Introduction to Pharmacy practice

Pharmacy practice

Definition

Pharmacy Practice is the discipline within Pharmacy that involves developing the professional roles of the pharmacist.

it can also be described as :

1-  application of the knowledge

2-   Use of skills acquired .

Historical perspectives

Sumerians

·       The development of cuneiform writing on clay tablets during the third millennium BC included lists of drugs of animal, vegetable and mineral origin that were used in the management of diseases, and prescriptions with details of the ingredients used in their compounding.

·       Many of the drugs listed were cited as having multiple uses since ailments were thought to be different manifestations of a condition.

·        Use of medicines was carried out by priests (ashipu) and physicians (asu).

Egyptians

·       The Ebers Papyrus (named after Georg Ebers, who purchased it in the nineteenth century) is a document dating back to 1550 BC, which describes prescriptions and modes of administration of drugs including gargles , inhalations, suppositories, ointments and lotions.

·       Many of the drugs listed were included in the Sumerian documents.

·       Use of medicines was carried out by priests.

·       Imhotep who is regarded as the earliest physician, was the High Priest of Heliopolis and described as god of medicine in Egyptian civilization.

India

·       Ayurvedic medicine was first described around 800 BC.

·       Documents list the use of drugs together with charms for expelling demons and make reference to the god of medicine, Dhanvantari. 

·       The Charaka Samhita includes reference to drugs of animal, plant and mineral origin used until the first century AD (ano domini ).

China

·       In China a comprehensive theory for diagnosis and treatment was developed.

·       Manuscripts on silk and bamboo describe use of drugs of animal and plant origin.

·       The text Huangdi Neijing listed the basic principles of pharmaceutical drug use in the third century BC.

·       Shengnon Bencao Jing outlined basic theory of Chinese pharmacy.

·       The Pen Ts’ao Kang Mu compilation presents details of drugs used in Chinese medicine in the late sixteenth century AD.

Greeks and Romans

·       Just as the Egyptians revered Imhotep as the god–physician, the Greeks worshipped Asklepios as their god of healing.

·       Later on, the use of medicines was carried out by the rhizotomoi (experts in medicinal plants), such as Empedocles, and the pharmakopoloi (preparers and sellers of drugs).

Hippocrates

• Considered to be the father of medicine.

• He is associated with a number of documents known collectively as the Hippocratic Corpus

dating to 420–370 BC, which list 200–400 drugs

of vegetable origin and describe the method of preparation of gargles, ointment and pessaries.

• His works placed emphasis on treating the patient with minimal reference to magical and religious powers.

Dioscorides

• Prepared the document De Materia Medica around AD 60–78. This document gives details about medicinal herbs including side-effects associated with their administration.

Galen

• A physician around AD 160.

• He compiled medical knowledge of the time drawing on the documents by Hippocrates and Dioscorides.

• He described the use of formulations made up of numerous plants which were referred to as ‘galenicals’.

The Arabs (Islamic)

• In the Arab world, a large number of texts including documents related to medicine and works by Galen were translated into Arabic and that is how these documents have been transferred along history. Documents that were prepared included formularies, herbals and books on materia medica and toxicology.

• The use of medications consisting of complex formulations (galenic medicine) was continued.

• This required skilled preparation which was entrusted to apothecaries who opened their shops in the ninth century in Baghdad.

The practice of the apothecaries was inspected by the state.

• Avicenna, a Persian philosopher, compiled the book Canon of Medicine, in which he merged the Greek and Arab works. The book describes

the use of around 760 drugs.

• Albucasis, from the Arabic dominion in Spain, prepared documents which included a detailed description of the pharmaceutical process for the preparation of drugs in various dosage forms.

Early definition of the pharmacy profession

• After the establishment of apothecaries in Baghdad, the pharmacy profession started developing in Europe.

• Early Middle Ages: monastic medicine.

• Late Middle Ages: in the eleventh century, public pharmacies in southern Italy and southern France were established.

• Drug formulary produced by Nicolas of Salerno which described compound formulae of galenicals.

• 1231–1240: the Liber Augustalis, an edict on the profession of pharmacy, was issued by the German emperor Frederick II.

The edict defined:

1-     the separation of the pharmaceutical profession from the medical profession.

2-    described the official supervision of pharmaceutical practice.

3-     outlined an obligation by oath to prepare drugs reliably according to skilled art, and of a uniform, suitable quality.

• Early nineteenth century:

-         retail pharmacies developed a separate manufacturing area, which included an area for extraction and purification, necessary for extraction of plant alkaloids such as quinine from cinchona bark used for malaria.

-         Boehringer and Merck have their origins in community pharmacies in Stuttgart (1817) and Darmstadt (1827), Germany, respectively.

• Late nineteenth century: separation of the manufacturing business from the retail community pharmacy.