Cpm
Cpm
Definition: The drugs which are used in the treatment of malaria are called antimalarials.
Classification
1. Cinchona alkaloids: e.g. quinine
2. 4-aminoquinolines: e.g. chloroquine, amodiaquine
3. 8-aminoquinolines: e.g. primaquine
Acridine: e.g. mepacrine
5. Biguanides, e.g. proguanil
2) Describe the professional responsibilities of community pharmacist?
Definition: Good pharmacy practice ensures pharmacists provide quality service to every
patient. Responds to patient needs for optimal, evidence-based care Based on pharmaceutical
care by pharmacists.
WHO Recommendations for GPP:
Professional responsibility as main philosophy.
➤ Pharmacist input crucial in medicine use decisions.
Therapeutic partnership with healthcare professionals.
Collaboration with colleagues for service improvement.
Importance of patient information provision.
Continual maintenance of professional competence.
Adherence to national GPP standards.
Elements of GPP:
Health Promotion: Achieving health objectives and preventing illness.
Rational Medicine Use: Supply and appropriate use of medicines.
Self-care Activities: Providing advice and medications for self-treatment.
Influencing Prescribing Activities to improve medicine use.
Collaboration: Health promotion and prevention activities.
Clinical Trials: Involvement at all stages.
Major Roles for Pharmacists in GPP:
Preparation, distribution, and disposal of medical products.
Providing effective therapy.
Maintaining and improving performance.
Improving the effectiveness of the healthcare system.
Requirements for GPP:
➤ Premises/Layout/Furniture: Easily identifiable pharmacy location. Neat, clean environment
with clear signage. Accessibility for disabled individuals. Adequate space for storage,
counselling, and waiting.
Equipment: Refrigerator for temperature-sensitive medicines. Counselling area with essential
equipment. Basic medical instruments and communication facilities.
➤ Manpower: Supervision by qualified pharmacists. Well-trained personnel with documented
guidelines. Proper attire , medical examinations, and qualifications.
➤ Storage: Quarantine and proper storage of medicines. Protection from light, dust, and
humidity. Proper labelling and segregation of expired medicines.
➤ Inventory Control: Effective procurement and inventory management. Ensuring availability of
medicines in sufficient quantities.
===Services: Home delivery and special care for patients. Detailed service manual and
operation schedule.
➤ Documentation: Maintenance of necessary documents and records. Proper handling of
operational documents.
4. Define prescription and explain different parts of prescription? Ans.
Definition: Prescription is an order written by physician, dentist, or any other Registered Medical
Practitioner to the pharmacists to compound and dispense a specific medication for the
individual patient.
Parts of Prescription:
a) Prescriber Information: Includes doctor's name, address, and contact number for
identification and communication.
b) Date of Prescription: Placed at the top to track issuance and prevent misuse, especially for
drugs like narcotics.
c) Patient Details: Includes patient's full name, age, weight, and address to ensure accurate
dispensing and avoid errors.
d) Superscription: Symbol "Rx" represents a historical prayer for healing and is understood as
an abbreviation of "recipe," meaning "take thou" or "you take."
e) Inscription: Lists medication composition, dosage, and quantities of prescribed ingredients,
including active medicament, adjuvants, and vehicles.
f) Subscription: Provides directions to the pharmacist on dosage form and quantity, such as "tab
paracetamol-10" for ten paracetamol tablets.
g) Signatura: Contains instructions for the patient on how and when to take the medication,
often abbreviated in Latin, such as "TDS" for three times a day.
h) Renewal Instructions: Specifies if the prescription can be renewed and how many times,
particularly crucial for habit-forming drugs to prevent misuse.
1) Registration Number and Seal: Includes the medical practitioner's registration number,
signature, and stamp for authentication and accountability.
5. Explain good dispensing practice?
Ans.
Definition: Good dispensing practice ensures that the right medicines of the desired quality are
delivered to the right patient at the right time, with the correct dose, strength, frequency, dosage
form and quantity as well as clear written and verbal instructions and appropriate packaging to
maintain the medicine's quality and efficacy.
Elements of the Dispensing Environment:
Qualified/trained staff.
Appropriate physical surroundings.
Adequate shelving and storage areas.
Proper work surfaces.
Suitable equipment.
Necessary packaging materials.
Aims and Objectives of GDPs:
➤ Ensure dispensing in accordance with laws.
Supply the right medicines to improve patient adherence.
Minimize adverse drug reactions.
Avoid medication errors.
Good Dispensing Practices:
Working Environment: Includes trained staff, suitable surroundings, adequate storage, proper
equipment, and packaging materials.
