Orientation of Pharmacy

Chapter 1

Orientation of pharmacy

CONTENTS
Introduction Official Books
Scope of Pharmacy History of Pharmacy

Pharmacy (from the Greek word „Pharmakon‟ = drug) is the health profession that links the
health sciences with the chemical sciences, and it is charged with ensuring the safe and effective
use of drugs.

“Pharmacy is the art & science of preparing & dispensing medications & the provision of drug-
related information to the public”

Pharmaceutics:

Drugs which are obtained from various sources are rarely administered in their pure chemical
form. Generally drugs are combined with other inert substances (excipients ) and converted into
suitable form of administration commonly termed as dosage form.

“Pharmaceutics is a branch of Pharmacy which includes the study of formulation of drug into
dosage form.”

Pharmaceutics is the discipline of pharmacy that deals with all facets of the process of turning
a new chemical entity (NCE) into a medication able to be safely and effectively used by patients
in the community. Pharmaceutics is the science of dosage form design. There are many
chemicals with known pharmacological properties but a raw chemical is of no use to a patient.
Pharmaceutics deals with the formulation of a pure drug substance into a dosage form.

Scope of Pharmacy:

The scope of pharmacy practice includes services related to health care, including clinical
services, reviewing medications for safety and efficacy, and providing drug information.
Pharmacists, therefore, are the experts on drug therapy and are the primary health professionals
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who optimize medication use to provide patients with positive health outcomes. The continuing
and expanding need for Pharmacists can be demonstrated by the society‟s changing and ever
increasing requirements, growing variety and demand for drugs and emphasis on research to find
new, safe and effective remedies.

Few professions offer the variety of specialization and opportunities that the profession of
Pharmacy does. Pharmacy offers a challenging, satisfying and rewarding career to the individual
whose interest lies in health services to the public, business, scientific research, university
teaching and hospital practice. Pharmacists are involved in following fields;

 Industrial Pharmacy
 Community and retail pharmacy
 Hospital Pharmacy
 Clinical Pharmacy
 Forensic Pharmacy
 Sales and marketing
 Research and development
1) Industrial Pharmacy:

Industrial pharmacists are involved in the discovery and development of safe, effective and
medicines. They can work at any stage of the process, drugs including research, development,
clinical trials, overseeing production, quality testing, marketing and applying to have the drug
legally registered.

2) Community and retail pharmacy:

Community pharmacists are the health professionals most accessible to the public. They supply
medicines in accordance with a prescription or, when legally permitted, sell them without a
prescription. In addition to ensuring an accurate supply of appropriate products, their
professional activities also cover counseling of patients at the time of dispensing of prescription
and non-prescription drugs, drug information to health professionals, patients and the general
public, and participation in health-promotion programs. They maintain links with other health
professionals in primary health care.

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3) Hospital Pharmacy:

While many of the pharmacist‟s activities in hospital may be similar to those performed by
community pharmacists, they differ in a number of ways. Additionally, the hospital or
institutional pharmacist has more opportunity to interact closely with the prescriber and,
therefore, to promote the rational prescribing and use of drugs. In larger hospital and institutional
pharmacies, is usually one of several pharmacists, and thus has a greater opportunity to interact
with others, to specialize and to gain greater expertise. Hospital Pharmacist is in a better position
to educate other health professionals about the rational use of drugs and more easily participates
in studies to determine the beneficial or adverse effects of drugs, and is involved in the analysis
of drugs in body fluids.

4) Clinical Pharmacy:

Clinical pharmacy is a branch of pharmacy which deals with the patient care and medication and
promotes health, wellness and disease inhibition. The pharmacist works in management with the
doctors for the patient healthcare. Clinical pharmacists have wide education in the biomedical,
pharmaceutical, and clinical sciences. Clinical Pharmacy consist of all the services accomplished
by pharmacists practicing in hospitals, community pharmacies, nursing homes, home-based care
services, clinics and any other setting wherever medicines are prescribed and used. The term
"clinical" does not necessarily suggest an action implemented in a hospital setting. It defines that
the type of activity is connected to the health of the patients. This suggests that community
pharmacists and hospital pharmacists both can accomplish clinical pharmacy activities.

Scope of clinical pharmacy:

 Drug Information
 Drug Utilization
 Drug Evaluation and Selection
 Medication Therapy Management
 Formal Education and Training Programs
 Disease State Management

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5) Forensic Pharmacy:

Forensic pharmacy is application of the sciences of drugs to legal issues. Forensic

pharmacists engage in work relating to litigation, the regulatory process, and the criminal justice
system.

6) Sales and marketing:

Sales & Marketing is a highly technical field & offers excellent opportunities for the
pharmacy graduates. A pharmacist becomes a vital link between the patients and the products
i.e., drugs.

7) Research & Development:

Pharmacists provide an invaluable interface in this process by liaising with scientists and
clinicians across the development arena. During the discovery research phase of development of
a medicine, pharmacists will work with other scientists to develop and select drug compounds
that may be valuable as medicines.

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Official Books:

As the need for uniform standards to ensure the quality of drug or drug products developed , this
need led to development and publication of monographs and reference books containing such
standards to be used by those involved in the production of drugs and pharmaceutical products.

Monographs:

These are the authorized standards available for the chemical substance / drugs and contain
complete information about that substance.

Pharmacopoeias:

The word pharmacopoeia is derived from the greek words “PHARMAKON” which means a
drug and “POIEO” which means to make. Literally it means a list of medicinal substances, crude
drugs and formulae for making the preparations from them. The pharmacopoeias are actually a
compilation of monographs. Organized sets of monographs are called as pharmacopoeias.
Pharmacopoeias are compiled by recognized authorities usually appointed by the government of
each country.

