Pharmacy is the health profession For purposes of finance and management, the healthcare industry is typically divided into several groups and sectors. The Global Industry Classification Standard and the Industry Classification Benchmark divide the industry into two main groups: health care equipment & services and (2) pharmaceuticals, biotechnology & related life sciences that links the health sciences There are two approaches to health science: the study and research of the food that we eat; and the study and research of health-related issues to understand how humans and other animals function, and the application of that knowledge to improve health and to prevent and cure diseases with the chemical sciences Chemistry is the science of matter and the changes it undergoes. The science of matter is also addressed by physics, but while physics takes a more general and fundamental approach, chemistry is more specialized, being concerned with the composition, behavior, structure, and properties of matter, as well as the changes it undergoes during chemical and it is charged with ensuring the safe and effective use of pharmaceutical drugs A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease. The word derives from the Greek Greek , an independent branch of the Indo-European family of languages, is the language of the Greeks. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. In its ancient form, it is the language of classical ancient Greek literature and the New Testament of φάρμακον (pharmakon), "drug, medicine"^[1] (the earliest form of the word is the Mycenaean Greek Mycenaean is the most ancient attested form of the Greek language, spoken on the Greek mainland and on Crete in the 16th to 12th centuries BC, before the hypothesised Dorian invasion which was often cited as the terminus post quem for the coming of the Greek language to Greece. The language is preserved in inscriptions in Linear B, a script first pa-ma-ko, attested in Linear B Linear B is a syllabic script that was used for writing Mycenaean Greek, an early form of Greek. It predated the Greek alphabet by several centuries and seems to have died out with the fall of Mycenaean civilization. Most of the tablets inscribed in Linear B were found in Knossos, Cydonia, Pylos, Thebes and Mycenae. The succeeding period, known as syllabic script^[2]).

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 Health care or healthcare is the treatment and prevention of illness. Health care is delivered by professionals in medicine, dentistry, nursing, pharmacy and allied health, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacists Pharmacists are health professionals who practice the science of pharmacy. In their traditional role, pharmacists typically take a request for medicines from a prescribing health care provider in the form of a medical prescription, evaluate the appropriateness of the prescription, dispense the medication to the patient and counsel them on the, 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 (in the first sense) is practiced is called a pharmacy, chemist's or drug store. These stores commonly sell not only medicines, but also miscellaneous items such as candy (sweets), cosmetics Cosmetics are substances used to enhance the appearance or odor of the human body. Cosmetics include skin-care creams, lotions, powders, perfumes, lipsticks, fingernail and toe nail polish, eye and facial makeup, permanent waves, colored contact lenses, hair colors, hair sprays and gels, deodorants, baby products, bath oils, bubble baths, bath, and magazines Magazines, periodicals, glossies or serials are publications, generally published on a regular schedule, containing a variety of articles, generally financed by advertising, by a purchase price, by pre-paid magazine subscriptions, or all three. Magazines can be distributed through the mail; through sales by newsstands, bookstores or other vendors;, as well as light refreshments or groceries.

The word pharmacy is derived from its root word pharma which was a term used since the 1400–1600s. In addition to pharma responsibilities, the pharma offered general medical advice and a range of services that are now performed solely by other specialist practitioners, such as surgery and midwifery. The pharma (as it was referred to) often operated through a retail shop which, in addition to ingredients for medicines, sold tobacco and patent medicines. The pharmas also used many other herbs not listed.

In its investigation of herbal and chemical ingredients, the work of the pharma may be regarded as a precursor of the modern sciences of chemistry and pharmacology, prior to the formulation of the scientific method.

Disciplines

The field of Pharmacy can generally be divided into three primary disciplines:

• Pharmaceutics Pharmaceutics is the discipline of pharmacy that deals with all facets of the process of turning a new chemical entity into a medication able to be safely and effectively used by patients in the community. Pharmaceutics is the science of dosage form design. There are many chemicals with known pharmacological properties but a raw chemical is of no
• Medicinal chemistry Medicinal or pharmaceutical chemistry is a discipline at the intersection of chemistry and pharmacology involved with designing, synthesizing and developing pharmaceutical drugs. Medicinal chemistry involves the identification, synthesis and development of new chemical entities suitable for therapeutic use. It also includes the study of existing and Pharmacognosy Pharmacognosy is the study of medicines derived from natural sources. The American Society of Pharmacognosy defines pharmacognosy as "the study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs or drug substances of natural origin as well as the search for new drugs from natural
• Pharmacy practice

The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut; and often, collaborative teams from various disciplines research together.

