PHARMACY IN ACTION

Community Pharmacy Usual setting is the independent drugstore |Types of Community Practice| Independent Drugstore Very common Pharmaceutical Centers Only items that are related to health are kept in stock Keeps family system, family health info. Center, prof. Lib. Direct patient pharmacist relationship Group Practice Formal association of three or more pharmacists 1. Geriatrics Mostly nursing homes American Society of Hospital Pharmacy initiated this 2. Mental Health Pharmacy Psychopharmacy American Society of Hospital Pharmacy Special Interest Group (ASHP SIG) Clinical Pharmacy Specialist in Psychiatry 3. Oncology Services Provide care to oncology patients Chain Drugstore/Multiple Pharmacy Two or more branches operate which are registered in the same name |Activities of a Community Pharmacist| Professional functions Dispensing&compounding a prescription Dispensing OTC drugs Storage and handling of drugs Providing professional advice to patients Selecting products for inventory Keeping records Administrative, supervisory and managerial functions Entrepreneural function related to investment of capital and ownership of pharmacies |Philippine Situation| Drugstore Usually owned by a pharmacist Botica sa Baryo Consignment for 15-30 days, discounts in bulk orders Chain Drugstore Started to operate about the year 1965 Mercury Drugstore (first&biggest, 450 branches), Watsons, The Generic Pharmacy, South Star Drug Industrial Pharmacy Technical areas: research, development, production, quality control Non-technical areas: marketing and administration |The Philippines Drug Industry| Started in 1900 with the establishment of Hizon Laboratories Followed by Manuel Zamora Lab. Which manufactured tiki-tiki in 1913

Drug Establishment Any organization or company involved in the manufacture, importation, repacking and/ or distribution of drugs and medicines 1. Drug manufacturer Operations involved in the production of a drug United Lab., Doctors Pharma 2. Drug Trader Registered owner of the drug product Cyanamid whose products are manufactured by Interphil Lab. 3. Drug Importer Imports raw materials, active ingredients and/ or finished products for its own use MDLD 4. Drug Exporter Exports raw materials, active ingredients and/ or finished products 5. Drug Wholesaler Procures raw materials, active ingredients and/ or finished products Zuellig Pharma., Metro Drug Distribution, Marsman and Co, Inc. 6. Small manufacturer under FIDA (Filipino Drug Association) and CFDM (Chamber of Filipino Drug Manufacturers) Serve the generic drug requirements Drugmakers, AM Europharma |Leading Philippine Pharmaceutical Companies| 1. United Lab. 2. GlaxoSmithKline 3. Pfizer 4. Wyeth |Registered Pharmaceutical Outlets| The Food and Drug Administration (FDA) issues license to drug firms Regulation Division I: drug outlets, distributor, cosmetic distributor, medical device distributor, food distributor, household hazardous substances Regulation Division II: drug manufacturer, cosmetic lab., medical device manufacturer, drug trader cosmetic tradr, medical device trader, house hold hazardous substances manufacturer/trader, food establishments License to Operate (LTO) must be applied first Certification of Product Registration (CPR) DR: drugs; CR/CL: cosmetics; FR: foods; HSR: household hazardous substances; DVR: medical devices FDA Inspectors make sure that pharmacists are present in designated hours, do routine inspection, monitor drug outlets |Top 10 Prescription/Ethical Brands| 1. Norvasc 2. Ventolin

3. 4.

Plavix Augmentin

Involves the application of new knowledge to benefit mankind

|Top 10 OTC Brands| Ceelin Solmux Neozep Biogesic |Dangerous Drug Board| Policy-making and strategy-formulating body in the planning and formulation of policies and programs on drug prevention and control Develop and adopt comprehensive, integrated, unified and balanced national drug abuse prevention and control strategy Under the Office of the President 1. S-1 Retail dealer of exempt dangerous drugs preparation (EDDP) 2. S-2 For physician, dentist, vet who is legally authorized to prescribe or administer dangerous drugs (DD) and EDDP 3. S-3 Retail dealer of DD and EDDP 4. S-4 Wholesale dealer/distributor of DD&EDDP 5. S-5-I Importer of DD&EDDP 6. S-5-C Compounder, producer&manufacturer of DD&EDDP 7. S-5-E Exporter of DD&EDDP 8. S-6 Legally authorized to obtain and use DD&EDDP for research, instruction or analysis in a laboratory 9. S-7 Importer, manufacturer, producr or compounder of DD in any form |Carry Out the Provisions| R.A. 9165/Comprehensive Dangerous Drug Acts of 2002 Philippine Drug Enforcement Agency (PDEA) serves as the implementing arm of the board and shall be responsible for the efficient and effective law enforcement of all the provisions on any DD |Research| Development Reseach Concerned with the formulation of new drug compounds, improvement of existing meds Basic Research Discovery and search for new knowledge Applied Research

