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Pharmacy
Pharmacy is the science and practice of
Pharmacy
discovering, producing, preparing, dispensing,
reviewing and monitoring medications, aiming to
ensure the safe, effective, and affordable use of
medicines. It is a miscellaneous science as it links
health sciences with pharmaceutical sciences and
natural sciences. The professional practice is
becoming more clinically oriented as most of the
drugs are now manufactured by pharmaceutical
industries. Based on the setting, pharmacy practice
Occupation
is either classified as community or institutional
pharmacy. Providing direct patient care in the Names Pharmacist, Chemist, Doctor of
community of institutional pharmacies is considered Pharmacy, Druggist,
clinical pharmacy.[1] Apothecary or simply Doctor
Occupation Professional
The scope of pharmacy practice includes more type
traditional roles such as compounding and Activity Health care, health sciences,
dispensing of medications. It also includes more sectors chemical sciences
modern services related to health care including
Description
clinical services, reviewing medications for safety
and efficacy, and providing drug information with Education Doctor of Pharmacy, Master of
required Pharmacy, Bachelor of
patient counselling. Pharmacists, therefore, are
experts on drug therapy and are the primary health Pharmacy, Diploma in
professionals who optimize the use of medication for Pharmacy
the benefit of the patients. In some jurisdictions, Related jobs Physician, pharmacy
such as Canada, Pharmacists may be able to technician, toxicologist,
prescribe or adapt/manage prescriptions, as well as chemist, pharmacy assistant,
give injections and immunizations.[2] other medical specialists

An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy (this
term is more common in the United States) or chemists (which is more common in Great Britain,
though pharmacy is also used). In the United States and Canada, drugstores commonly sell
medicines, as well as miscellaneous items such as confectionery, cosmetics, office supplies, toys,
hair care products and magazines, and occasionally refreshments and groceries.

In its investigation of herbal and chemical ingredients, the work of the apothecary may be regarded
as a precursor of the modern sciences of chemistry and pharmacology, prior to the formulation of
the scientific method.

Disciplines
The field of pharmacy can generally be divided into various disciplines:

Pharmaceutics and Computational Pharmaceutics

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Pharmacokinetics and Pharmacodynamics

Medicinal Chemistry and Pharmacognosy
Pharmacology
Pharmacy Practice
Pharmacoinformatics
Pharmacogenomics
The boundaries between these disciplines and with other
sciences, such as biochemistry, are not always clear-cut.
Often, collaborative teams from various disciplines
(pharmacists and other scientists) work together toward
the introduction of new therapeutics and methods for
patient care. However, pharmacy is not a basic or
biomedical science in its typical form. Medicinal chemistry The Green Pharmacy Cross (sometimes
is also a distinct branch of synthetic chemistry combining overlaid with Bowl of Hygieia), is widely
used in Europe and India on pharmacy
pharmacology, organic chemistry, and chemical biology.
signs.
Pharmacology is sometimes considered the fourth
discipline of pharmacy. Although pharmacology is
essential to the study of pharmacy, it is not specific to
pharmacy. Both disciplines are distinct. Those who wish to
practice both pharmacy (patient-oriented) and
pharmacology (a biomedical science requiring the scientific
method) receive separate training and degrees unique to
either discipline.

Pharmacoinformatics is considered another new discipline,

for systematic drug discovery and development with
efficiency and safety. A medication is a drug used to diagnose,
cure, treat, or prevent disease.
Pharmacogenomics is the study of genetic-linked variants
that effect patient clinical responses, allergies, and
metabolism of drugs.[3]

Professionals
The World Health Organization estimates that there are at
least 2.6 million pharmacists and other pharmaceutical
personnel worldwide.[4]

Pharmacists
Pharmacists are healthcare professionals with specialized
education and training who perform various roles to
ensure optimal health outcomes for their patients through
the quality use of medicines. Pharmacists may also be The Apothecary or The Chemist by
Gabriël Metsu (c. 1651–67)
small business proprietors, owning the pharmacy in which

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they practice. Since pharmacists know about the mode of

action of a particular drug, and its metabolism and
physiological effects on the human body in great detail,
they play an important role in optimization of drug
treatment for an individual.

