Pharmacy is the
science
Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe.
Science may be as old as the human species, and some of the earli ...
and practice of discovering, producing, preparing, dispensing, reviewing and monitoring
medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s, aiming to ensure the safe, effective, and affordable use of
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
s. It is a miscellaneous science as it links
health sciences with
pharmaceutical science
Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links healt ...
s and
natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered
clinical pharmacy
230px, A hospital pharmacist is checking a liquid solution.
Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease pr ...
.
The scope of pharmacy practice includes more traditional roles such as
compounding
In the field of pharmacy, compounding (performed in compounding pharmacies) is preparation of a custom formulation of a medication to fit a unique need of a patient that cannot be met with commercially available products. This may be done for me ...
and dispensing of medications. It also includes more modern services related to
health care including clinical services, reviewing medications for safety and efficacy, and providing drug information.
Pharmacists, therefore, are experts on drug therapy and are the primary health professionals who optimize the use of medication for the benefit of the patients.
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, ''
drugstore
A pharmacy (also called "drugstore" in American English or "community pharmacy" or "chemist" in Commonwealth English, or rarely, apothecary) is a retail shop which provides pharmaceutical drugs, among other products. At the pharmacy, a pharmaci ...
s'' commonly sell medicines, as well as miscellaneous items such as
confectionery,
cosmetics
Cosmetics are constituted mixtures of chemical compounds derived from either natural sources, or synthetically created ones. Cosmetics have various purposes. Those designed for personal care and skin care can be used to cleanse or protect ...
,
office supplies
Office supplies are consumables and equipment regularly used in offices by businesses and other organizations, by individuals engaged in written communications, recordkeeping or bookkeeping, janitorial and cleaning, and for storage of supplies o ...
,
toy
A toy or plaything is an object that is used primarily to provide entertainment. Simple examples include toy blocks, board games, and dolls. Toys are often designed for use by children, although many are designed specifically for adults and pet ...
s,
hair care products and
magazines, and occasionally refreshments and groceries.
In its investigation of herbal and chemical ingredients, the work of the
apothecary
''Apothecary'' () is a mostly archaic term for a medical professional who formulates and dispenses '' materia medica'' (medicine) to physicians, surgeons, and patients. The modern chemist (British English) or pharmacist (British and North Amer ...
may be regarded as a precursor of the modern sciences of chemistry and
pharmacology, prior to the formulation of the
scientific method
The scientific method is an empirical method for acquiring knowledge that has characterized the development of science since at least the 17th century (with notable practitioners in previous centuries; see the article history of scientific ...
.
Disciplines
The field of pharmacy can generally be divided into three primary disciplines:
*
Pharmaceutics
*
Pharmacokinetics
*
Medicinal Chemistry
Medicinal or pharmaceutical chemistry is a scientific discipline at the intersection of chemistry and pharmacy involved with designing and developing pharmaceutical drugs. Medicinal chemistry involves the identification, synthesis and developme ...
and
Pharmacognosy
*Pharmacy Practice
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 pharmacology is essential to the study of pharmacy, it is not specific to 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
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
estimates that there are at least 2.6 million pharmacists and other pharmaceutical personnel worldwide.
Pharmacists
Pharmacists are
healthcare professionals with specialized education and training who perform various roles to ensure optimal
health
Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
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
The International Pharmaceutical Federation or Fédération Internationale Pharmaceutique, abbreviated as FIP, is an international federation of national organizations that represent pharmacists and pharmaceutical scientists. It was founded in 19 ...
(FIP). They are represented at the national level by
professional organisations such as the
Royal Pharmaceutical Society
The Royal Pharmaceutical Society (RPharmS or RPS) is the body responsible for the leadership and support of the pharmacy profession (pharmacists) within England, Scotland, and Wales. It was created along with the General Pharmaceutical Council ...
in the UK,
Pharmaceutical Society of Australia
The Pharmaceutical Society of Australia (PSA) is a professional organisation of Australian pharmacists. PSA is the peak national body for pharmacists, representing all of the pharmacy profession in Australia, with approximately 18,000 members ...
(PSA),
Canadian Pharmacists Association
The Canadian Pharmacists Association (CPhA), previously known as the Canadian Pharmaceutical Association, is an organization that serves as the professional association of Canadian pharmacists and pharmacy students. It was founded in 1907 in Toront ...
(CPhA),
Indian Pharmacist Association
The Indian Pharmacist Association (IPA) is the professional body for pharmacists of India. Members include hospital pharmacists, manufacturing pharmacists, teachers and clinical pharmacist
230px, A hospital pharmacist is checking a liquid solu ...
(IPA),
Pakistan Pharmacists Association
Founded by Dr. Naim Anwar Muzzafar, the Pakistan Pharmacists Association (PPA) is the national professional body of pharmacists and pharmacy students in Pakistan. It has a mission to promote and expand the profession of pharmacy and the role of ph ...
(PPA),
American Pharmacists Association
The American Pharmacists Association (APhA, previously known as the American Pharmaceutical Association), founded in 1852, is the first-established professional society of pharmacists in the United States. The association consists of more th ...
(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
Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concer ...
of the profession.
In the United States, specializations in pharmacy practice recognized by the
Board of Pharmacy Specialties
The Board of Pharmacy Specialties (BPS) was established in 1976 and is an independent division of the American Pharmacists Association that grants recognition within the United States to appropriate pharmacy practice specialities and establishes s ...
include: cardiovascular,
infectious disease
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
,
oncology
Oncology is a branch of medicine that deals with the study, treatment, diagnosis and prevention of cancer. A medical professional who practices oncology is an ''oncologist''. The name's etymological origin is the Greek word ὄγκος ('' ...
, pharmacotherapy, nuclear,
nutrition
Nutrition is the biochemical and physiological process by which an organism uses food to support its life. It provides organisms with nutrients, which can be metabolized to create energy and chemical structures. Failure to obtain sufficient ...
