Professional Pharmacy Practice PDF

Okay, I will convert the provided images into a structured markdown format as requested. ### Professional Practice # THEME 1 ## Introduction To Professional Pharmacy Practice ### Disciplines #### What is Pharmacy? "The profession responsible for the appropriate use of medications, devices and...

Okay, I will convert the provided images into a structured markdown format as requested. ### Professional Practice # THEME 1 ## Introduction To Professional Pharmacy Practice ### Disciplines #### What is Pharmacy? "The profession responsible for the appropriate use of medications, devices and services to achieve optimal therapeutic outcomes." **The American Pharmacists Association (APhA)** "Pharmacy should be conceived as a knowledge that renders a health service by concerning itself with understanding drugs and their effects." **The Report of the Commission Of Pharmacy, Pharmacist for the future** #### Pharmacy aprovision of medication * Art and science of preparing and dispensing medication * This role now transitioned to the pharmaceutical industry * Pharmacists role taken by technology and/or pharmacy technicians #### Medication Use process includes: prescribing transcribing interpretation of the order preparation and dispensing **Medication** Small scale preparation of ointments, syrups, dosage forms **ADE** adverse drug effect harmful effect due to any pharmaceutical product, may not be direct relation **ADR** adverse drug reaction Unintended harmful effect of a drug direct relationship of the effect with drug **Side Effects.** known effects **Allergy** Body's immune response to drug cause and effect relationship **Advance Role of Pharmacists:** * Provision of drug related information to other healthcare professional * Public and disease-state management programs to ensure proper use of medicines * Pharmacy Practice involves * Review and interpretation of prescription orders * Compounding, Labeling, and dispensing of drugs auxillary Labels **NOT FOR ORAL USE, EXTERNAL USE ONLY** * drug product selection and medication-use evaluation (MUE)↓ all the steps evaluated to determine efficacy and to calculate how many errors * patient monitoring and intervention * identify the error and correct it during the medication use process * provision of information related to the use of medications and non-pharmacological modalities Yellow Label LASA drugs look alike sound alike ### DIFFERENCE BETWEEN DRUG AND MEDICINE | Drug | Medicine | | :---------------- | :---------------------- | | API only | API + excipient | | Crude | refined products | | Cannot be consume | directly administered to patient | **All medicines are drugs. BUT** **Not all drugs are medicines** ### EVOLUTION OF PHARMACISTS ROLE evolved through four stages * Traditional Era * Scientific Era * Clinical Era * Pharmaceutical-care Era #### 1) Traditional Era Early twentieth century Formulation of drugs from natural sources Pharmacognosy done by chomatography and more Systematic science of morphological, chemical and bidogical properties along with history, cultivation, collection, extraction, isolation, bio-assying, quality control and preparation of crude drugs of natural origin Galenical Pharmacy checking the potency (power), strength, purity Branch of science that deals with medicine prepared by extracting one or more active constituents of plant #### 2) Scientific Era Began after WWII (Sep2, 1945) Emergance of Pharmaceutical Industry (drugs made in factories, not apothecary shops) Pharmacology: Pharmacokinetics + Pharmacodynamics Study of medicines and drugs, including action, use and effects on body ......... 2. further types science of picparation, of drugs, dosage **Pharmacokinetics** what a body does to the drug CADME absorption) metabolism distribution elimination (excretion) broad specific for only urine, waste **Pharmacodynamics** what a drug does to body which receptors its binds to which systems it affects/ metabolic pathways * **Pharmaceutics:** Science of preparation of drugs, and dosage forms and drug delivery systems, taking into account the pharmacokinetics and pharmacodynamics of drug as well as its physical and chemical properties. **3) Clinical Era** 1975: Millis Report, Pharmacists of Future New educational emphasis on clinical (patient oriented) pharmacy * **Pharmacokinetics:** study of how the body interacts with administered substances for the entire duration of exposure * **Pathophysiology:** changes that occur during a disease process Patho processes or mechanisms that occur during disease process physio Physical changes that are observed **4) Pharmaceutical Care Era** Helper and Strand defined in 1990 * **Pharmaceutical Care** "the responsible provision of drug therapy for purpose of acheiving definite outcomes that improve quality of life" pharmacists are experts on medications * Most accessible members of health care team * first source of assistance and advice on many common ailments and healthcare matters **PROFESSION** * occupation * widespread traming * study and mastery of info * professional association * ethical code * procedure of certification **PROFESSIONALISM** A member of profession who displays the following: i. Knowledge and skills of the profession ii. Commitment to self-improvement of skills and knowledge iii. Service orientation iv. Pride in the profession v. Good relationship with clients / patients vi. Creativity and innovation vii. Trustworthiness viii. Accountability of his/her works ix. Ethically sound decision making x. Leadership ## SCOPE OF PHARMACY PRACTICE 1. **Community (Retail) Pharmacy** business model of pharmacy services provided to patients and role pharmacies play In communities * **Role Of Community Pharmacist includes** * Involved in patient care initiatives to prevent or identify disease * administration of immunization * screening for and educating about hypertension, diabetes and other condition * providing education about lifestyle choices and dietary supplements 2. **Hospital Pharmacy** health care services which comprises of * Choosing * preparing * storing (medicines + devices) * compounding * dispensing medicines and medical devices * advising patients, doctors, nurses and other health care professionals on their safe, effective, effivent use IPD pharmacy for the dispension of medicines to hospitalized patients OPD pharmacy patient is not hospitalisized. doctors consultation * **Role Of Hospital Pharmacist** * Dispenses oral medication * Prepares and dispenses parenteral medications * specializes with advanced training in an area of patient care * educates and counsels patients * provides drug Information * administers a department **3) Clinical Pharmacy** an area of pharmacy concerned with the science ACCP and practice of rational medication use Right patient Right drug Right dose Right route of administration Right time Right diagnosis 5 R's health science discipline in which pharmacists provide patient core that optimizes medication therapy and promotes health and disease prevention Role of Clinical Pharmacists Consultation: analyzing therapies, advising health care practitioners on correctness of drug therapy to produce maximum effect cost effective, safe to use providing pharmaceutical care to patients both at hospital and community level, which drug should be purchased in pharmacy Selection of Drugs: defining drug formularies or Limited lists of drugs in collaboration with hospital doctors. * Drug Information: seeking information and critically evaluating Scientific Literature, organizing information services for both the health care practitioners and patients. Formulation And Preparation Drug use studies and research 4) **Long Term Care Facilitres** residential care for people with disabilities and elderly individuals who cannot care for themselves LTCF anything from a person's home to medical centre **5) Academia** teaching + carrying out research for new API, new drug formulae, novel drug delivery system Should hold Master's and PhD degrees Lecturer: MPhil / Master's (18 years of education) Assistant Professor: PhD Associate Professor: PhD + 10 years OR 5 years post PhD experience. Professor:. 10 publication PhD and 15 years / 10 yrs past experience 15 publications **6) Pharmaceutical Industry** produce chemicals, medications (prescription and non-prescription) and other health care products * **Role of Industrial Pharmacists** * research and product development * manufacturing * quality control * sales and marketing \*regulatory affairs \*planning \*management \*developing new drugs + dosage forms for allready existing products **7) Mail Order/Internet Pharmacists** licensed pharmacists must review prescription, appropriateness review Licensed pharmacists must call the prescribmg physician if: * prescription is unclear as to drug, strength, dosage or instructions * prescription history raises concerns * patient allergy **8) Nuclear Pharmacy** Area of drug pharmacy practice involved with preparation of radioactive materials to improve and promote health through safe and effective use of radioactive drugs to diagnose and treat specific disease states. **Radionuclide therapy** main agents: du-177 and Y-90 * **Drug Information** provision of unbiased, well-referenced and critically evaluated information on any aspect of pharmacy practice * **Drug And Poison Information Center** service offered through the Pharmacy provides advice and acts as a referral service by directing the best available resources to respond to a query. and concern DPIC caters to the needs of health care professionals, patients, caregivers and community **Components Of DPIG** Requestor: the person requesting the information (nurse, doctor, other health care professional or Patient) Receiver: the person receiving the request (pharmacist) Drug Information Request: Simply a question regarding a medication Drug Information Source: primary, secondary and tertiary source **Goals of DPIC** provision of prompt and accurate drug or poison information to those who access the service * Provision of drug information to facilitate health professionals in better management of their patients * Education of public in areas of poisoning prevention and first aid * Education of health-care professionals in areas of clinical toxicology, poisoning epidemiology, prevention diagnosis and care * develop effective telecommunications and information technology systems to deliver dependable treatment recommendations **Role Of Pharmacists** * to stimulate the effective use of drug information resources * to educate pharmacy students/residents to serve as effective providers of drug information. * to provide an organized database of specialized information * on drug therapeutics to meet drug info needs * expand role of pharmacists to provide drug information services to hospital and community * to promote patient care through rational drug therapy: through improved availability and use of drug information **Other Functions** Recommendation to pharmacy and therapeutic committee (PST) * development of drug use policies * formulary consideration * co-ordination of reporting programs (ADR) * Drug Use Review (DUE) / Evaluation * Investigational Drug Program * Education and Training * Publications. * Community Services **SYSTEMIC APPROACH IN ANSWERING A QUESTION** Step 1: secure demographics of request or Step 2: obtain background information Step 3: determine and categorize the question Step 4: develop strategy and conduct search Step 5: perform evaluation, analysis, synthesis Step 6: formulate and provide response. Step 7: conduct follow-up and Documentation **Types Of Question:** * Product