Pharmacy Lecture Notes Fall 2024-2025 PDF

Pharmacy Bachelor of Pharmacy –PharmD program Fall 2024-2025 Pharmacy Orientation (PIP 111) Lecture 4: History of Pharmacy (Continue) Associate Professor : Dr. Sally A. El-Zahaby Associate Prof. Dr. Sally El-Zahaby  Learning outcomes After finishing this l...

Pharmacy Bachelor of Pharmacy –PharmD program Fall 2024-2025 Pharmacy Orientation (PIP 111) Lecture 4: History of Pharmacy (Continue) Associate Professor : Dr. Sally A. El-Zahaby Associate Prof. Dr. Sally El-Zahaby  Learning outcomes After finishing this lecture, you will acquire the following: 1. Understand the development of the profession of pharmacy in different historical periods. (Continue) 2. Identify the common symbols used in Pharmacy. 3. Detect an example of historical mistake and the action taken after it to ameliorate the pharmacy profession. Associate Prof. Dr. Sally El-Zahaby  American Pharmacy ▪ Apothecary: a person who prepares and sells drugs or compounds for medicinal purposes ( nowadays = pharmacist) ▪ By 1811, the position of apothecary at the New York hospital had changed. The chosen person was a full-time pharmaceutical practitioner for compounding medicines. ▪ Before this time, physicians were doing this job beside writing prescriptions. ▪ Pharmacopoeia of the United states (USP) was available in 1820 as a guide to drugs. ▪ First pharmacy school established in Philadelphia (US) in 1821. Associate Prof. Dr. Sally El-Zahaby American Pharmacy ▪ What’s counter-prescribing? ▪ American apothecaries have written prescriptions without physician authorization, a practice called counter-prescribing. ▪ Physicians and pharmacists were in competition, pharmacists were convinced that dispensing physicians and doctor’s shops were the cause of their difficulties, while physicians complained about counter-prescribing. ▪ Afterwards, the boundaries between apothecaries and physicians were clearer. Associate Prof. Dr. Sally El-Zahaby Transition to a modern profession ▪ During this period pharmacy’s part in health care solidified, and the dispensing of medicines by physicians had declined. ▪ Industrial research on drugs produced several new agents, such as: the analgesic and antipyretic aspirin or the sedative chloral hydrate, that reduced the pain and suffering associated with illness. ▪ Pharmacies served as important outlets for antitoxins, and vaccines. ▪ Courses shifted from the identification of crude plant drugs to a greater emphasis on the chemical compatibility of the ingredients within each prescription. Associate Prof. Dr. Sally El-Zahaby The 20th century ▪ At the 20th century, there was a dramatic change for all of the medical care including pharmacy. ▪ Production of antibiotics, anti-depressants, antihypertensives and oral contraceptives started in this era. ▪ The pharmacy which was concerned with the relief of suffering and treatment of minor diseases became more specialized in prevention and the cure for serious diseases. ▪ Following World War II, American pharmaceutical firms applied high technology to the production of medicines and became one of the most advanced industries in the world. ▪ New drugs, dosage forms, and marketing methods in the 1900s made the physicians shifted from prescribing complex mixtures of ingredients toward ready-made, single- entity medicines manufactured by large companies. Associate Prof. Dr. Sally El-Zahaby The 20th century ▪ You can understand the shift that happened to medicines production by the following numbers: ▪ In the 1930s, about 75% of prescriptions (Rx) required compounding by a pharmacist. ▪ By 1950s, about 25% of Rx required compounding by a pharmacist. ▪ By 1960, only 4% (1 in 25 Rx) needed compounding. ▪ In 1970s, only 1% (1 in 100 Rx) needed compounding skills Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” Ancient Chinese Medicine ▪ Chinese herbal remedies date back at least 3000 years. ▪ Doctors were divided into four categories: 1-Dietician, 2-Physician, 3-Surgeon, and 4-Veterinarian. ▪ The Chinese believe that poisonous substances may leave the body when the pores of the skin are opened. Thus, they used tea that can induces sweating. ▪ This tea was formed from a mixture of cinnamon, ginger and other herbs, honey was used to give a flavor. ▪ Cinnamon was used because it can increase blood circulation so can Cinnamon induce perspiration. Ginger is a carminative. Associate Prof. Dr. Sally El-Zahaby Ginger Examples from some countries about “History of Pharmacy” Ancient Chinese Medicine ▪ Besides medicinal plants, they used Acupuncture. ▪ Acupuncture is the introduction of a needle into the patient body or a corresponding point (there are 388 points in the body). ▪ The first needles were made of stone. ▪ Later, bamboo, metal (bronze, silver, gold, platinum, stainless steel) and silicon were used. ▪ There were 9 forms of needles (cylindrical, flat, round, triangular, lanceolate, needles with acute and a blunt end). Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” Indian Medicine: ▪ Pharmacy in India can be traced back to more than 5000 years ago. ▪ In ancient India the sources of drugs were of vegetable, animal and mineral origin. ▪ They were prepared by few experienced persons. Knowledge of that medical system was usually kept secret within a family. ▪ They used herbal juices to heal various diseases and injuries. ▪ The first chemist shop was opened in 1811. The pharmacy activities were performed according to London Pharmacopoeia. ▪ In Indian culture, there was no difference between a pharmacist and a doctor. Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” Indian Medicine: ▪ The official emergence of Pharmacology as a branch of education started in the 1870s in india, when the first class of chemist and druggist was organized at the Madras Medical College to impart the skills of pharmacy practice. ▪ In 1930, the first pharmaceutical company called Bengal Chemicals and Pharmaceuticals, which is still nowadays as one of the 5 government-owned drug manufacturers. ▪ Indian Pharmacopoeia: 1st Edition in 1955. India’s oldest pharma company: Bengal Chemicals and Pharmaceuticals Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” Indian Medicine: ▪ Examples of the used natural agents in treatment: Medicinal plant Action Curcumin Anti-inflammatory Piper nigrum (black pepper) Analgesic, anti-inflammatory, anti-diarrheal, antispasmodic Ginger Anti-inflammatory As a treatment for nausea and vomiting Associate Prof. Dr. Sally El-Zahaby Examples from some countries about “History of Pharmacy” Japanese history of medicine ▪ Treatment and prevention were based largely on religious practices, such as prayers, incantations (the use of words as a magic spell), at a later date drugs were also employed. ▪ Japanese Pharmacopoeia 1st edition was in 1886. ▪ Traditional Japanese medicine (TJM) used both acupuncture and herbal medicines. ▪ Examples: ▪ Geranium herb is used as an anti-diarrhaea. ▪ Cinnamon with liquorice and ginger were used together to treat headaches and fever. Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” Japanese history of medicine ▪ Japanese Ginseng was used as energy-boosting tonic to increase “energy levels”. ▪ In Japan, Ginseng is also used for gastroenteric disorders, as well as an antidiabetic, and antiulcer. It was used as well to manage hypertension. Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” The Evolution of pharmacy and the apothecaries in England ▪ During the 16th and 17th centuries, there were Apothecaries (a person who prepared and sold medicines and drugs). ▪ In the late 18th and 19th century, Chemist and Druggist terms were used to describe both chemical and drug merchants and practitioners of the profession of pharmacy. ▪ By the mid-19th century, the term ‘pharmaceutical chemist’ was being more widely applied to those interested in organic chemistry and in the skilled compounding of drugs. Associate Prof. Dr. Sally El-Zahaby Video about: “The Apothecary” during the early 17th century and the late 18th century https://www.youtube.com/watch?v=YnTeOK2D7xk Associate Prof. Dr. Sally El-Zahaby  Examples from some countries about “History of Pharmacy” The Evolution of pharmacy and the apothecaries in Italy: ▪ In 1499, Guild pharmacopoeia is published in Florence, Italy. ▪ Santa Maria Novella Pharmacy (Florence, Italy) is one of the oldest in the world, it dates back to 1221. ▪ They cultivated botanical gardens around this place and used the herb, plant and spices to prepare simple solutions. ▪ The industry was so profitable that it expanded to beauty products such as perfumes. The counter at the Santa Maria Novella Pharmacy in Florence Associate Prof. Dr. Sally El-Zahaby Kindly watch this video about Santa Maria Novella pharmacy: https://www.youtube.com/watch?v=b4r9LJSUXks Associate Prof. Dr. Sally El-Zahaby COMMON SYMBOLS USED IN PHARMACY: Bowl of Hygeia: the bowl with the snake coiled around it. ▪ The snake was a symbol of wisdom, immortality and healing power. ▪ Hygeia was a Greek Goddess of health. ▪ They