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pharmacy

 
Dictionary: phar·ma·cy   (fär'mə-sē) pronunciation

n., pl., -cies.
  1. The art of preparing and dispensing drugs.
  2. A place where drugs are sold; a drugstore. Also called apothecary.

[Middle English farmacie, a purgative, from Old French, from Medieval Latin pharmacīa, a medicine, from Greek pharmakeia, use of drugs, from pharmakon, drug.]


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pharmacy
Science dealing with collection, preparation, and standardization of drugs. Pharmacists, who must earn a qualifying degree, prepare and dispense prescribed medications. They formerly mixed and measured drug products from raw materials according to doctors' prescriptions, and they are still responsible for formulating, storing, and providing correct dosages of medicines, now usually produced by pharmaceutical companies as premeasured tablets or capsules. They also advise patients on the use of both prescription and over-the-counter drugs. Laws regulating the pharmaceutical industry are based on the national pharmacopoeia, which outlines the purity and dosages of numerous medicinal products.

For more information on pharmacy, visit Britannica.com.

Sci-Tech Encyclopedia:

Pharmacy

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The health profession concerned with the discovery, development, production, and distribution of drugs. Drugs are substances (other than devices) used to diagnose, prevent, cure, or relieve the symptoms of disease. For relations to closely allied fields. See also Medicine; Pharmaceutical chemistry; Pharmacognosy; Pharmacology.

General practice is carried on in exclusive prescription pharmacies, semiprofessional pharmacies, and drug stores. It consists of compounding and dispensing drugs on order of the physician, dentist, or veterinarian; serving as consultant on drugs to the health professions and to the public; and selling other health supplies such as antiseptics, bandages, and home remedies.

A hospital pharmacy includes special administrative features, provision of drugs for nursing stations, manufacturing of pharmaceutical preparations, teaching of nurses and medical and pharmacy interns, service to the hospital committee on pharmacy and therapeutics, preparation and revision of a hospital formulary, and monitoring the drug regimen of the individual patient (clinical pharmacy). The pharmacist may have charge of investigational drugs, radioactive pharmaceuticals, medical and surgical sterile supplies, and gaseous drugs for inhalation therapy.


World of the Body:

pharmacy

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Pharmacy derives its name from the Greek root pharmakon, a drug. Pharmacy is concerned with the manufacture, formulation, quality control, and dispensing of medicaments used to treat disease. The majority of modern medicaments consist of tablets, capsules, and injections, all produced under stringent conditions. Usually only a tiny part of the product is active drug, the rest being the ‘excipient’ which provides an appropriate vehicle for delivery to the patient. Many old-fashioned forms of medication — such as mixtures, tinctures, decoctions, elixirs, emulsions, and syrups — have now virtually disappeared, reducing the requirement for extemporaneous manufacture of products by dispensing pharmacists.

— Alan W. Cuthbert

See drugs.

Dental Dictionary:

pharmacy

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(fär′mə-sē)
n

1. the art and science of preparing and dispensing drugs. n 2. place where drugs are dispensed.

There were but few who could claim any prior pharmaceutical training in all the colonies in the seventeenth century. By the end of the eighteenth century, however, and far into the nineteenth, four types of practitioners of pharmacy were identifiable. First was the physician who compounded and dispensed his own medicines and often kept a "Doctor's shop." Second was the apothecary who, like his English model, not only compounded and dispensed drugs, but also diagnosed and prescribed. Third was the druggist, later also to be called a pharmacist. The term "druggist" was originally applied to wholesalers but subsequently described one who compounded medicines in shops in which a major concern was pharmaceuticals and related items. Fourth was the merchant who took on a supply of drugs; many eventually evolved into pharmacists.

The Drugstore

The nineteenth-century American drugstore carried a full line of simples (mainly crude vegetable drugs) and chemicals with which pharmacists compounded and dispensed medicines, with or without a prescription. They were artisans who spread their own plasters and prepared pills, powders, tinctures, ointments, syrups, conserves, medicated waters, and perfumes. Economic necessity forced them to handle such commodities as confections, tobacco, paints, glass, groceries, spices, and liquor. They were thus commonly also merchants, and pharmacists often differed among themselves as to whether theirs was a trade or a profession.

