PHARMACY IN ACTION
Community Pharmacy
Usual setting is the independent drugstore
|Types of Community Practice|
Independent Drugstore
Very common
Pharmaceutical Centers
Only items that are related to health are kept in stock
Keeps family system, family health info. Center, prof.
Lib.
Direct patient pharmacist relationship
Group Practice
Formal association of three or more pharmacists
1. Geriatrics
Mostly nursing homes
American Society of Hospital Pharmacy
initiated this
2. Mental Health Pharmacy Psychopharmacy
American Society of Hospital Pharmacy
Special Interest Group (ASHP SIG)
Clinical Pharmacy Specialist in Psychiatry
3. Oncology Services
Provide care to oncology patients
Chain Drugstore/Multiple Pharmacy
Two or more branches operate which are registered
in the same name
|Activities of a Community Pharmacist|
Professional functions
Dispensing&compounding a prescription
Dispensing OTC drugs
Storage and handling of drugs
Providing professional advice to patients
Selecting products for inventory
Keeping records
Administrative, supervisory and managerial functions
Entrepreneural function related to investment of capital and
ownership of pharmacies
|Philippine Situation|
Drugstore
Usually owned by a pharmacist
Botica sa Baryo
Consignment for 15-30 days, discounts in bulk orders
Chain Drugstore
Started to operate about the year 1965
Mercury Drugstore (first&biggest, 450 branches),
Watsons, The Generic Pharmacy, South Star Drug
Industrial Pharmacy
Technical areas: research, development, production,
quality control
Non-technical areas: marketing and administration
|The Philippines Drug Industry|
Started in 1900 with the establishment of Hizon
Laboratories
Followed by Manuel Zamora Lab. Which
manufactured tiki-tiki in 1913
Drug Establishment
Any organization or company involved in the
manufacture, importation, repacking and/ or
distribution of drugs and medicines
1. Drug manufacturer
Operations involved in the production of a
drug
United Lab., Doctors Pharma
2. Drug Trader
Registered owner of the drug product
Cyanamid whose products are
manufactured by Interphil Lab.
3. Drug Importer
Imports raw materials, active ingredients
and/ or finished products for its own use
MDLD
4. Drug Exporter
Exports raw materials, active ingredients
and/ or finished products
5. Drug Wholesaler
Procures raw materials, active ingredients
and/ or finished products
Zuellig Pharma., Metro Drug Distribution,
Marsman and Co, Inc.
6. Small manufacturer under FIDA (Filipino Drug
Association) and CFDM (Chamber of Filipino Drug
Manufacturers)
Serve the generic drug requirements
Drugmakers, AM Europharma
|Leading Philippine Pharmaceutical Companies|
1. United Lab.
2. GlaxoSmithKline
3. Pfizer
4. Wyeth
|Registered Pharmaceutical Outlets|
The Food and Drug Administration (FDA) issues license
to drug firms
Regulation Division I: drug outlets, distributor,
cosmetic distributor, medical device distributor, food
distributor, household hazardous substances
Regulation Division II: drug manufacturer, cosmetic
lab., medical device manufacturer, drug trader
cosmetic tradr, medical device trader, house hold
hazardous substances manufacturer/trader, food
establishments
License to Operate (LTO) must be applied first
Certification of Product Registration (CPR)
DR: drugs; CR/CL: cosmetics; FR: foods; HSR:
household hazardous substances; DVR: medical
devices
FDA Inspectors make sure that pharmacists are
present in designated hours, do routine inspection,
monitor drug outlets
|Top 10 Prescription/Ethical Brands|
1. Norvasc
2. Ventolin
 3. Plavix Involves the application of new knowledge to benefit
4. Augmentin mankind

