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Tareq Mukattash, PhD
Week 1 1-3 Topics Pharmacy history Pharmacy services in different sectors
Social and behavioral aspects of pharmaceutical work
Selecting, supplying and managing medicines
Ethics in healthcare Ethics & practice 1: -Patient rights
9 - 11
-Confidentiality -Different patient groups (i.e, patients with terminal illness) -Capacity & patients consent Ethics & practice 2: -Pharmaceutical work ethics
12 - 13
-Pharmaceutical research ethics -Availability of medicines -Unlicensed and off-label drugs
14 - 15
An introduction to laws governing pharmaceutical practices in Jordan
NB: all references are available at the University’s library
(1) A glance at history • Cavemen almost certainly rolled the first crude pills in their hands • The earliest known prescriptions date back to at least 2700 BC and were wri en by the Sumerians. • Chinese pharmacy traces its origins to the emperor Shen Nung in about 2000 BC. .
not only observed nature. • Greek philosophers began to influence medicine and pharmacy . and they learnt and practised their art in the temples.• Egyptian pharmacists were priests. but sought to explain what they saw. gradually transforming medicine into a science • Greek medicine continued with the rise of the Roman Empire .
and gives precise instructions for preparing them. . • In his Materia Medica he describes nearly 500 plants and remedies prepared from animals and metals.• The transition of pharmacy into a science received a major boost with the work of Dioscorides in the first century AD.
and was the first to define a drug as anything that acts on the body to bring about a change. .• The greatest influence on pharmacy was Galen (130 to 201 AD) • He introduced many previously unknown drugs. • He gave his name to pharmaceuticals prepared by mechanical means (galenicals).
Liber Continens. was to play an important part in Western medicine.• The first privately owned drug stores were established by the Arabs in Baghdad in the eighth century. including syrups and alcoholic extracts. • One of the greatest of Arab physicians was Rhazes (865–925 AD). developing a wide range of novel preparations. • They built on knowledge acquired from both Greece and Rome. • His principal work. .
Edited by Foxit Reader Copyright(C) by Foxit Software Company. • The greatest figure in the science of medicine and pharmacy during this period was the Persian. .• These new ideas became assimilated into the practice of pharmacy across western Europe following the Moslem advance across Africa. Spain and southern France. who was known by the western world as Avicenna. Ali ibn Sina (980 to 1037 AD).2005-2008 For Evaluation Only.
• His Canon Medicinae is a synopsis of Greek and Roman medicine.2005-2008 For Evaluation Only.Edited by Foxit Reader Copyright(C) by Foxit Software Company. • His teachings were treated as authoritative in the West well into the seventeenth century and they remain dominant influences in some eastern countries to this day .
German pharmacists. Published in 1498 .2005-2008 For Evaluation Only. pharmacy shops began to appear around the eleventh century • Frederick II of Hohenstaufen provided a key link between east and west. formed themselves into a society in 1632 (Basel Oath).• In European countries exposed to Arab influence. • The first official pharmacopoeia. • European countries. and it was in Sicily and southern Italy that pharmacy first became legally separated from medicine in 1231 AD. to be followed by all apothecaries. originated in Florence. for example. Edited by Foxit Reader Copyright(C) by Foxit Software Company. pharmacy emerged as a separate occupation over the centuries which followed.
followed by the establishment of pharmacy schools and faculties. Establishment of Pharmaceutical association around Europe. . established the first such shop in Philadelphia in 1729. During the 17th and 18th centuries many people in con nental Europe passed the examinations for both pharmacy and medicine.• The organisation of pharmacy • • • • • • In France. Early American pharmacy was heavily influenced by immigrants from Europe. Christopher Marshall. and practised both. The American Pharmaceutical Association. the pharmacien received official recognition with the establishment of the College de Pharmacie in 1777. open to ‘all pharmacists and druggists of good character’. was established some me later. which ushered in modern French pharmacy. An Irish pharmacist. in 1852.
• The practice of pharmacy • Problems: – – – – – Chain pharmacy & multiples!! The nature of retailing was changing The ﬁrst dental register appeared in 1879 World wars Poor people Edited by Foxit Reader Copyright(C) by Foxit Software Company. .2005-2008 For Evaluation Only. • Steps forward: – – – health insurance Separating dispensing and prescription Strength of societies • Pharmaceutical industry. Branding.
