Chapter 1 pharmacy and health care(2)


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  • There were actually many contributors – see noted in the preface of the book – from several pharmacists to nurses and certified pharmacy technicians
  • Welcome! Covering history of pharmacy – taking you through a time line of notable historic marks in pharmacy (ancient roots, medicine in nature, first antibiotic discovered, pharmacy today, educational requirements, computers) Well this will be very interesting; as you may be surprised as well as intrigued with the information I will be sharing
  • There wasn’t always doctors, but priests or advisors/counslers that helped when illness arose. Imhotep was an advisor to many pharaohs of Egypt and eventually became the Eygyptian god of medicine. In ancient history; there was more supernatural background
  • There were egpytian, greek, and chineses roots in medicine. Beginning with Imhotep, who was the first physician known by name
  • “ Deo scora dees” this book was in greek and actually had pictures of the corresponding plants or flowers
  • 4 basic substances of the body that need to be in balance for an individual to be healthy
  • Looking into some of the natural means, even the barks of trees were found to be helpful. (NOW CHANGE SLIDE)
  • Malaria- parasitic infection. Human to human via mosquito. It attacks RBC, inflames liver causing severe flu-like sx. TX-chloroquinine/malarone (proquanil)/lariam(mefloquine)
  • Hipp-ok-cratees
  • Be sure to mention the roots for words helps in knowing the meaning of a word. Ie ology- the study of; pan-all Materia medica- Dioscorides, a Greek physician, wrote original five books describing over 600 plants and their medicinal properties. Later called the pharmacopia
  • 1721 Boylston innoculated his own son and a slave with cowpox to produce immunity against smallpox-never went to medical school- the 1 st medical school wasn’t founded until 1765 UPENN 1796 Jenner innoculated his gardeners son with cowpox to prove it would produce immunity to smallpox
  • Date in time by Years of life expectancy
  • Between 1970 and 2000, total health care costs in the US increased by over 1,500 percent to $1.353 trillion dollars. By 2010 costs are projected to increase to $2.726 trillion dollars.
  • Abx-drug/substance that harms or kills microorganisms like bacteria and fungi. Antitoxin- substance that acts against a toxin in the body-vaccine. Hormones- chemicals produced by our body that regulates body function and processes.Materia Medica- Greek physician Dioscorides wrote – 5 books over 600 plants and their healing properties. Pharmacognosy-study of physical, chemical, biochemical, biological properties of drugs as well as the search for new drugs from natural sources
  • Chapter 1 pharmacy and health care(2)

    1. 1. 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
    2. 2. The Pharmacy Technician 4E Chapter 1 Pharmacy & Health Care
    3. 3. Chapter Outline <ul><li>Describe the origins of pharmacy </li></ul><ul><li>Medicine through the ages </li></ul><ul><li>Medicine in the 20 th Century </li></ul><ul><li>Pharmacy today </li></ul><ul><li>Computers in pharmacy </li></ul>
    4. 4. Origins <ul><li>In earliest times, medicine was based in magic and religion. </li></ul><ul><li>Sumerians living around 4,000 BC believed that demons were the cause of illness . </li></ul><ul><li>In many cultures, physicians were priests, and sometimes considered as gods. </li></ul>
    5. 5. Ancient Origins <ul><li>Egyptian </li></ul><ul><ul><li>Imhotep </li></ul></ul><ul><ul><li>Papyrus Ebers </li></ul></ul><ul><li>Greek </li></ul><ul><ul><li>Aesculapius </li></ul></ul><ul><ul><li>Hippocrates - Proposed that disease came from natural, not supernatural causes.Established the Hippocratic Oath </li></ul></ul><ul><li>Chinese </li></ul><ul><ul><li>Shen Nung Penn Tsao </li></ul></ul>
    6. 6. Dioscorides (First century) <ul><li>Wrote the first standard text/manual on drugs called De Materia Medica. </li></ul><ul><li>Also called PHARMACOPEIA </li></ul><ul><li>Published 5 books that covered over 600 plants and their healing properties </li></ul><ul><li>Main influence for Western pharmaceutics for over 1600 years </li></ul>
    7. 7. Galen (Second century) <ul><li>Galen </li></ul><ul><li>Established the theory of humors which needed to be in balance for good health (blood, phlegm, black bile, yellow bile) </li></ul><ul><li>Scientific approach – education, observation, and logic which formed the cornerstone for Western medicine </li></ul><ul><li>Galenical pharmacy </li></ul><ul><ul><li>The first pharmacy </li></ul></ul><ul><ul><li>Described the process of creating extracts of active medicinals from plants </li></ul></ul>
