3 Drug Distrubition in Hospital

A PRESENTATION ON
DRUG DISTRIBUTION SYSTEM IN HOSPITAL
Presented By
a.tirupathi rao, M.pharm,ph.d
Associate professor,
Department of Pharmacology
Contents
 Individual prescription method

 Floor stock method
 Unit dose drug distribution method
2
DRUG DISTRIBUTION
 Drug distribution is defined as, “Physical
transfer of drugs from storage area in the

hospital to the patient’s bedside”.
 This involves two types of drug distribution.
They are:
 In-patient distribution
 Out-patient distribution
3
IN-PATIENT DISTRIBUTION
 The drug distribution to the in patient
department can be carried out from the out

patient dispensing area.
 The pharmacists involved in dispensing the
drugs for out patient can dispense drugs for in

patients too.
 The pharmacist employed for drug distribution
to the in patient wards should be well skilled

and qualified staff.
4
OUTPATIENT DISTRIBUTION
 Out patient refers to the patients not occupying beds
in hospital or in clinics, health centers and other
places where out patients usually go for health care.
 No medicaments should be issued without the
prescription.
 After the issuance has been made the quantities
supplied must be recorded.
 In short form the out patient department was called as
OPD.
5
TYPES OF DRUG DISTRIBUTION
SYSTEMS
 There are five different systems in use for drug
distribution in hospitals:
i. Individual prescription order system
ii. Complete floor stock system
iii. Combination of individual prescription and
floor stock system
iv. Unit dose system
v. Non-floor stock system
6
INDIVIDUAL PRESCRIPTION ORDER
SYSTEM
 It is a type of drug distribution system where
the physician writes the prescription for
individual patient who obtains the drugs
prescribed from any medical store or hospital
dispensary by paying own charges.
 This system is generally used by the small
and/or private hospitals because of the reduced
man power requirements and desirability for
individualized service.
7
ADVANTAGES:
 All medication orders are directly reviewed by
pharmacist.
 It provides the interaction of pharmacist, doctor,
nurse & the patient.

 It provides clear inventory control.
DISADVANTAGES:
 illegible writings of the physicians.
 Physician may write high economic drugs in the
prescription or cost effective drugs.

 Delay in obtaining required medication.
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FLOOR STOCK SYSTEM
 Drugs are given to the patient from the nursing station & the
pharmacy supplies from the drug store.
 The way of floor-stock distribution includes 2 types
They are:
1) Charged floor-stock system
2) Uncharged floor-stock system
1) Charged floor stock system:
 In this method medicines which are stocked in the nursing
stations all the times& charged to the patients account after
administered to them.
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 The patient is charged for every single dose
administered to him.
 Once the floor-stock list is prepared it is the
responsibility of the hospital pharmacist to
make the drugs available.
 Pharmaceutical & related preparation
Category Prepaation
Anti-allergies Prednisolone tablet
Antibiotics Penicilin. G inj
Anticoagulants Heparin
Cardiovascular agents Digoxin.Inj
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HOSPITAL PHARMACY
Patient ward: __XXX_______
Phenobarbitone tablets
Each tablet contains
phenobabitone dose of 50gms
2) Non charged floor-stock system:

 These system includes the medicaments placed
in the nursing station that are used by all the

patients on the floor.
11
 There shall be no direct charge from the patients
account.
 This is divided into two methods.
 1) Drug basket method
 2) Mobile dispensary unit
 Drug basket method:
 Nurses fills a requisition form for the delivery of
drugs at their floor.
 When there is an empty container, the nurses place it
in the drug basket.
 Once the basket is completed, delivery of drugs is
done via messenger services.
12
13
 Mobile dispensary unit
 It is specially made up of stainless steel
 60 inches height
 48 inches wide & 25 inches deep
 It is mounted on bottom tyres.
14
 Label for non charged floor-stock drugs
HOSPITAL PHARMACY
Ward:__XXX________
Ferrous sulphate tablets
Each tablet contains
Ferrous sulphate dose of 0.3gms
15
 List of Uncharged Drugs
AMPOULE CAPSULE TABLET SOLUTION POWDERS
Adrenaline Dulcolax Atropine Tin.Belladona Glucose

