OT Pharmacy, IHC, NRI

Thursday 6-20

Tom and I learned more about the daily activities of the Operation Theatre (OT) pharmacy, which is located on the second floor of the hospital and at the entrance of OT (surgeries) department. OT pharmacy was the smallest of NRI pharmacies. People entering the OT department were required to take off their shoes, and we followed the rule. The staff was composed of three pharmacists that worked barefoot. This pharmacy offered a variety of anesthesia drugs, IV fluids, number of suturing materials and other surgical and disposable items. We noted that the hospital pharmacy was responsible for the provision of surgical materials. The OT pharmacy has two serving windows: one facing outside the OT department, and the other located inside the department were the OT staff/technicians brought orders and received items faster. When pharmacists received an order brought by an OT technician, they gathered the requested products, billed the patient and gave the products requested to the technician. The same process applied when patient brought an order, but in this case, it was a cash transaction instead of credit. As pointed in my previous blog entries, pharmacy here was about dispensing and assuring proper stock levels.

The pharmacy served about 10 OT in that department, and we were told that an average of 40 surgeries were performed daily. The OT pharmacy was opened from 8:30 am to 7:00 pm. In case of emergency, when products were needed from this pharmacy during closing hours, a pharmacist from the Main pharmacy (opened 24 hours/7days) could retrieve those items from the OT pharmacy, and contact the pharmacist in charge if further information were needed.

OT pharmacy staff. From left to right: Mrs. Dirya, Padma and Sujaynya

We spent the afternoon at the main pharmacy reviewing local and general anesthesia drugs. We did not return to the OT pharmacy because the power was down and it would have been very hot up there since that pharmacy had two fans to cool the room and no air conditioning. Consequently, the PIC suggested that we discussed the drugs in the main pharmacy which had two air conditioning units.

Friday, 6-21

Mr. Nayak arranged a visit at a drug manufacturing facility located in Vijayawada, approximately 30 minutes away from the NRI Academy of Science. We wanted to explore further the role of pharmacists in the industry, since it was an important avenue for graduates in India. International Health Care Limited (IHC) was the name of the company. IHC offered a variety of drugs including poultry, veterinary healthcare products. They also specialized in the designing and manufacturing of several pharmaceutical products used in human health. IHC was affiliated with P.V.S. Group.

First, we stopped by in the main office, which was at a separate location to talk with the founder chairman and managing director of the company.

He received us courteously, and at the end of our discussion, he told us we were welcome anytime to visit the facilities. Unfortunately, there was no manufacturing of drugs for human use at that time, and it might take about two weeks to start new batches, the time to distribute the previous ones. Therefore, we visited two manufacturing facilities that produced mainly poultry and veterinary products.

When we arrived at the first location, it was hard to say the staff was expecting us. After few phone calls, they gathered people that would help with the tour.We visited their stock, granulation, compression, and coating rooms as well as their quality control department. The staff literally showed us every room, and gave us a brief description of machines or equipments that they operated. The facility was separated in sections. For instance, it had sections for beta-lactum, non-beta lactum products. They manufactured multiple dosage forms including tablets, capsules, ointments, dry-powders and oral liquids. The sterilization of the water was performed on the last floor of the building.

I learned that pharmacists were employed in the production department as they knew drugs well and they were familiar with the production process and the equipments used. In the quality control department, employees had master in chemistry. There were three checks during the manufacturing process. Imported active ingredients were examined first. Second, during the production, a sample would be also checked. Third, quality control analyses were performed on the final product. During our visit, we also notice many workers that were probably technicians who were packing or attaching labels to products.

Manufacturing facility 1 

Packaging of blisters 

Tom looking at the packaging equipment 

Tom, thumb up with IHC liquid formulation

At the second location, the general manager of operations was a pharmacist and close friend of Mr. Nayak. There, we met the chemist that came up with formulations of more than a thousand of their products. He was particularly humble. They gave us a tour of their new and old facilities, both were running. They had a microbiology department that grew about 58 strains of microorganisms including bacteria, fungi and yeasts. Those strains were not for sale but they were added, as excipients, to their products to increase their effects in the body.

Manufacturing facility 2

Tom in IHC bacteria culture room 

Operation Manager Office. Chairman and general Manager in the portrait, Operation Manager,  Chemist, and Arsen

In the afternoon, we looked up some important points about bacteria at the main pharmacy. Mr. Nayak was particularly busy that afternoon managing the pharmacy.

Saturday 6-22

We went back to the OT pharmacy, yet it was busy, and only one pharmacist was handling all the activities. Consequently, Mr. Nayak decided it was a good time to look at the hospital sterilization center, and see how it functioned.

We went back to the OT pharmacy after visiting the sterilization center. There were then two pharmacists, and the workload had greatly decreased by the time we arrived. Mr. Nayak, showed us the indent process through the online system. In addition, he emphasized on reports run to appreciate stock level and drug movement.

In the afternoon, we went shopping in Vijayawada market since some shops were closed on Sundays, and it was our last weekend in India. Most items were exceptionally affordable in the shops our guide showed us.