Introduction
Pharmacy was considered as the art of science and practice
of preparing, preserving, compounding and dispensing of drugs. Later on,
due to the development of the various pharmaceutical services the term
pharmacy was re-defined, as patient oriented health services that applies a scientific
body of knowledge to improve and promote health, through assurance of safety and
efficiency in drug usage and related therapy.
The Traditional role of pharmacists was to compound the medicines
as per the directions of the apotehcaries. Later on, due to the complexity of the
disease state, polypharmacy started. So the workload of pharmacists
(so called compounders) tremendously increased. At the same time,
with the development of pharmaceutical industries, specific and potent synthetic
drugs in different dosage forms were marketed.
There after, the role of pharmacist changed into dispensing of
drugs, as per the prescription of a registered Medical Practitioner . As the number
of drugs increased and pharmaceutical services developed, the role of a
pharmacist changed into a number of areas where the pharmacist’s scientific
knowledge regarding medicines were properly utilized.
The important areas where the pharmacists are employed, are -
- Regulatory Control and Drug Management
- Community Pharmacy
- Hospital Pharmacy
- Clinical Pharmacy
- Pharmaceutical Industries
- Academic Institutions
- Training Centres
- Research Centers
REGULATORY CONTROL AND DRUG MANAGEMENT
Health and Drug Policy
Each Government, in all the countries have a Department
dealing with Pharmacy and Pharmaceutical affairs. Pharmacists employed in
Administrative Section
- Participate in formulating drug and health policies particularly those
on the selection, procurement and distribution of drugs
- They serve as source of information for health care professionals
and to the public
- They participate in the preparation of pharmacopoeias and other official
publications
- They cooperate with educators and the professional body of pharmacists in
establishing and modifying the academic programmes of pharmacy education
- In some countries, pharmacists have a role to play in environmental health
control and
in the control of quality of food, cosmetics and medicinal devices.
Regulatory and enforcement agencies
Pharmacists are employed by regulatory agencies concerned with
approval, registration and quality control of drugs, cosmetics and medicinal devices.
The regulatory agencies work through enforcement agencies including drug control departments,
customs departments etc.these departments have inspectors to check manufacturing, import,
distribution and sale of drugs
Professional registration authorities
Pharmacists are prominently engaged in agency such as Pharmacy
Council that establish criteria for registration of Pharmacists or licensing required
and monitor the way Pharmacies are operated and the professional conduct of Pharmacists.
International agencies and professional bodies
Pharmacists employed in these bodies perform a variety of technical
and administrative functions in professional bodies and in drug and health related
agencies like WHO, International Narcotic Control Board etc
COMMUNITY PHARMACY
The term community refers to a group of persons living in a locality
who share some common interest and privileges. Community pharmacy is defined as the
pharmacy services established in a community.
Community Pharmacists are the health professionals most accessible
to the public. They supply medicine in accordance with a prescription or when legally
permitted, sell them with a prescription .In addition to ensuring an accurate supply of
appropriate products, their professional activities also cover counseling patients at the
time of dispensing of the prescription and non prescription of drugs, drug information to
the health professionals, patients and the general public. They also participate in health
promoting programs.
Apart from the normal drugs, there is also heterogeneous group
of medical devices, which include some products analogue to medicines like dressing materials,
wound management products etc. which need special knowledge with regard to their use
and risks are handled by Community Pharmacists.
The important activities of pharmacists are described below -
Processing of Prescriptions
The Pharmacists verifies the legality, safety and appropriateness of
the prescription order, check the patient medication record before dispensing
the prescribed medicines to ensure that the medicines are in accordance with the previous
drug or disease history and treatment.
Monitoring drug utilization
The Pharmacist can participate in the arrangements for formatting
that utilization of drugs such as practice research projects and schemes to analyze
prescriptions for the monitoring of adverse drug reactions.
Extemporaneous preparations
According to the need of the patient, pharmacists prepare medicines
in the Pharmacy as per the official formulation techniques. In some countries Pharmacists
engage in the small scale manufacture of medicines in accordance with Goods Manufacturing
Practice (GMP) and distribution practice guide lines.
Drug information
The pharmacist compiles and maintains information on
all medicines and particularly on newly introduced medicines. The pharmacist
provides the informations necessary to the patient and other health care professional
and use it in promoting rational use of drugs by proving advice and explanations to
Physicians and to members of the public.
Health promotion
The pharmacist take part in health promotion campaign
locally and nationally on a wide range of health related topics, particularly on drug
related topics like rational use of drugs, alcohol abuse, care to be taken during pregnancy,
treatment and prevention of diseases like diarrhoea, tuberculosis and AIDS etc.
The pharmacist also takes part in educating local community on immunization,
physical exercise to maintain good health etc.
Domiciliary services
In many countries Community Pharmacist provides as advisory
and some time distributory services to elderly residents and patients on term treatment
of chronic diseases. In some countries policies are developed to provide counseling
services to such patients who are unable to visit the pharmacy.
Agricultural and veterinary services
Community pharmacist supply medicines and medicated substances, animal feeds etc for the agricultural and veterinary purposes.
COMMUNITY PHARMACY SERVICES IN INDIA
In India, we don’t have community pharmacy establishment
having the above standards. We have about four lakhs medical stores throughout
India selling allopathic medicines.
In an Indian set-up where communities are thickly
populated and most of them are poor and illiterate, community pharmacists
can work to achieve the objects and aims centered at the benefits of the patients
and the community. The pharmacist in the community pharmacy practice should be committed
to the highest conceivable standards of professional conduct and ethics.
