SPECIALTIES IN PHARMACY PRACTICE, FUNCTIONS, AND

RESPONSIBILITIES

Licensed pharmacists are also encouraged to become board certified once they have gained
adequate clinical experience. Board certification is a way of demonstrating to society that an
individual possesses a certain high level of expertise. It signifies that an individual pharmacy
specialist possesses a body of knowledge and skill in addition to that of a general practitioner.
Thus, patients are able to identify practitioners who can satisfy special needs. For pharmacy
professionals, board certification may yield the additional benefits of personal satisfaction,
financial rewards, and career advancement.

1. Ambulatory Care
(What is Ambulatory Care Pharmacy do?)
- Ambulatory care pharmacy practice is the provision of integrated, accessible
healthcare services by pharmacists who are accountable for addressing medication
needs, developing sustained partnerships with patients, and practicing in the
context of family and community. Ambulatory care pharmacists may work in
hospital-based or community-based settings, and are involved in the direct care of
a diverse patient population.
Ambulatory care pharmacists are involved in:
• Direct patient care and medication management for ambulatory patients
• Long term relationships with patients
• Coordination of care
• Patient advocacy
• Wellness and health promotion
• Triage and referral
• Patient education and self-management
What does an Ambulatory Care Pharmacist Do?
• Ambulatory Care Pharmacists provide comprehensive medication management for a wide
variety
of patients with chronic health conditions. They work closely with other members of the
healthcare team including physicians, nurses, behavioral health specialists, and others.
• Ambulatory Care Pharmacists may have an expanded scope of practice depending on their state
and practice location. Most states allow collaborative practice agreements with pharmacists and
physicians which enable pharmacists to initiate, adjust, and discontinue medications, order and
monitor laboratory studies, and perform limited physical assessment.
2. Critical Care Pharmacy
- Critical Care Pharmacy specializes in the delivery of patient care services by
pharmacists, as integral members of interprofessional teams, working to ensure
the safe and effective use of medications in critically ill patients.
Roles:
-Critical care pharmacists can practice in a variety of settings throughout the
hospital and can provide a wide range of services that include order verification,
dispensing medications for immediate use, rounding, medical record reviews,
emergency response, therapeutic drug monitoring, patient counseling, and
education
- Critical care pharmacists assist with educating nurses by providing lectures and
in-services on ICU disease states and their management, intravenous
compatibility of drugs, routes of administration of drugs, antimicrobial therapy,
and drug information.
- Critical care pharmacists also play an active role on hospital committees, in the
education of staff, students, and residents (pharmacy and medical), and in the
implementation of new institutional policies and protocols.
3. Nuclear Pharmacy
- Nuclear pharmacy is a specialty area of pharmacy practice involved with the
preparation of radioactive materials to improve and promote health through the
safe and effective use of radioactive drugs to diagnose and treat specific disease
states
- Nuclear pharmacy, also known as radiopharmacy, involves preparation of
radioactive materials for patient administration that will be used to diagnose and
treat specific diseases in nuclear medicine.
Roles: They specialize in the procurement, compounding, dispensation and use of
radiopharmaceuticals. These duties include bone scans, heart and breast scans, ovarian
imaging, brain imaging and prostate cancer imaging. They work with other specialists of nuclear
medicine in diagnosis and treatments.
4. Nutrition Support Pharmacy
- addresses the care of patients receiving specialized nutrition support, including
parenteral (IV) or enteral (feeding tube) nutrition.
Roles:
Nutrition support pharmacists compound the parenteral nutrition formulation prescribed and
provide direct patient care. In addition to this, they manage the specialized nutrition support
program and improve quality by educating other health care professionals, students, patients and
caregivers.
5. Oncology Pharmacy
- Oncology Pharmacy provides evidence-based, patient-centered medication
therapy management and direct patient care for individuals with cancer, including
treatment assessment and monitoring for potential adverse drug reactions and
interactions.
Roles: - Oncology pharmacists ensure safety in compounding, preparing, and
dispensing chemotherapy. They are responsible for minimizing drug waste, managing
drug shortages, and decreasing exposure to hazardous drugs.
- Oncology pharmacists are actively engaged in all aspects of cancer care—from
chemotherapy dose preparation and safety checks, to educating patients about side
effects, to drug development research.
- The oncology clinical pharmacist has a crucial role in cancer patient care through
improving medication use including chemotherapy and other high alert
medications. As part of multidisciplinary team clinical pharmacist has major role
in assuring safe, effective and cost-effective drug therapy. Role of the oncology
