Dear Readers,

I am so sorry, and I am asking for you understanding regarding my last seven blogs because of no headings. I tried so hard to insert them, but error always interrupted my connection every time I put the heading of Pharmacy Standard Operating Procedures, thus I decided to put the body only because of this problem. I hope you will understand what I placed there and identify the missing heading which can be patterned from my other previous blog articles. Thank you!

Blogger,
Tacio

Pharmacy Standard Operating Procedure: Housekeeping

I. OBJECTIVE: To produce a proper guidelines regarding the cleanliness of the drugstore.

II. SCOPE: Within the vicinity of the drugstore and cleaning of the shelves and good housekeeping.

III. RESPONSIBILITY

• Pharmacist
• Pharmacy Assistant

IV. PROCEDURE

1. Use a clean cloth for cleaning the shelves, clean mop with detergent or bleaching agent in cleaning the floors.
2. Transfer the medicines from the shelves to an empty box.
3. Wipe the shelves and clean it with cloth to remove dust.
4. In case of rigid smudges/stains, use damped cloth to clean them.
5. After completion, place the medicines back to where they belong.
6. Wash and dry up the cloth used in cleaning. Repeat cleaning every week.
7. Clean the floor with mop.
8. Throw the garbage when the time of collection is near. Do not place it outside because scavengers might scatter it.
9. Try to search for pest and make necessary action to eliminate them.

V. QUALITY OF RECORDS: N/A

VI. FORMS:

Logbook for cleaning

VII. END OF DOCUMENT

Pharmacy Standard Operating Procedure: Adverse Drug Reactions

I. OBJECTIVE: To participate actively in phamacovigilance.

To provide procedure on handling ADRs.

II. SCOPE: All complaints that caused from the unusual side effects of drugs that may appear after the

the clinical studies of the drug and/or phase IV and that only specific group of individuals can experience it.

III. RESPONSIBILITY

• Pharmacist

IV. PROCEDURE

1. Give courtesy greeting to the customer and ask what his concern all about.
2. After hearing the complaint, conduct an interview. The interview should be personal and private.
3. While interviewing the client, there should be a documentation of it, and if possible there must be proof of the adverse reaction of the drug such as pictures of it, recording of the talk and so on to forth.
4. Ask about his lifestyle and other medicines that he is taking.
5. The answers should be true and valid.
6. The ADR should be categorized according to its type and classification.
7. A form must be filled up and let the interviewee sign it to prove that all written complaints are true and original.
8. Keep the ADR form and report it to the company that involved and to the nearest FDA office, so that analyses, tests and studies on that event can be performed.

V. QUALITY OF RECORDS: Shall be written on the ADR and kept it for proof.

VI. FORMS: See figure 1A.

VII. END OF DOCUMENT

Types of ADRs:

1. Type A – dose related effects (Augmentation)
2. Type B – no dose related effects (Bizarre)
3. Type C – dose and time related effects (Continuous or chronic)
4. Type D – time related effects (Delayed)
5. Type F – therapeutic failure

Pharmacy Standard Operating Procedure: Disposal of Expired, Damaged, Returned or Rejected Products

I. OBJECTIVE: To execute the disposal of damage, expired, returned or rejected products.

II. SCOPE: Products that are expired, damaged, rejected or returned by customers due to defect.

III. RESPONSIBILITY

• Pharmacist
• Owner/Manager
• Pharmacy Assistant

IV. PROCEDURE

1. Pharmacy assistants are assigned to a specific shelves for checking near expired drugs. Nearly expiry drugs that are 3 months before to expire shall be removed.
2. Checking expiry date shall be done every month and shall be recorded and inventoried.
3. Pharmacist will ask the attention of the supplier to return nearly expire drugs, damaged, returned and rejected so that the product will be pulled-out and disposed.
4. When the supplier cannot accept anymore the product. The pharmacy must then dispose the products in an environmental conscious way. It can be done by coordinating to the garbage collector for proper disposal.

V. QUALITY OF RECORDS: N/A

VI. FORMS:

Logbook

VII. END OF DOCUMENT

Pharmacy Standard Operating Procedure: Good Storage Practice

I. OBJECTIVE: To have standard operating procedure for Storage of Medicines.

II. SCOPE: All products that within the drugstore. Should be under specific temperature for other

temperature-sensitive drugs and proper categorized.

III. RESPONSIBILITY

• Pharmacist
• Owner/Manager
• Pharmacy Assistant

IV. PROCEDURE

1. After initially checking the medicines delivered, all products should be wrapped by a clear plastic to avoid accumulation of dust particulates.
2. Transfer the goods to their respective areas.
3. Store the goods in an organized and orderly manner with the label bearing the name of the product in front.
4. First-Expire-First-Out will be the basis of disposing drugs.
5. Avoid direct contact to the sun or on the walls to avoid moisture accumulation.
6. Store controlled drugs substances and other potent drugs in the designated. Access this area should only be allowed to the pharmacist and owner.
7. Store expired goods in the storage room, marking it with “Expired” to prevent use.
8. Store medicines at stipulated temperature areas, protected from excessive light, dust and humidity. The temperature should be checked by the pharmacist daily and recorded in the monitoring sheet if necessary for cold chain drugs.
9. Store the other stock in a separated area. Maintain all sales invoice records for return or exchange of products to the supplier.
10. Clean and maintain the storage areas neat and tidy all the times.

