Transcript Chapter_1_Pharmacy_and_Health_Care

The Pharmacy Technician 4th
Edition
Created by Dr. Bisrat Hailemeskel,
Associate Professor and Director of
Drug Information Services of the
School of Pharmacy at Howard
University
Copyright © 2010
Morton Publishing and
Perspective Press
The Pharmacy
Technician
Chapter 1
Pharmacy & Health Care
Origins
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In earliest times, medicine was based in
magic and religion.
Sumerians living around 4,000 BC
believed that demons were the cause of
illness.
In many cultures, physicians were
priests, and sometimes considered as
gods.
E.g. Imhotep (born 3,000 BC) became
the Egyptian god of medicine.
Ancient Origins
• Hippocrates - Proposed that disease came from
natural, not supernatural causes.
• Established the theory of humors which needed to
be imbalanced for good health (blood, phlegm,
black bile, yellow bile).
• Beyond Hippocrates - an approach to medicine in
which natural causes were examined scientifically,
gradually grew to become the dominant approach to
treating human illness.
Natural Medicine
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Besides looking to the supernatural, ancient man also
looked to the natural world for medical answers.
Sources of Drugs - Drugs come from various sources
and can be classified as:
 Natural.
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Synthetic: created artificially.
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Synthesized: (created artificially but in imitation of
naturally occurring substances).
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Semisynthetic: (containing both natural and
synthetic components).
A Treatment for Malaria
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One of the most deadly disease in world’s history.
Still deadly in developing countries.
The first medicine was obtained from the Bark of a
Peruvian Tree.
Cinchona – Quinine
 Also called “Jesuite’s powder.”
Cocaine, the First Anesthetic
(numbing agent)
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The Indians of the Andes used to chew coca leaves for
its medicinal effects and also to increase endurance.
Cocaine is the active ingredient in the leaves.
Carl Koller, a Viennese surgeon in 1884 used it as the
first local anesthetic which revolutionized surgery and
dentistry.
Because of its harmful properties when abused, other
synthetic substitutes were procain (Novacain®) and
Lidocain.
Natural Aspirin
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The ancient Greek physician Hippocrates and
Dioscorides both wrote about the pain relieving
ability of a plant.
The bark of a white willow tree grew in the
Mediterranean.
The active ingredient was identified more than 2,000
years later and called salicylic acid.
Because of the difficulty of taking salicylic acid by
mouth, acetylsalicylic acid, popularly known as
aspirin, was developed synthetically (man-made).
It is the most widely used drug in the world.
Common Terms Used in Pharmacy
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Pharmacology -The study of drugs (from the Greek
pharmakon means drug).
Pharmacognosy - The study of physical, chemical,
biochemical and biological properties of drugs as
well as drugs from natural sources.
Pharmacopeia – An official listing of drugs and issues
related to their use.
Pharmaceutical – Of or about drugs; also, a drug
product.
Panacea – A cure-all (from the Greek panakeia).
Materia Medica – A dictionary of medicinal plants.
Dioscorides (First century)
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Wrote the first standard text/manual on drugs called
De Materia Medica.
Also called PHARMACOPOEIA.
Published 6 books that covered over 600 plants and
their healing properties.
His book was used for 1500 years.
Galen (Second century)
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Galen
 Conducted animal experiments.
 Produced a systematic classification of drugs for
treatment of disease.
Galenical pharmacy
 The first pharmacy .
 Described the process of creating extracts of
active medicinals from plants.
Foxglove – the First Heart
Medicine
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The British Physician, William Withering published his
study of the foxglove plant.
The active ingredient was digitalis.
 Widely used for heart failure.
 Now is called – digoxin.
Former President Bush was on digoxin for a racing
heart called atrial fibrillation.
Ancient Origins
• Boylston (18th Century) - The first person to
administer smallpox vaccine.
• Serturner (19th Century) - Extracts morphine from
opium.
• Pasteur (19the Century) - was the first scientist who
Showed that heat can be used to kill microorganisms
associated with food spoilage.
• Banting & Best (20th Century) - Show that insulin
lowers blood sugar in dogs and became a known drug
to treat diabetes.
The First Antibiotic - Penicillin
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Alexander Fleming discovered a fungus which
produces a chemical that kills bacteria.
