Pharmacy
Overview
 

Pharmacy is the health profession
Health profession
The health care industry, or medical industry, is the sector of the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, palliative, or, at times, unnecessary care...

 that links the health sciences with the chemical science
Chemistry
Chemistry is the science of matter, especially its chemical reactions, but also its composition, structure and properties. Chemistry is concerned with atoms and their interactions with other atoms, and particularly with the properties of chemical bonds....

s and it is charged with ensuring the safe and effective use of pharmaceutical drugs. The word derives from the (pharmakon), meaning "drug" or "medicine" (the earliest form of the word is the Mycenaean Greek pa-ma-ko, attested in Linear B
Linear B
Linear B is a syllabic script that was used for writing Mycenaean Greek, an early form of Greek. It pre-dated the Greek alphabet by several centuries and seems to have died out with the fall of Mycenaean civilization...

 syllabic script).

The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

, including clinical services, reviewing medications for safety and efficacy, and providing drug information.
Encyclopedia

Pharmacy is the health profession
Health profession
The health care industry, or medical industry, is the sector of the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, palliative, or, at times, unnecessary care...

 that links the health sciences with the chemical science
Chemistry
Chemistry is the science of matter, especially its chemical reactions, but also its composition, structure and properties. Chemistry is concerned with atoms and their interactions with other atoms, and particularly with the properties of chemical bonds....

s and it is charged with ensuring the safe and effective use of pharmaceutical drugs. The word derives from the (pharmakon), meaning "drug" or "medicine" (the earliest form of the word is the Mycenaean Greek pa-ma-ko, attested in Linear B
Linear B
Linear B is a syllabic script that was used for writing Mycenaean Greek, an early form of Greek. It pre-dated the Greek alphabet by several centuries and seems to have died out with the fall of Mycenaean civilization...

 syllabic script).

The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

s, therefore, are the experts on drug therapy and are the primary health professionals who optimize medication use to provide patients with positive health outcomes.

An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy, chemist's or drug store. In the United States and Canada, drug stores commonly sell not only medicines, but also miscellaneous items such as candy (sweets), cosmetics
Cosmetics
Cosmetics are substances used to enhance the appearance or odor of the human body. Cosmetics include skin-care creams, lotions, powders, perfumes, lipsticks, fingernail and toe nail polish, eye and facial makeup, towelettes, permanent waves, colored contact lenses, hair colors, hair sprays and...

, and magazine
Magazine
Magazines, periodicals, glossies or serials are publications, generally published on a regular schedule, containing a variety of articles. They are generally financed by advertising, by a purchase price, by pre-paid magazine subscriptions, or all three...

s, as well as light refreshments or groceries.

The word pharmacy is derived from its root word pharma which was a term used since the 15th–17th centuries. In addition to pharma responsibilities, the pharma offered general medical advice and a range of services that are now performed solely by other specialist practitioners, such as surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 and midwifery
Midwifery
Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also help care for the newborn and assist the mother with breastfeeding....

. The pharma (as it was referred to) often operated through a retail shop which, in addition to ingredients for medicines, sold tobacco and patent medicines. The pharmas also used many other herbs not listed.

In its investigation of herbal and chemical ingredients, the work of the pharma may be regarded as a precursor of the modern sciences of chemistry
Chemistry
Chemistry is the science of matter, especially its chemical reactions, but also its composition, structure and properties. Chemistry is concerned with atoms and their interactions with other atoms, and particularly with the properties of chemical bonds....

 and pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

, prior to the formulation of the scientific method.

Disciplines

The field of Pharmacy can generally be divided into three primary disciplines:
  • Pharmaceutics
    Pharmaceutics
    Pharmaceutics is the discipline of pharmacy that deals with all facets of the process of turning a new chemical entity into a medication able to be safely and effectively used by patients in the community. Pharmaceutics is the science of dosage form design...

