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What Is A Pharmacist?


The field of Pharmacy can generally be divided into three main disciplines. The boundaries between these disciplines and with other sciences, such as Biochemistry, are not always clear-cut. Often, collaborative teams from various disciplines research together.

Disciplines of Pharmacy

Pharmaceutics
Pharmaceutics is the discipline of pharmacy which 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 such as a tablet, capsule, suppository, injection, cream, ointment, eye-drop, eardrop, inhalation, nasal spray, transdermal patch, which is suitable for use on or by a patient.

Medicinal or Pharmaceutical Chemistry
This is a scientific discipline at the intersection of chemistry and pharmacy involved with designing and developing pharmaceutical drugs. Medicinal chemistry involves the identification, synthesis and development of new chemical entities suitable for therapeutic use. It also includes the study of existing drugs, their biological properties, and their Quantitative Structure-Activity Relationships (QSAR).
Medicinal Chemistry is a highly interdisciplinary science combining organic chemistry with biochemistry, computational chemistry, pharmacology, molecular biology, statistics, and physical chemistry.

Pharmacy Practice
Pharmacy Practice is the discipline of pharmacy that involves developing the professional roles of pharmacists.

Areas of Pharmacy Practice include:

Disease-state management
Clinical interventions
Professional development
Pharmaceutical Care
Communication skills
Health psychology
Patient care
Preventing drug abuse
Preventing drug/drug interactions or drug/food interactions

Pharmacology is sometimes considered a fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Therefore, it is usually considered to be a field of the broader sciences.
There are various specialties of pharmacy practice. Some specialization is based on the place of practice including: community, hospital, consultant, locum, drug information, regulatory affairs, industry, and academia. Other specializations are based on clinical roles including: nuclear, oncology, cardiovascular, infectious disease, diabetes, nutrition, geriatric, and psychiatric pharmacy.


What Does A Pharmacist Do?


Pharmacists distribute drugs prescribed by physicians and other health practitioners and provide information to patients about medications and their use. They advise physicians and other health practitioners on the selection, dosage, interactions, and side effects of medications. Pharmacists must understand the use, clinical effects, and composition of drugs, including their chemical, biological, and physical properties. Most pharmacists work in a community setting, such as a retail drugstore, or in a health care facility, such as a hospital, nursing home, mental health institution, or neighborhood health clinic.

Pharmacists in community and retail pharmacies counsel patients and answer questions about prescription drugs, including questions regarding possible side effects or interactions amongst various drugs. They also may give advice about the patient’s diet, exercise, or stress management, or about durable medical equipment and home health care supplies. Some community pharmacists provide specialized services to help patients manage conditions such as diabetes, asthma, smoking cessation, or high blood pressure. 
Pharmacists in healthcare facilities dispense medications and advise the medical staff on the selection and effects of drugs. They may make sterile solutions to be administered intravenously. They also plan and monitor drug programs or regimens. Pharmacists counsel hospitalized patients on the use of drugs and on their use at home when the patients are discharged. Pharmacists also may evaluate drug-use patterns and outcomes for patients in hospitals or managed-care organizations.

Pharmacists who work in home health care monitor drug therapy and prepare infusions—solutions that are injected into patients—and other medications for use in the home.
Most pharmacists keep confidential computerized records of patients’ drug therapies to prevent harmful drug interactions. Pharmacists are responsible for the accuracy of every prescription that is filled, but they often rely upon pharmacy technicians and pharmacy aides to assist them in the dispensing process. The pharmacist may delegate prescription-filling and administrative tasks and supervise their completion. Pharmacists also frequently oversee pharmacy students serving as interns in preparation for graduation and licensure.

Increasingly, pharmacists are pursuing nontraditional pharmacy work. Some are involved in research for pharmaceutical manufacturers, developing new drugs and therapies and testing their effects on people. Others work in marketing or sales, providing expertise to clients on a drug’s use, effectiveness, and possible side effects. Some pharmacists work for health insurance companies, developing pharmacy benefit packages and carrying out cost-benefit analyses on certain drugs. Other pharmacists work for the government, public health care services, the armed services, and pharmacy associations. Finally, some pharmacists are employed full time or part time as college faculty, teaching classes and performing research in a wide range of areas.

 


Choosing A Pharmacist


Choosing a Pharmacist is an important decision. Most people choose a pharmacy instead of the pharmacist, because of the pharmacy's location and convenience. A pharmacist is a very important part of your healthcare team. A good pharmacist can be a great resource of information, especially for people who are taking multiple medications. The pharmacist can inform and guide you about the effects and any dangers when taking multiple medications.

Thus, our goal is to assist you in making that decision.

