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PST NTA Level 6

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06103 Pharmaceutical Production

Quality Assurance and Quality Control – PST06103 Pharmaceutical Production

NTA Level 6 • Semester 1 • PST06103 Quality Assurance and Quality Control Pharmaceutical Production • Source Session/Topic 21 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 21: Quality Assurance and Quality Control Total Session Time: 120 minutes Pre-requisites • None Learning Tasks By the end of this session students are expected to be able to: • Explain quality assurance in pharmaceutical manufacturing • Explain quality control in pharmaceutical manufacturing • Differentiate between quality assurance and quality control • Explain quality variations in pharmaceutical manufacturing • Define documentation in pharmaceutical manufacturing • List documents required for pharmaceutical manufacturing • Explain the importance of documentation in pharmaceutical manufacturing Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • LCD projector and computer • Handout 21.1: Raw Material Quality Assurance Monograph SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |20 minutes |Presentation |Quality Assurance in Pharmaceutical | | | | |Production | |3 |15 minutes |Presentation |Quality Control in Pharmaceutical | | | | |Production | |4 |10 minutes |Presentation |Difference between QA and QC | |5 |30 minutes |Presentation |Quality Variation in Pharmaceutical | | | | |Production | |6 |30 minutes |Presentation |Documentation in Pharmaceutical | | | | |Production | |7 |05 minutes |Presentation |Key Points | |8 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Quality Assurance in Pharmaceutical Production (20 minutes) • Quality is the totality of features and characteristics of a medicinal product and its ability to satisfy stated and/ or implied needs o Quality begins with research and development o Quality is designed and built in the product • Quality assurance (QA) is a wide ranging concept covering all matters that individually or collectively influence the quality of a product • QA is a totality of the arrangements to ensure that the drug is continuously of the right quality for the intended use • Quality assurance is a part of quality management focused on providing confidence that quality requirements will be fulfilled • Quality Assurance incorporates GMP (which incorporates QC) and also includes product design and development with special focus on process design o GMP is a part of QA which ensures that products are consistently produced and controlled to the quality standards appropriate to their intended use o Quality relationships in a pharmaceutical industry is; Quality Management Quality Assurance Good Manufacturing Practice (GMP) Quality Control • Elements of Quality Assurance circle in Pharmaceutical Manufacturing; o Research o Development o Prototyping o Documentation o Raw materials o Facilities (buildings) o Equipment o Personnel and supervision o Monitoring, feedback, follow-up • Features of a good QA system; o It is a process, not an end point o It must be independent of financial pressures o Must ensure that quality policies are followed o Must have final authority in product acceptance, rejection and release to public o Must be an integral part in production o Must be responsible for day-to-day operations and for longer term goal settings • Responsibilities of QA include the following; o QA department is responsible for ensuring that the quality policies adopted by the company are followed o Helps to identify and prepare the necessary SOPs relative to the control of quality ▪ Ensures that SOPs are prepared, approved, used and updated o It must determine that the products meet all the applicable specifications and that it was manufactured according to the internal standards of GMP o QA is responsible for quality monitoring or audit function o QA functions to assess operations continually and to advise and guide them towards full compliance with all applicable internal and external regulations o Ensures that proper documentation is followed ▪ Documents are systematic and well kept ▪ Quality manuals are made and staff trained and motivated to comply • Primary functions of QA o Quality control (analytical testing of products) o Raw materials control (sampling, inspecting and testing of incoming raw materials) o Packaging and labelling components (bottles, foils, labels, measures, cartons) o Physical inspection of product and operations at critical intermediate stages ▪ In-process quality control ▪ Batch review ▪ Batch release o Management of internal audit system o Handle customers’ feedback and satisfaction o Management of deviations, incidents and investigations o Management of GMP training system o Management of validation system STEP 3: Quality Control in Pharmaceutical Production (15 minutes) • Quality control (QC) is a component of GMP concerned with sampling, specification and testing, documentation and release procedures which ensure that the necessary and relevant tests are performed and the product is released for use only after ascertaining its quality • QC is a part of quality management focused on fulfilling quality requirements • Responsibilities of QC o QC department is responsible for day-to-day control of quality within the company o QC plays major role in selection of qualified vendors from whom raw materials are purchased ▪ Tests representative samples as required ▪ Audit vendor’s operations to determine suitability of the vendor and degree of compliance with GMPs prior to being approved o QC is responsible for analytical testing of incoming raw materials (e.g. assay, titrations etc) o QC is responsible for analytical testing and inspection of packaging components, including labelling (e.g. appearance, spectroscopy, loss on drying etc) o QC is responsible for conducting in-process testing when required, perform environmental monitoring, and inspect operations for compliance o QC is responsible for conducting required tests on finished products or dosage forms (e.g. assay, dissolution, content uniformity etc) o Environmental areas for manufacturing of various dosage forms are tested and inspected by QC department o Generally QC is responsible for efficacy, safety,

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06103 Pharmaceutical Production