V. QUALITY OF RECORDS: N/A

VI. FORMS: N/A

VII. END OF DOCUMENT

Pharmacy Standard Operating Procedure: Good Dispensing Practice

I. OBJECTIVE: To provide standard operating procedure for Dispensing Prescription Drugs.

To insist use of generic equivalent drugs which are cost-effective in nature.

II. SCOPE: All prescriptions, generic equivalent drugs and Over-The-Counter drugs.

III. RESPONSIBILITY

• Pharmacist
• Pharmacy Assistant

IV. PROCEDURE

1. Greet the client with a smile.
2. Receive the prescription in a dignified manner.
3. Read the prescription properly the name, strength, dose and quantity. If in case of doubt ask the pharmacist.
4. Check the legality and legibility of the prescription.
5. If the prescription is illegible of in case of doubt, confirm with the doctor over phone. Do not dispense a prescription drug without a proper prescription order and do not dispense when doubting.
6. After that check for the availability of the stock and make sure that the product is the one that said in the prescription order. Make sure that the product is under the good condition and the expiration date is still far.
7. Give the client the chance to choose what is the most cheap but quality and effective when use.
8. Obtain the medicines from the gondola, double check if it is the medicine in the prescription order, and ask for the quantity to be bought.
9. Check the product in front of the customer and interpret the instruction of the doctor to him or give relevant information regarding the storage, administration and etc.
10. Proceed to the billing and an official receipt should be issued.

V. QUALITY OF RECORDS:

The pharmacist will file the fully filled prescription and shall be input in the prescription book.

The prescriptions will be kept for 2 years.

VI. FORMS:

Prescription order and prescription book

VII. END OF DOCUMENT

Pharmacy Standard Operating Procedure: Product Procurement

I. OBJECTIVE: To provide proper guidelines in procuring of stocks.

II. SCOPE: Applied to all products

III. RESPONSIBILITY

• Pharmacist
• Owner/Manager

IV. PROCEDURE

1. The procurer will make an order through phone, SMS, facsimile, sales representative and other media.
2. There should be a copy or list of the products to facilitate checking of them when delivered.
3. Upon delivery of the product, check the product's count, amount, batch no. and make sure that the expiry date is very far to make sure the product is safe and effective.
4. The procurer will pay the delivery man and ask for official receipt and copy of the sales invoice and filed them.
5. The procurer will price the product through an acceptable price mark-up.
6. The product will then display and ready to be sold.

V. QUALITY OF RECORDS:

The purchaser will file the invoice for future use and other case.

VI. FORMS:

Logbook

VII. END OF DOCUMENT

Pharmacy Standard Operating Procedure: Product Complaint

I. OBJECTIVE: To describe the respond given to customer when a product complaint is present.

II. SCOPE:

• Complaints are expressed by customer and other involved parties.
• DHO-FDA or local regulator body has authority to review actual complaint and other related cases.
• This procedure is applied in a case to case basis only.

III. RESPONSIBILITY

• Pharmacist
• Owner/Manager
• Pharmacy Assistant

IV. PROCEDURE

1. Upon receiving the complaint the pharmacy assistant immediately calls the attention of the pharmacist.
2. Ask the complainant for the official receipt to ensure that the product was bought in the drugstore.
3. The pharmacist will ask for details regarding the complaint. An interview shall be imposed.
4. Check the batch no., expiry date and condition of the medicine.
5. Have a record of the complaint.
6. If the complaint is justified the following will be done:

• Investigate proper action to prevent recurrence.
• Replace or refund the money.
• Inform the supplier.

7. If the complaint is not justified, advice the customer about the findings.
8. Submit a report to the authority.

V. QUALITY OF RECORDS:

The pharmacist will file the complain and keep for 1 year in case of another incident to happen.

VI. FORMS:

Logbook

VII. END OF DOCUMENT

Rebates, Incentives, Give-aways and Treats for Pharmacists

Being working in a community pharmacy is a tough work, and needs knowledge, skills and patience, so that every task will be accomplished. Working in this area of pharmacy profession is the most boring and causes the blunting the mind, but also a chance to have some privileges, rebates and treats given by salesmen and detailmen of pharmaceutical companies. Based on my own experience, I have already received a lot of things from them. Because their goal is to get you support in pushing and recommending their drug products to the customers, and most importantly is you affirmed to stock their products in your drugstore.

Usually detailmen and salesmen are offering great deals to choose from such as rebates, incentives, box-retrieval, sponsoring a seminar and etc. All of these can be yours only when you know how to handle their products well without compromising your drugstore's income and revenues.

