Pharmacy

The pharmacy is the health science that deals with the discovery, production, control, elimination and safe and effective use of medicines.

Stores from a pharmacy office.

Interior of the former Farmacia Sarrá, Havana, Cuba.

The pharmacy (from the Greek φάρμακον /fármakon/, 'medicine, poison, toxic') is the science and practice of preparing, preserving, presentation and dispensing of medicines; It is also the place where parapharmacy and medicinal products are prepared, dispensed and sold. This definition is the most universal and classic, which overlaps with the concept of Galenic Pharmacy (Galen was a Greek physician from the II, expert in preparing medicines).

Before the 20th century and the beginning of it, the formulation and preparation of medicines was done by a single pharmacist or with the master pharmacist. As of the XX century, medicines have been produced by the modern pharmaceutical industry, although pharmacists are still the who coordinate and investigate the formulation and preparation of drugs in large pharmaceutical companies.

Recently, it has also been considered the practice of pharmacies to advise patients regarding their medication and advise doctors or other professionals on medications and their use (clinical pharmacy and pharmaceutical care).

Pharmacists also collaborate in research groups with chemists, biochemists, biologists, and engineers to discover and develop chemical (and biological) compounds of therapeutic value. In addition, due to the new international regulations on hygiene and public health (WHO / ICH), their advice on public health issues is increasingly requested.

Pharmacists are represented through professional associations and pharmaceutical corporations. In Spain, through the Health Law of November 28, 1855.

Poster of a nickname made with tiles.

History of the pharmacy

Pharmacy of Santa Maria Novella, the oldest in Europe.

The history of pharmacy as an independent science is relatively young. The origins of pharmaceutical historiography go back to the first third of the s. XIX, which is when the first historiographies appear, which although it does not touch all aspects of pharmaceutical history, are the starting point for the definitive start of this science.

Until the birth of pharmacy as an independent science, there is a historical evolution, from classical antiquity to the present day that marks the course of this science, always related to medicine.

Pharmacy disciplines

Pharmacy has developed from various sciences such as organic chemistry, biochemistry, physiology, botany, cell biology, and molecular biology. Originally, medical and pharmaceutical practice were merged. They then parted ways and diverged. Currently they are complementary, a medicine without a pharmacy cannot be understood and a pharmacy without medicine does not make sense. Thus, pharmacy is, in truth, a meeting of multiple disciplines of science, and can be divided into two main branches:

Pharmaceutical Sciences and Pharmaceutical Practice.

• Pharmaceutical Sciences
  • Pharmacology
    • Pharmacodynamy
    • Pharmacokinetics
    • Pharmacometry
  • Pharmacogenetics and Pharmacogenetics
  • Toxicology
  • Pharmaceutical chemistry
    • Molecular drug design
    • Chemical synthesis of drugs
    • Pharmaceutical analysis
  • Pharmacognosis
    • Fitochemical
    • Pharmaceutical Ethnobotany or Ethnopharmacology
  • Gallic Pharmacy
    • Biopharmacy and Pharmacokinetics
• Pharmaceutical practice
  • Pharmaceutical Care and Clinical Pharmacy
    • Hospitality
    • Primary Care Pharmacy, especially in the UK and Spain
    • Community pharmacy or office (a pharmacy officer)
    • Some activities of the Pharmaceutical Care and Clinical Pharmacy, especially in hospital and primary practice are: (According to the Spanish Society of Hospital Pharmacy)
      • Pharmacovigilance and Pharmacoepidemiology
      • Drug information and evaluation
      • Clinical Pharmacokinetics and Therapeutic Monitoring
      • Nutritional support (Friendly nutrition)
      • Preparation and control of intravenous mixtures
      • Pharmacotherapeutic monitoring
      • Patient health education
  • Clinical analysis or clinical chemistry, especially in France and other European and Latin American countries, including Spain.
  • Master formula: development, preparation and quality control of ex-temporaneous dosing forms

Pharmacology and toxicology, in some environments and perhaps for historical reasons, are considered as separate sciences from pharmaceutical sciences, in any case they are currently basic in the training of Pharmacy graduates. Medical schools usually also have pharmacology programs in the training of their graduates. Clinical pharmacology is, in some countries (USA and the Netherlands are exceptions), an exclusive discipline for graduates in Medicine, however clinical pharmacokinetics is a discipline where graduates in Pharmacy in some cases have contributed significantly to it. in academic terms and in its industrial application and in others it is a part of the usual practice of Hospital Pharmacy.

In recent years there has also been talk of the use of gene therapy as another form of remedy against many new diseases, which is why everything related to pharmaceutical biotechnology is also gaining interest among pharmacists.

Apothecary

The pothecary is the place or establishment where a pharmacist works as a community pharmacy or provides healthcare services to a patient by offering advice, dispensing medicines resulting from this advice or prescribed by the doctor and other parapharmacy products such as cosmetic products, special foods, personal hygiene products, orthopedics, etc. Popularly, the pharmacy office is usually called simply pharmacy and is traditionally called apothecary. official preparations.

