Al-Ain University of Science and TechnologyCollege of Pharmacy

Orientation to Pharmacy Dr. Khairi M. Salem 2nd Semester 2012-2013**

COURSE DESCRIPTION

This course covers orientation to pharmacy, history of pharmacy, pharmacy profession on local and world-wide, career opportunities for pharmacists, education in pharmacy, college curriculum, with special emphasis on the differences between patient-oriented, and drug oriented education, local and international organizations, information resources in pharmacy, drug literature .It offers an introduction to various drug delivery systems concerning their definition, route of administration, advantages, disadvantages of and an overview on the prescription. **

COURSE OBJECTIVES

Orient students to pharmacy as a future career, using examples for comparing the advantages of pharmacy as a profession as compared with other professionals and the essential characters of the different opportunities for pharmacist. Overview the history and development of pharmacy from medicinal herbs to biotechnology using presentations, projects, researches and appropriate illustrations Be familiar with old civilizations in pharmacy with an overview on contemporary pharmacy especially the leadership of USA in clinical pharmacy. Gain the knowledge to illustrate the progress in pharmacy education and its implication on pharmacy profession with special emphasis on patient-oriented to pharmacy education using sources on the internet.Interpret, classify and evaluate different pharmaceutical dosage forms with special emphasis on simple drug delivery systems as solutions, syrups, pastilles, pastes and ointments using models of the products and internal inserts.Use available documentations and references to understand the pharmacy ethics and to enumerate the local and international pharmaceutical organizations with a summary of their roles **

COURSE OUTCOMESDiscuss the present situation and future of pharmacy as a career.Compare between the different career opportunities for a pharmacist concerning activities, advantages and disadvantages. Evaluate the role of Islam. Ancient Egyptians, Indians, Chinese and Babelions, Greek and Romans on pharmacy profession development. Compare drug-oriented with patient-oriented pharmacy education.. Enumerate the routes of administration of most important medications.Discuss the types, advantages and disadvantages of different dosage formsDefine patient compliance with the prescribed medication Discuss the importance of ethics in pharmacy practice **

LEARNING AND INFORMATION RESOURCES

1. Textbook Title:Pharmacy : An Introduction to the Profession Author: Michael Posey ISBN: 9781582121277 Edition: 2nd Publisher: American Pharmacists Association Year Published: 2009 2. Shargel L. et al (2005). Comprehensive pharmacy Review. Lippincott Williams Philadelphia. USAB. References:Lieberman A. et al (2004). Pharmaceutical Dosage Forms. Marcel Decker. U.S.A. Ansel ,An Introduction to pharmaceutical Dosage Forms 4th Ed. Lea and Febiger Philadelphia. USA

**

Internet ReferencesStudents are encouraged to visit web sites as a means of learning more about the profession:www.moh.gov.ae/en/ (Ministry of Health-UAE)www.haad.ae/haad/ (Health Authorities Abu Dhabi)www.pharmacist.com (American Pharmacists Association) www.ashp.org (American Society of Health-System Pharmacists) www.aacp.org (American Association of Colleges of Pharmacy) www.amcp.org (Academy of Managed Care Pharmacy) www.ascp.com (American Society of Consultant Pharmacists) www.ncpanet.org (National Community Pharmacists Association) www.npha.net (National Pharmaceutical Association) www.talkaboutrx.org (National Council on Patient Information and Education)www.nacds.org (National Association of Chain Drug Stores) www.phrma.org (Pharmaceutical Research and Manufacturers of America)www.nabp.net (National Association of Boards of Pharmacy) www.fda.gov (Food and Drug Administration) www.pharmacy.ohio-state.edu (OSUs College of Pharmacy)

**

Weekly lecturesWeek 1Introduction to pharmacy professionDefinition of relevant pharmacy termsThe future of Pharmacy as medical professionWeek 2The Pharmacist and Pharmacy Career opportunities Pharmaceutical Care and Medical CareCommunity PharmacistsWeek 3Pharmacist CareerHospital PharmacistClinical PharmacistWeek 4Pharmacist CareerIndustrial Research and development and QC PharmacistMarketing and promotional PharmacistAcademic PharmacistPharmacist and Public HealthWeek 5Pharmaceutical Dosage FormsTypes of dosage formsRequirements of drug delivery systemAssessment of drug dosage formsWeek 6Liquid Dosage FormsFormulation of Liquid dosage formsAdvantages and Disadvantages of liquid dosage forms

