Pharmacy -It’s even more Pharmacy -It’s even more than you imagine, than you imagine,

Today !Today !JuJune 17, 2015ne 17, 2015

K V GOPINATHK V GOPINATH Hospital Pharmacist T T Devasthanams Tirupati -517 501 APHospital Pharmacist T T Devasthanams Tirupati -517 501 AP

Pharma Vision and Pharma Vision and EducationEducation ““I realize Pharma is a noble profession I realize Pharma is a noble profession I will always apply science and technology in I will always apply science and technology in

pharmaceutical work pharmaceutical work I realize that pharmacy can provide cost effective pure I realize that pharmacy can provide cost effective pure

drugs and medicines to the people. drugs and medicines to the people. While I am working in Pharmacy from design to While I am working in Pharmacy from design to

formulation development, testing, quality control and formulation development, testing, quality control and marketing, I realize any flaw knowingly or unknowingly will marketing, I realize any flaw knowingly or unknowingly will result into a loss of human life. result into a loss of human life.

I love my pharmacy profession and I consider it as an I love my pharmacy profession and I consider it as an honor to work as a Pharmacist, may God help me to serve honor to work as a Pharmacist, may God help me to serve the humanity.” the humanity.” Dr A P J Abdul kalam Dr A P J Abdul kalam Former President of India Former President of India

Courtesy: Pharma TimesCourtesy: Pharma Times

Pharmacy –Who is a Pharmacy –Who is a Pharmacist ?Pharmacist ?

A specialist in medicationsA specialist in medications

A companion of the health A companion of the health care memberscare members

A counselor to the patientA counselor to the patient

A guardian of public healthA guardian of public health

Pharmacy – Drugs & Pharmacy – Drugs & Cosmetics Act 1948 !Cosmetics Act 1948 !

““Pharmacy” means any place licensed for the Pharmacy” means any place licensed for the retail sale of drugs which have a ‘qualified person’ retail sale of drugs which have a ‘qualified person’ and indulge in the compounding of drugs. and indulge in the compounding of drugs.

““Pharmacist” means an individual registered as Pharmacist” means an individual registered as pharmacists under the Pharmacy Act to engage in pharmacists under the Pharmacy Act to engage in the Practice of Pharmacy.the Practice of Pharmacy.

““Drug” means articles intended for use in the Drug” means articles intended for use in the diagnosis, cure, mitigation, treatment, or diagnosis, cure, mitigation, treatment, or prevention of disease in humans or other animals.prevention of disease in humans or other animals.

History of PharmacyHistory of Pharmacy

““Compounding” means the preparation of Compounding” means the preparation of Components into a Drug product as per the Components into a Drug product as per the Practitioner’s Prescription Drug OrderPractitioner’s Prescription Drug Order

The growth of pharmacy in India is like The growth of pharmacy in India is like

growing under 'Exotic' Banyan tree although growing under 'Exotic' Banyan tree although it is indigenous Indian national tree !!! There it is indigenous Indian national tree !!! There is a need to come out of the shadow to is a need to come out of the shadow to explore and serve better for the community, explore and serve better for the community, INDEPENDENTLY AND COLLECTIVELY WITH INDEPENDENTLY AND COLLECTIVELY WITH OTHER HEALTH CARE MEMBERS FOR THE OTHER HEALTH CARE MEMBERS FOR THE PATIENT.PATIENT.

Compounding & Compounding & DispensingDispensing

Scope of PharmacyScope of Pharmacy

Role of Pharmacists in Role of Pharmacists in Pharma / Biotech IndustryPharma / Biotech Industry

Research & DevelopmentResearch & Development – – Drug discovery, Drug discovery, Reverse Engineering, Formulation & Process Development, Up Reverse Engineering, Formulation & Process Development, Up scaling, Stability and Packaging Developmentscaling, Stability and Packaging Development

ProductionProduction – – Production of bulk drugs, intermediates, Production of bulk drugs, intermediates, Finished dosage forms (traditional and alternate medicines)Finished dosage forms (traditional and alternate medicines)

Quality ControlQuality Control – – Product testing through out the Product testing through out the product life cycleproduct life cycle

