Pharmacy & Drug Formulary
The Pharmacy Department provides pharmaceutical care to patients, contributes to the education of paediatric practitioners and pursues research which directly enhances patient care.
We utilize a computerized unit dose system to provide inpatient and ambulatory clinic services. In addition to intravenous admixtures and a total nutrition program, we operate an extensive compounding service that specializes in the many different dosage forms essential to paediatric practice. Some of our compounding recipes are available for other health-care professionals to reference.
Clinical Pharmacists help optimize medication use and improve health outcomes on the Nursing Units as part of the interdisciplinary care team. The Pharmacy also provides a comprehensive Therapeutic Drug Monitoring service and an important resource for evidence-based use of medications through the Drug Information service.
The functions of the Pharmacy Department are to:
- work with patients, families, and other health professionals to design, implement, and monitor a therapeutic plan for each patient's drug therapy, that will provide specific therapeutic outcomes
- identify, resolve, and prevent drug related problems
- provide a safe, efficient drug distribution service
- formulate and manufacture paediatric dosage forms which are not commercially available
- act as a drug information resource to health professionals involved in paediatric care, most especially those who are staff at SickKids
- provide counselling to patients and/or the patient's guardians on all aspects of drug treatment
- provide education and training to pharmacy students, pharmacy technicians, graduate pharmacists, and to other interested health professionals
- support and undertake research projects to increase the body of knowledge about drug use in children
Our SickKids Drug Handbook & Formulary is available for purchase and is the culmination of over 30 years of expertise in establishing evidence-based guidelines for medication use in children at SickKids. Written by over 50 pediatricians and allied healthcare professionals, the handbook features extensive information on drug selection and dosing recommendations for neonates, infants and children, and guidelines for drug usage and monitoring.
The contents of the Formulary reflect, wherever possible, evidence-based medication use, as well as the expertise of the SickKids medical and pharmacy staff. Given that reliable, scientific information is often limited or difficult to access in a paediatric health care environment, the goal of the Formulary is to provide a useful resource to promote the optimal and safe use of medication in children.
Lexicomp has partnered with SickKids to offer you access to the SickKids eFormulary Pediatric & Neonatal content which is available to add to a current institutional Lexicomp Online subscription. Users will receive unlimited access both online and through your institution's mobile site license. Stay current with new research and information through continually updated content. These guidelines are written by over 50 paediatricians and allied health-care professionals.
- SickKids IV guidelines
- Hospital-specific treatment restrictions and tips
- Comments on care for newborn infants and older children
- Drug selection
- Dosing and administration in neonates, infants and children
- Condition-specific treatment guidelines for sickle cell, antithrombotic therapy, hematology, parenteral nutrition, resuscitation and other conditions
This conference is intended for hospital and community pharmacists, pharmacy residents, interns and students who have an interest in paediatric pharmacy practice and a desire to increase their knowledge of paediatric pharmacotherapy. It is also open to other interested health professionals.
It will offer participants updates on key paediatric therapeutic issues, discuss treatment challenges and share interesting cases, and provide the opportunity to participate in interactive workshops.
Educational opportunities are varied within our Department. Pharmacy students can participate in Early Practice Experience (EPE) rotations and Applied Practice Pharmacy Experience (APPE) rotations in affiliation with the Leslie Dan Faculty of Pharmacy at the University of Toronto. We also offer pharmacy technician student rotations and a residency program (for Registered Pharmacists).
The Pharmacy Residency Program at SickKids is a one-year general residency program designed to prepare qualified and knowledgeable hospital pharmacists to work in paediatric pharmacy practice. The approach to practice and the problem-solving skills developed during the program will be useful in any practice setting. The program is clinically oriented and is designed to expose the resident to a broad range of activities. Case presentations, projects, rounds, seminars, journal clubs and relevant work experiences provide the basis for the education and training components of the program.
Program Director: Renu Lal, BSP, MSc, RPh, Clinical Director
Education Coordinator: Alicia Koo, RPh, PharmD, ACPR, B.Sc.Phm., Hon.B.Sc., Clinical Pharmacist, Haematology/Oncology and Blood & Marrow Transplant/Cellular Therapy Program
Weekend shifts: 1 in 5 weekends at current pharmacist rate
Vacation: 10 days
Applicants must be graduates or prospective graduates of a Faculty of Pharmacy, meeting the Standards of the Association of Faculties of Pharmacy in Canada. Applicants must also be eligible for licensure by a Canadian provincial licensing body. The program usually commences in September of each year and accepts two applicants.
By the end of the program, the resident will:
- Develop an understanding of the complete process of the drug distribution system, including our intravenous admixture service, total parenteral nutrition and chemotherapy.
- Be able to prepare and dispense medications for pediatric patients using appropriate techniques, observing age-related considerations, and following the health system's policies and procedures.
- Understand the role of a Drug Information Service in supporting the needs of health professionals within the hospital and be able to provide complete, accurate and objective responses to a wide variety of drug information requests.
- Develop an understanding of the principles of management and leadership as it applies to Pharmacy
- Become familiar with the scientific method and statistical analysis, demonstrate initiative and knowledge in the areas of clinical or pharmacy practice research, and contribute to patient care or to the profession of Pharmacy through the completion of a research project.
- Develop the necessary skills, knowledge and values to provide pharmaceutical care to patients.
- Design, recommend, monitor and evaluate patient-specific pharmacotherapy for paediatric patients.
- Understand the natural process of growth and development in children, understand educational methods appropriate for use with pediatric patients, and use appropriate behavioural and cognitive techniques in interactions with paediatric patients.
