Choosing Pharmaceutical Products for Clinics and Hospitals

Choosing Pharmaceutical Products for Clinics and Hospitals

To ensure your patients receive proper medical care, you must stock up your healthcare facility with the right type of pharmaceutical products in sufficient quantities.

However, this process can be complicated and incur high costs when not carried out systematically. Here are the factors you should consider when choosing products for your clinic or hospital.

1. Legal requirements

Legal requirements

To obtain drug supplies from manufacturers and wholesalers for your facility, you first need to have an Annual Practicing Certificate (APC) as stated in the Poisons Act 1952. You will also need to renew your APC annually.

2. Choosing the Right Pharmaceutical Products Supplier

Choosing the Right Pharmaceutical Products Supplier

Did you know that the cost of pharmaceutical products is the second-highest after staff costs in any given country’s healthcare system?

Besides that, the public has voiced their disapproval regarding private facilities known to overcharge for products. This has led to the public purchasing directly from pharmacies and companies sourcing from pharmacies to reduce staff medical benefit costs.

Therefore, researching and finding a supplier committed to providing reasonably-priced and high-quality products is critical. This way, you will be able to offer affordable services to your patients. Make sure to consider the supplier’s prices, shipping policy, dependability, return policy, drug quality and reputation.

3. Types and Quantities of Pharmaceutical Products

Types and Quantities of Pharmaceutical Products

The next question is: what products should you procure, and in what quantities? Equipping your facility with the right products and amount to meet your patients’ needs and avoid wastage is crucial.

Firstly, your facility should have sufficient quantities of essential drugs (basic medicines that meet the population’s healthcare needs) at all times. These products are listed on Malaysia’s National Essential Medicine List (NEML).

The NEML currently consists of 359 medicines. Ideally, a hospital should have 150-200 medication on hand, while smaller facilities need around 40-50 medications.

You will also need to carry out quantification to estimate the demand for specific products during a certain period. To quantify accurately, you will need information from the essential medicines list, consumption data, epidemiological data, prescription patterns, stock levels, stock-out frequencies, and length of procurement cycles.

4. Storing Pharmaceutical Products

Storing Pharmaceutical Products

Before purchasing pharmaceutical products, you need to ensure your facility has the right storage conditions for every product.

Besides, you will have to maintain proper segregation, temperature, lighting, humidity, sanitation, and ventilation levels. Additionally, you must keep dangerous drugs and psychotropic substances under lock and key with an alarm system.

These measures are vital to avoid contamination, disfiguration of labels, theft and loss, and pest infestation and maintain the product quality or potency.

Lastly, you should monitor and take note of each product’s expiry date regularly. Moreover, implementing a FEFO (First To Expire First Out) policy can help avoid wastage.

If you’re looking to procure pharmaceutical products for your facility, Mayflax can help you. Mayflax is a one-stop pharmaceutical wholesaler that provides over 2,000 quality pharmaceutical products to healthcare professionals at low prices. Find out more about them here.

Improper Inhaler Technique: Affect Asthma Control

Picture of inhaler

Improper Inhaler Technique: Affect Asthma Control

Healthcare professionals can support patients in optimizing their technique by examining the effects of the sub-optimal inhaler.

Inhalers used to treat asthma and chronic obstructive pulmonary disease (COPD). Thus, inhalation techniques play a major role in improving drug adherence.

About 92% people with asthma use their device incorrectly. Improper inhaler have been reported in children and adults, including experienced inhaler users

Moreover, improper inhaler technique can prevent drugs from reaching to lungs. It can be effective if the patient used in correct ways. Good inhalation techniques are very important to maximize the benefits of these drugs.

Hence, the correct technique depends on what type of inhaler. Some inhaler steps differ according to the type  of inhaler.

Besides, healthcare professionals must be proficient in how to use correctly of each inhaler device and need to be aware of common mistakes so they can confidently demonstrate in front of patients.

However, you can purchase the inhaler with doctor’s prescription at any pharmacy, and healthcare professional can buy from any pharmaceutical company such as Mayflax.

Types of Asthma Devices

    Common inhaler are used to deliver asthma and chronic obstructive pulmonary disease (COPD) medications which are metered dose inhalers (MDIs), dry powder inhalers (DPIs), and soft mist inhalers (SMIs).

Meanwhile, each type of inhaler has advantages and disadvantages. Below,  the various types and technique of inhaler medical device :-

1. Pressurised metered dose inhaler (PMDI)

Description

  • Drug is stored under pressure in the metal canister
  • A fine mist of medication is released upon pressing the canister that can be inhaled into the lungs
  • Works well with a valved holding chamber (VHC) or spacer.

How to use?

  1. First, need to remove cap.
  2. Second, hold inhaler upright and shake well.
  3. Third, breathe out gently and away from inhaler.
  4. Fourth, put mouthpiece between teeth without bite and close lips to form a good seal.
  5. Start to breathe in slowly and deeply. At the same time, press the inhaler device.
  6. Hence, hold breath for 5 to 10 seconds.
  7. While holding breath, remove inhaler from mouth.
  8. Breathe out gently and away from the inhaler.
  9. Repeat dose if needed and replace cap.
  10. Lastly, clean device if necessary after use.
Picture of metered dose inhaler

Available Brand in Malaysia

  • Ventolin® MDI (Salbutamol)
  • Flixotide MDI (Fluticasone)
  • Flutiform® MDI (Fluticasone/Formoterol)
  • Foster®  MDI (Beclometasone/Formoterol)
  • Alvesco® MDI (Ciclesonide)

2. Tuberhaler

Description

  • Dry powder inhaler (DPI)
  • No coordination required
  • Device dispenses a small amount of very fine powder directly into the lungs
  • Comes with a dose indicator

How to use?