In-process Quality Control (IPQC) – PST06103 Pharmaceutical Production

NTA Level 6 • Semester 1 • PST06103 In-process Quality Control (IPQC) Pharmaceutical Production • Source Session/Topic 22 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 22: In-process Quality Control (IPQC) Total Session Time: 120 minutes Pre-requisites • None Learning Tasks By the end of this session students are expected to be able to: • Explain the concept of in-process quality control • List tests and equipment/apparatus used for in-process quality control of tablets and capsules • Explain the consequences of in-process quality control of tablets and capsules • List the objectives of in-process quality control Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • LCD projector and computer SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |25 minutes |Buzzing |The Concept of In-process Quality | | | |Presentation |Control | |3 |20 Minutes |Presentation |Objectives of In-process Quality | | | | |Control | |4 |55 Minutes |Presentation |In-process Quality Control Tests in | | | | |the Manufacture of Tablets and | | | | |Capsules | |5 |05 minutes |Presentation |Key Points | |6 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: The Concept of In-process Quality Control (25 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What is in-process quality control? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • In-process quality control is a type of quality control that provides accurate specific and definite description of procedure to be employed from the receipt of raw material to the release of the finished product • In-process quality control performs checks during production in order to monitor and, if necessary, to adjust the process to ensure that the product conforms to its specifications • In-process quality controls are usually performed within the production area. The performance of such in-process controls should not have any negative effect on the quality of the product or another product • Generally, the in-process control procedures are usually rapid and simple tests or inspections that are performed when the manufacturing of a product batch is in progress STEP 3: Objectives of In-process Quality Control (20 minutes) • Some of the objectives of in-process quality control are; o To minimize human errors o To provide accurate, specific and definite description of the procedure to be employed in manufacturing of a product o To detect errors if and when they occur o To pin point responsibility to the personnel involved in the operation of the entire process o To ensure that the flow of manufacturing and packing operations according to established routes and practice is rigidly followed o To detect abnormality immediately and at the same time indicate action needed to correct the problem STEP 4: In-process Quality Control Tests in the Manufacture of Tablets and Capsules (55 minutes) • Evaluation of dosage forms (tablets); o General appearance ▪ Size, shape and texture ▪ Unique identification markings (embossing, engraving or printing) ▪ Organoleptic properties (e.g. colour distribution, taste, odour) o Content uniformity test ▪ 30 tablets are kept aside (sampled), 10 tablets are assayed, 9 tablets should have percentage limit of 85-115% ▪ If more than 1 tablet has 85-115%, then, 20 tablets are assayed and not more than 1 tablet should have 75-125% o Tablet hardness test or tablet crushing strength ▪ Hardness of a tablet is the force required to break a tablet in a diametric compression test ▪ Hardness testing is a laboratory technique used to test the breaking point and structural integrity of tablet under conditions of storage, transportation, and handling before usage (breaking point of a tablet is based on its shape) ▪ Tablet hardness is tested by using Tablet Hardness Tester e.g. Monstanto hardness tester, Stokes harness tester, Erweka tester, Schleuniger or heberlein tester, Strong Cobb tester and Pfizer hardness tester ▪ Conventional tablet hardness: 2.5 – 5 kg/cm2 ▪ Dispersible/chewable tablet hardness: 2.25 -2.5 kg/cm2 ▪ Extended release tablets hardness: 5-7.5 kg/cm2 o Friability ▪ Friability is the tendency of tablets to powder chip or fragment. This affects the elegant appearance of tablets and consumer acceptance of the tablets ▪ Friability leads to variation in the weight and content of tablets ▪ Friability is related to hardness of a tablet ▪ Instrument used for friability testing is known as Friabilator (e.g. Roche friabilator) ▪ Consisting of a plastic chamber that revolves at 25 rpm dropping the tablets through a distance of 6 inches in the friabilator, which is then operated for 100 revolutions ▪ From the friabilator, the tablets are reweighed ▪ Loss in weight is determined ▪ Allowable range is 0.5 – 1.0% o Weight variation ▪ 20 tablets are taken (sampled) and weighed individually ▪ Average weight of the 20 tablets is determined ▪ Weight of individual tablet is compared to the average weight ▪ Not more than 2 of the individual tablet weights deviate from the average weight by more than the prescribed percentage deviation and none deviates by more than twice that percentage (e.g. USP limits, I. P limits) o Disintegration test ▪ For most tablets, the first important step towards formation of solution is break down of the tablet into smaller particles or granules i.e. disintegration ▪ Disintegration test is performed by use of the disintegration apparatus ▪ The disintegration apparatus is comprised of glasses and a

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06103 Pharmaceutical Production