Pharmacology Pharmacology is the study of drug action. (At the same time, φάρμακος, pharmakos, means: whipping-boy.) More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function. If substances have medicinal properties, they are considered pharmaceuticals is sometimes considered a fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Therefore it is usually considered to be a field of the broader sciences Science is a systematic enterprise of gathering knowledge about nature and organizing and condensing that knowledge into testable laws and theories. As knowledge has increased, some methods have proved more reliable than others, and today the scientific method is the standard for science. It includes the use of careful observation, experimentation,.

Other specializations in pharmacy practice recognized by the Board of Pharmaceutical Specialties include: cardiovascular, infectious disease An infectious disease is a clinically evident illness resulting from the presence of pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are able to cause disease in animals and/or plants. Infectious pathologies are also, oncology Oncology (from the Ancient Greek onkos , meaning bulk, mass, or tumor, and the suffix -logy (-λογία), meaning "study of") is a branch of medicine that deals with tumors (cancer). A medical professional who practices oncology is an oncologist, pharmacotherapy, nuclear, nutrition Nutrition is the provision, to cells and organisms, of the materials necessary (in the form of food) to support life. Many common health problems can be prevented or alleviated with a healthy diet, and psychiatry Psychiatry is the medical specialty devoted to the study and treatment of mental disorders—which include various affective, behavioural, cognitive and perceptual disorders. The term was first coined by the German physician Johann Christian Reil in 1808. It literally means the 'medical treatment of the mind' . A medical doctor specializing in.^[3] The Commission for Certification in Geriatric Pharmacy The Commission for Certification in Geriatric Pharmacy is a non-profit organization which has established a voluntary professional certification program for pharmacists. Pharmacists must pass a written examination to become certified and must re-certify every five years. Candidates are expected to be knowledgeable about principles of geriatric certifies pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology Toxicology is the study of the adverse effects of chemicals on living organisms. It is the study of symptoms, mechanisms, treatments and detection of poisoning, especially the poisoning of people.

Pharmacists

Pharmacists Pharmacists are health professionals who practice the science of pharmacy. In their traditional role, pharmacists typically take a request for medicines from a prescribing health care provider in the form of a medical prescription, evaluate the appropriateness of the prescription, dispense the medication to the patient and counsel them on the are highly-trained and skilled healthcare professionals who perform various roles to ensure optimal health outcomes for their patients. Many pharmacists are also small-business A small business is a business that is privately owned and operated, with a small number of employees and relatively low volume of sales. Small businesses are normally privately owned corporations, partnerships, or sole proprietorships. The legal definition of "small" varies by country and by industry. In the United States the Small owners, owning the pharmacy in which they practice.

Pharmacists are represented internationally by the International Pharmaceutical Federation The International Pharmaceutical Federation or Fédération Internationale Pharmaceutique, abbreviated as FIP, is an international federation of national organisations that represent pharmacists and pharmaceutical scientists. It was founded in 1912 and is based in The Hague in the Netherlands (FIP). They are represented at the national level by professional organisations A professional association is a non-profit organization seeking to further a particular profession, the interests of individuals engaged in that profession, and the public interest such as the Dutch Pharmacists Association (VNA) Royal Pharmaceutical Society of Great Britain The Royal Pharmaceutical Society of Great Britain is the statutory regulatory and professional body for pharmacists and Pharmacy Technicians in England, Scotland and Wales. Its headquarters are at 1 Lambeth High Street, in the London Borough of Lambeth, there are also offices in Cardiff and Edinburgh (RPSGB), the Pharmacy Guild of Australia (PGA), the Pakistan Pharmacists Society The Pakistan Pharmacists Society is the national organization of pharmacists and student pharmacists, committed to providing leadership for the pharmacists. PPS has a mission to promote and expand the profession of pharmacy and the role of pharmacists in Pakistan. PPS is dedicated to improve public health and patient care by enhancing professional (PPS) and the American Pharmacists Association (APhA). See also: List of pharmacy associations The following is a list of organizations for professionals involved in the practice of pharmacy. Such organizations are typically professional societies, as opposed to trade associations.

