Pharmacyis thescienceand practice of discovering, producing, preparing, dispensing, reviewing and monitoringmedications,aiming to ensure the safe, effective, and affordable use ofmedicines.It is a miscellaneous science as it linkshealth scienceswithpharmaceutical sciencesandnatural sciences.The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is consideredclinical pharmacy.[1]
Occupation | |
---|---|
Names | Pharmacist, Chemist, Doctor of Pharmacy, Druggist, Apothecary or simplyDoctor |
Occupation type | Professional |
Activity sectors | Health care,health sciences,chemical sciences |
Description | |
Education required | Doctor of Pharmacy,Master of Pharmacy,Bachelor of Pharmacy,Diploma in Pharmacy |
Related jobs | Physician,pharmacy technician,toxicologist,chemist,pharmacy assistant, othermedical specialists |
The scope of pharmacy practice includes more traditional roles such ascompoundingand dispensing of medications. It also includes more modern services related tohealth careincluding clinical services, reviewing medications for safety and efficacy, and providing drug information with patient counselling.Pharmacists,therefore, are experts on drug therapy and are the primary health professionals who optimize the use of medication for the benefit of the patients.
An establishment in which pharmacy (in the first sense) is practiced is called apharmacy(this term is more common in the United States) orchemists(which is more common in Great Britain, thoughpharmacyis also used).[citation needed]In the United States and Canada,drugstorescommonly sell medicines, as well as miscellaneous items such asconfectionery,cosmetics,office supplies,toys,hair careproducts andmagazines,and occasionally refreshments and groceries.
In its investigation of herbal and chemical ingredients, the work of theapothecarymay be regarded as a precursor of the modern sciences of chemistry andpharmacology,prior to the formulation of thescientific method.[citation needed]
Disciplines
editThe field of pharmacy can generally be divided into various disciplines:
- Pharmaceuticsand Computational Pharmaceutics
- PharmacokineticsandPharmacodynamics
- Medicinal ChemistryandPharmacognosy
- Pharmacology
- Pharmacy Practice
- Pharmacoinformatics
- Pharmacogenomics
The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut. Often, collaborative teams from various disciplines (pharmacists and other scientists) work together toward the introduction of new therapeutics and methods for patient care. However, pharmacy is not a basic or biomedical science in its typical form. Medicinal chemistry is also a distinct branch of synthetic chemistry combining pharmacology, organic chemistry, and chemical biology.
Pharmacologyis sometimes considered the fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Both disciplines are distinct. Those who wish to practice both pharmacy (patient-oriented) and pharmacology (a biomedical science requiring the scientific method) receive separate training and degrees unique to either discipline.
Pharmacoinformaticsis considered another new discipline, for systematic drug discovery and development with efficiency and safety.
Pharmacogenomics is the study of genetic-linked variants that effect patient clinical responses, allergies, and metabolism of drugs.[2]
Professionals
editTheWorld Health Organizationestimates that there are at least 2.6 million pharmacists and other pharmaceutical personnel worldwide.[3]
Pharmacists
editPharmacists arehealthcare professionalswith specialized education and training who perform various roles to ensure optimalhealthoutcomes for their patients through the quality use of medicines.Pharmacistsmay also besmall businessproprietors, owning the pharmacy in which they practice. Since pharmacists know about the mode of action of a particular drug, and its metabolism and physiological effects on the human body in great detail, they play an important role in optimization of drug treatment for an individual.
Pharmacists are represented internationally by theInternational Pharmaceutical Federation(FIP), anNGOlinked withWorld Health Organization(WHO). They are represented at the national level byprofessional organisationssuch as theRoyal Pharmaceutical Societyin the UK,Pharmaceutical Society of Australia(PSA),Canadian Pharmacists Association(CPhA),Indian Pharmacist Association(IPA),Pakistan Pharmacists Association(PPA),American Pharmacists Association(APhA), and theMalaysian Pharmaceutical Society(MPS).[4]
In some cases, the representative body is also the registering body, which is responsible for the regulation andethicsof the profession.
In the United States, specializations in pharmacy practice recognized by theBoard of Pharmacy Specialtiesinclude: cardiovascular,infectious disease,oncology,pharmacotherapy, nuclear,nutrition,andpsychiatry.[5]TheCommission for Certification in Geriatric Pharmacycertifies pharmacists in geriatric pharmacy practice. TheAmerican Board of Applied Toxicologycertifies pharmacists and other medical professionals in appliedtoxicology.