Quality AssuranceQuality Assurance – – Preparing, receiving and Preparing, receiving and submitting written documentssubmitting written documents

MarketingMarketing – – Strategic planning, team management and Strategic planning, team management and ethical product promotionethical product promotion

Key Strengths of Indian Key Strengths of Indian Pharma / Biotech IndustryPharma / Biotech Industry

Strong R & D, Production, QA & QC and Marketing Strong R & D, Production, QA & QC and Marketing base like infrastructure, processing and man powerbase like infrastructure, processing and man power

Cost CompetitivenessCost Competitiveness World class Pharmaceutical or Biotech productsWorld class Pharmaceutical or Biotech products Strong Marketing and distribution networkStrong Marketing and distribution network An excellent centre for clinical trialsAn excellent centre for clinical trials Fast growing health care industryFast growing health care industry Rich BiodiversityRich Biodiversity Highest quality approvals from USFDA, EDQM, MHRA Highest quality approvals from USFDA, EDQM, MHRA

etcetc Rank 3Rank 3rdrd in the world class, accounts 8% by volume in the world class, accounts 8% by volume

and 2% by valueand 2% by value Strong Indian system of MedicinesStrong Indian system of Medicines

Pharmacists – Pharmacists – Teaching / Teaching / Research based teaching /Clinical Research based teaching /Clinical ResearchResearch

Ability to balance research & teaching Ability to balance research & teaching responsibilities with patient care responsibilities with patient care

Ability to serve as a role model for pharmacy Ability to serve as a role model for pharmacy students and residents students and residents

Comfort with sophisticated instrumentation, Comfort with sophisticated instrumentation, statistical analyses, animal handling and other statistical analyses, animal handling and other research methodsresearch methods

Practice sites: universities, schools of pharmacy, Practice sites: universities, schools of pharmacy,

local, state, national, and international organizations local, state, national, and international organizations

Pharmacists- Pharmacists- Regulatory Regulatory AffairsAffairs

Preparing, reviewing, communicating, submitting Preparing, reviewing, communicating, submitting registration documents on pharmaceuticals to registration documents on pharmaceuticals to regulatory agencies to get R & D , production, QA & regulatory agencies to get R & D , production, QA & QC, and marketing approvals, issues related to QC, and marketing approvals, issues related to patientspatients

Project management/organizational skills Project management/organizational skills - - Negotiation and communication skills Negotiation and communication skills - Understanding of the scientific and - Understanding of the scientific and technical technical background background of products of products - Willingness to keep up to date with - Willingness to keep up to date with regulatory policies regulatory policies and and procedures procedures

Practice sties:Practice sties: associations, government, consulting associations, government, consulting companies, pharmaceutical companies, universities companies, pharmaceutical companies, universities

Pharmacist – Community Pharmacist – Community PharmacyPharmacyWhat do you picture when you think What do you picture when you think of community pharmacy?of community pharmacy?

Role of pharmacist in Role of pharmacist in community pharmacy?community pharmacy?

Dispensing prescription medicines to the publicDispensing prescription medicines to the public Ensuring that different treatments are compatibleEnsuring that different treatments are compatible Checking dosage and ensuring that medicines are Checking dosage and ensuring that medicines are

correctly and safely supplied and labeled correctly and safely supplied and labeled (pharmacists are legally responsible for any (pharmacists are legally responsible for any dispensing errors)dispensing errors)

Supervising the preparation of any medicines (not all Supervising the preparation of any medicines (not all are supplied ready made-up by the manufacturer)are supplied ready made-up by the manufacturer)

Keeping a register of controlled drugs for legal and Keeping a register of controlled drugs for legal and stock control purposesstock control purposes

Liaising with doctors about prescriptionsLiaising with doctors about prescriptions Selling over-the-counter medicinesSelling over-the-counter medicines

Role of pharmacist in Role of pharmacist in community pharmacy?community pharmacy? Counseling and advising the public on the Counseling and advising the public on the

treatment of minor ailmentstreatment of minor ailments Advising patients of any adverse side-effects of Advising patients of any adverse side-effects of

medicines or potential interactions with other medicines or potential interactions with other medicines/treatmentsmedicines/treatments