In some cases, the representative body is also the registering body, which is responsible for the ethics Ethics is a branch of philosophy that addresses questions about morality—that is, concepts such as good vs. bad, noble vs. ignoble, right vs. wrong, and matters of justice, love, peace, and virtue of the profession. Since the Shipman Inquiry, there has been a move in the UK The United Kingdom of Great Britain and Northern Ireland[note 7] is a sovereign state located off the northwestern coast of continental Europe. It is an island country, spanning an archipelago including Great Britain, the northeastern part of the island of Ireland, and many small islands. Northern Ireland is the only part of the UK with a land to separate the two roles.

History of pharmacy

Paleopharmacological studies attest to the use of medicinal plants in pre-history.^[4]

The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita The Sushruta Samhita is a Sanskrit redaction text on all of the major concepts of ayurvedic medicine with innovative chapters on surgery, attributed to Sushruta. He is widely considered the "Father of Surgery", an Indian Ayurvedic treatise Ayurveda Ayurvedic medicine is a system of traditional medicine native to the Indian subcontinent and practiced in other parts of the world as a form of alternative medicine. In Sanskrit, the word ayurveda consists of the words āyus, meaning "longevity", and veda, meaning "related to knowledge" or "science". Evolving attributed to Sushruta The Sushruta Samhita is a Sanskrit redaction text on all of the major concepts of ayurvedic medicine with innovative chapters on surgery, attributed to Sushruta. Cataract surgery was performed by Sushruta before 800 BC in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.

Many Sumerian Cuneiform script is the earliest known writing system in the world. Cuneiform writing emerged in the Sumerian civilization of southern Iraq around the 34th century BC during the middle Uruk period, beginning as a pictographic system of writing. Cuneiform was the most widespread and historically significant writing system in the Ancient Near East (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets From the 4th millennium BCE in the Sumerian, Babylonian, Assyrian and Hittite civilizations of the Mesopotamia region, cuneiform characters were imprinted on a wet clay tablet with a stylus often made of reed. Once written upon, many tablets were dried in the sun or air, remaining fragile. Later, these unfired clay tablets could be soaked in water record prescriptions for medicine.^[5]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus The Ebers Papyrus of about 1550 BC is among the most important medical papyri of ancient Egypt. It is also commonly called Papyrus Ebers . It is one of the two oldest preserved medical documents anywhere, the other main source being the Edwin Smith papyrus (around 1600 BC). Another important medical papyrus is the Brugsch Papyrus (around 1300 BC) of 1550 BC, and the Edwin Smith Papyrus The Edwin Smith Papyrus is the only surviving copy of part of an Ancient Egyptian textbook on trauma surgery. It is among the world's earliest surviving examples of medical literature, the Kahun Gynecological Papyrus being older, and is the world's oldest surgical document. Written in the hieratic script of the ancient Egyptian language around the of the 16th century BC.

The earliest known Chinese manual on materia medica Materia medica is a Latin medical term for the body of collected knowledge about the therapeutic properties of any substance used for healing . In Latin, the term literally means "medical material/substance". The term was used from the period of the Roman Empire until the twentieth century, but has now been generally replaced in medical is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty The Han Dynasty was the second imperial dynasty of China, preceded by the Qin Dynasty (221–206 BCE) and succeeded by the Three Kingdoms (220–265 CE). It was founded by the peasant rebel leader Liu Bang, known posthumously as Emperor Gaozu of Han. It was briefly interrupted by the Xin Dynasty (9–23 CE) of the former regent Wang Mang. This and was attributed to the mythical Shennong Shennong , also known as the Emperor of the Five Grains (simplified Chinese: 五谷先帝; traditional Chinese: 五穀先帝; pinyin: Wǔgǔ xiāndì), was a ruler of China and cultural hero who lived some 5,000 years ago and who taught the ancient Chinese the practices of agriculture. Appropriately, his name means "the Divine Farmer". Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui Mawangdui is an archaeological site located in Changsha, China. The site consists of two saddle-shaped hills and contained the tombs of three people from the western Han Dynasty. The tombs belonged to the first Marquis of Dai, his wife, and a male who is believed to be their son. The site was excavated from 1972 to 1974. Most of the artifacts from tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China Pharmacy in China involves the activities engaged in the preparation, standardization and dispensing of drugs, and its scope includes the cultivation of plants that are used as drugs, the synthesis of chemical compounds of medicinal value, and the analysis of medicinal agents. Pharmacists in China are responsible for the preparation of the dosage article.