  • Medicinal chemistry
    Medicinal chemistry
    Medicinal chemistry and pharmaceutical chemistry are disciplines at the intersection of chemistry, especially synthetic organic chemistry, and pharmacology and various other biological specialties, where it is involved with design, chemical synthesis and development for market of pharmaceutical...

     and Pharmacognosy
    Pharmacognosy
    Pharmacognosy is the study of medicines derived from natural sources. The American Society of Pharmacognosy defines pharmacognosy as "the study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs or drug substances of natural origin as well...

  • Pharmacy practice
    Pharmacy practice
    Pharmacy practice is the discipline of pharmacy which involves developing the professional roles of pharmacists.-Areas of practice:Areas of pharmacy practice include:*Disease-state management...



The boundaries between these disciplines and with other sciences, such as biochemistry
Biochemistry
Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...

, are not always clear-cut; and often, collaborative teams from various disciplines research together.

Pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

 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 science
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...

s.

Pharmacoinformatics
Pharmacoinformatics
Drug discovery and development requires the integration of multiple scientific and technological disciplines. These include chemistry, biology, pharmacology, pharmaceutical technology and extensive use of information technology...

 is considered another new discipline, for systematic drug discovery and development with efficiency and safety.

Professionals

The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 estimates there are at least 2.6 million pharmacists and other pharmaceutical personnel worldwide.

Pharmacists

Pharmacists are allied health professionals with specialised education and training who perform various roles to ensure optimal health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

 outcomes for their patients through proper medication use. Many pharmacists are also small-business
Small business
A small business is a business that is privately owned and operated, with a small number of employees and relatively low volume of sales. Small businesses are normally privately owned corporations, partnerships, or sole proprietorships...

 proprietors, owning the pharmacy in which they practice. Since pharmacists know about the chemical synthesis mode of action of a particular drug, and its metabolism and physiological effects on human body in great detail, they play an important role in optimisation of a drug treatment for an individual.

Pharmacists are represented internationally by the International Pharmaceutical Federation
International Pharmaceutical Federation
The International Pharmaceutical Federation or Fédération Internationale Pharmaceutique, abbreviated as FIP, is an international federation of national organisations that represent pharmacists and pharmaceutical scientists...

 (FIP). They are represented at the national level by professional organisations
Professional body
A professional association is usually a nonprofit organization seeking to further a particular profession, the interests of individuals engaged in that profession, and the public interest.The roles of these professional associations have been variously defined: "A group of people in a...

 such as the Royal Pharmaceutical Society
Royal Pharmaceutical Society
The Royal Pharmaceutical Society is the body responsible for the leadership and support of the pharmacy profession within England, Scotland and Wales...

 in the UK, the Pharmacy Guild of Australia (PGA), the American Pharmacists Association
American Pharmacists Association
The American Pharmacists Association , founded in 1852, is the first-established professional society of pharmacists within the United States....

 (APhA), and the Pakistan Pharmacists Society
Pakistan Pharmacists Society
The Pakistan Pharmacists Society is the national organization of pharmacists and student pharmacists, committed to providing leadership for the pharmacists. PPS has a mission to promote and expand the profession of pharmacy and the role of pharmacists in Pakistan...

 (PPS). See also: List of pharmacy associations.

In some cases, the representative body is also the registering body, which is responsible for the regulation and ethics
Ethics
Ethics, also known as moral philosophy, is a branch of philosophy that addresses questions about morality—that is, concepts such as good and evil, right and wrong, virtue and vice, justice and crime, etc.Major branches of ethics include:...

 of the profession.

In the United States, specializations in pharmacy practice recognized by the Board of Pharmaceutical Specialties include: cardiovascular, infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

, oncology
Oncology
Oncology is a branch of medicine that deals with cancer...

, pharmacotherapy, nuclear, nutrition
Nutrition
Nutrition is the provision, to cells and organisms, of the materials necessary to support life. Many common health problems can be prevented or alleviated with a healthy diet....

, and psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

. The Commission for Certification in Geriatric Pharmacy
Commission for Certification in Geriatric Pharmacy
The Commission for Certification in Geriatric Pharmacy is a non-profit organization which has established a voluntary professional certification program for pharmacists. Pharmacists must pass a written examination to become certified and must re-certify every five years...

 certifies pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology
Toxicology
Toxicology is a branch of biology, chemistry, and medicine concerned with the study of the adverse effects of chemicals on living organisms...