Pharmacy support staff
editPharmacy technicians
editPharmacy technicians support the work of pharmacists and other health professionals by performing a variety of pharmacy-related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with medic's offices and insurance companies to ensure correct medications are provided and payment is received.
Legislation requires the supervision of certain pharmacy technician's activities by a pharmacist. The majority of pharmacy technicians work incommunity pharmacies.In hospital pharmacies, pharmacy technicians may be managed by other senior pharmacy technicians. In the UK the role of a PhT in hospital pharmacy has grown and responsibility has been passed on to them to manage the pharmacy department and specialized areas in pharmacy practice allowing pharmacists the time to specialize in their expert field as medication consultants spending more time working with patients and in research. Pharmacy technicians are registered with the General Pharmaceutical Council (GPhC). The GPhC is the regulator of pharmacists, pharmacy technicians, and pharmacy premises.
In the US, pharmacy technicians perform their duties under the supervision of pharmacists. Although they may perform, under supervision, most dispensing, compounding and other tasks, they are not generally allowed to perform the role of counseling patients on the proper use of their medications. Some states have a legally mandatedpharmacist-to-pharmacy technician ratio.
Dispensing assistants
editDispensing assistants are commonly referred to as "dispensers" and in community pharmacies perform largely the same tasks as a pharmacy technician. They work under the supervision of pharmacists and are involved in preparing (dispensing and labelling) medicines for provision to patients.
Healthcare assistants/medicines counter assistants
editIn the UK, this group of staff can sell certain medicines (including pharmacy only and general sales list medicines) over the counter. They cannot prepare prescription-only medicines for supply to patients.
History
editThe earliest known compilation of medicinal substances was theSushruta Samhita,an IndianAyurvedic treatiseattributed toSushrutain the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
ManySumerian(4th millennium BC – early 2nd millennium BC) cuneiformclay tabletsrecord prescriptions for medicine.[6]
Ancient Egyptian pharmacological knowledge was recorded in various papyri such as theEbers Papyrusof 1550 BC, and theEdwin Smith Papyrusof the 16th century BC.
InAncient Greece,Diocles of Carystus(4th century BC) was one of several men studying the medicinal properties of plants. He wrote several treatises on the topic.[7]The Greek physicianPedanius Dioscoridesis famous for writing a five-volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translationDe Materia Medica(Concerning medical substances) was used as a basis for many medieval texts and was built upon by many middle eastern scientists during theIslamic Golden Age,themselves deriving their knowledge from earlier GreekByzantine medicine.[8]
Pharmacy in Chinadates at least to the earliest known Chinese manual, theShennong Bencao Jing(The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during theHan dynastyand was attributed to the mythicalShennong.Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in theMawangdui,sealed in 168 BC.
In Japan, at the end of theAsuka period(538–710) and the earlyNara period(710–794), the men who fulfilled roles similar to those of modern pharmacists were highly respected. The place of pharmacists in society was expressly defined in theTaihō Code(701) and re-stated in theYōrō Code(718). Ranked positions in the pre-HeianImperial court were established; and this organizational structure remained largely intact until theMeiji Restoration(1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.[9]
There is a stone sign for a pharmacy shop with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey.[10]The current Ephesus dates back to 400 BC and was the site of the Temple of Artemis, one of the seven wonders of the world.
InBaghdadthe first pharmacies, or drug stores, were established in 754,[11]under theAbbasid Caliphateduring theIslamic Golden Age.By the 9th century, these pharmacies were state-regulated.[12][unreliable source?]