GMP for Pharmaceutical Premises – PST06103 Pharmaceutical Production

NTA Level 6 • Semester 1 • PST06103 GMP for Pharmaceutical Premises Pharmaceutical Production • Source Session/Topic 23 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 23: GMP for Pharmaceutical Premises Total Session Time: 120 minutes Pre-requisites • None Learning Tasks By the end of this session students are expected to be able to: • Explain the concept of GMP on pharmaceutical premises • List the general GMP Requirements on Design of Premises • Explain how pharmaceutical manufacturing premises are maintained Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • LCD projector and computer 0 SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |20 minutes |Presentation |GMP and Manufacturing Premises | |3 |25 minutes |Presentation |General GMP Requirements on Location | | | | |of Premises | |4 | |Small group |General GMP Requirements on Design of| | |40 Minutes |discussion |Premises | | | |Presentation | | |5 |20 Minutes |Buzzing |Maintenance of Premises | | | |Presentation | | |6 |05 minutes |Presentation |Key Points | |7 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: GMP and Manufacturing Premises (20 minutes) • Good Manufacturing Practices (GMP) are a part of Quality Assurance (QA) which ensures that products are consistently produced and controlled to the quality standards appropriate to their intended use • GMP is designed to minimize the risks involved in any pharmaceutical production that cannot be eliminated through testing the final product • GMP covers all aspects of production; o Raw materials o Premises o Equipment o Personnel • Principles of GMP are; o Proper design and construction of premises o Following written procedures and instructions o Documentation of work o Validation of work o Monitoring facilities and equipment o Writing SOPs o Designing, developing and demonstrating job competence o Protection against contamination o Controlling components and product related processes o Conducting planned and periodic audits • The premise for pharmaceutical production must meet the GMP standards STEP 3: General GMP Requirements on Location of Premises (25 minutes) • The land and buildings where the manufacturing operations are located must contribute towards the quality of the products • Proper location and design help avoid the risks of contamination, permitting effective cleaning and maintenance, minimizing the build-up of dirt and dust and preventing quality defects • Premises must be located, designed, constructed, adapted and maintained for production processes to; ➢ Minimize risks of errors and cross-contamination ➢ Permit effective cleaning ➢ Permit effective maintenance ➢ Minimize build-up of dirt and dust ➢ Eliminate any adverse effects on quality • Principle for the location of pharmaceutical production premise; o Location must minimize risks of cross-contamination ▪ Not located next to a melting factory with high airborne levels of yeast o Location must be in conducive climatic and geographic (e.g. away from noise, earthquake hazards, flooding, humidity, ) • A site inspection is useful before building commences to ensure that the area is suitable for the construction of a pharmaceutical factory STEP 4: General GMP Requirements on Design of Premises (40 minutes) |Activity: Small Group Discussion (10 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | |What are the GMP requirements on design of premise? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |CLARIFY and SUMMARIZE by using the contents below | • Premises should be laid out in such a way as to allow the production to take place in areas connected in a logical order corresponding to the sequence of the operations and to the requisite cleanliness levels • Working and in-process storage space should be adequate to permit orderly and logical positioning of equipment and materials to minimize risk of confusion between different pharmaceutical products or their components, to avoid cross-contamination and to minimize the risk of omission or wrong application of any of the manufacturing or control steps • The premise must have good pipe work, light fittings and ventilation points (air handling system) • Design of the premise must include the following design features; o Design of facilities required ▪ Adequate space for future expansion ▪ Zoning laws –to allow anticipated development, restricting undesirable developments in the vicinity ▪ Availability of water (quality and quantity), power, fuel, sewage and waste removal ▪ Accessibility to employees, materials and visitors ▪ Environmental issues such as site history (soil, water, and air quality) ▪ Proximity of undesirable activities likely to cause pollution ▪ Availability of a suitable labour force ▪ Ability to provide adequate security arrangements ▪ Political situation ▪ Government stability, trade policies and taxation, financial incentives o Design of Ancillary areas ▪ Rest and refreshment rooms must be separated from manufacturing and control areas ▪ Facilities for changing and storing clothes and for washing appropriate to the number of workers ▪ Toilets should not communicate directly with production or storage areas ▪ Maintenance workshops (should be separated from production area) ▪ Animal houses should be well isolated from other areas with separate entrance (animal access) and air handling facilities o Design of Storage areas ▪ Storage areas should have sufficient capacity for orderly storage of various categories of materials and product with proper separation and segregation ▪ Storage areas should be designed or adapted to ensure good storage conditions ▪ Special storage conditions (provided, controlled, monitored and recorded appropriately) ▪ Quarantine area must be allocated to restrict access to unauthorized personnel ▪ Secure areas for storage of controlled

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06103 Pharmaceutical Production

