1.

EVOLUTION OF PHARMACY
a) WHAT IS PHARMACY?
i. Derived from the Greek word PHARMAKON means “Medicine” or
“Drug”
ii. It is the art and science of preparing, dispensing, and proper utilization of
medications and the provision of drug-related information to the public.
iii. It is where we study how to prepare, how to dispense, and how to
properly utilize medications or drugs.
iv. In different aspect, it is also known as DRUGSTORE – it is a place
where drugs are sold.

2. HISTORY OF PHARMACY
Recent drugs in healing, was actually as old as civilization itself
It existed long before the word pharmacy / drug existed

a) SUPERSTITIOUS BELIEF
i. Before, the theories are often involved magic and superstitious beliefs
but development in medical, astronomical, and cosmological ideas.
ii. The first culture to consider this ideas, scientifically was actually the
Greeks, wherein they made a logical speculation rather than just
relying on myths or mythology.

b) TERRA SIGILLATA
i. The modern archeologist, they have an ----, CLAY TABLETS which
contains 300 medicinal preparation, we called it the Terra Sigillata
found in Mediterranean Island of Lemnos.
ii. It is consider as an early trademark drug

c) COMBINING DIFFERENT AGENTS

i. Nowadays, combination of different agents / extracts is referred to us, as
COMPOUNDING
ii. It was considered as an art form by priest and doctors before.
iii. The early inhabitants, they use the Trial and error method in order to
compile the list of drugs. They called that Dispensatories and now we
called them as Pharmacopeias.

d) PAPYRUS EBERS
i. It is Ebers Papyrus book.
ii. It is the best known and important pharmaceutical record, because it is a
collection of 800 prescriptions, mentioning 700 drugs.

e) DE MATERIA MEDICA
i. Pedanius Dioscorides
1. a Greek physician.
2. He is credited with writing one of the world’s greatest
pharmaceutical text, which we called it De Materia Medica or in
English “ on medical matters”
ii. It served as the standard reference text for drugs
iii. It is considered as the four runner of modern day reference such as the
United States of pharmacopeia (USP) and the Physicians
 iv. Thus, the modern day formularies are actually based on this drug list

f) GALEN
i. He is a Greek professor of Pharmacy and Medicine
ii. He studied the effect of herbal medicine on the human body leading to
the term Galenical Pharmacy or the process of creating extracts of
active medicinal from plants which we used as one of the component,
factor that we consider as a source in research for the discovery of drugs.

3. ROOTS OF THE PHARMACY PROFESSION

a) THE MIDDLE AGES
i. The profession of pharmacy was evolving in Persian and European
empires.
ii. The pharmacy began to develop as a profession now separate from
medicine in 18th century
iii. It is because before, doctors and pharmacy are the same

b) ARABIC CIVILIZATIONS
i. were some of the first cultures to develop a list of drugs and dosage
forms (pills, syrups, extracts), and to identify the pharmacist as a
qualified healthcare professional
ii. It starts in 18th century

c) APOTHECARY (Pharmacy)
i. modeled after ancient Greek and Arabic cultures

ii. The first Apothecary shop was first establish Baghdad by the Arabs
1. Arabs are the first culture who recognized Pharmacy profession

iii. The first school of pharmacy was established in 1821 founded by the
United States and now it is as called Philadelphia College of Pharmacy
and Science

iv. Professional guilds led to the training of chemists and pharmacists which
led to the rise of formalized universities and professional organizations.

4. ROLES OF EARLY PHARMACY PRACTITIONERS

a) Pharmacists in the colonies were druggists, doctors, merchants or
storekeepers.

b) Until the 19th century physicians typically owned the dispensary that
distributed drugs to patients.

c) Development of the United States formulary known as the United States

Formulary (USF) formerly known as the United States of Pharmacopeia
(USP).
i. Nuovo Receptario – the first pharmacopeia in 1498 which is written in
Italian, particularly made in Florence Italy.
d) MONASTERIES
i. served as the source of drugs because of their Herbs Gardens which
still exist today, including the development of abbreviations or medical
terms that derived from Greek or Latin words
ii. Medicine and Pharmacy began and originates in Rome and Greece
wherein their language became basis for medical terms

e) 1852, the American Pharmacist Association (APhA) addressed Adulteration

of imported drugs.
i. Adulterated Drug – it is contaminated that can be harmful to patients

f) Late 1800’s community pharmacist compounded many herbs and

chemicals for medicinal use.
i. The community pharmacist before, they are called to provide the first aid
and medicines for common ailments only.
ii. Examples: burns, bites, poisoning and minor pains

g) 1886, John Pemberton, began to sell a tonic called Coca – Cola

h) 1893, Caleb Bradham, created Pepsi – Cola.

i. Coca – Cola and Pepsi – Cola are used as tonic
ii. It is recommend by some physicians before to increase blood sugar

i) 20th century pharmaceutical manufacturing began to take hold.

j) The traditional compounding tasks (formulating own liquids, powders and

rolling their own pills) became less common, pharmacy became more
scientific and technical.

k) American society of Health System Pharmacist (ASHP) is credited with

many innovations in practice and training programs.
i. The industrial evolution has a strong impact in every aspect of
pharmacy, this leads to the creation of new drugs which aim to produce
economical and better quality medications.

ii. The rapid change from hand method to machine method happen. From
production – it is more on methods that uses machines. As the time
passes by pharmacist became more technologically oriented.

iii. Large scale drug manufacturing begin in the society wherein patent are
existed.
1. Patent drugs – they are the only one who produce a specific type
of drug.
2. Example: Digoxin - Lanoxin

iv. With the explosion of scientific resources and accessibility of

information, the Pharmacy profession is able to fit with medical
advances.
1. To compounding it has evolved from trial to error process to exact
science
5. Current Roles Of Pharmacist (including PTC)
a) Pharmacist
i. NOTES:
1. Pharmacy have many job opportunity
a) Can work in Community Hospital
b) Manufacturing Companies
c) Engage in research for drug formulation and identification

2. Regulatory:
a) DOST
b) PDEA
c) Department of Health (DOH)
d) FDA

3. Academe
a) Pharmacy instructors and professors

4. Hospital
a) Primary job or division ideally for pharmacist
i. Because they highlight the job opportunity for pharmacist
5. Community
6. Manufacturing
7. Research
a) For developing new drugs

ii. PHARMACIST
1. REGULATORY
a) Administrative services
b) Manufacturing and packaging
c) Radiopharmaceutical services

2. ACADEME
3. HOSPITAL
a) Administrative services
b) In-patient services
c) Out-patient services
d) Drug information services
e) Sterile product
f) Departmental services
g) Purchasing and inventory control
h) Central supply services
i) IV admixture
j) PTC

4. COMMUNITY
a) Out-patient services
b) Educational and training
c) Purchasing and inventory control

5. MANUFACTURING
 a) Pharmaceutical research
b) Manufacturing and packaging
c) Sterile products
d) Assay and quality control
e) IV mixture

6. RESEACH

b) Regulatory
i. Administrative Services
1. Pharmacist develop policies and provide supervision

ii. Manufacturing and packaging

1. Usually for manufacturing companies
2. They manufacture wide variety of items or support manufacturing
3. Packaging programs

iii. Education and training

1. Internship
a) There is a pharmacist who incharge for that
2. Training
3. Programs
a) Working (2:35)

iv. Radiopharmaceutical Services

1. They centralized the procurement, storage, and dispensing of radio
isotopes in clinical practices
2. *No services here in the Philippines
3. Kung meron very limited or rare

c) Hospital Pharmacy
i. In-patient services
1. Pharmacist dispense and provide drugs for inpatient
2. They also inspect and control drugs
3. Pharmacist DON’T counsel, Usually physician does (and nurse)
4. Maintain prescription record

ii. Out-patient services

1. Compound and dispense drug to out patient
2. They maintain prescription record
3. Counseling

iii. Drug information services

1. They provide information on the different drug and Drug therapy
to physician and other medical practitioners in hospitals
2. Provide information regarding the drugs to medical practitioners
(nurses, physician and midwives)
3. They maintain drug information center
4. Keep literature files
 iv. Sterile Products
1. They produce volume parenterals
2. Prepare aseptic dilution for stability

v. Departmental services
1. They control and dispense intravenous fluids or IV fluids
2. As well as controlled substances and they coordinates with drug
delivery and distribution system
3. Like central supply services

vi. Pharmaceutical Research

1. Formulation for a new drugs
2. for the improvement
3. Different product

vii. Purchasing and inventory control

1. Pharmacist contain drug inventory control (every month @ the end
of the month)
2. For purchasing of drugs
3. For receiving, storing and distributing of drugs
4. For interviewing medical representative
a) Community pharamcy
i. Once a month
b) Hospital Pharmacy
i. Weekly

viii. Central supply services

1. They develop and coordinates distribution of medical supplies
2. And irrigating fluids

ix. Assay and quality control

1. They perform analyses
2. Develop and revise assay procedure in order to check the quality
and clean, safe or effectiveness of drug

x. IV mixture
1. Preparation of IV solution admixture
2. They review each admixture for physical, chemical
incompatibilities to see:
a) Soluble
b) Miscible
c) Aggregate
d) Problems in administration

d) Pharmacy and Therapeutic Committee (PTC)