clinical pharmacist is mainly to identify, prevent and manage any drug related
problem including drug choice, dosage, interactions, administration and side
effects.
6. Pediatric pharmacy
- Pediatric pharmacy practice specializes in the delivery of patient care services by
pharmacists that ensures the safe and effective use of medications for all children
from neonates through to adolescents.
- Pediatric Pharmacy ensures safe and effective drug use and optimal medication
therapy outcomes in children up to 18 years of age.
Roles: - A pediatric pharmacist is a licensed healthcare professional who writes
prescriptions, provides counsel to patients and their parents on the medication they
are taking and helps track their progress to make sure there are no side effects or
harmful outcomes from the drugs being prescribed.
-
The pharmacist shall provide pediatric patient–specific drug information and
accurate, comprehensive information about drugs and drug therapy to health
professionals, patients, and patients' caregivers as appropriate.
7. Pharmacotherapy
- Pharmacotherapy ensures the safe, appropriate and economical use of medications
as part of interprofessional treatment teams in a variety of settings, including
hospitals and health systems.
- Pharmacotherapy (pharmacology) is the treatment of a disorder or disease with
medication. In the treatment of addiction, medications are used to reduce the
 intensity of withdrawal symptoms, reduce alcohol and other drug cravings, and
reduce the likelihood of use or relapse for specific drugs by blocking their effect.
Roles: - Pharmacists have the expertise to detect, resolve, and prevent medication
errors and drug-related problems, such as overtreatment, undertreatment, adverse
drug events, and nonadherence. Therefore, in global health care systems, teams caring
for elders should involve pharmacists to optimize pharmacotherapy.
- A pharmacotherapist is almost always a pharmacist who is highly trained in the
treatment of disease with medications. Often, these healthcare professionals make
clinical observations and incorporates them with information gained from other
healthcare providers to optimize therapeutic decisions.
- What is the role of pharmacist in pharmacotherapy?
- Pharmacists have been involved in different approaches for the optimization of
prescribing and rational medication use in older people. The provision of
pharmaceutical care, medication reviews and educational interventions by
pharmacists in the nursing home, ambulatory and acute care settings are
discussed.
8. Psychiatric Pharmacy
- Psychiatric Pharmacy addresses the pharmaceutical care of patients with
psychiatric-related illnesses and disorders.
- Psychiatric pharmacy, also known as mental health pharmacy, is the area of
clinical pharmacy specializing in the treatment of people with psychiatric illnesses
through the use of psychotropic medications. It is a branch of neuropsychiatric
pharmacy, which includes neurologic pharmacy. Areas where psychiatric
pharmacists are found most abundantly are in chemical dependency,
developmental disabilities, long-term care facilities, adherence clinics, mental
health clinics, and within the prison system. However, psychiatry and neurology
are not the only areas where psychiatric pharmacists require comprehensive
knowledge. They must also be proficient in clinical problem solving,
interprofessionalism, and communication with understanding and empathy for the
patient population they serve, as they are a sensitive group.
Roles: - Providing direct patient care including treatment assessment and
medication management activities. Monitoring for potential adverse drug
reactions and interactions. Evaluating and educating others on medical literature.
Conducting original research (e.g., clinical trials, pharmacogenomics, epidemiology)
- Psychiatric pharmacists work in conjunction with psychiatrists and other
physicians to coordinate care for patients with mental illnesses or a combination
of physical and mental disorders. Patients often take a battery of drugs, such as
antidepressants, antipsychotics and antispasmodics, in a normal day.
- Psychiatric pharmacists understand the interactions of these and other
medications. They can guide the physician in choosing products that won't cause
 potentially hazardous interactions. They're also better-trained in recognizing those
adverse reactions when they occur, improving patient care.
- Pharmacists are also skilled in titration, the calculation of optimal dosages for a
particular medication.
- Psychiatric pharmacists also play a role in the design and testing of new
therapeutic drugs, working for pharmaceutical companies or independent research
laboratories. Psychiatric pharmacists have the necessary training and experience
to suggest potential contra-indications or conflicts with new drugs, based on
similar drugs of the same class or general type.
- Like other pharmacists, psychiatric pharmacists spend much of their time
educating others. In some cases, they must find creative ways to explain the use of
their medications to mentally-ill patients.
- Psychiatric pharmacists educate their peers and other practitioners through
published papers and articles in industry magazines, and many serve as faculty at
universities and other institutions. They might also educate the public through
mental-health seminars, newspaper articles, websites and similar forms of
outreach.
 Latin (or New Latin)
Abbrev. Meaning
origin