GMP for Pharmaceutical Equipments – PST06103 Pharmaceutical Production

NTA Level 6 • Semester 1 • PST06103 GMP for Pharmaceutical Equipments Pharmaceutical Production • Source Session/Topic 24 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 24: GMP for Pharmaceutical Equipments Total Session Time: 120 minutes Pre-requisites • None Learning Tasks By the end of this session students are expected to be able to: • Explain the GMP requirements for equipment used in pharmaceutical manufacturing • Explain the construction features of GMP compliant equipment • Outline the basic equipment used in pharmaceutical production • Explain the calibration of equipment used in pharmaceutical production • Explain the cleaning of equipment used in pharmaceutical production • Explain the preventive maintenance of equipment used in pharmaceutical production Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • LCD projector and computer SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Buzzing |General Features of Manufacturing | | | |Presentation |Equipment | |3 | |Small group |GMP Requirements for Equipments | | |35 minutes |discussion | | | | |Presentation | | |4 |20 Minutes |Presentation |Construction of Equipment | |5 |25 minutes |Presentation |Basic Equipment in Pharmaceutical | | | | |Manufacturing | |6 |25 Minutes |Presentation |Calibration, Cleaning and Maintenance| | | | |of Equipment | |7 |05 minutes |Presentation |Key Points | |8 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: General Features of Manufacturing Equipment (10 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the features of pharmaceutical manufacturing equipment? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Equipment used in the manufacture, processing, packing or holding of a drug product must be of appropriate design, adequate size, and suitably located to facilitate operations for its intended use and for its cleaning and maintenance • Effectiveness of equipment starts at the design stage • Pharmaceutical manufacturing companies contribute indirectly in the design of equipment by providing information on requirements and feedback on existing equipment • Equipment must be located, designed, constructed, adapted and maintained to suit the operations to be carried out • Equipment should be constructed of materials that suit the operation and use of the equipment for the range of products manufactured and tested on site. • The construction materials should not corrode or deteriorate and thus influence the manufacturing or testing procedure. STEP 3: GMP Requirements for Equipments (35 minutes) |Activity: Small Group Discussion (10 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | | | |What are the GMP requirements for equipment used in pharmaceutical | |production? | | | |ALLOW students to discuss for 10 minutes | |ALLOW few groups to present and the rest to add points not mentioned | | | |CLARIFY and SUMMARIZE by using the contents below | • Pharmaceutical manufacturing equipment should meet the following requirements; o Operating criteria ▪ Should be adequate to meet process, size, speed and effectiveness requirements o Spare parts ▪ Availability of spares and servicing ▪ This can result in using different makes of an equipment in different parts of the world o Maintenance ▪ Frequency and ease of maintenance significantly impact on productivity and even quality ▪ Equipment break down during process could adversely affect quality ▪ Cleanability of the equipment ▪ Accessibility to the parts of equipment needed to be cleaned ▪ Easy of disassembling and re-assembling the equipment o Environmental issues ▪ Dust dissemination ▪ Potential for contamination of other products and requiring operators to wear additional protective clothing and frequent cleaning of facility ▪ Noise and energy use o Equipment design, size and space required for its location o Construction materials of the equipment o Process controls on the equipment ▪ Automatic weight adjustment on tablet presses ▪ Temperature recorders on ovens o Cost of the equipment ▪ Base price of the equipment ▪ Additional costs related to installation, etc. o Design and maintenance manuals ▪ Manuals are important for validation/qualification of the equipment and maintenance programs STEP 4: Construction of Equipment (20 minutes) • Equipment layout and design must aim to minimize risks of error and permit effective cleaning and maintenance o This will avoid cross-contamination, dust and dirt-build up and any adverse effect on the quality of the product • Equipment must be installed to minimize risks of error and contamination • The construction of the equipment must meet the following features; o Surfaces ▪ Surfaces that contact components, in-process materials or drug product should be smooth, nonreactive or absorptive ▪ These surfaces should not alter the safety, identity, strength, quality or purity of the drug product beyond the official or other established requirements o Fixed pipework (for transfer of materials through pipelines) ▪ All pipes used must be of right standard and specification for the material and pipeline to prevent any wrong connections and mix- ups ▪ All pipes must be clearly labelled ▪ Labels in all pipes should indicate contents and direction of flow ▪ Servicing pipings and devices must be adequately marked ▪ The use of adaptors is not recommended ▪ Piping system should allow monitoring and testing of materials delivered in them at regular intervals o Substances required for operation of equipment ▪ Coolants, lubricants and other substances required for operation of the equipment

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06103 Pharmaceutical Production