|The Federated Pharmaceutical Industry of the Phil.| Composed of the members of the Chamber of Drug Manufacturers, the Philippine Manufacturers Association and the Drug Association of the Philippines Concerned with the solution of the common problems of the industry and undergoes direct dialogue with government agencies Hospital Pharmacy Department or service in a hospital which is under the direction of a professional competent, legally qualified pharmacist, and from which all meds are supplied to nursing units and other services, where special prescriptions are filled for patients in the hospital, where prescription are filled for ambulatory patients and out-patients... |Duties of a Hospital Pharmacist| Responsible for the management of the hospital pharmacy Must be knowledgeable on: Drug&their actions Pharmacy manufacturing program Control procedure regarding quality control&drug distribution throughout the hospital Research activities Teaching techniques Pharmacy administration in a hospital |Philippine Setting| Activities of a hospital pharmacist Prepare the annual budget for drugs Initiate drug orders Watch price fluctuations Maintain a system of records Exercise overall supervision of the Pharmacy Department Prepare sched. Of all staff duties Coordinate with the medical and nursing staff Represent her department in staff meeting Prepare annual report Serve in vital committees |Duties of the Pharmaceutical Staff| Dispnsing of drugs, chemicals and pharmaceutical preparations Filling&labelling of all drug containers Maintaining an approved stock of antidotes Dispensing of narcotics&alcohol Furnishing information regarding medications to doctors, interns&nurses Charging paients for drugs&pharmaceutical supplies Maintaining adequate control over requisitioning&dispensing of all drugs Implementing the decision of the Pharmacy and the Therapeutics Committee

Manning the Drug Information Service

|The Philippine Society of Hospital Pharmacy| Organized in 1962 to promote the interest of hospital pharmacists Holds monthly seminars Clinical Pharmacy Health discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness and disease prevention Embraces the philosophy of pharmaceutical care |Activities of the Clinical Pharmacist| 1. Consulting 2. Selection of drugs Defining drug formularies/limited lists of drugs 3. Drug information Seeking info. And critically evaluating scientific literature 4. Formulation and preparation 5. Drug use studies and research Collecting data on drug therapies 6. Pharmacokinetics/therapeutic drug monitoring Studying the kinetics of drugs 7. Clinical trials 8. Pharmaeconomy Using the results of clinical trials and outcome studies 9. Dispensation and administration 10. Teaching&training |Philippine Experience| First practiced in Makati Medical Center Patient-oriented Make rounds with the physician and other members of the health care team Take charge of taking patient drug histories, maintaining patient drug profiles, keeping close surveillance for adverse drug reaction (ADR), counselling patients on drug use |Pharmaceutical Care| Functions performed by a pharmacist in ensuing the optimal use of medications to achieve specific outcomes that improve a patients quality of life Responsible for the provision of drug therapy for the purpose of achieving definite outcomes that improve a patients quality of life Knowledge of Drugs and Drug Therapy, Communication Skills, Drug Information Skills, |Goal of Pharmaceutical Care| Optimize the patients health related quality of life Professional relationship must be established Patient-specific medical info. Must be collected, organized, recorded and maintained Patient-specific medical info. Must be evaluated

Assures that the patient has all supplies, info. And knowledge necessary to carry out the drug therapy plan Reviews, monitors, and modifies the therapeutic plan

Pharmacist in Government Service |Career oppurtunities| 1. Commissioned officer in the Army, Navy, Air Force 2. Civil service employees in different offices |Philippine Setting| 1. FDA Licensing of pharmaceutical establishments Drug inspection Registration of new drugs 2. Bureau of Research and Lab, DOH Researches on med.&public health aspects Production of biological products 3. National Academy of Science and Technology Medical Research Center Microbiological Research Center 4. Commission on Audit (COA) 5. Bureau of Plant Industry 6. Bureau of Customs 7. National Bureau of Investigation&Dangerous Drugs Board 8. Professional Regulation Commission (PRC)

Control of the Practice of Pharmacy

|Legal Control| Republic Act No. 5921 Approved on June 23, 1969 Concerned with the regulation of the practice of pharmacy and the setting of standards of pharmaceutical education Council of Pharmaceutical Education: implement the provision of the act Board of Pharmacy |Council of Pharmaceutical Education| Composed of: 1. Secretary of Education as the chairman 2. Undersecretary of Health Services 3. Director of the Bureau of Foods and Drugs 4. Chairman of the Board of Pharmacy 5. Dean of the College of Pharmacy of UP 6. Dean of the Colleges of Pharmacy 7. Representative of a bonafide national pharmaceutical organization in the Phils. Functions: 1. Promulgate rules&regulations relative to Pharmaceutical Education in the Philippines 2. Recognize&accredit colleges of pharmacy 3. Accredit community or prescriptions pharmacies... |The Board of Pharmacy| Composed of a chairman and two members appointed by the President