Every time my birthday comes some salesmen and detailmen bring food in our drugstore (almost all kinds of food spaghetti, pancit, ice cream, pizza, cakes, and etc, but not on the same time), or treating me for dinner or a lunch which extends up to a month. So I am celebrating my birthday for a month. Additional is a gift is given to me. Some offer rebates that come from the products you procured to them. Sometimes up to 30% is the rebate that will be yours if you know how to push their products and increase its turn-over. So if the purchase is PhP 10000.00, your rebate will be PhP3000.00. But it depends on the budget of the company or the affirmed price of the drug products that will be the basis of the percentage of the rebate you will receive. Also a box-retrieval and ear-flap redemption is available. Each box or ear-flap has an amount corresponding. For example, a box of Mefenamic Acid 500mg cap is redeemed for Php30.00 and multiplied to the total boxes of Mefenamic Acid 500mg Cap, for instance is 10boxes, your gain is Php300.00 already. The same is applied to ear-flaps. However, there are times also that not cash is offered to you, but freebies such as umbrella, mugs, pizza and food. Some are offering lunch out, reimbursement of the money you incurred in your lunch. Most of the time pens are given but if you are lucky an umbrella, towel, hand-sanitizer, and etc are given away. The best treat that medical representatives and salesmen could provide is to sponsor you into a seminar or your convention such as pharmacists' convention. Airfare or hotel accommodation is free of charge. But all of these depend on the profit they gain from you in a year.

Also when Christmas comes, we are usually requesting them to sponsor us for our Christmas party, and as early as September, we are distributing letters, so that they will not forget to give us gifts which in the form of appliances, or things that useful in our drugstore and home. Every staff has its own wish item, could it be an appliances (which are not so expensive or the request might not be granted). And when December comes, all the wish in the wishlist is granted. That is how generous are the companies that we procuring our drugs, usually local companies.

But the bottomline here is that you much help the pharmaceutical companies to gain and profit in a year or at least 6 months, so that of all these will be given to you! At the same time your drugstore's income will not be compromised and to gain more, while you are experiencing all of these treats and deals.

Methergin Ampules and Syntocinon Ampules Are Out of Stock

I do not know if you have still stocks of Methergin and Syntocinon Ampules in your drugstore, because lately Zuellig Pharma, the main distributor of these products, is out of stock already or no stock to serve its client. No reason or explanation could be found regarding this massive out of stock. It is been three weeks already when Methergin and Syntocinon ampules are absent in the market. Norvartis, the company owns and manufactures these drugs is being discreet about it. May be a problem sprung or a possible hoarding is done, that is why no stock is available to serve the market. This

Isotonicity

How to compute for the weight of Sodium Chloride or Substance to make a solution isotonic.

Step 1:  NaCl Equivalent of the Active  x  Wt of the Active  =  Wt. of NaCl represented by Active
             (See the Table of NaCl Equivalents)

Step 2: Volume of Solution  x  0.9%NaCl  =  Wt of NaCl in volume solution of an isotonic NaCl solution

Step 3: Answer from Step 2  -  Answer from Step 1  =  Wt of NaCl needed to be used

*Step 4: Answer from Step 3  /  NaCl equivalent of Substance needed  =  Wt of substance needed to
                                                    to make the solution isotonic                      cause the solution isotonic

*Step 4 will be needed when NaCl does not cause the solution isotonic.


Example:

How many grams of sodium chloride should be used in compounding the prescription?

Rx

     Zinc Sulfate                 0.08g
     Boric Acid                  q.s.
     Purified Water   ad      10ml
     Make isotonic solution
     Sig. Drop in eyes.

Solutions:

Step 1:  0.16  x  0.08g  =  0.0128g NaCl represented by Zinc Sulfate

Step 2:  10  x  0.9%  =  0.09g NaCl in 10ml of an isotonic NaCl solution

Step 3:  0.09g  -  0.0128g  =  0.0772g NaCl to be used, but in this case boric acid is to be used so proceed
                                                                                       on Step 4.

Step 4:  0.0772g  /  0.52  =  0.1485g of boric acid needed to make the solution isotonic.

 

Contemporary Problems Facing by Newly Passed Pharmacists

Questions and Answers

1. Question: I just passed the licensure exam for pharmacists, yet I am below 21 years old. Could I practice  my profession or not?

Answer: As long as you have your PRC ID you may practice and be employed. However, PRC ID is released and given on individuals who are on 21 years old and beyond. Thus, if you do not reach at least this age limit you are not nominated to practice.

2. Question: I am enthusiast to work already and an employer is deploying me already, but my age is below 21 y/o and I do not have my PRC ID too. Should I accept the offer or not?

Answer: If you are an additional pharmacist or do not need to register your name and license in FDA  you can accept the work. If your name and license shall be registered in the FDA such as for opening of drugstore or an incoming pharmacist-in-charge, you need to have your PRC ID. PRC ID is very important for us pharmacists, because it is the prerequisite for other documents (such as PTR no.). So if you do not have it you are not valid to practice. But if you are very persistent to work, you can have serious talk with FDA and convince them to register you as pharmacist-in-charge for that certain establishment.

3. Question: I have my PRC ID and I am 21 y/o already, but my board certificate is not yet served to me. Could it be that FDA will register me for my employment?

Answer: There are three main reasons why your board certificate is deferred from releasing.

