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Chapter 1 pharmacy and health care
 

Chapter 1 pharmacy and health care

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    Chapter 1 pharmacy and health care Chapter 1 pharmacy and health care Presentation Transcript

    • The Pharmacy Technician 4 th Edition Created by Dr. Bisrat Hailemeskel, Associate Professor and Director of Drug Information Services of the School of Pharmacy at Howard University Copyright © 2010 Morton Publishing and Perspective Press
    • The Pharmacy Technician 4E Chapter 1Pharmacy & Health Care
    • Chapter Outline• Describe the origins of pharmacy• Medicine through the ages• Medicine in the 20th Century• Pharmacy today• Computers in pharmacy
    • Origins In earliest times, medicine was based in magic and religion. Sumerians living around 4,000 BC believed that demons were the cause of illness. In many cultures, physicians were priests, and sometimes considered as gods. E.g. Imhotep (born 3,000 BC) became the Egyptian god of medicine.
    • Ancient Origins• Hippocrates - Proposed that disease came from natural, not supernatural causes. • Established the theory of humors which needed to be imbalanced for good health (blood, phlegm, black bile, yellow bile).• Beyond Hippocrates - an approach to medicine in which natural causes were examined scientifically, gradually grew to become the dominant approach to treating human illness.
    • Natural Medicine Besides looking to the supernatural, ancient man also looked to the natural world for medical answers. Sources of Drugs - Drugs come from various sources and can be classified as:  Natural.  Synthetic: created artificially.  Synthesized: (created artificially but in imitation of naturally occurring substances).  Semisynthetic: (containing both natural and synthetic components).
    • A Treatment for Malaria One of the most deadly disease in world’s history. Still deadly in developing countries. The first medicine was obtained from the Bark of a Peruvian Tree. Cinchona – Quinine  Also called “Jesuite’s powder.”
    • Cocaine, the First Anesthetic (numbing agent) The Indians of the Andes used to chew coca leaves for its medicinal effects and also to increase endurance. Cocaine is the active ingredient in the leaves. Carl Koller, a Viennese surgeon in 1884 used it as the first local anesthetic which revolutionized surgery and dentistry. Because of its harmful properties when abused, other synthetic substitutes were procain (Novacain®) and Lidocain.
    • Natural Aspirin The ancient Greek physician Hippocrates and Dioscorides both wrote about the pain relieving ability of a plant. The bark of a white willow tree grew in the Mediterranean. The active ingredient was identified more than 2,000 years later and called salicylic acid. Because of the difficulty of taking salicylic acid by mouth, acetylsalicylic acid, popularly known as aspirin, was developed synthetically (man-made). It is the most widely used drug in the world.
    • Common Terms Used in Pharmacy Pharmacology -The study of drugs (from the Greek pharmakon means drug). Pharmacognosy - The study of physical, chemical, biochemical and biological properties of drugs as well as drugs from natural sources. Pharmacopeia – An official listing of drugs and issues related to their use. Pharmaceutical – Of or about drugs; also, a drug product. Panacea – A cure-all (from the Greek panakeia). Materia Medica – A dictionary of medicinal plants.
    • Dioscorides (First century) Wrote the first standard text/manual on drugs called De Materia Medica. Also called PHARMACOPOEIA. Published 6 books that covered over 600 plants and their healing properties. His book was used for 1500 years.
    • Galen (Second century) Galen  Conducted animal experiments.  Produced a systematic classification of drugs for treatment of disease. Galenical pharmacy  The first pharmacy .  Described the process of creating extracts of active medicinals from plants.
    • Foxglove – the First Heart Medicine The British Physician, William Withering published his study of the foxglove plant. The active ingredient was digitalis.  Widely used for heart failure.  Now is called – digoxin. Former President Bush was on digoxin for a racing heart called atrial fibrillation.
    • Ancient Origins• Boylston (18th Century) - The first person to administer smallpox vaccine.• Serturner (19th Century) - Extracts morphine from opium.• Pasteur (19the Century) - was the first scientist who Showed that heat can be used to kill microorganisms associated with food spoilage.• Banting & Best (20th Century) - Show that insulin lowers blood sugar in dogs and became a known drug to treat diabetes.