Pharmacists are represented internationally by the

International Pharmaceutical Federation (FIP), an NGO
linked with World Health Organization (WHO). They are
represented at the national level by professional
organisations such as the Royal Pharmaceutical Society in
the UK, Pharmaceutical Society of Australia (PSA),
Canadian Pharmacists Association (CPhA), Indian
Pharmacist Association (IPA), Pakistan Pharmacists
Association (PPA), American Pharmacists Association Pharmacy, Tacuinum sanitatis
casanatensis (14th century)
(APhA), and the Malaysian Pharmaceutical Society
(MPS).[5]

In some cases, the representative body is also the registering body, which is responsible for the
regulation and ethics of the profession.

In the United States, specializations in pharmacy practice recognized by the Board of Pharmacy
Specialties include: cardiovascular, infectious disease, oncology, pharmacotherapy, nuclear,
nutrition, and psychiatry.[6] The Commission for Certification in Geriatric Pharmacy certifies
pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies
pharmacists and other medical professionals in applied toxicology.

Pharmacy support staff

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
A pharmacy worker distributing drugs to an
medic's offices and insurance companies to ensure
old woman at a local clinic.
correct medications are provided and payment is
received.

Legislation requires the supervision of certain pharmacy technician's activities by a pharmacist.

The majority of pharmacy technicians work in community pharmacies. In hospital pharmacies,
pharmacy technicians may be managed by other senior pharmacy technicians. In the UK the role
of a PhT in hospital pharmacy has grown and responsibility has been passed on to them to manage
the pharmacy department and specialized areas in pharmacy practice allowing pharmacists the
time to specialize in their expert field as medication consultants spending more time working with
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patients and in research. Pharmacy technicians are registered with the General Pharmaceutical
Council (GPhC). The GPhC is the regulator of pharmacists, pharmacy technicians, and pharmacy
premises.

In the US, pharmacy technicians perform their duties under the supervision of pharmacists.
Although they may perform, under supervision, most dispensing, compounding and other tasks,
they are not generally allowed to perform the role of counseling patients on the proper use of their
medications. Some states have a legally mandated pharmacist-to-pharmacy technician ratio.

Dispensing assistants
Dispensing assistants are commonly referred to as "dispensers" and in community pharmacies
perform largely the same tasks as a pharmacy technician. They work under the supervision of
pharmacists and are involved in preparing (dispensing and labelling) medicines for provision to
patients.

Healthcare assistants/medicines counter assistants

In the UK, this group of staff can sell certain medicines (including pharmacy only and general sales
list medicines) over the counter. They cannot prepare prescription-only medicines for supply to
patients.

History
The earliest known compilation of medicinal substances
was the Sushruta Samhita, an Indian Ayurvedic treatise
attributed to Sushruta in the 6th century BC. However, the
earliest text as preserved dates to the 3rd or 4th century
AD.

Many Sumerian (4th millennium BC – early 2nd

millennium BC) cuneiform clay tablets record
prescriptions for medicine.[7]

Ancient Egyptian pharmacological knowledge was

recorded in various papyri such as the Ebers Papyrus of
1550 BC, and the Edwin Smith Papyrus of the 16th century
BC.

In Ancient Greece, Diocles of Carystus (4th century BC)

Physician and Pharmacist, illustration
was one of several men studying the medicinal properties
from Medicinarius (1505) by Hieronymus
of plants. He wrote several treatises on the topic.[8] The Brunschwig
Greek physician Pedanius Dioscorides is famous for
writing a five-volume book in his native Greek Περί ύλης
ιατρικής in the 1st century AD. The Latin translation De Materia Medica (Concerning medical
substances) was used as a basis for many medieval texts and was built upon by many middle
eastern scientists during the Islamic Golden Age, themselves deriving their knowledge from earlier
Greek Byzantine medicine.[9]

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Pharmacy in China dates at least to the earliest known

Chinese manual, the Shennong Bencao Jing (The Divine
Farmer's Herb-Root Classic), dating back to the 1st
century AD. It was compiled during the Han dynasty and
was attributed to the mythical Shennong. Earlier literature
included lists of prescriptions for specific ailments,
exemplified by a manuscript "Recipes for 52 Ailments",
found in the Mawangdui, sealed in 168 BC.