1. They are compose of :
a) Health chairman
i. Physician
b) Secretary
i. Pharmacist
 c) Nurses
d) Administrator
e) Other practitioners

ii. Responsible for policy development, evaluation, selection and for

checking the therapeutic uses of drugs

iii. Education
1. Formulation of programs for the needs or updates of profession

iv. Formulary
1. Formulation of formulary
2. Sila ang gumagawa sa hospital formulary

6. BRIEF DUTIES OF PHARMACIST

a) The Work
i. Prepare and dispense drugs prescribed by doctors.
ii. Advise doctors, patients and other health care professionals on proper
dosage and possible side effects.
1. They must know what’s in the drug, how it works, and how it affects
people.
2. They should know the pharmacodynamic and pharmacokinetic
action of drugs in simple terms
iii. They should know the contents of the drug, generic name, brand name,
indication, side effect or adverse effect

iv. Simple description of work:

1. Purchase medical supplies
2. Answer customer questions
3. Go with doctors and hospital staff on rounds
4. Advise patients on medical equipment and over-the-counter
medication
5. HELP PATIENTS GET WELL

b) GOAL: Promote rational drug use

c) Main role: counselling

i. For patients with prescription drugs and patients with OTC drugs (they
need counselling because some patients use paracetamol, ibuprofen as
vitamins which is wrong)
d) The Cycle of Change, How to Bring it about pharmacy services

7. FUTURE OF PHARMACISTS
a) HEALTH MANAGEMENT CENTRES INSTEAD OF DRUG
DISTRIBUTION MACHINES
i. For technical innovation counselling of patients. So, instead of just
dispensing drugs there is a help. They want to have wearable sensors and
tracker data. It will help focus on health management using computer
system.
 ii. It is not impossible but it is uncertain to be implemented nowadays (it is
like our goal maybe in 2030, 2040, 2050 it can)
iii. The association of pharmacist (HENDI KO MAINTINDIHAN)

b) HEALTH CONSULTANCIES INSTEAD OF DRUG DISTRIBUTION

MACHINES
i. The problem with pharmacist (HENDI KO MAINTINDIHAN). So, in
order to prevent that they want to establish health consultancies.
Medicine already started it for accessibility (via call). which is one
example of (HENDI KO MAINTINDIHAN). The patient will be
diagnosed or advised in a timely manner in health offices and (HENDI
KO MINTINDIHAN) as well in their most convenient time made by the
clinical pharmacist (or via call)

c) PERSONALIZING THERAPIES AND PRINTING OUT DRUGS ON

DEMAND
i. Physicians they need culture-sensitive test in order to prescribe a narrow
antibiotic rather than prescribe imaging broad spectrum antibiotic.
ii. They are starting to study biomarker
1. Biomarker a substance used as an indicator of a biologic state. A
fragment of the DNA sequence (examples: proteins, nucleic acids,
carbohydrate, lipid).
iii. With the use of 3D printers. They will print out (HENDI KO
MINTINDIHAN) layer by layer to make it dissolve faster than average
spills. There will be faster distribution.
iv. Personalizing therapies based on biomarker
v. Printing drugs on demand - 3D printers

d) CONTINUED GROWTH OF SPECIALTY MARKET

i. Actually the ship from traditional brand name drug to specialty drugs
(very expensive products)
ii. Specialty drugs
1. these are biologics or drugs derived from living cells (example: stem
cells).
2. Usually parenteral for the treatment of typical illnesses like cancer,
sexually transmitted infection, arthritis.

e) EXPANSION OF PHARMACOGENOMICS
i. Related to no. 3
ii. We have the personal healthcare using genetic testing. Result of
sequencing the genome which can be use to link a person’s gene with
personalized specific treatment to improve overall health
iii. The patient holds the opportunity to with the pharmacist and select the
best drugs based on their DNA profile. (here, they like to group the
patients and check the DNA profile and categorize to know the drug that
suits. They’ll check your diseases and learn based on your genes. For the
drug to become suitable and doesn’t have side effects and become really
effective)
 f) TARGETING COMPLIANCE AND ADHERENCE TO BIG DATA
i. We all know that data is an effective focus adherence or the compliance.
Retrospective data cannot use data like past history of patients. Drugs
will be given based on their present case. It is updated and continuous.
There will be an availability of real time data which promotes
compliance and the guardians also be inform

g) DIGITAL FUTURE: GROWTH OF THE e-patient

i. We are actually envisioning on global networking buy inexpensive
sensor and that there will be a real time biometric.
1. Here, they want through fingerprint information will be capture
2. They also want wearable technology object (wearable watch) to
monitor patients; diseases and drug that can be given. Home-
based telehealth devices that can help monitor and manage the
health of patient.

h) COORDINATED HEALTHCARE NETWORKS

i. If there is a connective pharmacist and patient this is the same as the
pharmacist with the other healthcare team

8. FUTURE PHARMACIST
a) ROLE OF ARTIFICIAL INTELLIGENCE
i. with the used of smart machines or robots
ii. uses computers that…. (bilis ni ma’am magsalita guys hahahaha kaiyak)

b) HEALTH TEAM (ideal)

i. Group of persons who share common objectives determined by
Community needs and toward the achievement of which each member of
the team contributes in accordance with his/her competence and skills,
and respecting the functions of the other.
ii. So we have the; PHYSICIANS, NURSES, PHARMACIST,
RADTECHS, AND OTHER PRACTITIONERS/PROFESSIONS.

c) HEALTHCARE TEAM
i. Health care is a collaborative effort between physicians, nurse
practitioners, dentists, vets, nurses, and pharmacist.
ii. Paraprofessionals like pharmacy technicians, physician assistants, dental
assistants, hygienists, vet assistants, and licensed practical nurses assist
professionals in routine but necessary tasks.
iii. Pharmacy technicians assist pharmacist allowing pharmacists more time
to meet the mission of the profession: to ensure positive outcomes for
drug therapy in patient population.

d) THE PHYSICIAN HEALTH TEAM

i. Physician is a doctor or a person who is authorized to practice
medicines. They are responsible for diagnosis or (guys diko na marinig
hahhaha basta andami niyang sinabi nag c”’cut) they prescribed
interventions/medicines.

e) THE NURSE HEALTH TEAM

 i. Nurse like for example they administered drugs (chappy na mga
sumunod na sinabi niya uwuuu). In the hospital the nurse are very hands
on to the patient.

f) THE PHARMACIST HEALTH TEAM

i. Pharmacist they dispensed drugs and medications prescribed by the
physicians and the dentist which be administered by nurses.

g) THE PHYSIOTHERAPIST HEALTH TEAM

i. Physical Therapist they provide assistants to patients that has a problem
related to musculoskeletal system --> includes bones, muscles,
tendons, ligaments and soft tissues.
ii. They asses mobility and strength.
iii. They provide therapeutic measures and they also teach patients to skills
and measures.
iv. Physiotherapist
1. they treat patient who suffered from injuries, accidents, strokes.

h) THE DIETICIAN HEALTH TEAM

i. Dietician is they design a special diets and they supervise the (nag
chappy na naman si ma’am mwehehe she’s under the water charot
hoyyyy heyward!!!!)

i) THE SOCIAL WORKER HEALTH TEAM

i. Social worker they provide assistants to the patients for example may
mga problema ang pasyente.
ii. They provide individual counseling, help patients determine appropriate
health care and other health services and provide support to patients with
serious or chronic illnesses. (sinearch ko nalang po hehe)

j) THE LABORATORY SCIENTIST HEALTH TEAM

i. Medical Technologist they examines a studies of specimens such as like
urine, feces, blood and other body fluids and tissue samples. They are
more on diagnosis.

k) THE OCCUPATIONAL THERAPIST HEALTH TEAM

i. Occupational Therapist (ma’am madik naawatan promise nisearch ko
nalang uli guys pasensya na puuu) they help patients develop, recover,
improve, as well as maintain skills needed for daily living and working.
They use scientific bases and a holistic perspective to promote a person’s
ability to fulfill their daily routines and roles.
ii. Occupational Therapist
1. they provide treatment for those who have inborn impairments or
Person with Disabilities (PWD).

l) THE RADIOLOGIC TECHNOLOGIST HEALTH TEAM

i. Radiologic Technologist they assist wide variety of xray procedures
(chappy manin)
 ii. They are responsible for accurately positionig patients and ensuring that
a quality diagnostic image is produced. They diagnose or rule out disease
or injury. (search again)

Sabi ni ma’am sa dulo if you have any concers just message me in our gc
HAHAHAHAH may discussion daw na Part 2 nextweek :)
1. SOCIAL AND BEHAVIORAL ASPECTS OF PHARMACY
a) Relationship Between Social Inequalities and Health

2. SOCIAL INEQUALITY
a) refers to relational processes in society that have the effect of limiting or
harming a group`s social status, social class, and social circle
b) Unhealthy relationship within a community or group due to some adversities

c) SOCIAL STEREOTYPING
i. Having a fix ideas about people
ii. They are close-minded

d) DISCRIMINATORY LEGISLATION
i. For example, friends or relatives are the one accepted in the government
or public institution
ii. Or they follow the role which is “whom you know, not what you know”
- rules about priorities, not equal

e) WEALTH
i. Rich people are prioritized and have advantage than poor people

f) RACE
i. For example, in US there are still racist (white people have more
advantage, they bully black people)

g) GENDER
i. Sometimes, in institution or establishments there are preferences. For
example, they don’t accept LGBTQ, they prefer men in a specific work
than women