, and
psychiatry
Psychiatry is the specialty (medicine), medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psych ...
. The
Commission for Certification in Geriatric Pharmacy
The Commission for Certification in Geriatric Pharmacy (CCGP) 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 mus ...
certifies pharmacists in geriatric pharmacy practice. The
American Board of Applied Toxicology
The American Board of Applied Toxicology (ABAT) was established in 1985 as a standing committee by the American Academy of Clinical Toxicology
The American Academy of Clinical Toxicology (AACT) is a non-profit multidisciplinary health associat ...
certifies pharmacists and other medical professionals in applied
toxicology
Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating e ...
.
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 The pharmacist-to-pharmacy technician ratio is a legal regulation that establishes the maximum number of pharmacy technicians that may be supervised by a licensed pharmacist at one given time. For example, a 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.
Education requirements
There are different requirements of schooling according to the national jurisdiction where the student intends to practise.
United States
In the United States, general pharmacist will attain a Doctor of Pharmacy Degree (Pharm.D.). The Pharm.D. can be completed in a minimum of six years, which includes two years of pre-pharmacy classes, and four years of professional studies. After graduating pharmacy school, it is highly suggested that the student go on to complete a one or two-year residency, which provides valuable experience for the student before going out independently to be a generalized or specialized pharmacist.
The curriculum specified for a Pharm.D. consists of at least 208-credit hours.
Of the 208 credit hours, 68 are transferred-credit hours, and the remaining 140 credit hours are completed in the professional school. There are a series of required standardized tests that students have to pass throughout the process of pharmacy school. The standardized test to get into pharmacy school in the United States is called the Pharmacy College Admission Test (PCAT). In a student's third professional year in pharmacy school, it is required to pass the Pharmacy Curriculum Outcomes Assessment (PCOA). Once the Pharm.D. is attained after the fourth year of professional school, the student is then eligible to take the North American Pharmacist Licensure Exam (NAPLEX) and the Multistate Pharmacy Jurisprudence Exam (MPJE) to work as a professional pharmacist.
[
]
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 tablet
In the Ancient Near East, clay tablets ( Akkadian ) were used as a writing medium, especially for writing in cuneiform, throughout the Bronze Age and well into the Iron Age.
Cuneiform characters were imprinted on a wet clay tablet with a sty ...
s 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
Ancient Greece ( el, Ἑλλάς, Hellás) was a northeastern Mediterranean Sea, Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of Classical Antiquity, classical antiquity ( AD 600), th ...
, Diocles of Carystus Diocles of Carystus (; el, Διοκλῆς ὁ Καρύστιος; la, Diocles Carystius; also known by the Latin name Diocles Medicus, i.e. "Diocles the physician"; c. 375 BC – c. 295 BC) was a well-regarded Greek physician, born in Carystus, ...
(4th century BC) was one of several men studying the medicinal properties of plants. He wrote several treatises on the topic. The Greek physician Pedanius Dioscorides
Pedanius Dioscorides ( grc-gre, Πεδάνιος Διοσκουρίδης, ; 40–90 AD), “the father of pharmacognosy”, was a Greek physician, pharmacologist, botanist, and author of '' De materia medica'' (, On Medical Material) —a 5-vo ...
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
(Latin name for the Greek work , , both meaning "On Medical Material") is a pharmacopoeia of medicinal plants and the medicines that can be obtained from them. The five-volume work was written between 50 and 70 CE by Pedanius Dioscorides, ...
'' (''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
The Islamic Golden Age was a period of cultural, economic, and scientific flourishing in the history of Islam, traditionally dated from the 8th century to the 14th century. This period is traditionally understood to have begun during the reign ...
, themselves deriving their knowledge from earlier Greek Byzantine medicine Byzantine Medicine
Byzantine medicine encompasses the common medical practices of the Byzantine Empire from c. 400 AD to 1453 AD. Byzantine medicine was notable for building upon the knowledge base developed by its Greco-Roman predecessors. In preserving medical pr ...
.
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 t ...
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
The Han dynasty (, ; ) was an imperial dynasty of China (202 BC – 9 AD, 25–220 AD), established by Liu Bang (Emperor Gao) and ruled by the House of Liu. The dynasty was preceded by the short-lived Qin dynasty (221–207 BC) and a warr ...
and was attributed to the mythical Shennong
Shennong (), variously translated as "Divine Farmer" or "Divine Husbandman", born Jiang Shinian (), was a mythological Chinese ruler known as the first Yan Emperor who has become a deity in Chinese and Vietnamese folk religion. He is vene ...
. 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
The was a period in the history of Japan lasting from 538 to 710 (or 592 to 645), although its beginning could be said to overlap with the preceding Kofun period. The Yamato polity evolved greatly during the Asuka period, which is named after ...
(538–710) and the early Nara period
The of the history of Japan covers the years from CE 710 to 794. Empress Genmei established the capital of Heijō-kyō (present-day Nara). Except for a five-year period (740–745), when the capital was briefly moved again, it remained the c ...
(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
The was an administrative reorganisation enacted in 703 in Japan, at the end of the Asuka period. It was historically one of the . It was compiled at the direction of Prince Osakabe, Fujiwara no Fuhito and Awata no Mahito. Nussbaum, Louis ...
(701) and re-stated in the Yōrō Code
The was one iteration of several codes or governing rules compiled in early Nara period in Classical Japan. It was compiled in 718, the second year of the Yōrō regnal era by Fujiwara no Fuhito et al., but not promulgated until 757 under ...
(718). Ranked positions in the pre- Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration
The , referred to at the time as the , and also known as the Meiji Renovation, Revolution, Regeneration, Reform, or Renewal, was a political event that restored practical imperial rule to Japan in 1868 under Emperor Meiji. Although there were ...
(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.