The advances made in the Middle East inbotanyandchemistryledmedicine in medieval Islamsubstantially to developpharmacology.Muhammad ibn Zakarīya Rāzi(Rhazes) (865–915), for instance, acted to promote the medical uses of chemical compounds.Abu al-Qasim al-Zahrawi(Abulcasis) (936–1013) pioneered the preparation of medicines bysublimationanddistillation.HisLiber servitorisis of particular interest, as it provides the reader with recipes and explains how to prepare the "simples" from which werecompoundedthe complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to record his findings in apharmacopoeia,describing a large variety of drugs and remedies for ailments.Al-Biruni(973–1050) wrote one of the most valuable Islamic works on pharmacology, entitledKitab al-Saydalah(The Book of Drugs), in which he detailed the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist.Avicenna,too, described no less than 700 preparations, their properties, modes of action, and their indications. He devoted in fact a whole volume to simple drugs inThe Canon of Medicine.Of great impact were also the works byal-Maridini of BaghdadandCairo,andIbn al-Wafid(1008–1074), both of which were printed inLatinmore than fifty times, appearing asDe Medicinis universalibus et particularibusby 'Mesue' the younger, and theMedicamentis simplicibusby 'Abenguefit'.Peter of Abano(1250–1316) translated and added a supplement to the work of al-Maridini under the titleDe Veneris.Al-Muwaffaq's contributions in the field are also pioneering. Living in the 10th century, he wroteThe foundations of the true properties of Remedies,amongst others describingarsenious oxide,and being acquainted withsilicic acid.He made clear distinction betweensodium carbonateandpotassium carbonate,and drew attention to the poisonous nature ofcoppercompounds, especially coppervitriol,and alsoleadcompounds. He also describes thedistillation of sea-waterfor drinking.[13][verification needed]
InEurope,pharmacy-like shops began to appear during the 12th century. In 1240, emperorFrederic IIissued a decree by which the physician's and the apothecary's professions were separated.[14]
There are pharmacies in Europe that have been in operation since medieval times. InFlorence,Italy, the director of the museum in the formerSanta Maria Novella pharmacysays that the pharmacy there dates back to 1221.[15]InTrier(Germany), theLöwen-Apothekeis in operation since 1241, the oldest pharmacy in Europe in continuous operation.[16]InDubrovnik(Croatia), a pharmacy that first opened in 1317 is located inside the Franciscan monastery: it is the 2nd oldest pharmacy in Europe that is still operating.[17][18]In the Town Hall Square ofTallinn(Estonia), there is a pharmacy dating from at least 1422.[citation needed]The medievalEsteve Pharmacy,located inLlívia,aCatalanenclaveclose toPuigcerdà,is a museum: the building dates back to the 15th century and the museum keepsalbarellosfrom the 16th and 17th centuries, old prescription books and antique drugs.
Practice areas
editPharmacists practice in a variety of areas including community pharmacies, infusion pharmacies, hospitals, clinics, insurance companies, medical communication companies, research facilities, pharmaceutical companies, extended care facilities, psychiatric hospitals, and regulatory agencies. Pharmacists themselves may have expertise in amedical specialty.
Community pharmacy
editApharmacy(also known as achemistinAustralia,New Zealandand theBritish Isles;ordrugstoreinNorth America;retail pharmacyin industry terminology; orapothecary,historically) is where most pharmacists practice the profession of pharmacy. It is the community pharmacy in which the dichotomy of the profession exists; health professionals who are also retailers.
Community pharmacies usually consist of a retail storefront with a dispensary, where medications are stored and dispensed. According to Sharif Kaf al-Ghazal, the opening of the first drugstores are recorded byMuslimpharmacists inBaghdadin 754 AD.[11][19]
Hospital pharmacy
editPharmacies withinhospitalsdiffer considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues, and pharmacists in community pharmacies often have more complex business and customer relations issues.
Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) andpatient complianceissues (in the hospital and at home), many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency, sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy.
For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care,emergency medicine,toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics,herbal medicine,neurology/epilepsy management, pediatrics, neonatal pharmacists and more.
Hospital pharmacies can often be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients includingtotal parenteral nutrition(TPN), and other medications are given intravenously. That is a complex process that requires adequate training of personnel,quality assuranceof products, and adequate facilities.
Several hospital pharmacies have decided tooutsourcehigh-risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology and the potential impact of medications and pharmacy services on patient-care outcomes and patient safety require hospital pharmacies to perform at the highest level possible.