Receiving Prescription: Pharmacist maintains a professional appearance and impression while
receiving prescriptions.
➤ Review and Interpretation of Prescription: Pharmacist reviews and interprets the prescription
following efficiency guidelines.
Filling of Prescription: Selection of medicines ensured by double-checking labels. Dispensed
medicines labelled according to legal requirements. Prescription and filled medicines
cross-checked for accuracy.
Issuing Medicines to the Patient: Registered pharmacist issues medicines, ensuring the "five
Rs": Right patient, medicine, dose, route, and duration.
Medication Counselling: Essential for proper medicine use. Records of counselling sessions
maintained.
6. Explain Dispending errors?
Definition: Dispensing error is defined as any preventable event that may cause or lead to
inappropriate medication use or patient harm while the medication is in the control of the
healthcare professional, patient, or consumer.
Types of Dispensing Errors:
Dispensing for the wrong patient
Dispensing wrong medicine
Dispensing wrong drug strength (dose)
Dispensing the wrong quantity
Dispensing wrong dosage form
➤ Dispensing with wrong information on label
Dispensing at wrong time
Failure to dispense.
➤ Dispensing medicines of inferior quality
➤ Dispensing expired or almost expired drugs
Reasons of Dispensing Errors:
➤ Wrong prescription evaluation
Dispensing the wrong medicine
Poor handwriting and communication among healthcare professionals
➤ Ambiguities in product names, directions, or abbreviations
Poor dispensing procedures or techniques
➤ Inadequate knowledge of drug usage and treatment
Lack of understanding of medication directions and adverse effects
➤ Unsafe working environment and lack of communication
➤ Incorrect abbreviation use
➤Incorrect dosage and dosage form
➤ Similar packaging and labelling
Wrong labelling
➤ Providing wrong quantity or strength of medication
Dispensing expired medicines
Common Dispensing Errors:
Look-alike and sound-alike (LASA) drug names causing unintended interchange.
Incorrect selection of similar drug names in electronic order entry systems.
. Define comunication skills? Explain types of communication skills?
Definition: Communication skills are the abilities used while giving and receiving different kinds
of information. Communication skill is the ability to use language and express information.
Communication skill involves listening, speaking, observing, and empathizing.
Types of Communication skills:
A) Verbal Communication Skills: Verbal communication is the most common type of
communication. Verbal communication occurs when we speak with others. It involves
face-to-face, via mobile phones, radio, and video conferencing. Verbal communication use
words to convey message. When pharmacist communicates with patients it is best example of
verbal communication.
B) Non-verbal Communication: Non-verbal communication is the use of gestures, tone and
voice, body language and facial expressions to communicate your thoughts and feelings without
using words. It involves complex mix of behaviours, psychological and physical environment.
Non-verbal expressions convey attitudes and emotions.
8. Explain Verbal communication in detail?
Ans.
Verbal Communication: Verbal communication is the most common type of communication.
Verbal communication occurs when we speak with others. It involves face-to-face, via mobile
phones, radio, and video conferencing. Verbal communication use words to convey message.
When pharmacist communicates with patients it is best example of verbal communication.
Advantages:
Time-efficient communication
Quick feedback acquisition
➤ Offers complete understanding and clarity.
Reliability in conveying messages
Flexibility and effectiveness
Cost-effective communication method
Disadvantages:
➤ Emotional cues can lead to misunderstandings.
Lack of legal validity in certain situations
Absence of permanent record without modern recording methods
Challenges in communication with distant individuals
Difficulty in understanding due to varied speech tones.
Not suitable for lengthy messages
Risk of information leakage through modern devices like polygraphs
Types of Verbal Communication:
a. One-to-one verbal communication:
➤ Occurs between two individuals.
Effective when both parties are relaxed and take turns speaking and listening.
Common in healthcare settings for professionals interacting with patients,
partners, relatives, or friends.
Key aspects include friendly greetings, focus on objectives, and positive closure.
b. Communication over the Telephone:
➤Integral part of individuals' lives.
Vital in community pharmacies.
na Unit
Involves transmitting information over distances using phones.
Used to communicate with patients, their families, physicians, nurses, and other healthcare
professionals.
9. Explain Written communication skills in detail?
Definition: Written communication skills are those skills that use written words for conveying a
message to another person. Written communication is the best channel for communicating with
a large group of people, transmitting a large amount of data or keeping a record of the
communication.
Advantages:
➤ Written communication allows for the retention of important information, unlike oral or
non-verbal methods.
It provides a clear and structured way to convey intricate ideas and data.
Disadvantages:
Written communication involves costs such as paper, ink, and labour, making it comparatively
costly.
Both composing and reading written messages consume valuable time.