  1. First, need to unscrew and remove cover.
  2. Second, check dose counter.
  3. Third,  keep inhaler upright while twisting grip at the base.
  4. Twist around and then back until click is heard.
  5. Then, breathe out gently, and away from the inhaler.
  6. Fourth, put mouthpiece between teeth without bite and close lips to form good seal
  7. Do not cover the air vents.
  8. Breathe in strongly and deeply.
  9. Fifth, hold breath about 5 to 10 seconds.
  10. Hence, remove the device before breathing out fully.
  11. If more than one dose is needed, repeat all steps starting from step 3.
  12. Lastly, replace cover and clean the device if necessary.
PIcture of taking tuberhaler

Available Brand in Malaysia

  • Symbicort® Turbuhaler (Budesonide/Formoterol)
  • Pulmicort® Turbuhaler (Budesonide)
  • Bricanyl® Turbuhaler (Terbutaline)

3. Respimat soft mist inhaler

Description

  • Dispenses fine and easy to inhale droplets directly deep into the lungs.
  • Requires very less effort during inhalation
  • Comes with a dose indicator

 How to use?

  1. Hold inhaler upright with the cap closed.
  2. Then, turn base in direction of arrows on label until it clicks. Half a turn.
  3. Open the cap until it snaps fully open.
  4. Breathe out gently, and away from inhaler.
  5. Moreover, put mouthpiece in mouth and close lips to form a good seal.
  6. After that, start to breathe in slowly and deeply through mouth;
  7. And at the same time, press down on the dose button.
  8. Continue to breathe in slowly and deeply.
  9. Hold breath for 5 to 10 seconds.
  10. While holding breath, remove inhaler from mouth.
  11. Breathe out gently, away from mouthpiece.
  12. Close cover to click shut.
  13.  If you need two doses, repeat from step 1 to get the full dose.
Picture of taking Respimat soft mist inhaler

Available Brand in Malaysia

  • Spriva Respimat® (Tiotropium)

4. Accuhaler

Description

  • Dry powder inhaler (DPI)
  • No coordination required
  • Device dispenses a small amount of very fine powder directly into the lungs
  • Comes with a dose indicator

How to use?

  1. Check dose counter.
  2. Open cover using thumb grip.
  3. Load dose.
  4. Keep device horizontal or upright while sliding lever until it clicks and do not shake.
  5. Then, breathe out gently but not into device.
  6. Put mouthpiece in mouth, without biting and close lips to form a good seal. 
  7. Breathe in quickly and deeply.
  8. After that, hold breath for a count of ten.
  9. While holding breath, remove inhaler from mouth.
  10. Slowly breathe out.
  11. If more than one dose is needed, repeat all steps starting from step 3.
  12. Close cover to click shut.
  13. Clean device if necessary after use.
Picture of Accuhaler

Available Brand in Malaysia

  • Seretide® Accuhaler (Salmeterol/Fluticasone)

5. Ellipta

Description

  • Medication is stored under pressure in the metal canister
  • A fine mist of medication is released upon pressing the canister that can be inhaled into the lungs
  • Works well with a valved holding chamber (VHC) or spacer.

How to use?

  1. First, check dose counter and do not shake.
  2. Second, slide cover down until click is heard.
  3. Third, breathe out away from inhaler.
  4. Fourth, put mouthpiece in mouth and close lips to form a good seal;
  5. And do not block air vent with fingers.
  6. Then, breathe in steadily and deeply.
  7. Fifth, hold breath about 5 to 10 seconds.
  8. While holding breath, remove inhaler from mouth.
  9. After that, breathe out gently, and away from inhaler.
  10. Slide the cover upwards as far as it will go, to cover the mouthpiece.
  11. Lastly, rinse your mouth with water and spit it out for a steroid-containing inhaler.

Available Brand in Malaysia

  • Ventolin® MDI (Salbutamol)
  • Flixotide MDI (Fluticasone)
  • Flutiform® MDI (Fluticasone/Formoterol)
  • Foster®  MDI (Beclometasone/Formoterol)
  • Alvesco® MDI (Ciclesonide)
Picture of taking ellipta

Common Errors with Inhaler Technique

  • Not breathing with the proper way.
  • Breathing in too early and too late when pressing the inhaler canister.
  • Forget to shake the inhaler before use.
  • Not waiting for the next puff. Some inhalers, need to wait at least 30 to 60 seconds before taking the next puff.
  • Hence, not breathing out before using the inhaler and does not have  a tight lip seal.
  • Not lifting your chin slightly before breathing in. 
  • Furthermore, not holding your breath after taking the inhaler;
  • As well as, not using a spacer when needed.

Guidance of How To Use Your Asthma Devices?

This video shown how to use different types of inhalers. 

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ABOUT THE AUTHOR

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Raihan Ridzuan

Raihan Ridzuan, Bachelor of Science (Hons) Pharmacology, is staff officer of Mayflax, one of the nation’s leading healthcare and marketing company.

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