In Spain, pharmacies are regulated by each Autonomous Community through Pharmaceutical Regulation Laws. They establish the requirements that must be met by premises where pharmacies can be opened, the price of licenses and concessions pharmacy, as well as other aspects such as the distance between pharmacies, with which it is intended to maintain free competition.

Pharmacy office staff

The pharmacy is the place where the community pharmacist develops his professional work. Pharmacies may be owned by a pharmacist, or in some countries owned by a chain of pharmacies or entrepreneurs. In any case, in a pharmacy office there must always be a licensed pharmacist at all times, either owner or employee. In terms of categories, in Spain the law distinguishes between pharmacists:

• Number
• attachments
• substitutes
• Regent.

While assistant pharmacist is understood to work jointly” with the owner or managing pharmacist(s), in the case of substitutes it is understood that they act "instead of". In Spain, the number of assistant pharmacists required is regulated by the autonomous communities and varies from one to another.

But in the pharmacy there is also auxiliary personnel, who help the pharmacist in dispensing and receiving orders. Little by little, pharmacy technicians are being introduced.

Stores from a pharmacy office.

The staff performs the following functions:

• Diligence and control products.
• Billing and information in pharmacy establishments.
• Dispensing medications and parapharmacy products.
• To inform customers about their use.
• Determine simple anatomical-physiological parameters and encourage healthy habits in customers.
• Prepare medicines, diets and cosmetics, under established protocols and supervision of the physician.
• Conduct elementary and standardized clinical analyses, under the supervision of the physician.

In Latin America, the pharmacy cannot exist without the pharmaceutical chemist, who must prepare medicines, control and supervise the dispensing of medicines, does not always serve the public, the one who attends the public is an ideal or technician in pharmacy.

But today most drugs are mass-produced in a factory, applying the most sophisticated technology such as tanks, mixers, and more industrial facilities to make huge batches of different dosage forms, not to mention the use of quality control systems. quality and administration that allow them to be manufactured in series, of the best quality and economically viable.

Health and environmental awareness work of the pharmacist

Spanish pharmacies usually have specific containers, called SIGRE Points, where citizens can deposit empty containers and the remains of medicines, either at the end of a treatment or every time the medicine cabinet is checked to remove those that expired, in poor condition or no longer needed.

In this way, the pharmacist performs an important task of advising patients on everything related to the correct closing of the life cycle of medicines, advising on the proper way to dispose of them, without harming the environment and avoiding uncontrolled self-medication. Likewise, by keeping the container, he also guarantees that the remains of medicines or containers deposited at the SIGRE Point cannot be extracted or manipulated, with the consequent risk that this would entail.

Pharmaceutical symbols

The pharmacy is represented by many symbols. The most common in Argentina, Spain and France are the Cup of Hygieia, the green Greek cross or the kicked cross, the latter especially in the lights of the pharmacy offices. There are also others such as the mortar and pestle, the recipe character, ℞(recipere), conical measures, caduceus, Rod of Aesculapius or a A and stylized in the case of Germany. The A comes from Apotheke, the German word for Pharmacy.

In Chile the Rx (Recipe) or Rp symbol, which is the Latin translation, is used to head the recipes; both correspond to the Latin expression of the delivery of the healing product.

• 

  Greek Green Cross

• 

  Mortar and pistil

• 

  Recipe Symbol Recipe Symbol (Receive; Take) in Recipes of Chile

• 

  "A" German red stylized

• 

  Vara de Esculapio, also used in the pharmacy

• 

  Cross of Malta

Hospital pharmacy services

Hospital pharmacy services in Spain are, by law, general clinical services. Its functions were described by legislation. Hierarchically, they usually depend on the hospital's medical management, as well as clinical analysis services, Microbiology or Nuclear Medicine, among others. In summary, they are responsible for the acquisition, conservation, dispensing and preparation of medicines as well as the selection and evaluation of medicines, pharmacotherapeutic information, clinical pharmacokinetic activities, pharmacovigilance, the control of products in the clinical investigation phase and the conducting drug utilization studies. They are responsible for coordinating hospital pharmacy and therapeutic commissions and for preparing and maintaining pharmacotherapeutic guides or forms. That is, they perform management, logistics, and clinical functions for healthcare, teaching, and research purposes.

Recently, its involvement in the monitoring and control of pharmacological treatments of both hospitalized and outpatients (pharmaceutical care and clinical pharmacy), the preparation and control of parenteral preparations (antineoplastic agents, antibiotics and parenteral nutrition) and the automation of processes of individualized dispensing of medications to hospitalized patients (distribution in unit doses).

