Pharmacy Orientation PDF

1 PHARMACY ORIENTATION PHYSICAL PHARMACY  PHARMACY 2 Pharmacy is the health profession that links the health sciences with the chemical sciences and is concerned with ensuring the safe and effective use of pharmaceutical drugs. The word derives from...

1 PHARMACY ORIENTATION PHYSICAL PHARMACY  PHARMACY 2 Pharmacy is the health profession that links the health sciences with the chemical sciences and is concerned with ensuring the safe and effective use of pharmaceutical drugs. The word derives from the Greek word pharmakon, meanin g "drug" or "medicine. 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.  PHARMACY 3 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. An establishment in which pharmacy is practiced is called a pharmacy, chemist's or drug store  PHARMACIST 4 Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use. Historically, the fundamental role of pharmacists as a healthcare practitioner was to distribute drugs to doctors for medication that had been prescribed to patients. In more modern times, pharmacists distribute drugs prescribed by physicians and other health practitioners and provide information to patients about medications and their use. Pharmacists advise patients and health care providers on the selection, dosages, interactions, and side effects of medications, and act as a learned intermediary between a prescriber and a patient.  PHARMACIST 5 Pharmacists also monitor the health and progress of patients in response to drug therapy to ensure the safe and effective use of medication. Pharmacists play a vital role in the health care system through the medicine and information they provide. Although responsibilities vary among the different areas of pharmacy practice, the bottom line is that pharmacists help patients get well.  PHARMACIST 6 Pharmacists may practice compounding; however, many medicines are now produced by pharmaceutical companies in a standard dosage and drug delivery form. Pharmacists are drug experts ultimately concerned about their patients’ health and wellness. Pharmacists must understand the use, clinical effects, and composition of drugs, including their chemical, biological, and physical properties.  1- HOSPITAL PHARMACY 7 The department or service in a hospital which is under the direction of a professionally competent, legally qualif ied pharmacist, and from which allmedications are supplied to the nursing units and other services, where special prescriptions are f il led for patients in the hospital, where prescriptions are f illed for ambulatory patients and out-patients, where pharmaceuticals are manufactured in bulk, where narcotic and other prescribed drugs are dispensed, where injectable preparations should be prepared and sterilized, and where professional supplies  1- HOSPITAL PHARMACY 8 Hospital pharmacists work in a hospital pharmacy service. They are responsible for ensuring the safe, appropriate and cost-effective use of medicines. Hospital pharmacists use their specialist knowledge to dispense drugs and advise patients about the medicines they have been prescribed. They work collaboratively with other health care professionals to devise the most a ppro pri a t e d rug t re a t m e nt fo r pa t i e nt s. So m e pharmacists are also involved in manufacturing required drug treatments. The role of the hospital pharmacist sometimes extends outside the hospital, with responsibility for medicines in health centres, nursing homes, hopices and general practitioners' (GP) surgeries. 9 Hospital pharmacy is the health care service, which comprises the art, practice, and profession 10 of choosing, preparing, storing, compounding, and dispensing medicines and medical devices, advising healthcare professionals and patients on their safe, effective and efficient use. Hospital pharmacy is a specialised field of pharmacy which forms an integrated part of patient health care in a health facility. Hospital pharmacy is the profession that strives to continuously maintain and improve the medication management and pharmaceutical care of patients to the highest standards in a hospital setting. Hospital pharmacists provide services to patients and health care professionals in hospitals. https://youtu.be/l6Nzmd7oZlM 11  THE MISSIONS OF THE HOSPITAL 12 PHARMACIST to be part of the medication management in hospitals, w hi c h e nc o m pa sse s t he e nt i re w ay i n w hi c h me d i c i ne s are se l e c t e d , pro c ure d , d e l i v e re d , prescribed, administered and reviewed to optimize the contribution that medicines make to producing informed and desired outcomes to enhance the safety and quality of all medicine related processes affecting patients of the hospital to ensure the 7 “rights” are respected: right patient, right dose, right route, right time, right drug with the right information and documentation  1- HOSPITAL PHARMACY 13 Typical work activities include: 1. participating in ward rounds, taking patient drug histories and contributing to the treatment decision-making process - this includes highlighting a drug's potential side effects, identifying harmful interactions with other drugs and assessing the suitability of treatments for patients with particular health conditions. 2. liaising with physicians, nurses and other fellow health care professionals to ensure the delivery of safe, effective and economic drug treatment.  14 3. educate patients about medicines, including appropriate selection, dosage, route of administration and drug interactions, potential side effects and therapeutic effects, particularly those who require complex drug therapy. 4. monitoring every stage of medication therapy to improve all aspects of delivery and reporting patient side effects. 5. communicating effectively with patients' relatives, community pharmacists, general practitioners (GPs), etc.  15 6. ensuring medicinal products are stored appropriately and securely to ensure freshness and potency. 7. ensuring medication reaches the patient in the correct form and dose - this may include tablets, capsules, ointments, injections, inhalers. 8. being responsible for the accurate dispensing and timely distribution of drugs and medicines for inpatients or outpatients. 9. supervising and checking the work of less experienced and less qualified staff.  16 11. responding to medication-related queries from within the hospital, other hospitals and the general public. 12. keeping up to date with, and contributing to, research and development, often in collaboration with medical staff and colleagues in the pharmaceutical industry. 13. writing guidelines for drug use within the hospital, preparing bulletins and implementing hospital regulations. 14. providing information to individual wards on budgets and expenditure on drugs.  17 15. More experienced pharmacists may be involved in teaching, both within the pharmacy department and more widely within the hospital. In teaching hospitals, this may include lecturing clinical staff on various aspects of drug treatment. 16. be involved in researching new medicines. 17. participate in patient safety initiatives including drug use evaluation.  18 19. help deliver initiatives such as Hospital in the Home to help reduce hospital admissions. 20. manage pharmacy services. 21. work in specialist areas such as oncology and cardiology. 22. dispense medicines and formulate special medicine such as individualized medicines required by hospital patients. 