Preparing dosette and cassette boxes, usually for Preparing dosette and cassette boxes, usually for the elderly but also for those with memory/learning the elderly but also for those with memory/learning difficulties, where tablets are placed in difficulties, where tablets are placed in compartments for specified days of the weekcompartments for specified days of the week

Undertaking Medicine Use Reviews (MUR), an Undertaking Medicine Use Reviews (MUR), an advanced service to help patients understand how advanced service to help patients understand how their medicines work and why they have to take their medicines work and why they have to take themthem

Role of pharmacist in Role of pharmacist in community pharmacy?community pharmacy? Managing a needle and syringe exchangeManaging a needle and syringe exchange Measuring and fitting compression hosieryMeasuring and fitting compression hosiery Monitoring blood pressure and cholesterol levelsMonitoring blood pressure and cholesterol levels Offering a diabetes screening serviceOffering a diabetes screening service Arranging the delivery of prescription medicines Arranging the delivery of prescription medicines

to patientsto patients Managing, supervising and training pharmacy Managing, supervising and training pharmacy

support staffsupport staff Budgeting and financial managementBudgeting and financial management Keeping up to date with current pharmacy Keeping up to date with current pharmacy

practice, new drugs and their usespractice, new drugs and their uses

How do community How do community pharmacy help people?pharmacy help people?

NutritionNutrition 91%91%DeliveryDelivery 86%86%Patient Charge AccountsPatient Charge Accounts 86%86%CompoundingCompounding 79%79%Herbal MedicineHerbal Medicine 75%75%Community OutreachCommunity Outreach 67%67%HospiceHospice 62%62%DMEDME 61% 61% Health ScreeningHealth Screening 58%58%OstomyOstomy 52%52%Assisted LivingAssisted Living 48%48%

Source: 2007 NCPA Pfizer Digest

Disease Management Disease Management ServicesServices

Community pharmacies are the nation’s leaders in Community pharmacies are the nation’s leaders in providing disease management services to patients providing disease management services to patients with chronic health conditions such as diabetes, with chronic health conditions such as diabetes, asthma, hypertension, and high cholesterol.asthma, hypertension, and high cholesterol.

Disease Management Disease Management Services OfferedServices Offered Blood Pressure MonitoringBlood Pressure Monitoring 69%69% Diabetes TrainingDiabetes Training 50%50% ImmunizationsImmunizations 43%43% Lipid MonitoringLipid Monitoring 19%19% Weight ManagementWeight Management 14%14% Smoking CessationSmoking Cessation 14%14% OsteoporosisOsteoporosis 11%11% AsthmaAsthma 10%10%

Source 2007 NCPA Pfizer Digest

What does it take to be an What does it take to be an community pharmacist?community pharmacist?

Entrepreneurial Skills

Thinking

Communication Technical Skills

Human Relations

Drive

The benefits of a The benefits of a community pharmacy community pharmacy Flexible Management StructureFlexible Management Structure

– No “chain” of commandNo “chain” of command

Job SatisfactionJob Satisfaction– A good pharmacist is a happy pharmacistA good pharmacist is a happy pharmacist

Patient’s like independents betterPatient’s like independents better– ““Where everybody knows your name.”Where everybody knows your name.”

Financial RewardsFinancial Rewards– Control your own financial destinyControl your own financial destiny

The Hospital Pharmacist – The Hospital Pharmacist – Medicine ExpertMedicine Expert

Hospital Pharmacist – Hospital Pharmacist – Dispensing & Inventory Dispensing & Inventory managementmanagement Checking prescriptions to ensure that there are Checking prescriptions to ensure that there are

no errors no errors Providing advice on the dosage of medicines and Providing advice on the dosage of medicines and

the most appropriate form of medication, for the most appropriate form of medication, for example, tablet, injection, ointment or inhalerexample, tablet, injection, ointment or inhaler

Participating in ward rounds, taking patient drug Participating in ward rounds, taking patient drug histories and involvement in decision-making on histories and involvement in decision-making on appropriate treatmentsappropriate treatments