    8. 8. Natural Medicine <ul><li>Besides looking to the supernatural, ancient man also looked to the natural world for medical answers. </li></ul><ul><li>Sources of Drugs - Drugs come from various sources and can be classified as: </li></ul><ul><ul><li>Natural </li></ul></ul><ul><ul><li>Synthetic: created artificially </li></ul></ul><ul><ul><li>Synthesized: (created artificially but in imitation of naturally occurring substances) </li></ul></ul><ul><ul><li>Semisynthetic: (containing both natural and synthetic components) </li></ul></ul>
    9. 9. A Treatment for Malaria <ul><li>One of the most deadly disease in world’s history </li></ul><ul><li>Still deadly in developing countries </li></ul><ul><li>The first medicine was obtained from the Bark of a Peruvian Tree </li></ul><ul><li>Cinchona – Quinine </li></ul><ul><ul><li>Also called “Jesuite’s powder” </li></ul></ul>
    10. 10. Cocaine, the First Anesthetic (numbing agent) <ul><li>The Indians of the Andes used to chew coca leaves for its medicinal effects and also to increase endurance </li></ul><ul><li>Cocaine is the active ingredient in the leaves </li></ul><ul><li>Carl Koller, a Viennese surgeon in 1884 used it as the first local anesthetic which revolutionized surgery and dentistry </li></ul><ul><li>Because of its harmful properties when abused, other synthetic substitutes were produced such as procain (Novacain®) and Lidocaine </li></ul>
    11. 11. Natural Aspirin <ul><li>The ancient Greek physician Hippocrates and Dioscorides both wrote about the pain relieving ability of a plant </li></ul><ul><li>The bark of a white willow tree grew in the Mediterranean </li></ul><ul><li>The active ingredient was identified more than 2,000 years later and called salicylic acid </li></ul><ul><li>Because of the difficulty of taking salicylic acid by mouth, acetylsalicylic acid, popularly known as aspirin, was developed synthetically (man-made ) </li></ul><ul><li>It is the most widely used drug in the world </li></ul>
    12. 12. Foxglove – the First Heart Medicine <ul><li>The British Physician, William Withering published his study of the foxglove plant. 1785 </li></ul><ul><li>The active ingredient was digitalis. </li></ul><ul><ul><li>Widely used for heart failure, arrhythmyias </li></ul></ul><ul><ul><li>Now is called – digoxin </li></ul></ul><ul><ul><li>Narrow therapeutic index window </li></ul></ul>
    13. 13. Common Terms Used in Pharmacy <ul><li>Pharmacology -The study of drugs (from the Greek pharmakon means drug) </li></ul><ul><li>Pharmacognosy - The study of physical, chemical, biochemical and biological properties of drugs as well as drugs from natural sources </li></ul><ul><li>Pharmacopeia – An official listing of drugs and issues related to their use </li></ul><ul><li>Pharmaceutical – Of or about drugs; also, a drug product </li></ul><ul><li>Panacea – A cure-all (from the Greek panakeia) </li></ul><ul><li>Materia Medica – A dictionary of medicinal plants </li></ul>
    14. 14. Medicine History Timeline <ul><li>Boylston (18 th Century) - The first person to administer smallpox vaccine. </li></ul><ul><ul><li>Edward Jenner – successfully uses vaccine from milder cowpox disease to inoculate against smallpox </li></ul></ul><ul><li>Serturner (19 th Century) - Extracts morphine from opium. </li></ul><ul><li>Pasteur (19th Century) – Proved that heat can be used to kill microorganisms associated with food spoilage. Wide acceptance of the “Germ Theory” </li></ul><ul><li>Banting & Best (20 th Century) - Show that insulin lowers blood sugar in dogs and became a known drug to treat diabetes. </li></ul>
    15. 15. The First Antibiotic - Penicillin <ul><li>Alexander Fleming discovered a fungus which produces a chemical that kills bacteria. </li></ul><ul><li>He named it penicillin. </li></ul><ul><li>Penicillin was the first antibiotic drug. </li></ul><ul><li>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 . </li></ul>
    16. 16. Medicine History Timeline <ul><li>1950’s </li></ul><ul><ul><li>Watson and Crick : the two people who identified the structure of DNA genetic make up </li></ul></ul><ul><li>1960 – 1990’s </li></ul><ul><ul><li>The birth control pill was introduced </li></ul></ul><ul><ul><li>AZT becomes the first drug approved by the FDA for AIDS treatment. </li></ul></ul><ul><ul><li>HAART (Highly Active Antiretroviral Therapy) is introduced for AIDS treatment . </li></ul></ul>
    17. 17. The 20 th Century <ul><li>The average life span in the United States increased by over twenty years in the 20th Century. </li></ul><ul><li>1900 – early 50’s……….. 2000 – 77.9 years </li></ul><ul><li>In the US the life span increased about 64% in the last century </li></ul>
    18. 18. The 20 th Century <ul><li>A major factor in the increased health and life expectancy seen in this century, was the dramatic growth in pharmaceutical medicine. </li></ul><ul><li>With the increasing availability of powerful drugs, their regulation became more important than ever. </li></ul><ul><li>Food and Drug Administration (FDA) was established in response to this need to regulate the sale and use of medication in the US. </li></ul>