|Top 10 OTC Brands| |The Federated Pharmaceutical Industry of the Phil.|

Ceelin
Solmux
Neozep
Biogesic
|Dangerous Drug Board|
Policy-making and strategy-formulating body in the
planning and formulation of policies and programs
on drug prevention and control
Develop and adopt comprehensive, integrated,
unified and balanced national drug abuse
prevention and control strategy
Under the Office of the President
1. S-1
Retail dealer of exempt dangerous drugs
preparation (EDDP)
2. S-2
For physician, dentist, vet who is legally
authorized to prescribe or administer
dangerous drugs (DD) and EDDP
3. S-3
Retail dealer of DD and EDDP
4. S-4
Wholesale dealer/distributor of DD&EDDP
5. S-5-I
Importer of DD&EDDP
6. S-5-C
Compounder, producer&manufacturer of
DD&EDDP
7. S-5-E
Exporter of DD&EDDP
8. S-6
Legally authorized to obtain and use
DD&EDDP for research, instruction or analysis
in a laboratory
9. S-7
Importer, manufacturer, producr or
compounder of DD in any form
|Carry Out the Provisions|
R.A. 9165/Comprehensive Dangerous Drug Acts of
2002
Philippine Drug Enforcement Agency (PDEA) serves
as the implementing arm of the board and shall be
responsible for the efficient and effective law
enforcement of all the provisions on any DD
|Research|
Development Reseach
Concerned with the formulation of new drug
compounds, improvement of existing meds
Basic Research
Discovery and search for new knowledge
Applied Research
Composed of the members of the Chamber of Drug
Manufacturers, the Philippine Manufacturers
Association and the Drug Association of the
Philippines
Concerned with the solution of the common
problems of the industry and undergoes direct
dialogue with government agencies
Hospital Pharmacy
Department or service in a hospital which is under
the direction of a professional competent, legally
qualified pharmacist, and from which all meds are
supplied to nursing units and other services, where
special prescriptions are filled for patients in the
hospital, where prescription are filled for ambulatory
patients and out-patients...
|Duties of a Hospital Pharmacist|
Responsible for the management of the hospital pharmacy
Must be knowledgeable on:
Drug&their actions
Pharmacy manufacturing program
Control procedure regarding quality control&drug
distribution throughout the hospital
Research activities
Teaching techniques
Pharmacy administration in a hospital
|Philippine Setting|
Activities of a hospital pharmacist
Prepare the annual budget for drugs
Initiate drug orders
Watch price fluctuations
Maintain a system of records
Exercise overall supervision of the Pharmacy
Department
Prepare sched. Of all staff duties
Coordinate with the medical and nursing staff
Represent her department in staff meeting
Prepare annual report
Serve in vital committees
|Duties of the Pharmaceutical Staff|
Dispnsing of drugs, chemicals and pharmaceutical
preparations
Filling&labelling of all drug containers
Maintaining an approved stock of antidotes
Dispensing of narcotics&alcohol
Furnishing information regarding medications to
doctors, interns&nurses
Charging paients for drugs&pharmaceutical supplies
Maintaining adequate control over
requisitioning&dispensing of all drugs
Implementing the decision of the Pharmacy and the
Therapeutics Committee
 Manning the Drug Information Service
|The Philippine Society of Hospital Pharmacy|
Organized in 1962 to promote the interest of hospital
pharmacists
Holds monthly seminars
Clinical Pharmacy
Health discipline in which pharmacists provide
patient care that optimizes medication therapy and
promotes health, wellness and disease prevention
Embraces the philosophy of pharmaceutical care
|Activities of the Clinical Pharmacist|
1. Consulting
2. Selection of drugs
Defining drug formularies/limited lists of
drugs
3. Drug information
Seeking info. And critically evaluating
scientific literature
4. Formulation and preparation
5. Drug use studies and research
Collecting data on drug therapies
6. Pharmacokinetics/therapeutic drug monitoring
Studying the kinetics of drugs
7. Clinical trials
8. Pharmaeconomy
Using the results of clinical trials and outcome
studies
9. Dispensation and administration
10. Teaching&training
|Philippine Experience|
First practiced in Makati Medical Center
