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PHARMACY IN ACTION

Community Pharmacy

Usual setting is the independent drugstoreTypes of Community Practice|

ndependent Drugstore

Very commonharmaceutical Centers

Only items that are related to health are kept in stock Keeps family system, family health info. Center, prof.

Lib.

Direct patient pharmacist relationshipGroup Practice

Formal association of three or more pharmacists1. Geriatrics

Mostly nursing homes American Society of Hospital Pharmacy

initiated this

2. Mental Health PharmacyPsychopharmacy American Society of Hospital Pharmacy

Special Interest Group (ASHP SIG)

Clinical Pharmacy Specialist in Psychiatry3. Oncology Services

Provide care to oncology patientsChain Drugstore/Multiple Pharmacy

Two or more branches operate which are registeredin the same name

Activities of a Community Pharmacist|

rofessional 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 functionsntrepreneural 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

ndustrial Pharmacy

Technical areas: research, development, production,quality control

Non-technical areas: marketing and administrationThe Philippines Drug Industry|

Started in 1900 with the establishment of HizonLaboratories

Followed by Manuel Zamora Lab. Whichmanufactured tiki-tiki in 1913

Drug Establishment

Any organization or company involved in themanufacture, importation, repacking and/ or

distribution of drugs and medicines

1. Drug manufacturer Operations involved in the production of

drug

United Lab., Doctors Pharma2. 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

MDLD4. Drug Exporter

Exports raw materials, active ingredientsand/ or finished products

5. Drug Wholesaler Procures raw materials, active ingredient

and/ or finished products

Zuellig Pharma., Metro Drug Distribution,Marsman and Co, Inc.

6. Small manufacturer under FIDA (Filipino DrugAssociation) and CFDM (Chamber of Filipino Drug

Manufacturers)

Serve the generic drug requirements Drugmakers, AM Europharma

|Leading Philippine Pharmaceutical Companies|

1. United Lab.2. GlaxoSmithKline3. Pfizer4. Wyeth

|Registered Pharmaceutical Outlets|

The Food and Drug Administration (FDA) issues licto drug firms

Regulation Division I: drug outlets, distributor,cosmetic distributor, medical device distributor, fo

distributor, household hazardous substances

Regulation Division II: drug manufacturer, cosmetlab., medical device manufacturer, drug trader

cosmetic tradr, medical device trader, house hol

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 arepresent in designated hours, do routine inspection

monitor drug outlets

|Top 10 Prescription/Ethical Brands|

1. Norvasc2.

Ventolin

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3. Plavix4. Augmentin

Top 10 OTC Brands|

Ceelin Solmux Neozep Biogesic

Dangerous Drug Board|

Policy-making and strategy-formulating body in theplanning 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 President1. S-1

Retail dealer of exempt dangerous drugspreparation (EDDP)

2. S-2 For physician, dentist, vet who is legally

authorized to prescribe or administerdangerous 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&EDDP8. 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 of2002

Philippine Drug Enforcement Agency (PDEA) servesas 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 drugcompounds, improvement of existing meds

asic Research

Discovery and search for new knowledgeApplied Research

Involves the application of new knowledge to bemankind

|The Federated Pharmaceutical Industry of the Phil.|

Composed of the members of the Chamber of DManufacturers, the Philippine Manufacturers

Association and the Drug Association of the

Philippines

Concerned with the solution of the commonproblems of the industry and undergoes direct

dialogue with government agencies

Hospital Pharmacy

Department or service in a hospital which is undthe direction of a professional competent, legally

qualified pharmacist, and from which all meds ar

supplied to nursing units and other services, where

special prescriptions are filled for patients in the

hospital, where prescription are filled for ambulat

patients and out-patients...

|Duties of a Hospital Pharmacist|

Responsible for the management of the hospital pharmacMust be knowledgeable on:

Drug&their actions Pharmacy manufacturing program Control procedure regarding quality control&dru

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 pharmaceutic

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 supp Maintaining adequate control over

requisitioning&dispensing of all drugs

Implementing the decision of the Pharmacy and Therapeutics Committee

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Manning the Drug Information ServiceThe Philippine Society of Hospital Pharmacy|

Organized in 1962 to promote the interest of hospitalpharmacists

Holds monthly seminarsClinical Pharmacy

Health discipline in which pharmacists providepatient care that optimizes medication therapy and

promotes health, wellness and disease prevention Embraces the philosophy of pharmaceutical care

Activities of the Clinical Pharmacist|

1. Consulting2. Selection of drugs

Defining drug formularies/limited lists ofdrugs

3. Drug information Seeking info. And critically evaluating

scientific literature

4. Formulation and preparation5. Drug use studies and research

Collecting data on drug therapies6. Pharmacokinetics/therapeutic drug monitoring

Studying the kinetics of drugs7. Clinical trials8. Pharmaeconomy

Using the results of clinical trials and outcomestudies

9. Dispensation and administration10. 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 theoptimal 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. Andknowledge necessary to carry out the drug thera

plan

Reviews, monitors, and modifies the therapeutic pPharmacist in Government Service

|Career oppurtunities|

1. Commissioned officer in the Army, Navy, Air Force2. Civil service employees in different offices

|Philippine Setting|1. FDA

Licensing of pharmaceutical establishme Drug inspection Registration of new drugs