Management of Pharmaceutical Wastes – PST06103 Pharmaceutical Production

NTA Level 6 • Semester 1 • PST06103 Management of Pharmaceutical Wastes Pharmaceutical Production • Source Session/Topic 25 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 25: Management of Pharmaceutical Wastes Total Session Time: 120 minutes Pre-requisites • None Learning Tasks By the end of this session students are expected to be able to: • Define pharmaceutical wastes • List sources of pharmaceutical wastes • List types of wastes in pharmaceutical production • Explain the problems caused by pharmaceutical wastes • Explain methods used in the disposal of pharmaceutical wastes Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • LCD projector and computer SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Buzzing |Definitions | | | |Presentation | | |3 | |Small group |Sources of Pharmaceutical Wastes | | |35 minutes |discussion | | | | |Presentation | | |4 |30 Minutes |Presentation |Types of wastes produced during | | | | |pharmaceutical production and their | | | | |problems | |5 |30 minutes |Presentation |Disposal of Pharmaceutical wastes | |6 |05 minutes |Presentation |Key Points | |7 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definitions (10 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What is a pharmaceutical waste? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Wastes are unwanted materials which are no longer used in the manufacturing process that can eventually turn into hazardous or non hazardous material to human or the environment or both • Pharmaceutical wastes are wastes are unwanted materials resulting from pharmaceutical production processes • Pharmaceutical wastes are in different forms mainly as expired materials, manufacturing wastes and others STEP 3: Sources of Pharmaceutical Wastes (35 minutes) |Activity: Small Group Discussion (15 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | |What are the sources of waste in pharmaceutical manufacturing? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |CLARIFY and SUMMARIZE by using the contents below | • Manufacturing processes o Wastes generated during pharmaceutical production ▪ by-products from different stages of manufacturing ▪ Spillages ▪ Waste water • Raw materials o Unusable/expired/rejected/obsolete raw materials o Expired/unusable/rejected active pharmaceutical ingredients • Products o Rejected finished products • Packaging materials o Unusable or damaged packaging materials • Quality control laboratories o Used chemical by products o Spills o Unused/unusable solvents, chemicals and reagents o Waste water • Cleaning and maintenance processes o Cleaning substances e.g. detergents, soaps o Waste waster STEP 4: Types of Wastes Produced in Pharmaceutical Production and their Problems (30 minutes) • Pharmaceutical wastes are classified into o Hazardous wastes o Non-hazardous wastes o Hazardous wastes ▪ Hazardous wastes are wastes that are dangerous or potentially harmful to human health or environment ▪ Hazardous wastes can be liquids, solids, gases or sludges ▪ Hazardous wastes exhibit hazardous properties such as: Ignitability ▪ Ignitibility is a property of a pharmaceutical waste to present fire hazard under routine storage, disposal and transportation or are capable of exacerbating a fire once it has started ▪ Ignitable wastes are easily combustible or flammable ▪ Ignitable wastes include flammable liquids and compressed gases Corrositity ▪ Corrosive pharmaceutical wastes are wastes capable or corroding metals or other materials or burn the skin ▪ These have a pH of 2 or lower or 12.5 or higher Reactivity ▪ Reactive wastes are unstable under normal conditions ▪ They undergo violent changes ▪ They can cause explosions, toxic fumes, gases or vapours when heated, compressed, or mixed with water ▪ They include glacial acetic acid, sodium hydroxide etc Toxicity ▪ Wastes that are toxic contain toxic organic chemicals or toxic heavy metals such as chromium, lead, mercury or cadmium Infectivity ▪ Ability of waste to cause infection ▪ These are from microbiological laboratories or from production of vaccines or immunological preparations o Non-hazardous wastes ▪ Non-hazardous pharmaceutical wastes are those wastes that present no significant hazardous properties ▪ These wastes are below the threshold of causing harm to human health • Problems associated with pharmaceutical wastes |Activity: Small Group Discussion (15 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | |What are the problems associated with industrial pharmaceutical | |wastes? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned| | | | | |CLARIFY and SUMMARIZE by using the contents below | o Environmental contamination with drug substances ▪ Fumes, dust etc. ▪ Antimicrobial resistance when antimicrobial wastes contaminate the environment STEP 5: Disposal of Pharmaceutical Wastes (30 minutes) • Methods for disposal of pharmaceutical wastes; o Incineration ▪ Incineration is an effective method for disposal of wastes (solid, liquid and gaseous waste), in which solid organic wastes are subjected to combustion so as to convert them into residue and gaseous products (heat, gas, steam and ash) by use of an incinerator ▪ Is useful for disposal of residue of both solid waste management and solid residue from waste water management ▪ Reduces the volumes of

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06104 Health and Medicine Policy

Introduction to the Health System in Tanzania – PST06104 Health and Medicine Policy