By the mid-nineteenth century this artisanal role of pharmacists had begun to diminish. A pharmaceutical industry was providing medicines that pharmacists had previously made entirely by hand. There was a burgeoning growth of proprietary ("patent") medicines, flamboyantly advertised, with which pharmacists had to deal. Economic competition from department stores, groceries, and chain stores added to the pressure. Late in the century the competition—including that among pharmacists, for the "cut-rate" pharmacy shop had become ubiquitous—led to a number of plans to fix prices, but both these plans and the fair trade statutes of the mid-twentieth century fell afoul of federal antitrust laws.

One peculiarly American development was the drugstore soda fountain, which was an outcome of the pharmacist's knowledge of flavors and carbonated water. The pharmacist Elias Durand operated a soda fountain in his Philadelphia shop as early as 1825. American soft drinks, the colas particularly, had their beginnings in the drugstore. The soda fountain was not to disappear from the drugstore until the mid-twentieth century, when it gave way to more profitable alternative uses for the space.

Science and Technology

The great scientific and technological advances in the medical and biological sciences in the late nineteenth century transformed pharmacy in a number of ways. First, the old materia medica—still showing evidence of ancient lineage—increasingly gave way to new medications based on a better scientific understanding of the etiology of diseases and of the mechanisms of drug action. These medications were the products of synthetic and medicinal chemistry, new powerful tools. Second, in the twentieth century these new medications were largely the discoveries and innovations of the rapidly developing pharmaceutical industry and, moreover, were the products of research and manufacture that the individual pharmacist could not duplicate. This meant that the compounding of medicines by the pharmacist gave way to the dispensing of medications completely prepared by industry. By the 1970s only one percent of prescriptions required some combination or manipulation of ingredients. Third, the sciences gave impetus to the separation of pharmaceutical practice from medical practice.

Pharmacy Law

The training of the pharmacist was accomplished largely through the apprenticeship system and, in the absence of legal restrictions—a concomitant of Jacksonian democracy—it was possible for any persons to set themselves up as pharmacists. The first laws providing for the examination and licensing of pharmacists in an American jurisdiction were passed in Louisiana, where the Franco-Spanish tradition in pharmacy prevailed in regulations of the Territory of Orleans in 1808 and of the state in 1816. The few other such attempts before the Civil War, in three southern states and a few localities, were, in the prevailing democratic milieu, ineffectual.

Rhode Island passed the first modern state law for the examining and licensing of pharmacists in 1870. Pressure for such laws came from the American Pharmaceutical Association, founded in 1852, and from state and territorial pharmaceutical associations (of which there were forty-five and two, respectively, by 1900). As a consequence, forty-seven states had such laws by the end of the century. This legislation established state boards of pharmacy, composed originally of pharmacists. The boards, among other powers, examined candidates and imposed educational requirements that became more advanced as the colleges of pharmacy increased the depth and length of the pharmacy curricula. Following standards and accreditation requirements developed by the American Association of Colleges of Pharmacy (founded in 1900) and by the American Council on Pharmaceutical Education (founded in 1932), these curricula increased from two and three-year Graduate in Pharmacy (Ph.G.) and Pharmaceutical Chemist (Ph.C.) programs, to four-and five-year baccalaureate programs, and to six–year Doctor of Pharmacy (Pharm.D.) programs. In 1999 over 45 percent of all the pharmacy graduates in the country received the Pharm.D. degree as their first professional degree.

Under the American constitutional system it was state law that regulated pharmacy and imposed restrictions on the sales of poisons and abortifacients. The federal government first became involved in the regulation of pharmacy with the Pure Food and Drug Act of 1906. That legislation and its principal amendments (1912, 1938, 1952, and 1962) and the Harrison Narcotic Act of 1914 set the stage for what became the very close federal involvement in the control of drugs. "Legend drugs, " requiring a physician's prescription, and a list of "controlled dangerous substances" made the pharmacist subject to federal, as well as state, authority.

Pharmaceutical Education

Pharmaceutical education began in the United States with the founding of the Philadelphia College of Pharmacy (now the University of the Sciences in Philadelphia) in 1821.