• Professionalism versus commercialism • The conflict between trade and profession has been a central issue throughout pharmacy’s history • Pharmacists have always been paid for the products they sell. not the advice they give. and almost all engage in retail trade stretching beyond the strict confines of pharmacy • It was undesirable for nonprofessional business to predominate in a pharmacy. and that the extension of this kind of business in pharmacies should be controlled .
one knew there was a future for industrial pharmacists. the Na onal Pharmaceu cal Association (UK) began its ‘Ask Your Pharmacist’ campaign. . In 1982. Some important initiatives were taken.• THE EMERGENCE OF ‘THE NEW PHARMACY’: 1986 TO PRESENT • By the early 1980s there was widespread uncertainty about the future of pharmacy. But what was really needed was an independent and far-ranging inquiry into the profession. particularly community pharmacy. in which it promoted the use by the public of their local pharmacy. • ‘one knew there was a future for hospital pharmacists. for example. but one was not sure that one knew the future for the general practice pharmacist’ • Pharmacy needed to re-invent itself.
• The Nuﬃeld Report 1986 (UK): • ‘to consider the present and future structure of the practice of pharmacy in its several branches and its potential contribution to health care and to review the education and training of pharmacists accordingly’. • ‘we believe that the pharmacy profession has a distinctive and indispensable contribution to make to health care that is capable of still further development’ • ‘every prescription for a medicine must be seen by a pharmacist. and a judgement made by him as to what action is necessary’ .
• The extended role of the pharmacist: • • • • • increasing the range of medicines available for sale by pharmacists the maintenance of patient medication records by pharmacists the extension of needle and syringe exchange schemes participation in health promotion campaigns having separate areas for providing advice and counselling. . • New age: • Four key areas for pharmacy involvement were identified: – – – – the management of prescribed medicines the management of chronic conditions the management of common ailments (diseases) the promotion and support of healthy lifestyles.
. the extended role.• Is pharmacy returning to its roots? • The ‘Ask Your Pharmacist’ campaign. and the Pharmacy In A New Age initiative can be seen collectively as an attempt to draw pharmacists out of the dispensary (which was usually at the back of the shop). to the front of the shop where they would be more accessible to the public. • Here they would be the – ‘first port of call’ for the public seeking medical attention – they would be a source of advice and information about medicines to the public – they would prescribe from an increasingly long list of recently deregulated medicines.
• At the same time as pharmacists were becoming more accessible. doctors were becoming less accessible. • The changes in pharmacy practice in the last quarter of the twentieth century represented a shift away from a product-oriented approach to medicines towards a patientfocused one .
and the history of hospital pharmacy is closely allied to the history of hospitals. . • The history of hospital pharmacy can be considered within three time frames: – An emergent period up to 1897 – a period of standardisa on up to 1948 – a period of expansion and consolidation since then.• A BRIEF HISTORY OF HOSPITAL PHARMACY • Pharmacy practice in hospitals can be traced back over many centuries.
. • Hospital pharmacy was never immune. such as paediatrics or cardiology. and many pharmacists began to specialise in a particular area of clinical pharmacy. so the Church began to care for the sick and needy. such as formulary development. • Many employed an apothecary and contained a dispensary. Edited by Foxit Reader Copyright(C) by Foxit Software Company.2005-2008 For Evaluation Only. The apothecary usually combined the roles of resident medical officer and dispenser of medicines. • As Europe converted to Christianity. It was nevertheless able to establish new activities which contributed to cost control.• The first hospitals in which it is known pharmacy was practised were the Roman military hospitals known as valetudinaria.
• Clinical pharmacists often collaborate with physicians and other healthcare professionals. . wellness and disease prevention.• Clinical pharmacy • Clinical pharmacy is the branch of Pharmacy where pharmacists provide patient care that optimizes the use of medication and promotes health. • Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics.
clinical pharmacists are experts in the therapeutic use of medications. appropriate. and cost-effective use of medications . • They routinely provide medication therapy evaluations and recommendations to patients and other health care professionals. • Clinical pharmacists are a primary source of scientifically valid information and advice regarding the safe.• Within the system of health care.
"Clinical pharmacy is the branch of pharmacy which deals with – various aspect of patient care – dispensing of drugs – advising patient on the safe and rational use of drug • Basic components of clinical pharmacy practice: – – – – – – – Prescribing drugs Dispensing and administering drugs Documenting professional services Reviewing drug use Communication Counselling Consulting • Scope of clinical pharmacy: – – – – – – – Drug Distribution Systems Drug Information Drug Utilization Drug Evaluation and Selection Medication Therapy Management Formal Education and Training Program Disease State Management .• A more appropriate definition for clinical pharmacy is.
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