RETAIL PHARMACY

A pharmacy (commonly known as chemist,drugist in Australia, New Zealand and the UK; or drugstore in America and developing countries as well. retail pharmacy in other areas; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed 20 A community or retail pharmacist works according to legal and ethical guidelines to ensure the correct and safe supply of medical products to the general public They are involved in maintaining and improving people's health by providing advice and information, and supplying prescription medicines. Some pharmacists will also offer specialist health check services, such as blood pressure monitoring and diabetes screening. 21 1. Dispensing prescription medicines to the public. 2. Checking dosage and ensuring that medicines are correctly and safely supplied and labelled (pharmacists are legally responsible for any dispensing errors). 3. Supervising the preparation of any medicines (not all are supplied ready made-up by the manufacturer). 4. Keeping a register of controlled drugs for legal and stock control purposes. 5. Liaising with doctors about prescriptions.  22 6. Selling over-the-counter medicines. 7. Counseling and advising the public on the treatment of minor ailments. 8. Advising patients of any adverse side-effects of medicines or potential interactions with other medicines/treatments. 9. Preparing dosette and cassette boxes, usually for the elderly but also for those with memory/learning difficulties, where tablets are placed in compartments for specified days of the week. 10. Monitoring blood pressure and cholesterol levels. 11. Offering a diabetes screening service. 12. Providing pregnancy testing. 13. Overseeing the ordering and safe storage of medical products. 14. Arranging the delivery of prescription medicines to patients. 15. Keeping up to date with current pharmacy practice, new drugs, and their uses. 16. Maintaining computerized records. 17. Managing, supervising and training pharmacy support staff. 18. Selling healthcare and other products, such as toiletries, cosmetics, and photographic items. 19. Budgeting and financial management. 20. Promoting sales and developing the business. 24  3- CLINICAL PHARMACY 25 Closely connected to Hospital Pharmacy. “Clinical pharmacy is a health speciality, which describes the activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of medicinal products and devices.” OR All services provided by the Pharmacist to promote RATIONAL DRUG THERAPY (safe, appropriate and Cost effective)  26 All activities performed by pharmacists in hospitals, community pharmacies, nursing homes, home-based care services, clinics and any other setting where medicines are prescribed and used. The term “clinical” does not necessarily imply an activity implemented in a hospital setting. A community pharmacist may perform clinical activities as well as a hospital practitioner. provide direct patient care services that optimize the use of medication and promote health, wellness, and disease prevention https://youtu.be/mtPlTyV5YsE  27 Clinic al pharmac y movement initially began insid e hospitals and clinics. Clinical pharmacists 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 and work collaboratively in various medical and surgical areas. They often participate in patient care rounds and drug product selection.  CLINICAL PHARMACY - OVERALL 28 GOAL Promote the correct and appropriate use of medicinal products and devices. maximizing the clinical effect of medicines, by using the most effective treatment for each type of patient. minimizing the risk of treatment-induced adverse events, by monitoring the therapy course and the patient’s compliance with therapy. minimizing the expenditures for treatments and trying to provide the best treatment alternative for the greatest number of patients.  PRINCIPLE ACTIVITIES OF CLINICAL
29 PHARMACISTS 1. Consultation:  analyzing therapies, prescription monitoring, advising healthcare practitioners on the appropriateness of drug therapy and providing pharmaceutical care to patients.  ward rounds and clinical meetings promotion of rational drug therapy the time of decision making.  30 2. Selection of drugs:  defining “drug formularies” in collaboration  with doctors and other decision makers. The function of selecting drug therapy is one, which is normally carried out by the medical staff. Pharmacists can provide guidance and recommendations in the form of information and opinion, and are often in a position to influence prescribing. 31 3. Prevention, Assessment and Management of Drug Interactions:  Drug interactions can occur through pharmacokinetic, pharmacodynamic, physical or chemical mechanisms and may result in enhanced action, reduced drug efficacy, increased incidence of adverse effects or misinterpretation of laboratory tests (including therapeutic drug assay). Pharmacists can assist the medical personnel in identifying and solving the drug interactions). 32  33 4. Drug information:  seeking information and critically evaluating scientific literature; organizing services for healthcare practitioners and patients. 5. Formulation and preparation of medicinal products and devices:  according to acceptable standards to meet specific patients’ needs. 6. Drug use studies and research in areas such as:  drug use, pharmacoepidemiology, patient outcomes. 34 7. Pharmacovigilance: monitoring drug safety, collecting and distributing information on adverse events and adverse drug reactions. 8. Pharmacoeconomics: comparing treatment strategies in terms of cost and effectiveness. 9. Pharmacokinetics/therapeutic drug monitoring: studying the kinetics of drugs and optimizing dosage. 10. Clinical trials: planning, evaluating and participating in clinical trials. 35 11. Dispensing and administration of medicinal products and devices: studying and developing systems that can guarantee greater safety in administration, a reduction in expenditure and a reduction in medicine errors. BEFORE AFTER 36 physician physician interaction RX Rx pharmacist DUR patient dispensing patient pharmacist 37