1. You did not attend the oath taking ceremony for newly passed pharmacists where they are distributing the board certificate of those individuals who are 21 y/o and above.
2. You are still underage the time you are applying for it.
3. You are not applying for it in the PRC.

FDA is giving a moderate consent to this predicament of newly passed pharmacist, although permission is given a copy of it shall be submitted to them upon acquisition from PRC, and shall be displayed in a conspicuously area within the drugstore or establishment.

Code of Ethics For Pharmacists

Preamble

Pharmacists are health professionals who help individuals protect themselves against diseases, maintain good health and make the best use of their medication. The pharmacists ensure the provision of safe, effective and quality drugs, for improved patient care and quality of life. This Code, prepared and supported by pharmacists, is intended to state publicly the principles that form the fundamental basis of their roles and responsibilities which are based on moral obligations and virtues and to guide pharmacists in their relationship with patients, health professionals and society.

1. A pharmacist places the well being of the patient at the center of professional practice.

2. A pharmacist promotes the welfare of each individual in a caring and compassionate manner.

3. A pharmacist serves the needs of the individual, community and society and provides health for all.

4. A pharmacist respects the rights of patient and upholds confidentiality of patient records.

5. A pharmacist acts with honesty, integrity and professionalism in relationship with the patient and other 

    health professionals.

6. A pharmacist respects the abilities, values and contributions of colleagues and other health professionals 

    and work with the closely to ensure better patient care.

7. A pharmacist is committed to continuously enhance professional competence.

8. A pharmacist, in coordination with the government and other health professionals helps in the formulation

    and implementation of health care policies, standards and programs designed for the benefit of society.

FDA Repeatedly Warns Physicians Regarding Proper Prescribing

According to Administrative Order No. 62, s. 1989 all physicians should follow the guidelines on prescribing to implement the Generic Act of 1988. Physicians, veterinarians and dentists are the only professionals who can prescribe medicines in a form of prescription and have the power to influence the patients to what brand of medicines he wants to buy for his therapy. But sometimes they are the violators of the law, especially against the Generic Act of 1988 and Republic Act 9502 or The Universally Accessible Cheaper and Quality Medicine Act of 2008.

In these laws, physicians, veterinarians and dentists are to follow the specially guide prescribing, such as:

• Generic names must be used in all prescription.
• The generic name must be written in full but the salt or chemical form may be abbreviated.
• The generic name of the drug ordered must be clearly written on the prescription immediately after the Rx symbol, or on the order  chart.
• Only one drug shall be prescribed on one prescription form.
• In prescribing drugs enumerated in List B which needs strict precautions in their use, the prescriber must comply with the following:

1. After the Rx symbol but before the generic name, he must write clearly "List B".
2. He must ensure that the following pieces of information are accurately written on the prescription:
• The generic name of the active ingredients and the specific salt or chemical form;
• The manufacturer.
• The brand name, if so desired.
• The strength or dose level using units of the metric system
• The delivery mode or delivery system and the corresponding, appropriate dose frequency or dose interval.

But all of these are violated by most of doctors, so that the law impose a provision regarding the wrong prescription writings, info and habits of doctors. They are Violative, Erroneous and Impossible Prescriptions.
The FDA is strictly imposing this provision, but there is lacked of participation of pharmacists, who directly held and received prescriptions. But even though this is the situation, FDA is still enthusiast to redeem wrong prescriptions to correct doctors.

Thus, when FDROs are routinely inspecting drugstores, they do not forget to check the Prescription Book, where pharmacist is inputting the dispensed prescription and filed it. By seeing the filed prescriptions, FDROs are looking for such erring or wrong habits of prescribing of doctors . The officer will collect the wrong prescriptions, either violative, erroneous and impossible prescription, or combination of the three, to surrender them to their office and notify the concerned doctor regarding his violation (so pharmacists do not be worried to show your Prescription Book, because it is one way to catch violators and correct them, unless you do not write and file, you will be the violator then). FDA will send letter to doctor who committed violation that in the letter, the doctor is given 15 days to write an explanation regarding his violation in a letter also and send back to FDA Philippines. Until the concerned perpetrator is not responded to the letter, thus FDA will impose a necessary sanction up to the revocation of the his PRC license as the severe penalty.

I know two Physicians that were committed the same violation. They were not able to place the generic name of the drug as it is the brand name is written alone. The FDA caught them through unanticipated inspection from a branch drugstore (Mercury Drugstore somewhere in Mandaluyong City). They both received letter that informing them that a case has been opened to them with the copy of the prescription error attached to the letter. The physicians were immediately responded to it and sent them in expressed mail. They were anxious about what had happened and said never to prescribe without generic names or the completeness of the proper prescription as it is written in the law to avoid open up cases against them.