3. HEALTH INEQUITIES
a) these are the factors that affect medical services quality. It is focus on
physicians, but then it relates to other medical practitioners because their
ideas are the same

b) PATIENT SOCIO-DEMOGRAPHIC VARIABLES

i. Medical practitioner should be aware of the culture of the patient in
order to prevent a misunderstanding and in order to establish trust, so,
they will obey and converse with truth
ii. The way you talk to literate is different from the way ou talk to illiterate,
is different
iii. For example, in language (if it is english or tagalog)
iv. You have to make your patient comfortable
v. Because of that, you can have proper communication or conversation
with each other

c) PATIENT COOPERATION
i. It repels noncompliance. When there is a compliance, the medical
personnel is effective and thus the patient will be treated properly.
Remember that the quality of medical services does not only depend on
 the capabilities of the medical practitioners but also the cooperation of
the patient.

d) PATIENT ILLNESS
i. Severe illness causes anxiety and stress among staff especially deaths
ii. If a patient die, you feel that it is your fault

e) SOCIO-DEMOGRAPHIC VARIABLES OF MEDICAL

PRACTITIONERS
i. Physician’s character and personality and appearance and social class -
components
ii. The way he put himself closer to patients like a friend for example

f) COMPETENCE OF HEALTH PROFESSIONALS

i. Knowledge and skill. Skill, expertise, commitment and how the
physician or medical practitioner shall the pharmacist, the nurses
examine the patient properly
ii. So, medical practitioner often undergo training and seminars for
continuous education and for updates also. Because of the use of
technology, the machine needs updates
iii. Once you explained very well the condition of the patient, they will
return

g) MOTIVATION AND SATISFACTION OF HEALTHCARE

PRACTITIONERS
i. Pay or salary. Physicians works more in private than government
because of professional fee. Other medical professionals they prefer
government than private
ii. Working environment, they prefer conducive, complete basic needs,
work procedures and proper equipment
iii. Managerial leadership, if they just practice being a boss and do not know
how to lead, we don’t want that
iv. Organizational policies, policies are well-implemented and strictly
followed
v. Co workers, if they are very polite and responsible enough

i. Recognition
1. What motivate a medical practitioner
a) Promotion
b) Acknowledgement when something is achieve
2. Some institution have:
a) Best employee of the week, month or year
3. This are the factors that will encourage us to work harder

ii. Job security

iii. Stability and for retirement

iv. Job Identity

1. Describe and presented the scope of your work
 a) Hindi yung “ikaw na nga manager, ikaw pa ung cashier” diba.
Ayaw na tin yun

v. Chances of promotion
1. As what I said kanina, we tend to take masteral, doctoral, doctorate
for promotion

b) HEALTH CARE SYSTEM

i. Patient is free to choose the health care settings or provider
ii. Problem:
1. The role of Health care system is not valued or is ignored resulting
to long medical intervention being provided
2. Or in complete medication regarding it
a) Health care delivery is not rendered properly because
i. it was not recognized by the patient as an important factor
ii. Financial problem
iii. They do not trust the medical practitioners

c) RESOURCES AND FACILITIES

i. Health care resources are limited because:
1. Low budget or funds
2. Resources are to old or destroyed
3. Already not reliable

d) COLLABORATION AND PARTNERSHIP DEVELOPMENT

i. Doctors expect their co-worker to be more responsible and empowered
enough to perform the job well
ii. There should be good communication
1. (this is true when a patient has too many physicians, if they don’t
communicate their patient will die)

2. Personality, Motivation, Empowerment and Compliance

a) Personality
i. Ambitious
1. the perfect employee will always want to improve and will have big
goals
2. Example:
a) “I want to be Recognize”
i. You will study masteral, doctorate to be promoted

ii. Autonomous
1. the ability to work on tasks by themselves with very little help
2. You are independent and responsible enough
3. You can accomplish something or what your boss tell you from the
amount of time given to you

iii. Humble
1. it`s important to stay grounded and not too arrogant
2. *do not fight with the patient, even though they are angry just smile
a) You don’t know what are they going through with their life
iv. Passionate
1. they have an incredible amount of passion for what they are doing
2. They work not only for money but love their work

v. Confident
1. confident employee will take risks because they believe in
themselves
2. They believe in their capabilities
3. Not to brag what they know but they practice the skill form what
they develop through experiences
4. Experiences make people grow and its what makes you, you
5. Have healthy confident

vi. Honest
1. nobody likes a liar.The perfect employee always speaks the truth
2. Quotes:
a) Honesty denotes truthfulness
b) “Honesty id the best policy” (William Shakespeare)
c) “if I lose my honor, I will lose myself”
3. This is very important especially when you counsel patients
4. Paghindi mo alam ung gamot, pwede namang kayong yumingin sa
libro
a) “Maam wait lng po, I will confirm it, I will check it if ganito
ganyan”

vii. Creative
1. look for the employee who asks unexpected questions
2. That’s for innovation
3. For smooth work flow of organization
4. It is best to suggest and recommend

viii. Reliable
1. someone you can always count on, no matter what
2. Responsible, obedient, and has initiative

ix. Eager
1. an ideal employee will be eager and hungry always wanting to learn
new things
2. Training
3. Seminar

x. Positive
1. having a positive attitude especially when times are rough
2. Being optimistic
a) When there is a problem, you can think of a solution without
being depress
b) Thinking ahead
 xi. Personal Qualities
1. Have a good memory
a) You have organized work because you have good memory
2. Enjoy learning about new medications & treatments
3. Be trustworthy & detail oriented
4. Good communication skills
5. Good problem solving abilities
i. Enjoy people

b) MOTIVATION
i. WHAT MOTIVATES AN EMPLOYEE?
1. Peers
2. Salaries/wages
3. Incentives/benefits
4. Awards and other recognition

c) EMPOWERMENT
i. Empowering Approach?
1. “Empowerment occurs when the practitioner’s goal is to increase the
capacity of the client to think critically and make autonomous,
informed decisions…it also occurs when clients are actually making
autonomous informed decisions”
a) Empowerment IS TO Adherence
b) Empowerment is a process and an outcome
c) No empowerment without respect

ii. Defining Empowerment for Health

1. “Empowerment is an educational process designed to help patients
develop the knowledge, skills, attitudes, and degree of self-
awareness necessary to effectively assume responsibility for their
health related decisions.” - Feste – Anderson

2. “Empowerment is a process by which people gain mastery over their

lives.” ~ J. Rappaport

3. “Let’s decide together what is the best care for your conditions.”
a) An agreement designed to support the promotion of self-
management, taking into account the patients’ perspectives on
their condition, their goals, expectations, and needs.

4. According to ma’am that this is the 5 big words

a) TRUST
b) FREEDOM
c) SELF-RULE
d) CONFIDENCE
e) ACCOUNTABILITY

5. This are the opportunity motivational power that are given to any
employee that embodies freedom to choose and gain control of their
resources skills competence but with corresponding accountability.
 iii. Empowered Patients – “Own” Their Health Condition
1. Have skills for making decisions and changes as needed
a) Make decisions and direct their life in a way that helps them
meet their goals

2. Are effective self-managers

a) Active participants in:
i. Setting goals
ii. Building action plans
iii. Identifying barriers
iv. Problem solving

3. Have strong self-efficacy

a) Comfortable and confident about taking needed action

iv. How Do Patients Become Empowered?

1. Through Self-Management Education

2. Traditional Patient Education

a) Offers information
b) Defines problems

3. Self-Management Education
a) Teaches problem solving
b) Helps patients identify problems, make decisions, take actions

d) PATIENT COMPLIANCE
i. Compliance
1. “You must do what I tell you.”
2. An authoritative act designed to reduce patient autonomy and
constrain freedom of choice.

3. ILLNESS, STRESS, AND COPING MECHANISMS

a) Stress
i. can cause fatigue
ii. emotional and physical response you experience when you perceive an
imbalance between demands placed on you and your resources at a time
when coping is important.
iii. Common causes:
1. Time pressure
2. Fatigue
3. Depressions
4. Diseases which are sometimes terminal

iv. WHY DO WE CARE?

1. Because there are many effects of stress and maraming
naaapektuhan sa pagkatao mo when you have stress *ma’am laugh

v. STRESS HAS TWO EFFECTS

 1. GOOD
a) Helpful when it increases ability to be
i. Alert
ii. Energized
iii. Switched on
iv. Resourceful

2. BAD
a) Unhelpful when it leaves us feeling
i. Fatigued
ii. Tense
iii. Anxious
iv. Burnt out
v. Overwhelmed

vi. CAUSES OF STRESS

1. FAMILY OR RELATIONSHIP PROBLEMS
a) Broken hearted, family problems and more

2. WORK/OCCUPATION
a) Full loads of work

3. ILLNESS
a) If you have family members who are in pain or sick or even
yourself.

4. FAMILY MEMBER WHO IS UNDER STRESS

a) Your family members are stress too.