The term"college" was intended at first to suggest only a society rather than a school, but the Philadelphia College offered lectures almost from the start. Local societies of pharmacy, also calling themselves colleges, were formed in Boston, New York City, Baltimore, Cincinnati, Chicago, and St. Louis, and all of them sooner or later engaged in pharmaceutical instruction. By 1900 about sixty programs were or had been in operation. The program of instruction in these institutions, especially in the good number that were private and proprietary, was indeed meager, consisting mainly of a series of lectures in the evening in rented rooms.

In 1868 the University of Michigan embarked upon a full program of scientific training in pharmacy, eventually developing a full-time, day program of two years. The University of Wisconsin followed suit in 1883 and nine years later it pioneered in offering a four-year program leading to a bachelor's degree. As noted, the length and the curricular requirements took off from there, reflecting new developments in the pharmaceutical sciences and the changing professional role of the pharmacist, both in and beyond the drugstore. The curriculum changes demanded by the doctorate included more attention to the humanities and emphasized clinical pharmacy and relatively new sciences like pharmacokinetics and pharmacotherapeutics. Externship programs in community, industrial, hospital, and clinical pharmacy became part of the curriculum.

The Changing Role of the Pharmacist

The plethora of new and complex medicines that industry was providing, along with the increasing demands for prescription drugs as the population aged, meant that pharmacists who dealt directly with the patient needed to be more than just artisans who compounded or dispensed drugs. Limited in their freedom of activity by the introduction of Medicaid and Medicare, the new managed care systems, and computerization, pharmacists found that their choice of drugs and their prices were no longer under their control. The pharmacist assumed a new, consultative role in health-care delivery that demanded knowledge of the drugs and their action in the body and the monitoring of the drug regimen of the patients.

The responsibility of the pharmacist in providing correct and effective medication and in preventing errors was evident in the great expansion of pharmacists into the health field beyond the drugstore. Hospital pharmacy goes back in the United States to before the Revolution; by 1942 hospital pharmacists had become so significant a part of the heath-care community that they formed the American Society of Hospital Pharmacists. As the twentieth century progressed, the practice of clinical pharmacy developed. In clinical pharmacy the pharmacist is responsible in a hospital situation for cooperating with the physician in monitoring the prescribed medications. Clinical and consulting pharmacists also are involved in other institutions, such as nursing homes and assisted living quarters. In recognition of the broader role of clinical and consultative pharmacy, the American Society of Hospital Pharmacists became the American Society of Health System Pharmacists in 1995.

Demographics and Infrastructure

The demography of pharmacy personnel changed quite rapidly in the late twentieth century. Beginning in 1985, more than half of each year's pharmaceutical degree recipients were women. In 1999 women graduates made up 63.5 percent of the total. The ethnicity of personnel was also changing. The percentage of white graduates fell from 86 percent in 1979 to 64 percent in 1999, while the percentage of Asian, Native Hawaiian, and Pacific Islanders rose from under 4 percent to over 18 percent in the same period. African Americans rose from 3.6 percent to 5.6 percent; Hispanics and Latinos declined from 3.8 percent to 3.7 percent.

The last decade of the twentieth century saw a drop in the total number of drugstore outlets from 58,642 in 1990 to 53,105 in 1999. The decline, however, was only among independent pharmacies. They went from 31,879 to 20,649, a decrease of 11,230 units in the decade. Chain stores, supermarket units, and mass merchandiser units all increased in number. One factor in the decline of independent pharmacies was the development of Pharmacy Benefit Management organizations (PBMs) and the accompanying growth of mail-order prescription services.

At the end of the twentieth century the National Community Pharmacists Association (founded as the National Association of Retail Druggists in 1898) still had a membership of 25,000. The American Society of Health-System Pharmacists had an equal number of members. Pharmacy had developed in two directions.

Bibliography

Cowen, David L., and William H. Helfand. Pharmacy: An Illustrated History. New York: Abrams, 1990.

Higby, Gregory J. In Service to American Pharmacy: The Professional Life of William Procter, Jr. Tuscaloosa: University Alabama Press, 1992.

Nona, Daniel A. "A Brief History of the Present—As Told by Accreditation Standards for Pharmaceutical Education." Journal of the American Pharmaceutical Association 40 no. 5 suppl. 1 (2000).

Ozick, Cynthia. "A Drugstore Eden." In Quarrel & Quandary: Essays by Cynthia Ozick. New York: Knopf, 2000.