Clinical pharmacy
editPharmacistsprovide direct patient care services that optimize the use of medication and promotes health, wellness, and disease prevention.[20]Clinical pharmacistscare for patients in allhealth caresettings, but the clinical pharmacy movement initially began insidehospitalsandclinics.Clinical pharmacists often collaborate withphysiciansand other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They often participate in patient care rounds for drug product selection. In the UK clinical pharmacists can also prescribe some medications for patients on the NHS or privately, after completing a non-medical prescribers course to become an Independent Prescriber.[21]
The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to dispensing and administration to the patient. The review process often involves an evaluation of the appropriateness of drug therapy (e.g., drug choice, dose, route, frequency, and duration of therapy) and its efficacy. Research shows that pharmacist led strategies reduce errors related to medication use.[22]The pharmacist must also consider potential drug interactions, adverse drug reactions, and patient drug allergies while they design and initiate a drug therapy plan.[23]
Ambulatory care pharmacy
editSince the emergence of modern clinical pharmacy, ambulatory care pharmacy practice has emerged as a unique pharmacy practice setting. Ambulatory care pharmacy is based primarily on pharmacotherapy services that a pharmacist provides in a clinic. Pharmacists in this setting often do not dispense drugs, but rather see patients in-office visits to manage chronic disease states.
In the U.S. federal health care system (including the VA, the Indian Health Service, and NIH) ambulatory care pharmacists are given full independent prescribing authority. In some states, such asNorth CarolinaandNew Mexico,these pharmacist clinicians are given collaborative prescriptive and diagnostic authority.[24]In 2011 the board of Pharmaceutical Specialties approved ambulatory care pharmacy practice as a separate board certification. The official designation for pharmacists who pass the ambulatory care pharmacy specialty certification exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the initials BCACP.[25]
Compounding pharmacy/industrial pharmacy
editCompounding involves preparing drugs in forms that are different from the generic prescription standard. This may include altering the strength, ingredients, or dosage form.[26]Compounding is a way to create custom drugs for patients who may not be able to take the medication in its standard form, such as due to an allergy or difficulty swallowing. Compounding is necessary for these patients to still be able to properly get the prescriptions they need.
One area of compounding is preparing drugs in new dosage forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicatedlollipopthat contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead.
Another form of compounding is by mixing different strengths (g, mg, mcg) of capsules or tablets to yield the desired amount of medication indicated by thephysician,physician assistant,nurse practitioner,orclinical pharmacist practitioner.This form of compounding is found at community or hospital pharmacies or in-home administration therapy.
Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies.
Consultant pharmacy
editThe examples and perspective in this sectionmay not represent aworldwide viewof the subject.(December 2019) |
Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services" ) than on actual dispensing of drugs. Consultant pharmacists most typically work innursing homes,but are increasingly branching into other institutions and non-institutional settings.[27]Traditionally[where?]consultant pharmacists were usually independent business owners, though in the United States many now work for a large pharmacy management company such asOmnicare,Kindred HealthcareorPharMerica.This trend may be gradually reversing[citation needed]as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services.
The main principle of consultant pharmacy is developed by Hepler and Strand in 1990.[28][29]
Veterinary pharmacy
editVeterinary pharmacies, sometimes calledanimal pharmacies,may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill the pharmaceutical needs of animals. Because the needs of animals, as well as the regulations onveterinary medicine,are often very different from those related to people, in some jurisdictions veterinary pharmacy may be kept separate from regular pharmacies.
Nuclear pharmacy
editNuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients.
Military pharmacy
editThe examples and perspective in this sectionmay not represent aworldwide viewof the subject.(December 2019) |
Military pharmacy is a different working environment to civilian practise because military pharmacy technicians perform duties such as evaluating medication orders, preparing medication orders, and dispensing medications. This would be illegal in civilian pharmacies because these duties are required to be performed by a licensed registered pharmacist.[30]In the US military, state laws that prevent technicians from counseling patients or doing the final medication check prior to dispensing to patients (rather than a pharmacist solely responsible for these duties) do not apply.
Pharmacy informatics
editPharmacy informatics is the combination of pharmacy practice science and applied information science.[31]Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or forhealthcare information technologyvendor companies. As a practice area and specialist domain, pharmacy informatics is growing quickly to meet the needs of major national and international patient information projects and health system interoperability goals. Pharmacists in this area are trained to participate in medication management system development, deployment, and optimization.
