Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

PHARMACY Gk word pharmakon meaning drugs/medicines Act of dispensing and compounding of medicines to alleviate or treat a disease. Aka botica/drugstore where medicines are merchandised. Fields: 1) Community 2) Hospital 3) Clinical

4) Industrial 5) Academe 6) Regulatory as liaison pharmacist

Types of Community Pharmacy: 1. Traditional (Apothecaries) focused on dispensing and compounding of drugs 2. Modern New type of pharmacies One-stop-shop Health and beauty stores Convenience stores (with grocery stores) Ownership of Pharmacies: 1. Single Proprietor 2. Partnership 3. Drugstore Chains (Corporation) Key factors in operating a pharmacy business: Place Price Product availability People Programs and processes Profitable business Roles & Responsibilities of a Pharmacist as a professional: Has thorough knowledge of merchandise (drug products generic name, available brand names, dosing, therapeutic use) Reads and interprets prescriptions of customers and provide medication substitute if needed Eg. Na increases cardiac output, hypertension occurs thus, K is being recommended Ensures the quality of medicines and accuracy and prompt dispensing at all times Provides health and wellness counselling to customers as needed

Entertains customers complaints and resolves the same to maintain or promote good public relations Strictly implements and monitors pharmacy assistants adherence to Senior Citizens Act and Person with Disability Act Updates and monitors pharmacy record books: Prescription Record Book Dangerous/Regulated Drugs Record Book Opium Additional Book Poison Record Book Senior Citizen Record Book Implements safety and security procedures Assist the stock analyst 100% compliant to government laws, rules, and regulations RA 5921 RA 6675 RA 8203 RA 3720 RA 9994 RA 9442 RA 9502 Pharmacy Law Generics Act of 1988 Special Law in Counterfeit Drugs Food, Drugs, Devices, & Cosmetics Act Senior Citizens Act of 2010 Magna Carta for Disabled People Cheaper Medicine Act

Facilitates application and/or renewal of business requirements Pharmacists PRC License LTO (License to Operate) from FDA S3 License for Regulated Drugs from PDEA Business Permit Mayors Permit Sanitary/Fire Prevention Certificate Building Permit (if applicable) Terms: Generic Name international non-proprietory name, not covered by a patent, usually enclosed in a box seen on packaging materials. Brand Name proprietory name, assigned to a product by a manufacturer, and is enclosed in a parenthesis seen on prescription orders. Dispensing an act by a pharmacist of filling a prescription or doctors order on the patients chart. Indication drug classification according to its therapeutic use. Partial filling dispensing less than the total use or function number of units prescribed. Fully served dispensing the total amount of units prescribed.

Nicole Eileen M. Bagon University of Santo Tomas

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Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

Dose/dosage strength refers to the quantity of a drug, therapeutic agent, that is taken or applied all at one time or in fractional amounts within a given period. Dosage format form of drug according to its physical appearance. PARTS OF PACKAGE OF DRUGS Package size Generic name Brand name Dose/dosage and format Indication or drug classification according to therapeutic use Manufacturer

MIMS, Better Pharmacy (for reference)

WWHAM W Who will take the medicine? How old? W What are the symptoms? How long? H Have you experienced drug/food related allergies? A Action already taken? Have you consulted your doctor? M Medicines being taken for other health problems Rationale Drug Therapy Right Medicine for Right Illness with the Right Dose at the Right Time with the Right Patient/Customer OTC PRODUCTS 1. Drug Registered Cough & cold and antihistamine Digestive tract preparation Pain, fever, and flu Anti-obesity agents Selected vitamins Lozenges Adult nutritionals Medicated skin, hair, and foot 2. Supplements Vitamins Multivitamins Solo-vitamins Food supplements Herbal supplements Dietary (anti-obesity) supplements 3. Devices/Galenicals Galenicals/apothecary (first aid) Condoms Diagnostics BPMs Glucosemeter Devices PT Kit UTI Test Kit Test Strips Rehabilitative Ambulatory Contact lenses

4 GENERAL CATEGORIES OF DRUG 1. OTC Aka over-the-counter drugs Do not require any prescription in dispensing Eg. Paracetamol 2. Herbal Product having a tagline of No Approved Therapeutic Claim Associated with herbal teas Eg. Sleepasil 3. Ethical/Rx Medicines to be dispensed with a proper and valid prescription Eg. Norvasc 4. Dangerous Drug/S2 S2 drugs Drugs regulated by the government regulatory board known as Philippine Drug Enforcement Agency Eg, Diazepam OVER-THE-COUNTER DRUG 3 types: OTC Drug OTC Supplement OTC Device No requirement in dispensing OTC drug WWHAM Guideline and Rationale Drug Therapy can be used Non pharmacologic options and drug products, dosing, common side effects, precautions, proper storage procedure (for advice) Nicole Eileen M. Bagon University of Santo Tomas