Patient-oriented
Make rounds with the physician and other members
of the health care team
Take charge of taking patient drug histories,
maintaining patient drug profiles, keeping close
surveillance for adverse drug reaction (ADR),
counselling patients on drug use
|Pharmaceutical Care|
Functions performed by a pharmacist in ensuing the
optimal use of medications to achieve specific
outcomes that improve a patients quality of life
Responsible for the provision of drug therapy for the
purpose of achieving definite outcomes that improve
a patients quality of life
Knowledge of Drugs and Drug Therapy,
Communication Skills, Drug Information Skills,
|Goal of Pharmaceutical Care|
Optimize the patients health related quality of life
Professional relationship must be established
Patient-specific medical info. Must be collected,
organized, recorded and maintained
Patient-specific medical info. Must be evaluated
Assures that the patient has all supplies, info. And
knowledge necessary to carry out the drug therapy
plan
Reviews, monitors, and modifies the therapeutic plan
Pharmacist in Government Service
|Career oppurtunities|
1. Commissioned officer in the Army, Navy, Air Force
2. Civil service employees in different offices
|Philippine Setting|
1. FDA
Licensing of pharmaceutical establishments
Drug inspection
Registration of new drugs
2. Bureau of Research and Lab, DOH
Researches on med.&public health aspects
Production of biological products
3. National Academy of Science and Technology
Medical Research Center
Microbiological Research Center
4. Commission on Audit (COA)
5. Bureau of Plant Industry
6. Bureau of Customs
7. National Bureau of Investigation&Dangerous Drugs
Board
8. Professional Regulation Commission (PRC)
Control of the Practice of Pharmacy
|Legal Control|
Republic Act No. 5921
Approved on June 23, 1969
Concerned with the regulation of the practice of
pharmacy and the setting of standards of
pharmaceutical education
Council of Pharmaceutical Education: implement the
provision of the act
Board of Pharmacy
|Council of Pharmaceutical Education|
Composed of:
1. Secretary of Education as the chairman
2. Undersecretary of Health Services
3. Director of the Bureau of Foods and Drugs
4. Chairman of the Board of Pharmacy
5. Dean of the College of Pharmacy of UP
6. Dean of the Colleges of Pharmacy
7. Representative of a bonafide national
pharmaceutical organization in the Phils.
Functions:
1. Promulgate rules&regulations relative to
Pharmaceutical Education in the Philippines
2. Recognize&accredit colleges of pharmacy
3. Accredit community or prescriptions pharmacies...
|The Board of Pharmacy|
Composed of a chairman and two members
appointed by the President
Functions:
1. Examine applicants for the practice of pharmacy
2. Issue certificates of registration of pharmacists
3. Reprimand any pharmacists or to suspend or revoke
his certificate of registration
4. Promulgate rules and regulations
5. Study the condition affecting the practice of
pharmacy
6. Check employment of qualified personnel in
drugstores
7. Encourage the development of botanical gardens
|Practice of Pharmacy|
A person shall be deemed to be practicing pharmacy...
Prepare/manufacture, analyze, assay, preserve,
store, distribute or sell medicine, drug, chemicals, etc.
Render pharmaceutical service
Engage in teaching scientific, technical or
professional pharmacy subjects
Conduct or undertake scientific pharmaceutical
research
|Requirements for the Opening and Operation of Drugstores
and Pharmacies|
Shall be in accordance with the rules and regulations
prescribed by the Bureau of Foods and Drugs (BFAD)
Should be signed by a Filipino registered pharmacist
|Sale of Medicine, Pharmaceutical, Drugs and Devices|
Licensed under the Retail Trade Law
|Definition of Terms|
Pharmacy/Drugstore
Establishment where drug, chemical products, active
principles of drugs etc. Are compounded and
dispensed
Drug/Pharmaceutical Laboratory/Pharmaceutical
Manufacturing Laboratories
Where pharmaceuticals, proprietary medicines, etc.
Are prepared, compounded standardized and
distributed or sold
Pharmaceuticals/Proprietary Medicines/Pharmaceutical
Specialties
Any drug, preparation or mixtures of drugs mixed
under a trade name