NTA Level 6 • Semester 1 • PST06104 Introduction to the Health System in Tanzania Health and Medicine Policy • Source Session/Topic 1 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 1: Introduction to Health System in Tanzania 1 Learning Tasks By the end of this session students are expected to be able to: Define terms related to health system State the vision and mission of the MoHCDGEC List levels of health care in Tanzania List roles of the MoHCDGEC (Ministry of Health, Community Development, Gender, Elderly and Children) in Health care System in Tanzania 2 Definition of Terms Related to Health System Health is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity. (WHO) Policy is a law, regulation, procedure or administrative action created by government or non-government institution Health policy is a visionary program of action adopted by the government to have a healthy society, with improved social wellbeing that will contribute effectively to personal and national development. 3 Definitions Cont… Medicines Policy is a written document specifying the medium – to long – term goals set by the government for the pharmaceutical sector, their relative importance, and their main strategies for attaining them. It is a political commitment to a goal and a guide for action. It provides a framework for coordinating activities for pharmaceutical sector. 4 Vision and Mission of Ministry of Health in Health and Medicine system Vision To improve health and wellbeing of all Tanzanian, with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of the people 5 Cont… Mission To facilitate the provision of basic health services that are good, quality, equitable, accessible, affordable, sustainable and gender sensitive 6 Levels of Health Care in Tanzania Community health services Dispensaries: village/ street level Health centres: ward level District hospitals: district level Regional/referral hospitals: regional level (are consultant hospitals) National, Consultant and specialized hospitals: national level 7 Community Health Services It is the responsibility of each individual and/or household to take care of its own health Village Government should recognize and enhance the essential role of communities in directing local health services. The community will have the mandate to choose their own community health worker who will be the main linkage between the community and the nearest health facility. 8 Dispensary Services This is the first formal health unit of level one health services. It is a primary health facility which offers outpatient services including reproductive and child health services, and diagnostic services. A dispensary caters for 5,000 people and oversees all the village health services. Dispensaries shall provide primary health care services to the community. Refer the references to identify the primary health services to be provided at dispensary level 9 Health Center Services This is the second formal health unit of level one-health services. It is a primary health facility, which offers Outpatient and In-patient services, maternity care, laboratory, dispensing and mortuary services. A Health Centre shall cater for 50,000 people and supervise all the dispensaries in the Division. 10 District Hospital Services It is also a level one health services and plays the following roles: Out-patient and In-patient care Act as the second referral level f or the primary health care facilities in the district or catchment’s area Perform general surgical and obstetric operations Conduct teaching, training and research programs in the district concerning community health Give supportive supervision and inspection and provide technical skills to lower health facilities in the district and refers patients to the regional hospital. 11 Regional Hospital Services This is a hospital establishment providing level two (Secondary) referral services from level one hospital This level have the following functions: To provide all services offered at district level but at a higher level of expertise Conduct health research programs in the Region Provide technical skills to lower health facilities in the Region and offer specialized treatment in Medicine, Surgery, Obstetrics and Gynaecology and Paediatric, and shall include Eye, Dental, Mental illnesses, Orthopaedics and Trauma 12 National, Consultant and Specialized Hospital Services This is level three and the highest level of hospital services in the country It acts as referral centre for level two hospitals. 13 National Hospital Muhimbili is the currently national hospital It also acts as Eastern zonal referral hospital 14 Zonal Consultant Hospitals At present there are four zonal referral or consultant hospitals. Muhimbili National Hospital Two voluntary agency hospitals: Bugando Medical Centre and Kilimanjaro Christian Medical Center (KCMC) Mbeya Referal Hospital (owned by the government) 15 Specialized Hospitals There are two specialized hospitals Mirembe Hospital (Dodoma) and Kibongoto ( Moshi ) They provide services to the mentally sick and TB patients respectively 16 Roles of the MoH in Health and Medicine Policy Policy formulation, health legislation, regulation and control Resource mobilization and allocation Management support of level three hospitals including National, Consaltant and Special Hospitals Supervision and Monitoring of special and Consultant Hospitals owned by NGOs Monitoring and evaluation of health services countrywide Activity: Use the given references for extra roles of MoH 17 Key Points Health Policy is important in a country like ours where resources and technology are more limited than in other countries. Medicines Policy is a written document specifying the medium – to long – term goals set by the government for the pharmaceutical sector, their relative importance, and their main strategies for attaining them. MoHCDGEC mission is to facilitate the provision of basic health services that are good, quality, equitable, accessible, affordable, sustainable and gender sensitive 18 Review Questions What is the vision and mission of the MoH of health care in Tanzania? What are the levels of health care in Tanzania. 19 References URT (2007): The National Health Policy , Dar es Salaam, Tanzania. Government Printer URT (2016): Task sharing policy guidelines for health sector services

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06104 Health and Medicine Policy

Introduction to Primary Health Care – PST06104 Health and Medicine Policy

NTA Level 6 • Semester 1 • PST06104 Introduction to Primary Health Care Health and Medicine Policy • Source Session/Topic 2 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 2: Introduction of Primary Health Care (PHC) 1 Learning Tasks By the end of this session students are expected to be able to: Define primary health care List principles of primary health care Mention components of primary health care Explain WHO strategies of primary health care Explain the basic requirements for sound primary health care List rights and responsibilities of all participants in PHC 2 Introduction Primary Health Care (PHC) is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination It is the first level of contact of individuals, the family, and the community with the national health system 3 Determinants of Health Internal Biological and cognitive Genetics, race, sex and age (diabetes, breast cancer are genetic in nature; diarrheal more common in children) Psychological and spiritual Life stress causes mental disorders, hypertension, heart attack, diabetes, gastric ulcer 4 Cont… External Environmental Socio-economic conditions Welfare services Food and nutrition Education Occupation Culture 5 Activity What are the emphasizes of government on primary health care? Brainstorming : What could be the principals of primary health care? 6 Principles of Primary Health Care Equity Accessible Acceptable Affordable Appropriate Technology Community Participation Intersectoral Coordination Decentralization Health Prevention and Promotion 7 Components of Primary Health Care Health education Food supply and nutrition Safe drinking water and sanitation Maternal and child health, family planning Expanded programme in Immunization (EPI) Prevention and control of endemic diseases Appropriate treatment and prevention of common diseases, injuries and accidents Provision of essential drugs 8 Global Targets on Primary Health Care All people globally will have ready access at least to essential health care and to first-level referral facilities All people will be actively involved in caring for themselves and their families in community action for health Communities throughout the world will share government’s responsibility for the health care of their members All governments will assume the overall responsibility for the health of their people Safe drinking water and sanitation will be available to all people 9 Cont… All people will be adequately nourished/fed All children will be immunizes against the major diseases of childhood Communicable diseases in the developing countries will be of no greater public health significance Essential drugs will be available to all 10 WHO Strategies of Primary Health Care Reducing excess mortality of poor marginalized populations Reducing the leading risk factors to human health Developing Sustainable Health Systems Developing an enabling policy and institutional environment: Primary Health Care policy must be integrated with other policy domains 11 Basic Requirements for Sound Primary Health Care Appropriateness Availability Adequacy Accessibility Acceptability Affordability Assessability Accountability Completeness Comprehensiveness Continuity Review clarification of each requirement 12 Rights and Responsibility of all participants in PHC Individual Responsibility Personal hygiene Healthy lifestyles Healthy environment Sanitation Family planning and population management Rights Vaccination and preventing diseases Medical examination/ treatment Safe water 13 Cont… Community Responsibility Utilizing health facilities Supporting and strengthening health centres Activist for health promotion and protection Improving sanitation and environment Rights Community health workers training Promoting family planning, breastfeeding, healthy lifestyles Restricting causative factors of ill health like poverty Food safety, adequate water 14 Cont… Government Policies and plans Resources Accessibility Awareness – building Human resources development Monitoring/ support Outbreak control Exchanging of experiences 15 Cont… International Human resources development Capacity building Technical corporation among developing countries Information sharing Technical support Building partnerships Financial support 16 Activity Refer Handout 1: Essential Health Care Package to understand more about primary health care 17 Key Points The principles of primary health care are: equity, accessible, acceptable, affordable, appropriate technology, community participation, intersectoral coordination, decentralization, health prevention and promotion The following are components of primary health care; health education, food supply and nutrition, safe drinking water and sanitation, maternal and child health, family planning, expanded programme in Immunization (EPI), prevention and control of endemic diseases, appropriate treatment and prevention of common diseases, injuries and accidents, provision of essential drugs 18 Review Questions What are the WHO strategies of primary health care? What are the basic requirements for the sound primary health care? 19 References Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. (2004). Development, 47 (2), 159-161. doi:10.1057/palgrave.development.1100047 Alma Ata Conference 1978 Report. ( n.d .). Retrieved from https://www.scribd.com/document/158435776/Alma-Ata-Conference-1978-Report WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . 20 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06104 Health and Medicine Policy