.

Pharmacy technicians

Pharmacy technicians support the work of pharmacists and other health professionals by performing a variety of pharmacy related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with doctor's offices and insurance companies to ensure correct medications are provided and payment is received.

History

The history of pharmacy as an independent science is relatively young. The origins of historiography pharmaceutical back to the first third of the s. XIX which is when the first historiographies that while not touching all aspects of pharmaceutical history is the starting point for the final start of this science.

Until the birth of pharmacy
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...

 as an independent science, there is a historical evolution from antiquity to the present day that marks the course of this science, always connected to the medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

.

Types of pharmacy practice areas

Pharmacists practice in a variety of areas including retail, hospitals, clinics, nursing homes, mental hospitals, and regulatory agencies. Pharmacists can specialize in various areas of practice including but not limited to: hematology/oncology, infectious diseases, ambulatory care, nutrition support, drug information, critical care, pediatrics, etc.

Community pharmacy

A pharmacy (commonly the chemist in Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

, New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...

 and the UK
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

; or drugstore in North America
North America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...

; retail pharmacy in industry terminology; or Apothecary
Apothecary
Apothecary is a historical name for a medical professional who formulates and dispenses materia medica to physicians, surgeons and patients — a role now served by a pharmacist and some caregivers....

, 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 opening of the first drugstores are recorded by Muslim pharmacists
Islamic medicine
In the history of medicine, Islamic medicine, Arabic medicine or Arabian medicine refers to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization....

 in Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

 in 754.

In most countries, 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 technician
Pharmacy technician
A pharmacy technician, also sometimes known as a pharmaceutical technician, is a health care worker who performs pharmacy related functions, generally working under the direct supervision of a licensed pharmacist or other health professional...

s while the pharmacist spends more time communicating with patients. Pharmacy technicians are now more dependent upon automation to assist them in their new role dealing with patients' prescriptions and patient safety issues.

Pharmacies are typically required to have a pharmacist on-duty at all times when open. It is also often a requirement that the owner of a pharmacy must be a registered pharmacist, although this is not the case in all jurisdictions, such that many retailers (including supermarket
Supermarket
A supermarket, a form of grocery store, is a self-service store offering a wide variety of food and household merchandise, organized into departments...

s and mass merchandisers) now include a pharmacy as a department of their store.

Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional items such as cosmetics
Cosmetics
Cosmetics are substances used to enhance the appearance or odor of the human body. Cosmetics include skin-care creams, lotions, powders, perfumes, lipsticks, fingernail and toe nail polish, eye and facial makeup, towelettes, permanent waves, colored contact lenses, hair colors, hair sprays and...

, shampoo
Shampoo
Shampoo is a hair care product used for the removal of oils, dirt, skin particles, dandruff, environmental pollutants and other contaminant particles that gradually build up in hair...

, office supplies
Office supplies
Office supplies is the generic term that refers to all supplies regularly used in offices by businesses and other organizations, from private citizens to governments, who work with the collection, refinement, and output of information .The term includes small, expendable, daily use items such as...

, confections, snack foods, durable medical equipment
Durable medical equipment
Durable medical equipment is a term of art used to describe any medical equipment used in the home to aid in a better quality of living. It is a benefit included in most insurances. In some cases certain Medicare benefits, that is, whether Medicare may pay for the item...

, greeting cards, and provide photo processing services.

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.

Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) and patient compliance issues (in the hospital and at home) many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy. For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care, emergency medicine
Emergency medicine
Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...

, toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics, herbal medicine
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...

, neurology/epilepsy management, pediatrics, neonatal pharmacists and more.

Hospital pharmacies can often 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. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition
Total parenteral nutrition
Parenteral nutrition is feeding a person intravenously, bypassing the usual process of eating and digestion. The person receives nutritional formulae that contain nutrients such as glucose, amino acids, lipids and added vitamins and dietary minerals...

