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دوتنه:Bowl hygeia.jpg
Bowl of Hygeia

Pharmacy (from the Greek φάρμακον = drug) is the profession charged with ensuring the safe use of medication. Traditionally, pharmacists have compounded and dispensed medications on the orders of physicians. More recently, pharmacy has come to include other services related to patient care including clinical practice, medication review, and drug information. Some of these new pharmaceutical roles are now mandated by law in various legislatures. Pharmacists, therefore, are drug therapy experts, and the primary health professionals who optimize medication management to produce positive health-outcomes.

The symbols most commonly associated with pharmacy are the mortar and pestle and the ℞ (recipere) character. Pharmacy organisations often employ other elements, such as the Bowl of Hygieia, conical measures, and caduceuses in their logos. Other symbols are common in different countries such as the green Greek cross in France and Great Britain, and the Gaper in The Netherlands.

اصول

The field of Pharmacy can generally be divided into three main disciplines:

The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut; and often, collaborative teams from various disciplines research together.

Pharmacology is sometimes considered a fourth discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Therefore it is usually considered to be a field of the broader sciences.

There are various specialties of pharmacy practice. Some specialisation is based on the place of practice including: community, hospital, consultant, locum, drug information, regulatory affairs, industry, and academia. Other specialisations are based on clinical roles including: nuclear, oncology, cardiovascular, infectious disease, diabetes, nutrition, geriatric, and psychiatric pharmacy.

Pharmacists

Main article: Pharmacist

Pharmacists are highly-trained and skilled healthcare professionals who perform various roles to ensure optimal health outcomes for their patients. Many pharmacists are also small-business owners, owning the pharmacy in which they practice. This unique dichotomy is often the subject of debate within the profession—in part due to the perception of pharmacists as "common shopkeepers" by many in the community.

Pharmacists are represented internationally by the International Pharmaceutical Federation (FIP). They are represented at the national level by professional organisations such as the Royal Pharmaceutical Society of Great Britain (RPSGB), the Pharmaceutical Society of Australia (PSA) and American Pharmacists Association (APhA). In some cases, the representative body is also the registering body, which is responsible for the ethics of the profession. Since the Shipman Inquiry, there has been a move in the UK to separate the two roles.

Separation of prescribing from dispensing

In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. Specifically, the legislation stipulates that the practice of prescribing must be separate from the practice of dispensing. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments.

In the minority of jurisdictions (particularly in Asian such as China, Malaysia and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is integrated with that of the physician.

The reason for the majority rule is the high risk of a conflict of interest. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects.

A campaign for separation has begun in many countries and has already been successful (like in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have percuniary interests may prove a major stumbling block (e.g. in Malaysia).

Community Pharmacy

A pharmacy (commonly the chemist in Australia, New Zealand and the UK; or drugstore in North America; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers.

Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications; there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients.

All pharmacies are required to have a pharmacist on-duty at all times when open. In many jurisdictions, it is also a requirement that the owner of a pharmacy must be a registered pharmacist (R.Ph.). This latter requirement has been revoked in many jurisdictions, such that many retailers (including grocery stores and mass merchandisers) now include a pharmacy as department of their store.

Hospital Pharmacy

Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues.

Unlike community pharmacies, which are usually independently owned, hospital pharmacies can usually be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Traditionally, hospital pharmacies have also prepared various injectable preparations, such as saline, total parenteral nutrition (TPN), and other drug infusions; but there has been a trend to outsource these functions to specialised pharmaceutical companies.

Internet Pharmacy

Recently, a number of pharmacies have begun operating over the internet. Many such pharmacies are, in some ways, similar to community pharmacies; the primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient than traveling to a community drugstore.

Some internet pharmacies sell prescription drugs without requiring a prescription. Some customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There have also been reports of such pharmacies dispensing substandard products.

In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. Although importation of prescription medication currently violates FDA regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers.

The future of pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists will be paid for their cognitive skills. This paradigm shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. Many universities are altering their programs to increase emphasis in fields such as pharmacotherapeutics, clinical pharmacy, nuclear pharmacy, disease state management, etc. In Great Britain, pharmacists (and nurses) who undertake additional training are obtaining prescribing rights.

See also

External links

Professional Organisations

Regulatory

History and traditions

Other

کينډۍ:BranchesofChemistry

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