- Demonstrate leadership skills to contribute to the goals of the program, department, organization and profession.
- Demonstrate skill in the four roles used in practice-based teaching: direct instruction, modeling, coaching, and facilitation.
Medication Use Management - 6 weeks
During the six-week distribution rotation, the pharmacy resident will develop an understanding of the drug distribution system in place at the hospital, which at SickKids is a computerized, unit dose drug distribution system. The resident will develop an understanding of an intravenous admixture service, including parenteral nutrition and chemotherapy and will gain an understanding of the principles involved in formulating paediatric dosage forms.
The resident will become proficient at auditing medication orders for paediatric patients, handling problem orders and checking dispensing of first doses of medications. By the end of the rotation, the resident will understand the importance of the role of the drug distribution system as a foundation to the provision of pharmaceutical care to the paediatric patient.
Leadership - 2 to 3 weeks (longitudinal)
The resident shall develop an understanding of the principles of management which may be applied to the provision of pharmacy services as well as the role of the Pharmacy Management Team and the role of the department within the health-care organization.
Drug Information - 4 weeks (longitudinal)
Activities of the Drug Information residency rotation include:
- providing paediatric drug information to health-care providers, parents and patients, and the public;
- developing a systematic approach to searching and accessing primary, secondary and tertiary drug information resources;
- critically appraising the primary literature and applying principles of evidence-based clinical practice, understanding the role of Drug Information Service in providing support to the Drugs and Therapeutics committee, and applying the process of adverse drug reaction reporting.
Included in this rotation is the preparation of a Drug Information Bulletin, a formulary drug review for the Drugs and Therapeutics Committee, a patient drug information pamphlet, and a journal club presentation.
Pharmacokinetics - 4 weeks (longitudinal)
The resident will learn the knowledge and skills to;
- Critically appraise literature on pharmacokinetics and/or TDM issues and the clinical applicability of such information.
- Integrate pharmacokinetic principles with patient specific parameters (e.g. demographics, disease states, serum drug concentrations, laboratory results, therapeutic endpoints) to perform appropriate calculations and/or estimations to optimize drug therapy.
Paediatric Medicine - 4 weeks
The goal of the General Paediatrics rotation is to develop the necessary skills and knowledge base to provide pharmaceutical care to patients with a variety of paediatric conditions.
Some of the rotation’s learning objectives include:
- describing the pathophysiology, epidemiology, clinical presentation and diagnosis of common diseases in the paediatric medicine patient population;
- explaining and comparing the treatment and/or prevention of common diseases in the paediatric medicine patient population, in terms of efficacy, adverse effects, dosing, administration and relevant monitoring parameters;
- preparing a pharmacy care plan (e.g. drug, dose, route, frequency, duration of therapy, expected outcomes and relevant monitoring), documenting ongoing care plans in a pharmaceutical care format and communicating pertinent information to the appropriate health care professional(s);
- reviewing a patient’s home medication regimen and interviewing the patient and/or caregiver to identify and/or prevent actual or potential drug-related problems.
Some of the common conditions covered in the rotation include sickle cell disease, asthma, gastroesophageal reflux disease and seizures (afebrile and febrile). Learning activities include, but are not limited to: participation in hand-over and teaching rounds, identification of paediatric drug administration problems, presentation of an in-service to nurses or physicians and presentation of a case to the pharmacy staff.
Project - 8 to 10 weeks (longitudinal)
The Resident shall complete a project which is of general interest to the resident and preceptor and of benefit to the individual, patients, health care organization and pharmacy profession.
Teaching Rotation - 1 week (longitudinal)
The goal of this rotation is to provide formal education and opportunity for the resident to demonstrate skill in the four roles (direct instruction, modeling, coaching and facilitation) used in practice-based teaching.
For all clinical electives, the resident will:
- Gain knowledge of paediatric pharmacology/therapeutics
- Acquire experience in the evaluation of drug therapy
- Develop an understanding of the pharmacist in a clinical role using the pharmaceutical care model
- ASP/Infectious Diseases: 4 weeks
- Haematology/Oncology (H/O): 3 to 4 weeks
- Haematology/Oncology Clinic: 2 weeks
- Blood and Marrow Transplant/Cell Therapy: 3 to 4 weeks, or 2 to 3 weeks if combined with H/O rotation
- Transplant and Regenerative Medicine: 4 weeks
- Paediatric Critical Care: 3 to 4 weeks (Paediatric Intensive Care or Cardiac Critical Care)
- Neonatal Intensive Care: 3 to 4 weeks
- Cardiology: 3 to 5 weeks rotation in combination with Cardiac Critical Care
- Surgical Consult Services: 2 weeks
- Nephrology: 3 to 4 weeks
- Neurology: 4 weeks
University of Toronto Course
Audit up to one full graduate course
Residents Clinical Conference
Clinical Skills Building Conference for Ontario Pharmacy Residents
Conferences (up to 10 days)
- Choice of one out-of-town conference (for example, ACCP, PPAG, CSHP-AGM)
- Paediatrics for Pharmacy Professionals Conference (SickKids) [link to anchor within page]
- Professional Practice Conference (PPC)
Inpatient Pharmacy Administration
Compounding Pharmacy (for health-care professionals only)
Hours: Monday to Friday, 8 a.m. to 4 p.m.
Drug Information Service
Contact our team
Alicia Koo, Education Coordinator
Elaine Lau, Drug Information Coordinator
Erin Chung, Therapeutic Drug Monitoring Coordinator
Sabrina Boodhan, Interim Antimicrobial Stewardship Pharmacist