This document provides an overview of different areas of pharmacy practice, including:
1. Community pharmacy, which involves preparing and dispensing medications, providing drug information, and monitoring patients.
2. Pharmaceutics, which deals with developing medications for safe and effective use.
3. Hospital pharmacy, which supplies medications to hospital units and provides specialized services like IV preparations and drug information.
4. Industrial pharmacy, which involves drug research, development, production, quality control, and marketing of pharmaceutical products.
Careers in Pharmacy in India, 1. Pharmacist, 2. Drug Inspector, 3. Governmental Agencies, 4. As Government Analyst, 5. Clinical Pharmacy, 6. Community Pharmacy, 7. Nuclear Pharmacy, 8. Pharmaceutical Industry, 9. Drug researcher, 10. As Manufacturing Chemist, 11. In Quality Control / Quality Assurance, 12. Clinical Research, 13. Medical Communications/ Information, 14. Medical Transcription, 15. Medical Coding 16. In Regulatory Affairs 17. Sales and Marketing 18. Pharma-Biotechnology, 19. Academic Pharmacy, 20. Health policy makers, 21. Specialized Area Opportunities, 22. Higher Studies With Research Fellowship
Careers in Pharmacy in India, 1. Pharmacist, 2. Drug Inspector, 3. Governmental Agencies, 4. As Government Analyst, 5. Clinical Pharmacy, 6. Community Pharmacy, 7. Nuclear Pharmacy, 8. Pharmaceutical Industry, 9. Drug researcher, 10. As Manufacturing Chemist, 11. In Quality Control / Quality Assurance, 12. Clinical Research, 13. Medical Communications/ Information, 14. Medical Transcription, 15. Medical Coding 16. In Regulatory Affairs 17. Sales and Marketing 18. Pharma-Biotechnology, 19. Academic Pharmacy, 20. Health policy makers, 21. Specialized Area Opportunities, 22. Higher Studies With Research Fellowship
Full detailed about pharmacy and Scope of pharmacy like Formulation and development, Manufacturing, Packaging, Pharmaceutical marketing, Drug inspector, research and development, Academic area and work of drug analyst.
A hospital exists mainly to provide therapeutic services to the patients.
Drugs are an integral part of patient care. In every hospital, medicines are crucial to the hospital services.
Appropriate use of medicines in the hospital is a multidisciplinary responsibility that includes doctors, nurses, pharmacists, administrators, support personnel and patients.
The availability of medicines in the hospitals depends not only on good supplies, but also on efficient use through good distribution system, rational prescribing, and dispensing practices.
"When a drug is required, the appropriate drug must be chosen. It must be available at the right time, at the right price. It must be dispensed correctly, must be delivered in a right dose, at the right intervals and for the right length of time".
Pharmacy Practice (BP703T) Unit-3.pptxSagarpamu123
This PPT Covers B. Pharm, Pharmacy Practice Unit-III topics with 1. Pharmacy and Therapeutics Committee, 2. Information Services, 3. Patient Counseling, 4. Education and Training Program in the Hospital 5. Prescribed Medication Order and Communication Skills.
Retail pharmacy
Retail community pharmacy
Retail pharmacist
Retail pharmacy practice in Bangladesh
Retail pharmacy practice in Abroad
Retail pharmacy is a pharmacy in which drugs are sold to patients, as opposed to a hospital pharmacy. Also known as a community pharmacy.
The term ‘retail community pharmacy’ means an independent pharmacy, a chain pharmacy, a supermarket pharmacy, or a mass merchandiser pharmacy that is licensed as a pharmacy by the State and that dispenses medications to the general public at retail prices.
Full detailed about pharmacy and Scope of pharmacy like Formulation and development, Manufacturing, Packaging, Pharmaceutical marketing, Drug inspector, research and development, Academic area and work of drug analyst.
A hospital exists mainly to provide therapeutic services to the patients.
Drugs are an integral part of patient care. In every hospital, medicines are crucial to the hospital services.
Appropriate use of medicines in the hospital is a multidisciplinary responsibility that includes doctors, nurses, pharmacists, administrators, support personnel and patients.
The availability of medicines in the hospitals depends not only on good supplies, but also on efficient use through good distribution system, rational prescribing, and dispensing practices.
"When a drug is required, the appropriate drug must be chosen. It must be available at the right time, at the right price. It must be dispensed correctly, must be delivered in a right dose, at the right intervals and for the right length of time".