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
Baghdad (; ar, بَغْدَاد , ) is the capital of Iraq and the second-largest city in the Arab world after Cairo. It is located on the Tigris near the ruins of the ancient city of Babylon and the Sassanid Persian capital of Ctesiphon. I ...
the first pharmacies, or drug stores, were established in 754,[
] under the Abbasid Caliphate
The Abbasid Caliphate ( or ; ar, الْخِلَافَةُ الْعَبَّاسِيَّة, ') was the third caliphate to succeed the Islamic prophet Muhammad. It was founded by a dynasty descended from Muhammad's uncle, Abbas ibn Abdul-Muttalib ...
during the Islamic Golden Age
The Islamic Golden Age was a period of cultural, economic, and scientific flourishing in the history of Islam, traditionally dated from the 8th century to the 14th century. This period is traditionally understood to have begun during the reign ...
. By the 9th century, these pharmacies were state-regulated.
The advances made in the Middle East in botany
Botany, also called , plant biology or phytology, is the science of plant life and a branch of biology. A botanist, plant scientist or phytologist is a scientist who specialises in this field. The term "botany" comes from the Ancient Greek w ...
and chemistry led medicine in medieval Islam
In the history of medicine, "Islamic medicine" is the Science in the medieval Islamic world, science of medicine developed in the Middle East, and usually written in Arabic language, Arabic, the ''lingua franca'' of Islamic civilization.
Islam ...
substantially to develop pharmacology. Muhammad ibn Zakarīya Rāzi
Abū Bakr al-Rāzī (full name: ar, أبو بکر محمد بن زکریاء الرازي, translit=Abū Bakr Muḥammad ibn Zakariyyāʾ al-Rāzī, label=none), () rather than ar, زکریاء, label=none (), as for example in , or in . In m ...
(Rhazes) (865–915), for instance, acted to promote the medical uses of chemical compounds. Abu al-Qasim al-Zahrawi
Abū al-Qāsim Khalaf ibn al-'Abbās al-Zahrāwī al-Ansari ( ar, أبو القاسم خلف بن العباس الزهراوي; 936–1013), popularly known as al-Zahrawi (), Latinised as Albucasis (from Arabic ''Abū al-Qāsim''), was ...
(Abulcasis) (936–1013) pioneered the preparation of medicines by sublimation and distillation
Distillation, or classical distillation, is the process of separating the components or substances from a liquid mixture by using selective boiling and condensation, usually inside an apparatus known as a still. Dry distillation is the heat ...
. 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 record his findings in a pharmacopoeia
A pharmacopoeia, pharmacopeia, or pharmacopoea (from the obsolete typography ''pharmacopœia'', meaning "drug-making"), in its modern technical sense, is a book containing directions for the identification of compound medicines, and published by ...
, describing a large variety of drugs and remedies for ailments. Al-Biruni
Abu Rayhan Muhammad ibn Ahmad al-Biruni (973 – after 1050) commonly known as al-Biruni, was a Khwarazmian Iranian in scholar and polymath during the Islamic Golden Age. He has been called variously the "founder of Indology", "Father of Co ...
(973–1050) wrote one of the most valuable Islamic works on pharmacology, entitled ''Kitab al-Saydalah'' (''The Book of Drugs''), in which he detailed the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Avicenna, too, described no less than 700 preparations, their properties, modes of action, and their indications. He devoted in fact a whole volume to simple drugs in ''The Canon of Medicine
''The Canon of Medicine'' ( ar, القانون في الطب, italic=yes ''al-Qānūn fī al-Ṭibb''; fa, قانون در طب, italic=yes, ''Qanun-e dâr Tâb'') is an encyclopedia of medicine in five books compiled by Persian physician-phi ...
''. Of great impact were also the works by al-Maridini of Baghdad and Cairo
Cairo ( ; ar, القاهرة, al-Qāhirah, ) is the Capital city, capital of Egypt and its largest city, home to 10 million people. It is also part of the List of urban agglomerations in Africa, largest urban agglomeration in Africa, List of ...
, and Ibn al-Wafid
ʿAlī ibn al-Ḥusayn ibn al-Wāfid al-Lakhmī () (c. 1008 – 1074), known in Latin Europe as , was an Andalusian Arab pharmacologist and physician from Toledo. He was the vizier of Al-Mamun of Toledo. His main work is ''Kitāb al-adwiya al- ...
(1008–1074), both of which were printed in Latin
Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
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
Arsenic trioxide, sold under the brand name Trisenox among others, is an inorganic compound and medication. As an industrial chemical, whose major uses include in the manufacture of wood preservatives, pesticides, and glass. As a medication, i ...
, and being acquainted with silicic acid
Silicon dioxide, also known as silica, is an oxide of silicon with the chemical formula , most commonly found in nature as quartz and in various living organisms. In many parts of the world, silica is the major constituent of sand. Silica is one ...
. He made clear distinction between sodium carbonate and potassium carbonate
Potassium carbonate is the inorganic compound with the formula K2 CO3. It is a white salt, which is soluble in water. It is deliquescent, often appearing as a damp or wet solid. Potassium carbonate is mainly used in the production of soap and gl ...
, and drew attention to the poisonous nature of copper
Copper is a chemical element with the symbol Cu (from la, cuprum) and atomic number 29. It is a soft, malleable, and ductile metal with very high thermal and electrical conductivity. A freshly exposed surface of pure copper has a pinkis ...
compounds, especially copper vitriol
Vitriol is the general chemical name encompassing a class of chemical compound comprising sulfates of certain metalsoriginally, iron or copper. Those mineral substances were distinguished by their color, such as green vitriol for hydrated iron( ...
, and also lead
Lead is a chemical element with the symbol Pb (from the Latin ) and atomic number 82. It is a heavy metal that is denser than most common materials. Lead is soft and malleable, and also has a relatively low melting point. When freshly cu ...
compounds. He also describes the distillation of sea-water for drinking.
