Pharmacy: Old and New Concept
Dear friends, I am going to post my first topic of this current month which is based on the old and New Concept of Pharmacy, especially in a clinical pharmacy aspect. But before any words about it, please allow me to share with you how far I came to fall in love with Clinical Pharmacy.
I am youngest kid of a family of six (6) children. My Mother was a nurse at the Obstetrics & Gynecology department of the Hospital of the city where I did my whole study life (elementary School & High school). Spending lot of time with her at her working place had built up in me the desire and the passion to work in a medical & Health field. When I went to College, I was oriented to do Medicine in My country, but I felt that it might be harder than I thought. One year later I was given a scholarship to come to China to study Pharmacy. In my last year of bachelor I just felt in Love with "Clinical Pharmacy" which has been my major from my master till today. It gives me a wide range of opportunities and career options to work in the Future. Within it, I see and challenge myself like someone who in directly in contact with the needy, the patients. I have the grace to discover and to solve several issues that cannot be addressed to a simple pharmacist but only to someone ? clinical Pharmacist, who is closer to patients.
Now let's stress out the old and New Concept of Pharmacy and point out the value of Clinical Pharmacy among all the pharmacy practice areas. We owe detailed information on this topic from a Nord-ltalian, probably a professor of Bologna or Padua, who under the pen-name of Mesues wrote a Grabadin or summary of Arabic pharmacy.
Origin of Pharmacy. a
Ancient Hindus recognized pharmacy as a complimentary health care profession to obtain remedies mainly from vegetable sources. But in this object they were obviously deficient and even the works which survive are little avail to the present generation. b
One of science, however, owes everything, even its very existence, to the Arabs, is Pharmacy. The period from the 7th to the 12th century can be regarded as the period of transmission of the cultural and scientific heritage of Antiquity and of the East to the West. a
Pharmacy always existed, but not so for pharmacists. Originally medicine and pharmacy were not independent from one another. He who made the diagnosis also provided the medicine, be it in prayers, exorcisms, amulets, herbs or whatever. The physician was a man of authority, the magician a man without formal education but with much experience, an old man, a presbyteros, to be translated as "elder" or "priest".
During the Roman period, small occult shop in little street were settle up where products can only be sold in night time. Those who were running those stores were not called pharmacists but pharmacopolae, unguentarii or aromatarii. With their clear insight and mathematical approach, the Arabs realized that people dealing with the health of others ought to acquire a solid education, both professionally and ethically. They also realized that the simultaneous exercises of medicine and pharmacy were incompatible. The mutual control between physician and pharmacist provides a much higher degree of safety.
Thus, for the first time in history, medicine and pharmacy were divided and the first pharmacy was opened in Bagdad in 770 under caliphe Al-Mansoer, who cared very much for science. The first pharmacists had much experience with medicines but did not possess the required education. The story of this separation involved both different professional tasks or skills and different professional goals
Another merit of the Arabs in the field of pharmacy was the development of a number of new drug delivery forms. As artists of life the Arabs succeeded in producing less drastic and less repulsive medicines by designing syrups (the Arabic sirab means potion), pellets, preserves, confections, marmalades. The Arabs ended each formula with the wish: with God's help and this is the origin of our Recipe. Many present-day prescribers think that the R which nowadays preceeds the prescription means: Recipe (take). In fact this is the interpretation of the last century. In earlier times the Jupiter signPs was used, which was later hastily transformed into ki and still later became . In older pharmaceutical formularies we always find with a bar through the shaft of R, never R alone. This R corresponded in fact to what the Arabs wrote in full: a prayer, a wish. As some Catholics start their letters or writings with K`, one used in earlier times the sign of Jupiter, to invoke God's help. Accordingly, the R in the recipe is not Recipe but the wish that the recipe should not contain impurities and should benefit the patient.