Secrecy can be challenging to uphold through written means.
Altering written documents is not as easy as modifying oral communications, limiting
adaptability.
Replies to written messages often take longer, lacking the immediacy of oral exchanges.
Maintaining written records can be both cumbersome and expensive.
The use of complex language may hinder understanding for some recipients.
Types of Written Communications:
Emails, Letters, Contracts, Briefs, Memos, Meeting agendas, Bulletins, Announcements
10. Explain in detail about patient interviewing technique?
Ans.
Definition: The patient's interview is the primary way of obtaining comprehensive information
about the patient to provide effective patient-centred care and the medication history component
is the pharmacist's expertise.
Patient interviewing technique:
➤ Building Rapport: First impression sets the tone for the interview. Establishing rapport fosters
openness and honesty in communication.
Active Listening: Mastering active listening is crucial.
➤Respect Patient's Privacy: Consider patient's privacy, especially with sensitive questions. Be
mindful of delicate topics like pregnancy or psychiatric conditions.
Recognize Facial Expressions: Pay attention to patient's facial expressions for clues. Facial
cues can indicate unspoken concerns or severity of issues.
➤ Consider Appearance: Physical appearance influences patient's willingness to share
information.
➤ One Thing at a Time: Ask questions sequentially to prevent patient confusion.
Ask Open-Ended Questions: Encourage detailed responses beyond simple yes or no answers.
Utilize Silence: Allow moments of silence for reflection, leading to more thoughtful responses..
11. Define patient counselling and explain different stages of patient counselling?
a) ADS/HIV: Adapt counselling style to patient's communication and literacy level. Facilitate
discussions about coping with HIV status. Provide HIV transmission prevention information and
support services. Offer counselling and therapy monitoring. Provide individual, relationship, and
family counselling. Instruct on barrier method usage during sexual activity. Inform about
antiretroviral drugs and emphasize medication adherence. Monitor medication adherence.
Stress lifelong commitment to antiretroviral therapy. Encourage healthy lifestyle habits.
b) Asthma: Describe asthma symptoms and prescribed medications. Demonstrate inhaler use.
Warn about side effects and interactions. Stress proper storage. Ensure regular check-ups.
Encourage smoking cessation and avoidance of respiratory irritants.
c) Diabetes: Educate on diabetes symptoms: Instruct on medication timing and food intake.
Stress importance of medication adherence. Warn about drug interactions. Highlight proper
storage. Emphasize regular medication intake. Inform about potential complications.
d) Hypertension: Define hypertension and its risks. Explain medication usage and dosage
instructions. Emphasize regular medication intake to prevent rebound hypertension. Notify
physician about potential drug interactions. Advise on proper storage conditions. Encourage
lifestyle changes like exercise, smoking cessation, and dietary adjustments.
e) Chronic obstructive pulmonary disease: Assess COPD risk. Educate on dosage, treatment
expectations, and adherence. Encourage smoking cessation and provide nicotine replacement
advice. Recommend annual flu vaccination. Demonstrate inhaler use and storage. Support
self-management plans. Identify and address medication non-adherence. Advise on lifestyle
modifications. Highlight importance of air quality awareness. Provide detailed instructions on
inhaler usage.
13. Write in detail about patient information leaflets (PIL)?
Definition: Patient information leaflets are defined as written or printed document in simple
language that provide the essential information which patient need to enable them to use
medicines safely and gain the most benefit.
Contents of Patient information leaflets:
Identity of the medicine.
Therapeutic indications.
Dosage instructions.
Description of side effects.
Additional information.
Uses of patient information leaflets:
Widely used as reliable sources of medication and health information.
Provide patients with crucial details on medication administration, precautions, and potential
side effects.
Enable immediate patient involvement in their own healthcare.
Enhance patient understanding of diagnosis, treatment, and prognosis, facilitating informed
decision-making.
Encourage patient participation in managing long-term conditions and promoting well-being
Support disease prevention, medication treatment, and compliance objectives as part of patient
education or health promotion.
Facilitate pharmacist-patient dialogue and empower patients through informed decision-making
14. Explain about patient package insert (PPI)?
Definition: Patient package insert is defined as an officially technical document and prescription
of OTC medications containing information about that medication and its use, written in plain
language intended for the end-user, the person who will take the drug or give the drug to
another person such as a minor.
Contents of patient package insert:
Definition: Medication adherence is defined as the extent to which patient take medication as
prescribed by their doctors. WHO defines medication adherence as "the degree to which the
person behaviour corresponds with the agreed recommendation from a healthcare provider.