sulphate
Digoxine Multivitamin Paracetamol Cator oil Sodium

bicarbonate
Lidocaine HCl Digitalis Nitroglycerine Tin.Benzoin Talc

compound
16
 Difference between charged & non Charged
floor stock
Charged floor-stock Non charged floor-stock
system
I. The charges are made into the I. The drugs are not made in the
patients account after they have account directly even after the
been administered. drug have been administered.
II. Every dose of the drug administered II. Charges are made indirectly to
to the patients are charged. the patient.
III. Only the dose of the drug charged III. The cost of the drugs are not as
which are expensive & rarely used. high as the drugs Used are
tablets & capsules.
IV. Floor-stock list is prepared which is IV. A pre-determined list is

sent to make the drugs available at prescribed by the nursing
all the nursing stations station.
17
3.Combination of Individual & floor stock
method
 This system is followed by all government
hospitals and also private hospitals those run

on the basis of no -profit and no loss.
 Surgical items are given to the patients, who
purchases and deposit those items in a hospital

wards on rooms under the supervision of
registered headnurse.
18
 4. UNIT DOSING DISPENSING:
 Those medications ordered, stored, packed,
handed, administrated and charged in
multiples of single dose units containing a
predetermined amount of a drug or supply
sufficient for one regular dose.
 A single unit package is one which contain one
complete pharmaceutical dosage form.
EX- 1 tablet or 1 capsule.
19
Advantages
 Better financial control
 It prevents loss of partially used medications.
 Does not require storage facilities at nursing
stations.
DISADVANTAGES
 Irregular dosage
 Skill person is required for administration of
drug.
 Regular monitoring is required
20
 TYPES OF UNIT DOSE DRUG
DISPENSING SYSTEMS:
1) TYPE A- CENTRALISED UDDDS
2) TYPE B-DECENTRALISED UDDDS
 All inpatients drugs are dispensed in unit
doses and all drugs are stored in central area of

pharmacy and dispensed at a time of dose that
is to be given to the patient
21
 2) TYPE B-DECENTRALISED UDDDS:
 This is operated through satellite pharmacies
located on each floor of hospital.

PROCEDURE:
 Patient profile card containing full data, disease,
diagnosis, is prepared.
 Prescriptions are sent directly to the pharmacist
which are then entered in patient profile card.
22
 Pharmacist check the medication order is filled by
pharmacy technicians.
 The nurse administers the drug and make entry in
their record.
ADVANTAGES:
 Easy for admission of staff.
 Accounting becomes easier in certain cases.
DISADVANTAGES:
 High cost
 Consumption is more time.
 Will occupy more space for sorting out ledger
posting and inventory control problem. 23
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A PRESENTATION ON

DRUG DISTRIBUTION SYSTEM IN HOSPITAL

 Individual prescription method

transfer of drugs from storage area in the

department can be carried out from the out

drugs for out patient can dispense drugs for in

to the in patient wards should be well skilled

nurse & the patient.

 Physician may write high economic drugs in the

prescription or cost effective drugs.

Each tablet contains

phenobabitone dose of 50gms

2) Non charged floor-stock system:

in the nursing station that are used by all the

AMPOULE CAPSULE TABLET SOLUTION POWDERS

Adrenaline Dulcolax Atropine Tin.Belladona Glucose

Digoxine Multivitamin Paracetamol Cator oil Sodium

Lidocaine HCl Digitalis Nitroglycerine Tin.Benzoin Talc

IV. Floor-stock list is prepared which is IV. A pre-determined list is

hospitals and also private hospitals those run

purchases and deposit those items in a hospital

 It prevents loss of partially used medications.

 Does not require storage facilities at nursing

 Skill person is required for administration of

doses and all drugs are stored in central area of

located on each floor of hospital.

which are then entered in patient profile card.

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