From Wikipedia,
the free encyclopedia
-
Pharmacy (from the
Greek φάρμακον = drug)
is the
profession charged with
ensuring the safe use of
medication. Traditionally,
pharmacists have compounded and
dispensed medications on the
orders of physicians. More
recently, pharmacy has come to
include other services related to
patient care including
clinical practice, medication
review, and drug information. Some
of these new pharmaceutical roles
are now mandated by law in various
legislatures.
Pharmacists, therefore, are
drug therapy experts, and the
primary health professionals who
optimize medication management to
produce positive health-outcomes.
The
symbols most commonly
associated with pharmacy are the
mortar and pestle and the ℞ (recipere)
character. Pharmacy organisations
often employ other elements, such
as the
Bowl of Hygieia,
conical measures, and
caduceuses in their
logos. Other symbols are
common in different countries such
as the green
Greek cross in
France and
Great Britain, and the
Gaper in
The Netherlands.
Disciplines
The field of Pharmacy can
generally be divided into three
main disciplines:
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 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.
There are various specialties
of pharmacy practice. Some
specialisation is based on the
place of practice including:
community, hospital,
consultant,
locum, drug information,
regulatory affairs, industry, and
academia. Other specialisations
are based on clinical roles
including: nuclear, oncology,
cardiovascular, infectious
disease, diabetes, nutrition,
geriatric, and psychiatric
pharmacy.
Pharmacists
- Main article:
Pharmacist
A pharmacy in
Cherbourg, France.
Pharmacists 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 owners, owning
the pharmacy in which they
practice. This unique
dichotomy is often the subject
of debate within the profession—in
part due to the perception of
pharmacists as "common
shopkeepers" by many in the
community.
Pharmacists are represented
internationally by the
International Pharmaceutical
Federation (FIP). They are
represented at the national level
by professional organisations such
as the
Royal Pharmaceutical Society of
Great Britain (RPSGB), the
Pharmaceutical Society of
Australia (PSA) and
American Pharmacists Association
(APhA). In some cases, the
representative body is also the
registering body, which is
responsible for the
ethics of the profession.
Since the
Shipman Inquiry, there has
been a move in the
UK to separate the two roles.
Pharmacy is a field of science
related to medicine.
Separation of prescribing from
dispensing
In most jurisdictions (such as
the
United States),
pharmacists are regulated
separately from
physicians. Specifically, the
legislation stipulates that the
practice of prescribing must be
separate from the practice of
dispensing. 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.
In the minority of
jurisdictions (particularly in
Asian such as
China,
Malaysia and
Singapore),
doctors are allowed to
dispense
drugs themselves and the
practice of pharmacy is
integrated with that of the
physician.
The reason for the majority
rule is the high risk of a
conflict of interest. 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.
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 percuniary interests may
prove a major stumbling block
(e.g. in
Malaysia).
Community Pharmacy
A pharmacy (commonly the
chemist in
Australia,
New Zealand and the
UK; or drugstore in
North America; 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
grocery stores and
mass merchandisers) now
include a pharmacy as department
of their store.
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.
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. Traditionally, hospital
pharmacies have also prepared
various injectable preparations,
such as saline,
total parenteral nutrition (TPN),
and other drug infusions; but
there has been a trend to
outsource these functions to
specialised pharmaceutical
companies.
Internet Pharmacy
Recently, a number of
pharmacies have begun operating
over the
internet. Many such pharmacies
are, in some ways, similar to
community pharmacies; the primary
difference is the method by which
the medications are requested and
received. Some customers consider
this to be more convenient than
traveling to a community
drugstore.
Some internet pharmacies sell
prescription drugs without
requiring a prescription. Some
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 have also been
reports of such pharmacies
dispensing substandard products.
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.
Although importation of
prescription medication currently
violates
FDA regulations and federal
laws, enforcement is generally
targeted at international drug
suppliers, rather than consumers.
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 cognitive
skills. This paradigm shift has
already commenced in some
countries; for instance,
pharmacists in
Australia receive remuneration
from the
Australian Government for
conducting comprehensive Home
Medicines Reviews. Many
universities are altering their
programs to increase emphasis in
fields such as
pharmacotherapeutics, clinical
pharmacy, nuclear pharmacy,
disease state management, etc. In
Great Britain, pharmacists (and
nurses) who undertake additional
training are obtaining prescribing
rights.
