Pharmacy is the science and practice of dispensing, preparing, reviewing safety and efficacy, monitoring, discovering, producing, and consulting about medications, aiming to ensure the safe, effective, and affordable use of medicines. It is an interdisciplinary science as it links health sciences, pharmaceutical sciences, and natural sciences with the humanities. The professional practice is clinically oriented, with most drugs now being manufactured by pharmaceutical industries and prescribed in the medical setting. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care is considered clinical pharmacy, mainly practiced in institutions like hospitals, long-term care facilities, hospice, ambulatory clinics, or psychiatric hospitals. However, more clinical application are becoming important in the community setting to combat barriers to accessing healthcare (e.g., immunizations, point of care testing, oral contraceptive prescribing, administering injectable therapies, suggesting OTC products, or prescribing under Physician backed protocols).
The scope of pharmacy practice includes more traditional roles such as dispensing and compounding of medications based on compendiums, like the USP. It also includes more modern services related to health care including clinical services involving medical guideline appropriateness, reviewing medications for safety and efficacy, and providing drug information with patient counselling. Pharmacists, therefore, are considered the experts on drug therapy and are the primary health professionals who optimize the use of medication for the benefit of the patient.
In some jurisdictions, such as Colorado, Canada, and Australia, Pharmacists have more liberties to prescribe or adapt/manage prescriptions.
An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy (this term is more common in the United States) or chemists (which is more common in Great Britain, though pharmacy is also used). In the United States and Canada, drugstores commonly sell medicines, as well as miscellaneous items such as confectionery, cosmetics, office supplies, toys, hair care products and magazines, and occasionally refreshments and groceries.
In its investigation of herbal and chemical ingredients, the work of the apothecary 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 various disciplines: Pharmacy Practice (pharmacist) Pharmaceutics (drug development, drug discovery) and Computational Pharmaceutics Medicinal Chemistry (drug design) and Pharmacognosy Pharmacology (includes pharmacokinetics and pharmacodynamics) Pharmacoinformatics Pharmacogenomics
The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut. Often, collaborative teams from various disciplines (pharmacists and other scientists) work together toward the introduction of new therapeutics and methods for patient care. However, pharmacy is not a basic or biomedical science in its typical form. Medicinal chemistry is also a distinct branch of synthetic chemistry combining pharmacology, organic chemistry, and chemical biology.
Pharmacology is sometimes considered the fourth discipline of pharmacy. Although knowledge of pharmacology is essential to the study of pharmacy, both disciplines are distinct. Those who wish to practice both pharmacy (patient-oriented) and pharmacology (a biomedical science requiring the scientific method) receive separate training and degrees unique to either discipline.
Pharmacoinformatics is considered another new discipline, for systematic drug discovery and development with efficiency and safety.
Pharmacogenomics is the study of genetic-linked variants that effect patient clinical responses, allergies, and metabolism of drugs.
Professionals The World Health Organization estimates that there are at least 2.6 million pharmacists and other pharmaceutical personnel worldwide.World Health Organization. World Health Statistics 2011 – Table 6: Health workforce, infrastructure, and essential medicines. Geneva, 2011. Accessed 21 July 2011.
Pharmacists
Pharmacists are healthcare professionals with specialized education and training who perform various roles to ensure optimal health outcomes for their patients through the quality use of medicines. Pharmacists may also be small business proprietors, owning the pharmacy in which they practice. Since pharmacists know about the mode of action of a particular drug, and its metabolism and physiological effects on the human body in great detail, they play an important role in optimization of drug treatment for an individual.
Pharmacists are represented internationally by the International Pharmaceutical Federation (FIP), an NGO linked with World Health Organization (WHO). They are represented at the national level by professional organisations such as the Royal Pharmaceutical Society in the UK, Pharmaceutical Society of Australia (PSA), Canadian Pharmacists Association (CPhA), Indian Pharmacist Association (IPA), Pakistan Pharmacists Association (PPA), American Pharmacists Association (APhA), and the Malaysian Pharmaceutical Society (MPS).
In some cases, the representative body is also the registering body, which is responsible for the regulation and ethics of the profession.
In the United States, specializations in pharmacy practice recognized by the Board of Pharmacy Specialties include: cardiovascular, infectious disease, oncology, pharmacotherapy, nuclear, nutrition, and psychiatry. The Commission for Certification in Geriatric Pharmacy certifies pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology.
Pharmacy support staff
Pharmacy technicians
Pharmacy technicians support the work of pharmacists and other health professionals by performing a variety of pharmacy-related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with medic's offices and insurance companies to ensure correct medications are provided and payment is received.
Legislation requires the supervision of certain pharmacy technician's activities by a pharmacist. The majority of pharmacy technicians work in community pharmacies. In hospital pharmacies, pharmacy technicians may be managed by other senior pharmacy technicians. In the UK the role of a PhT in hospital pharmacy has grown and responsibility has been passed on to them to manage the pharmacy department and specialized areas in pharmacy practice allowing pharmacists the time to specialize in their expert field as medication consultants spending more time working with patients and in research. Pharmacy technicians are registered with the General Pharmaceutical Council (GPhC). The GPhC is the regulator of pharmacists, pharmacy technicians, and pharmacy premises.
In the US, pharmacy technicians perform their duties under the supervision of pharmacists. Although they may perform, under supervision, most dispensing, compounding and other tasks, they are not generally allowed to perform the role of counseling patients on the proper use of their medications. Some states have a legally mandated pharmacist-to-pharmacy technician ratio.
Dispensing assistants Dispensing assistants are commonly referred to as "dispensers" and in community pharmacies perform largely the same tasks as a pharmacy technician. They work under the supervision of pharmacists and are involved in preparing (dispensing and labelling) medicines for provision to patients.
Healthcare assistants/medicines counter assistants In the UK, this group of staff can sell certain medicines (including pharmacy only and general sales list medicines) over the counter. They cannot prepare prescription-only medicines for supply to patients.
History
The earliest known compilation of medicinal substances was the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (4th millennium BC – early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.
Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.
In Ancient Greece, Diocles of Carystus (4th century BC) was one of several men studying the medicinal properties of plants. He wrote several treatises on the topic.Edward Kremers, Glenn Sonnedecker (1986). "Kremers and Urdang's History of pharmacy ". Amer. Inst. History of Pharmacy. p.17. The Greek physician Pedanius Dioscorides is famous for writing a five-volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translation (Concerning medical substances) was used as a basis for many medieval texts and was built upon by many middle eastern scientists during the Islamic Golden Age, themselves deriving their knowledge from earlier Greek Byzantine medicine. Medicine and Pharmacy in Byzantine Hospitals: A study of the extant formularies (Medicine in the Medieval Mediterranean) 1st Edition by David Bennett
Pharmacy in China dates at least to the earliest known Chinese manual, 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 and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui, sealed in 168 BC.
In Japan, at the end of the Asuka period (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.Titsingh, Isaac. (1834) Annales des empereurs du Japon, p. 434.
There is a stone sign for a pharmacy shop with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey. The current Ephesus dates back to 400 BC and was the site of the Temple of Artemis, one of the seven wonders of the world.
In Baghdad the first pharmacies, or drug stores, were established in 754, under the Abbasid Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were state-regulated.