manual on management of drugs

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MESSAGE BY THE SECRETARY/ MINISTRY OF HEALTHCARE & NUTRITION I am pleased to release this message for the 3 rd edition of the “Manual of Management of Drugs”. Sri Lanka has based its healthcare system on the Primary Healthcare approach and one of the key areas in this approach is the supply of pharmaceuticals which take up a sizable portion of the health budget. In order to achieve the maximum benefit from this sizable investment, it is necessary to ensure proper management of drugs. Hence this publication is very important in this context. The first 2 editions of this book have been widely used by healthcare professionals and administrators not only from Sri Lanka but from numerous regions in the world. I anticipate that this edition too, which has taken into account the numerous changers that have taken place especially with the devolution of management of Health Services to the provinces will be well received. I also wish to thank all the officials from the Ministry of Healthcare & Nutrition especially the Director of the Medical Supplies Division and the Director of the Medical Technology & Supplies for their valuable contribution in publishing this book. Dr.H.A.P. Kahadaliyanage Secretary/Ministry of Healthcare & Nutrition iii
PREFACE It is with pleasure that I write this preface to the 3 rd edition of the “Manual on Management of Drugs.” This Manual, first published in May 1987 and revised in June 1993, was well received both nationally and internationally. It is widely known and used by those involved in the drug supply system in Sri Lanka. Over the fifteen years the contents of the <strong>manual</strong> were discussed at various workshops and meetings and the views expressed noted. Far reaching changes also took place in the drug management system, with the setting up of the Regional MSD in provincial councils. There was thus a need for a revision of the <strong>manual</strong>, and this second revision is the result. I am thankful to all those who were involved in revising this edition. Special mention must be made of Director, MSD and his staff, Director, MT & S and his staff, and all the contributors who actively participated and contributed much towards this revision. It is my hope that this <strong>manual</strong> will contribute positively towards the ready availability and efficient management of essential drugs in the health care institutions in Sri Lanka. Dr. U. A. Mendis Director General of Health Services Ministry of Healthcare & Nutrition iv
Page 2 and 3: MANUAL ON MANAGEMENT OF DRUGS SECON
Page 6 and 7: ACKNOWLEDGEMENT It is a great pleas
Page 8 and 9: Dr. J. M. J. Munasinghe Dr. K. C. L
Page 10 and 11: ABBREVIATIONS AD CP CDD CDDA D(F) D
Page 12 and 13: CONTENTS Message by the Hon. Minist
Page 14 and 15: X Form for Drug sample for quality
Page 16 and 17: CHAPTER 1 INTRODUCTION 1.Ensuring a
Page 18 and 19: 3.The expenditure on drugs has been
Page 20 and 21: of poisons, opium, and dangerous dr
Page 22 and 23: (Medical Technology & Supplies) No
Page 24 and 25: c) NDQAL for quality assurance of d
Page 26 and 27: Deputy Director General (Finance) D
Page 28 and 29: (d) The Institutional Drug Therapeu
Page 30 and 31: CHAPTER 4 ESTIMATION OF ANNUAL REQU
Page 32 and 33: Step 2 Identify the stock available
Page 34 and 35: In the case of institutions under t
Page 36 and 37: oard appointed by him and a report
Page 38 and 39: Head of the Institution may add any
Page 40 and 41: ii. Injections costing Rs. 25.00 or
Page 42 and 43: 42. Delivery schedules are planned
Page 44 and 45: CHAPTER 6 CARE IN PRESCRIBING DRUGS
Page 46 and 47: CHAPTER 7 DISTRIBUTION AND LOGISTIC
Page 48 and 49: the institution. Records of the inv
Page 50 and 51: RMSD or institutional stores, the o
Page 52 and 53: CHAPTER 8 QUALITY ASSURANCE OF DRUG
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ioavailability. Further, in apprais
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x. Details of any preservative adde
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To request institutions to inform t
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CHAPTER 9 STORAGE OF DRUGS. 1. Prop
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xi. Storage of vaccine in the refri
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CHAPTER 10 MONITORING OF CONSUMPTIO
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ii. VEN analysis ( See annexure XV
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9. Monitoring of quality of drugs;
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alance as per ledger, actual balanc
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1.3 In case of institutions coming
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Ampoules should be crushed and buri
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ANNEXURE I1: Main functions of Medi
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I - Annual stock holding cost as a
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Anti Rabies cell culture vaccine. (
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unobservable (animal dead, killed,
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on D0, D3, D7, D14 & D30. 6.1.2 For
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All patients who receive rabies PET
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Monthly return for vaccine consumpt
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Death in the house / outside a Medi
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2.2 In case of major exposures: 2.2
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ANNEXURE - V MyNo……/…../….
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Advertisement Screening Unit Unit o
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ANNEXURE VIII (To be amended To: My
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ANNEXURE X ……………………
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6. Quality failure of registration
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ANNEXURE XIII Lot Card SR No……
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ANNEXURE XV VEN Analysis This analy
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Sample Guidelines for VEN Category
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Unsatisfactory clinical response, a
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Local Agents of supplier (on reques
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