Apart from the dispensing of medicines the community pharmacist has a greater
role in patient counseling to get better therapeutic effectiveness and to prevent
the misuse of drugs and to increase the patient compliance.
The Community Pharmacists should feel themselves proud
in wearing the identity and uniform. They should have the facilities to update
their knowledge. They should attend re-orientation and continuing pharmacy practice.
Since the community pharmacists are more exposed to the public than hospital or
clinical pharmacists, they should develop extra skill to communicate with patients and public.
Community pharmacist should also provide additional information
like insulin injection training to diabetic patients, use of inhalers to asthmatic
patients, blood pressure measurements and normal biochemical data. The community pharmacist can also provide proper directions about financial aspects related to the therapy like reimbursement, medical insurance etc.
HOSPITAL PHARMACY
As the name implies the pharmacies are established in hospitals.
Basically most of the activities may be similar to those performed by community pharmacist,
but they differ in a number of ways.
- Hospital Pharmacist has more opportunity to interact closely with the prescriber and
therefore to promote rational use of drugs.
- They serve as a member of policy-making committee like DTC.
- They control hospital pharmacy manufacturing unit to ensure quality.
Functions of Hospital pharmacist
- General activities
The general activities include selection, purchase, store, distribution, compounding, manufacturing, quality control, quality assurance, inventory control etc of drugs and pharmaceuticals.
Professionally managed drug distribution is a vital key to pharmacy practice.
Ward pharmacy and unit dose dispending are the new techniques of drug distribution to in patients. In multispeciality hospitals with different blocks, satellite pharmacies are established for easy availability drugs.
Teaching and training
This includes in-house training for pharmacy students, fresh pharmacists, seminars for pharmacists and other healthcare professionals, continuing pharmacy education, arrangements of workshop etc.
- Special activities
- Institutional
Participating in PTC, hospital formulary committee, contribute to the Drug bulletin. Involve in preparing protocols and policies for drugs and related issues.
- Patient Oriented
Provide pharmaceutical care through various pharmacies like ward pharmacy, satellite pharmacy, causality pharmacy etc.
CLIINICAL PHARMACY
Pharmacy service became more patient oriented through the development of hospital pharmacy service in developed countries. Clinical Pharmacy is the applied pharmaceutical care to bedside. It deals not only with the dispensing of drugs but also counseling the patient on the safe and rational use of drugs.
The important functions of clinical pharmacist are,
- On admission of the patient he must obtain and prepare patient medication history
- During diagnosis by the physician, clinical pharmacist help in getting required clinical investigation data.
- Recommend appropriate drug and dosage regimens
- Dispensing of the prescribed drugs
- Patient counseling and patient education
- Monitoring of the drug therapy by
- Patient prescription review
- Pharmacokinetic evaluation
- Study and report patient compliance and feedback after discharge of the patient from the hospital.
- Drug information to medical staff and other health care professionals.
- Involve in total parenteral nutrition (TPN).
- Undertake clinical trials of new drugs along with clinicians.
- Undertake pharmacokinetic studies of drugs.
CLINICAL PHARMACY SERVICES IN INDIA
The scope of clinical pharmacy is immense. But unfortunately clinical pharmacy is still in the primitive level in India. Important barriers or constraints on the implementation of the clinical pharmacy services in India are
- Non-availability of hospital oriented education and training facilities in clinical pharmacy.
- Isolation of pharmacist from other health care professional due to lack of interactions with them.
- Pharmacists are not aware about the contributions that they can provide to health Care.
INDUSTRIAL PHARMCY
The main activities of pharmacist in pharmaceutical industry are
Manufacturing and quality assurance
In some countries it is statutory that any drug-manufacturing unit should have pharmacist in charge for the manufacturing and quality control departments.
The pharmaceutical broad knowledge of pharmaceutical services ensures an integrated approach to good manufacturing practice and quality assurance.
Research and development
Pharmacist contributes to the drug research and formulation development particularly on bioavaliability and pharmaco kinetic studies.
Clinical trials and post marketing surveillance
Pharmacist utilizes his basic knowledge of drugs and health care provisions required to facilitate clinical trials of new drugs and surveillance of drugs in the markets.
The pharmacist facilitates collaboration between companies, health care professionals and government or other regulatory bodies to carryout these work.
Patent application and drug registration
The pharmacist has knowledge and expertise to provide information required for patent and authorization submission. Pharmacists also work in the department for the registration of drugs.
Drug Information
The pharmacists provide detailed information on drugs and related topics to all members of the industry sales and marketing.
The pharmacist whose professional ethics helps to put him in the proper marketing practice. Now a days pharmacist are widely employed in drug marketing at different levels.
Management
Pharmacists are included in all levels of management in industry as well as marketing.
ACADEMIC INSTITUTIONS
Academic pharmacists are engaged in teaching, pharmaceutical practice and research in schools of pharmacy. These three aspects of academic activity are inter-related. The pharmacist working as educators at undergraduate, post graduate level need to have expertise in various branches of pharmaceutical sciences.
The pharmacist educator for pharmaceutical practice should have, in addition, clinically oriented practical experience to teach and train the professionals in that area.
Research activities are carried out as a part of the study or a program leading to doctorate in that branch of pharmaceutical science.
TRAINING CENTRES
Training provided by the pharmacists to pharmacy students as qualified pharmacist to optimize drug therapy by promoting rational use and storage of drug.
Training should be given to all areas of various pharmacy services. These in house porgrammes enable the pharmacist to work independently in the respective areas.
RESEARCH CENTRESPharmacist contributes to research and expertise in formulation development, drug activities, drug interactions, pharmacokinetics etc.
Pharmacists are widely employed as research fellows in various research organizations and R&D of pharmaceutical companies.
