Clinical Pharmacy

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 Clinical Pharmacy

CAREER IN
PHARMACY

CLINICAL
HOSPITAL
PHARMACY
PHARMACY

INDUSTRIAL TRADITIONAL
PHARMACY PHARMACY

EMERGING
PHARMACY

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CLINICAL PHARMACY
➢ INTRODUCTION:
“Every drug is a poison, it’s the dose that differentiate the poison or a drug
the substance is”

Clinical pharmacy is a branch of

pharmacy that involves the provision
of patient care with the use of
medications to optimize the health
outcomes of patients. This includes
promoting wellness and preventing
disease.
It is the modern and extended field of
pharmacy.
The term ‘clinical ’doesn’t
necessarily imply an activity implemented in a hospital setting. It describes that the type of
activity is related to the health of patient. The community and hospital pharmacist both can
perform clinical activities.
➢ DEFINITION:
“The discipline that embodies the application and development (by pharmacist) of scientific
principles of Pharmacology, Toxicology, Therapeutics and Clinical Pharmacokinetics,
Pharmacoeconomics, Pharmacogenomics and other allied sciences for the care of the patient”

➢ HISTORY:

1785: William withering published

an account of the foxglove and
some of its medical uses, which
contained reports on clinical trials
and notes on digitalis’s effects and
toxicity.
1884; John Mitchell Bruce wrote
his textbook entitled ‘MALERIA
MEDICA AND THERAPEUTICS’
1914: Hans Horst Meyer and
Rudolf Gott lied wrote a book in
German title was translated as
‘Pharmacology: Clinical and Experimental’
1953: The term clinical pharmacy was first used. The term was coined in the U.S By
‘HEPPLER AND STRAND ‘It is relatively new professional discipline, being about 15 years
old.

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1960s: The concept started with two incidents.

1962: First was ‘the thalidomide tragedy’ birth of babies with sealed limbs.
1968: Second was ‘phenytoin toxicity’
The movement began at the university of Michigan but the much pioneering work was done
by David Burkholder, Paul parker and Charles Walton at the university of Kentucky in the
later part of 1960s.so the clinical pharmacy enhances more and until today in Nepal it’s
practice is at the embryonic stage.

➢ EDUCATION AND CREDENTIARING:

Clinical pharmacists have extensive education in the biomedical, pharmaceutical, socio-
behavioral and clinical sciences. Most clinical pharmacists have a Doctor of
Pharmacy (Pharm.D.) degree and many have completed one or more years of post-
graduate training (for example, a general and/or specialty pharmacy residency). In the United
States, clinical pharmacists can choose to become Board-certified through the Board of
Pharmacy Specialties (BPS), which was organized in 1976 as an independent certification
agency of the American Pharmacists Association. The BPS certifies pharmacists in the
following specialties.

• Ambulatory care pharmacy (BCACP)

• Critical care pharmacy (BCCCP)
• Nuclear pharmacy (BCNP)
• Nutrition support pharmacy (BCNSP)
• Oncology pharmacy (BCOP)
• Pediatric pharmacy (BCPPS)
• Geriatric pharmacy (BCGP)
• Pharmacotherapy (BCPS)
• Infectious disease pharmacy (BCIDP)
• Compounded sterile preparations pharmacy (BCSCP)
• Cardiology pharmacy (BCCP)
• Transplant Pharmacist (BCTXP)
• Psychiatric Pharmacy (BCPP)
There are several types of clinical pharmacists in the United States. In California they are
called advanced practice pharmacists (APh). In New Mexico, they are known as Pharmacist
Clinicians (Ph.C.) and lastly in Montana and North Carolina they are known as Clinical
Pharmacist Practitioners (CPP). Clinical pharmacists in the Veteran Administration are
known as Clinical Pharmacy Specialists (CPS).

➢ GOALS OF CLINICAL PHARMACY:

The overall of goal of clinical pharmacy activities is to promote the correct and appropriate
use of medicinal products and devices. These activities aim at:
Maximizing the clinical effect of medicine; using the most effective type of drug and
treatment for each and every type patient.
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Minimizing the risk of treatment induced adverse events; monitoring the therapy course for
adverse reaction as well as patient’s compliance with therapy.
Minimizing the expenditures for pharmacological treatments by governments and by the
patient; trying to provide the best treatment options for the greatest numbers of patients at the
most cost effect.
In short the aim and goal of clinical pharmacy is to provide and describe the present and
future functional role in drug research, professional education and patient care.

➢ ROLE OF CLINICAL PHARMACIST:

Clinical pharmacists are the experts in the therapeutic use of medicines in the healthcare team
and may perform various tasks
including:

• Evaluating medication therapy and

making appropriate
recommendations to patients or
health practitioners.
• Providing evidence-based
information and advice about the
safe and effective use of
medications.
• Recognizing untreated health
conditions that could be managed with medication therapy. Monitoring patient progress
with medications and making relevant recommendations to change.
• Advising patients about the best way to take medications.
• Assisting in direct care of patients in hospitals and surgeries.
• Developing requirements for post registration continued professional development for
governing bodies.