    19. 19. The Food and Drug Administration (FDA) <ul><li>Monitors drugs before a drug is marketed in the United States </li></ul><ul><li>Also monitors after the drug is approved for sale to the public for any adverse effects – called Post Marketing Surveillance </li></ul><ul><li>Recalls drugs if they have proven dangerous within public safety </li></ul>
    20. 20. Discovery of New Drugs <ul><li>Pharmaceutical companies spend 1/6 of their income on research and development. </li></ul><ul><li>Bringing drugs to market is a long and difficult process. Thousands of chemicals must be tried. </li></ul><ul><li>Drugs must go through an extensive testing and approval process before it can be made available to the public. </li></ul><ul><li>The length of time from the beginning of development through testing and to ultimate FDA approval is often more than ten years . </li></ul>
    21. 21. <ul><li>Pharmacists : Consistently rated among top trusted professionals in US </li></ul><ul><li>Gallop poll (2008) </li></ul><ul><ul><li>Nurses </li></ul></ul><ul><ul><li>Pharmacists </li></ul></ul><ul><ul><li>Medical Doctors </li></ul></ul><ul><ul><li>Police Officers </li></ul></ul><ul><ul><li>Clergy </li></ul></ul>
    22. 22. Pharmacy Today <ul><li>Prescription is a written paper for a drug product by a licensed prescriber to treat a patient. </li></ul><ul><li>Prescriptions filled increased by 72% while the number of pharmacists increased by 15% (1997 – 2007). </li></ul>
    23. 23. Education and Licensing Requirements <ul><li>Pharmacists Education - Doctor of Pharmacy (PharmD) degree - 6 year program – the only degree program to become a pharmacist </li></ul><ul><ul><li>2 years Pre-Pharmacy (calculus, chemistry, biology) </li></ul></ul><ul><ul><li>+ 4 years of pharmacy education </li></ul></ul><ul><ul><li>Pharmacy College Admission Test (PCAT) </li></ul></ul><ul><ul><li>Completes required Internship or practice setting experience </li></ul></ul><ul><li>Residency in specialty area is optional </li></ul>
    24. 24. Education and Licensing Requirements <ul><li>Pharmacists Licensing </li></ul><ul><ul><li>Required by all states, and overseen by board of pharmacy </li></ul></ul><ul><ul><li> Pass certification exams: law and national boards </li></ul></ul><ul><ul><li>Perform experiential training under a licensed pharmacist </li></ul></ul><ul><li>Continuing education for license renewal </li></ul><ul><ul><li>30 hours every two years </li></ul></ul><ul><ul><li>States may differ on the type of continuing education </li></ul></ul>
    25. 25. Pharmacy Settings <ul><li>Community Pharmacies - Over 50,000 community pharmacies account for approximately half of the distribution of prescription drugs. </li></ul><ul><li>Hospitals - The next greatest area of employment </li></ul><ul><li>Mail order pharmacies sell drugs by mail to patients. </li></ul><ul><ul><li>The fastest growing area. </li></ul></ul><ul><li>Long-term care pharmacies provide drugs to patients in nursing homes and other long-term facilities. </li></ul><ul><li>Managed care pharmacies provide service to patients in managed care insurance. </li></ul><ul><li>Home care pharmacies provide drugs to patients in their home. </li></ul>
    26. 26. Economic Trends
    27. 27. Computers in Pharmacy <ul><li>Patient Profile </li></ul><ul><ul><li>Allows complete information about patients, including prescribers, insurer, and medication history, and allergies; identifies drug interactions for patients taking multiple medications </li></ul></ul><ul><li>Billing </li></ul><ul><ul><li>Checks policies of third parties such as HMOs and insurers; authorizes third party transactions and credit cards electronically </li></ul></ul><ul><li>Prescriber Profile </li></ul><ul><ul><li>Includes state identification numbers and affiliations with facilities and insurers </li></ul></ul><ul><li>Labeling </li></ul><ul><ul><li>Creates label, receipt, customer information, and usage instructions </li></ul></ul>
    28. 28. Computers in Pharmacy <ul><li>Pricing </li></ul><ul><ul><li>Provides prices for medications and possible substitutes, automatically updates prices, scans prices from bar codes. </li></ul></ul><ul><li>Education/Counseling </li></ul><ul><ul><li>Patient information about drugs, usage, interactions, allergies, etc. </li></ul></ul><ul><li>Product Selection </li></ul><ul><ul><li>Locates items by various means (brand name, generic name, product code, category, supplier, etc.). Gives updates of prices and other product information. </li></ul></ul><ul><li>Inventory </li></ul><ul><ul><li>Adjusts inventor y as prescriptions are filled, analyzes turnover, produces status reports, automatically re-orders based on inventory levels, and generates purchase orders. </li></ul></ul>
    29. 29. Terms To Remember <ul><li>Antibiotic </li></ul><ul><li>Antitoxin </li></ul><ul><li>Data </li></ul><ul><li>Hormones </li></ul><ul><li>Human genome </li></ul><ul><li>Materia medica </li></ul><ul><li>Panacea </li></ul><ul><li>Pharmaceutical </li></ul><ul><li>Pharmacognosy </li></ul><ul><li>Pharmacology </li></ul><ul><li>Pharmacopeia </li></ul><ul><li>Synthetic </li></ul>