5. THE NEWS
a) Negative news about what happens nowadays

6. RECENT MAJOR CHANGES

a) Changes in your work flow or responsibility (nadagdagan ang
trabaho)

vii. PHYSICAL SYMPTOMS

1. POUNDING HEART
2. SLEEP DISTURBANCE
3. ELEVATED BLOOD PRESSURE
4. TIREDNESS
5. SWEATY PALMS
6. SUSCEPTIBILITY TO MINOR ILLNESS
7. CHEST TIGHTNESS AND PAINS
8. ITCHING
9. ABDOMINAL CRAMPS
10. EASILY STRATLED
11. ACHING NECK,JAW AND BACK MUSCLES
12. HEADACHE
13. FORGETFULNESS
 14. NAUSEA
15. TREMBLING

viii. YOU MAY ALSO EXPERIENCE

1. MIND RACING
2. MIND GOING BLANK
3. NOT BEING ABLE TO SWITCH OFF
4. LACK OF ATTENTION TO DETAIL
5. PLUMMETING SELF-ESTEEM
6. ANDCONFIDENCE
7. DISORGNANIZED THOUGHTS
8. DIMINISHED SENSE OF MEANING IN LIFE
9. LACK OF CONTROL
10. NEGATIVE SELF-STATEMENTS AND EVALUATION
11. DIFFICULTY IN MAKING DECISIONS
12. LOSS OF PERSPECTIVE

ix. Behavior
1. Withdrawn from others
2. Do not want to socialize
3. Increase alcohol, nicotine and/or drugs intake
4. Under eat or over eat
5. Accident prone and careless
6. Impatient
7. Aggressive or compulsive (pacing, fidgeting, swearing, blaming,
throwing, hitting)
8. Work longer hours
9. Headless chicken under pressure
10. Manage time poorly
11. No time for leisure activities

x. Feelings
1. IRRITABLE
2. ANGRY
3. DEPRESSED
4. JEALOUS
5. RESTLESS
6. ANXIOUS
7. UNREAL OR HYPER ALERT
8. UNNECESSARY GUILTY
9. PANICKED

xi. CONSEQUENCES OF STRESS

1. CHRONIC STRESS
a) CHRONIC FIGHT OR FLIGHT
2. PHYSICAL ILLNESS
a) heart disease, migraines, hypertension, irritable bowel
syndrome, muscle pain, back and joint pain, ulcers.
3. MENTAL HEALTH PROBLEMS
a) Stereotyping
4. History of Mental Disorders
a) Ancient Egyptians did not differentiate between mental and physical illnesses
b) Thought the heart was responsible for mental symptoms
c) Later shifted to blaming, stigmatizing
d) The label of mental illness became the entire definition of who the person is
e) Stigma continues to be one of the largest barriers to understanding and
treatment

f) MYTHS AND MISCONCEPTIONS ABOUT MENTAL ILLNESS

i. Depressed people should just “snap out of it”
ii. The mentally ill are dangerous, often commit crimes
iii. All mental illness involves psychotic episodes
iv. It’s fun to be manic
v. Schizophrenia – multiple personality disorder
vi. Families are the cause of mental illness
vii. Supportive therapy can’t help the mentally ill
viii. People with schizophrenia can only do low level jobs
ix. A schizophrenic is a schizophrenic is a schizophrenic

g) CONCLUSIONS
i. A combination of environmental and genetic factors contribute to mental
illness
ii. Mental disorder are not caused by personal laziness or weak character.
iii. It is actually an illness that have causes

h) INEFFECTIVE WAYS OF COPING

i. DRINKING
ii. EATING
iii. SHOPPING
iv. SMOKING
v. USING DRUGS
vi. ROOM PRISONER
i) EFFECTIVE COPING STRATEGIES
i. EXERCISE, PRAYER/MEDITATION
ii. SOCIALIZATION
iii. BREATHING
iv. YOGA
v. HUMOR
vi. WATCHING TV
vii. PLAYING
viii. LISTEN TO MUSIC
ix. HOT BATH OR SHOWER
x. GET ENOUGH SLEEP
xi. GET PROFESSIONAL HELP
5. Critical Thinking, Characteristics of a Critical Thinker
a) What is thinking?
i. A purposeful, organized cognitive process that we use to make sense of
our world.
ii. WE ARE NOT HUMANS IF WE DO NOT THINK, BECAUSE IT IS
THE ROLE OF OUR BRAIN
b) Characteristics of Uncritical Thinkers
i. Uncritical Thinkers
1. Pretend they know more than they do, ignore their limitations, and
assume their views are error free.
2. Regard problems and controversial issues as nuisances or threats to
their ego.
3. Are inpatient with complexity and thus would rather remain
confused than make the effort to understand.
4. Base judgments on first impressions and gut reactions. They are
unconcerned about the amount or quality of evidence and cling to
their views steadfastly.
5. Are preoccupied with themselves and their own opinions, and so are
unwilling to pay attention to others' views. At the first sign of
disagreement, they tend to think, "How can I refute this?"
6. Ignore the need for balance and give preference to views that
support their established views.
7. Tend to follow their feelings and act impulsively.

c) TYPES OF THINKING
i. CREATIVE THINKING\
1. Devising or formulating, innovating ways or solutions, - these are
the exploration of the mind / exploring many, usually from
brainstorming
2. Approach: more relax, simple, open and playful

ii. CRITICAL THINKING

1. Thinking in a serious manner of handling things, much deeper.
2. General term given to a wide range of cognitive and intellectual
skills needed to
a) Effectively identify, analyze, and evaluate arguments
b) Discover and overcome personal prejudices and biases
c) Formulate and present convincing reasons in support of
conclusions
d) Make reasonable, intelligent decisions about what to believe and
what to do
e) Critical thinking skills emphasized in this course, include:
reasoning, analyzing, evaluating, decision making and problem
solving.

d) CHARACTERISTICS OF A CRITICAL THINKER

i. PASSIONATE
1. Wants to learn more, hard worker, workaholic, looking for a better
and improvement of ways

ii. AWARENESS
1. Knowledgeable, reads a lot of books and updates

iii. CURIOSITY
1. Always curious about everything. They are researchers
 iv. OPEN-MINDEDNESS
1. If the problem arises, they doesn’t focus only on one factor but
considers a lot of factors

v. HONESTY
1. Fratch (prangka)

vi. PERSEVERANCE
1. You don’t stop in one thing only

vii. RESOLUTENESS
1. Always stand for what you believing

viii. AUTONOMY
1. Independent

ix. EMPATHY
1. Understand and accept the perspective of other peoples

x. CREATIVITY
1. Creativity on how they innovate and formulate drugs

e) CRITICAL THINKERS
i. Are honest with themselves, acknowledging what they don't know,
recognizing their limitations, and being watchful of their own errors.
ii. Regard problems and controversial issues as exciting challenges.
iii. Strive for understanding, keep curiosity alive, remain patient with
complexity, and are ready to invest time to overcome confusion.
iv. Base judgments on evidence rather than personal preferences, deferring
judgment whenever evidence is insufficient. They revise judgments
when new evidence reveals error.
v. Are interested in other people's ideas and so are willing to read and listen
attentively, even when they tend to disagree with the other person.
vi. Recognize that extreme views (whether conservative or liberal) are
seldom correct, so they avoid them, practice fair-mindedness, and seek a
balance view
vii. Practice restraint, controlling their feelings rather than being controlled
by them, and thinking before acting.
viii.
COMMUNICATION
● This also topic for interpersonal communication
● It is an exchange of information from one individual to another individual/s
● It’s a way in delivering information
1. Sender
⮚ Sends the message
⮚ Aka: encoder
2. Message
⮚ Most important element because it’s the information to be relate/relay
between the sender and receiver
3. Receiver
⮚ They receive the massage
⮚ They translate
⮚ Aka: decoder = decoder of the massage

EFFECTIVE COMMUNICATION
● Effective communication skills or effective communication must be practice by
different medical practitioner when they interact with the patient in order to
make the intervention more effective.

● If the patient understands about their medication, they will be more

compliance that will result to good intervention.
⮚ Health care workers must be able to relate to patients, family, coworkers, and
others
⮚ Understanding communication skills assists in this process

TYPES OF COMMUNICATION
1. Verbal
⮚ This is when you deliver messages through conversation of face to face

2. Written
⮚ Written instructions or you write the instruction
⮚ Example:
▪ Writing memos
▪ letter

3. Nonverbal
⮚ how you express the message, information, or opinion
▪ gesture,
▪ mannerism,
▪ facial expression and
▪ Body language
▪ Tone of voice
ELEMENTS OF EFFECTIVE COMMUNICATION
1. The message must be clear
⮚ Example: counseling the patient
▪ You have to be clear and understandable
▪ don’t say “This is antipyretic” instead “this is for fever”

2. The sender must deliver the message in a clear and concise manner
⮚ Complete and detailed
⮚ Simple and short but understandable

3. The receiver must be able to hear and receive the message

4. Avoid interruptions and distractions

⮚ Hospital have private counseling area
▪ Not noisy so that you will counsel the patient correctly.
▪ If there is a patient, you have to turn off your phone or in silent mode
para to avoid any distractions

LISTENING
● Is essential for communication,
● attempt to hear what others are saying
● A good listening skill techniques observe speaker closely, reflect statement
made by the speaker back to them
● Listen also to the nonverbal action of the patient in order for you to know what
the information the patient thoroughly conveying.