In Europe
Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located entirel ...
, 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.
There are pharmacies in Europe that have been in operation since medieval times. In Florence
Florence ( ; it, Firenze ) is a city in Central Italy and the capital city of the Tuscany Regions of Italy, region. It is the most populated city in Tuscany, with 383,083 inhabitants in 2016, and over 1,520,000 in its metropolitan area.Bilan ...
, Italy, the director of the museum in the former Santa Maria Novella pharmacy says that the pharmacy there dates back to 1221. In Dubrovnik
Dubrovnik (), historically known as Ragusa (; see notes on naming), is a city on the Adriatic Sea in the region of Dalmatia, in the southeastern semi-exclave of Croatia. It is one of the most prominent tourist destinations in the Mediterran ...
(Croatia), a pharmacy that first opened in 1317 is located inside the Franciscan monastery: it is oldest pharmacy in Europe that is still operating. In the Town Hall Square of Tallinn
Tallinn () is the most populous and capital city of Estonia. Situated on a bay in north Estonia, on the shore of the Gulf of Finland of the Baltic Sea, Tallinn has a population of 437,811 (as of 2022) and administratively lies in the Harju '' ...
(Estonia), there is a pharmacy dating from at least 1422. The medieval Esteve Pharmacy
The Esteve Pharmacy ( ca, Farmàcia Esteve, ) is a medieval pharmacy and museum located in the town of Llívia, in the comarca of Cerdanya, Catalonia, Spain. Llívia is a Spanish exclave within the French region of Pyrénées-Orientales. The Es ...
, located in Llívia
Llívia (; es, Llivia ) is a town in the ''comarca'' of Cerdanya, province of Girona, Catalonia, Spain. It is a Spanish exclave surrounded by the French ''département'' of Pyrénées-Orientales. In 2009, the municipality of Llívia had a to ...
, a Catalan
Catalan may refer to:
Catalonia
From, or related to Catalonia:
* Catalan language, a Romance language
* Catalans, an ethnic group formed by the people from, or with origins in, Northern or southern Catalonia
Places
* 13178 Catalan, asteroid #1 ...
enclave close to Puigcerdà
Puigcerdà (; es, Puigcerdá) is the capital of the '' Catalan comarca'' of Cerdanya, in the province of Girona, Catalonia, northern Spain, near the Segre River and on the border with France (it abuts directly onto the French town of Bourg-Ma ...
, is a museum: the building dates back to the 15th century and the museum keeps albarello
An albarello (plural: ''albarelli'') is a type of maiolica earthenware jar, originally a medicinal jar designed to hold apothecaries' ointments and dry drugs. The development of this type of pharmacy jar had its roots in the Middle East during ...
s from the 16th and 17th centuries, old prescription books and antique drugs.
Practice areas
Pharmacists practice in a variety of areas including community pharmacies, infusion pharmacies, hospitals, clinics, insurance companies, medical communication companies, research facilities, pharmaceutical companies, extended care facilities, psychiatric hospitals, and regulatory agencies. Pharmacists themselves may have expertise in a medical specialty
A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...
.
Community pharmacy
A ''pharmacy'' (also known as a ''chemist'' in Australia, New Zealand
New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...
and the British Isles
The British Isles are a group of islands in the North Atlantic Ocean off the north-western coast of continental Europe, consisting of the islands of Great Britain, Ireland, the Isle of Man, the Inner and Outer Hebrides, the Northern Isles, ...
; or ''drugstore'' in North America; ''retail pharmacy'' in industry terminology; or apothecary
''Apothecary'' () is a mostly archaic term for a medical professional who formulates and dispenses '' materia medica'' (medicine) to physicians, surgeons, and patients. The modern chemist (British English) or pharmacist (British and North Amer ...
, historically) is where most pharmacists practice the profession of pharmacy. It is the community pharmacy in which 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. According to Sharif Kaf al-Ghazal, the opening of the first drugstores are recorded by Muslim pharmacists in Baghdad
Baghdad (; ar, بَغْدَاد , ) is the capital of Iraq and the second-largest city in the Arab world after Cairo. It is located on the Tigris near the ruins of the ancient city of Babylon and the Sassanid Persian capital of Ctesiphon. I ...
in 754 AD.
Hospital pharmacy
Pharmacies within hospitals
A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues, and 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
In medicine, patient compliance (also adherence, capacitance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as m ...
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, 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 often 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
Parenteral nutrition (PN) is the feeding of nutritional products to a person intravenously, bypassing the usual process of eating and digestion. The products are made by pharmaceutical compounding companies. The person receives a nutritional mix ...
(TPN), and other medications are given intravenously. That 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 and the potential impact of medications and pharmacy services on patient-care outcomes and patient safety require hospital pharmacies to perform at the highest level possible.
Clinical pharmacy
Pharmacists
A pharmacist, also known as a chemist ( Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who prepares, controls and distributes medicines and provides advice and instru ...
provide direct patient care services that optimize the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings, but the clinical pharmacy movement initially began inside hospitals and clinic
A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...
s. Clinical pharmacists often collaborate with physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They often participate in patient care rounds for drug product selection. In the UK clinical pharmacists can also prescribe some medications for patients on the NHS or privately, after completing a non-medical prescribers course to become an Independent Prescriber.
The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to dispensing and administration to the patient. The review process often involves an evaluation of the appropriateness of drug therapy (e.g., drug choice, dose, route, frequency, and duration of therapy) and its efficacy. Research shows that pharmacist led strategies reduce errors related to medication use. The pharmacist must also consider potential drug interactions, adverse drug reactions, and patient drug allergies while they design and initiate a drug therapy plan.
