Community Pharmacy Introduction PDF

Community Pharmacy Dr. Sara Youssif Ibrahim PhD, Bcps  Pharmacy practice Pharmacists practice in a variety of areas including 1) Community Pharmacy 2) Hospital Pharmacy 3) Clinical Pharmacy 4) Industrial Pharmacy 5) Compoundin...

Community Pharmacy Dr. Sara Youssif Ibrahim PhD, Bcps  Pharmacy practice Pharmacists practice in a variety of areas including 1) Community Pharmacy 2) Hospital Pharmacy 3) Clinical Pharmacy 4) Industrial Pharmacy 5) Compounding Pharmacy 6) Regulatory Pharmacy 7) Academic pharmacist 8) Pharmacovigilance pharmacist 9) Pharmacoeconomics pharmacist 10) Infection control specialist 11) Quality control specialist  Definition Community pharmacy ( A retail pharmacy)  Community pharmacy means any place under the direct supervision of a pharmacist where the practice of pharmacy occurs or where prescription orders are compounded and dispensed.  Community Pharmacy  Community pharmacies are also known as retail pharmacies and are the most common and well-known type of pharmacy.  Community pharmacists are considered the most accessible health professionals and can provide healthcare advice on a walk-in basis without an appointment.  Provide a combination of over-the-counter and prescription medications.  Prescription orders are compounded and dispensed at community pharmacies.  Community pharmacies range from individually owned and operated to large retail chains. Hospital pharmacies typically stock a large range of medications ,those of which are more specialized.  Pharmacovigilance pharmacist Pharmacovigilance is defined by the World Health Organization as the science and activities related to detecting, assessing, understanding and preventing adverse effects and other medicine- related problems. Pharmacists play crucial roles in health systems in maintaining the rational and safe use of medicines since they are drug experts who are specifically trained in this field. Pharmacoeconomics pharmacist Pharmacoeconomics examines and compares the costs and benefits of various pharmaceutical interventions. Pharmacoeconomics analysis is important for inclusion in formularies or coverage by the drug insurance companies. It assesses therapeutic advantages and disadvantages of the drug and cost-effectiveness of the drug relative to accepted therapy.  Infection control specialist Infection control prevents or stops the spread of infections in healthcare settings. Reducing the transmission of infections, promoting the rational use of antimicrobial agents, and educating health professionals and patients.  Quality control specialist QC pharmacist is responsible for inspecting compliance with standard operating procedures. Revising all departments manual regarding quality issues. Follow up implementing quality standards & communicate results with the hospital management. Co-operation of a pharmacist with a patient and other professionals in  Designing  Implementing  Monitoring Therapeutic plan that will produce specific therapeutic outcomes for the patient and improve qualityof life.  Types of patients in community pharmacy Category1 Category2 Patient looking for OTC drug in Patient visiting a clinic for diagnosis community pharmacy need followed by determination of therapy pharmaceutical care. by drugs need pharmaceutical care. Objective of pharmaceutical care Help patients in proper selection of OTC.  Types of patients in hospitals Category3 Patient visiting a hospital for diagnosis followed by determination of therapy by drugs and leave the hospital in the same day of admission (Out-Patient) and need pharmaceutical care. Role of pharmaceutical care Review prescription , identify and resolve drug therapy problems and patient counseling. Category4 Patient visiting a hospital looking for diagnosis followed by determination of therapy by drugs or other means and don’t leave the hospital in the same day of admission (In-Patient ) need clinical pharmacy consultation.  Community pharmacist’s responsibilities (Pharmaceutical care) 1. Check dosage and ensure that medicines are correctly and safely supplied and labelled. 2. Patients counselling to explain what they need to know about their medications (how to use?). 3. Communicate with doctors about prescriptions. 4. Prescribe over-the-counter medications. 5. Advise the public on the treatment of minor illness. 6. Advise patients of any adverse side-effects of medicines or potential interactions with other medications/food. Applications for drug-drug interactions Micromedex  Community pharmacist’s responsibilities (pharmaceutical care) 6. Offer specialist health checks, such as blood pressure and diabetes screening. 7. Arrange the delivery of prescription medicines to patients. 8. Manage, supervise and train pharmacy support staff. 9. Manage finance and budgets. 10.Keep up to date with current pharmacy practice, new drugs and their uses.  Skills of community pharmacists 1. Excellent communication skills - you must listen carefully to what patients say, as well as explain complex and sometimes sensitive information to the general public and other healthcare professionals. 2. The ability to work with others in a multidisciplinary team, as well as to lead others in a team 3. Accuracy and great attention to detail. 4. Understanding of business principles. 5. a high level of customer service. 6. Professional and confident manner. 7. The ability to inspire the trust of others.  What are OTC drugs?  