2. Bureau of Research and Lab, DOH Researches on med.&public health aspe 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 Industry6. Bureau of Customs7. National Bureau of Investigation&Dangerous Drug

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: implemen

provision of the act

Board of Pharmacy|Council of Pharmaceutical Education|

Composed of:

1. Secretary of Education as the chairman2. Undersecretary of Health Services3. Director of the Bureau of Foods and Drugs4. Chairman of the Board of Pharmacy5. Dean of the College of Pharmacy of UP6. Dean of the Colleges of Pharmacy7. Representative of a bonafide national

pharmaceutical organization in the Phils.

Functions:

1. Promulgate rules&regulations relative toPharmaceutical Education in the Philippines

2. Recognize&accredit colleges of pharmacy3. Accredit community or prescriptions pharmacies

|The Board of Pharmacy|

Composed of a chairman and two membersappointed by the President

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unctions:

1. Examine applicants for the practice of pharmacy2. Issue certificates of registration of pharmacists3. Reprimand any pharmacists or to suspend or revoke

his certificate of registration

4. Promulgate rules and regulations5. Study the condition affecting the practice of

pharmacy

6. Check employment of qualified personnel indrugstores

7. Encourage the development of botanical gardensPractice 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 pharmaceuticalresearch

Requirements for the Opening and Operation of Drugstoresand Pharmacies|

Shall be in accordance with the rules and regulationsprescribed by the Bureau of Foods and Drugs (BFAD)

Should be signed by a Filipino registered pharmacistSale of Medicine, Pharmaceutical, Drugs and Devices|

Licensed under the Retail Trade LawDefinition of Terms|

harmacy/Drugstore

Establishment where drug, chemical products, activeprinciples of drugs etc. Are compounded anddispensed

Drug/Pharmaceutical Laboratory/Pharmaceutical

Manufacturing Laboratories

Where pharmaceuticals, proprietary medicines, etc.Are prepared, compounded standardized and

distributed or sold

harmaceuticals/Proprietary Medicines/Pharmaceutical

pecialties

Any drug, preparation or mixtures of drugs mixedunder a trade name

Devices

Instruments, apparatus/contravances

iologic Products

Viruses, sera, toxins and analogous products used forthe prevention or cure human diseases

oison

Drug, active principle or preparation of the same,capable of destroying life

Cipher

Method of secret writingCode

System of words or other symbols kept from theknowledge of others

|Generic Act of 1988 (R.A. 6675)|

An act to promote, require and ensure theproduction of an adequate supply, distribution, u

and acceptance of drugs and medicines indenti

by their generic names

|Definition of Terms|

Generic Name/Terminology

Identification of drugs and medicine by theirscientifically and internationally recognized active

ingredientsActive Ingredient

Chemical component responsible for the claimedtherapeutic effect of the pharmaceutical produc

Chemical Name

Description of the chemical structure of thedrug/medicine

Drug Product

Finished product form that contains the activeingredients

Core List

List of drugs that meets the Health Care needs ofmajority of the population

Complementary List

List of alternative drugs used when there is noresponse to the core essential drug

Brand Name

Proprietary name given by the manufacturer todistinguish 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 person2. All medical, dental and veterinary practitioners3. 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 ofhuman acts

Deals with right conduct directed towards theformation of the individual

Special Ethics Deals with the application of the general principle

morality to the particular actions of man

Objectives of the professional code of ethics:

Define professional privileges, behaviours andresponsibilities

Promote professional quality, conduct and moralmethod of procedure

Defend private professions from undue interferenby the government

Preserve the dignity of the profession Defend clients from unscrupulous professionals

Fix certain standards of compensation

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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

acts 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 self-medication

Compounding and dispensing prescriptions Clandestine arrangements

o Exploitation of the patient by certainarrangements of the pharmacist with other

members of the health team should never bedone

Relations to Fellow Pharmacists (Inter-professional)|

Self-improvement Recruitment Instruction Professional organizations Unethical practices

Pharmacy: Its Future, Its Problems

Its Future|

People are having a longer lifespan, hence moreservices 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 servicesPrograms|

Voluntary health insurance program Union/company Social security benefits

|Its Problems|

Role of Pharmacist

They must be able to control the proper use of drPharmaceutical Education

It must be aimed to meet the needs of the societOrganization of Practice

Must organize to increase the efficiency&perfectof pharmaceutical service

Economics of Professional Service

Commercialism should not be practicedPharmaceutical Ethics

Proper of improper ethical behaviour can make ounmake the profession of pharmacy