Devices
Instruments, apparatus/contravances
Biologic Products
Viruses, sera, toxins and analogous products used for
the prevention or cure human diseases
Poison
Drug, active principle or preparation of the same,
capable of destroying life
Cipher
Method of secret writing
Code
System of words or other symbols kept from the
knowledge of others
|Generic Act of 1988 (R.A. 6675)|
An act to promote, require and ensure the
production of an adequate supply, distribution, use
and acceptance of drugs and medicines indentified
by their generic names
|Definition of Terms|
Generic Name/Terminology
Identification of drugs and medicine by their
scientifically and internationally recognized active
ingredients
Active Ingredient
Chemical component responsible for the claimed,
therapeutic effect of the pharmaceutical product
Chemical Name
Description of the chemical structure of the
drug/medicine
Drug Product
Finished product form that contains the active
ingredients
Core List
List of drugs that meets the Health Care needs of
majority of the population
Complementary List
List of alternative drugs used when there is no
response to the core essential drug
Brand Name
Proprietary name given by the manufacturer to
distinguish its products from those of competitors
Generic Drugs
Drugs not covered by patent protection
|Who shall Use Generic Terminology|
1. All government health agencies and their personnel
2. All medical, dental and veterinary practitioners
3. Any organization or company involved in the
manufacture, importation repacking, marketing
and/or distribution of drugs and medicines
4. Drug outlets
|Ethical control|
Ethics
Philosophical science dealing with the morality of
human acts
Deals with right conduct directed towards the
formation of the individual
Special Ethics
Deals with the application of the general principles or
morality to the particular actions of man
Objectives of the professional code of ethics:
Define professional privileges, behaviours and
responsibilities
Promote professional quality, conduct and moral
method of procedure
Defend private professions from undue interference
by the government
Preserve the dignity of the profession
Defend clients from unscrupulous professionals
Fix certain standards of compensation
|Code of Ethics| |Its Problems|
(SEE BOOK) Role of Pharmacist
Prepared and supported by pharmacists They must be able to control the proper use of drugs
Ethics of pharmacy is based on SERVICE Pharmaceutical Education
It must be aimed to meet the needs of the society
|Relationship with the Public| Organization of Practice
Drugs of good quality Must organize to increase the efficiency&perfection
Conformity to Laws of pharmaceutical service
Confidential information Economics of Professional Service
Physical facilities Commercialism should not be practiced
Civic responsibilities Pharmaceutical Ethics
Renumeration Proper of improper ethical behaviour can make or
unmake the profession of pharmacy
|Pharmacist-Patient-Prescriber Relationship|
Inviting him to the pharmacy
Keeping him informed of unusual patient problems
Detailing him on new products
Participating in inter-professional meetings
Facts that destroy this triangular relationship
Counter prescribing
Physician/nurse dispensing
Self-service counters
Mail-order service
Drug distribution through non-professional outlets

|Relations to the Other Health Professions (Inter-professional)|

Drug consultant
Diagnosing and prescribing
o Auto-therapy: persons who engage in self-
medication
Compounding and dispensing prescriptions
Clandestine arrangements
o Exploitation of the patient by certain
arrangements of the pharmacist with other
members of the health team should never be
done

|Relations to Fellow Pharmacists (Inter-professional)|

Self-improvement
Recruitment
Instruction
Professional organizations
Unethical practices

Pharmacy: Its Future, Its Problems

|Its Future|
People are having a longer lifespan, hence more
services for geriatric pharmacy will be required
People are becoming more health conscious
Pre-natal and post-natal care is a must which calls for
more drugs
Make good liaison officer for public health services

|Programs|
Voluntary health insurance program
Union/company
Social security benefits