Specialty pharmacy
editSpecialty pharmacies supply high-cost injectable, oral, infused, or inhaled medications that are used for chronic and complex disease states such as cancer, hepatitis, and rheumatoid arthritis.[32]Unlike a traditional community pharmacy where prescriptions for any common medication can be brought in and filled, specialty pharmacies carry novel medications that need to be properly stored, administered, carefully monitored, and clinically managed.[33]In addition to supplying these drugs, specialty pharmacies also provide lab monitoring, adherence counseling, and assist patients with cost-containment strategies needed to obtain their expensive specialty drugs.[34]In the US, it is currently the fastest-growing sector of the pharmaceutical industry with 19 of 28 newly FDA approved medications in 2013 being specialty drugs.[35]
Due to the demand for clinicians who can properly manage these specific patient populations, the Specialty Pharmacy Certification Board has developed a new certification exam to certify specialty pharmacists. Along with the 100 questions computerized multiple-choice exam, pharmacists must also complete 3,000 hours of specialty pharmacy practice within the past three years as well as 30 hours of specialty pharmacist continuing education within the past two years.[36]
Pharmaceutical sciences
editThis sectionneeds additional citations forverification.(February 2017) |
The pharmaceutical sciences are a group ofinterdisciplinaryareas of study concerned with thedesign,manufacturing,action,delivery,andclassificationofdrugs.They apply knowledge fromchemistry(inorganic,physical,biochemicalandanalytical),biology(anatomy,physiology,biochemistry,cell biology,andmolecular biology),epidemiology,statistics,chemometrics,mathematics,physics,andchemical engineering.[37]
The pharmaceutical sciences are further subdivided into several specificspecialties,with four main branches:
- Pharmacology:the study of the biochemical and physiological effects of drugs onhuman beings.
- Pharmacodynamics:the study of the cellular and molecular interactions of drugs with theirreceptors.Simply "What the drug does to the body"[38]
- Pharmacokinetics:the study of the factors that control the concentration of drug at various sites in the body. Simply "What the body does to the drug"[39]
- Pharmaceutical toxicology:the study of the harmful or toxic effects of drugs.[citation needed]
- Pharmacogenomics:the study of theinheritanceof characteristic patterns of interaction between drugs and organisms.[40]
- Pharmaceutical chemistry:the study ofdrug designto optimize pharmacokinetics and pharmacodynamics, andsynthesisof newdrug molecules(Medicinal Chemistry).
- Pharmaceutics:the study and design ofdrug formulationfor optimumdelivery,stability,pharmacokinetics, andpatient acceptance.[41]
- Pharmacognosy:the study of medicines derived from natural sources.[42]
As new discoveries advance and extend the pharmaceutical sciences, subspecialties continue to be added to this list. Importantly, asknowledgeadvances, boundaries between these specialty areas of pharmaceutical sciences are beginning to blur. Many fundamental concepts are common to all pharmaceutical sciences. These shared fundamental concepts further the understanding of their applicability to all aspects ofpharmaceutical researchanddrug therapy.
Pharmacocybernetics(also known as pharma-cybernetics, cybernetic pharmacy, and cyber pharmacy) is an emerging field that describes the science of supporting drugs and medications use through the application and evaluation of informatics and internet technologies, so as to improve thepharmaceutical careof patients.[43]
Society and culture
editEtymology
editThe wordpharmacyis derived fromOld Frenchfarmacie"substance, such as a food or in the form of a medicine which has a laxative effect" fromMedieval LatinpharmaciafromGreekpharmakeia(‹See Tfd›Greek:φαρμακεία) "a medicine", which itself derives frompharmakon(φάρμακον), meaning "drug,poison,spell"[44][45][a](which is etymologically related topharmakos).
Separation of prescribing and dispensing
editSeparation of prescribing and dispensing, also called dispensing separation, is a practice inmedicineand pharmacy in which thephysicianwho provides amedical prescriptionis independent from thepharmacistwho provides theprescription drug.
In theWestern worldthere are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs.
In contemporary time researchers and health policy analysts have more deeply considered these traditions and their effects. Advocates for separation and advocates for combining make similar claims for each of their conflicting perspectives, saying that separating or combining reducesconflict of interest in the healthcare industry,unnecessary health care,and lowers costs, while the opposite causes those things. Research in various places reports mixed outcomes in different circumstances.