▪ Meron kasi ung yes ng yes pero di niya talaga naintindihan

▪ Iba ang sinasabi niya sa action niya
▪ Facial expression

● Essential for communication

● Attempt to HEAR what the other is really saying
● Good listening skills techniques
● Observe speaker closely
● Reflect statements made by the speaker back to them

BARRIERS TO COMMUNICATION
Common barriers
1. Physical disabilities
⮚ Hearing impaired
▪ Need written instruction or accompanied by guardian

2. Environment
⮚ Noise
⮚ temperature
 3. Psychological attitudes and prejudice
⮚ Personal opinion
▪ Whatever you say, the patient will still answer you according to their
belief

4. Cultural diversity
⮚ Actually look the same as Psychological attitudes and prejudice
▪ Belief
▪ tradition

GOOD COMMUNICATION
1. When there is good communication everywhere of course people will never
have to misunderstand or misinterpret
⮚ Walng nadadagdag, Walng nababawas

2. In hospital, when the patient are open to share their information and
honest in explaining their medical history
⮚ Mas maganda ung intervention na maibibigay sa kanya
⮚ if the patient is open to share their information, the intervention will be
more effective

3. If the practitioners is knowledgeable and patience enough to discuss

everything in laymans term (madaling intindihin)
⮚ Dialect
▪ Kung ilokano siya, at kaya mo ring mag ilokano edi why not
▪ Kung foreigner, edi magenglish ka

⮚ Don’t use medical terms because they don’t understand

4. If the health care team are also open to share ideas, suggest and recommend
and open to changes it make the institution be better
5. REMEMBER “GOOD
COMMUNICATION
ESTABLISH TRUST”
⮚ Good communication skills allow development of good interpersonal
relationships
⮚ Health care worker also relates more effectively with coworkers and
other individuals

PRINCIPLES OF GOOD CUSTOMER SERVICE

● Good customer service:
▪ Is the very core of institution and establishment
▪ It serve as its life
▪ It is very valuable and greatly affect whatever business you have

1. SERVICE -
⮚ Make serving others your number-one priority.
 ⮚ Great customer service happens when you exceed customers’
expectations by adding your special touch and by having the courage
to make things right.
⮚ You have to be service oriented and not profit oriented
⮚ If you treat patient right, hahanap hanapin ka niya, hahanap hanapin ka
niya kahit lumayo ka, thats true actually in physician

2. ATTITUDE - Choose your attitude. How you think about the customer is
how you will treat them.
⮚ A shining attitude is contagious around customers and shows in
the quality of your work.
⮚ Service and attitude is quite related

⮚ Costumer is a KING not costumer is always right

▪ Kasi nagkakamali rin sila
▪ as health care practitioners, our priority is serving our patient
for what they thoroughly deserve
▪ They be treated fair and well
▪ We have to empathize with them by forming a bond, by being
polite being kind
▪ Act like professional
▪ don’t be arrogant, as we see today educated people is just
educated only in name and in license but not in practice

3. CONSISTENCY - Customers return because they liked what happened last

time. Set high service standards and live them every day. Add your special
touch and exceed their expectations.
⮚ Be consistent in what you do and offer the patient
⮚ Patient actually choose the quality of service
▪ Complete equipment
▪ Maganda ung services na ino ofer mo
▪ Affordable
▪ Hindi pa bago bago
▪ Make sure to maintain what you started

4. TEAMWORK - Commit to teamwork. Look for ways to make each other

look good. In the end, every action by you and your staff will become
visible in your business and to your clients, whether you work at the counter
or behind the scenes.
⮚ Coordinate and collaborate
⮚ All practitioners should be knowledgeable and trained and informed
⮚ In establishment or institution, everyone is part of the team even
Maintenance and utility
⮚ Policies are implemented weekly meetings are held and job description
are presented

GOOD CUSTOMER SERVICE

1. Getting the prescription ready on time
⮚ Even if there is patient on the line make sure to fill the prescription as soon
as it given to you by the patient
 ⮚ If you need to attend to something
▪ Example;
o Intusan ka ng chief pharmacist mo
o Solution:
▪ tell the patient to wait for a minute
▪ Or give the prescription to other available pharmacist

2. Following up with the patient

⮚ Evaluate the patient have understood regarding on what you told him or her
⮚ Example:
▪ You instruct him for the dosing regimen of medication or drug
▪ Solution:
o You need to question him again
o So that you will know if he understood what you said

3. Tend to issues encircling the patient, pharmacy store and the physician
who prescribed the medication/s
⮚ If there is concerns regarding on what the physician prescribe, then you
should call or contact him (doctor or physician) and ask him nicely
⮚ Example:
▪ Ibuprofen 500mg (in the prescription) but There is only 2 dosage
strength which is 200 mg and 400 mg. What will you do?
o don’t call him wrong
o Doc wala pong 500 mg na ibuprofen, ang available lng po ay 200
and 400 mg.
⮚ There is instances where nagkakamali rin sila sa dosage strength

4. Practicing professionalism all the time

⮚ You have to be responsible
⮚ You have to think more than twice before you say something or before you
act
⮚ Kasi pag nasabi mo na, di mo na mababalik pa

INTERPERSONAL COMMUNICATION
● It circle about personal and relational ideas or opinions between people
● It counts and check about the attitude toward what was said or what was
conveyed
▪ communication between two people
▪ came to being when men began to exchange ideas and thoughts to one
another
▪ a kind of communication in which people communicate their feelings,
ideas, emotions and information face to face to each other
▪ It can be in verbal or non-verbal form
▪ Not only about what is said and what is received but also about how it is
said, how the body language used, and what was the facial expression.

PRINCIPLES OF INTERPERSONAL COMMUNICATION

1. Interpersonal communication is inescapable
⮚ We cannot “not communicate”.
⮚ The very attempt not to communicate communicates something. Through not
only words, but through tone of voice and through gesture, posture, facial
expression, etc., we constantly communicate to those around us. Through
these channels, we constantly receive communication from others. Even
when you sleep, you communicate. Remember a basic principle of
communication in general: people are not mind readers. Another way to put
this is: people judge you by your behavior, not your intent.
⮚ You cannot escape from it
⮚ Ung mga baby, umiiyak sila
▪ Usually crying means gutom
⮚ We have to communicate with one another

2. Interpersonal communication is irreversible

⮚ You can't really take back something once it has been said.
⮚ The effect must inevitably remain. Despite the instructions from a judge to a
jury to "disregard that last statement the witness made," the lawyer knows
that it can't help but make an impression on the jury.
⮚ A Russian proverb says, "Once a word goes out of your mouth, you can
never swallow it again."

3. Interpersonal communication is complicated

⮚ No form of communication is simple. Because of the number of variables
involved, even simple requests are extremely complex.
⮚ Theorists note that whenever we communicate there are really at least six
"people" involved:
▪ 1) who you think you are;
▪ 2) who you think the other person is;
▪ 3) who you think the other person thinks you are;
▪ 4) who the other person thinks /she is;
▪ 5) who the other person thinks you are; and
▪ 6) who the other person thinks you think s/he is.

⮚ It is complicated because of our views towards other person and our behavior
and traditions are all parts of the message which makes it complicated.
⮚ Example:
- you are talking with your friend and you have different views and
opinions then maya-maya may galit na sa isa sa inyo.
⮚ Parts of communication:
✔ Who do you think you are?
✔ Who you think the other person is?
✔ Who you think the other person think you are?
✔ Who the other person thinks to other person she/he is?
✔ Who the other person think you are?
✔ Who the other person thinks you he/she is?
4. Interpersonal communication is contextual
 ⮚ In other words, communication does not happen in isolation. There is:

● Psychological context,
o which is who you are and what you bring to the interaction.
o Your needs, desires, values, personality, etc., all form the
psychological context. ("You" here refers to both participants
in the interaction.)

● Relational context,
o which concerns your reactions to the other person--the "mix."
o Reactions that make the conversation complex which concerns
your reaction to the other person

● Situational context 
o deals with the psycho-social "where" you are communicating.
An interaction that takes place in a classroom will be very
different from one that takes place in a bar.
o Different topic with different place
o Ang pinag-uusapan sa loob ng Bahay ay di dapat pag
usapan sa labas

● Environmental context 
o deals with the physical "where" you are communicating.
o example:
▪ Furniture
▪ location
▪ noise level
▪ temperature
▪ season
▪ time of day
▪ all are examples of factors in the environmental context.
o It talks with environmental factors

● Cultural context 
o includes all the learned behaviors and rules that affect the
interaction.
o If you come from a culture (foreign or within your own
country) where it is considered rude to make long,

o example:
▪ direct eye contact, you will out of politeness avoid eye
contact.
▪ If the other person comes from a culture where long,
direct eye contact signals trustworthiness, then we
have in the cultural context a basis for
misunderstanding.