In Japan, at the end of the Asuka period (538–710) and the

Dioscorides, De Materia Medica,
early Nara period (710–794), the men who fulfilled roles
Byzantium, 15th century
similar to those of modern pharmacists were highly
respected. The place of pharmacists in society was
expressly defined in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions
in the pre-Heian Imperial court were established; and this organizational structure remained
largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—
and even pharmacist assistants—were assigned status superior to all others in health-related fields
such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked
above the two personal physicians of the Emperor.[10]

There is a stone sign for a pharmacy shop with a tripod, a mortar, and a pestle opposite one for a
doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey.[11] The current Ephesus dates
back to 400 BC and was the site of the Temple of Artemis, one of the seven wonders of the world.

In Baghdad the first pharmacies, or drug stores, were established in 754,[12] under the Abbasid
Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were state-
regulated.[13]

The advances made in the Middle East in botany and chemistry led medicine in medieval Islam
substantially to develop pharmacology. Muhammad ibn Zakarīya Rāzi (Rhazes) (865–915), for
instance, acted to promote the medical uses of chemical compounds. Abu al-Qasim al-Zahrawi
(Abulcasis) (936–1013) pioneered the preparation of medicines by sublimation and distillation.
His Liber servitoris is of particular interest, as it provides the reader with recipes and explains how
to prepare the "simples" from which were compounded the complex drugs then generally used.
Sabur Ibn Sahl (d 869), was, however, the first physician to record his findings in a
pharmacopoeia, describing a large variety of drugs and remedies for ailments. Al-Biruni (973–
1050) wrote one of the most valuable Islamic works on pharmacology, entitled Kitab al-Saydalah
(The Book of Drugs), in which he detailed the properties of drugs and outlined the role of
pharmacy and the functions and duties of the pharmacist. Avicenna, too, described no less than
700 preparations, their properties, modes of action, and their indications. He devoted in fact a
whole volume to simple drugs in The Canon of Medicine. Of great impact were also the works by
al-Maridini of Baghdad and Cairo, and Ibn al-Wafid (1008–1074), both of which were printed in
Latin more than fifty times, appearing as De Medicinis universalibus et particularibus by 'Mesue'
the younger, and the Medicamentis simplicibus by 'Abenguefit'. Peter of Abano (1250–1316)
translated and added a supplement to the work of al-Maridini under the title De Veneris. Al-
Muwaffaq's contributions in the field are also pioneering. Living in the 10th century, he wrote The
foundations of the true properties of Remedies, amongst others describing arsenious oxide, and
being acquainted with silicic acid. He made clear distinction between sodium carbonate and

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potassium carbonate, and drew attention to the poisonous nature of copper compounds, especially
copper vitriol, and also lead compounds. He also describes the distillation of sea-water for
drinking.[14][15]

In Europe, pharmacy-like shops began to appear during the 12th century. In 1240, emperor
Frederic II issued a decree by which the physician's and the apothecary's professions were
separated.[16]

There are pharmacies in Europe

that have been in operation since
medieval times. In Florence,
Italy, the director of the museum
in the former Santa Maria
Novella pharmacy says that the
pharmacy there dates back to
1221.[17] In Trier (Germany), the
Löwen-Apotheke in
Löwen-Apotheke is in operation
Trier, operating
continuously from at
since 1241, the oldest pharmacy
Sign of the Town Hall Pharmacy in
least 1241 in Europe in continuous Tallinn, operating continuously from at
operation.[18] In Dubrovnik least 1422, showing the Bowl of Hygieia
(Croatia), a pharmacy that first
opened in 1317 is located inside the Franciscan monastery:
it is the 2nd oldest pharmacy in Europe that is still operating.[19][20] In the Town Hall Square of
Tallinn (Estonia), there is a pharmacy dating from at least 1422. The medieval Esteve Pharmacy,
located in Llívia, a Catalan enclave close to Puigcerdà, is a museum: the building dates back to the
15th century and the museum keeps albarellos from the 16th and 17th centuries, old prescription
books and antique drugs.