The Greek physician Pedanius Dioscorides Pedanius Dioscorides was an ancient Greek physician, pharmacologist and botanist from Anazarbus, Cilicia, Asia Minor, who practised in ancient Rome during the time of Nero. He had the opportunity to travel extensively seeking medicinal substances from all over the Roman and Greek world is famous for writing a five volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translation De Materia Medica (Concerning medical substances) was used a basis for many medieval texts, and was built upon by many middle eastern scientists during the Islamic Golden Age The Islamic Golden Age is traditionally dated from the mid-8th to the mid-13th century A.D. although it has been extended by one scholar to at least the 15th century. During this period, artists, engineers, scholars, poets, philosophers, geographers and traders in the Islamic world contributed to agriculture, the arts, economics, industry, law,. The title coined the term materia medica Materia medica is a Latin medical term for the body of collected knowledge about the therapeutic properties of any substance used for healing . In Latin, the term literally means "medical material/substance". The term was used from the period of the Roman Empire until the twentieth century, but has now been generally replaced in medical.

In Japan, at the end of the Asuka period The Asuka period , was a period in the history of Japan lasting from 538 to 710 (or 592-645), although its beginning could be said to overlap with the preceding Kofun period. The Yamato polity evolved much during the Asuka period, which is named after the Asuka region, about 25 km south to the modern city of Nara (538-710) and the early Nara period (710-794), the men who fulfilled roles similar to those of modern pharmacists were highly respected. The place of pharmacists in society was expressly defined in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.^[6]

There is a stone sign for a pharmacy with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey. http://www.pbase.com/tsechien/ephesus_ has photos. The current Ephesus dates back to 400BC and was the site of the Temple of Artemis one of the seven wonders of the world, the home of Mark Anthony and Cleopatra, Mary Magdalen and where St Paul read his letter to the Ephesians.

In Baghdad the first pharmacies, or drug stores, were established in 754,^[7] under the Abbasid Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were state-regulated.^[8]

The advances in made in the Middle East in botany and chemistry led medicine in medieval Islam substantially to develop pharmacology. Muhammad ibn Zakarīya Rāzi (Rhazes) (865-915), for instance, acted to promote the medical uses of chemical compounds. Abu al-Qasim al-Zahrawi (Abulcasis) (936-1013) pioneered the preparation of medicines by sublimation and distillation. His Liber servitoris is of particular interest, as it provides the reader with recipes and explains how to prepare the `simples’ from which were compounded the complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to initiate pharmacopoedia, describing a large variety of drugs and remedies for ailments. Al-Biruni (973-1050) wrote one of the most valuable Islamic works on pharmacology entitled Kitab al-Saydalah (The Book of Drugs), where he gave detailed knowledge of the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Ibn Sina (Avicenna), too, described no less than 700 preparations, their properties, mode of action and their indications. He devoted in fact a whole volume to simple drugs in The Canon of Medicine. Of great impact were also the works by al-Maridini of Baghdad and Cairo, and Ibn al-Wafid (1008-1074), both of which were printed in Latin more than fifty times, appearing as De Medicinis universalibus et particularibus by `Mesue' the younger, and the Medicamentis simplicibus by `Abenguefit'. Peter of Abano (1250-1316) translated and added a supplement to the work of al-Maridini under the title De Veneris. Al-Muwaffaq’s contributions in the field are also pioneering. Living in the 10th century, he wrote The foundations of the true properties of Remedies, amongst others describing arsenious oxide, and being acquainted with silicic acid. He made clear distinction between sodium carbonate and potassium carbonate, and drew attention to the poisonous nature of copper compounds, especially copper vitriol, and also lead compounds. He also describes the distillation of sea-water for drinking.^[9]

In Europe pharmacy-like shops began to appear during the 12th century. In 1240 emperor Frederic II issued a decree by which the physician's and the apothecary's professions were separated.^[10] The first pharmacy in Europe (still working) was opened in 1241 in Trier, Germany.^{[citation needed]}

In Europe there are old pharmacies still operating in Dubrovnik, Croatia located inside the Franciscan monastery, opened in 1317 ; and one in the Town Hall Square of Tallinn, Estonia dating from at least 1422. The oldest is claimed to be set up in 1221 in the Church of Santa Maria Novella in Florence, Italy, which now houses a perfume museum. The medieval Esteve Pharmacy, located in Llívia, a Catalan enclave close to Puigcerdà, is also now a museum dating back to the 15 century, keeping albarellos from the 16th and 17th centuries, old prescription books and antique drugs.