PRINCIPLES OF INTERCULTURAL COMMUNICATION

1. CHOOSE WORDS PROPERLY
 ⮚ control yourself when saying something
⮚ think before you say

2. KNOW TO LISTEN WITH UNDERSTANDING

⮚ evaluate and assess gestures, tone of voice and facial expression

3. RECOGNIZE THE ACCENT AND INTONATION

⮚ Intonation – talks with the pitch of voice (signs of Impatience)

4. RESPECT DIFFERENT IDENTITIES

⮚ Always respect in all situations

DIFFERENT TYPES OF CLIENTS (some)

1. PATIENT CUSTOMER
⮚ Rare costumers who are willing to endure (willing to wait kahit gaano
kahaba ang pila)
2. TALKATIVE CUSTOMER
⮚ Patient who have many questions ( curiosity)
3. IRATE CUSTOMER
⮚ Violent costumers
4. DEMANDING CUSTOMER
5. INDIFFERENT CUSTOMER
⮚ No care costumer

PRINCIPLES OF HANDLING DIFFERENT TYPES OF CLIENTS

▪ PATIENCE IS A VIRTUE.
▪ HONESTY IS THE BEST POLICY.
BE HUMBLE YOU COULD BE WRONG.
1. DISPENSING AND MEDICATION COUNSELLING
a) ADMINISTRATIVE ORDER no. 63 series of 1989
i. Under this, it is stated about the rules and regulations to implement
dispensing requirement under the generic act of 1988 which is RA 6675

ii. In relation to RA 6675

1. The Generic Law

iii. In relation to RA 3720

1. Food, Drug and Cosmetic Act

iv. Amended by Executive Order No. 175

v. Amended by RA 5921
1. Former Pharmacy Law
2. We now have 10918

vi. Amended by RA 6425 (Dangerous Drug Act of 1972)

vii. RA 9165 (Comprehensive Dangerous Drugs Act of 2002)

2. DISPENSING
a) Act by a validly-registered pharmacist of filling a prescription or doctor`s
order/ medical`s order on the patient`s chart
b) Responsibility or function of the pharmacist in filling up the prescription
in giving the prescribed drug to the patient

3. GENERIC DISPENSING
a) dispensing the patient`s choice from among generic equivalents
b) If the prescribed drug isn’t available tell the patient the available drug with
the same generic name, same active ingredient, same dosage form, same
strength as the prescribe drug. Then, the patient will choose.
c) You don’t recommend, you just give the choices

4. PARTIAL FILLING
a) dispensing less than the total number of units prescribed
b) If the physician prescribe 6 tablets of paracetamol and you don’t have
enough money, so, you just bought 3. Partially filled will be indicated in
the prescription. The pharmacist will return the prescription to the patient.
c) There are fully filled, it will be kept in the drug store

5. GUIDELINES ON DISPENSING BASED ON PRIOR LAWS

a) Prescription or ethical drugs

i. They can only be dispensed with a prescription given by the physician
ii. These are prescripted drugs, those drugs that made prescription before
the pharmacist will dispense

b) Non-prescription or over-the-counter drugs

 i. can be given to patients without a prescription but counselling is
necessary

ii. For example,

1. neozep or paracetamol, ibuprofen.
a) Need counselling because there are some patients that are not
familiar or knowledgeable about the drug

c) Prescription keeping
i. prescriptions shall be kept for 2 years and should be recorded in a
prescription book registered by FDA which shall be open for inspection
by FDA at anytime during business hours.
ii. Fully filled prescription will get by the drugstore or the pharmacist to be
kept and record in the prescription book, that should be kept for 2 years.
Anytime it should be available because FDA will inspect

6. ADDITIONAL GUIDELINES ON DISPENSING TO IMPLEMENT THE

GENERICS ACT OF 1988
a) All drug outlets are required to practice generic dispensing

b) Drug stores, boticas, and other drug outlets

i. Inform the buyers of all the available generic equivalents of the drug
prescribed but should not suggest a particular product.
ii. List of drug products using generic names with their brand names should
be posted in a conspicuous place.

iii. Prescriptions filled should be kept for two years and recorded in a
prescription book

c) HOSPITAL PHARMACIES
i. Individually informing the buyer on the available generic equivalents of
the drug prescribed and their corresponding price.
1. Corresponding price
a) there is a handbook in hospital pharmacy containing this
information and it should be available in every ward and
hospital room

ii. Prescriptions filled should be kept for two years and recorded in a
prescription book

d) HOSPITAL PHARMACY
i. The drug products in unit dose transferred in small bottles should contain
the following information
1. Name of the patient
2. Generic name of the drug
3. Brand name (if any)
4. Manufacturer
5. Dosage strength
6. Expiry date
7. Directions for use
 8. Name of the pharmacist

e) HOSPITAL PHARMACY
i. In partial filling of prescription, the following should be written on the
face of the prescription
1. Date of partial filling
2. The quantity served and balance of the prescription unserved
3. Name and address of the drugstore

4. Stamp
a) name of the hospital or drugstore and address
ii. The partial filled prescription shall be returned to the buyer after
recording the partial filling in the prescription book. The drugstore which
completes the filling should keep the prescription.

f) HOSPITAL PHARMACY
i. In dispensing drugs included in
1. List A
a) (PROHIBITED AND REGULATED DRUGS) and

2. List B
a) ( DRUGS REQUIRING STRICT PRECAUTIONS IN
THEIR USE) attached as Annex 1 and 2 respectively:
i. It can also be drugs of abuse aside from dangerous drug and
with narrow therapeutic index (digoxin)

ii. Dispensing must be done by the pharmacist who shall affix

his/her signature on the prescription filled.
3. The order of the physician should be precisely followed. (ex. STAT
means immediately)
4. Partial filling of prescription for drugs belonging to List A is not
allowed. (like dangerous drugs)

7. DEFINITION OF TERMS FOR THE PURPOSE OF GENERICS ACT

a) GENERIC NAME
i. non-proprietary name based on the chemical name of the drug
ii. the identification of drugs and medicines by their scientifically and
internationally recognized active ingredients or by their official generic
name as determined by the FDA of the DOH

b) ACTIVE INGREDIENT
i. chemical component responsible for the claimed therapeutic effect of
the pharmaceutical product

c) CHEMICAL NAME
i. description of the chemical structure of the drug or medicine and serve
as the complete identification of a compound
ii. If it is amine, phenol, carboxylic acid
iii. Basis for its generic name
d) DRUG PRODUCT
i. finished product form that contains the active ingredients, generally
but not necessarily in association with inactive ingredients

e) DRUG ESTABLISHMENT
i. any organization or company involved in the
1. Manufacture
2. Importation
3. repacking
4. distribution of drugs or medicines

ii. Establishment means the company responsible for the manufacturing

for distributing drugs

f) DRUG OUTLETS
i. means drugstores, pharmacies, and any other business establishments
which sell drugs or medicines

g) ESSENTIAL DRUGS LIST (NATIONAL DRUG FORMULARY)

i. list of drugs prepared and periodically updated by the DOH on a
basis of health conditions obtaining in the Philippines as well as on
internationally accepted criteria.
ii. It shall consist of a core list and a complementary list.

h) CORE LIST
i. list of drugs that meets the health care needs of majority of the
population, usually the prescripted drugs

i) COMPLEMENTARY LIST
i. a list of alternative drugs used when there is no response to the core
essential drug or when there is a hypersensitivity reaction to the core
essential drug or when, for one reason or another, the core essential drug
cannot be given.
1. ex. OTC drugs like (di ko maintindihan), herbal drugs in
combination and chemicals..
2. Serve as alternative for core list

j) BRAND NAME
i. the proprietary name given by the manufacturer to distinguish its
product from those competitors
ii. Doesn’t base on the chemical name or anything

k) GENERIC DRUGS
i. drugs not covered by patent protection and which are labeled solely by
their international non-proprietary or generic name
ii. Not patented means anyone can produce the drug
iii. Patented means only one manufacturing company, sole manufacture
of specific drug
1. Ex. (di ko maintindihan) digoxin, lanoxin
 2. Expire for 7-20 years. Doesn’t apply again because it is expensive.
Other manufacturers can now release their generic drug

8. GUIDELINES ON WHAT TO DO WITH VIOLATIVE, ERRONEOUS AND

IMPOSSIBLE PRESCRIPTIONS

a) REVIEW OF THE PARTS OF THE PRESCRIPTION

i. VIOLATIVE – violates the ra 6675
1. When generic name is not written
2. When generic name is not legible and the brand name is legible
3. Where the brand name is indicated and instructions added like no
substitution
a) shall be filled
b) Kept and reported to the nearest DOH

ii. IMPOSSIBLE – cannot be dispensed

1. Only the generic name is written but not legible
2. Generic name does not correspond to the brand name
3. When both the generic name and brand name are not legible
4. The product is not registered with FDA
a) Shall not be filled; reported to the nearest doh

iii. VIOLATIONS ON THE PART OF DISPENSERS AND OUTLETS

1. Imposing a particular product
2. Inaccurate dispensing
3. Failure make accessible the required information on drug products
(updated)- counsel
4. Failure to inadequately inform the buyer about the available
products that meet the prescription
a) generic equivalents
5. Failure to indicate the generic name- very important for 6675 (yan
ang narinig ko haha)
6. Failure to record and keep prescriptions filled
a) violation in the fda (during inspection)

7. Failure to report to the nearest DOH office of cases of the

erroneous, violative, and impossible prescriptions
a) once they inspect, you will be subject to interrogation
b) accomplice
9. SECTION 6
a) REPORTING AND MONITORING OF NON-COMPLIANCE (responsible
entities)
i. DOH
ii. Secretary of Health (appropriate action)

10. SECTION 7
a) ADMINISTRATIVE SANCTIONS
i. Suspension or revocation of license to operate (LTO) the drug outlet by
the Secretary of Health
 ii. Secretary of Health report to PRC (Professional Regulation
Commission)

