Pharmacy
Pharmacy is the health science that studies the use of drugs in biological systems. The Pharmacy profession is charged with the safe and effective use of drug therapy. A practitioner of pharmacy is a pharmacist.
A pharmacy is also the location where drugs are dispensed. Pharmacies are located in both the community as a business, or in an institutional setting such as a hospital or nursing home.
Disciplines
Pharmacy is broken into many disciplines and practice areas.
- Pharmacology- how drugs interact with biological systems. This field encompasses pharmacokinetics and pharmacodynamics.
- Medicinal Chemistry- how drugs interact with biochemicals, and how drugs are discovered and created
- Pharmacognosy- the study of drugs derived from natural sources
- Pharmaceutics- how drugs dosage forms are made
- Pharmacy Practice- interactions with patients to optimize drug therapy
Within each field, and practitioner of pharmacy can specialize in a number of processes, from specific types of dosage forms, to specific types of diseases (cardiology or infectious disease for example), to specific drug families (examples: ACE inhibitors or fluroquinolones).
Practitioners
The usual practitioner of pharmacy is a pharmacist. A pharmacist is trained in a professional program for 6-8 years, and is then licensed in the state in which they practice. Pharmacists generally practice in a community or institutional (hosptial) setting, and are concerned with optimizing drug therapy in patients.
Ph. D. programs are also available in the field of pharmacy. These programs are often concerned with drug development.
Areas of Practice
Community Pharmacy
A community pharmacy is where pharmacists dispense drugs upon a medical prescription written by a physician or other prescriber. Pharmacists, with the help of pharmacy technicians, interpret prescriptions, organize them into a patient profile (usually computerized), submit the claim to the patient's prescription insurance policy, fill the prescription ( compounding if necessary), and finally dispense the prescription the the patient. The pharmacist is responsible for checking drug interactions, verifying the drug is appropriate based on the patient's profile, and verifying the correct drugs are given, and educating the patient on the proper use of the medication.
Community pharmacies can specialize in a specific area. Some are compounding pharmacies, focused on providing on an individual basis a drug in a dosage form that is not commercially available. Home infusion pharmacies and specialty pharmacies dispense injectable drugs that may require expensive preparation equipment and more extensive patient education.
Some community pharmacies are internet or mail order based. These pharmacies fill prescriptions from a central location and mail them to the patient. Some local community pharmacies take refill prescriptions from the internet, but the medications are available for pickup at the normal location.
Institutional Pharmacy
An institutional pharmacy dispenses drugs to residents of an institution (hospitals, long term care facilities, mental health institutions) persuent to a medication order. Institutional pharmacies often dispense the same type of medication as an community pharmacy, as well as prepare and dispense injectable medications used in the facilities. Institutional pharmacies often split their clinical and distribution practices.
Clinical Pharmacy
Clinical pharmacists evaluate patients and make drug decisions directly, usually under the supervision of a physician. These pharmacists manage difficult drug regimens, that often require more monitoring and education that other drugs, and may require the use of advanced pharmacokinetic principles. Examples include warfarin management, diabetes and hypertension management, HIV medication management, oncological drug management, total parenteral nutrition management, and serving as a general drug reference in a specific field.
A consultant pharmacists manages medication therapy in an long-term care facility.
Nuclear Pharmacy
Nuclear pharmacy is concerned with creating radioactive drugs that can be used to diagnose or treat diseases.
Veterinarian Pharmacy
Veterinarian pharmacists are concerned with providing drugs to animals. This requires knowing the physiology of animals (and where it differs from human physiology), and how to compound drugs in a dosage form that an animal can take.
Drug Development and Research
Drug development and pharmaceutical research is carried out by private companies, academic institutions, and governmental entities. Researchers in this field research new molecular entities to bring to a market, find uses for existing drugs, and participate in regulatory activities by ensuring the drugs are both safe and effective.
Future of Pharmacy
The pharmacy profession is actively moving away from the strict dispensing model to a cognitive services model used by other health-care professionals.
Medication Therapy Management
Medication Therapy Management (MTM) is a collaboration between a pharmacist, a patient, and other heath-care provider that provides for the safe and effective use of medication, and helps patients and providers reach the goals of therapy.[1] MTM services continue to be implemented across the world, as the interaction has been shown to improve patient outcomes.
Behind the Counter Dispensing
Traditionally there are two drug classes: prescription, which require a prescription from a physician or other prescriber, and over-the-counter, which a patient can by without any prescription. Recently, there has been proposals of a third class of pharmacist-dispensed "behind-the-counter" drugs. A current example in the United States is Plan B, a morning after contraceptive, which can be sold by a pharmacist.
Other candidates for this class of medications include the popular statin drugs, and oral contraceptives.