Types of pharmacy practice areas

Pharmacists practice in a variety of areas including retail, hospitals, clinics, nursing homes, drug industry, and regulatory agencies. Pharmacists can specialize in various areas of practice including but not limited to: hematology/oncology, infectious diseases, ambulatory care, nutrition support, drug information, critical care, pediatrics, etc.

Community pharmacy

A pharmacy (commonly the chemist in Australia, New Zealand and the UK; or drugstore in North America; retail pharmacy in industry terminology; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers.

Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications; there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients.

All pharmacies are required to have a pharmacist on-duty at all times when open. In many jurisdictions, it is also a requirement that the owner of a pharmacy must be a registered pharmacist (R.Ph.). This latter requirement has been revoked in many jurisdictions, such that many retailers (including supermarkets and mass merchandisers) now include a pharmacy as a department of their store.

Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional items such as cosmetics, shampoo, office supplies, confections, snack foods, durable medical equipment, greeting cards, and provide photo processing services.

Hospital pharmacy

Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues.

Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) and patient compliance issues (in the hospital and at home) many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy. For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care, emergency medicine, toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics, herbal medicine, neurology/epilepsy management, pediatrics, neonatal pharmacists and more.

Hospital pharmacies can usually be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology, combined with the potential impact of medications and pharmacy services on patient-care outcomes and patient safety, make it imperative that hospital pharmacies perform at the highest level possible.

Clinical pharmacy

Dr Sajad Issop of Airedale General Hospital explains: Clinical pharmacists provide direct patient care services that optimizes the use of medication and promotes health, wellness, and disease prevention.^[11] Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often 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. They work collaboratively with physicians, nurses and other healthcare personnel in various medical and surgical areas. They often participate in patient care rounds and drug product selection. In most hospitals in the United States, potentially dangerous drugs that require close monitoring are dosed and managed by clinical pharmacists.

Compounding pharmacy

Compounding is the practice of preparing drugs in new forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated lollipop that contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead.

Another form of compounding is by mixing different strengths,(g,mg,mcg)of capsules or tablets to yield the desire therapy indicated by the doctor. This form of compounding is found at community or hospital pharmacies or in-home administration therapy.

Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies.

Consultant pharmacy

Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work in nursing homes, but are increasingly branching into other institutions and non-institutional settings.^[12] Traditionally consultant pharmacists were usually independent business owners, though in the United States many now work for several large pharmacy management companies (primarily Omnicare, Kindred Healthcare and PharMerica). This trend may be gradually reversing as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services.

The main principle of consultant pharmacy is pharmaceutical care developed by Hepler and Strand in 1990.^[13][14]

Internet pharmacy

Since about the year 2000, a growing number of internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as Online Pharmacies) are also recommended to some patients by their physicians if they are homebound.

While most internet pharmacies sell prescription drugs and require a valid prescription, some internet pharmacies sell prescription drugs without requiring a prescription. Many customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There also have been reports of such pharmacies dispensing substandard products.^{[citation needed]}

Of particular concern with internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin, generically known as hydrocodone) via the internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are many instances where a practitioner issues a prescription, brokered by an internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship.

Canada is home to dozens of licensed internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers, who pay one of the world's highest drug prices.^{[citation needed]} In recent years, many consumers in the US and in other countries with high drug costs, have turned to licensed internet pharmacies in India, Israel and the UK, which often have even lower prices than in Canada.

In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.

Recently-developed online services like Australia's Medicine Name Finder and the Walgreens' Drug Info Search provide information about pharmaceutical products but do not offer prescriptions or drug dispensations. These services often promote generic drug alternatives by offering comparative information on price and effectiveness.

Veterinary pharmacy

Veterinary pharmacies, sometimes called animal pharmacies, may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill 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.

Nuclear pharmacy

Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients.

Military pharmacy

Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal. State laws of Technician patient counseling and medication checking by a pharmacist do not apply.

