Pharmacy Orientation (PHT101) PDF

Pharmacy Orientation (PHT101) Introduction Pharmacy Definition: The art and science of preparing and dispensing medications and the provision of drug-related information to the public. It involves: 1. The interpretation of prescription orders; 2. The compo...

Pharmacy Orientation (PHT101) Introduction Pharmacy Definition: The art and science of preparing and dispensing medications and the provision of drug-related information to the public. It involves: 1. The interpretation of prescription orders; 2. The compounding, labeling, and dispensing of drugs and devices; 3. Drug product selection and drug utilization reviews; 4. Patient monitoring and intervention; and 5. The provision of cognitive services related to use of medications and devices. It is also defined as every store or shop licensed by authority where drugs, controlled substances, poisons, medicines or chemicals are stored, possessed, dispensed, sold, displayed for sale, or where prescriptions are compounded or dispensed. Types: Outpatient hospital, community, nuclear, institutional and internet pharmacies. Pharmacist Pharmacist is educated and licensed to dispense drugs and to provide drug information. Pharmacist should be graduated from an accredited School of Pharmacy. 1 Pharmaceutical care The term holds that the important role of the pharmacist is "the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life". No one can imagine how many words of wisdom from pharmacists to patients each day may have prevented unnecessary visits to doctors' offices and gratified countless recipients with precious, professional health counseling. Nature and sources of drugs 1. Plant sources: Parts of plants e.g., castor oil (laxative). 2. Animal sources: Insulin and heparin. 3. Mineral sources: Magnesium sulphate and iodine. 4. Microorganisms: Fungi and bacteria isolated from soil are important sources of antibiotics e.g., penicillin. 5. Synthetic drugs: Produced in the laboratory by synthetic chemist e.g., aspirin, sulphonamide, barbiturate. 6. Biotechnology (Recombinant DNA): Preparation of many complex chemical structure drugs e.g., Human insulin, Vaccines, Antibiotics, Interferon. Classification of drugs 1. Prescription-Only drugs: Drugs prescribed by the physician and dispensed through a prescription. 2  2. OTC drugs: Drugs which the patient can have without prescription i.e., according to his choice or according to the pharmacist advice; such drugs may be referred to as over the counter drugs (OTC drugs). Drug versus medicine: A substance or material, other than food, intended for use in the diagnosis, cure, alleviation, treatment or prevention of disease in humans or other animals, intended to affect the structure or any function of the body of humans or other animals. The “drug” is the active material or the substance having a pharmacological or therapeutic activity. The “medicine” is a drug on a pharmacy store shelf after being mixed with excipients (inactive materials), formulated, packed and labeled. Drugs processed on large scale by pharmaceutical manufacturers are known as "pharmaceutical products", when again dispensed to the patient they are referred to as medicines. Other terms: Drug Product: A dosage form containing one or more active ingredients along with other substances included during the manufacturing process. Excipient: Anything other than the drug substance in the dosage form. Strength: The concentration of the drug in a dosage form Dose: The amount of the drug which is taken each time Dose regimen: The frequency of use of the drug 3 Placebo: A fake treatment that in some cases can produce a very real response. It can also be defined as a substance with no known medical effects, such as sterile water or a sugar, starch or talc pill. Placebo is prescribed for the psychological benefit to the patient rather than for any physiological effect. It is originated when physicians discovered that giving sugar pills to patients could have surprisingly good results. The doctor knows the patient wants treatment, so he gives the patient a pill containing no medication. In some cases, it relieves the symptoms. Today, the use of a placebo would be considered dishonest and unethical. It is commonly used in blind clinical studies that test the effectiveness of new medicines in which one group is given the medicine or treatment being tested, and the other group is not. Participants are not aware of which group they are belonging to. Double blind trials are preferred as they eliminate bias. Quality control Physical or chemical tests used to ensure the required specification of a raw material or a dosage form. Specifications are those given by pharmacopoeia or those of the factory. Stability of a Pharmaceutical product Definition: The ability of the formulation, in a specific container closure system, to remain within the defined physical, chemical, microbiological, therapeutic, and toxicological specifications till the end of the stated dating, under defined storage conditions. 4 Expiration date The date (placed on the container) through which the product is expected to remain within specifications under appropriate storage conditions. It is the time at which 90% of the material remains. Storage Storage describes the safe keeping of starting materials, packaging materials and drug products. Storage conditions The conditions specified for storing the product and include temperature, humidity, container and light. Temperature for storing the product 1. Cold place: Less than 8°C 2. Refrigerator: Between 2°C & 8°C 3. Deep freezer: Less than -10°C 4. Cool place: Between 8°C & 15°C 5. Warm place: Between 30°C & 40°C 6. Room temperature: Between 15°C & 30°C Drug nomenclature 1. Empirical formula, as C15H12N2O2 for phenytoin. 