    • The First Antibiotic - Penicillin Alexander Fleming discovered a fungus which produces a chemical that kills bacteria. He named it penicillin. Penicillin was the first antibiotic drug. A pharmaceutical company Pfizer developed a method to mass produce it, and it was used to save millions of lives during the World War era.
    • Ancient Origins• 1950’s • Watson and Crick: are the two people who identified the structure of DNA genetic make up.• 1960 – 1990’s • The birth control pill was introduced. • AZT becomes the first drug approved by the FDA for AIDS treatment. • HAART (Highly Active Antiretroviral Therapy) is introduced for AIDS treatment .
    • The 20th Century The average life span in the United States increased by over twenty years in the 20th Century. 1900 – early 50’s……….. 2000 – 77.9 years.
    • The 20th Century A major factor in the increased health and life expectancy seen in this century, was the dramatic growth in pharmaceutical medicine. With the increasing availability of powerful drugs, their regulation became more important than ever. Food and Drug Administration (FDA) was established in response to this need to regulate the sale and use of medication in the US.
    • The Food and Drug Administration (FDA) Monitors drugs before a drug is marketed in the United States Also monitors after the drug is approved for sale to the public for any adverse effects – called Post Marketing Surveillance Recalls drugs if they have proven dangerous within public safety
    • Discovery of New Drugs Pharmaceutical companies spend 1/6 of their income on research and development. Bringing drugs to market is a long and difficult process. Thousands of chemicals must be tried. Drugs must go through an extensive testing and approval process before it can be made available to the public. The length of time from the beginning of development through testing and to ultimate FDA approval is often more than ten years.
    • OBRA ’90 requires that pharmacist counsel all Medicaid patients.
    • Pharmacy Today Prescription is a written paper for a drug product by a licensed prescriber to treat a patient. Prescriptions filled increased by 27% while the number of pharmacists increased by 15% (1997 – 2007).
    • Education and Licensing Requirements Pharmacists Education - Doctor of Pharmacy (PharmD) degree - 6 year program – the only degree program to become a pharmacist.  2 years Pre-Pharmacy (calculus, chemistry, biology)  + 4 years of pharmacy education.  Pharmacy College Admission Test (PCAT).  Completes required Internship or practice setting experience. Residency in specialty area is optional.
    • Education and Licensing Requirements Pharmacists Licensing  Required by all states.  Overseen by board of pharmacy/ To become a pharmacist involves:  Graduation from an accredited college of pharmacy.  Passing a state board certification examination.  Perform experiential training under a licensed pharmacist. Continuing education for license renewal.
    • The Top 5 trusted professions in the United StatesGallop poll (2008) 1. Nurses 2. Pharmacists 3. Medical Doctors 4. Police Officers 5. Clergy
    • Pharmacy Settings Community Pharmacies - Over 50,000 community pharmacies account for half of the sales of prescription drugs. Hospitals - The next greatest area of employment Mail order pharmacies sell drugs by mail to patients.  The fastest growing area. Long-term care pharmacies provide drugs to patients in nursing homes and other long-term facilities. Managed care pharmacies provide service to patients in managed care insurance. Home care pharmacies provide drugs to patients in their home.
    • Economic Trends
    • Computers in Pharmacy Patient Profile  Allows complete information about patients, including prescribers, insurer, and medication history, and allergies; identifies drug interactions for patients taking multiple medications. Billing  Checks policies of third parties such as HMOs and insurers; authorizes third party transactions and credit cards electronically. Prescriber Profile  Includes state identification numbers and affiliations with facilities and insurers. Labeling  Creates label, receipt, customer information, and usage instructions.
    • Computers in Pharmacy Pricing  Provides prices for medications and possible substitutes, automatically updates prices, scans prices from bar codes. Education/Counseling  Patient information about drugs, usage, interactions, allergies, etc. Product Selection  Locates items by various means (brand name, generic name, product code, category, supplier, etc.). Gives updates of prices and other product information. Inventory  Adjusts inventor y as prescriptions are filled, analyzes turnover, produces status reports, automatically re-orders based on inventory levels, and generates purchase orders.
    • Terms To Remember1. Antibiotic 7. Panacea2. Antitoxin 8. Pharmaceutical3. Data 9. Pharmacognosy4. Hormones 10. Pharmacology5. Human genome 11. Pharmacopeia6. Materia medica 12. Synthetic