Liaising with other medical staff on problems Liaising with other medical staff on problems patients may experience when taking their patients may experience when taking their medicinesmedicines

Hospital Pharmacist – Hospital Pharmacist – Dispensing & Inventory Dispensing & Inventory managementmanagement Discussing treatments with patients' relatives, Discussing treatments with patients' relatives,

community pharmacists and GPscommunity pharmacists and GPs Ensuring medicines are stored appropriately Ensuring medicines are stored appropriately

and securelyand securely Supervising the work of less experienced and Supervising the work of less experienced and

less qualified staffless qualified staff Answering questions about medicinesAnswering questions about medicines Keeping up to date with, and contributing to, Keeping up to date with, and contributing to,

research and developmentresearch and development

Hospital Pharmacist – Hospital Pharmacist – Dispensing , Inventory & Research Dispensing , Inventory & Research

Writing guidelines for drug use within the Writing guidelines for drug use within the hospital and implementing hospital regulationshospital and implementing hospital regulations

Providing information on expenditure on drugsProviding information on expenditure on drugs Preparing and quality-checking sterile Preparing and quality-checking sterile

medications, for example, intravenous medications, for example, intravenous medicationsmedications

Setting up and supervising clinical trials.Setting up and supervising clinical trials. More experienced pharmacists may be More experienced pharmacists may be

involved in teaching, both within the pharmacy involved in teaching, both within the pharmacy department and in other areas of the hospital.department and in other areas of the hospital.

Clinical Pharmacist – Clinical Pharmacist – Effective Therapy Effective Therapy ManagerManager

Pharmacist – Need a Pharmacist – Need a (under) transition !(under) transition ! ““Pharmacists should move from behind the counter Pharmacists should move from behind the counter

and start serving the public by providing care and start serving the public by providing care instead of pills only. There is no future in the mere instead of pills only. There is no future in the mere act of dispensing. That activity can and will be act of dispensing. That activity can and will be taken over by the internet, machines, and/or hardly taken over by the internet, machines, and/or hardly trained technicians. The fact that pharmacists have trained technicians. The fact that pharmacists have an academic training and act as health care an academic training and act as health care professionals puts a burden upon them to better professionals puts a burden upon them to better serve the community than they currently do.”serve the community than they currently do.”

Compounding Pharmacist – Dispensing Pharmacist Compounding Pharmacist – Dispensing Pharmacist – Clinical Pharmacist– Clinical Pharmacist

(From: Pharmaceutical care, European developments in concepts, implementation, and research: a review.)(From: Pharmaceutical care, European developments in concepts, implementation, and research: a review.)

Clinical Pharmacist–Clinical Pharmacist–Pivotal role in therapy Pivotal role in therapy management!management! The term “clinical pharmacy” was coined to describe The term “clinical pharmacy” was coined to describe

the work of pharmacists whose primary job is to the work of pharmacists whose primary job is to interact with the health care team, interview and interact with the health care team, interview and assess patients, make specific therapeutic assess patients, make specific therapeutic recommendations, monitor patient responses to recommendations, monitor patient responses to drug therapy and provide medicines information.drug therapy and provide medicines information.

(From: Pharmaceutical care, European developments in concepts, implementation, and research: a review.)(From: Pharmaceutical care, European developments in concepts, implementation, and research: a review.)

Clinical Pharmacy – Clinical Pharmacy – Evidence & practice Evidence & practice based medicine !based medicine !

"Health care interventions can no longer "Health care interventions can no longer be based on opinion or individual be based on opinion or individual experience alone. Scientific evidence, experience alone. Scientific evidence, built up from good quality research, is built up from good quality research, is used as a guide, and adapted to each used as a guide, and adapted to each individual patient’s circumstances"… individual patient’s circumstances"…

Clinical Pharmacist – Clinical Pharmacist – Daily activities !Daily activities ! Medication history review.Medication history review. Ward round participationWard round participation Drug therapy monitoring.Drug therapy monitoring. Treatment chart reviewTreatment chart review Medication administration reviewMedication administration review Patient counseling and educationPatient counseling and education Monitoring of treatment outcomeMonitoring of treatment outcome Therapeutic drug monitoringTherapeutic drug monitoring Adverse drug reaction managementAdverse drug reaction management Drug information and poison informationDrug information and poison information News letter developmentNews letter development

Clinical Pharmacy – Clinical Pharmacy – Patient Patient centered and product oriented education centered and product oriented education !! ““Pharmaceutical care is the responsible Pharmaceutical care is the responsible

provision of drug therapy for the purpose provision of drug therapy for the purpose of achieving definite outcomes that of achieving definite outcomes that improve a patient’s quality of life”.improve a patient’s quality of life”.