If you open the average person’s medicine cabinet, you will probably find a variety of medications, such as pain relievers, cough medicines, allergy medications, stomach pain medications, and so on. Most of these types of medicines can be bought at your local pharmacy without a prescription (a written note from a doctor). These drugs are called over-the-counter medications, or OTC drugs.  “Over-the-counter” means that a person doesn’t need a prescription to buy them.  What are OTC drugs?  all OTC drugs have a drug facts label (pamphlet). This label tells what the medicine is and what the medicine is supposed to treat (use). OTC medications also must list the active ingredients (those ingredients that actually treat the problem) and include instructions for proper doses based on age and weight. OTC medications also must have warnings about the safety of taking the medicine if you are taking any other medicines, if you are pregnant, or if you are below a certain age.  Because over-the-counter medications are commonly used and accessible, many people believe they are safe. When these medicines are not used according to their directions, however, the results can be harmful.  Paracetamol (Acetaminophen) Max. total daily dose g/day Max. total daily dose for liver impairment g/day Because over-the-counter medications are used so frequently. It is important to know the differences between prescription-only medicines (POM) and over-the-counter medications (OTC). Differences between prescription and over-the-counter medications Routes for medication administration By Mouth PO Per rectum PR sublingually SL intramuscularly IM intravenously IV subcutaneously SQ  Common frequencies abbreviations for prescription writing  The frequency is simply how often you want the patient to take the medication.  Daily (no abbreviation) every other day (no abbreviation)  BID/b.i.d. (twice a day)  TID/t.i.d. (three times a day)  QID/q.i.d. (four times a day)  QHS (every bedtime)  Q4h (every 4 hours) Q4-6h (every 4 to 6 hours)  QWK (every week) PrescriptionBasis  Medical Prescription  The prescription is one of the most important therapeutic transaction between physician and patient. The word "prescription" derive from pre (before) and "script“(writing written) which denotes that it is an order that must be written down before or for the prescription and administration of drug.  The symbol "℞", is recorded in 16th century manuscripts as an abbreviation of the late Latin instruction recipe, meaning 'receive'.  Commonly the term prescription is used to mean an order to take certain medication.  Prescription basis  Definition of prescription (Rx) It is a written order for the medication to be used for diagnosis and treatment of specific patient directed by physician.  Every medical prescription consists of seven parts: 1. Prescriber’s Information  This information is usually found at the top of the prescription. It generally consists of the prescribing clinician’s name, office address, and contact information (usually the office’s telephone number). 2. Patient’s Information  Below the prescriber’s information is the patient’s information. This section will include the patient’s full name, age, and date of birth. Sometimes the patient’s home address will be found here, as well. You should also specify the date you wrote the prescription. 3. Recipe (Rx) The recipe should include the medication being prescribed, its dose, and its dosage form. For example, if you are prescribing 1000 milligrams (mg) tablets of acetaminophen, you would write “acetaminophen 1000 mg tablets”. 4. Signatura (Sig) (The patient instructions )  After the recipe is the signature (Sig), theses are the doctor’s instructions to the pharmacist indicating how the patient should use the medication.  The Sig should include information on how much drug to take, how to take it, and how often to take it.  For example, if you would like your patient to take one 1000 mg tablet of acetaminophen every six hours, you would write “Take 1 tablet by mouth every six hours” or, using abbreviations, “1 tab PO q6h.”   For as-needed or pro re nata (PRN) prescriptions, you should indicate that the prescription is PRN and describe the conditions under which your patient can take the prescribed medication.  Let’s say that you would like your patient to be able to take one 500 mg tablet of Paracetamol every 6 hours when he or she has fever.  In that case, your instructions would read, “Take 1 tablet by mouth every 6 hours as needed for 6 fever” or “1 tab PO q6h PRN fever.” 5. Dispensing Instructions (Disp)  Dispensing instructions, which let the pharmacist know how much medication you would like your patient to receive.  You should include the amount of medication you would like to be dispensed and the form in which it should be released.  For example , if you would like your patient to receive a one-week supply of acetaminophen, (or 28 tablets), you would write “28 (twenty-eight) tablets” or “28 (twenty-eight) tabs.” 6.Number of Refills (Rf)  After the dispensing instructions, specify how many times you would like your patient to use this prescription to refill his or her medication.  If you do not want to prescribe any refills, write “zero refills.”  For our acetaminophen example, if you are prescribing one refill, you would write “1 (one) refill.” 7. Prescriber’s Signature  At the bottom of the prescription, physician should sign his name.  Oftentimes, physician will include his National Provider Identifier (NPI) in this section.  For controlled substances, physician usually will include his Drug Enforcement Agency Number (DEA).  These are necessary for the pharmacy to verify your prescription more easily. Dr. Sara Youssif