Practice areas
Pharmacists practice in a variety of areas including community pharmacies, infusion pharmacies,
hospitals, clinics, insurance companies, medical communication companies, research facilities,
pharmaceutical companies, extended care facilities, psychiatric hospitals, and regulatory agencies.
Pharmacists themselves may have expertise in a medical specialty.

Community pharmacy
A pharmacy (also known as a chemist in Australia, New
Zealand and the British Isles; or drugstore in North
America; retail pharmacy in industry terminology; or
apothecary, historically) is where most pharmacists
practice the profession of pharmacy. It is the community
pharmacy in which 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
A pharmacy in Klaukkala, Finland
and dispensed. According to Sharif Kaf al-Ghazal, the

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opening of the first drugstores are recorded by Muslim pharmacists in Baghdad in 754 AD.[12][21]

Hospital pharmacy
Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists
in hospital pharmacies may have more complex clinical medication management issues, and
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, 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, toxicology, nuclear pharmacy, pain management,
psychiatry, anti-coagulation clinics, herbal medicine, 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 (TPN), and other medications are given intravenously.
That is a complex process that requires adequate training of personnel, quality assurance 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 and the potential impact of medications and pharmacy
services on patient-care outcomes and patient safety require hospital pharmacies to perform at the
highest level possible.

Clinical pharmacy
Pharmacists provide direct patient care services that optimize the use of medication and promotes
health, wellness, and disease prevention.[22] Clinical pharmacists care for patients in all health care
settings, but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical
pharmacists often collaborate with physicians and other healthcare professionals to improve
pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary
approach to patient care. They often participate in patient care rounds for drug product selection.
In the UK clinical pharmacists can also prescribe some medications for patients on the National
Health Services (NHS) or privately, after completing a non-medical prescribers course to become
an Independent Prescriber.[23]

The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-
specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to
dispensing and administration to the patient. The review process often involves an evaluation of
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the appropriateness of drug therapy (e.g., drug choice, dose, route, frequency, and duration of
therapy) and its efficacy. Research shows that pharmacist led strategies reduce errors related to
medication use.[24] The pharmacist must also consider potential drug interactions, adverse drug
reactions, and patient drug allergies while they design and initiate a drug therapy plan.[25]

Ambulatory care pharmacy

Since the emergence of modern clinical pharmacy, ambulatory care pharmacy practice has
emerged as a unique pharmacy practice setting. Ambulatory care pharmacy is based primarily on
pharmacotherapy services that a pharmacist provides in a clinic. Pharmacists in this setting often
do not dispense drugs, but rather see patients in-office visits to manage chronic disease states.

In the U.S. federal health care system (including the VA, the Indian Health Service, and National
Institute of Health (NIH)) ambulatory care pharmacists are given full independent prescribing
authority. In some states, such as North Carolina and New Mexico, these pharmacist clinicians are
given collaborative prescriptive and diagnostic authority.[26] In 2011 the board of Pharmaceutical
Specialties approved ambulatory care pharmacy practice as a separate board certification. The
official designation for pharmacists who pass the ambulatory care pharmacy specialty certification
exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the
initials BCACP.[27]

Compounding pharmacy/industrial pharmacy

Compounding involves preparing drugs in forms that are different from the generic prescription
standard. This may include altering the strength, ingredients, or dosage form.[28] Compounding is
a way to create custom drugs for patients who may not be able to take the medication in its
standard form, such as due to an allergy or difficulty swallowing. Compounding is necessary for
these patients to still be able to properly get the prescriptions they need.