Alma-Ata Declaration – PST06104 Health and Medicine Policy

NTA Level 6 • Semester 1 • PST06104 Alma-Ata Declaration Health and Medicine Policy • Source Session/Topic 3 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 3: Alma-Ata Declaration 1 Learning Tasks By the end of this session students are expected to be able to: Define Alma-Ata declaration Mention themes leading to Alma Ata List objectives of Alma Ata declaration Explain components of Alma Ata declaration 2 Activity: Brainstorming What could you explain about alma- ata declaration? 3 Definition Alma Ata declaration is the International Declaration on Primary Health Care expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world It identified primary health care as the key to the attainment of the goal of health for all 4 Themes of Alma-Ata Declaration Changing theories of health and development Concerns about poverty and population control Increasing reliance upon alternative approaches to medical care model Success of community health workers and associated emphasis on community participation Revival of interest in public health: tackling causes of ill health rather than symptoms 5 Objectives of Alma-Ata Declaration To promote the concept of primary health care in all countries To exchange experience and information on the development of primary health care within the national health systems and services To evaluate the present health and health care situation throughout the world as it relates to primary health care To define the principles of primary health care as well as the operational means of overcoming practical problems in the development of primary health care 6 Cont… To define the role of governments, national, and international organizations in technical cooperation and support for the development of primary health care To formulate recommendations for the development of primary health care. 7 Components of Alma-Ata Declaration Current world health situation Primary health care approach Primary health care and development Technical and operational aspects National strategies and international support 8 Current world health situation The conference declared that the health status of hundreds of people in the world today is unacceptable, particularly in developing countries. More than half the population of the world does not have the benefit of proper health care. The conference analyzed the magnitude of health problems and the inadequate and inequitable distribution of health resources between and within countries The Conference called for a new approach to health and health care to achieve more equitable distribution of health resources. 9 Primary health care approach The Conference considered primary health care to be essential It is the first level of contact of individuals, the family, and the community with the national health system The Conference reaffirmed that governments have a responsibility for the health of their peoples Each country must interpret and adapt particular, detailed aspects of primary health care within the country’s own social, political, and developmental context All persons have the right and duty to participate individually and collectively in the planning and implementation of their health care The Conference affirmed that the primary health care approach (health for all) would be attained by the year 2000 10 Primary health care and development The Conference considered the close interrelationship and interdependence of health, social and economic development Health activities should be undertaken concurrently with measures such as those for the improvement of nutrition, increase in production and employment and protection and improvement of the environment The Conference Emphasized the importance of full and organized community participation in the recognition and solution of their health problems Self-reliance. Affirmed the need for a balanced distribution of all available resources. 11 Technical and Operational Aspects in Primary Health Care The varied experience of countries dealing with diverse health problems in rural and urban areas was discussed. Thus the national health system have to support primary health care through appropriate training, super-vision, referral, and logistic support. The government should ensure the main health problems in the community are identified and taken to action with special attention to vulnerable groups The agreed translation of the principles of primary health care into action would require the priority allocation of budgetary resources to primary health care, better distribution and use of existing resources Also research with full involvement of populations especially in health services should be carried out 12 National strategies and international support Each nation should now make a strong and continuing commitment to primary health care at all levels of government and society. National strategies are required to: Translate policies into action Make health care available, equitably to the entire population. Take into account socioeconomic factors and policies, available resources and the particular health problems and needs of the population The Conference emphasized that the strategies should be formulated and applied with fullest participation of communities and sectors of the government. Countries can learn and benefit from each other’s experience 13 Cont… International organizations, multilateral and bilateral agencies, nongovernmental organizations, and other partners should actively promote the national development of primary health care and give technical and financial support with full respect for the principles of national self-reliance and self determination and maximum utilization of locally available resources. Any progress towards universal peace would release resources that could be used to accelerate socioeconomic development including primary health care and also benefit populations . 14 Key Points Alma Ata Declaration is the International Declaration on Primary Health Care, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world The components of the Alma Ata declaration are Current World Health Situation, Primary Health Care Approach, Primary Health Care and Development, Technical and Operational Aspects, National Strategies and International Support 15 Review Questions What are the objectives of Alma Ata declaration? What was the world situation before declaration? List themes