Other physicians error are:
1. Multiple drugs are written in one prescription.
2. Prescribing Regulated Drugs in an ordinary prescription.
3. Wrong dosage.
4. Lack of description of the drugs, if syrup, suspension, the dose and ect.
5. Insufficient patient's information
6. No prescriber's name, PRC No., PTR No.(except for government employee) or S2 license (if available)
7. Using others S2 license or yellow pad
8. Forcing for "No Substitution" for drug's brand name.
9. Illegible hand writing and ciphering or using codes.
10. No salt or chemical form.
11. No Rx symbol
10. All the situation said in the Erroneous, Violative and Impossible Prescriptions

So I advice doctors to follow the proper guidelines in prescribing provided in the law, because you may not know that one of these days you are sent by FDA Philippines a letter regarding your erring in prescription and enforcing you to write an explanatory letter about this case.

Pascual Laboratories Voluntarily Recalled Calchew Chocolate Flavor

Pascual Laboratories recalled their CalchewsTM Chocolate Flavor. CalchewsTM is a calcium supplement fortified with Vitamin D3 in the form of chewy candy and variants of two flavors, rich chocolate and creamy caramel. As notified for FDA Philippines, Pascual Laboratories voluntarily recalled this specific product due to contamination of Staphylococcus aureus and Salmonella infections that can cause illnesses to any individual contracted with them.  Lot Nos 382BWA & 382BWB with Expiry Date: 8/2014 of CalchewsTM Chocolate Flavor are been specifically recalled. Pascual Lab has been conducting its investigation to identify and determine the origin of the contamination.

In line with this FDA is advising the community to be informed and vigilant. FDA Philippines has provided a strict procedure to follow to achieve full recall and compliance, as it follows:

• Consumers who have purchased said products are advised not to consume the affected CALCHEWS and to return the same tos Pascual Consumer Healthcare Corporation located at 10/F ETON Cyberpod 1, Centris Bldg., Edsa corner Quezon Avenue, Quezon City. Consumers may contact Chiko Lara, Corporate Communication Manager at 0917727 1710 or Mr. James F. Yaranon Pharmacovigilance Officer at 0917727 1304 and email address jfyaranon@pascuallab-pharma.com.

• Persons who think they may have become ill from taking the affected calchews are advised to consult their health care providers.

•  Concerned FDROs are instructed to immediately identify the affected establishments and conduct outright monitoring, and if possible, assess and coordinate with affected establishments to prevent distribution of products, the quality or safety of which have been compromised.

Pharmacy Symbol

HemostanTM Will Leave also the Pharmacy Market

How true is the allegedly speculation that the HemostanTM will be leaving the market soon? Yes folks, you read it right! HemostanTM (generic: Tranexamic Acid) an aged product of Unilab will be phased-out in the market soon. I do not know the real reason behind it, but a new product from Biofemme, which is subsidiary company of Unilab, is to market and an official tranexamic acid product to be sold to consumers. HemanexTM will be the next generation that will be holding the reputation of HemostanTM in the market.

Revicon Max Says Goodbye to the Market

A very big decision made by Unilab to phase-out their Revicon MaxTM but to launch a new brand that is the same to the latter. The new brand that is been already distributed to the market and being sold to drugstores and pharmacy is MaxvitTM. Revicon MaxTM was a supplementary vitamins, containing multivitamins, minerals, ginseng and royal jelly,  intended for consumption of men to increase stamina and libido. It was a brand competitor of Unilab for other supplementary vitamins for men in the market like Rogin-ETM (Bayer), PharmatonTM (Boehringer Ingelheim) and alike. Because of the name that was derived from Revicon Forte, which is more famous than Revicon Max, possibly the reason why this product is not salable. So the tough decision arrived and to change the name to be able to have distinction between the other. MaxvitTM is now the new revamped of Revicon MaxTM. Thus, all the features, the components and contents, and the use are not changed, though the brand, of course, the packaging and the product description were changed.

Cup of Hygeia

This was an article made in my art class back when I was college. The class was tasked to make any item made from clay that related to their discipline. I came to think about the Cup of Hygeia, because it has a big connection to and symbolized pharmacy profession. I hope you would appreciate it even 

though the background is bad. Thank You!

Answers

STABILITY COMPUTATION

Formulation:
Active 1: 65 mg (limits 95-105%)
Active 2: 15 mg (limits 90-110%)
Active 3: 122 mg (limits 90-110%)

Results of Analysis:




Questions:
1. Determine the minimum and maximum limits of each active based on the specifications:

• Active 1 = 61.75mg - 68.25mg
• Active 2 = 13.50mg - 16.50mg
• Active 3 = 109.80mg - 134.20mg

2. What is the shelf-life of the formulation?
A) 24mos
B) 12 mos
C) 36 mos
D) 48 mos
E) 6 mos

3. What would be the expiry date of a product manufactured on October 30, 2012?
A) October 30, 2013
B) October 30, 2014
C) October 30, 2015
D) October 30, 2016
E) October 30, 2017

Answers and Computations

Theoretical weight of 10 tablets is 5.12 grams. Each tablet contains 375 mg of active ingredient. Using these data, determine the following:

1. The amount of active ingredient needed to prepare 60,000 tablets.
A) 307.20 grams
B) 11.718 grams
C) 22.50 kilograms
D) 307.20 kilograms
E)  30.72 kilograms

Solution:
X / 60,000tablets = 375mg / 10tablets
(X)(10tablets) = (375mg)(60,000tablets)
X = (375mg)(60,000tablets) / 10tablets
X = 22,500,000mg