Ambulatory care pharmacy
Since the emergence of modern clinical pharmacy, ambulatory care pharmacy practice has emerged as a unique pharmacy practice setting. Ambulatory care pharmacy is based primarily on pharmacotherapy services that a pharmacist provides in a clinic. Pharmacists in this setting often do not dispense drugs, but rather see patients in-office visits to manage chronic disease states.
In the U.S. federal health care system (including the VA, the Indian Health Service, and NIH) ambulatory care pharmacists are given full independent prescribing authority. In some states, such North Carolina
North Carolina () is a state in the Southeastern region of the United States. The state is the 28th largest and 9th-most populous of the United States. It is bordered by Virginia to the north, the Atlantic Ocean to the east, Georgia and ...
and New Mexico
)
, population_demonym = New Mexican ( es, Neomexicano, Neomejicano, Nuevo Mexicano)
, seat = Santa Fe
, LargestCity = Albuquerque
, LargestMetro = Tiguex
, OfficialLang = None
, Languages = English, Spanish ( New Mexican), Navajo, Ke ...
, these pharmacist clinicians are given collaborative prescriptive and diagnostic authority. In 2011 the board of Pharmaceutical Specialties approved ambulatory care pharmacy practice as a separate board certification. The official designation for pharmacists who pass the ambulatory care pharmacy specialty certification exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the initials BCACP.
Compounding pharmacy/industrial pharmacy
Compounding involves preparing drugs in forms that are different from the generic prescription standard. This may include altering the strength, ingredients, or dosage form. Compounding is a way to create custom drugs for patients who may not be able to take the medication in its standard form, such as due to an allergy or difficulty swallowing. Compounding is necessary for these patients to still be able to properly get the prescriptions they need.
One area of compounding is preparing drugs in new dosage forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated lollipop
A lollipop is a type of sugar candy usually consisting of hard candy mounted on a stick and intended for sucking or licking. Different informal terms are used in different places, including lolly, sucker, sticky-pop, etc. Lollipops are ava ...
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 desired amount of medication indicated by the physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
, physician assistant, nurse practitioner
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe ...
, or clinical pharmacist practitioner. 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 home
A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to i ...
s, but are increasingly branching into other institutions and non-institutional settings. Traditionally consultant pharmacists were usually independent business owners, though in the United States many now work for a large pharmacy management company such as Omnicare
Omnicare is an American company working in the health care industry. It was established in April 1981 as a spinoff of healthcare businesses from Chemed and W. R. Grace and Company. It is currently a pharmacy specializing in nursing homes. In 20 ...
, Kindred Healthcare
Kindred Healthcare was a post-acute healthcare services company that operated long-term acute-care hospitals and provides rehabilitation services across the United States.
Kindred's headquarters and support center were located in Louisville, Ke ...
or PharMerica
PharMerica is a Fortune 1000 company formed in January 2007 from the merger of Kindred Healthcare's pharmacy business with a subsidiary of AmerisourceBergen.
The company is headquartered in Louisville, Kentucky, and operates a major customer sup ...
. 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 developed by Hepler and Strand in 1990.
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
Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in animals. Along with this, it deals with animal rearing, husbandry, breeding, research on nutri ...
, are often very different from those related to people, in some jurisdictions veterinary pharmacy may be 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 a different working environment to civilian practise because military pharmacy technicians perform duties such as evaluating medication orders, preparing medication orders, and dispensing medications. This would be illegal in civilian pharmacies because these duties are required to be performed by a licensed registered pharmacist. In the US military, state laws that prevent technicians from counseling patients or doing the final medication check prior to dispensing to patients (rather than a pharmacist solely responsible for these duties) 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 in this area are trained to participate in medication management system development, deployment, and optimization.
Specialty pharmacy
Specialty pharmacies supply high-cost injectable, oral, infused, or inhaled medications that are used for chronic and complex disease states such as cancer, hepatitis, and rheumatoid arthritis. Unlike a traditional community pharmacy where prescriptions for any common medication can be brought in and filled, specialty pharmacies carry novel medications that need to be properly stored, administered, carefully monitored, and clinically managed. In addition to supplying these drugs, specialty pharmacies also provide lab monitoring, adherence counseling, and assist patients with cost-containment strategies needed to obtain their expensive specialty drugs. In the US, it is currently the fastest-growing sector of the pharmaceutical industry with 19 of 28 newly FDA approved medications in 2013 being specialty drugs.
Due to the demand for clinicians who can properly manage these specific patient populations, the Specialty Pharmacy Certification Board has developed a new certification exam to certify specialty pharmacists. Along with the 100 questions computerized multiple-choice exam, pharmacists must also complete 3,000 hours of specialty pharmacy practice within the past three years as well as 30 hours of specialty pharmacist continuing education within the past two years.
Pharmaceutical sciences
The pharmaceutical sciences are a group of interdisciplinary areas of study concerned with the design
A design is a plan or specification for the construction of an object or system or for the implementation of an activity or process or the result of that plan or specification in the form of a prototype, product, or process. The verb ''to design' ...
, manufacturing
Manufacturing is the creation or production of goods with the help of equipment, labor, machines, tools, and chemical or biological processing or formulation. It is the essence of secondary sector of the economy. The term may refer to ...
, action
Action may refer to:
* Action (narrative), a literary mode
* Action fiction, a type of genre fiction
* Action game, a genre of video game
Film
* Action film, a genre of film
* ''Action'' (1921 film), a film by John Ford
* ''Action'' (1980 fil ...
, delivery, and classification of drugs. They apply knowledge from chemistry (inorganic
In chemistry, an inorganic compound is typically a chemical compound that lacks carbon–hydrogen bonds, that is, a compound that is not an organic compound. The study of inorganic compounds is a subfield of chemistry known as ''inorganic chemist ...
, physical, biochemical and analytical), biology
Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary i ...
(anatomy
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
, physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
, biochemistry
Biochemistry or biological chemistry is the study of chemical processes within and relating to living organisms. A sub-discipline of both chemistry and biology, biochemistry may be divided into three fields: structural biology, enzymology and ...