Pharmacy informatics

Pharmacy informatics is the combination of pharmacy practice science and applied information science. Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or for healthcare information technology vendor companies. As a practice area and specialist domain, pharmacy informatics is growing quickly to meet the needs of major national and international patient information projects and health system interoperability goals. Pharmacists are well trained to participate in medication management system development, deployment and optimization.

Issues in pharmacy

Separation of prescribing from dispensing

In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments. However, the American Medical Association (AMA) Code of Ethics provides that physicians may dispense drugs within their office practices as long as there is no patient exploitation and patients have the right to a written prescription that can be filled elsewhere. 7 to 10 percent of American physicians practices reportedly dispense drugs on their own.^[15]

In some rural areas in the United Kingdom, there are dispensing doctors ^[16] who are allowed to both prescribe and dispense prescription-only medicines to their patients from within their practices. The law requires that the GP practice be located in a designated rural area and that there is also a specified, minimum distance (currently 1.6 kilometres) between a patient's home and the nearest retail pharmacy.

In other jurisdictions (particularly in Asian countries such as China, Malaysia, and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is sometimes integrated with that of the physician, particularly in traditional Chinese medicine.

In Canada it is common for a medical clinic and a pharmacy to be located together and for the ownership in both enterprises to be common, but licensed separately.

The reason for the majority rule is the high risk of a conflict of interest and/or the avoidance of absolute powers. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects. This system reflects much similarity to the checks and balances system of the U.S. and many other governments.

A campaign for separation has begun in many countries and has already been successful (like in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia).

The future of pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists will be paid for their patient care skills.^[17]

Medication Therapy Management (MTM)- A practice of pharmacy currently being taught at schools of pharmacy nationwide includes the clinical services that pharmacists can provide for their patients. Such services include the thorough analysis of all medication (prescription, non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system.^[18]

This shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. In Canada, pharmacists in certain provinces have limited prescribing rights (as in Alberta and British Columbia) or are remunerated by their provincial government for expanded services such as medications reviews (Medschecks in Ontario). In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights. They are also being paid for by the government for medicine use reviews. In the United States, pharmaceutical care or clinical pharmacy has had an evolving influence on the practice of pharmacy.^[11] Moreover, the Doctor of Pharmacy (Pharm. D.) degree is now required before entering practice and some pharmacists now complete one or two years of residency or fellowship training following graduation. In addition, consultant pharmacists, who traditionally operated primarily in nursing homes are now expanding into direct consultation with patients, under the banner of "senior care pharmacy."^[19]

See also

• American Society for Pharmacy Law
• Apothecary
• Bachelor of Pharmacy, Master of Pharmacy, Doctor of Pharmacy
• Classification of Pharmaco-Therapeutic Referrals
• Clinical pharmacy
• Consultant pharmacist
• Evidence-based pharmacy in developing countries
• Hospital pharmacy
• International Pharmaceutical Federation
• International Pharmaceutical Students’ Federation
• List of pharmacies
• List of pharmacy associations
• List of pharmacy organizations in the United Kingdom
• List of pharmacy schools
• Nuclear pharmacy
• Online pharmacy
• Pharmaceutical company
• Pharmacogenetics
• Pharmacogenomics
• Pharmacognosy
• Pharmacology
• Pharmaconomist
• Pharmacy residency
• Pharmacy informatics
• Professional Further Education in Clinical Pharmacy and Public Health
• Raeapteek (one of the oldest continuously run pharmacies in Europe dating from the 15th century)

Symbols

The two symbols most commonly associated with pharmacy are the mortar and pestle and the ℞ (recipere) character, which is often written as "rx" in typed text. The show globe was also used in English speaking countries until the early 20th century. Pharmacy organizations often use other symbols, such as the Bowl of Hygieia which is often used in the Netherlands, conical measures, and caduceuses in their logos. Other symbols are common in different countries: the green Greek cross in France, Argentina, the United Kingdom, Belgium, Italy and Spain, the increasingly-rare Gaper in the Netherlands, and a red stylized letter A in Germany and Austria (from Apotheke, the German word for pharmacy, from the same Greek root as the English word 'apothecary').

