (as the quality of medicines is dependent on storage
and transport)
 The wholesaler should have proper storage including a refrigerator and freezer. The whole
facility must have air conditioning
 Whether the vendor has, and follows, Standard Operating Procedure for its activities
 Conditions of supply like modes and dates for payment, frequency of supply, etc.
 When there are many vendors offering quality products, market reputation and
 economic aspects are considered.
b) Define communication skills. Enlist the points to make telephone conversation effective.
Define: Communication is the sharing of information, ideas, thoughts and feelings.
It involves not just the spoken word but also what is conveyed through inflection, vocalquality,
facial expression, body posture and other behavioral responses.
Points To Make Telephone Conversation Effective:Speak slowly and clearly: Listen actively:Develop
rapport:Attention:Clarifying the content:Be friendly and welcoming:Privacy protection:Remembering names,
Prepare in advance.Friendliness:Be professional.Clear enunciation:
c) Explain the procedure of measuring capillary blood glucose level by using
glucometer.
Wash Hands: Begin by washing your hands with soap and water to ensure cleanliness.
Prepare GlucometerTurn on the digital glucometer and ensure it is calibrated and has enough battery
power.Insert Test Strip: Insert a new, compatible test strip into the glucometer as per the manufacturer's
instructions.Lance Finger: Use a lancet to prick the side of your fingertip gently. A small drop of blood
will form at the puncture site.Apply Blood Sample: Touch the blood droplet to the designated area on the
test strip. Ensure enough blood is applied to get an accurate reading.Wait for Result: The glucometer will
process the blood sample and display the blood glucose level on the screenRecord the Reading: Note
down the blood glucose reading along with the date and time for record-keeping or to share with your
healthcare provider.Dispose of Test Strip: Safely dispose of the used test strip according to the
manufacturer's instructions.Clean Up: Clean the glucometer and your hands as needed after the
measurement.
Define community pharmacy. Explain the current scenario of community pharmacy in India.Define:
Community Pharmacy is defined as any place under the direct supervision of a pharmacist where the
practice of pharmacy occurs or where prescription orders are compounded and dispensed other than a
hospital pharmacy or a limited-service pharmacy. Current Indian Scenario:
The pharmacy practice scenario and especially community pharmacy practice during the pre-independence
era was highly unregulated and there were no restrictions on the practice of pharmacy in India. The
standardization of pharmacy education was introduced in 1945.
In 1949 Pharmacy Council of India was established under pharmacy act 1948.
In 1953 education regulation came into force in some States but other states lagged behind.
In 1954 drugs and magic remedy act was passed to stop misleading advertisement.
In 1955 medicinal and toilet preparations Act was introduced to enforce uniform duty for all states for
Alcohol products.
In India, provisions of the Pharmacy Act 1948 enforced community pharmacists working in India to have a
pharmacist registration certificate issued by the State Pharmacy Council of the respective State. To obtain a
registration certificate, the prospective pharmacist must acquire the minimum diploma (D. Pharm.) from a
pharmacy institute recognized by the Pharmacy Council of India (PCI). Both D. Pharm. and B. Pharm.
holders are allowed to practice in any community pharmacy.In1985narcotic and psychotropicsubstances
act was enacted to protect society from the danger of attitudedrugs.
The primary objective of education and training of community pharmacists is the safe and effective use of
medicines to improve patient outcomes. The training was provided during educational programs but to
maintain registration continued professional development was essential to ensure that the practice is kept
up-to- date.
d) What are the advantages and disadvantages of self-medication? Ans.
Advantages of self-medication
 Number of doctors available are limited. So it is not practical to treat every minor ailment
through a doctor.
 It can save patients’ money & time.
 Quick relief to patients
 Wide variety of OTC medicines are readily available.
 The OTC products are relatively safe & efficacious.
Disadvantages of self-medication
 Self-diagnosis may not be correct
  Wrong & prolonged self-medication can delay proper diagnosis & treatment
 Possibility of adverse drug reaction & drug dependence
 It should only be done for minor illness with OTC medicines & for limited time only.
e) What are the professional responsibilities of community pharmacist? Ans.
Professional responsibilities of a pharmacist:
Prescription processing - The pharmacist has to receive the prescription and check its legality.
Dispensing of medication - The pharmacist dispenses the medications in a proper manner.
Patient counselling - Patient counselling services are an important part of the duty of pharmacists while
dispensing medicines.Drug information services - Pharmacists should provide information regarding
standard therapy, alternative therapy, adverse drug reactions, etc.
Health screening services - Community pharmacists should help in detection of diseases, reduce risk
factors and maintain well-being by various health screening programmes.
Response to minor and common ailments - Community pharmacists can advise the patients to visit a
physician depending on the condition. They can advise on self- limiting ailments.
Health promotion - They can promote health by helping in rational drug use and various disease
eradication programmes.
Professional relationship - Community pharmacists have professional relationships with other healthcare
professionals like doctors to promote patient’s well-being.