, cell biology, and molecular biology
Molecular biology is the branch of biology that seeks to understand the molecular basis of biological activity in and between cells, including biomolecular synthesis, modification, mechanisms, and interactions. The study of chemical and physi ...
), epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evide ...
, statistics, chemometrics
Chemometrics is the science of extracting information from chemical systems by data-driven means. Chemometrics is inherently interdisciplinary, using methods frequently employed in core data-analytic disciplines such as multivariate statistics, a ...
, mathematics, physics
Physics is the natural science that studies matter, its fundamental constituents, its motion and behavior through space and time, and the related entities of energy and force. "Physical science is that department of knowledge which r ...
, and chemical engineering
Chemical engineering is an engineering field which deals with the study of operation and design of chemical plants as well as methods of improving production. Chemical engineers develop economical commercial processes to convert raw materials int ...
.
The pharmaceutical sciences are further subdivided into several specific specialties, with four main branches:
* Pharmacology: the study of the biochemical and physiological effects of drugs on human beings
Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, an ...
.
**Pharmacodynamics
Pharmacodynamics (PD) is the study of the biochemical and physiologic effects of drugs (especially pharmaceutical drugs). The effects can include those manifested within animals (including humans), microorganisms, or combinations of organisms ...
: the study of the cellular and molecular interactions of drugs with their receptor
Receptor may refer to:
* Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse
*Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a ...
s. Simply "What the drug does to the body"
** Pharmacokinetics: the study of the factors that control the concentration of drug at various sites in the body. Simply "What the body does to the drug"
** Pharmaceutical toxicology: the study of the harmful or toxic effects of drugs.
**Pharmacogenomics
Pharmacogenomics is the study of the role of the genome in drug response. Its name ('' pharmaco-'' + ''genomics'') reflects its combining of pharmacology and genomics. Pharmacogenomics analyzes how the genetic makeup of an individual affects the ...
: the study of the inheritance
Inheritance is the practice of receiving private property, titles, debts, entitlements, privileges, rights, and obligations upon the death of an individual. The rules of inheritance differ among societies and have changed over time. Officia ...
of characteristic patterns of interaction between drugs and organisms.
*Pharmaceutical chemistry
Medicinal or pharmaceutical chemistry is a scientific discipline at the intersection of chemistry and pharmacy involved with designing and developing pharmaceutical drugs. Medicinal chemistry involves the identification, synthesis and developme ...
: the study of drug design
Drug design, often referred to as rational drug design or simply rational design, is the inventive process of finding new medications based on the knowledge of a biological target. The drug is most commonly an organic small molecule that acti ...
to optimize pharmacokinetics and pharmacodynamics, and synthesis of new drug molecules (Medicinal Chemistry
Medicinal or pharmaceutical chemistry is a scientific discipline at the intersection of chemistry and pharmacy involved with designing and developing pharmaceutical drugs. Medicinal chemistry involves the identification, synthesis and developme ...
).
* Pharmaceutics: the study and design of drug formulation for optimum delivery, stability
Stability may refer to:
Mathematics
*Stability theory, the study of the stability of solutions to differential equations and dynamical systems
** Asymptotic stability
** Linear stability
** Lyapunov stability
** Orbital stability
** Structural sta ...
, pharmacokinetics, and patient acceptance.
* Pharmacognosy: the study of medicines derived from natural sources.
As new discoveries advance and extend the pharmaceutical sciences, subspecialties continue to be added to this list. Importantly, as knowledge
Knowledge can be defined as Descriptive knowledge, awareness of facts or as Procedural knowledge, practical skills, and may also refer to Knowledge by acquaintance, familiarity with objects or situations. Knowledge of facts, also called pro ...
advances, boundaries between these specialty areas of pharmaceutical sciences are beginning to blur. Many fundamental concepts are common to all pharmaceutical sciences. These shared fundamental concepts further the understanding of their applicability to all aspects of pharmaceutical research and drug therapy
Pharmacotherapy is therapy using pharmaceutical drugs, as distinguished from therapy using surgery (surgical therapy), radiation (radiation therapy), movement (physical therapy), or other modes. Among physicians, sometimes the term ''medical ther ...
.
Pharmacocybernetics
Pharmacocybernetics (also known as pharma-cybernetics, cybernetic pharmacy and cyberpharmacy) is an upcoming field that describes the science of supporting drugs and medications use through the application and evaluation of informatics and interne ...
(also known as pharma-cybernetics, cybernetic pharmacy, and cyber pharmacy) is an emerging field that describes the science of supporting drugs and medications use through the application and evaluation of informatics and internet technologies, so as to improve the pharmaceutical care
Pharmaceutical care is the direct, responsible provision
of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life.
Definition
Hepler and Linda Strand's definition is the most well-known ...
of patients.
Society and culture
Etymology
The word ''pharmacy'' is derived from Old French
Old French (, , ; Modern French: ) was the language spoken in most of the northern half of France from approximately the 8th to the 14th centuries. Rather than a unified language, Old French was a linkage of Romance dialects, mutually intellig ...
''farmacie'' "substance, such as a food or in the form of a medicine which has a laxative effect" from Medieval Latin
Medieval Latin was the form of Literary Latin used in Roman Catholic Western Europe during the Middle Ages. In this region it served as the primary written language, though local languages were also written to varying degrees. Latin functione ...
''pharmacia'' from Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
''pharmakeia'' ( grc-gre, φαρμακεία) "a medicine", which itself derives from ''pharmakon'' (), meaning "drug, poison, spell" (which is etymologically related to ''pharmakos
A pharmakós ( el, φαρμακός, plural ''pharmakoi'') in Ancient Greek religion was the ritualistic sacrifice or exile of a human scapegoat or victim.
Ritual
A slave, a cripple, or a criminal was chosen and expelled from the community at tim ...