Milligram is converted to Kilogram, thus

X = 22.50 Kilograms

2. The amount of active ingredient needed to prepare 70 kilograms batch.
A) 136.719 grams
B) 186.70 grams
C) 43.50 grams
D) 51.27 kilograms
E) 5.127 kilograms

Solution:
Convert all unit to Kilogram
70kg
0.00512kg 
0.000375kg, thus

X / 70kg = 0.000375kg / 0.00512kg
(X)(0.00512kg) = (70kg)(0.000375kg)
X =  (70kg)(0.000375kg) / 0.00512kg
X =  5.127Kg

3. Determine the percentage amount of additive A per tablet if its actual amount is 35% of total additives.
A) 26.76%
B) 14.81%
C) 9.37%
D) 15.83%
E) 25.63%

Solution:
5.12g /10 tablets = 0.512g, convert into milligrams --> 512mg
512mg  - 375mg of active = 137mg
(137mg)x(35%)  = 47.95mg
% of additive per tablet = (47.95mg / 512mg) x100%
% of additive per tablet = 9.37%

4. If the tablet weight specification requires a limit of +/-10%, determine the upper and lower control limits of the tablets.
A) 460.80g - 463.20g
B) 337.50g - 412.50g
C) 460.80mg - 583.20mg
D) 337.50mg - 412.50mg
E) 4.608g - 5.632g

Solution:
Upper control limit = (512mg x 10%) + 512mg
Upper control limit = 563.2mg

Lower control limit = (512mg x 10%) - 512mg
Lower control limit = 460.8mg

460.8mg - 563.2mg

5) At what amount of the active ingredient is the product considered to be expired?
A) below 337.50mg
B) below 375.00 mg
C) below 356.25mg
D) below 365.50mg
E) below 568.89mg

Solution:
375mg x 90% = 337.5mg

Extraction of Valences before REDOX Reactions

1. Compute for the total valences of each extreme element of the compound. If subscript is available, multiply it with the existing valence of the element.

Eg.

K₂Cr₂O₇ thus, K₂¹⁺Cr₂O₇^-2 

 

Subscript is available so multiply it with the original valence.

K₂⁺¹⁽²⁾Cr₂O₇^{-2 (7)} thus, the total valences will be K₂⁺²Cr₂O₇^-14

2. Subtract the valences (disregard the signs). The difference will be the oxidation state of the middle element. When subscript is present divide the difference using it. The quotient will be the final valence of the middle element. Divide the remaining elements with their subscript to return to their original oxidation.

Eg.

K₂⁺²Cr₂O₇^-14 from the +2 valence of Potassium and -14 valence of Oxygen, subtract them producing a difference, irregardless of the signs, of +12 which is the valence of Chromium.

K₂^+2/2Cr₂^+12/2O₇^-14/7 the quotient will be +6

thus, K₂⁺¹Cr₂⁺⁶O₇^-2 

 

3. To check if the valences are correctly given, the positive signs and the negative signs should be equaled to zero when added in their final oxidation state.

Eg.

K₂⁺²Cr₂⁺¹²O₇^-14           

  (+2)+(+12)+(-14) = 0

4. The final valence of each element extracted from step 2 will be the final oxidation state to be used in the REDOX Reactions. The element that reacts to gain or lose electrons shall be prioritized.

Eg.

Cr₂⁶⁺ + 6e 2Cr⁺³

Duties and Responsibilities of the Pharmacist

The following are the duties and responsibilities of the pharmacist in community pharmacy:

1. Maintains the cleanliness in the dispensing area.
2. Promotes rational drug use to patients and clients.
3. Make and supervise the filling and refilling of prescriptions.
4. Shall check the labels of all dispensed drugs.
5. Inhibitor against use of cipher or unusual terms in prescription and prescription switching.
6. Dispenses contraceptives and devices
7. Monitors quality of stocks and their inventory.
8. Assesses supplier's capability to produce quality products.
9. Responds to laws and policies implemented by DOH-FDA.
10. Shall be pharmacovigilant to drugs' auxiliary effects and adverse effects while they are in the market.

______Sign over Printed Name_______

             Pharmacist-In-Charge

DOH-FDA Clears Six Korean Noodles from Containing Benzopyrene

After the DOH-FDA conducted tests against the six Korean Noodle Brands, the results were found out that these Korean Noodles contained petty amount of benzopyrene chemical, which does not cause harm when taken in very very little amount in human body based on the threshold of the chemical to bring toxicity. The DOH-FDA removes the warning and clears out that the noodles are safe for consumption and do not cause cancerous disease as stated in their previous statement.

Mugs Are Not Safe This Christmas

The public is warned against procuring and buying of mugs that are containing harmful chemicals and heavy metals such as lead, cadmium, mercury and alike, which are detrimental to the well-being of people. Especially, this upcoming Christmas season where people are accustomed to gift giving and gift surprises, that they may be considered mugs as their choice of present this season. Beware of these items, and buy only the legal ones that passed the criteria of DTI for this product. If mugs are suspiciously come from an unreliable source or production, you may ask where it made and how is the craft done or ask for certification of registration or any proof that the mugs are passed under DTI's requirements. It is better to be meticulous and critical than to cause harm to your family or friends that must be turned out to joy and love this holiday seasons.