a.c. before meals ante cibum

a.d., ad, AD right ear auris dextra

a.m., am, AM morning ante meridiem

nocte every night Omne Nocte

a.s., as, AS left ear auris sinistra

aures unitas or auris
a.u., au, AU both ears together or each ear
uterque

b.d.s, bds, BDS 2 times a day bis die sumendum

b.i.d., bid, bed,

twice a day / twice daily / 2 times daily bis in die
BID

gtt., gtts drop(s) gutta(e)

h., h hour hora

qhs, h.s., hs at bedtime or half strength hora somni

 Latin (or New Latin)
Abbrev. Meaning
origin

ii two tablets duos doses

iii three tablets trēs doses

n.p.o., npo,
nothing by mouth / not by oral administration nil per os
NPO

qd, o.d., od, once a day omne in die

OD right eye oculus dexter

o.s., os, OS left eye oculus sinister

o.u., ou, OU both eyes oculus uterque

p.c. after food post cibum

p.m., pm, PM afternoon or evening post meridiem

per os / nonstandard
p.o., po, PO orally / by mouth / oral administration
form per orem

p.r., pr, PR rectally per rectum

as needed, (also Pertactin - a key antigen of

p.r.n., prn, PRN pro re nata
ac.Pertussis vaccine)

q. every quaque

q.1.h., q1h every hour quaque hora

 Latin (or New Latin)
Abbrev. Meaning
origin

q.2.h., q2h every 2 hours quaque secunda hora

q.4.h., q4h every 4 hours quaque quarta hora

q.6.h., q6h every 6 hours quaque sexta hora

q.8.h., q8h every 8 hours quaque octava hora

q.a.m., qAM,
every morning quaque ante meridiem
qam

q.d., qd every day / daily quaque die

q.h.s., qhs every night at bedtime quaque hora somni

q.d.s, qds,
4 times a day quater die sumendum
QDS

q.i.d, qid 4 times a day quater in die

q.h., qh every hour, hourly quaque hora

q.o.d., qod every other day / alternate days quaque altera die

q.p.m., qPM,
every afternoon or evening quaque post meridiem
qpm

q.s., qs a sufficient quantity (enough) quantum sufficiat

 Latin (or New Latin)
Abbrev. Meaning
origin

q.wk. also qw weekly (once a week)

Rx, Rx, ℞ prescription recipe

Sig., S. directions signa

Stat. immediately, with no delay, now statim

t.d.s, tds, TDS,

take by mouth 3 times a day ter die sumendus
TID

u.d., ud as directed ut dictum