The location of the pharmacy that you will use is important so it will be easy to pick up prescriptions and especially when time is of the essence. We suggest getting referrals but you don’t want one from someone who doesn’t live or work near you. You need to ask local people who have experience in dealing with pharmacists in the immediate vicinity. 

First of all, when selecting a pharmacist, you may want to begin your search several different ways:

Ask your local family doctor if they can recommend anyone.
Ask family, friends, neighbors and/or co-workers.
Contact your local Chamber of Commerce or Better Business Bureau for reputable pharmacists.
What are some things to consider when choosing a pharmacist and/or pharmacy?
Some suggested questions to ask when choosing a pharmacist and/or pharmacy include:

Is the staff friendly and accommodating?
What are the regular office hours?
Is the pharmacy open during hours that fit your schedule?
Is the location convenient to your home or to work?
Does the pharmacy deliver? If so, are there restrictions or additional charges?
How are emergencies handled during and after normal business hours? 
How long does it take for a prescription to be filled?
Does the pharmacy handle the drugs you expect to be taking?
What about holidays?
Does the pharmacy have an associate that covers for them when they are not available?
If there is an emergency, does the pharmacy provide after-hours service or a special emergency telephone number?
Do they have more than one location and if they do how is their time divided between offices?
Does the pharmacist have any specialties in disease management?
Do they accept phone calls during office hours?
What type of insurance coverages do they accept?
Do they accept credit cards?
Are charge accounts available?
How are questions over the phone handled?
Is the staff knowledgeable and courteous?
Is the pharmacist easy to talk to?
Does the pharmacist take the time to explain any new medications such as how, when and what not to take with it?
Does the pharmacist take time to answer your questions in a manner that you understand?
Discuss your medical history and any particular problems you are concerned about.

How Should I Choose a Pharmacist?
It's important to establish a relationship with one pharmacy so that your pharmacist has a complete history of your family's prescribed medications. A pharmacist is an important resource when it comes to making sure you and your family are getting the right medications.
If you move, you might want to consider staying within the same chain of pharmacy stores to ensure that your patient profiles and records are available in a common computer database. Or you could request that your most recent pharmacist give you a copy of your family's patient profiles and pharmaceutical history to take with you and share with your new pharmacist.

Do all pharmacies provide the same services?
All pharmacies are required to meet minimum standards. Most, however, offer services and conveniences beyond the minimum requirements. When choosing a pharmacist, you should evaluate your needs and make a selection to meet those needs.

Once you choose a pharmacy, it is strongly recommended that you use this pharmacy for all of your prescriptions needs. This allows you to receive the greatest benefit from the screening for drug interactions by your pharmacist, since this one pharmacy has all of your prescription drug records.
 
Know Your Medical History
It's important to keep a comprehensive record of your health information nearby. In many cases, this information can help a medical professional make quicker diagnoses and decisions during an emergency, when each second counts.

If you have diabetes , some pharmacies can demonstrate glucose monitors and help to guide you on which model works best for you. Some pharmacies are now offering the ability to download the readings from your diabetes monitor and print them out for you. This service can help you and you doctor better control your diabetes.

When you're checking out the facility make sure that there is convenient parking and notice if there is handicap parking close if that applies to you or any family members that may use the pharmacy.

Communication and being able to talk freely with your potential pharmacist is of paramount importance. The pharmacist should listen to your needs and concerns and answer any questions you may have. After you have consulted a few pharmacists you should have a good idea about which one you felt most comfortable with and who best answered your questions.


How Pharmacists Were Selected


Consumers’ Research Council of America has compiled a list of Top Pharmacists throughout the United States by utilizing a point value system. This method uses a point value for criteria that we deemed valuable in determining top Pharmaceutical professionals.

The criteria that was used and assessed a point value is as follows:

Experience:

Each year the Pharmacist has been in practice

Education:

Education, specialty training and continuing education

Professional Organizations:

Membership and/or affiliations with pharmaceutical associations

Simply put, Pharmacists that have accumulated a certain amount of points qualified for the list. This does not mean that Pharmacists that did not accumulate enough points are not skilled at administering pharmaceutical care, but merely did not qualify for this list because of the points needed for qualification.

Similar studies have been conducted with other professions using a survey system. This type of study would ask fellow professionals whom they would recommend; we found this method to be more of a popularity contest. For instance, professionals who work in a large office have a much better chance of being mentioned than a professional who has a small private practice. In addition, many professionals have a financial arrangement for back-and-forth referrals. For these reasons, we developed the point value system.

Since this is a subjective call, there is no guarantee that this study that is 100% accurate. As with any profession, there will be some degree of variance in opinion: If you survey 100 patients from a particular pharmacist on their level of satisfaction, you will undoubtedly hear that some are very satisfied, some moderately satisfied and some dissatisfied. This is really quite normal.