Factors Affecting Non-adherence:
Patient-related: Age, education, and physical abilities influence adherence. Cultural belief and
economic factors are contributing factors.
Disease-related: Overprescription of medications can confuse patients. Ineffective
communication about medication instructions contributes to non-adherence.
Doctor-related: Overprescribing medications overwhelms patients. Lack of effective
communication and rapport with patients leads to non-adherence. Prescription-related: Illegible
or inaccurate prescriptions cause confusion.
Forgetting to refill prescriptions or complex medication regimens result in non-adherence.
Pharmacist-related: Pharmacist counselling and professionalism play a role in improving
adherence. Patient counselling before dispensing medications is crucial for understanding and
adherence.
Health System-related: Long waiting times and uncaring staff contribute to non-adherence.
Accessibility issues hinder patients' ability to adhere to treatment plans.
16. Explain in detail about health screening services in community pharmacy? Ans.
Definition: Health screening services are the services provided by healthcare professionals to
screen the health status of individual with or without positive signs or symptoms.
Importance of Health screening services:
Facilitates early detection and treatment of health problems like cancer, hypertension, diabetes,
osteoporosis, and high cholesterol.
Reduces the risk of serious complications through early identification of issues.
Enhances awareness and understanding of personal health.
Validates adherence to a healthy lifestyle.
Enables timely and effective treatment.
Provides preventive measures for individuals with a family history of cardiovascular diseases,
stroke, or diabetes,
Saves lives and improves quality of life by preventing or reducing complications of
chronicdiseases.
Health Screening Services Include:
Blood pressure measurement, Blood sugar level testing, Lang function assessment, Body mass
index (BMI) measurement. Lipid profile checking. Assessment of drug addiction, abuse, and
misuse, Nutritional assessment, Pulmonary function tests, Health awareness and adherence
testing. Smoking, and alcohol cessation counselling.
17. Define OTC medication and explain role of Pharmacy in OTC medication?
Definition: Over-the-counter medicines are defined as the drugs which can be purchased
without a prescription of registered medical practitioner from healthcare professionals
(pharmacist).
Role of Pharmacy in OTC medication:
a) Pharmacists assist in proper selection of OTC medication, which should be the best resource
for patients.
b) Pharmacists encourage self-medication among consumers and ensure appropriate OTC
drugselection.
c) Pharmacies control the dispensing of OTC drugs and provide counselling to consumers.
d) Pharmacists should educate the patient on Self-medication which will reduces burden on
healthcare system,
e) Pharmacists should advise patient on possible contraindications, interactions, and guide
patients before OTC use.
1) They assess symptoms to determine if self-treatment or medical intervention is necessary.
g) Pharmacists listen to patient complaints, counsel on OTC drug use, and advise on
consumption.
h) Counselling by pharmacists helps understand patient complaints and seriousness of issues.
i) Pharmacists educate themselves on OTC dispensing practices and refer patients to doctors
when necessary.
j) Dispensing non-OTC drugs without prescription is prohibited; pharmacists identify when to
refer patients to doctors.
k) Regulated OTC drug advertising ensures consumers receive accurate information.
18. Write about OTC medication in India?
In India, till date, there are no guidelines for licensing of OTC medicines. There is no separate
category allotted for OTC medicines in India, and the drugs which do not come under the
prescription medicines schedule are generally sold as over-the-counter medicines. OTC drugs
allow faster and cheaper access to healthcare but the possibilities of misuse and adverse
effects cause concerns. In India, over the counter drugs are not recognized by the courts. A
large proportion of the population relies on over the counter medications to treat minor ailments
such as headaches, colds, fevers, coughs, indigestion, flu, dermatitis. A large safety margin
must be established to ensure the safety of OTC medications. The major factor contributing to
growth in OTC market includes consumers attitude towards self-medication, the easy access,
convenience, time saving, fast relief and high consulting fees of the physician. In India,
Fegulatory control over drug is exercised through variety of Acts and rules. In Schedule K of the
Drugs and Cosmetics Rules 1945, drugs have been listed under the little household remedies.
The distribution and sale of these drugs are exempted from certain provisions applicable to
distribution and sale of drugs. These are considered as OTC medications and can be sold for
self-medication purpose or sold by pharmacists without the prescription or RMP. The list of OTC
drugs consists of aspirin tablets, paracetamol tablets, analgesic balms, antacid preparations,
gripe water used for infants, inhalers, syrups, lozenges, pills and tablets for cough, liniments,
skin ointments, burn ointments, absorbent, cotton wool, castor oil, liquid paraffin, eucalyptus oil,
tincture of iodine, etc. In India, medications in the name of OTC have been recognized legally.