availability * Adverse drug event * IV compatibility and stability * Drug - to drug interaction * Alternative medication and natural products * Identification * Pharmacokinetics (what body does to the drug} * Therapeutic use/ efficacy * Safety in pregnancy and nursing * Toxicity and poisoning drug monograph Handbooks- complete information related to drug if dosage forms and methods of analysis **Contains** * Chemical name * Specific optical rotation * Formula * Loss on Drying * Solubility * Sulphated ash * Identification * Pose * PH * Assay material safety data sheet All lab chemicals and equipments have MSDS which contains all info related to it how to use, solubility, handling, protocols of handling during spillage, exposure ## THEME 2 INTRODUCTION TO LITERATURE SOURCES Drug Literature Use providing information in response to questions concerning drug products from patients and healthcare workers preparing drug evaluations of drug products for inclusion in drug formularies providing documents (newslatters, presentation) on therapeutic issues updating knowledge about drug therapy issues for personal growth and education PRIMARY SOURCE most updated, latest research original materials first formal appearance of results in physical, print or electronic format original thinking reports a discovery shares new information ⇒ from the time period involved and have not been filtered through interpretation or evaluation **Examples:** peer-reviewed articles * Journals journals) journal of American Medical Association British medical journal urea experts some journal publish them Chave Reviewed The articles and they are now tertiary school secondary, they have second when or or or reviewed, not primary Clinical studies, case reports * audio recording * diaries, notes, autobiographies * Internet communications * Interview User Manuals * Video recording * Survey results and analysis SECONDARY SOURCE Interpretations and evaluations of primary sources Not evidence, but commentary on and discussion of evidence Use to find information from other sources of drug information Use to identify primary literature sources that can be used to answer a specific question **Examples:** * Pubmed * Medscape * Medline * BIDS Embase. International "Pharmaceutical Abstracts Index Medicus TERTIARY SOURCE Introduces key research findings and accepted concepts Consists of information that is distillation and collection of primary and secondary sources. Advantage and of access Well and standards standard of practice Disadvantage resources there years to complated therefore contains data material leg time, Examples: textbooks therapy: is Applied Therapeutics Compendia Physician's Desk Reference (PDR) Handbook of Pharmaceuticals pharmaceuticals Injectable United States Compendia Pharmaceuticals *** CASE SCENARIO Which will provide the most updated information's? American Hospital Formulary service® Dru Information UPDATE Anualle, updates Updates throughout Pharmaceutical that a Currently every two years sgd-1 Professional Practice-I identifying the medicinal properties Case Scenario 1 Mr. AB = diligent research assistant working * Journal Of Natural Products in field of natural products research article * Primary Source isolation Research and identification google website Scholar (elseviers) Journal ***Source article reviewing data Tertiary Source journal He wants He wants to publish journals name 1 Pharmacology & experimental Therapeutics 1. American Journal of Health System Pharmacy (2) as 2. American Journal of medicinal association 3. Bmj 4. medichemisrty journal 5. natural medicine product Case Scenario 2 Searched research articles on covid-19 of on in *Primary Source & most updated/latest search conducted * Journals: QJM: An International Journal of Medicine Archives Of Women's - Mental Health JAMA Internal Medicine Journal of Mental Health Case Scenario 3 Mr. a suffering From Lower Respiratory Information *Source & most author * Pediatric Clinics New Journal Of medicine Research and Review and article articles primary source literature articles Of all research done Without refering another expirement others the Work and it's a literature reviewing compiling one something on it on what Pharmacopoeias formulanes and compendia Pharmaceutical The official and standards prepared the of Country and identify body of the States and country region ebook with standards and Body in with or throughout the with societies with pharmakon poico and stands the a Formulare formula formulare collection Formularies and the other more of Short & comprehensive details and the it's & 131140771 & * Formularies Pharmacopoeias Importance of pharmacy dates the the Maintain and standards Control available and to avoid and adulterated on on them from their dosage avoid and it's laboratory Industries institutions Collection and drug Contains drug analysis and to chemical assay the it's and it's (rotation rotation light) and the pharmacy chemical of The used official versus and government with or versus books under them agencies country it Britain and Pharmaceuticals And Pharmacy Formulary and them, from used for Auxillary label 717-17) and in shake tall And And BNF about and care in with and Prescriptions The pharmaceutical society that those Involved formulary that in the uk is The pharmaceutical Agency? dental, Prescribers the literature with the that the what happened omeprazole on a protron inhibitor common for in that or through the 48 48 pregnancy that in their life it diabetes and. that is. that action action what happened in 2 to 4 Disclaimer: I've done my best to accurately transcribe and format the content. Please review carefully for any potential errors I may have introduced. Some ambiguities in the original text might exist due to image quality or handwriting. I hope this is helpful!