have thoughts that it is a magical serpent and the bowl is of healing medicine. ▪ The word hygiene originated from her name. Associate Prof. Dr. Sally El-Zahaby COMMON SYMBOLS USED IN PHARMACY: CADUCEUS: The symbol of two snakes on a staff having wings. The staff of the Greek messenger god Hermes. CADUCEUS Hermes, a god of the Greeks Associate Prof. Dr. Sally El-Zahaby  COMMON SYMBOLS USED IN PHARMACY: The serpent around a palm tree symbol ▪ The serpent around a palm tree symbol is used by French and Portuguese pharmaceutical bodies, and was introduced in the 1800s. ▪ The snake is associated with healing, as discussed before. ▪ The palm tree represents the vegetable kingdom and the serpent the animal kingdom. Associate Prof. Dr. Sally El-Zahaby  COMMON SYMBOLS USED IN PHARMACY: The unicorn ▪ Another animal symbol commonly seen in pharmaceutical branding is the unicorn. ▪ It was first mentioned by the ancient Greeks as a symbol of purity, whose spiralling horn had the power to heal, especially as an antidote to poisons. Apothecaries Hall in London Associate Prof. Dr. Sally El-Zahaby COMMON SYMBOLS USED IN PHARMACY: MORTAR AND PESTLE: ▪ The mortar and pestle has been used as a pharmaceutical symbol in Britain and Europe, and still widely employed as a pharmacy shop sign in Scotland. ▪ The mortar and pestle are tools of traditional pharmacy. Associate Prof. Dr. Sally El-Zahaby  COMMON SYMBOLS USED IN PHARMACY: The green cross is used in many countries like France, the United States, Ireland, Italy, Spain , India and many others. Originally this cross is red. The pharmacists borrowed this symbol from the international organization of the Red Cross, an organization created in the late 19th century. ▪Why green? This might be due to the vegetarian origin of many medications. Associate Prof. Dr. Sally El-Zahaby  COMMON SYMBOLS USED IN PHARMACY: Rx symbol: This sign appears at the start of prescriptions. ▪ The most popular interpretation is that it could have derived from the ancient Egyptian eye symbol, the Eye of Horus (symbol of protection, royal power and good health). ▪ The Eye of Horus was believed to have healing and protective powers. ▪ Or it could have been derived from the symbol for Jupiter (God of healing in Egypt). Left to right: The Eye of Horus, the symbol for Jupiter, and the Rx symbol Associate Prof. Dr. Sally El-Zahaby  Rx symbol: ▪ It is also believed that Rx is an abbreviation for the Latin verb “recipere”, which translated and means “Take” or “ Receive”. ▪ Hence it became the heading for the formula or prescription that followed. ▪ The English word recipe is derived from it and is taken to mean a list of ingredients and directions for making something, especially a food/ pharmaceutical preparation. Associate Prof. Dr. Sally El-Zahaby  Mortar and pestle with Rx: Today in America, the old mortar and pestle is often used by pharmacists as an industry symbol along with Rx. Associate Prof. Dr. Sally El-Zahaby  Historical mistake and the action taken after it to ameliorate the pharmacy profession Thalidomide tragedy: an example on historical mistakes Clinical trials started by a German company led to the promotion of thalidomide for treating respiratory infections as early as 1956. The drug was marketed under the name Grippex, which contained a combination of thalidomide, vitamin C, acetylsalicylic acid, quinine and phenacetin. Nearly 60 years ago thalidomide was prescribed to treat morning sickness (nausea & vomiting) in pregnant women. What followed was the biggest man-made medical disaster ever, where over 10,000 children were born with a range of severe malformations. Historical mistake and the action taken after it to ameliorate the pharmacy profession Thalidomide tragedy: an example on historical mistakes These babies were born with missing or abnormal limbs, feet or hands. Other defects included abnormal or absent ears, heart and kidney problems, in addition to digestive system disorders. In the United Kingdom, the drug was licensed in 1958. However, thalidomide was found to cause deformity in children born to mothers who took the drug and it was withdrawn in the UK during the early 1960s. Thalidomide was the first example of a drug that passed legal specifications and regulations without full evaluation of its safety for use in pregnant and breastfeeding mothers. After 1961, drug regulatory authorities tightened their laws so that any new drug was screened for the potential to cause harm to the unborn baby. Associate Prof. Dr. Sally El-Zahaby