The Pharmacy Profession Today
In an era of rapid change in health care delivery, the pharmacy profession is experiencing significant growth and development
Although pharmacists represent a traditional health profession with ancient roots, they are often viewed with considerable ambiguity and uncertainty by those outside of the profession
Pharmacy, like every other profession, has been undergoing radical changes. The knowledge and skills base required by the profession are affected by external changes including patient demographics and expectations, emerging disease state priorities, technological developments, regulatory requirements and development in other professions
How far pharmacy has come? From pharmacists in shops selling soda fountain delights to present day highly skilled doctors of pharmacy with residency training and board certifications who are integral parts of clinical teams in research hospitals. The transformation of pharmacy from a product-based profession toward a patient-focused one has taken nearly a century and has not been without setbacks.
For example, in 1915, Abraham Flexner refused to reprise his study of medicine for pharmacy on the grounds that he did not consider pharmacy to be a profession. That task would fall to W. W. Charters, whose report in 1927 argued that pharmacy was indeed a profession and recommended that the entry level degree for pharmacists should be a four-year Bachelor of Science degree. c
An Ever-Evolving Profession
Pharmacists function in a wide and evolving number of ways within health, healthcare and medical research. While practicing in a community setting, pharmacists are responsible for dispensing medications, ensuring their suitability to the patient and his/her condition, and, if required, to tailor a medication to the specific needs of the individual
Types of pharmacy practice areas d
O Community Pharmacy (Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed)
O Hospital Pharmacy (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)
O Clinical Pharmacy (Clinical pharmacy is the branch of Pharmacy where pharmacists and pharmaconomists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. d Within the system of health care, clinical pharmacists are experts in the therapeutic use of medications)
O Compounding Pharmacy (Compounding is the practice of preparing drugs in new forms)
O Consultant Pharmacy (Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs)
O Internet Pharmacy (Online pharmacies, or Internet pharmacies, are pharmacies that operate over the Internet)
O Veterinary Pharmacy
O Nuclear Pharmacy (Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases)
O Military Pharmacy (Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal)
O Social Pharmacy (Social Pharmacy is the interdisciplinary discipline that enables the pharmacy profession to act, take part and take responsibility in drug matters at a societal level.)
O Pharmacy Informatics (Pharmacy informatics is the combination of pharmacy practice science and applied information science)
Pharmacy is one of the most dynamic professions in developed countries such in America today. Pharmacists are considered the most accessible and most trusted healthcare professionals in the country and have been repeatedly listed in the top five of all professions according to the Gallup Polle. Pharmacists are well educated, have broad clinical experience, and provide health information and professional expertise in the retail community; long term care; and hospital or health system settings. Pharmacists are becoming more involved in direct patient care services such as counseling patients; providing disease management programs for disorders like diabetes and hypertension; and, participating in drug therapy and compliance or adherence programs.
The Three-Part Definition of Clinical Pharmacy
Clinical pharmacy is a health science discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention. The practice of clinical pharmacy embraces the philosophy of pharmaceutical care; it blends a caring orientation with specialized therapeutic knowledge, experience, and judgment for the purpose of ensuring optimal patient outcomes. f
The clinical pharmacist's application of evidence and evolving sciences points out that clinical pharmacy is a scientifically rooted discipline; the application of legal, ethical, social, cultural, and economic principles serves to remind us that clinical pharmacy practice also takes into account societal factors that extend beyond science. f
By noting that the clinical pharmacist is an expert in the therapeutic use of medications, this section indicates that the clinical pharmacist is recognized as providing a unique set of knowledge and skills to the health care system and is therefore qualified to assume the role of drug therapy expert. f
b. R.D.Rana. Pharmacy in Ancient India. Indian Journal of History of Science 1987; 22(2):119-121
c. ROBERT M. ELENBAAS and DENNIS B. WORTHEN. Clinical Pharmacy in the United States: Transformation of a Profession. Lenexa, Kansas, American College of Clinical Pharmacy, 2009. xiv, 201 pp., illus