He named it penicillin.
Penicillin was the first antibiotic drug.
A pharmaceutical company Pfizer developed a
method to mass produce it, and it was used to
save millions of lives during the World War era.
Ancient Origins
• 1950’s
• Watson and Crick: are the two people who
identified the structure of DNA genetic make up.
• 1960 – 1990’s
• The birth control pill was introduced.
• AZT becomes the first drug approved by the FDA
for AIDS treatment.
• HAART (Highly Active Antiretroviral Therapy) is
introduced for AIDS treatment .
The 20th Century
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The average life span in the United States increased
by over twenty years in the 20th Century.
1900 – early 50’s……….. 2000 – 77.9 years.
The 20th Century
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A major factor in the increased health and life
expectancy seen in this century, was the dramatic
growth in pharmaceutical medicine.
With the increasing availability of powerful drugs,
their regulation became more important than ever.
Food and Drug Administration (FDA) was
established in response to this need to regulate the
sale and use of medication in the US.
The Food and Drug Administration
(FDA)
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Monitors drugs before a drug is marketed in the
United States
Also monitors after the drug is approved for sale to
the public for any adverse effects – called Post
Marketing Surveillance
Recalls drugs if they have proven dangerous within
public safety
Discovery of New Drugs
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Pharmaceutical companies spend 1/6 of their
income on research and development.
Bringing drugs to market is a long and difficult
process. Thousands of chemicals must be tried.
Drugs must go through an extensive testing and
approval process before it can be made available to
the public.
The length of time from the beginning of
development through testing and to ultimate FDA
approval is often more than ten years.
OBRA ’90 requires that
pharmacist counsel all
Medicaid patients.
Pharmacy Today
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Prescription is a written paper for a drug product by
a licensed prescriber to treat a patient.
Prescriptions filled increased by 27% while the
number of pharmacists increased by 15% (1997 –
2007).
Education and Licensing Requirements
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Pharmacists Education - Doctor of Pharmacy
(PharmD) degree - 6 year program – the only degree
program to become a pharmacist.
 2 years Pre-Pharmacy (calculus, chemistry, biology)
 + 4 years of pharmacy education.
 Pharmacy College Admission Test (PCAT).
 Completes required Internship or practice setting
experience.
Residency in specialty area is optional.
Education and Licensing Requirements
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Pharmacists Licensing
 Required by all states.
 Overseen by board of pharmacy/
To become a pharmacist involves:
 Graduation from an accredited college of
pharmacy.
 Passing a state board certification examination.
 Perform experiential training under a licensed
pharmacist.
Continuing education for license renewal.
The Top 5 trusted professions in the
United States
Gallop poll (2008)
1. Nurses
2. Pharmacists
3. Medical Doctors
4. Police Officers
5. Clergy
Pharmacy Settings
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Community Pharmacies - Over 50,000 community
pharmacies account for half of the sales of
prescription drugs.
Hospitals - The next greatest area of employment
Mail order pharmacies sell drugs by mail to patients.
 The fastest growing area.
Long-term care pharmacies provide drugs to patients
in nursing homes and other long-term facilities.
Managed care pharmacies provide service to patients
in managed care insurance.
Home care pharmacies provide drugs to patients in
their home.
Economic Trends
Computers in Pharmacy
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Patient Profile
 Allows complete information about patients,
including prescribers, insurer, and medication
history, and allergies; identifies drug interactions
for patients taking multiple medications.
Billing
 Checks policies of third parties such as HMOs and
insurers; authorizes third party transactions and
credit cards electronically.
Prescriber Profile
 Includes state identification numbers and
affiliations with facilities and insurers.
Labeling
 Creates label, receipt, customer information, and
usage instructions.
Computers in Pharmacy
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Pricing
 Provides prices for medications and possible substitutes,
automatically updates prices, scans prices from bar codes.
Education/Counseling
 Patient information about drugs, usage, interactions,
allergies, etc.
Product Selection
 Locates items by various means (brand name, generic
name, product code, category, supplier, etc.). Gives
updates of prices and other product information.
Inventory
 Adjusts inventor y as prescriptions are filled, analyzes
turnover, produces status reports, automatically re-orders
based on inventory levels, and generates purchase orders.