 (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance
Quality Assurance
Quality assurance, or QA for short, is the systematic monitoring and evaluation of the various aspects of a project, service or facility to maximize the probability that minimum standards of quality are being attained by the production process...

 of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology, combined with the potential impact of medications and pharmacy services on patient-care outcomes and patient safety, make it imperative that hospital pharmacies perform at the highest level possible.

Clinical pharmacy

Clinical pharmacists provide direct patient care services that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 settings but the clinical pharmacy movement initially began inside hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

s and clinic
Clinic
A clinic is a health care facility that is primarily devoted to the care of outpatients...

s. Clinical pharmacists often collaborate with physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They work collaboratively with physicians, nurses and other healthcare personnel in various medical and surgical areas. They often participate in patient care rounds and drug product selection.

In most hospitals in the United States, potentially dangerous drugs that require close monitoring are dosed and managed by clinical pharmacists.

Compounding pharmacy

Compounding is the practice of preparing drugs in new forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated lollipop
Lollipop
A lollipop, pop, lolly, sucker, or sticky-pop is a type of confectionery consisting mainly of hardened, flavored sucrose with corn syrup mounted on a stick and intended for sucking or licking. They are available in many flavors and shapes.- Types :Lollipops are available in a number of colors and...

 that contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead.

Another form of compounding is by mixing different strengths (g,mg,mcg) of capsules or tablets to yield the desired amount of medication indicated by the doctor. This form of compounding is found at community or hospital pharmacies or in-home administration therapy.

Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies.

Consultant pharmacy

Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work in nursing home
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...

s, but are increasingly branching into other institutions and non-institutional settings. Traditionally consultant pharmacists were usually independent business owners, though in the United States many now work for several large pharmacy management companies (primarily Omnicare
Omnicare
Omnicare is a Fortune 500 company based in Covington, Kentucky. Omnicare functions primarily as a provider of pharmaceuticals, related consulting and data management services. As of December 31, 2009 the company provided its pharmacy services to skilled nursing, assisted living, and other...

, Kindred Healthcare
Kindred Healthcare
Kindred Healthcare Incorporated is a healthcare services company that through its subsidiaries operates hospitals, nursing centers, and contract rehabilitation services across the United States...

 and PharMerica
PharMerica
PharMerica is a publicly-traded Fortune 1000 company formed in January 2007 from the merger of Kindred Healthcare's pharmacy business with a subsidiary of AmerisourceBergen...

). This trend may be gradually reversing as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services.

The main principle of consultant pharmacy is pharmaceutical care
Pharmaceutical care
Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life...

 developed by Hepler and Strand in 1990.

Internet pharmacy

Since about the year 2000, a growing number of internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...

 pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as Online Pharmacies) are also recommended to some patients by their physicians if they are homebound.

While most internet pharmacies sell prescription drug
Prescription drug
A prescription medication is a licensed medicine that is regulated by legislation to require a medical prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription...

s and require a valid prescription, some internet pharmacies sell prescription drugs without requiring a prescription. Many 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 also have been reports of such pharmacies dispensing substandard products.

Of particular concern with internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin
Vicodin
Hydrocodone/paracetamol is a combination of two analgesic products hydrocodone and paracetamol used to relieve moderate to severe pain...

, generically known as hydrocodone
Hydrocodone
Hydrocodone or dihydrocodeinone is a semi-synthetic opioid derived from either of two naturally occurring opiates: codeine and thebaine. It is an orally active narcotic analgesic and antitussive...

) via the internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are many instances where a practitioner issues a prescription, brokered by an internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship.

Canada is home to dozens of licensed internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers, who pay one of the world's highest drug prices. In recent years, many consumers in the US and in other countries with high drug costs, have turned to licensed internet pharmacies in India, Israel and the UK, which often have even lower prices than in Canada.

In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, there has been a push to legalize importation of medications from Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

 and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...

 (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.