Updating of the pharmacopoeias:

The pharmacopoeias are revised from time to time so as to introduce the latest information. In
order to introduce new information and and to keep the size of the book within reasonable limits,
it becomes necessary to omit certain less frequently used drugs from each new edition of the
book. Therefore in each new edition, certain new monographs are added and the older ones are
deleted.

Formularies:

A list of pharmaceutical drugs along with their formulas, their uses and how to prepare them.

Difference between a pharmacopoeia and a formulary:

 The pharmacopoeias are mostly used in the industrial sector where the drugs are prepared
whereas the formulary is used in hospitals, health care units retail pharmacy where the
drug is administered.

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 The pharmacopoeias contain the generic name of the therapeutic drug whereas the
formularies also contain the brand names.

Drug compendia:

The pharmacopoeias and the formularies are collectively known as drug compendia.

Classification:

The drug compendia are classified as

1. Official compendia

2. Unofficial compendia

Official compendia;

These are the compilation of drugs and other related substances which are recognized as legal
standards by a government authority/agency of the respective country. E.g,

 British Pharmacopeia
 United States Pharmacopeia

Unofficial compendia:

The books other than official compendia which are used as the secondary reference sources for
drugs or other related substances. e.g.

 Merck index

 Remington's pharmaceutical sciences

 Martindale's extra pharmacopoeia

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Pharmacy History –I -Pharmacy in Ancient Times up to Modern Era:

No one can be sure when pharmacy started. However, early humans most likely discovered that
by applying water, mud, and some plants the skin. By simple trial and error, humans slowly
discovered things in nature that helped them. Therefore pharmacy was practiced instinctively as
people used the elements around them for soothing compresses on wounds and ailments.
The earliest known record of the art of apothecary (the forerunner of the pharmacist) is in
Mesopotamia at about 2600 B.C. Babylonian healing practitioners combined the responsibilities
of priest, physician, and pharmacist. Some of the oldest pharmacy records are found in Sumerian
(Babylonian) clay cuneiform tablets that date back to about 2000 B.C.

In ancient China (2000 B.C) legend tells that Emperor Shen Nung investigated the medical
properties of hundreds of herbs. He recorded 365 native herbal drugs in the first Book called “the
Great Herbal”).
In ancient Egypt, Egyptian priests, as part of their duties, prepared medicines. Exact time
unknown, approximate time 1900-1100 B.C, the most famous papyrus of Egyptian medicine was
written.
It was uncovered by a German Egyptologist Georg Ebers, and is now known as Ebers Papyrus. It
is the best known and most important pharmaceutical record from ancient history.
It contains 800 prescriptions using 700 drugs; of particular note in the papyrus is inclusion of
quantities of substances, which were largely missing from Babylonian clay tablets. Many modern
dosage forms are also referred to in the Ebers Papyrus as gargles, inhalations, suppositories,
ointments, plasters, and lotions.
In ancient Greece, Lived the father of Botany, Theophrastus (300 B.C). His observations about
the medicinal qualities of herbs have proven accurate. Theophrastus covered most aspects of
botany: descriptions of plants, classification, plant distribution, propagation, germination, and
cultivation. Hippocrates was a Greek Physician and considered one of the most outstanding
figures in the history of medicine. He is credited with greatly advancing the medical profession
and for writing the Hippocratic oath.

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In Ancient Rome:
Galen (A.D 130-200) was a prominent Roman physician, surgeon, and philosopher.
 Developed principles of preparing and compounding medicinal agents
 Sought to restore humeral balances within a patient by the use of medicine of opposing
qualities. e.g. Inflammation would be treated with cucumber, a cool drug.
 Moreover, Galen also drew from many available sources and attempted to systematize
the work begun by Hippocrates.
The middle Ages:
Pharmacy differentiates in the middle ages. Pharmaceutical Knowledge and the number of drugs
available began to grow considerably, thanks to the Arab World. Pharmacy as a separate activity
began to develop and privately owned pharmacies were established in Islamic lands. Medicine
and pharmacy were for the first time separated from each other.
First known apothecary shop was opened in Baghdad in the 18th century, and the Muslims
carried this concept into Europe during wars and other excursions into Africa, Spain, southern
France. These shops were open street stalls that sold sweets, syrups, perfumes, and medicines.

Fig. 1.1 First Apthecary shop

Ibn-e-Sina (980-1037 A.D) was a physician, poet, philosopher, diplomat. His Canon Medicinae
brought together the best knowledge of the Greeks and Arabs into a single medical text.

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Pharmacy differentiates during middle ages. German emperor Frederick II issued an edict in
about 1240 that legally separated pharmacy from medicine. This edict is known as the Magna
 Carta of pharmacy.
 Magna-Great (Latin)
 Carta-Charter, or document (Italian)

The three decrees of the Magna Carta:

 The pharmaceutical profession was to be separated from the medical profession
 The pharmaceutical profession should be supervised officially.
 Pharmacists should take an oath to prepare drugs reliably, according to skilled art, and in
a uniform suitable quality.

The Swiss physician Parcelsus (1493-1541 A.D) introduced two ideas:

 Disease might be localized in a specific organ (rather than the entire body being
affected), and that such conditions could be treated internally using the chemical
properties of medicinal agents
 Some plants contained minute quantities of active chemicals, which could be removed by
making tinctures, extracts, and essences.

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References

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