One area of compounding is preparing drugs in new dosage forms. For example, if a drug
manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated
lollipop 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 physician, physician assistant, nurse
practitioner, or clinical pharmacist practitioner. 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 homes, but are increasingly branching into other institutions and non-institutional
settings.[29] Traditionally consultant pharmacists were usually independent business owners,
though in the United States many now work for a large pharmacy management company such as
Omnicare, Kindred Healthcare or PharMerica. This trend may be gradually reversing as consultant
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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 was developed by Hepler and Strand in 1990.[30][31]

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, are often very
different from those related to people, in some jurisdictions veterinary pharmacy may be 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 a different working environment to
civilian practise because military pharmacy technicians
perform duties such as evaluating medication orders,
preparing medication orders, and dispensing medications.
This would be illegal in civilian pharmacies because these
duties are required to be performed by a licensed
registered pharmacist.[32] In the US military, state laws
that prevent technicians from counseling patients or doing
the final medication check prior to dispensing to patients Airman 1st Class Breanna DeMasters
(rather than a pharmacist solely responsible for these and Staff Sgt. Giovanni Fiorito, 332nd
duties) do not apply. Expeditionary Medical Group pharmacy
technicians, fill prescription medication
for patients, Oct. 7, Joint Base Balad
Pharmacy informatics Iraq.

Pharmacy informatics is the combination of pharmacy

practice science and applied information science.[33] Pharmacy informaticists work in many
practice areas of pharmacy, however, they may also work in information technology departments
or for healthcare information technology 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.

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Specialty pharmacy
Specialty pharmacies supply high-cost injectable, oral, infused, or inhaled medications that are
used for chronic and complex disease states such as cancer, hepatitis, and rheumatoid arthritis.[34]
Unlike a traditional community pharmacy where prescriptions for any common medication can be
brought in and filled, specialty pharmacies carry novel medications that need to be properly stored,
administered, carefully monitored, and clinically managed.[35] In addition to supplying these
drugs, specialty pharmacies also provide lab monitoring, adherence counseling, and assist patients
with cost-containment strategies needed to obtain their expensive specialty drugs.[36] In the US, it
is currently the fastest-growing sector of the pharmaceutical industry with 19 of 28 newly Food and
Drug Administration (FDA) approved medications in 2013 being specialty drugs.[37]

Due to the demand for clinicians who can properly manage these specific patient populations, the
Specialty Pharmacy Certification Board has developed a new certification exam to certify specialty
pharmacists. Along with the 100 questions computerized multiple-choice exam, pharmacists must
also complete 3,000 hours of specialty pharmacy practice within the past three years as well as 30
hours of specialty pharmacist continuing education within the past two years.[38]

Pharmaceutical sciences
The pharmaceutical sciences are a group of interdisciplinary areas of study concerned with the
design, manufacturing, action, delivery, and classification of drugs. They apply knowledge from
chemistry (inorganic, physical, biochemical and analytical), biology (anatomy, physiology,
biochemistry, cell biology, and molecular biology), epidemiology, statistics, chemometrics,
mathematics, physics, and chemical engineering.[39]

The pharmaceutical sciences are further subdivided into several specific specialties, with four main
branches:

Pharmacology: the study of the biochemical and physiological effects of drugs on human
beings.
Pharmacodynamics: the study of the cellular and molecular interactions of drugs with their
receptors. Simply "What the drug does to the body"[40]
Pharmacokinetics: the study of the factors that control the concentration of drug at various
sites in the body. Simply "What the body does to the drug"[41]
Pharmaceutical toxicology: the study of the harmful or toxic effects of drugs.
Pharmacogenomics: the study of the inheritance of characteristic patterns of interaction
between drugs and organisms.[42]
Pharmaceutical chemistry: the study of drug design to optimize pharmacokinetics and
pharmacodynamics, and synthesis of new drug molecules (Medicinal Chemistry).
Pharmaceutics: the study and design of drug formulation for optimum delivery, stability,
pharmacokinetics, and patient acceptance.[43]
Pharmacognosy: the study of medicines derived from natural sources.[44]
As new discoveries advance and extend the pharmaceutical sciences, subspecialties continue to be
added to this list. Importantly, as knowledge advances, boundaries between these specialty areas of
pharmaceutical sciences are beginning to blur. Many fundamental concepts are common to all
pharmaceutical sciences. These shared fundamental concepts further the understanding of their
applicability to all aspects of pharmaceutical research and drug therapy.