Hospital pharmacy services staff

To work in hospital pharmacy services, in Spain and in many European countries, a graduate in pharmacy is also required to have a postgraduate degree, which is the title of specialist in hospital pharmacy. This official title is achieved by passing a national selection test to choose a hospital and four years of paid residence (it is known as the FIR, internal resident pharmacist). During the four years of residency, the pharmacist acquires all the knowledge and skills to practice the specialty. In Spain, the MIR-FIR system emerged as an adaptation of the American medical training system in the 1960s and 1970s, and one of the pioneering hospitals was the Hospital Marqués de Valdecilla in Santander. Today no one doubts the benefits of this training system due to its quality and excellence.

There are pharmacists specializing in hospital pharmacy who have also obtained super-specialization diplomas in pharmaceutical oncology, clinical pharmacokinetics, pharmacoeconomics, pharmacoepidemiology, and parenteral and enteral nutrition (not official in Spain but endorsed by North American and Spanish academic institutions). In addition, many specialist pharmacists work full-time in activities such as clinical pharmacokinetics, pharmaceutical care in different medical specialties, nutritional monitoring, pharmacotherapeutic information and documentation, pharmacovigilance and pharmacoepidemiology, and outpatient education and information, among others.

In a 600-bed tertiary hospital pharmacy service, there are typically 5-6 specialist pharmacists and 4-8 resident pharmacists. In addition, there are usually 5th year pharmacy students doing supervised internships. Apart from technicians and/or nurses and auxiliary personnel. In some large hospitals (over 1,500 beds) the number of specialist pharmacists may be around 15.

Classification of drugs

Medications are the most widely used medical technology, with a wide variety of these manufactured by the pharmaceutical industry for therapy, prevention and/or rehabilitation, ready for distribution, storage, sale and dispensing in establishments. The classification is established in the General Health Law in articles 224 and 226, according to its preparation, nature, sale and supply; and in the World Health Organization (WHO) for its therapeutic effect.

Forms of preparation

• Teachers: When prepared according to the formula prescribed by a doctor,

• Offices: When the preparation is made according to the rules of the pharmacopea of the United Mexican States.

• Pharmaceutical Specialties: When prepared with formulas authorized by the Health Secretariat, in chemical-pharmaceutical industry establishments.

By nature

• Alopathic: Any substance or mixture of substances of natural or synthetic origin that has therapeutic, preventive or rehabilitative effect, that is presented in pharmaceutical form and is identified as such by its pharmacological activity, physical, chemical and biological characteristics, and that is registered in the Pharmacopea of the United Mexican States for allopathic drugs.

• Homeopathic: Any substance or mixture of substances of natural or synthetic origin that has therapeutic, preventive or rehabilitative effect and that is elaborated in accordance with the manufacturing procedures described in the Homeopathic Pharmacopea of the United Mexican States, in other countries or other sources of national and international scientific information.

• Herbolarios: The products produced with plant material or some derivative of this, whose main ingredient is the aerial or underground part of a plant or extracts and tinctures, as well as juices, resins, fatty and essential oils, presented in pharmaceutical form, whose therapeutic efficacy and safety has been scientifically confirmed in national or international literature.
• Biotechnology: any substance that has been produced by molecular biotechnology, which has therapeutic, preventive or rehabilitated torium, which is presented in a pharmaceutical form, which is identified as such by its pharmacological activity and physical, chemical and biological properties (Art. 222 bis).

For sale and supply to the public

• Medicines that can only be purchased with special prescription or permission, issued by the

Ministry of Health.

• Medicines that require for your purchase medical prescription to be kept at the pharmacy that you sweat it and be registered in the control books that will be taken. The treating doctor may prescribe two presentations of the same product at most, specifying its contents. This requirement shall be valid for thirty days from the date of preparation of the same.

• Medicines that can only be purchased with a medical prescription that can be delivered up to three times, which must be sealed and recorded every time in the control books that are taken.

This prescription must be retained by the establishment that fills it on the third occasion; the attending physician will determine the number of presentations of the same product and their content that can be purchased on each occasion.

• Medicines to be purchased require a medical prescription, but may be resurrected as often as prescribed by the doctor.

• Unprescription drugs, tied for sale exclusively in pharmacies.

• Medicines to be purchased do not require a medical prescription and may be sold in other establishments other than pharmacies.

Note: The sanitary registry for the commercialization of medicines can only be granted by the Ministry of Health. The registration key will be unique, it cannot be applied to two products that differ either in their generic or distinctive name or in their formulation. The owner of a registration will not have possession of two registrations that hold the same drug, pharmaceutical form or formulation.

The elements that make up the registry key are: a consecutive number assigned by the health authority, the acronym that indicates the type of medication, M for allopathic, P for herbalist And for homeopathic, the year it was authorized and the initials SSA. The labels of the medicines indicate, in addition to the above, the fraction to which they belong, as shown in the following example: Reg. No.0310M2009 SSA IV.