Week 7Solvents used in liquid dosage formsWater; advantages, disadvantages and typesEthyl alcoholGlycerol Co-solvency Hydrotrophy and Soulbilization Week 8Excipients used in liquid dosage formsAromatic WaterSolutionsSpiritsElixirsTincturesWeek 9SyrupsSuspensionsEmulsionsOral MixturesExternal SolutionsWeek 10Solid Dosage FormsPowdersGranulesCapsulesWeek 11TabletsAdvantages and disadvantagesProperties of ideal tabletsFormulation of tablets as sold dosage form**Week 12Semi Solid dosage FormsOintments and CreamsSuppositories

Week 13Pharmacy EducationsDrug oriented and Patient oriented curriculaCollege of pharmacy curricula

Week 14History of PharmacyAncient Egyptians, Indians, Chinese and BabelionsOld Creeks and Chinese medicinesArabic and Islamic contributions

Week 15Ethics in PharmacyCode of ethics

Week 16Revision

Introduction to pharmacy profession(Chapters 1,2and 3)Textbook. Pharmacy : An Introduction to the Profession

Chapters 1Definition of relevant pharmacy termsThe future of Pharmacy as medical professionOutcomes: By the end of this chapter the student will be able to:Demonstrate the different terms related to the professionDiscuss the present situation and future of pharmacy as a career

Definition of relevant pharmacy termsPharmacy is the is a health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of drugs and pharmaceuticals The word derives from the Greek word: (pharmakon), meaning "drug" or "medicine The scope of pharmacy practice includes certain traditional roles such as compounding and dispensing medications, and it also includes more modern services related to Health Care, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacist, therefore, are the experts on drug therapy and are the primary health professionals who optimize medication use to provide patients with positive health outcomes

Medication Therapy Management:For centauries, the pharmacists have been paid when they provide medicinal agent to patientWhen the responsibilities of medicine and pharmacy were separated, the pharmacist concentrated on the art of preparing their medicines prescribed by the physicians( a few centuries ago)The new automated and advanced pharmaceutical industries Limited the pharmacist to practice the profession in this field ( 19th -20th century) start of MTM (2003)Health Care: Effect of aging and the pharmacist rolePharmacist and drug preparations

Chapter 2

Development of Pharmacy in History as Healing professionOutcomes:Illustrate the history of pharmacy from its origins in ancient times through the middle of twentieth century 1. Pharmacy differentiates during the Middle ages: The separation between pharmacy and medicine in Islamic land.The first pharmacy shop: in eight century in BagdadGerman Frederick II issued an act in1240 that separates the pharmacy profession2. The European Renaissance : Emerging the association of pharmacists3. Pharmacy in USA: in the old days and in nineteenth century1820. USA Pharmacopeia , 1821 the Philadelphia college of pharmacy, new York college of pharmacy 1829.4. Twentieth century pharmacy: improvement of pharmaceutical industryThinking of other practices of pharmacy as patient oriented practices **

**History of Pharmacy 1. Ancient Egyptian Period:The ancient Egyptians 3000 B.C . Were expert in using drugs for disease curing.Son was a priest doctor and pharmacist, who prescribe and prepare medicines. The ancient Egyptians used to prepare their medicines and drugs either from biological sources either from animal origin or plant origin.