Recently developed online services like Australia's Medicine Name Finder and the Walgreens' Drug Info Search provide information about pharmaceutical products but do not offer prescriptions or drug dispensations. These services often promote generic drug
Generic drug
A generic drug is a drug defined as "a drug product that is comparable to brand/reference listed drug product in dosage form, strength, route of administration, quality and performance characteristics, and intended use." It has also been defined as a term referring to any drug marketed under its...

 alternatives by offering comparative information on price and effectiveness.

Veterinary pharmacy

Veterinary pharmacies, sometimes called animal pharmacies, may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill the pharmaceutical needs of animals. Because the needs of animals, as well as the regulations on veterinary medicine
Veterinary medicine
Veterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...

, are often very different from those related to people, veterinary pharmacy is often kept separate from regular pharmacies.

Nuclear pharmacy

Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients.

Military pharmacy

Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal. State laws of Technician patient counseling and medication checking by a pharmacist do not apply.

Pharmacy informatics

Pharmacy informatics is the combination of pharmacy practice science and applied information science. Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or for healthcare information technology
Health informatics
.Health informatics is a discipline at the intersection of information science, computer science, and health care...

 vendor companies. As a practice area and specialist domain, pharmacy informatics is growing quickly to meet the needs of major national and international patient information projects and health system interoperability goals. Pharmacists in this area are trained to participate in medication management system development, deployment and optimization.

Separation of prescribing from dispensing

In most jurisdictions (such as the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

), pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

s are regulated separately from physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnership
Partnership
A partnership is an arrangement where parties agree to cooperate to advance their mutual interests.Since humans are social beings, partnerships between individuals, businesses, interest-based organizations, schools, governments, and varied combinations thereof, have always been and remain commonplace...

s with physicians or give them "kickback" payments. However, the American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...

 (AMA) Code of Ethics provides that physicians may dispense drugs within their office practices as long as there is no patient exploitation and patients have the right to a written prescription that can be filled elsewhere. 7 to 10 percent of American physicians practices reportedly dispense drugs on their own.

In some rural areas in the United Kingdom, there are dispensing doctors who are allowed to both prescribe and dispense prescription-only medicines to their patients from within their practices. The law requires that the GP practice be located in a designated rural area and that there is also a specified, minimum distance (currently 1.6 kilometres) between a patient's home and the nearest retail pharmacy.

In other jurisdiction
Jurisdiction
Jurisdiction is the practical authority granted to a formally constituted legal body or to a political leader to deal with and make pronouncements on legal matters and, by implication, to administer justice within a defined area of responsibility...

s (particularly in Asia
Asia
Asia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.7% of the Earth's total surface area and with approximately 3.879 billion people, it hosts 60% of the world's current human population...

n countries such as China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

, Malaysia, and Singapore
Singapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...

), doctor
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s are allowed to dispense drug
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

s themselves and the practice of pharmacy is sometimes integrated with that of the physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

, particularly in traditional Chinese medicine.

In Canada it is common for a medical clinic and a pharmacy to be located together and for the ownership in both enterprises to be common, but licensed separately.

The reason for the majority rule is the high risk of a conflict of interest and/or the avoidance of absolute powers. 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
Adverse effect (medicine)
In medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as surgery.An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. If it results from an unsuitable or incorrect dosage or...

. This system reflects much similarity to the checks and balances system of the U.S. and many other governments.

A campaign for separation has begun in many countries and has already been successful (like in Korea
Korea
Korea ) is an East Asian geographic region that is currently divided into two separate sovereign states — North Korea and South Korea. Located on the Korean Peninsula, Korea is bordered by the People's Republic of China to the northwest, Russia to the northeast, and is separated from Japan to the...

). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia).

The future of pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....

. Rather than simply dispensing medication, pharmacists are increasingly expected to be compensated for their patient care skills. In particular, Medication Therapy Management
Medication therapy management
Medication therapy management is a partnership of the pharmacist, the patient or their caregiver, and other health professionals that promotes the safe and effective use of medications and helps patients achieve the targeted outcomes from medication therapy. MTM was first proposed by Ronald...