Notes

1. ^ φάρμακον, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library
2. ^ Palaeolexicon, Word study tool of ancient languages
3. ^ Board of Pharmaceutical Specialties, Current Specialties
4. ^ Ellis, Linda (2000). Archaeological Method and Theory: An Encyclopedia. Taylor & Francis. pp. 443–448. ISBN 9780815313052.
5. ^ John K. Borchardt (2002). "The Beginnings of Drug Therapy: Ancient Mesopotamian Medicine". Drug News & Perspectives 15 (3): 187–192. doi:10.1358/dnp.2002.15.3.840015. ISSN 0214-0934. PMID 12677263.
6. ^ Titsingh, Isaac. (1834) Annales des empereurs du japon, p. 434.
7. ^ Hadzovic, S (1997). "Pharmacy and the great contribution of Arab-Islamic science to its development" (in Croatian). Medicinski Arhiv 51 (1-2): 47–50. ISSN 0025-8083. OCLC 32564530. PMID 9324574.
8. ^ al-Ghazal, Sharif Kaf (October 2003). "The valuable contributions of Al-Razi (Rhazes) in the history of pharmacy during the Middle Ages" (pdf). Journal of the International Society for the History of Islamic Medicine 2 (4): 9–11. ISSN 1303-667X. OCLC 54045642. http://www.ishim.net/ishimj/4/02.pdf.
9. ^ Levey M. (1973), ‘ Early Arabic Pharmacology’, E. J. Brill; Leiden.
10. ^ History of Pharmacy Web Pages - Sweden´s oldest pharmacies
11. ^ ^{a b} American College of Clinical Pharmacy, Clinical Pharmacy Defined
12. ^ American Society of Consultant Pharmacists, Frequently Asked Questions
13. ^ Strand LM (1990). "Pharmaceutical care and patient outcomes: notes on what it is we manage". Top Hosp Pharm Manage. 10 (2): 77–84. PMID 10128568.
14. ^ Hepler CD, Strand LM (1990). "Opportunities and responsibilities in pharmaceutical care". Am J Hosp Pharm. 47 (3): 533–43. PMID 2316538.
15. ^ American Association of State Compensation Insurance Funds, Prepackaged Drugs in Workers' Compensation
16. ^ British Medical Association, briefing on dispensing doctors, 30 January 2009 [1]
17. ^ American College of Clinical Pharmacy, Evidence of the Economic Benefit of Clinical Pharmacy Services: 1996–2000
18. ^ American Pharmacy Student Alliance (APSA)
19. ^ American Society of Consultant Pharmacists, What is a Senior Care Pharmacist?

References

• Watkins, Elizabeth Siegel, “From History of Pharmacy to Pharmaceutical History,” Pharmacy in History, 51 (no. 1, 2009), 3–13.
• (Japanese) Asai,T. (1985). Nyokan Tūkai. Tokyo: Kōdan-Sha.
• (French) Titsingh, Isaac, ed. (1834). [Siyun-sai Rin-siyo/Hayashi Gahō, 1652], Nipon o daï itsi ran; ou, Annales des empereurs du Japon. Paris: Oriental Translation Fund of Great Britain and Ireland....Click link for digitized, full-text copy of this book (in French)
• High Performance Pharmacy - A landmark study in hospital pharmacy performance based on an extensive literature review and the collective experience of the Health Systems Pharmacy Executive Alliance.

External links

• Navigator History of Pharmacy Collection of internet resources related to the history of pharmacy
• RPSGB Museum Information Sheets Illustrated information sheets on objects in the history of pharmacy
• History of Pharmacy Web Pages Perbo's History of Pharmacy Web Pages
• Soderlund Pharmacy Museum - Information about the history of the American Drugstore
• The Lloyd Library Library of botanical, medical, pharmaceutical, and scientific books and periodicals, and works of allied sciences
• American Institute of the History of Pharmacy American Institute of the History of Pharmacy—resources in the history of pharmacy
• International Pharmaceutical Federation (FIP) Federation representing national associations of pharmacists and pharmaceutical scientists. Information and resources relating to pharmacy education, practice, science and policy
• Pharmaboard FSR BioPharm German association of pharmacy students

Other

• The Virtual Library of Pharmacy - Extensive index of pharmacy-related resources, including information on careers in pharmacy, pharmacy schools, pharmaceutical companies, associations and conferences.

Categories: Pharmacy | Medicinal chemistry | Greek loanwords

See Also:

• Pharmaceuticals Policy
• Pharmacy: Encyclopedia
• Pharmacist: Encyclopedia
• Health: Pharmacy: Directory
• Pharmacovigilance: Encyclopedia

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