4- INDUSTRIAL PHARMACY  Research ( R &D) Formulation Reformulation Drug-excipient Compatibility Testing Determine proper route of administration of drug Product’s stability including the proper packaging material innovations 38 PRODUCTION Conversion of raw materials to finished products Supervises the operation, CGMP must be observed, planning for production RAW PRODUCTION FINISHED MATERIALS PROCEDURE PRODUCTS QUALITY CONTROL  Qualitative/quantitative checks of RM, intermediate and finished products.  Tests are performed on products  Assay – determine the % purity of active ingredient  Stability testing.  Doumentation etc.  5- SALES AND 41 MARKETING Ambitious achievers with pleasant personality and good communication skills can opt for the job of Medical Sales Representative. Contact prescribers regarding company’s products. Explain product in detail. The companies prefer pharmacy graduates for this job, as they have a good knowledge about the drug molecules, their therapeutic effects and the drug – drug interactions. MBA-Pharm.D combination preferred in Marketing. 42 43  6- DRUG WHOLESALING 44 Important part of distributive scheme, provide mechanism to obtain various prod ucts manufactured by different labs from single agency. Less hazards in stock handling, record keeping and bill paying for the retailer. 7- FORENSIC PHARMACIST 45 Forensic pharmacy overlaps with the criminal justice system and other branches of forensics. Forensic pharmacists play an integral role in legal cases relating to malpractice, drunk and drugged driving and adverse side effects of certain drugs. Forensic pharmacists apply medication sciences to legal issues.  They make be asked to testify in court, consult with lawyers or law enforcement of ficials and engage in any 46 other type of work that bridges medication and the legal system. For example, in a drunk or drugged driving case, they might perform a physical examination of the defendant in the aftermath of the incident, noting his blood alcohol content (BAC). The forensic pharmacist will then be expected to testify in court regarding her f indings. In addition, victims of malpractice, or those who have experienced adverse side effects resulting from a prescription medication, might hire a forensic pharmacist to corroborate their claims to a judge or jury.  8 - VETERINARY PHARMACY 47 Ve t e ri nary pharmac i e s, so me t i me s c al l e d animal pharmacies, may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock d ifferent varieties and d ifferent strengths of medications to fulf il l 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.  9- NUCLEAR PHARMACY 48 Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specif ic to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients. 49 10- EDUCATION 50 Most important segment of pharmacy. Represented by colleges of pharmacy. Responsible for the quality of pharmaceutical education. Knowledge of diffrent physical, biological sciences qualifies a pharmacist to teach. Masteral/ Doctoral degree.  11- RESEARCH 51 discovery/isolation of new drugs for Treatment of diseases. The development of better drugs through chemical modification. Industry or other organizations.  12- PHARMACEUTICAL 52 JOURNALISM People Gifted with writing and editing talents. Scientific journalas. Magazines, brochures, newsletter about different drugs for marketing purposes. Latest researches are published in journals.  13- ORAGANIZATION 53 MANAGEMENT Pharmacist as of ficer of diffrent recognized associations. Prov ides sem inars to keep pharm acist abreast with latest technology. Scientific conferences.  14- PHARMACIST IN GOVERNMENT 54 SERVICE Officer in Army, Navy, Air force. licensing , inspection, registration. research on tropical diseases, public health DTL (analyst, microbiologist) Consultant ( mental health, family planning, p o l l ut i o n, p o i so ns, se l f - m e d i c a t i o n, immunization) 15- INTERNET PHARMACY 55 Online pharmacy, cyber pharmacy or e pharmacy. Many o f these pharmac ies are similar to c o mmunity pharmacies. more convenient and private method rather than traveling to a community drugstore. most internet pharmacies sell prescription drugs and require a v alid pre sc riptio n, so me inte rne t pharmac ie s se ll prescription drugs without requiring a prescription. 56