 (MTM) includes the clinical services that pharmacists can provide for their patients. Such services include the thorough analysis of all medication (prescription
Prescription
Prescription may refer to:Health care*Prescription drug, a drug available only by a medical prescription*Medical prescription, a plan of care written by a physician or other health care professional...

, non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system.

This shift has already commenced in some countries; for instance, pharmacists in Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

 receive remuneration from the Australian Government
Government of Australia
The Commonwealth of Australia is a federal constitutional monarchy under a parliamentary democracy. The Commonwealth of Australia was formed in 1901 as a result of an agreement among six self-governing British colonies, which became the six states...

 for conducting comprehensive Home Medicines Reviews. In Canada, pharmacists in certain provinces have limited prescribing rights (as in Alberta and British Columbia) or are remunerated by their provincial government for expanded services such as medications reviews (Medschecks in Ontario). In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights. They are also being paid for by the government for medicine use review
Medicine use review
A Medicine Use Review is an advanced service offered by pharmacies in the United Kingdom. It is part of the current contract pharmacies hold with the NHS. An MUR is an opportunity for patients to discuss their medicines with a qualified pharmacist. An MUR is a free NHS service that is held in a...

s. In Scotland the pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for controlled drugs, when the patient is unable to see their doctor, as could happen if they are away from home or the doctor is unavailable. In the United States, pharmaceutical care or clinical pharmacy
Clinical pharmacy
Clinical pharmacy is the branch of Pharmacy where pharmacists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside...

 has had an evolving influence on the practice of pharmacy. Moreover, the Doctor of Pharmacy
Doctor of Pharmacy
A Doctor of Pharmacy is a professional doctorate degree in pharmacy. In some countries, it is a first professional degree, and a prerequisite for licensing to exercise the profession of pharmacist.-Kenya :...

 (Pharm. D.) degree is now required before entering practice and some pharmacists now complete one or two years of residency or fellowship training following graduation. In addition, consultant pharmacist
Consultant pharmacist
A consultant pharmacist is a specialized pharmacist. The main principle of consultant pharmacy is Pharmaceutical care term developed by Hepler and Strand in 1990.- United States :...

s, who traditionally operated primarily in nursing home
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...

s are now expanding into direct consultation with patients, under the banner of "senior care pharmacy."

See also

  • American Society for Pharmacy Law
    American Society for Pharmacy Law
    The American Society of Pharmacy Law is an professional organisation of pharmacist-attorneys, pharmacists, attorneys, and students in schools of pharmacy or law who are interested in the law as it applies to pharmacy.- Goals :...

  • Apothecary
    Apothecary
    Apothecary is a historical name for a medical professional who formulates and dispenses materia medica to physicians, surgeons and patients — a role now served by a pharmacist and some caregivers....

  • Bachelor of Pharmacy
    Bachelor of Pharmacy
    A Bachelor of Pharmacy is an undergraduate academic degree in the field of pharmacy. The degree is the basic prerequisite for registration to practice as a pharmacist in many countries. In some countries, it has been superseded by the Master of Pharmacy and Doctor of Pharmacy degrees...

    , Master of Pharmacy
    Master of Pharmacy
    A Master of Pharmacy is an academic degree in the field of pharmacy, which may be undergraduate or postgraduate depending on the country concerned. In many countries, it has superseded a Bachelor of Pharmacy as the prerequisite for registration to practice as a pharmacist...

    , Doctor of Pharmacy
    Doctor of Pharmacy
    A Doctor of Pharmacy is a professional doctorate degree in pharmacy. In some countries, it is a first professional degree, and a prerequisite for licensing to exercise the profession of pharmacist.-Kenya :...

  • Classification of Pharmaco-Therapeutic Referrals
    Classification of Pharmaco-Therapeutic Referrals
    The Classification of Pharmaco-Therapeutic Referrals is a taxonomy focused to define and group together situations requiring a referral from pharmacists to physicians regarding the pharmacotherapy used by the patients. It has been published in 2008...

  • Clinical pharmacy
    Clinical pharmacy
    Clinical pharmacy is the branch of Pharmacy where pharmacists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside...