11. R.A. 10918 (on dispensing)

a) Section 30. Dispensing/Sale of Pharmaceutical Products.— No
pharmaceutical product, of whatever nature and kind, shall be compounded,
dispensed, sold or resold, or otherwise be made available to the consuming
public, except through a retail drug outlet duly licensed by the FDA.
b) Prescription drugs and pharmacist-only OTC medicines shall be dispensed
only by a duly registered and licensed pharmacist, except in emergency
cases, where the services of a registered and licensed pharmacist are not
available: Provided, That a report shall be made to the supervising
pharmacist within twenty-four (24) hours after the occurrence of the
emergency so that product recording in the prescription books can be done.
i. (like for examples: pwede naman yung pharmacy assistant, pharmacy
technicians as long as they’ll inform the pharmacist regarding of that)
c) Compounding and dispensing shall be done only by duly registered and
licensed pharmacists, in accordance with current Good Manufacturing
Practice, laboratory practice, Philippine Practice Standards for Pharmacists
and dispensing guidelines. A registered and licensed pharmacist may refuse
to compound, dispense or sell drugs and pharmaceutical products, if not in
accordance with this Act and the above mentioned standards.
d) Licensed manufacturers, importers, distributors, and wholesalers of
pharmaceutical products are authorized to sell their products only to duly
licensed pharmaceutical outlets.
i. (lahat ay involved ay ang mga registered pharmacist, registered outlets
and establishments this will be check by the Food and Drug
Development)
ii. In Drug establishments in quality control, quality assurance for sampling
and for checking of the different drugs, for viewing different drugs, for
distribution, for marketing- the responsible in this are Licensed
Pharmacist
iii. For those pharmacy assistant and pharmacy technicians they are related
in the course of Pharmacy and they should attend training and seminars
that are for them
e)
1. DISPENSING DANGEROUS DRUGS
a) REPUBLIC ACT NO. 9165
i. An act instituting the comprehensive dangerous drugs act of 2002,
repealing republic act no. 6425, otherwise known as the dangerous drugs
act of 1972, as amended, providing funds therefore, and for other
purposes.
ii. Policy of the state to safeguard the integrity of its territory and the well
being of its citizenry particularly the youth, from the harmful effects of
dangerous drugs to their physical and mental well-being

2. GOVERNMENT BODIES
a) The Philippine Drug Enforcement Agency or Prohibited Drug
Entrapment Agency (PDEA)
i. is the lead anti-drug law enforcement agency, responsible for
preventing, investigating and combating any dangerous drugs,
controlled  precursors and essential chemicals within the Philippines

ii. DANGEROUS DRUG BOARD

1. Actually for the policy making it is more on the DDB, for the
implementation of that policy we have the PDEA.
2. PDEA
a) Policy making body, strategy making body, implementing body

3. CLASSIFICATIONS OF DANGEROUS DRUGS

a) Prohibited Drugs (opium and its derivatives)
i. they are actually hypnotic drugs
1. Hypnotic- pampa sleep

a) Alfentanyl * pethidine/meperidine
b) Codeine
c) Dihydrocodeine
d) Fentanyl
e) Hydrocodone
f) Morphine
g) opium

b) Regulated Drugs
i. barbitals, benzodiazepines and amphetamines (anxiolytic and sedative)
1. Sedative- pampa kalma

a) Amobarbital * diazepam
b) Amphetamine * nitrazepam
c) Phenobarbital * paraldehyde
d) Pentazocine
e) Dexamphetamine * pentothal
f) Ephedrine * propoxyphene
g) Ethinamate * pseudoephedrine

4. DISPENSING DANGEROUS DRUGS

 a) preparations not injectable form
b) capsules, tablets or syrup
i. Actually pwede ng gumamit ng white prescriptions pero TRIPLICATE
at dapat 1 drug per prescriptions

c) preparations that are injectable

i. Yellow prescription, TRIPLICATE and 1 drug per prescriptions

5. DRUGS OF ABUSE
a) TOLERANCE
i. to a physiological state where the effectiveness of a drug has decreased
due to chronic administration.
1. Example: once mo siya lagi tinetake and then ngayon dahil lagi mo
siyang tinetake ng once sa susunod kailangan mo ng taasan yung
dose pwedeng twice na.

b) DEPENDENCE
i. Refers to how the body experiences physiological adaptation in
response to chronic use of a drug.
ii. This is actually referred to us WITHDRAWAL SYMPTOMS
iii. Dependence ay kumbaga hindi kana mabubuhay kung wala yung drug.
Dependent kana don.
iv. Or for example masakit ulo mo lagi kana magtetake ng ganitong drug
kasi nga yun na yung lagi mong ginagawa.

c) ADDICTION
i. -defined as the compulsive use of drugs for non-medical reasons.
ii. -the individual is likely to have developed physical as well as
psychological dependence on the symptoms.

1. Tolerance and Physical Dependence

a) they are actually a Physiological changes while Addiction is a
type of behavior we call that Dis-functional Behavioral
Syndrome.

2. Addiction
a) taking the drug for leisure activities
b) Robitussin DM (Guaifenesin + Dextrometorphan) - they take
this dahil ayaw nila makatulog.

d) RESISTANCE
i. Reduction/loss in effectiveness of a drug if not taken with right
dosage regimen
ii. Examples:
iii. Antibiotic
1. Cephalosporins- there are 4 generations of Cephalosporins
2. For example
a) ang prinescribe ay 3rd generation, yun yung medyo
magkakaroon tayo ng problema kapag hindi yun tinake ng
 mabuti kasi lahat na ng 3rd generations Cephalosporin sayo hindi
na magiging effective. That is called ANTIBIOTIC
RESISTANCE

6. DRUGS OF ABUSE
a) CNS STIMULANTSCNS DEPRESSANTS
b) HALLUCINOGENS
c) OPIODS AND OPIATES (AGONISTS AND ANTAGONISTS)

7. CNS STIMULANTS
a) CAFFEINE (COFFEA ARABICA)
i. Sources:
1. COFFEA ARABICA (well known)
a) 1, 3, 7 trimethylxanthein caffeine
b) This is an alkaloid
2. COFFEA ROBUSTA

ii. 1-2 cups coffee (100-200mg caffeine)

1. Taking 1 to 2 cups of coffee will decrease fatigue
2. But, will decrease alertness
3. However it is not recommended that when you wake up, you will
take coffee immediately
4. You must wait for 30 minutes or 1 hour because we have a happy
hormone that will act for us to awake, now if we take coffee
immediately, the coffee will have no effect because we are already
awake.

iii. 12-15 cups (1.5g)

1. Taking 12 – 15 cups of coffee will causes anxiety and tremors
(palpitation)

iv. Crosses placenta

1. The baby will also experience the effects / inherited
2. Example: Cardiac Arrhythmia

v. Side Effects:
1. tachycardia
2. palpitations
3. Arrhythmia
4. seizures
5. diuresis ( cathartic / laxative)
6. increase acid secretion

b) NICOTINE
i. Sources:
1. NICOTIANA TOBACCUM

ii. Cigarettes
1. Nicotine is the main component of Cigarettes that causes addiction
 2. Tar – causes cancer

iii. Central Nervous System Effects:

1. low: arousal, relaxation
2. high: respiratory depression

iv. Peripheral Nervous System Effects:

1. low: increase heart rate ( tachycardia)
2. high: hypotension (low blood pressure)

v. Nicorette Gum and patch

1. Use to facilitates withdrawal
2. Example: your habit is smoking, if you want to stop it, it is not
abruptly but gradually
3. For instance you can smoke 1 pack in one day, for the next week try
taking only the half until you stop taking cigarettes
4. Others use vape, because it has a smaller amount of nicotine unlike
cigarettes

vi. Withdrawal Symptoms

1. Abruptly: irritability and Gastro Intestinal (GI) Distress

c) METHYLPHENIDATE
i. It is the drug use for the treatment of:
1. ADHD – Attention Deficit Hyperactivity Disorder
2. NARCOLEPSY

ii. If Chronically use / prescribed:

1. The patient will suffer from Severe Social Disability
2. They don’t know how to interact to others

iii. Abuse of methylphenidate drugs may cause a :

1. Sudden heart attack even in those with no signs of heart disease. 

iv. Even if you have no cardiovascular disorders/disease if we abuse

methylphenidate then it may cause sudden heart attack.

v. ADHD AND NARCOLEPSY

1. Attention-deficit/hyperactivity disorder (ADHD)
a) A Brain disorder marked by an ongoing pattern of inattention
and/or hyperactivity-impulsivity that interferes with
functioning or development.
b) Inattention means a person wanders off task, lacks persistence
c) Patient with ADHD has:
i. difficulty sustaining focus and he/she is disorganized
ii. this problems are not due to defiance or lack of
comprehension
iii. they are absent minded
 2. Hyperactivity 
a) means a person seems to move about constantly
b) including situations in which it is not appropriate
c) excessive fidgets, laughs or talks

3. Impulsivity 
a) means a person makes hasty actions that occur in the
moment without first thinking about them and that may have
high potential for harm;
b) An impulsive person maybe socially intrusive and excessively
interact others or make important decisions without
considering the long term consequences.
i. Example: impulsive buyer