Historically, the role of the clinical pharmacist was usually limited to hospital, clinics and
educational institutes, but this is quickly growing Pharmacy. And they are becoming more
easily accessible to the public. This growth is coming about through the involvement of
clinical pharmacists in reviewing medication regimens and assisting with advice on
information hotlines to prevent medication errors in the future. Depending on the country or
state of practice, some clinical pharmacists are also able to prescribe some medications and
the scope for this continues to expand.

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➢ PURPOSE OF CLINICAL PHARMACIST:

The main purpose of the clinical pharmacist is to evaluating medical therapy and making
appropriate recommended to patient or health practician.
By taking care of some following things:
1. Knowledge about disease (pathophysiology)
2. Drug use evaluation
3. Therapeutic drug level
4. Evaluate treatment outcome
5. To provide info about history of drug allergy

➢ WHY WE NEED A CLINICAL PHARMACIST:

• Asses the status of the patient’s health problems and determine whether the prescribe
medication are optimally meting the patient’s needs.
• Recognize untreated health problems that could be improve and resolved with appropriate
medication therapy.
• Follow the patient’s progress to determine the effects of patient’s medication on his or her
health.
• Consult with the patient’s physician in selecting the medication therapy and the
requirements of the patients.
• Advice the patient that how to use his or her medication.
• Refer the patient to his or her physician or health care professionals to address specific
health and wellness and the social services concerns as they arise.

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➢ FUNCTIONS OF CLINICAL PHARMACIST:

1. A clinical pharmacist can perform

certain numbers of functions some
are as fellows.
He perform the work of providing
the information of drugs to the
patient prescribed by a physician.
2. Medicine Management, Preparation
and Dispensing of medicine which
means dealing and informing the
patient about the proper and
effective use of medicine belongs to
the work of clinical pharmacist.
3. He has a great responsibility to deal with which is counseling of patients, which involves
telling the patients dose adjustments, identification of side effects of relevant drugs and
advising them how to prevent from the diseases and spend a hygienic and healthy life.
4. Clinical pharmacist formulates pharmaceutical care plan for patients that involves
improvement in the patient’s health with the help of collaborative relationship with the
physician.

➢ LEVEL OF THE ACTIONS OF CLINICAL PHARMACIST:

Clinical pharmacy activities may influence the correct use of medicines at three different
levels
1. Before the prescription
2. During the Prescription
3. After the prescription

➢ REQUIREMENTS OF CLINAL PHARMACY

The basic requirement for the clinical pharmacy is to have D-Pharmacy degree means Doctor
of pharmacy based on 5 years.
after the degree the clinical pharmacist must have to work in hospitals along with the
physicians to get more and more knowledge and experience too so he will have a complete
grip on it. This is their initial work state by which they can get more skills.

➢ ROLE IN HEALTH CARE SYSTEM:

Within the system of health care, clinical pharmacists are experts in the therapeutic use of
medications. They routinely provide medication therapy evaluations and recommendations to
patients and other health care professionals.
Clinical pharmacists are a primary source of scientifically valid information and advice
regarding the safe, appropriate, and cost-effective use of medications.

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Clinical pharmacists are also making themselves more readily available to the public. In the
past, access to a clinical pharmacist was limited to hospitals, clinics, or educational
institutions.
Clinical pharmacists are making themselves available through a medication information
hotline, and reviewing medication lists, all in an effort to prevent medication errors in the
foreseeable future.
In the United Kingdom, clinical pharmacists are routinely involved in the direct care of
patients within hospitals, and increasingly, in doctors’ surgeries. They also develop post
registration professional education, professional curricula for workforce development,
provide expertise on the use of medicines to national organizations such as NICE,
the Department of Health, and the MHRA, and develop medicines guidelines for use in
therapeutic areas.

➢ PRACTICE AREAS:
• Ambulatory care
• Critical care
• Drug information
• Geriatrics and long-term care
• Cardiology
• Surgery
• Endocrinology
• Infectious disease
• Neurology
• Nephrology
• Nuclear Pharmacy
• Pediatrics
• Pharmacokinetics
• Nutrition
• Gynecology
• Psychiatry
• pulmonary disease

➢ SALARIES:

Clinical pharmacists play a crucial role in ensuring patients' safety because they help them
prevent adverse drug events (ADEs).
so the salaries of clinical pharmacist in Pakistan ranges from 53000 PKR lowest to
160,000PKR highest.

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➢ IDEAL PHARMACIST CANDIDATE SHOULD BE:

• Responsible
• Motivated
• Competent
• Problem Solver
• Good Communication skills
• Team work spirit
• Serve as a front-line educator
• Good memory
• Knowledgeable
• Strong Moral Character
• Having honesty and patience

“TO KILL ILL BY PILL, NOT BY BILL”

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