'').
Separation of prescribing and dispensing
Separation of prescribing and dispensing, also called dispensing separation, is a practice in medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
and pharmacy in which the physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
who provides a medical prescription
A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historicall ...
is independent from the pharmacist who provides the prescription drug.
In the Western world
The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania. there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs.
In contemporary time researchers and health policy analysts have more deeply considered these traditions and their effects. Advocates for separation and advocates for combining make similar claims for each of their conflicting perspectives, saying that separating or combining reduces conflict of interest in the healthcare industry
Conflict of interest in the health care industry occurs when the primary goal of protecting and increasing the health of patients comes into conflict with any other secondary goal, especially personal gain to healthcare professionals, and increasin ...
, unnecessary health care
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate.
In the United States, where health care costs are the highest as a percentage of GDP, overuse was the ...
, and lowers costs, while the opposite causes those things. Research in various places reports mixed outcomes in different circumstances.
Environmental impacts
In 2022 the Organisation for Economic Co-operation and Development proposed that pharmaceutical companies should be required to collect and destroy unused or expired medicines that they have put on the market in order to reduce public health risks around the misuse of medicines obtained from waste bins, the development of antimicrobial resistant bacteria from the discharge of antibiotics into environmental systems and "economic losses" from wasted healthcare resources. Potentially harmful concentrations of pharmaceutical waste has been detected in more than a quarter of water samples taken from 258 rivers around the world. OECD recommend that medicines should be collected separately from household waste and that "marketplaces and redistribution platforms for unused close-to-expiry-date medicines" should be set up. Such extended producer responsibility schemes are already running in France, Spain and Portugal.
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 are increasingly expected to be compensated for their patient care skills. In particular, Medication Therapy Management Medication therapy management, generally called medicine use review in the United Kingdom, is a service provided typically by pharmacists that aims to improve outcomes by helping people to better understand their health conditions and the medication ...
(MTM) includes the clinical services that pharmacists can provide for their patients. Such services include a 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.
This shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government
The Australian Government, also known as the Commonwealth Government, is the national government of Australia, a federal parliamentary constitutional monarchy. Like other Westminster-style systems of government, 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 and this is because of pharmacy education
The basic requirement for pharmacists to be considered for registration is often an undergraduate or postgraduate pharmacy degree from a recognized university. In many countries, this involves a four- or five-year course to attain a bachelor o ...
. They are also being paid for by the government for medicine use review
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practice ...
s. In Scotland, the pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for controlled drugs, when the patient is unable to see their doctor, as could happen if they are away from home or the doctor is unavailable. In the United States, pharmaceutical care or clinical pharmacy
230px, A hospital pharmacist is checking a liquid solution.
Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease pr ...
has had an evolving influence on the practice of pharmacy.[American College of Clinical Pharmacy]
Clinical Pharmacy Defined
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 pharmacist
A consultant pharmacist is a pharmacist who works as a consultant providing expert advice on clinical pharmacy, academic pharmacy or practice, public health pharmacy, industrial pharmacy, community pharmacy or practice, pharmaceutical analysis et ...
s, who traditionally operated primarily in nursing home
A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to i ...
s, are now expanding into direct consultation with patients, under the banner of "senior care pharmacy".
In addition to patient care, pharmacies will be a focal point for medical adherence initiatives. There is enough evidence to show that integrated pharmacy based initiatives significantly impact adherence for chronic patients. For example, a study published in NIH shows "pharmacy based interventions improved patients' medication adherence rates by 2.1 percent and increased physicians' initiation rates by 38 percent, compared to the control group".
Pharmacy journals
* List of pharmaceutical sciences journals
Symbols
The symbols most commonly associated with pharmacy are the mortar and pestle
Mortar and pestle is a set of two simple tools used from the Stone Age to the present day to prepare ingredients or substances by crushing and grinding them into a fine paste or powder in the kitchen, laboratory, and pharmacy. The ''mortar'' ( ...
(North America) and the ℞ (medical prescription
A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historicall ...
) character, which is often written as "Rx" in typed text; the green Greek cross
The Christian cross, with or without a figure of Christ included, is the main religious symbol of Christianity. A cross with a figure of Christ affixed to it is termed a ''crucifix'' and the figure is often referred to as the ''corpus'' (La ...
in France
France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of overseas regions and territories in the Americas and the Atlantic, Pacific and Indian Oceans. Its metropolitan area ...
, Argentina
Argentina (), officially the Argentine Republic ( es, link=no, República Argentina), is a country in the southern half of South America. Argentina covers an area of , making it the second-largest country in South America after Brazil, th ...
, the United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...
, Belgium
Belgium, ; french: Belgique ; german: Belgien officially the Kingdom of Belgium, is a country in Northwestern Europe. The country is bordered by the Netherlands to the north, Germany to the east, Luxembourg to the southeast, France to th ...
, Ireland
Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic Ocean, in Northwestern Europe, north-western Europe. It is separated from Great Britain to its east by the North Channel (Grea ...
, Italy
Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
, Spain
, image_flag = Bandera de España.svg
, image_coat = Escudo de España (mazonado).svg
, national_motto = ''Plus ultra'' (Latin)(English: "Further Beyond")
, national_anthem = (English: "Royal March")
, i ...
, and India
India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
; the Bowl of Hygieia (only) often used in the Netherlands
)
, anthem = ( en, "William of Nassau")
, image_map =
, map_caption =
, subdivision_type = Sovereign state
, subdivision_name = Kingdom of the Netherlands
, established_title = Before independence
, established_date = Spanish Netherl ...
but may be seen combined with other symbols elsewhere. Other common symbols include conical measure
A conical measure is a type of laboratory glassware which consists of a conical cup with a notch on the top to allow for the easy pouring of liquids, and graduated markings on the side to allow easy and accurate measurement of volumes of liquid.