Ensures safety, efficacy, appropriate and Ensures safety, efficacy, appropriate and economic pharmaceutical careeconomic pharmaceutical care

(Hepler and Strand, 1990)2(Hepler and Strand, 1990)2

Special skills of a clinical Special skills of a clinical pharmacistpharmacist Knowledge of pharmacotherapeuticsKnowledge of pharmacotherapeutics Knowledge of disease processKnowledge of disease process Knowledge of pharmaceutical products Knowledge of pharmaceutical products Strong communication skills Strong communication skills Drug monitoring skills Drug monitoring skills Knowledge of physical and laboratory Knowledge of physical and laboratory

findings findings Drug information & Therapeutic Drug information & Therapeutic

planning skills planning skills

Specialties of a Specialties of a pharmacist in healthcarepharmacist in healthcare

Critical Care Pharmacist Critical Care Pharmacist Drug Information Specialist Drug Information Specialist Home Care Pharmacist Home Care Pharmacist Hospice Pharmacist Hospice Pharmacist Infectious Disease Infectious Disease

Pharmacist Pharmacist Psychiatric PharmacistPsychiatric Pharmacist Poison Control PharmacistPoison Control Pharmacist Long-term Care Pharmacist Long-term Care Pharmacist Managed Care Pharmacist Managed Care Pharmacist Military Pharmacist Military Pharmacist Nuclear Pharmacist Nuclear Pharmacist

Nutrition Support Pharmacist Nutrition Support Pharmacist Oncology PharmacistOncology Pharmacist Operating Room PharmacistOperating Room Pharmacist Pediatric PharmacistPediatric Pharmacist Pharmacist in a Grocery Pharmacist in a Grocery

Chain Chain Pharmacy Benefit Manager Pharmacy Benefit Manager Primary Care PharmacistPrimary Care Pharmacist Veterinary Pharmacist Veterinary Pharmacist Regulatory Pharmacist Regulatory Pharmacist Public Health Service Public Health Service

Pharmacist Pharmacist

Pharmacists Job Pharmacists Job SatisfactionSatisfaction Community pharmacists 76%Community pharmacists 76% Supermarket pharmacists 69% Supermarket pharmacists 69% Hospital pharmacists 63%Hospital pharmacists 63% Chain pharmacists 59% Chain pharmacists 59% Mass-merchandiser pharmacists Mass-merchandiser pharmacists

51%51%

National Pharmacist Workforce Study, March 2006

Facts/JokesFacts/Jokes

A good pharmacist is a A good pharmacist is a happy pharmacist - 8 star happy pharmacist - 8 star

Super Stars Super Stars

The Executive Officer, The Executive Officer, The Joint Executive officers –T T The Joint Executive officers –T T DD

Dr A Vijay Kumar, T T D D E ODr A Vijay Kumar, T T D D E O Smt.Y Yashodamma Co - Smt.Y Yashodamma Co -

coordinatorcoordinator Dr V Sudha Devi, ConvenerDr V Sudha Devi, Convener Dr G Asuntha, Head of PharmacyDr G Asuntha, Head of Pharmacy The staff of S P W Polytechnic & The staff of S P W Polytechnic &

StudentsStudents

K V GOPINATHK V GOPINATHHospital Pharmacist T T D &Hospital Pharmacist T T D &Joint SecretaryJoint SecretaryIndian Pharmaceutical AssociationIndian Pharmaceutical AssociationTirupati branchTirupati branchAndhra Pradesh IndiaAndhra Pradesh Indiagopinath.karnam@gmail.comgopinath.karnam@gmail.com98493 7619998493 76199