Dequalinium Chloride, from Oral Lozenge to Vaginal Tablet

How amazing that something we used to treat oral thrush and other infections on mouth can now be used for vaginal infections. Dequalinium Chloride, known to be Dequadin lozenge, has been transformed into vaginal tablet. Dequalinium Chloride is not just effective to treat mouth thrush and other oral infections, but found out clinically to be effective against vaginal infection, trichomoniasis, and can be used as an achievement of asepsis before gynecological operations and deliveries.

Under the brandname of FluomizinTM (Medinova Switzerland) and imported and distributed by Chemway Pharma Inc. in the Philippines. The drug is in the form of tablet, of course, but a vaginal tablet of white oval and biconvex, that inserted deeply into the vagina. Each tablet contains 10mg of Dequalinium Chloride. Fluomizin is therapeutically against vaginal infection of bacterial and mycotic origin such as bacterial vaginosis and candidiasis, trichomoniasis and achievement of asepsis before gynecological operations and deliveries. One vaginal tablet everyday for six days is recommended dosage.

Adverse effects may include itchiness, burning sensation or redness on the area of administration, but which can be also associated with vaginal infection, local irritation reactions and some very rare cases of fever have been reported. For more information about this drug, please consult your pharmacist or your OB-Gyne doctor about the proper use, dosage and administration and other information.

Zuellig Pharma Philippines Uses Firmus to Ship Drug Products to Their Clients

Firmus, to be the third subsidiary business owned by Zuellig Pharma besides from MetroDrug, Inc., is meanwhile shipping drugs and medical products for Zuellig Pharma Philippines. After the migration of Zuellig Pharma from their old system to the new one (SAP), practice and adaptation are needed to able to perfect and master the new one to improve their services and transactions with clients in ordering, booking and shipping drugs and medical products. Because of the bad feedback they received from the MetroDrug, Inc's migration, Zuellig Pharma had already anticipated the errors and troubles that might sprout out while in the process, so that choosing Firmus, as part of the contingency plans for incessantly service without subverting the transactions and other business processes to their clients. The Firmus is used, because it has the old system that the mother company once used before migration. Firmus serves Zuellig Pharma to dispatch and deliver all their products, except for 50 major accounts which are all vials, injectables, ampoules and other parenteral products which are all exclusively served by Zuellig Pharma.

So do not be dismayed about this event, sooner or later everything will be back to normal after Zuellig Pharma has already mastered the new system. Any queries you may ask their salesmen or call their customer service.

Could It Be that the Intimate Area Whitened using Feminine Wash?

This year Sanofi-Adventis Philippines launched their newest innovation in feminine hygiene, Lactacyd White Intimate. The pioneering innovation promise a result of whitening the intimate area of females that associates to low-esteem, self-consciousness and inhibiting intimacy. With this product, women are free from their distress against their darkened intimate area. Darkening of the intimate area is caused by friction of tight clothes and sweat. The new innovation was made possible through the augmentation of ingredients that effectively whiten the skin. Plant-based Actipone-B and marine-based Algowhite gently lighten the surrounding are of the intimate part. Based of the clinical trials and actual used of the product by Asian women, the result is 9 out of 10 claims to see visible results of lightening within 4 weeks of actual use.

The product is still enhanced with the its original content, Lactoserum plus Lactic Acid, that dermatologically tested safe and gently cleanse and bring all around freshness. The product is formulated naturally to cleanse and also whitens. It is dermatologically tested safe to intimate area.

Criticism
The product is tested only to Asian women, but not to other races. Therefore, some possible hypersensitivity reaction to women who are mixed blood can be occurred. Maybe their market is most Asian women, but other race may want to try so.

Significance of SOP for Pharmacy

Importance of SOP for pharmacy has a great role in helping personnel gain right function, achievable task and synchronize work. They are produced to overcome overlapping of tasks and functions, handling each work, resolve intrinsic problems and dissolve disorganized work place.

1. To create a concrete step by step procedures to follow by everybody.
There maybe a chance when working heights is turning into confusion and disorganized. But upon surrendering to a procedural manual this maybe eliminated. A good personnel knows how to handle each tasks with organization and following very simple steps to have efficient work and readily finished the tasks with ease and faster, even, to create more activities in just one working day.

2. Resolves functional and responsibility overlapping.
A working place is where everybody is concerned to each other work. They are connected, but have different responsibility and function with each other. Because of the connection, some task can be also done by other personnel causing to a multitasking. Doing it so, problems may appear when one business is everbody's business. This could bring work crisis because no one is set up for certain function and a disorganization can occur. Thus when a procedural manual is available, each function can be rationalized to whom it goes and who can only act that responsibility.

3. Scope and to what extend is created.
 It defines the categories, limits and coverage for certain personnel, task, or responsibility. 

4. Identifies the synchronization of recording and filing of records.
Helps to organize the input and output of records, and traces files when it is followed.