The other responsibilities of a community pharmacist includes:Establishing a
Pharmacy,Extemporaneous preparations, Rational drug use, Patient care Act as family
pharmacist,Individualization of drug therapy,Pharmacovigilance,Non Pharmacological counselling
Women, infants and elderly care,Home care,Addiction help,Social work and national health programmes
What documents are required to open a new retail drug store? Ans.Documents required for opening
Retail Drug Store:Application in duplicate on Form 19 of the Drugs & Cosmetic Rules 1945Challan of fee
deposited for obtaining drug licence
Details of the premises- The minimum space for retail pharmacy is 10 sq.m.Plan of the premise duly signed
by proprietor/partner, A copy of partnership deed in case of partnership firm.
Pharmacist details- Name, attested copy of Diploma in Pharmacy from Institution recognized by PCI,
Affidavit of registered pharmacist.
Applicant’s Details - Affidavit of non-conviction of proprietor/partner/director under the D & C Act
1940. Passport size photograph, address & identity proof.Details of the storage facilities: Refrigerator
purchase receipt, Air conditioner purchase receipt along with their installation certificate.
Write a note on handling of prescription.
Ans.Prescription handling
The dispensing of medicines requires proper prescription handling. The various stepsinclude
Receiving the prescription - The pharmacist should receive the prescription from the patient or
the relative in a professional manner with a smile, eye to eye contact and friendly courtesy.
Checking the prescription - The pharmacist should always check the prescription for its proper format
(legality) and completeness. In case of any difficulty, the pharmacist should consult another pharmacist or
the prescriber. The pharmacist should never guess the medicines on a prescription as it may lead to serious
issues.
Assembling the medicines - While taking out the medicines from the shelves, the pharmacist should pay
attention to the dosage form, strength and the expiry date. All the medicines should be kept in a tray.
Packing the medicines and labelling - The medicines should be packed properly to keep the potency of
the medicines intact. Medicines requiring storage in cold temperatures should be packed with ice packs.
Proper labelling of the products is required in case dispensing is done from bulk containers.
Billing and filling the patient medications report - The medicines should be checked for dosage form,
strength, quantity and expiry date while billing. The pharmacist should make an entry into the patient
medication report for each patient while billing. The bill should be signed by a registered pharmacist.
Instructions to the patient - Patient counselling is an important step while dispensing of medicines. The
pharmacist should provide instructions regarding dosing time and simple advice regarding the medications.
Endorsement - The prescription should be stamped with date and sign of the pharmacist.
f) Explain the importance of body language with respect to posture and eye contact. Ans.
Role of Body Language in Communication:
This is important for face-to-face meetings and video conferencing. Make sure that you appear accessible,
so have open body language. This means that you should not cross your arms and keep eye contact so that
the other person knows that you are paying attention.
Your posture has the greatest impact on your communication. The impression you have on others is split
approximately:Body (visuals) 55%,Voice (sound) 38%, Words (content) 7%.
Folded arms, crossed legs, hunched shoulders, hands in pockets, looking down these are just some of the
protective measures that make us feel safer, and should be avoided when giving a presentation or speech.
Appearing relaxed makes us exert dominance and authority.If you watch politicians speak, notice how
relaxed and confident they appear, talking slowly and making positive body movements. Use your arms to
emphasize a point and illustrate the message.
g) What are the benefits of patient counselling?
Ans
Counseling is beneficial in understanding the patients and their illnesses, and to frame strategies to deal
with the health issues.Patients will have a better understanding of the prescribed therapy and the
appropriate use of the medication.Counseling helps to ensure that correct medicine is supplied to the
correct patient.It improves patient adherence to the treatment.It is beneficial in verifying patients'
understanding, knowledge, and ability to self- manage therapy.It helps to reduce medication errors and
misuse and enhance patient monitoring.It helps to reduce healthcare costs of individuals, society and
government by preventing adverse events.Promotes the image of pharmacist as a professionalIt helps to
build trusting relationships with patients.
h) What are the patient related factors for medication non-adherence? Ans.
Medication adherence is adversely affected by patient-related factors that are closely linked to the
other factors previously discussed. Most of the time patient behavioral factors may not be perceived
well by the doctors resulting in decreased adherence. Most variations in taking medication occur
include omission of doses or delays in the timing of doses.Patients with low literacy usually have
difficulties in understanding instructions; which ultimately results in decreased adherence and poor
medication management. The list of these factors includes:
Physical factors,Visual impairment, Hearing impairment,Impaired mobility/dexterity
Swallowing problems,Psychological/behavioral factors,Motivation,Fear of possible adverse effects
Fear of dependence,Feeling stigmatized by disease,Frustration with healthcare providers
Psychosocial stress/anxiety/anger,Alcohol/substance abuse.,Chronic disease

Q.3 DEFINE Finance may be defined as the management of money such as to start a business or
support it.OR It is defined as a provision of money when business requires it.
self-medication WHO has defined self-medication as selection and use of medicines by individuals to
treat self-recognized illnesses or symptoms.
COPDChronicObstructivePulmonaryDi
sease
Stadiometer measures the HEIGHT of the patient.
Define pharmaceutical pictogram. A
Pharmaceutical pictograms are representation of the information in the form of simple
pictures or symbols which include directions for use, warning and precautions while taking
medications.
Define daybook.
A day book is a book of original entry in which the transactions are recorded by date in
chronological order.