Sonnedecker, Glenn. Kremers and Urdang's History of Pharmacy.4th ed. Philadelphia: Lippincott, 1976.

 
Columbia Encyclopedia:

pharmacy

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pharmacy, art of compounding and dispensing drugs and medication. The term is also applied to an establishment used for such purposes. Until modern times medication was prepared and dispensed by the physician himself. In the 18th cent. the practice of pharmacy began to be separated from that of medicine. The Philadelphia College of Pharmacy and Science was founded in 1821, the first school of its kind in the United States. The American Pharmaceutical Association was formed in 1851. The progress of medicine, and therefore the expansion of pharmacy, has necessitated more stringent requirements in the training of pharmacists; it is of vital interest that medications be formulated accurately according to the physician's prescription. Schools of pharmacy are now associated with universities, and a degree in pharmacy follows a four-year course of instruction. Examination and licensing by the state is mandatory.


Veterinary Dictionary:

pharmacy

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1. the branch of the health sciences dealing with the preparation, dispensing and proper utilization of drugs.
2. a place where drugs are compounded or dispensed.

Word Tutor:

pharmacy

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pronunciation

IN BRIEF: The art or business of compounding and dispensing medicines.

pronunciation The best and most efficient pharmacy is within your own system. — Robert C. Peale

Sign Language Videos:

pharmacy

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sign description: The middle finger vibrates back and forth in the center of the hand. Then both CLOSED AND-hands move forward in a twisting motion.




Wikipedia:

Pharmacy

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The mortar and pestle, an internationally recognized symbol to represent the pharmacy profession

Pharmacy (from the Greek φάρμακον 'pharmakon' = drug) is the health profession that links the health sciences with the chemical sciences, and it is charged with ensuring the safe and effective use of pharmaceutical drugs.

The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to health care, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacists, therefore, are the experts on drug therapy and are the primary health professionals who optimize medication use to provide patients with positive health outcomes. Pharmacy is also the term for an establishment where pharmacy (in the first sense) is practiced. Drugstore is a common American term for a pharmacy. Drugstores sell not only medicines, but also miscellaneous items such as candy, cosmetics, and magazines, as well as light refreshments.

The word pharmacy is derived from its root word pharma which was a term used since the 1400–1600s. In addition to pharma responsibilities, the pharma offered general medical advice and a range of services that are now performed solely by other specialist practitioners, such as surgery and midwifery. The pharma (as it was referred to) often operated through a retail shop which, in addition to ingredients for medicines, sold tobacco and patent medicines. The pharmas also used many other herbs not listed.

In its investigation of herbal and chemical ingredients, the work of the pharma may be regarded as a precursor of the modern sciences of chemistry and pharmacology, prior to the formulation of the scientific method.

Contents

Disciplines

Pharmacy, tacuinum sanitatis casanatensis (XIV century)

The field of Pharmacy can generally be divided into three primary disciplines:

The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut; and often, collaborative teams from various disciplines research together.

Pharmacology is sometimes considered a fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Therefore it is usually considered to be a field of the broader sciences.

Other specializations in pharmacy practice recognized by the Board of Pharmaceutical Specialties include: cardiovascular, infectious disease, oncology, pharmacotherapy, nuclear, nutrition, and psychiatry.[1] The Commission for Certification in Geriatric Pharmacy certifies pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology.

Pharmacists

Pharmacists are highly-trained and skilled healthcare professionals who perform various roles to ensure optimal health outcomes for their patients. Many pharmacists are also small-business owners, owning the pharmacy in which they practice.

Pharmacists are represented internationally by the International Pharmaceutical Federation (FIP). They are represented at the national level by professional organisations such as the Dutch Pharmacists Association (VNA) Royal Pharmaceutical Society of Great Britain (RPSGB), the Pharmacy Guild of Australia (PGA), the Pakistan Pharmacists Society (PPS) and the American Pharmacists Association (APhA). See also: List of pharmacy associations.

In some cases, the representative body is also the registering body, which is responsible for the ethics of the profession. Since the Shipman Inquiry, there has been a move in the UK to separate the two roles.

History of pharmacy

Paleopharmacological studies attest to the use of medicinal plants in pre-history.[2]

The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.

Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article.

The Greek physician Pedanius Dioscorides is famous for writing a five volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translation De Materia Medica (Concerning medical substances) was used a basis for many medieval texts, and was built upon by many middle eastern scientists during the Islamic Golden Age. The title coined the term materia medica.

In Japan, at the end of the Asuka period (538-710) and the early Nara 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 the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji 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.[4]

There is a stone sign for a pharmacy with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey. http://www.pbase.com/tsechien/ephesus_ has photos. The current Ephesus dates back to 400BC and was the site of the Temple of Artemis one of the seven wonders of the world, the home of Mark Anthony and Cleopatra, Mary Magdalen and where St Paul read his letter to the Ephesians.

In Baghdad the first pharmacies, or drug stores, were established in 754,[5] under the Abbasid Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were state-regulated.[6]

The advances in made in the Middle East in botany and chemistry led medicine in medieval Islam substantially to develop pharmacology. 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 by sublimation and distillation. His Liber servitoris is of particular interest, as it provides the reader with recipes and explains how to prepare the `simples’ from which were compounded the complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to initiate pharmacopoedia, describing a large variety of drugs and remedies for ailments. Al-Biruni (973-1050) wrote one of the most valuable Islamic works on pharmacology entitled Kitab al-Saydalah (The Book of Drugs), where he gave detailed knowledge of the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Ibn Sina (Avicenna), too, described no less than 700 preparations, their properties, mode of action and their indications. He devoted in fact a whole volume to simple drugs in The Canon of Medicine. Of great impact were also the works by al-Maridini of Baghdad and Cairo, and Ibn al-Wafid (1008-1074), both of which were printed in Latin more than fifty times, appearing as De Medicinis universalibus et particularibus by `Mesue' the younger, and the Medicamentis simplicibus by `Abenguefit'. Peter of Abano (1250-1316) translated and added a supplement to the work of al-Maridini under the title De Veneris. Al-Muwaffaq’s contributions in the field are also pioneering. Living in the 10th century, he wrote The foundations of the true properties of Remedies, amongst others describing arsenious oxide, and being acquainted with silicic acid. He made clear distinction between sodium carbonate and potassium carbonate, and drew attention to the poisonous nature of copper compounds, especially copper vitriol, and also lead compounds. He also describes the distillation of sea-water for drinking.[7]

In Europe pharmacy-like shops began to appear during the 12th century. In 1240 emperor Frederic II issued a decree by which the physician's and the apothecary's professions were separated.[8] The first pharmacy in Europe (still working) was opened in 1241 in Trier, Germany.[citation needed]

In Europe there are old pharmacies still operating in Dubrovnik, Croatia located inside the Franciscan monastery, opened in 1317 ; and one in the Town Hall Square of Tallinn, Estonia dating from at least 1422. The oldest is claimed to be set up in 1221 in the Church of Santa Maria Novella in Florence Itlay, which now houses a perfume museum. Another in Llívia few kilometres from Puigcerdà is a Catalan enclave in Spain almost within France which is also now a museum dating back to the 15 century.

Types of pharmacy practice areas

Pharmacists practice in a variety of areas including retail, hospitals, clinics, nursing homes, drug industry, and regulatory agencies. Pharmacists can specialize in various areas of practice including but not limited to: hematology/oncology, infectious diseases, ambulatory care, nutrition support, drug information, critical care, pediatrics, etc.

Community pharmacy

19th century Italian pharmacy
Modern pharmacy in Norway

A pharmacy (commonly the chemist in Australia, New Zealand and the UK; or drugstore in North America; retail pharmacy in industry terminology; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where 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. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications; there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients.

All pharmacies are required to have a pharmacist on-duty at all times when open. In many jurisdictions, it is also a requirement that the owner of a pharmacy must be a registered pharmacist (R.Ph.). This latter requirement has been revoked in many jurisdictions, such that many retailers (including supermarkets and mass merchandisers) now include a pharmacy as a department of their store.

Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional items such as cosmetics, shampoo, office supplies, confections, snack foods, durable medical equipment, greeting cards, and provide photo processing services.

Hospital pharmacy

Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas 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) and patient compliance issues (in the hospital and at home) many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and 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 usually 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 including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology, combined with the potential impact of medications and pharmacy services on patient-care outcomes and patient safety, make it imperative that hospital pharmacies perform at the highest level possible.