2. The Mesopotamian Formula: The Babylonian medicine was known through interpretation of a written table known as (Laws of Hammurabi in 772 B.C . The formula contain 250 materials of plant and 180 of animal source which usually mixed with honey or water before administration.:

3. Old Indian Medicine :The aim of the old Indian drugs (2000 B.C) is used to prolong the human life.The drugs obtained from plant materials by pure religious person.The fresh plants were considered to be more effective, after its collection from fertile soil washed with pure water and exposed to sun

**4. Old Chinese Medicines :Famous in the acupuncture and the Chinese herbal medicine before 1000 B.C. The Chinese thought that for every disease, there must be a drug curing it, and the drug is only provided by nature. Many drugs of plant and animal origin were used and prepared in form of suppositories and ointments or as dry powders

5. The Greek and Romans: Well Known Hippocrates (466 B.C) was familiar with numerous drugs and wrote Corpus Hippocraticum . Alexander the great helped to increase the number of the drugs used at that time. Dioscorides was first to describe the drugs and his work Greek Herbal of Dioscorides included about 5000 medical plats + animal and mineral drugs.

6. Islamic contribution :The Islamic civilization added many scientific terms as Kemia alcohol .Famous Islamic scientist as Abu al Hassan Ibn-Sina (980-1037 A.D). His Book (canon of Medicine) was known as the best written medical test.Ibn Al- Bitar born in Spain in 1197 A.D, he was the best pharmacognosit from fertile soil washed with pure water and exposed to sun, his book Jameul- muffradat contains description of 2000 drugs.Dawood El- Antaki and his book Tazkert Uli Ai- AlbabAl- Buiruni and his book pharmacy and medical material

Chapter 3Pharmaceutical Care and Medication Therapy ManagementOutcomes:Discuss the pharmacy profession and the new application of Pharmaceutical care and medication therapy Management1. Pharmacy (occupation vs profession): 2. Pharmaceutical Care as reprofessionlization : Drug information, Decentralized drug distribution, pharmacology and Biopharmaceutics3. The Millis report: Pharmacists for future(1975 AACP)Development of clinical pharmacy, NAPLEX exam, enhancing the clinical studies in the pharmacy colleges, board of pharmaceutical specialties within APHA4. Pharm.D program.1989 accreditation by ACPE, 2000 eliminating B.Sc. in pharmacy replaced by Pharm.D5. Pharmaceutical care in community pharmaciesTill 1990 Pharm. care provided in hospital only, in 2003 US congress approved the MTM for high- risk people elderly and disabled people **

Pharmacy: A branch of Science, technology and art dealing with the following aspects:The Discovery of New MedicamentsNatural SourceAnimal SourceMicrobial FermentationMineral and trace elementsChemical synthesis or semi synthesis 2. Production of Pharmaceutical Dosage Forms3. Quality control of Pharmaceutical Dosage Forms4. Distribution of the formulated Dosage Forms5. Dispensing of drugs 6. Marketing and promotion

**

The Pharmacist and the Pharmacy Careers Pharmacist must conceive knowledge that improve health services, through the Pharmaceutical Care (PC) which is a necessary element for the Total Health Care (THC)

Physicians carry out Medical Care (MC)Pharmacist carry out Pharmaceutical Care (PC)

Pharmaceutical Care (PC) : Can be defined as Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patients quality of life

Medicaments: Agent used in the prevention, control and treatment of a disease (PCT)

**

Pharmacist: A highly qualified person whose profession is pharmacy (practicing Pharmacy ) and may be : Community PharmacistHospital PharmacistClinical PharmacistManufacturing PharmacistQuality control PharmacistResearch & Development PharmacistGovernmental PharmacistMarketing PharmacistAcademic Pharmacist

Pharmacist Careers : Community Pharmacist:Dispensing of Prescriptions ( To Give Drugs According to Prescription ).The Role Of Community Pharmacist include:Review prescriptions for the following reasons:

**

Possible Unaccepted indicationsPossible dug drug interactions ( Tetracycline with Calcium)Possible dug food interactions ( Tetracycline with Meat)Possible dug smoking interactions Possible contraindications ( Voltaren with Peptic Ulcer)Possible tetratogenic drugs (Danger for fetes) Amino glycosidesPossible danger for babes during breast feeding ( Hormones in oral contraceptive) Possibility of dose errors ( high or Low dose)2. Suggest Alternatives on scientific backgroundStandard Product is the most effective product as Lanoxin for digoxin, Augmentin for Amox-clav , etcIf the standard product is not available, the pharmacist must select an alternative which must be bioequivalentBioequivalent = dosage forms that give similar concentration in blood to the standard product