T ...
s, and (in the US) caduceuses, in their logos
''Logos'' (, ; grc, λόγος, lógos, lit=word, discourse, or reason) is a term used in Western philosophy, psychology and rhetoric and refers to the appeal to reason that relies on logic or reason, inductive and deductive reasoning. Ari ...
. A red stylized letter A in used Germany
Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwe ...
and Austria
Austria, , bar, Östareich officially the Republic of Austria, is a country in the southern part of Central Europe, lying in the Eastern Alps. It is a federation of nine states, one of which is the capital, Vienna, the most populous ...
(from ''Apotheke'', the German
German(s) may refer to:
* Germany (of or related to)
** Germania (historical use)
* Germans, citizens of Germany, people of German ancestry, or native speakers of the German language
** For citizens of Germany, see also German nationality law
**Ge ...
word for pharmacy, from the same Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
root as the English
English usually refers to:
* English language
* English people
English may also refer to:
Peoples, culture, and language
* ''English'', an adjective for something of, from, or related to England
** English national ide ...
word "apothecary
''Apothecary'' () is a mostly archaic term for a medical professional who formulates and dispenses '' materia medica'' (medicine) to physicians, surgeons, and patients. The modern chemist (British English) or pharmacist (British and North Amer ...
"). The show globe
A show globe is a glass vessel of various shapes and sizes containing a colorful liquid. It has been a symbol of pharmacy from the 17th century England to the early 20th century in the United States. It marked the drugstore or apothecary in much ...
was used in the US until the early 20th century; the Gaper
A gaper (Dutch pronunciation: ɣaːpər is a stone or wooden figurehead, often depicting a Moor, Muslim, or North African. The figurehead first appeared in the late 16th century as a hangout sign used outside the storefronts of drug stores ...
in the Netherlands is increasingly rare.
Image:Asclepius staff.svg, Rod of Asclepius
In Greek mythology, the Rod of Asclepius (⚕; grc, Ράβδος του Ασκληπιού, , sometimes also spelled Asklepios), also known as the Staff of Aesculapius and as the asklepian, is a serpent-entwined rod wielded by the Greek god A ...
, the internationally recognised symbol of medicine
File:Aiga FirstAid - Green.svg, green cross (AIGA
The American Institute of Graphic Arts (AIGA) is a professional organization for design. Its members practice all forms of communication design, including graphic design, typography, interaction design, user experience, branding and identity ...
symbol for First Aid
First aid is the first and immediate assistance given to any person with either a minor or serious illness or injury, with care provided to preserve life, prevent the condition from worsening, or to promote recovery. It includes initial in ...
)
Image:Green_Pharmacy_Cross_w_Bowl_of_Hygieia.svg, Green cross and Bowl of Hygieia used in Europe
Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located entirel ...
(with the exception of Germany
Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwe ...
and Austria
Austria, , bar, Östareich officially the Republic of Austria, is a country in the southern part of Central Europe, lying in the Eastern Alps. It is a federation of nine states, one of which is the capital, Vienna, the most populous ...
) and India
Image:Pharmacy Green Cross.svg, Simple green Greek cross, widely used in often an animated neon sign
In the signage industry, neon signs are electric signs lighted by long luminous gas-discharge tubes that contain rarefied neon or other gases. They are the most common use for neon lighting, which was first demonstrated in a modern form in D ...
File:Deutsche Apotheke Logo.svg, Red "A" (''Apotheke'') sign, used in Germany
Image:Apotheke Oesterreich Logo.svg, Similar red "A" sign, used in Austria
Image:PharmacistsMortar.svg, The mortar and pestle, used in the United States and Canada
Image:Red Hanging Show Globe2.jpg, A hanging Show globe
A show globe is a glass vessel of various shapes and sizes containing a colorful liquid. It has been a symbol of pharmacy from the 17th century England to the early 20th century in the United States. It marked the drugstore or apothecary in much ...
, formerly used in the United States
Image:De_Gaper,_Nijmegen.jpg, The Gaper, formerly used in the Netherlands
File:Rx_symbol_border.svg, The symbol used on medical prescriptions, from the Latin ''recipe'' (take thou).
File:Bowl Of Hygieia by David.svg, the Bowl of Hygieia
See also
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*Bachelor of Pharmacy
A Bachelor of Pharmacy (abbreviated B Pharm or PharmB or BS Pharm) is a graduate academic degree in the field of pharmacy. In many countries, this degree is a prerequisite for registration to practice as a pharmacist. Since both PharmB and Phar ...
, Master of Pharmacy
The Master of Sciences of Pharmacy (MPharm) is the standard master's degree program in Pharmacy. It is the oldest honorable Diploma (Degree) authorized from the European Faculties of Pharmacy as it takes five years to complete. It is based on a c ...
, Doctor of Pharmacy
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Notes and references
;Notes
;References
References
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* Asai, T. (1985). ''Nyokan Tūkai''. Tokyo: Kōdan-Sha.
* Titsingh, Isaac, ed. (1834). iyun-sai_Rin-siyo/Hayashi_Gahō,_1652.html" ;"title="Hayashi_Gahō.html" ;"title="iyun-sai Rin-siyo/Hayashi Gahō">iyun-sai Rin-siyo/Hayashi Gahō, 1652">Hayashi_Gahō.html" ;"title="iyun-sai Rin-siyo/Hayashi Gahō">iyun-sai Rin-siyo/Hayashi Gahō, 1652 ''Nipon o daï itsi ran; ou, Annales des empereurs du Japon.'' Paris: Royal Asiatic Society, Oriental Translation Fund of Great Britain and Ireland]
...Click link for digitized, full-text copy of this book (in French)
Pharmacy Consulting Services , McKesson
– 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
Collection of internet resources related to the history of pharmacy
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
{{Short description, Clinical health science
Medicinal chemistry
Symbols
Greek words and phrases