Clinical pharmacy

Clinical pharmacists provide direct patient care services that optimizes the use of medication and promotes health, wellness, and disease prevention.[9] Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often collaborate with physicians and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They work collaboratively with physicians, nurses and other healthcare personnel in various medical and surgical areas. They often participate in patient care rounds and drug product selection. In most hospitals in the United States, potentially dangerous drugs that require close monitoring are dosed and managed by clinical pharmacists.

Compounding pharmacy

Compounding is the practice of preparing drugs in new forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated lollipop that 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 tables to yield the desire therapy indicated by the doctor. 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

Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work in nursing homes, but are increasingly branching into other institutions and non-institutional settings.[10] Traditionally consultant pharmacists were usually independent business owners, though in the United States many now work for several large pharmacy management companies (primarily Omnicare, Kindred Healthcare and PharMerica). This trend may be gradually reversing 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 pharmaceutical care developed by Hepler and Strand in 1990.[11][12]

Internet pharmacy

Since about the year 2000, a growing number of internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as Online Pharmacies) are also recommended to some patients by their physicians if they are homebound.

While most internet pharmacies sell prescription drugs and require a valid prescription, some internet pharmacies sell prescription drugs without requiring a prescription. Many customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There also have been reports of such pharmacies dispensing substandard products.[citation needed]

Of particular concern with internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin, generically known as hydrocodone) via the internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are many instances where a practitioner issues a prescription, brokered by an internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship.

Canada is home to dozens of licensed internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers, who pay one of the world's highest drug prices.[citation needed] In recent years, many consumers in the US and in other countries with high drug costs, have turned to licensed internet pharmacies in India, Israel and the UK, which often have even lower prices than in Canada.

In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.

Recently-developed online services like Australia's Medicine Name Finder and the Walgreens' Drug Info Search provide information about pharmaceutical products but do not offer prescriptions or drug dispensations. These services often promote generic drug alternatives by offering comparative information on price and effectiveness.

Veterinary pharmacy

Veterinary pharmacies, sometimes called animal 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 on veterinary medicine are often very different from those related to people, veterinary pharmacy is often kept separate from regular pharmacies.

Nuclear pharmacy

Nuclear 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

Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal. State laws of Technician patient counseling and medication checking by a pharmacist do not apply.

Pharmacy informatics

Pharmacy informatics is the combination of pharmacy practice science and applied information science. Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or for healthcare information technology vendor 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 are well trained to participate in medication management system development, deployment and optimization.

Issues in pharmacy

Separation of prescribing from dispensing

In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments. However, the American Medical Association (AMA) Code of Ethics provides that physicians may dispense drugs within their office practices as long as there is no patient exploitation and patients have the right to a written prescription that can be filled elsewhere. 7 to 10 percent of American physicians practices reportedly dispense drugs on their own.[13]

In other jurisdictions (particularly in Asian countries such as China, Malaysia, and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is sometimes integrated with that of the physician, particularly in traditional Chinese medicine.

In Canada it is common for a medical clinic and a pharmacy to be located together and for the ownership in both enterprises to be common, but licensed separately.

The reason for the majority rule is the high risk of a conflict of interest and/or the avoidance of absolute powers. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects. This system reflects much similarity to the checks and balances system of the U.S. and many other governments.

A campaign for separation has begun in many countries and has already been successful (like in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia).

The future of pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists will be paid for their patient care skills.[14]

This shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for 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. They are also being paid for by the government for medicine use reviews. In the United States, pharmaceutical care or clinical pharmacy has had an evolving influence on the practice of pharmacy.[9] Moreover, the Doctor 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 in nursing homes are now expanding into direct consultation with patients, under the banner of "senior care pharmacy."[15]

The evolution of pharmacy

Evolution of Clinical Pharmacy

The Evolution of Clinical Pharmacy - 40 years of Progress is a new publication describing the pioneering work in key areas of clinical pharmacy that have led to today's advanced, specialized practices. Originally published as a series in The Annals of Pharmacotherapy, this book contains all 112 articles: 71 from early volumes of the journal and 41 describing the growth of the profession over time. In addition, articles published during the early years of the journal that chronicle the development of the American College of Clinical Pharmacy (ACCP) are included.