5. Provides knowledge in emergency situation and errors.
SOP can help to trace mistake of personnel as their negligence of work. Mistakes and errors can be avoided when the procedures are strictly followed. Thus, one step overlooked can destroy the whole course of work. In emergency cases, SOP can be a manual to direct a personnel to what to do in case a very rare situation is taken place.

A powerful life-saving medicines that help in childbirth delivering on laboring mothers, Methergin and Syntocinon ampules are trusted and main choice by OB-Gyne doctors for laboring mothers. The main action of Methergin is to cease the uterine bleeding and Syntocinon to contract the uterine, and help the propulsion of the baby. They are the main choice by most physicians, because they cannot cause atony and excessive bleeding, that may result to hysterectomy (removal of uterus) or even sudden death of the mother, due to severe bleeding, when not prevented.
Comparing to other brands they showed the most efficient and the least to produce these cases to the laboring mothers.

I just wondered why Wyeth merged with Pfizer? Because lately I saw all the drug products of Wyeth before are now packaged and labeled customary as same as to those other drug products of Pfizer, and bearing the Pfizer name now. Including the vitamins and supplements, Pfizer name is in their labels and enjoined with the Pfizer Consumer products, but not having the blue color of packaging but retained the official packing of them. But I think all the milk products are not included in the merging.

Strepsils New Packaging: In Blisters Now!

Strepsils new packaging is interesting because from pouch form to blisters now. When I first saw the new packaging, I was curiously to see what's inside of each box. The pouch or pack I knew before had difficulty in resealing to keeping the freshness and stability of the lozenges. Also, if you needed only one or two, you need to buy the whole. I opened the box and saw each lozenge blistery packed in six pieces in two halves of a whole pack. The box contains two whole packs of 24 pieces blistered. It is nice to know that having this packaging can easily be sold. A customer was stunned when he knew about the new packaging of Strepsils. He said it is not expensive anymore to buy one or two, unlike before you need to buy a whole pack to be able to use one or two only. The new pack gives convenience and cost-effectiveness to customers. However, the pouch is also a choice for customers other than the blister ones.

Fleet Enema moved to Getz Bros. Philippines

If you are looking for the new distributor of Fleet Enema,  you should be informed that it has new distributor to serve the market. From Blooming Fields Philippines, CB Fleet had transferred the rights and authority to distribute and market it to Getz Bros. Philippines. It was effective this third quarter of the year, and also their other product, Phosphosoda is also moved in their list. So far Fleet Enema was back in the stores and sold to patients already!

Illegal Importation and Selling of Introcan IV Catheters

B. Braun Medical Inc. had been abolished their importation and registration of Introcan IV Catheters in the Philippine market approved by the FDA Philippines. But some smuggles of them are being sold in the Avenida St. and Bambang St. Medical Suppliers are hoarding these smuggled supply products and are being served to customers who are looking for them. Hospitals and medical professionals were not informed about the cessation of distribution of these supplies, thus continuing of usage is done. FDA should enforce inspection on the those establishments with Bureau of Customs to eliminate the marketing of such imported and unregistered medical supplies in our country.

Zuellig Pharma migration to SAP

Lately, Zuellig Pharma Philippines had migrated to a new system to upgrade their services for their customers and clients. Systems Application Program (SAP) is a program that gives proficient, optimized and productive services and distribution of medical products to clients and partners. The system was tested before the actual application to them to MetroDrug, Inc., a subsidiary company of Zuellig Pharma. MetroDrug's experienced was so malignant and severely critical that principal companies where at the point of gravid rage because of the failure and bad feedback they received from the migration. No contingency plans, no back-ups or even no assurance that the system will work. Thus, from their migration in the first quarter of this year, Metrodrug's services, distributions and other concerns are not really fixed yet. The major principal companies such as Pfizer Consumer, Boehringer Ingelheim, and Sanofi-Adventis were prioritized due to their importance in company's revenues and solely partnership to distribute their products. Their system is downgraded and  not synchronized even their sales representatives were very messed and hassled because of use of tabs that do not perfectly installed and programmed. That's why, an errors were always experiencing and some of their bookings of orders were not recorded. Moreover, their deliveries and dispatchments are improved but most problems were experienced often. In their migration until the third quarter of the year, enormous revenues were lost, and other partners are looking for another distributors to serve their products to the clients, the same is applied to client's diversion to find other distributors to server them. But as of the moment, their services are slowly back to normal, yet other products are not served and delivered.

Because of what the MetroDrug, Inc experienced, Zuellig Pharma has planned a lot of strategies and back falls to subdue the failure. Zuellig Pharma migrated into their new system on October 15, 2012 with contingency plans that fifty major accounts will be serviced of them (mostly injections, lifesaving drugs, parenterals and alike) and the other accounts will be serviced by Firmus, a new company subsidized by Zuellig Pharma. Two weeks were said to finish the migration, but sales representative's informed that the service will be normalized before the year ends, because their two warehouses are not yet ready and still mastering the new system. I hope for fast catch up to the new system so that drug distribution will be balanced and not to end to out of stock, which clients do not want to happen.