Environmental impacts
editIn 2022 theOrganisation for Economic Co-operation and Developmentproposed that pharmaceutical companies should be required to collect and destroy unused or expired medicines that they have put on the market in order to reduce public health risks around the misuse of medicines obtained from waste bins, the development of antimicrobial resistant bacteria from the discharge of antibiotics into environmental systems and "economic losses" from wasted healthcare resources. Potentially harmful concentrations of pharmaceutical waste has been detected in more than a quarter of water samples taken from 258 rivers around the world. OECD recommend that medicines should be collected separately from household waste and that "marketplaces and redistribution platforms for unused close-to-expiry-date medicines" should be set up. Such extended producer responsibility schemes are already running in France, Spain and Portugal.[47]
The future of pharmacy
editIn the coming decades, pharmacists are expected to become more integral within thehealth care system.Rather than simply dispensing medication, pharmacists are increasingly expected to be compensated for their patient care skills.[48]In particular,Medication Therapy Management(MTM) includes the clinical services that pharmacists can provide for their patients. Such services include a thorough analysis of all medication (prescription,non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system.[49][unreliable source?]
This shift has already commenced in some countries; for instance, pharmacists inAustraliareceive remuneration from theAustralian Governmentfor conducting comprehensive Home Medicines Reviews. In Canada, pharmacists in certain provinces have limited prescribing rights (as in Alberta and British Columbia) or are remunerated by their provincial government for expanded services such as medications reviews (Medschecks in Ontario). In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights and this is because ofpharmacy education.They are also being paid for by the government formedicine use reviews.In Scotland, the pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for controlled drugs, when the patient is unable to see their doctor, as could happen if they are away from home or the doctor is unavailable. In the United States, pharmaceutical care orclinical pharmacyhas had an evolving influence on the practice of pharmacy.[50]Moreover, theDoctor of Pharmacy(Pharm. D.) degree is now required before entering practice and some pharmacists now complete one or two years of residency or fellowship training following graduation. In addition,consultant pharmacists,who traditionally operated primarily innursing homes,are now expanding into direct consultation with patients, under the banner of "senior care pharmacy".[51]
In addition to patient care, pharmacies will be a focal point for medical adherence initiatives. There is enough evidence to show that integrated pharmacy based initiatives significantly impact adherence for chronic patients. For example, a study published in NIH shows "pharmacy based interventions improved patients' medication adherence rates by 2.1 percent and increased physicians' initiation rates by 38 percent, compared to the control group".[52]
Pharmacy journals
editSymbols
editThesymbolsmost commonly associated with pharmacy are themortar and pestle(North America) and the ℞ (medical prescription) character, which is often written as "Rx" in typed text; the greenGreek crossinFrance,Argentina,theUnited Kingdom,Belgium,Ireland,Italy,Spain,andIndia;theBowl of Hygieia(only) often used in theNetherlandsbut may be seen combined with other symbols elsewhere. Other common symbols includeconical measures,and (in the US)caduceuses,in theirlogos.A red stylized letter A in usedGermanyandAustria(fromApotheke,theGermanword for pharmacy, from the sameGreekroot as theEnglishword "apothecary"). Theshow globewas used in the US until the early 20th century; theGaperin the Netherlands is increasingly rare.
-
Rod of Asclepius,the internationally recognised symbol of medicine
-
Simple green Greek cross, widely used inEurope and India,[citation needed]often an animatedneon sign
-
Red "A" (Apotheke) sign, used in Germany
-
Similar red "A" sign, used in Austria
-
The mortar and pestle, used in the United States and Canada
-
A hangingShow globe,formerly used in the United States
-
The Gaper, formerly used in the Netherlands
-
The symbol used on medical prescriptions, from the Latinrecipe(take thou).