5 2. Chemical name, which is usually a lengthy name as: sodium 5,5-diphenyl-2, 4- imidazolidinedione. It is named according to its chemical structure following IUPAC (International Union of Pure and Applied Chemistry) rules. 3. Code numbers before the assignment of a non-proprietary name. 4. Generic (official, non-proprietary) name when approved: Phenytoin used in the Pharmacopoeia and is called official name. 5. Brand (proprietary or trademark or trade) name: Dilantin. Brand and Generic names When a drug is under patent protection, the company markets it under its brand name. Other companies that file for approval to market the off-patent drug must use the same generic name but create their own brand name. As a result, the same generic drug may be sold under either the generic name or one of many brand names. Generic and brand names must be unique to prevent one drug from being mistaken for another when drugs are prescribed, and prescriptions are dispensed. The medical authorities must agree to every proposed brand name. The term generic, when applied to such items as foods and household products, is used to describe a less expensive, sometimes less effective or lower-quality imitated version of a brand-name product. However, most generic drugs, although less expensive than the comparable brand-name drug, are as effective and of the same quality as the brand-name drug. 6 Name choice: Be short and distinctive in sound and spelling and not easily confused with existing names. It should indicate the general pharmacologic or therapeutic class into which the substance falls. It should also embody the syllable or syllables characteristic of a related group of compounds. e.g., Lopressor lowers blood pressure, Glucotrol controls high blood sugar (glucose) levels, Disflatyl relieves flatulence, etc. General mission for health care “All health care organizations, professional groups, and private and public purchasers should adopt a clear purpose to continually reduce the burden of illness, injury, and disability and to improve the health and functioning of the public”. Aims of health care system quality 1. Effective: Quality health care is effective: this means you will be accurately diagnosed and treated. In some countries, only 35% of patients get the correct diagnosis. 2. Safe: Quality health care is safe: this means that the care you receive does not harm you. Around the world, nearly 14% of patients are harmed from the health care they receive during their hospital stay. 7 3. Patient-centered: This means that decisions about your care are tailored to your needs and preferences and you are treated with respect and compassion. 4. Timely: Quality health care is timely: this means you can see your doctor when you need to, without waiting too long. In some countries: 74% of patients have to wait between 60- 120 minutes to be seen by a doctor. 5. Equitable: This means that all people, regardless to their gender, race, ethnicity, geographical location, socioeconomic status, receive the good quality health care they need. 6. Integrated: If you have multiple chronic diseases, your medicinal care is coordinated across all the doctors and specialists who take care of you. 7. Efficient: This means that your laboratory tests will not be repeated unnecessarily. You will not undergo needless imaging tests. Antibiotics will be prescribed only in the case of confirmed infection. 8 Pharmacist role in the society Pharmacy does not lie just in dispensing medication but in the provision of relevant drug information and drug therapy recommendation to the people in the society. No longer a fixed and rigid profession but has been continuously changing and redefining its meaning and significance and that’s why the bond between a pharmacist and society is becoming stronger day by day and acquiring new dimensions. Consumerism versus Paternalism Paternalism is ‟the belief that the health care professional knew best”. It was accepted as standard practice by most health care professionals and their patients. The medical rights of patients were not as widely recognized as other rights (food, shelter, voting...). Today, patients have become true consumers of medical care. Patients have a right to be informed and ask for their consent. For a health care professional to do otherwise would not only be unprofessional and unethical, but also illegal. Health professionals who fail to meet the demands of medical consumers for care will quickly find themselves without customers and, sometimes, with legal problems. Patient’s rights 1. Pharmacists will employ their knowledge and experience in caring for them. 2. Pharmacists will respond to their wishes about their treatment. 3. Choose their own physician, pharmacy, and hospital. 9 4. Give their approval, through the process of informed consent, prior to the initiation of care. 5. Choose from multiple options of treatment when they exist. 6. Treatment is both safe and effective within given parameters. Pharmaceutical Symbols The serpent of Epidaurus on the staff (rod) of Aesculapius. The bowl of Hygeia with the serpent of Epidaurus. The Caduceus (Satff of Hermes) 10