**

3. Improve adherence or compliance :The proper use of medications according to the regulations given by the prescribed ( non- adherence = 22 88%) Examples as:Changing the dose by increase or decreaseChange frequency ( every 6 Hours to every 8 hours)Earlier stop of drugs (use antibiotic for 1-3 days instead of 5-7 days)4. Purchasing drug Product: ( Effectiveness, Price, needs of patients.5. Proper storage of drugs ( sera, vaccines and suppositories)6. Preparation of certain formula( exp. Na bicarbonate - Glycerol )Advantages: Fresh, decrease Load on manufactures and Utilize pharmacist knowledge7. Patient Consultant for: Selection over the counter (OTC) as anti-acids and anti-cough drugs for diarrhea, constipation etc Adherence : ensure the using of drug in proper way by the Patient Patient educationGood storage conditionRefill ( repeat the prescription for diabetes, hypertension etc)8. Pharmaceutical carePreventive TherapyNon-Pharmacological Therapy9. Patient Monitoring10. Arrangement of drug Product According to:Manufacturing companyPharmacological groupsAlphabetical11. Computerization

**

Hospital Pharmacist (HP):This is the pharmacist working in hospital, including army, police , company etc, Hp activities include the following:Administration as chief pharmacistDispensing pharmacistUnite Dose preparationPurchasing & Storage of DrugsPharmaceutical Care activitiesManufacturing of certain Pharmaceutical ProductIncluded in pharmacy and therapeutic committee.Unit Dose System: The dispensing of each dose (doses) in a special box for in-patient ( Patient well receive at proper time a box containing one tablet , one capsule etc) Pharmaceutical Care : new concept in pharmacist activity which means the participation of the pharmacist in clinical activity by direct or indirect way. Drug information center: a unit containing all facilities (software, CD, internet to answer any questions about drugs as drug-drug interactions, side effects, contraindicationsetc Patient Education: to give patient full idea about disease, importance of medication and proper use & storage of drugPatient monitoring :For insuring adequate response & avoid adverse reactions

**

Industrial Pharmacist :This is the pharmacist working in pharmaceutical industry, whose activities include the following:Storage of raw material s and finished productsProduction of pharmaceutical dosage formsQuality control of pharmaceutical dosage formsResearch and development of pharmaceutical dosage formsQuality assuranceSynthesis of raw materialExtraction of natural source ( plant, animal)Biotechnology and genetic engineering industryManufacturing and quality control of cosmetics

**

Marketing and Promotion of drug products :In Arab world, Pharmacist is involved in this activity Bylaw, it is not allowed for any one except the pharmacist to work in promotion in UAE, Oman and Saudi Arabia, The promotion activity include:Regular visits to Physician and pharmacist to give presentation on the advantage s of a product Marketing studies Design of promotional aidsParticipation in conferences Governmental ActivitiesAs pharmacist in Pharmacy departments in Ministry of Health or general authority for health services which has the following responsibilities:Registration of new drug product and re- Registration of present drug product Licensure to new graduate pharmacist & to non-national pharmacistLicensure to pharmacies & pharmaceutical companiesEstablish and monitor the drug policies

**

Other activities:As researcher in research centers I.e. Sheik Zayed center for medical herbs.UniversitiesMedical Laboratories ( Biochemical and Microbiological)Medicinal HerbsCosmetic industryDistribution of drug products to pharmacy.

Pharmacist and Public Health:Prevention of DiseaseFactors like : smoking , improper diet, less exercise, alcohol, obesityInfectious disease like AIDSVaccines and seraNosocomial infections

**

Chapter 4

Communication skills in Pharmacy PracticeOutcomes:Understand the techniques used to build the relationships and improve health care.

1. Developing the relationship: 2. Listening and effective response: Give complete attention listen , empathic response , trust3. Supportive communication: Adherence 4. Patient counseling:5. Interacting with physicians6. Word choice and nonverbal cues**

Thank You

Khairi M. Salem. B.Pharm. PhDAssociate Prof. in pharmaceutical analysis **

*********************