  • Consultant pharmacist
    Consultant pharmacist
    A consultant pharmacist is a specialized pharmacist. The main principle of consultant pharmacy is Pharmaceutical care term developed by Hepler and Strand in 1990.- United States :...

  • Evidence-based pharmacy in developing countries
    Evidence-based pharmacy in developing countries
    Many developing nations have developed national drug policies, a concept that has been actively promoted by the WHO. For example, the national drug policy for Indonesia drawn up in 1983 had the following objectives:...

  • History of pharmacy
    History of pharmacy
    The history of pharmacy as an independent science is relatively young. The origins of historiography pharmaceutical back to the first third of the nineteenth century which is when the first historiographies that while not touching all aspects of pharmaceutical history is the starting point for the...

  • Hospital pharmacy
    Hospital pharmacy
    A hospital pharmacy is concerned with pharmacy service to all types of hospital and differs considerably from a community pharmacy.Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex...

  • International Pharmaceutical Federation
    International Pharmaceutical Federation
    The International Pharmaceutical Federation or Fédération Internationale Pharmaceutique, abbreviated as FIP, is an international federation of national organisations that represent pharmacists and pharmaceutical scientists...

  • International Pharmaceutical Students’ Federation
    International Pharmaceutical Students’ Federation
    Founded in London in 1949, the International Pharmaceutical Students’ Federation is one of the world’s oldest international student volunteer organisation...

  • List of pharmacies
  • List of pharmacy associations
  • List of pharmacy organizations in the United Kingdom
  • List of pharmacy schools

  • Nuclear pharmacy
    Nuclear pharmacy
    Nuclear Pharmacy involves the preparation of radioactive materials that will be used to diagnose and treat specific diseases. It was the first pharmacy specialty established in 1978 by the Board of Pharmaceutical Specialties...

  • Online pharmacy
    Online pharmacy
    Online pharmacies, Internet pharmacies, or Mail Order Pharmacies are pharmacies that operate over the Internet and send the orders to customers.Online or internet pharmacies might include:...

  • Pharmaceutical company
    Pharmaceutical company
    The pharmaceutical industry develops, produces, and markets drugs licensed for use as medications. Pharmaceutical companies are allowed to deal in generic and/or brand medications and medical devices...

  • Pharmaceutical industry
  • Pharmacogenetics
    Pharmacogenetics
    The terms pharmacogenomics and pharmacogenetics tend to be used interchangeably, and a precise, consensus definition of either remains elusive...

  • Pharmacogenomics
    Pharmacogenomics
    Pharmacogenomics is the branch of pharmacology which deals with the influence of genetic variation on drug response in patients by correlating gene expression or single-nucleotide polymorphisms with a drug's efficacy or toxicity...

  • Pharmacognosy
    Pharmacognosy
    Pharmacognosy is the study of medicines derived from natural sources. The American Society of Pharmacognosy defines pharmacognosy as "the study of the physical, chemical, biochemical and biological properties of drugs, drug substances or potential drugs or drug substances of natural origin as well...

  • Pharmacology
    Pharmacology
    Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

  • Pharmaconomist
    Pharmaconomist
    Pharmaconomist means expert in pharmaceuticals . Pharmaconomists are a pharmaceutical professional group in Denmark with a 3 year higher tertiary education...

  • Pharmacy Automation - The Tablet Counter
  • Pharmacy residency
    Pharmacy residency
    Pharmacy Residency is education a pharmacist can pursue beyond the degree required for licensing as a pharmacist .-In France:The residency lasts four years....

  • Pharmacy informatics
  • Professional Further Education in Clinical Pharmacy and Public Health
    Professional Further Education in Clinical Pharmacy and Public Health
    Professional Further Education in Clinical Pharmacy and Public Health is a Danish professional postgraduate higher further education for Danish pharmaconomists ....

  • Raeapteek
    Raeapteek
    The Raeapteek is in the center of Tallinn city, Estonia.Opposite the Town Hall, at house number 11, it is one of the oldest continuously running pharmacies in Europe, having always been in business in the same exact house since the early 15th century...

