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Introduction to the formulary

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Formulary management is another key component of medication management. Chang will explain the history, rationale, and design behind formularies. He also describes how the pharmacist is involved in this process.

Key points

Formulary is a list of medications available for use at a hospital or health system. Formulary also includes the different dosage forms, strengths, and package sizes of each recorded medication.

An open formulary has no limitation to medication access, while a closed formulary may limit drugs to specific physicians, patient care areas, or disease states.

Formulary reviews should be evidence-based, taking the clinical, ethical, legal, social, philosophical, quality-of-life, safety, and economic factors into account. PTC needs to evaluate the pros and cons before making every decision. Item restrictions reduce the cost of inventory and the need for system management but may also reduce the quality of care.

It is the pharmacist’s responsibility to make sure the quality, quantity, and sources of all medications, chemicals, biologicals, and pharmaceutical preparations used in the diagnosis and treatment of patients are correct.

Occasionally pharmacists are authorized to use non-formulary medications or non-preferred medications without contacting the prescriber. However, this must be regulated by detailed guidelines specifying the dosage strength, dose frequency, and route of administration for the interchange.

In Taiwan:

According to Taiwanese regulations, pharmacists are not allowed to change medication without the approval of the prescriber, unless there is a shortage. In that case, the pharmacist can dispense an alternative with the same chemical name, dosage form, and strength.

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Good Pharmacy Practice: Medication Management

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