See also

Symbols

The two symbols most commonly associated with pharmacy are the mortar and pestle and the (recipere) character, which is often written as "rx" in typed text. The show globe was also used in English speaking countries until the early 20th century. Pharmacy organizations often use other symbols, such as the Bowl of Hygieia which is often used in the Netherlands, conical measures, and caduceuses in their logos. Other symbols are common in different countries: the green Greek cross in France, Argentina, the United Kingdom, Belgium, Italy and Spain, the increasingly-rare Gaper in The Netherlands, and a red stylized letter A in Germany and Austria (from Apotheke, the German word for pharmacy, from the same Greek root as the English word 'apothecary').

Notes

  1. ^ Board of Pharmaceutical Specialties, Current Specialties
  2. ^ Ellis, Linda (2000). Archaeological Method and Theory: An Encyclopedia. Taylor & Francis. pp. 443–448. ISBN 9780815313052. 
  3. ^ John K. Borchardt (2002). "The Beginnings of Drug Therapy: Ancient Mesopotamian Medicine". Drug News & Perspectives 15 (3): 187–192. ISSN 0214-0934. PMID 12677263. 
  4. ^ Titsingh, Isaac. (1834) Annales des empereurs du japon, p. 434.
  5. ^ Hadzovic, S (1997). "Pharmacy and the great contribution of Arab-Islamic science to its development" (in Croatian). Medicinski Arhiv 51 (1-2): 47–50. ISSN 0025-8083. OCLC 32564530. PMID 9324574. 
  6. ^ 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. ISSN 1303-667X. OCLC 54045642. http://www.ishim.net/ishimj/4/02.pdf. 
  7. ^ Levey M. (1973), ‘ Early Arabic Pharmacology’, E. J. Brill; Leiden.
  8. ^ History of Pharmacy Web Pages - Sweden´s oldest pharmacies
  9. ^ a b American College of Clinical Pharmacy, Clinical Pharmacy Defined
  10. ^ American Society of Consultant Pharmacists, Frequently Asked Questions
  11. ^ Strand LM (1990). "Pharmaceutical care and patient outcomes: notes on what it is we manage". Top Hosp Pharm Manage. 10 (2): 77–84. PMID 10128568. 
  12. ^ Hepler CD, Strand LM (1990). "Opportunities and responsibilities in pharmaceutical care". Am J Hosp Pharm. 47 (3): 533–43. PMID 2316538. 
  13. ^ American Association of State Compensation Insurance Funds, Prepackaged Drugs in Workers' Compensation
  14. ^ American College of Clinical Pharmacy, Evidence of the Economic Benefit of Clinical Pharmacy Services: 1996–2000
  15. ^ American Society of Consultant Pharmacists, What is a Senior Care Pharmacist?

References

External links

Other

  • The Virtual Library of Pharmacy - Extensive index of pharmacy-related resources, including information on careers in pharmacy, pharmacy schools, pharmaceutical companies, associations and conferences.

Translations:

pharmacy

Top
Pharmacy

Dansk (Danish)
n. - apotek

Nederlands (Dutch)
apotheek, drogist, het bereiden/verkopen van geneesmiddelen, voorraad geneesmiddelen

Français (French)
n. - pharmacie

Deutsch (German)
n. - Apotheke, Arzneimittelkunde

Ελληνική (Greek)
n. - φαρμακευτική, φαρμακολογία, φαρμακείο

Italiano (Italian)
farmacia

Português (Portuguese)
n. - farmácia (f)

Русский (Russian)
аптека

Español (Spanish)
n. - farmacia, botica

Svenska (Swedish)
n. - apotek, farmaci, apotekaryrke

中文(简体)(Chinese (Simplified))
药房, 配药学

中文(繁體)(Chinese (Traditional))
n. - 藥房, 配藥學

한국어 (Korean)
n. - 조제술, 약학, 약국

日本語 (Japanese)
n. - 薬学, 製薬業, 薬屋, 薬局

العربيه (Arabic)
‏(الاسم) صيدليه, مخزن أدويه‏

עברית (Hebrew)
n. - ‮בית מרקחת, רוקחות‬


 
 

 

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