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06104 Health and Medicine Policy

National Health Policy – PST06104 Health and Medicine Policy

NTA Level 6 • Semester 1 • PST06104 National Health Policy Health and Medicine Policy • Source Session/Topic 4 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 4: National Health Policy 1 Learning Tasks By the end of this session students are expected to be able to: Define policy State the vision and mission of the national health policy List objectives of national health policy 2 Activity: Brainstorming What is policy? 3 Introduction Policy directs how the government has to achieve its goals and objectives with regard to a specific area such as health, education, agriculture. It can be described as a deliberate plan of action to guide decisions and achieve rational outcome 4 Vision and Mission of National Health Policy Vision To have a healthy community that contributes effectively to individual and nation’s development To improve the health and well being of all Tanzanians with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of the people. 5 Cont… Mission The mission is to facilitate the provision of basic health services that are of good quality, equitable, accessible, affordable, and sustainable and gender sensitive This will help to reduce disability, morbidity and mortality, improving nutritional status and raising life expectancy. The policy recognizes that, good health is a major resource essential for poverty eradication and economic development. 6 Objectives of National Health Policy Effective health promotion services Reduced malnutrition in the country Comprehensive and sustainable immunization services Improved reproductive, maternal, newborn, child and adolescent health services. Reduced prevalence of communicable diseases Efficient prevention and management of Neglected Tropical Disease (NTD) Reduced morbidity, disability and mortality due to non-communicable diseases. 7 Refer handout 2: National Health Policy Statements for further reading 8 Key Points Policy is a statement on how the government is to achieve its goals and objectives with regard to a specific area such as health, education, agriculture. It can be described as a deliberate plan of action to guide decisions and achieve rational outcome(s). Health policy is a visionary program of action adopted by the government to have a healthy society, with improved social wellbeing that will contribute effectively to personal and national development. The vision of the government is to have a healthy community that contributes effectively to individual as well as to the nation’s development towards becoming a middle income country. 9 Review Question What are the objectives of National Health Policy ? 10 References URT(2007). The National Health Policy , Dar es salaam, Tanzania: Government Printer URT(1991). The National Drugs Policy , Dar es salaam, Tanzania: Government Printer WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . URT. (Draft – 2017). National Health Policy . Dar es Salaam, Tanzania 11 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

Pharmaceutical Sciences Notes, PST Level 6 Semester 1, PST NTA Level 6, PST06104 Health and Medicine Policy

National and International Health Initiatives – PST06104 Health and Medicine Policy

NTA Level 6 • Semester 1 • PST06104 National and International Health Initiatives Health and Medicine Policy • Source Session/Topic 5 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 5: National and International Health Initiatives 1 Learning Tasks By the end of this session students are expected to be able to: Define medicine policy Explain links between National Health Policy with National and International Initiatives Explain factors which influences implementation of National Health and Medicines Policy 2 Definition National Medicines Policy (NMP) is a political commitment guide for action that shows how the government will ensure that efficacious and safe medicines of good quality are affordable, accessible, and rationally used It provides a frame work for coordinating the activities of all the parties involved, such as public and private sectors, nongovernmental organizations (NGO’s), donors and other interested stakeholders. 3 Links Between National Health Policy with National and International Initiatives Refer handout 3: National Health Policy and National and International Initiatives 4 Factors which Hinder Implementation of National Health Policy Weak implementation structure for quality improvement approach Attitude change problem among health workers Shortage of human resources Unreliable resource supplies and allocation Poor implementation of several approaches to health sector 5 Factors that Influence Decision Making Past experiences A variety of cognitive biases An escalation of commitment and sunk outcomes Individual differences i.e. age and socioeconomic status A belief in personal relevance Policies and beliefs of a nation 6 Factors that affect community health. Housing Financial security Community safety Employment Education Environment Risk behaviours of a population Health status Others??? 7 Key points Tanzania’s One Health Strategic Plan focuses on five thematic areas in consonance with its objectives The Task Sharing Policy Guidelines constitutes an important guiding document regarding the expansion of a task sharing approach as one method of strengthening and expanding the health workforce rapidly to a health services 8 Review Questions Which factors hinder implementation of quality improvement approach? What are factors which influence implementation of National Health Policy? 9 References URT (2015): National One Health Strategic Plan 2015 – 2025 , Dar es Salaam, Tanzania: Government Printer URT (2016): Task Sharing Policy Guidelines for Health Sector Services in Tanzania , Dar es Salaam, Tanzania: Government Printer WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . URT. (Draft – 2017). National Health Policy . Dar es Salaam, Tanzania 10 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

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