      (one of the oldest continuously run pharmacies in Europe)

Symbols

The two symbol
Symbol
A symbol is something which represents an idea, a physical entity or a process but is distinct from it. The purpose of a symbol is to communicate meaning. For example, a red octagon may be a symbol for "STOP". On a map, a picture of a tent might represent a campsite. Numerals are symbols for...

s most commonly associated with pharmacy are the mortar and pestle
Mortar and pestle
A mortar and pestle is a tool used to crush, grind, and mix solid substances . The pestle is a heavy bat-shaped object, the end of which is used for crushing and grinding. The mortar is a bowl, typically made of hard wood, ceramic or stone...

 and the (recipere
Rx
RX is the telegraph and radio abbreviation for "receive" or "receiver".Rx, RX, or rx may also refer to:, medical prescriptions* Rx, the symbol used to describe apparent retrograde motion of planets...

) character, which is often written as "Rx" in typed text. The show globe
Show globe
A show globe is a glass vessel of various shapes and sizes containing a colorful liquid. It has been a symbol of pharmacy from the 17th century England to the early 20th century in the United States. It marked the drugstore or apothecary in much the same way as the barber's pole marked tonsorial...

 was also used in English-speaking countries until the early 20th century. Pharmacy organizations often use other symbols, such as the Bowl of Hygieia
Bowl of Hygieia
Bowl of Hygieia is one of the symbols of pharmacy. Hygieia was the Greek goddess of health.- Usage of symbol by pharmaceutical associations :...

 which is often used in the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...

, conical measure
Conical measure
A conical measure is a type of laboratory glassware which consists of a conical cup with a notch on the top to allow for the easy pouring of liquids, and graduated markings on the side to allow easy and accurate measurement of volumes of liquid....

s, and caduceus
Caduceus
The caduceus is the staff carried by Hermes in Greek mythology. The same staff was also borne by heralds in general, for example by Iris, the messenger of Hera. It is a short staff entwined by two serpents, sometimes surmounted by wings...

es in their logos
Logos
' is an important term in philosophy, psychology, rhetoric and religion. Originally a word meaning "a ground", "a plea", "an opinion", "an expectation", "word," "speech," "account," "reason," it became a technical term in philosophy, beginning with Heraclitus ' is an important term in...

. Other symbols are common in different countries: the green Greek cross in France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

, Argentina
Argentina
Argentina , officially the Argentine Republic , is the second largest country in South America by land area, after Brazil. It is constituted as a federation of 23 provinces and an autonomous city, Buenos Aires...

, the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

, Belgium
Belgium
Belgium , officially the Kingdom of Belgium, is a federal state in Western Europe. It is a founding member of the European Union and hosts the EU's headquarters, and those of several other major international organisations such as NATO.Belgium is also a member of, or affiliated to, many...

, Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

 and Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...

, the increasingly rare Gaper
Gaper
A gaper is a stone or wooden head, often depicting a Moor, on the front of a building in the Netherlands. It was used to indicate that this building is a pharmacy....

 in the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...

, and a red stylized letter A in Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...

 and Austria
Austria
Austria , officially the Republic of Austria , is a landlocked country of roughly 8.4 million people in Central Europe. It is bordered by the Czech Republic and Germany to the north, Slovakia and Hungary to the east, Slovenia and Italy to the south, and Switzerland and Liechtenstein to the...

 (from Apotheke, the German
German language
German is a West Germanic language, related to and classified alongside English and Dutch. With an estimated 90 – 98 million native speakers, German is one of the world's major languages and is the most widely-spoken first language in the European Union....

 word for pharmacy, from the same Greek
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...

 root as the English
English language
English is a West Germanic language that arose in the Anglo-Saxon kingdoms of England and spread into what was to become south-east Scotland under the influence of the Anglian medieval kingdom of Northumbria...

word 'apothecary').



External links


Other

  • The Virtual Library of Pharmacy - Extensive index of pharmacy-related resources, including information on careers in pharmacy, pharmacy schools, pharmaceutical companies, associations and conferences.
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
x
OK