We feel that a point value system takes out the personal and emotional factor and deals with factual criteria. We  have made certain assumptions. For example, we feel that the more years in practice is better than less years in practice; more education is better than less education, etc.

The Top Pharmacist list that we have compiled is current as of a certain date and other Pharmacists may have qualified since that date. Nonetheless, we feel that the list of Top Pharmacists is a good starting point for you to find a qualified pharmaceutical specialist.

No fees, donations, sponsorships or advertising are accepted from any individuals, professionals, pharmacists, pharmacies, healthcare facilities, research organizations, corporations or associations. This policy is strictly adhered to, ensuring an unbiased selection.

 


Why Should I Talk To My Pharmacist?


Pharmacists cannot diagnose medical conditions, but your pharmacist can answer many questions about medicines, recommend nonprescription drugs, and discuss side effects of specific medications. And some pharmacists can also provide blood sugar and blood pressure monitoring and offer advice on home monitoring tests.
Most pharmacists who graduated in the 1980s received 5-year bachelor's degrees. Recently, it has become popular for pharmacists to receive a doctor of pharmacy degree. This 6- to 8-year-program requires pharmacists in training to go on hospital rounds with doctors and be there when decisions are made to begin drug use. These skills are particularly useful for pharmacists who operate within hospital settings.
Pharmacists are required to stay up-to-date on the changing world of medicine. Every 2 years, U.S. law requires your pharmacist to complete 30 credits of continuing education classes on drug therapy.

What Questions Should I Ask The Pharmacist?


A typical question is about allergies. Make sure that your pharmacist knows exactly what allergies you have and what medications you are already taking. This will help the pharmacist protect against possible drug interactions that could potentially be harmful.
Once you have received your medication, always look at it carefully before you leave the pharmacy. Read the instructions to be sure you understand how to take it. Even if the medication is a refill, check to make sure the drug is the same size and shape that you are used to receiving. If anything doesn't look right, ask.
Consider the following additional questions for your pharmacist:

Does this medication require special storage conditions (for example, room temperature or refrigeration)?
How many times a day should it be given? Should it be given with food? Without food?
Should my child avoid certain foods (such as dairy products) when taking this medication?
Are there special side effects that I should look for? What should I do if I notice any of these side effects?
Should I take special precautions, such as avoiding exposure to sunlight, when taking this medication?
What should I do if I skip a dose?
Is it OK to cut pills in half or crush them to mix into foods?


Which Tips does a Pharmacist Usually Offer?

Pharmacists usually offer the following advice:

Do not keep medicine in the medicine cabinet. The medicine cabinet in a steamy, moist bathroom is not the best place to keep any medication. The room's moisture can make medications less potent. It's best to keep medicines in a hall closet or on a high shelf in the kitchen.

What if you take the wrong dosage? Call the pharmacist or doctor right away, and follow his or her instructions.

Never repackage medications. Keep them in their original childproof containers so that you'll have the expiration date and instructions on hand.

If medications need to be refrigerated, make sure you keep them cool while traveling. Freezer packs in coolers work fine. If you can, take the entire medicine bottle. That way, you won't have any reason to forget the prescription dosage and if something happens to the medication, you can get a refill. And never mix two different drugs in the same pillbox – it is easy to get the two confused.

Remember to keep prescription and nonprescription medications out of the reach of children.

Toss medications when they have expired (usually 1 year for pills or sooner for liquids - check the prescription label for the expiration date) or the doctor has told you that you should stop taking them.

Though most liquid medications are now flavored, some may not be very palatable to a young child. Some medicines can be mixed with chocolate or maple syrup to encourage children to take the entire dosage. Check with your pharmacist to see what would work best with which drug. However, pharmacists discourage putting liquid medication into a bottle for babies; if they don't finish the bottle, they won't get all the medication.


Education And Licensing Requirements


People seeking to become pharmacists must complete a pre-pharmacy undergraduate program. This program consists of a minimum of 60-70 semester of undergraduate coursework in basic and advanced sciences (chemistry, biology, zoology, physics, and anatomy); however, many students go on to complete a four-year program leading to a Bachelor of Science degree in biology, chemistry, or a similar field. In addition, a high PCAT (Pharmacy College Admission Test) score is required at most colleges and schools of pharmacy.

After admission, a student will complete a four-year pharmacy program and will be awarded the Doctor of Pharmacy (PharmD) degree upon graduation.

A pharmacy graduate must complete internship requirements and pass the North American Pharmacist Licensure Examination, or NAPLEX, and an additional state exam before they can acquire a license to practice pharmacy in that state. The National Association of Boards of Pharmacy (NABP) created the NAPLEX.