-
the Bowl of Hygieia
See also
edit- American Society for Pharmacy Law– Professional organization
- Apothecary– Former name for a pharmacist
- Bachelor of Pharmacy,Master of Pharmacy,Doctor of Pharmacy
- Classification of Pharmaco-Therapeutic Referrals– Taxonomy of cases requiring referral
- Clinical pharmacy– Branch of pharmacy for direct provision
- Consultant pharmacist– Provider of expert pharmaceutical advice
- Drug packaging– Packaging for pharmaceutical preparations
- Evidence-based pharmacy in developing countries
- Health informatics– Computational approaches to health care
- History of pharmacy
- Hospital pharmacy– Dispensary within a hospital
- International Pharmaceutical Federation
- International Pharmaceutical Students' Federation
- List of drugs by year of discovery
- List of pharmaceutical laboratories by year of foundation
- List of pharmacies
- List of pharmacy associations
- List of pharmacy organizations in the United Kingdom
- List of pharmacy schools in the United States
- List of pharmacy schools
- Nuclear pharmacy– Branch of pharmacy focused on radioactive pharmaceuticals
- Online pharmacy– Pharmacy that operates over the Internet
- Pharmaceutics– Science of the properties of medicines
- Pharmaceutical industry– Industry involved with discovery, development, production and marketing of drugs
- Pharmacogenomics– Study of the role of the genome in drug response
- Pharmacognosy– Study of drugs obtained from natural sources
- Pharmacology– Science of drugs and medications and their effects
- Pharmaconomist– Danish qualification like BPharm
- Pharmacy automation– Mechanical handling of medications
- Pharmacy residency– Post-graduate internship
- Professional Further Education in Clinical Pharmacy and Public Health– academic publisher
- Raeapteek– One of Europe's longest-lived pharmacies
- Telepharmacy– Pharmacy care by telecommunication
Notes
editReferences
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- ^Reference, Genetics Home."What is pharmacogenomics?".Genetics Home Reference.Archivedfrom the original on 19 December 2016.Retrieved20 November2019.
- ^World Health Organization.World Health Statistics 2011– Table 6: Health workforce, infrastructure, and essential medicines. Geneva, 2011. Accessed 21 July 2011.
- ^"Member organizations".FIP.Open Publishing. 9 September 2019.Archivedfrom the original on 1 January 2021.Retrieved17 November2020.
- ^"BPS Specialties".Board of Pharmacy Specialties.
- ^John K. Borchardt (2002). "The Beginnings of Drug Therapy: Ancient Mesopotamian Medicine".Drug News & Perspectives.15(3): 187–192.doi:10.1358/dnp.2002.15.3.840015.ISSN0214-0934.PMID12677263.
- ^Edward Kremers, Glenn Sonnedecker (1986). "Kremers and Urdang's History of pharmacyArchived19 August 2020 at theWayback Machine".Amer. Inst. History of Pharmacy. p.17. ISBN0931292174
- ^ISBN978-1409441656Medicine and Pharmacy in Byzantine Hospitals: A study of the extant formularies (Medicine in the Medieval Mediterranean) 1st Edition by David Bennett
- ^Titsingh, Isaac. (1834)Annales des empereurs du Japon,p. 434.
- ^"PBase.com".www.pbase.com.Archivedfrom the original on 13 September 2009.Retrieved6 September2019.
- ^ab Hadzovic, S (1997). "Pharmacy and the great contribution of Arab-Islamic science to its development".Medicinski Arhiv(in Croatian).51(1–2): 47–50.ISSN0025-8083.OCLC32564530.PMID9324574.
- ^al-Ghazal, Sharif Kaf (October 2003)."The valuable contributions of Al-Razi (Rhazes) in the history of pharmacy during the Middle Ages"(PDF).Journal of the International Society for the History of Islamic Medicine.2(4): 9–11.ISSN1303-667X.OCLC54045642.Archived(PDF)from the original on 21 September 2017.Retrieved24 October2008.
- ^Levey M. (1973), "Early Arabic Pharmacology", E. J. Brill; Leiden.
- ^"History of Pharmacy Web Pages – Sweden's oldest pharmacies".Archived fromthe originalon 23 June 2011.
- ^CBS News (19 May 2019)."The World's Oldest Pharmacy".CBS News. Archived fromthe originalon 31 May 2019.Retrieved30 May2019.
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- Pharmacy Consulting Services | McKesson– A landmark study in hospital pharmacy performance based on an extensive literature review and the collective experience of the Health Systems Pharmacy Executive Alliance.
External links
edit- Navigator History of PharmacyCollection of internet resources related to the history of pharmacy
- Soderlund Pharmacy Museum– Information about the history of the American Drugstore
- The Lloyd LibraryLibrary of botanical, medical, pharmaceutical, and scientific books and periodicals, and works of allied sciences
- American Institute of the History of PharmacyAmerican Institute of the History of Pharmacy—resources in the history of pharmacy
- International Pharmaceutical Federation (FIP)Federation representing national associations of pharmacists and pharmaceutical scientists. Information and resources relating to pharmacy education, practice, science and policy