Pharmacy Practice (BP703T) Unit-3.pptxSagarpamu123
This PPT Covers B. Pharm, Pharmacy Practice Unit-III topics with 1. Pharmacy and Therapeutics Committee, 2. Information Services, 3. Patient Counseling, 4. Education and Training Program in the Hospital 5. Prescribed Medication Order and Communication Skills.
Retail pharmacy
Retail community pharmacy
Retail pharmacist
Retail pharmacy practice in Bangladesh
Retail pharmacy practice in Abroad
Retail pharmacy is a pharmacy in which drugs are sold to patients, as opposed to a hospital pharmacy. Also known as a community pharmacy.
The term ‘retail community pharmacy’ means an independent pharmacy, a chain pharmacy, a supermarket pharmacy, or a mass merchandiser pharmacy that is licensed as a pharmacy by the State and that dispenses medications to the general public at retail prices.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Pharmacy Orientation.pdf
1. Pharmacy orientation
Pharmacy
It is the art and science of preparing and dispensing
medications and the provision of drug related
information to the public. It involves the interpretation
of prescription orders; the compounding, labeling and
dispensing of drugs and devices; drug product
selection and drug utilization reviews (DURs involve a
comprehensive review of patients' prescription and medication data before,
during, and after dispensing to ensure appropriate medication decision making
and positive patient outcomes); patient monitoring and
intervention; and the provision of cognitive services
related to use of medications and devices.
2. Pharmaceutics
Pharmaceutics is the discipline of pharmacy that deals
with the process of turning a new chemical entity or
old drugs into a medication to be used safely and
effectively by patients.
It can also be defined as “ the science of dosage form
design”.
3. Hospital Pharmacy
The department or services in a hospital which is
under the directions of a professionally competent,
legally qualified pharmacist and from which all
medications are supplied to the nursing units and other
services, where special prescriptions are filled for
ambulatory patients (emergency patients) and out
patients (OPD), where pharmaceuticals are
manufactured in bulk, where narcotics and other
prescribed drugs are dispensed, where biologicals are
stored and dispensed.
4. Where injectable preparations should be prepared and
sterilized and where professional supplies are often
stocked and dispensed.
Hospital pharmacist participate in patient education
programs, poison control center activities, preparation
of patient drug use profiles, parenteral nutrition
program participation, cooperating in the teaching and
research program of the hospital, communicating new
product information to nursing services and other
hospital personnel and dispensing
radiopharmaceuticals.
5. Responsibilities of hospital pharmacist
1.Effective administration and management of a
pharmacy department in an institution
The pharmacist must have good management and
administrative skills. He must be familiar with the
health care system.
Broad areas of administrative and management
responsibilities includes
Planning and integrating professional services
Budgeting
6. Inventory control (supervision of supply and storage)
Cost review
Cost effectiveness (the minimum expenditures
necessary to achieve health care results)
Audit
Maintenance of records and preparation of reports
For this purpose hospital pharmacist should be
familiar with the organization of hospital.
7. Pharmacy activities must be coordinated with medical,
nursing and other services.
Hospital pharmacist is responsible for maintenance of
records which may be legally or administratively
required. These may include
Data on prescription dispensed
Controlled drugs dispensed
Drug purchase etc.
8. 2. Assimilation and provision of comprehensive
information on drugs and their actions
The pharmacy department is the primary source of
information concerning drugs.
The pharmacy must maintain the appropriate
information source and make arrangements for the
transmission of these information's to the professional
staff and to patients.
9. The pharmacist must have knowledge of drug action
such as absorption, distribution, metabolism and
excretion of drugs, drug interaction with other drugs,
food or diagnostic agents, effects of a disease state on
the drug action and miscellaneous patient and drug
variables.
He must be knowledgeable in chemistry,
pharmacology, toxicology, pathophysiology,
pharmaceutics, therapeutics and patient care
techniques.
10. 3. Development and conduct of a product
formulation and packaging program.
He must respond to the need for special dosage form
and formulations not available commercially.
An adequate understanding of the principle involved
in the formulation and preparation of pharmaceutical
dosage form is needed.
This involves the concept of biopharmaceutics,
bioavailability, pharmacokinetics, pharmaceutics,
stability, physicochemical kinetics, microbiology,
quality assurance, and techniques of medication
administration.
11. Hospital pharmacist is also responsible for the
preparation of IV admixtures and total parenteral
nutrition as well as he must be familiar with
radiopharmaceuticals.
12. 4. Conduct and participation in research
Hospital pharmacist must be prepared to participate in
clinical research originated by the medical staff and to
conduct pharmaceutical research or initiate research
himself.