The drugs not included in Schedule H, X, and G can be sold by pharmacist without prescription
from RMP and thus can be considered as OTC medication.
19. Explain role of pharmacist in promoting the safe practice and self-medication?
5) Participate in health screening initiatives to identify health issues and at-risk individuals within
the community. Vigilantly monitor and report adverse events related to self-medication to ensure
pharmacovigilance. Contribute to raising awareness about health issues, disease prevention,
and provide tailored health advice to empower individuals in making informed decisions.
6) Address the challenge of a low pharmacist-to-population ratio by advocating for and providing
pharmaceutical training and orientation to other healthcare workers, community health workers,
household caretakers, and relevant laypeople.
7) Work towards improving access to pharmaceutical care through innovative solutions and
community engagement efforts.
20. Write about the legal requirements to set up a community pharmacy?
Definition: Digital health refers to the use of information and communication technologies in
medicine and other health professions to manage illnesses and health risks and to promote
wellness.
Objectives and Goals of Digital Health:
Improve the quality-of-care outcomes.
➤ Enhance population health.
Enhance patient experience.
Enhance physician and non-physician provider experience.
Address health disparities.
Examples of Digital Health Products and Services:
Remote sensing and wearables, Telemedicine and health information, Data analytics and
intelligence, predictive modelling.
Health and wellness behaviour modification tools, Bioinformatics tools (omics), Medical social
media, Digitized health record platforms, Patient-physician-patient portals, DIY diagnostics,
compliance, and treatment, Decision support system, Imaging.
Importance of Digital Health:
Prevents diseases and lowers healthcare costs.
➤ Personalizes medicine for patients.
Provides quick access to health services, improving quality of care.
Facilitates early detection of disease progression.
Increases partnership, trust, and transparency between patient and doctor.
Enables patients to share health information with physicians anytime.
Reduces financial burdens for hospitals and patients.
Increases efficiency and improves medical outcomes.
Expands access to information through smartphones, social networks, and internet applications.
Extends the reach of healthcare professionals.
23. Explain in detail about online pharmacy? Ans.
Definition: Online pharmacy is a pharmacy that works over the web that facilitates the availability
of medicines and other healthcare items without the need for people to visit the pharmacies.
Advantages
Easy ordering of medicines online, particularly beneficial for those living far from pharmacies or
with mobility issues.
Supports initiatives like Jan Aushadhi Program under Digital India, enhancing access to quality
medicines.
Saves time compared to visiting physical pharmacies.
Offers competitive prices for medications.
Allows discreet purchasing, especially for sensitive conditions.
Provides a variety of medications and healthcare products.
Some platforms offer valuable medical information and resources.
Disadvantages
No medical supervision or physical evaluation, potentially leading to inappropriate medication
use.
Lack of continuity if not consistently using the same online pharmacy.
Some platforms may not require prescriptions, risking inappropriate medication use.
Risks associated with sharing personal and financial information online.
Various Online Pharmacies in India: PharmEasy, Practo, ing. NetMeds, BookMeds,
SmartMedies, We Chemist, BrownPacket
24. Write about customer relation management?
Ans.
Importance of CRM:
Better service provision.
Fostering loyalty and retention.
Enhancing profitability.
Establishing long-lasting relationships.
Enhancing customer satisfaction.
Staff training for customer orientation.
Gaining a competitive advantage.
Building pharmacy image and reputation.
Generating high returns on investments.
25. Explain in detail about inventory control method?
Ans.
Definition: Inventory control is an effective way to keep a watch over losses from
misappropriation, damage, deterioration and carelessness and proper control over maintenance
and stock. Modern inventory control systems help your business to maintain profitability.
Objectives of Inventory Control:
Ensure maximum customer satisfaction by meeting demand promptly.
Lower operating costs by maintaining stable production through sufficient inventory.
➤ Minimize inventory investment to reduce storage and production costs.
Functions of Inventory Control:
Keep the right amount of inventory based on market needs.
Prevent running out of stock to avoid expensive last-minute purchases.
Make sure there's enough product to meet customer demand.
Keep accurate records for smart decision-making.
Predict market trends to plan inventory accordingly.
Keep track of purchases and supplies effectively.
Avoid buying the same things twice.
Determine prices correctly.
Manage working funds efficiently.
Use storage space wisely.
Manage cash flow by keeping inventory levels low.
Maintain the right amount of inventory to keep operations running smoothly.
Methods of Inventory Control: ABC analysis, VED analysis, Economic Order
Quantity (EOQ), Setting various inventory levels, Perpetual inventory control system, Review of
slow-moving and fast-moving items, Input-output ratio analysis, Want book, Effective purchase
procedures.