A pharmacist can become certified in recognized specialty practice areas by passing an examination administered by the Board of Pharmaceutical Specialties. There are five specialties in which a pharmacist can become Board-certified. The Pharmacotherapy specialty also has two subspecialties, as follows:

Nuclear Pharmacy
Nutrition Support Pharmacy
Oncology Pharmacy
Pharmacotherapy
Cardiology
Infectious Disease
Psychiatric Pharmacy

Areas of graduate study include pharmaceutics and pharmaceutical chemistry (physical and chemical properties of drugs and dosage forms), pharmacology (effects of drugs on the body), toxicology and pharmacy administration.
Prospective pharmacists should have scientific aptitude, good communication skills, and a desire to help others. They also must be conscientious and pay close attention to detail, because the decisions they make affect human lives.

 


All About Internet Pharmacies


Recently a number of pharmacies have begun operating over the internet. Many such pharmacies are, in some ways, similar to community pharmacies. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient than traveling to a community drugstore.
Some internet pharmacies sell prescription drugs without requiring a prescription. Some customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications that their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous – especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There have also been reports of such pharmacies dispensing substandard products.

In the United States, there has been a push to legalize importation of medications from Canada and other countries in order to reduce consumer costs. Although importation of prescription medications currently violates FDA regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers.

The Future of Pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medications, pharmacists expect to be paid for their cognitive skills.
Many universities are altering their programs to increase emphasis in fields such as pharmacotherapeutics, clinical pharmacy, nuclear pharmacy, disease state management, etc.

 


Medications


Certain medications can't be taken together, so pharmacists need to know all medications (prescription and nonprescription) you are currently taking before they can administer any drug. In addition, you need to know the doses, the dosing schedules, and when the medications were taken last. You'll need to know when you last took the medication last, and how much was taken.

Allergies
Record a list any known allergies your have to medications, both prescription and nonprescription. Allergic reactions to insect stings and bites and food allergies are also important to list. In many cases, allergy information will help medical personnel discover a cause for problems like seizures or difficulty breathing.

Hospitalizations and Operations
List the dates you have been hospitalized and the types of operations you have undergone. This information may help during the course of treatment following an emergency situation.

Pre-existing Conditions

Pre-existing illnesses or conditions can have a great impact on the kinds of tests or treatments administered during an emergency. If you have any health problem - from diabetes to epilepsy to asthma - emergency medical personnel must know.

Immunizations
Keeping an updated record of all of your immunizations is important. If you need help remembering or compiling all the information, the staff at your doctor's office can assist you. Be sure to include information about any reactions you may have had following an immunization, such as seizures, high fever, or severe discomfort.

Height and Weight
When calculating medication doses, it can be helpful for doctors to know your approximate height and weight. 

Common Problems With Medications
Some people may forget to finish their prescription. If the medication (for example, a pain medication) is to be taken "as needed for symptoms," you don't need to finish the entire prescription within a set number of days. But with prescriptions like antibiotics, the medication must be finished for it to be effective.
Throw away any old prescriptions. If you don’t finish a medication, it's not a good idea to save it for a future illness because most drugs lose their potency after 1 year. Do not use after the expiration date and talk with your doctor before taking old prescriptions.

Another common problem is the sharing of medications. Pharmacists and doctors recommend that no one take a drug prescribed for anyone else or offer prescription drugs to another person, no matter how similar the symptoms or complaints.


The Process Of Drug Discovery


Identification
The first step of drug discovery involves the identification of new active compounds, often called “hits,” which are typically found by screening many compounds for the desired biological properties. These hits can come from natural sources, such as plants, animals, or fungi. More often, the hits can come from synthetic sources, such as historical compound collections and combinatorial chemistry.

Recent developments in robotics and miniaturization have greatly accelerated and automated the screening process. Typically, a company will examine over 100,000 individual compounds before moving to the optimization step.

Optimization
The second step of drug discovery involves the synthetic modification of the hits in order to improve the biological properties of the compound pharmacophore. The quantitative structure-activity relationship of the pharmacophore play an important part in finding "lead compounds", which exhibit the most potency, most selectivity, and least toxicity.

Development
The final step involves the rendering the "lead compounds" suitable for use in clinical trials. This involves the optimization of the synthetic route for bulk production, and the preparation of a suitable drug formulation.


Pharmaceutical Abbreviations


The following Latin abbreviations are often used in prescribing medicines:

i one
ii two
iii three
iv four
po take by mouth
QD take once a day
BID take twice a day
TID take three times a day
QID take four times a day
Q12h take every 12 hours
Q4-6h take every 4-6 hours
PRN as needed or if needed
PC after a meal
AC before a meal
as left ear
ad right ear
ou both eyes
od right eye
os left eye
tsp teaspoonful
ml milliliter

 


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