13. 5. Development and conduct of patient oriented
services
These services includes
Drug information
Collection of pharmacy patient data base
Patient education
The monitoring and auditing of therapeutic regimens
Drug use review
The monitoring of specific adverse drug reactions to
decrease their incidence
14. 6. Conduct of and participation in educational
activities
The director of pharmacy is responsible for training
new personnel and for carrying educational programs
for pharmacists and pharmacy supportive personnel's.
15. 7. Development and conduct of a quality assurance
program for pharmaceutical services
A major responsibility of this department is the
assurance of the quality of its services and product
dispensed coupled with a controlled program for the
distribution of drugs throughout the institution.
16. Industrial Pharmacy
The industrial pharmacist work involves the
manufacture and distribution of drugs and medicinal
products.
This involves quality control, product development,
formulation, production, management, research and
sale.
17. The work of pharmacist in industry is about
discovering safe and effective new drugs, developing
them into new medicines and marketing the finished
product to customer.
Discovery…..Formulation……Marketing
19. 1. Sale
The sale area is one of the way for pharmacist to get
into pharmaceutical industry.
The sale representative usually call upon physicians,
pharmacists, nurses and in some cases dentists and
veterinarians and provide them comprehensive
information about the drugs and encourage them about
the appropriate use of the drug.
20. Usually the candidates are selected having good
personality, effective oral communication skills and a
strong interest in selling.
Most pharmaceutical companies offer excellent
benefits packages such as company cars, expensive
reimbursement, travel and medical allowance, medical
insurance for the family and reimbursement for
education program.
21. 2. Marketing
This department is responsible for developing and
implementing marketing plans to promote company
products to the appropriate audience.
In some industries the department is divided into
Prescription product marketing and OTC product
marketing
In other firms the marketing is divided into therapy
areas
22. Such as cardiovascular or respiratory products
Most marketing departments include
Marketing research
Which analyze business trends, sale histories of the
company products, competitive information's,
prescribing and recommendation habits of the
practitioners and new business opportunities within
the market.
23. Marketing strategy/planning
Which is responsible for anticipating and developing
products and services to meet the needs of the market
place in long term (when a segment of customers is not effectively
served by existing providers and the company develops and promotes
products or services to match).
Product management
Which oversees the overall marketing plan for a
specific product and is responsible for the profits and
losses generated by that product.
24. Life cycle management
Which evaluates new uses for the product and support
research to study these uses leading to new indications
(minoxidil spray)
Promotion
Which develops the promotional activities for the
product.
A degree of pharmacy may be helpful but is not
required generally for a marketing position.
25. Understanding the health care delivery system, general
business principles and a basic knowledge of R & D,
manufacturing, QA and distribution are helpful in
obtaining a position in the marketing department.
The MBA would be an appropriate advance degree
and is helpful in marketing department.
26. 3. Medical affairs department
This department provides information and services to
health care practitioners, give presentations to
practitioners, does sale training and obtain the output
of though leaders (experts in the field with innovative
ideas).
27. 4. Research and development
Pharmacist in industry are also engaged in R & D of
new drugs or new indications or dosage form for new
existing products.
5. Production
Pharmacist working in production often work in
managerial position. They plan to fulfill the company
needs and planning for the plant facilities, equipment's
and personnel's who will be needed to meet the
company's production goals.
28. They are also responsible for establishing and
administering manufacturing procedures and control to
ensure the production of high quality products.
6. Quality control department
This department is responsible to conduct assays and
quality assurance tests to maintain the quality of their
products. QA activities begins while the safety and
efficacy of new products are being established.
29. The R & D, manufacturing and QA department of the
company jointly established final production and QA
specification for new products.
The QA department establishes sampling and testing
procedures to make certain that each lot of product
meets both company and FDA specifications.
The system also ensure the potency (effectiveness),
purity and dose to dose uniformity of the product.
30. This department also ensures the stability of the
finished dosage form and appropriate expiry dates.
This department also checks not only for the quality
and quantity of active ingredients but also for the
uniformity of active drug.
31. 7. Legal department or regulatory affairs
department
Pharmacist in this department provide legal consult on
the laws and regulations for marketing
pharmaceuticals.
This department handles the interaction between the
company and the medicine regulatory bodies of the
country.
This department is responsible for process like
Investigational new drug application IND
New drug application NDA etc.
32. IND: this application intends to provide sufficient data
to the FDA that it is reasonable to begin clinical tests
of new drugs on humans
NDA: NDA contains all of the information's and data
that the FDA requires for market approval of a drug
33. Management and administration
Pharmacist at the managerial and administrative
position have the responsibility that the department
function smoothly and achieve its objectives.