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Pharmacocybernetics (also known as pharma-cybernetics, cybernetic pharmacy, and cyber

pharmacy) is an emerging field that describes the science of supporting drugs and medications use
through the application and evaluation of informatics and internet technologies, so as to improve
the pharmaceutical care of patients.[45]

Society and culture

Etymology
The word pharmacy is derived from Old French farmacie "substance, such as a food or in the form
of a medicine which has a laxative effect" from Medieval Latin pharmacia from Greek pharmakeia
(Ancient Greek: φαρμακεία) "a medicine", which itself derives from pharmakon (φάρμακον),
meaning "drug, poison, spell"[46][47][a] (which is etymologically related to pharmakos).

Separation of prescribing and dispensing

Separation of prescribing and dispensing, also called dispensing separation, is a practice in
medicine and pharmacy in which the physician who provides a medical prescription is
independent from the pharmacist who provides the prescription drug.

In the Western world there are centuries of tradition for separating pharmacists from physicians.
In Asian countries, it is traditional for physicians to also provide drugs.

In contemporary time researchers and health policy analysts have more deeply considered these
traditions and their effects. Advocates for separation and advocates for combining make similar
claims for each of their conflicting perspectives, saying that separating or combining reduces
conflict of interest in the healthcare industry, unnecessary health care, and lowers costs, while the
opposite causes those things. Research in various places reports mixed outcomes in different
circumstances.

Environmental impacts
In 2022 the Organisation for Economic Co-operation and Development (OECD) proposed that
pharmaceutical companies should be required to collect and destroy unused or expired medicines
that they have put on the market in order to reduce public health risks around the misuse of
medicines obtained from waste bins, the development of antimicrobial resistant bacteria from the
discharge of antibiotics into environmental systems and "economic losses" from wasted healthcare
resources. Potentially harmful concentrations of pharmaceutical waste has been detected in more
than a quarter of water samples taken from 258 rivers around the world. OECD recommend that
medicines should be collected separately from household waste and that "marketplaces and
redistribution platforms for unused close-to-expiry-date medicines" should be set up. Such
extended producer responsibility schemes are already running in France, Spain and Portugal.[49]

The future of pharmacy

In the coming decades, pharmacists are expected to become more integral within the health care
system. Rather than simply dispensing medication, pharmacists are increasingly expected to be
compensated for their patient care skills.[50] In particular, Medication Therapy Management
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(MTM) includes the clinical services that pharmacists can

provide for their patients. Such services include a thorough
analysis of all medication (prescription, 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.[51]

This shift has already commenced in some countries; for

instance, pharmacists in Australia receive remuneration Pharmacists now go on rounds with
from the Australian Government for conducting doctors and have more patient
comprehensive Home Medicines Reviews. In Canada, interaction.
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 and this is because of pharmacy education. They are also being
paid for by the government for medicine use reviews. 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 has had an evolving influence on the practice of pharmacy.[52] Moreover, the
Doctor of Pharmacy (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 pharmacists, who traditionally operated primarily in nursing
homes, are now expanding into direct consultation with patients, under the banner of "senior care
pharmacy".[53]

In addition to patient care, pharmacies will be a focal point for medical adherence initiatives.
There is enough evidence to show that integrated pharmacy based initiatives significantly impact
adherence for chronic patients. For example, a study published in National Institute for Health
(NIH) shows "pharmacy based interventions improved patients' medication adherence rates by 2.1
percent and increased physicians' initiation rates by 38 percent, compared to the control
group".[54]

Pharmacy journals
List of pharmaceutical sciences journals

Symbols
The symbols most commonly associated with pharmacy are the mortar and pestle (North America)
and the ℞ (medical prescription) character, which is often written as "Rx" in typed text; the green
cross in France, Argentina, the United Kingdom, Belgium, Ireland, Italy, Spain, and India; the
Bowl of Hygieia (only) often used in the Netherlands but may be seen combined with other
symbols elsewhere. Other common symbols include conical measures, and (in the US) caduceuses,

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in their logos. A red stylized letter A is used in Germany and Austria (from Apotheke, the German
word for pharmacy, from the same Greek root as the English word "apothecary"). The show globe
was used in the US until the early 20th century; the Gaper in the Netherlands is increasingly rare.