4. Narcolepsy
a) It is often associated with:
i. sudden sleep attacks,
ii. insomnia,
iii. dreamlike hallucinations and a
iv. condition called sleep paralysis or coma

b) Neurological disorder caused by the brain's inability to

regulate sleep-wake cycles normally.
c) The main features of narcolepsy are fatigue and cataplexy
i. Cataplexy – sudden loss of muscle tone that is triggered by
the experience of an intense emotions, sudden muscle
weakness due to laughing or crying while you are conscious

d) Amphetamine
i. A strong stimulant that speeds up the heart and breathing and dilates the
eyes or mydriasis.
ii. It is a treatment
1. for Attention-deficit/hyperactivity disorder (ADHD)
2. It is also used for the treatment of Hypertension but in low dosage
only
iii. Bypassing all the body’s normal capabilities for creating energy,
amphetamine makes a person feel alert and powerful.
1. Fatigue and hunger go away
2. So Amphetamine abusers does not eat or rest

e) METAMPHETAMINE
i. chronic abusers may exhibit symptoms that can include significant
1. anxiety,
2. confusion,
3. insomnia,
4. mood disturbances, and
5. violent behavior (rage syndrome)
a) if you have this violent behavior there is a possibility that you
can kill a person
 b) in short Rage syndrome – your anger can turn you into a
murderer
ii. They also may display a number of psychotic features, including
paranoia, visual and auditory hallucinations, and delusions

iii. Delusions – alienated

1. Horror stories are usually delusions
2. Examples:
a) sensation of insects
b) creeping under the skin

iv. Paranoia
1. Involves intense anxious or fearful feelings and thoughts often
related to treat or conspiracy and persecution.
2. Example:
a) you are very afraid because you have the feeling that someone
can kill you
3. You are being paranoid

f) PHENTERMINE
i. It is a stimulant that is similar to an amphetamine
ii. Used as an appetite suppressant that can affect the central nervous
system.
iii. Phentermine is known to treat obesity in people with risk factors such
as high blood pressure, high cholesterol or diabetes.

iv. Effects of Phentermine:

1. SOB
2. Chest pain
3. Feeling of fainted
4. Unusual thoughts or behaviors
5. Dangerously high blood pressure

v. Ingredient of Phentermine are actually combination of:

1. Caffeine
2. Ephedrine
3. Phenylpropanolamine (PPA)

8. CNS DEPRESSANTS
a) ALCOHOL
i. Synthesis of Alcohol
1. (ethanol) ROH -synthesize by -- OH dehydrogenase -Into -
Acetaldehyde --synthesized in Acetic Acid by aldehyde dehydrogenase
through releasing CO2 and water through burp, flatulence and
diuresis
ii. 1 glass women (14g); 2 glasses men (28g)
1. Moderate drinking ( drink responsibly)

iii. Low consequences:

1. (confusion, ataxia, amnesia)
 iv. High consequences:
1. cirrhosis, peptic ulcer, oral esophageal and liver & gastric cancer

v. Usual side effects:

1. Acute (short time)
a) Euphoria, Slurred speech, ataxia (loss of muscle coordination)
2. Hangover syndrome, the responsible is the Acetaldehyde
3. Chronic
a) mernichu chorsocop syndrome aka. Alcoholic psychosis
(vomiting), lethargy (poisoning)
vi. Antidote:
1. thiamine
vii. Treatment for acute: DISULFIRAM ANTABUSE
viii. Drinking too much alcohol may also decrease brain cells (neurons)

ix. WITHDRAWAL SYMPTOMS

1. Delirium tremens
2. Tremor
3. Anxiety
4. Tachycardia

x. FETAL ALCOHOL SYNDROME cause

1. Microcephaly (to pregnant women) – small brain of babies
2. Facial abnormalities
3. Mental retardation

xi. DISULFIRAM (ANTABUSE)

1. antidote for acute alcohol toxicity
2. Which will inhibit the aldehyde dehydrogenase that will convert into
acetic acid

b) COCAINE
i. 1st local anaesthetic from Erythroxylon coca
ii. It is also known as powder, snow, ski, soft, blow, slopes, coca, and
nose candy. 
iii. It is normally found as a white, crystalline powder or as an off-white,
chunky substance.

iv. Effects:
1. Euphoria
2. Alertness
3. motor activity
4. and energy

v. It can be smoke, injected, and snorted

vi. Long term use of Cocaine

1. Increase the risk of Heart Disease
 vii. Usually use by the rich
1. Ampules
viii. Poor mans cocaine
1. Shabu or methamphetamine

c) BENZODIAZEPINES
i. a class of psychoactive drugs used to treat
1. Anxiety
2. insomnia, and a range of other conditions.
ii. Have a Lesser side effect than barbitals

iii. Effects:
1. Drowsiness
2. poor concentration (over sedation)
a) Acute intravenous administration cause greater decrease of
Respiratory Depression
3. impairment of memory
iv. Antidote:
1. FLUMAZENIL – BENZODIAZEPINE ANTAGONIST

9. HALLUCINOGENS

a) PHENCYCLIDINE
i. Hetamine analog
ii. Sn: Supergrass, Boat, Tic Tac, Zoom,ANGEL DUST,pcp
iii. Used as a Dissociative anaesthesia
1. a unique anesthesia characterized by analgesia and amnesia with 
minimal effect on respiratory function. 
iv. The patient send to appear and anaesthetize and can swallow and open
his eyes but he does not process information
v. Side effect:
1. Indus aggressiveness
2. Hypertension
3. Psychotic symptoms

10. LYSERGIC ACID DIETHYLAMIDE (LSD)

b) King of Hallucinogen because it is the most potent mood changing chemical
i. Odorless
ii. Colorless
iii. And has slightly bitter taste
c) Ergot derivative (from a fungi)

d) For :
i. cluster headaches
1. Severe painful headache in short time
2. Series of relatively short but very painful headaches every day, for
weeks or months at a time
ii. depression,
iii. obsessive compulsive disorder
 1. Kung may dumi, lilinisan nila
2. Kung may mali sa sinulat, uulitan nanaman nila
3. If they don’t do this, they feel that their live is a mess
iv. severe anxiety in cancer patients

v. MARIJUANA
1. Cannabis sativa
2. Active constituent
a) Delta 9 - THC (tetrahydroxycanabinol)
3. Street names:
a) Dope
b) Pot
c) grass, 
d) weed,
e) head,
f) Mary jane
i. Mas kilala sa pinas
g) Doobie
i. Mas kilala sa pinas
h) Bud
i) Ganja
j) Hashish
k) Hash
l) bhang.

4. Dronabinol
a) man-made form of cannabis
b) Tx
i. Anorexia
ii. Antiemetic in chemotherapy

c) Philippines doesnt recognize this as a drug but recognize in

other country
d) Kasi daming nagaabuse sa pinas

e) Side Effect
i. Sedation
ii. Euphoria
iii. Hypertension
iv. Blood shot eye
v. Increase appetite

11. OPIATES AND OPIODS

e) Call then Narcotics
f) Constituent:
g) Alkaloids from the juice of opium poppy seed (Papaver somniferum)
i. *they can make marijuana a drug because opium has more addictive
properties than marijuana (under debate parin)
h) Effects
i. Euphoria
 ii. Sedation
iii. Respiratory depression
iv. Decreased GI motility

12. AGONISTS
i) MORPHINE (abv ng kanyang effect)
i. HECk of a DREAM
ii. Histamine release
1. Cause Urticaria or pruritus, bronchoconstriction
iii. Emesis
iv. Cardiovascular
1. Hypotension or decrease blood pressure
v. Depression of cough reflex/decrease GI motility/depress the CNS
vi. Respiratory depression
vii. Euphoria
viii. analgesic
ix. Miosis

x. USES
1. Analgesia (pain or headaches)
a) DOC to moderate to severe pain
2. Diarrhea
a) paregoric or camphorated tincture of opium
3. Poisoning triad
a) Coma
b) pinpoint pupils
c) respiratory depression
xi. Side effect
1. Tolerance
2. Dependence
3. Addiction

13. Meperidine
j) narcotic analgesic
i. Short-term treatment of moderate to severe pain.
k) It may also be used before and during surgery for pain relief during labor and
delivery (to support anesthesia)
l) Prolong term:
i. Cause seizure

2. FENTANYL
a) 80 times more potent than morphine
b) Employed as an analgesic for severe pain only
c) >>TOXICITY – respiratory depression, coma, hypotension, circulatory
failure, convulsions
d) Fentanyl + droperidol (innovar)
i. Dissociative anesthesia

3. NALBUPHINE
 a) It can also be used for pain relief before and after surgery and during
childbirth.
b) Also analgesic for treatment and prevention of moderate to severe pain
c) Toxicity: respiratory depression, sedation, and miosis

4. CODEINE
a) AKA 3-methyl morphine / methylated morpine
b) Use as antitussive (cough)
c) Toxicity: bradycardia, severe drowsiness, muscle weakness, miosis

5. METHADONE
a) Methadone reduces withdrawal symptoms in people addicted to heroin or
other narcotic drugs
b) Use as drug addiction detoxification
c) Methadone is used as a pain reliever
d) Toxicity:
i. torsades de pointes
1. Life threatening ventricular trachycardia

6. HEROIN
a) Acetylated morphine / diacetyl morphine
b) More potent than morphine in addictive property
c) Effect: euphoria, constipation, cns depression, nephropathy, severe muscle
and bone aches
d) Decreases kidney function
e) Cough suppressant and antidiarrheal

7. Opioids ANTAGONISTS
a) Antidote for narcotic toxicity
i. NALOXONE
ii. NALTREXONE
iii. NALORPHINE
14. NALMEFENE