34. Retail pharmacy
Retail is an establishment for selling of the products or
services in individual units to the final consumer for
consumption
Currently, the professional activities of retail
pharmacist are confined to the traditional role such as
Dispensing
Recommending
And selling of OTC drugs and health aids
35. The international retail roles of the pharmacist
include
Clinical services and managerial services
Clinical services includes
Patient counseling
Consulting with physicians
Developing patient medication profile
Calling the prescriber for refill
Screening for drug interaction
Checking for allergic reactions
36. Patient counseling may consist of necessary
information and answering the routine questions
regarding drugs, their preparation (reconstitution),
proper use etc.
The prescriber consultation areas include
Way to lowers the cost of drugs
Alternative choices
Patient complaints against the side effects of a given
drug.
37. The managerial activities of a retail pharmacist
include purchasing, inventory control, stocking
shelves and supervising the technicians
Retail categories
Based on services, retail outlets can be divided into
two categories
1. Independent pharmacy
An independent retail pharmacy is a set up with a
single retail store without branches or any contractual
agreement with others.
38. It exist at a single location. However, it may be selling
all drug categories including or excluding narcotics
and other controlled drugs
It has the following advantages
Require less investment
No profit sharing
Freedom in control and from restriction
Disadvantage
Unable to attract or retain a qualified person
39. Chain pharmacy
Chain pharmacy stores are branched stores existing at
various locations but operating under a common
ownership. It was first initiated by Farmacia, a
subsidiary Ferozesons, Nowshera.
Umar pharmacy
Cure pharmacy
D. Watson chemist
40. Advantages
More credibility
Wide geographical coverage
Economical buying due to bulk purchase making more
profit
Able to attract qualified person because of having a
job structure
Efficient as can afford more employees, better
services, sale training et.
Promotional activities can be initiated with more
investment
41. Superstore
Drug superstore is one carrying drugs along with a
wide variety of commodities. The pharmacy has
allocated a separate area within the unit. It attracts
more consumer traffic due to wide variety of
commodity available.
42. Community pharmacy
Pharmacist in community pharmacy dispense
medications, council patients on the use of
prescription and over the counter medications and
advise physician about patient medication therapy.
They also advise patient about general health topics
such as diet, exercise and stress management and
provide information on products such as medical
equipment's or health home care supplies.
43. Some community pharmacist provide specialized
services to help patients with condition such as
diabetes, asthma, smoking cessation or high blood
pressure.
They also keep computerized record of patient drug
therapy to prevent harmful drug interactions.
They are also responsible for the preparation of sterile
solutions which are administered IV. Many of them are
involved in extemporaneous preparations.
44. 1. Dispense prescription medicines to the public
2. Ensure that different treatments are compatible
3. Check dosage and ensure that medicines are
correctly and safely supplied and labelled (pharmacists
are legally responsible for any dispensing errors)
4. Supervise the preparation of any medicines (not all
are supplied ready made-up by the manufacturer)
5. Keep a register of controlled drugs for legal and
stock control purposes
6. Communicate with doctors about prescriptions
45. 7. Sell over-the-counter medicines
8. Advise the public on the treatment of minor ailments
9. Advise patients of any adverse side-effects of medicines
or potential interactions with other medicines/treatments
10. Prepare dosette and cassette boxes, usually for the
elderly, but also for those with memory/learning
difficulties or who have several combinations of tablets to
take, where tablets are placed in compartments for
specified days of the week
11. Undertake Medicine Use Reviews (MUR), an
advanced service to help patients understand how their
medicines work and why they have to take them
46. 12. Manage a needle and syringe exchange
13. Offer specialist health checks, such as blood
pressure and cholesterol monitoring and diabetes
screening
14. Run stop-smoking clinics and weight-reduction
programs
15. Arrange the delivery of prescription medicines to
patients
16. Manage, supervise and train pharmacy support
staff
47. 17. Manage finance and budgets
18. Keep up to date with current pharmacy practice,
new drugs and their uses
48. Forensic pharmacy
It is the application of the drug sciences to legal issues.
Forensic pharmacists engage in professional work relating
to litigation (legal process, court case etc.), the regulatory
(supervisory) process, or the criminal justice system.
Forensic pharmacy is not an exotic (unusual) field. Many
issues concerning society are relevant to forensic
pharmacy including substance abuse control, impaired
driving, crime, fraud, date rape, and employment testing
for drugs. Pharmacists may provide valuable testimony
(proof) in cases involving drunk driving, homicide
(murder), suicide, malpractice, child abuse, personal
injury cases, patents (copyrights), and so on.