Rod of Asclepius, the green cross (AIGA Green cross and Simple green Greek
internationally symbol for First Aid) Bowl of Hygieia used cross, widely used in
recognised symbol of in Europe (with the Europe and India,
medicine exception of often an animated
Germany and Austria) neon sign
and India

Red "A" (Apotheke) Similar red "A" sign, The mortar and A hanging Show
sign, used in used in Austria pestle, used in the globe, formerly used
Germany United States and in the United States
Canada

The Gaper, formerly The symbol used on the Bowl of Hygieia

used in the medical prescriptions,
Netherlands from the Latin recipe
(take thou).

See also
American Society for Pharmacy Law – Professional organization
Apothecary – Former name for a pharmacist
Bachelor of Pharmacy, Master of Pharmacy, Doctor of Pharmacy
Classification of Pharmaco-Therapeutic Referrals – Taxonomy of cases requiring referral
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Clinical pharmacy – Branch of pharmacy for direct provision

Consultant pharmacist – Provider of expert pharmaceutical advice
Drug packaging – Packaging for pharmaceutical preparations
Evidence-based pharmacy in developing countries
Health informatics – Computational approaches to health care
History of pharmacy
Hospital pharmacy – Dispensary within a hospital
International Pharmaceutical Federation
International Pharmaceutical Students' Federation
List of drugs by year of discovery
List of pharmaceutical laboratories by year of foundation
List of pharmacies
List of pharmacy associations
List of pharmacy organizations in the United Kingdom
List of pharmacy schools in the United States
List of pharmacy schools
Nuclear pharmacy – Branch of pharmacy focused on radioactive pharmaceuticals
Online pharmacy – Pharmacy that operates over the Internet
Pharmaceutics – Science of the properties of medicines
Pharmaceutical industry – Industry involved with discovery, development, production and
marketing of drugs
Pharmacogenomics – Study of the role of the genome in drug response
Pharmacognosy – Study of drugs obtained from natural sources
Pharmacology – Science of drugs and medications and their effects
Pharmaconomist – Danish qualification like BPharm
Pharmacy automation – Mechanical handling of medications
Pharmacy residency – Post-graduate internship
Professional Further Education in Clinical Pharmacy and Public Health
Raeapteek – One of Europe's longest-lived pharmacies
Telepharmacy – Pharmacy care by telecommunication

Notes
a. Its earliest attested form in Greek could be the Mycenaean 𐀞𐀔𐀒, pa-ma-ko, written in the
Linear B syllabic script and found on the PY Un 1314 tablet; this tablet is also found listed as
PY Vn 1314 or PY Sb 1314.[48]

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(in French) Titsingh, Isaac, ed. (1834). [Siyun-sai Rin-siyo/Hayashi Gahō, 1652], Nipon o daï
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External links
Navigator History of Pharmacy (https://web.archive.org/web/20051102083751/http://www.ubka.
uni-karlsruhe.de/pharm/pharmaziegeschichte/index-e.html) Collection of internet resources
related to the history of pharmacy
Soderlund Pharmacy Museum (http://www.drugstoremuseum.com) – Information about the
history of the American Drugstore
The Lloyd Library (http://www.lloydlibrary.org/) Library of botanical, medical, pharmaceutical,
and scientific books and periodicals, and works of allied sciences
American Institute of the History of Pharmacy (http://www.aihp.org) American Institute of the
History of Pharmacy—resources in the history of pharmacy
International Pharmaceutical Federation (FIP) (http://www.fip.org) Federation representing
national associations of pharmacists and pharmaceutical scientists. Information and resources
relating to pharmacy education, practice, science and policy

Retrieved from "https://en.wikipedia.org/w/index.php?title=Pharmacy&oldid=1303238192"

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