Functions: 1. Examine applicants for the practice of pharmacy 2. Issue certificates of registration of pharmacists 3. Reprimand any pharmacists or to suspend or revoke his certificate of registration 4. Promulgate rules and regulations 5. Study the condition affecting the practice of pharmacy 6. Check employment of qualified personnel in drugstores 7. Encourage the development of botanical gardens |Practice of Pharmacy| A person shall be deemed to be practicing pharmacy... Prepare/manufacture, analyze, assay, preserve, store, distribute or sell medicine, drug, chemicals, etc. Render pharmaceutical service Engage in teaching scientific, technical or professional pharmacy subjects Conduct or undertake scientific pharmaceutical research |Requirements for the Opening and Operation of Drugstores and Pharmacies| Shall be in accordance with the rules and regulations prescribed by the Bureau of Foods and Drugs (BFAD) Should be signed by a Filipino registered pharmacist |Sale of Medicine, Pharmaceutical, Drugs and Devices| Licensed under the Retail Trade Law |Definition of Terms| Pharmacy/Drugstore Establishment where drug, chemical products, active principles of drugs etc. Are compounded and dispensed Drug/Pharmaceutical Laboratory/Pharmaceutical Manufacturing Laboratories Where pharmaceuticals, proprietary medicines, etc. Are prepared, compounded standardized and distributed or sold Pharmaceuticals/Proprietary Medicines/Pharmaceutical Specialties Any drug, preparation or mixtures of drugs mixed under a trade name Devices Instruments, apparatus/contravances Biologic Products Viruses, sera, toxins and analogous products used for the prevention or cure human diseases Poison Drug, active principle or preparation of the same, capable of destroying life Cipher Method of secret writing Code System of words or other symbols kept from the knowledge of others

|Generic Act of 1988 (R.A. 6675)| An act to promote, require and ensure the production of an adequate supply, distribution, use and acceptance of drugs and medicines indentified by their generic names |Definition of Terms| Generic Name/Terminology Identification of drugs and medicine by their scientifically and internationally recognized active ingredients Active Ingredient Chemical component responsible for the claimed, therapeutic effect of the pharmaceutical product Chemical Name Description of the chemical structure of the drug/medicine Drug Product Finished product form that contains the active ingredients Core List List of drugs that meets the Health Care needs of majority of the population Complementary List List of alternative drugs used when there is no response to the core essential drug Brand Name Proprietary name given by the manufacturer to distinguish its products from those of competitors Generic Drugs Drugs not covered by patent protection |Who shall Use Generic Terminology| 1. All government health agencies and their personnel 2. All medical, dental and veterinary practitioners 3. Any organization or company involved in the manufacture, importation repacking, marketing and/or distribution of drugs and medicines 4. Drug outlets |Ethical control| Ethics Philosophical science dealing with the morality of human acts Deals with right conduct directed towards the formation of the individual Special Ethics Deals with the application of the general principles or morality to the particular actions of man Objectives of the professional code of ethics: Define professional privileges, behaviours and responsibilities Promote professional quality, conduct and moral method of procedure Defend private professions from undue interference by the government Preserve the dignity of the profession Defend clients from unscrupulous professionals Fix certain standards of compensation

|Code of Ethics| (SEE BOOK) Prepared and supported by pharmacists Ethics of pharmacy is based on SERVICE |Relationship with the Public| Drugs of good quality Conformity to Laws Confidential information Physical facilities Civic responsibilities Renumeration |Pharmacist-Patient-Prescriber Relationship| Inviting him to the pharmacy Keeping him informed of unusual patient problems Detailing him on new products Participating in inter-professional meetings Facts that destroy this triangular relationship Counter prescribing Physician/nurse dispensing Self-service counters Mail-order service Drug distribution through non-professional outlets |Relations to the Other Health Professions (Inter-professional)| Drug consultant Diagnosing and prescribing o Auto-therapy: persons who engage in selfmedication Compounding and dispensing prescriptions Clandestine arrangements o Exploitation of the patient by certain arrangements of the pharmacist with other members of the health team should never be done |Relations to Fellow Pharmacists (Inter-professional)| Self-improvement Recruitment Instruction Professional organizations Unethical practices

|Its Problems| Role of Pharmacist They must be able to control the proper use of drugs Pharmaceutical Education It must be aimed to meet the needs of the society Organization of Practice Must organize to increase the efficiency&perfection of pharmaceutical service Economics of Professional Service Commercialism should not be practiced Pharmaceutical Ethics Proper of improper ethical behaviour can make or unmake the profession of pharmacy

Pharmacy: Its Future, Its Problems

|Its Future| People are having a longer lifespan, hence more services for geriatric pharmacy will be required People are becoming more health conscious Pre-natal and post-natal care is a must which calls for more drugs Make good liaison officer for public health services |Programs| Voluntary health insurance program Union/company Social security benefits