49. Pharmacist Malpractice
Pharmacists have been sued (charged) for many
reasons including dispensing the wrong medication,
compounding errors, failure to detect interactions,
failure to contact prescribers about excessive dosages,
and failure to warn patients about side effects.
Clinical pharmacists can be liable for improperly
monitoring drug therapy. Malpractice cases against
pharmacists generally require testimony from another
pharmacist.
50. Most lawyers will not file lawsuits against pharmacists
unless an affidavit is obtained from another pharmacist
expressing an opinion of negligence. This pharmacist
expert witness would express an opinion supporting
the allegations of malpractice.
51. Malpractice against other health professionals
The forensic pharmacist can assist lawyers regarding
malpractice cases of other health professionals, for
example physicians and nurses. If the case involves an
adverse drug reaction, the pharmacist can testify about
causation. The pharmacist can also testify about
alternative therapies with less risk. The pharmacist
can provide opinions about medications that can
prevent disease complications. For example, if a
patient develops renal failure from diabetes or
hypertension, the pharmacist can discuss medications
that would have prevented or reduced the risk of
kidney damage.
52. Blood Levels
Certain drugs have a narrow therapeutic range and
need to be closely monitored (eg digoxin,
theophylline, lithium, etc). Clinical reasons for which
to draw blood samples include high doses and
borderline doses, signs of toxicity occurring, lack of a
therapeutic effect, or suspected poor adherence.
Toxicology analysis is a common part of the forensic
autopsy (post-mortem ) and often forensic pharmacists
are consulted to interpret drug levels. Numerous
changes occur postmortem that may increase or
decrease the blood level detected at autopsy. The
postmortem blood level may not reflect an antemortem
blood level.
53. Drugs,Alcohol, and Driving
The forensic pharmacist can interpret the levels of
blood alcohol and discuss the typical effects from
different alcohol levels. Pharmacists can apply
pharmacokinetics to estimate the level of alcohol at
the time of the alleged event. Pharmacokinetics
calculations can especially be helpful if an extended
time period exists between the incident and time of
collection.
54. Certain medications can have additive effects with
ethanol, that is lower levels of ethanol will produce
greater effects. Other medications can alter the
absorption or metabolism of ethanol. Certain disease
states may make a person susceptible to the effects of
ethanol. Pharmacists can provide input regarding these
other factors relating to alcohol consumption such as
personal injury cases.
55. Criminal Cases
The work of forensic pharmacists may be needed in
various types of criminal cases. This includes cases
where the drug or poison was used as a weapon, or
where medications impair the mental capacity of the
defendant or victim.
The effects of drugs on victims are often related to
criminal cases. Medications are often used as agents
for suicide and in suicide attempts. Drugs and poisons
have been used as tools of homicide.
56. Drugs have been used to facilitate sexual assault,
especially in dating situations. The most well-known
date rape drug is flunitrazepam, although alcohol is
the most common agent. Other well-known date rape
drugs include gamma-hydroxybutyrate (GHB) and
ketamine. In theory, any drug that has sedating, mind
alerting effects, or impairs memory could be used to
facilitate a sexual assault. Chemical weapons have
been used in terrorism and continue to be risk to this
day.
57. Off-Label Drug Use
A pharmaceutical company may only market the drug
for conditions that the FDA has approved. However,
health care providers may prescribe marketed
medications for uses other than FDA-approved uses.
These are referred to as ‘‘unlabeled’’ or ‘‘off-label’’
uses.
Prescribing offlabel medications is in itself not
malpractice. Many off-label uses of medications are
appropriate and medically necessary. The forensic
pharmacist may offer testimony about the need for
unlabeled indications and provide insight into
appropriate use of that medication.
58. Fraud and White-Collar Crime
Types of fraud related to forensic pharmacy include:
1. Scientific Fraud: Submitting intentional false data
for publication in a book or journal.
2. Quackery: The promotion of remedies that lack
scientific support to consumers or health
professionals.
3. Drug Diversion: Obtaining controlled substances
for misuse or abuse.
59. 4. Health care Fraud: Submitting intentionally false
data to insurance companies.
5. Occupational Fraud and Abuse: This is in no way
limited to pharmacy and or even the health care
industry.
6. Record Tampering: Improper changes in the writing
in the medical records after a lawsuit has been initiated
or fear lawsuit after an unexpected occurrence.
7. Counterfeit Drugs