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Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

Cough & Cold and Antihistamine Cough (dry/chesty) Mucolytics Expectorants Anti-tussive Colds Decongestants Allergy Anti-histamine Pain, Fever, Flu Pain Analgesic Anti-inflammatory Fever Anti-pyretic Flu Analgesic Decongestants Digestive Tract Hyperacidity/Ulcer Antacid/Anti-ulcer (Gavisconnewest; algae) Constipation Laxative Diarrhea Anti-diarrheal Pedialyte kids Glucolyte, Hydryte - oldies Oral Rehydration Therapy Indigestion Digestant Gastrokinetic Spasm Anti-spasmodic

3. ANTIPYRETIC lowers body temperature Paracetamol Calpol Tempra 550mg tab, syr Ibuprofen Dolan FP syr Medicol tab, SGC 4. ANTACID relieves the acidity of the stomach Al(OH)3, Mg(OH)2, Kremil Simethicone Maalox Plus Hydrotalcite Mg(OH)2, Simeco Dimethicone Al(OH)3, Mg(OH)2 Maalox OTC ANTACID INGREDIENT Mg(OH)2 Al(OH)3 Dimethicone/Si methicone ACTION Prevents constipation Prevents diarrhea Anti-flatulent SIDE EFFECT Diarrhea Constipation

1. ANALGESIC - relieves pain Paracetamol Biogesic 500mg, syr Tempra 550mg Kiddielet Ibuprofen Medicol 200mg tab, SGC Advil 200mg tab, SGC Para + Ibu Alaxan FR 2. ANTI-INFLAMMATORY reduces or prevents the swelling of tissues Mefenamic Acid Ponstan 250 Gardan 250 Dolfenal 250 Naproxen Na Flanax 275 Skelan 275

5. ANTI-SPASMODIC (OTC/Rx) relieves spasm or stomach pains Hyoscine n-butylbromide Buscopan 10mg Dicycloverine Bentyl (Rx) 6. GASTROKINETIC/DIGESTANT aid digestion or dyspepsia Al(OH)3, Mg(OH)2, Kremil Simethicone Domperidone Motilium 10mg Pancreatin Pankreoflat (Rx) 7. ANTI-ULCER (OTC/Rx) relieves ulcers on stomach lining Ranitidine Zantac 75 (OTC) Zantac 150, 300 (Rx) 8. ANTHELMINTIC (OTC/Rx) expels intestinal worms Mebendazole Antiox 500mg, 100mg Pyrantel pamoate Combantrin *Anthelmintics are best given at bed times, sometimes together with anti-histamine. 9. ANTI-DIARRHEAL control or prevent diarrhea or loose bowel movement Loperamide Diatabs 2mg cap Imodium 2mg cap *Loperamide must not be taken for more than 3 days, with maximum of 6-8 caps a day only. 10. LAXATIVE (OTC/Rx) relieve mild constipation Bisacodyl Dulcolax ect2mg Dulcolax supp (Rx) Conc Senna Senokot Lactulose Duphalac (Rx)

Nicole Eileen M. Bagon University of Santo Tomas

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Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

11. PURGATIVE expel all waste matter in the intestine Balsamo carminativo Castor oil Mineral oil 12. ANTI-HISTAMINE (OTC/Rx) Loratidine Claritin 10mg tab Allerta 10mg tab Cetirizine Virlix 10, 25 Diphenhydramine HCl + Benadryl 13. DECONGESTANT cures nasal congestion Phenylpropanolamine HCl (PPA) Phenylephrine HCl (PPE) Neozep (Fte/No drowse) Decolgen (Fte/No drowse) Sinutab Nafarin A Nasatapp OTC DECONGESTANTS BRAND NAME GENERIC ACTIONS NAME Neozep Forte Phenylephrine Decongestant HCl Chlorphenamine Antihistamine Maleate Paracetamol Analgesic & antipyretic Neozep (No Phenylephrine Decongestant drowse) HCl Paracetamol Analgesic & antipyretic 14. ANTI-TUSSIVE suppresses the cough reflex center Butamirate citrate Sinecod Fte 50mg Lagundi Ascof Plemex Dextromethorphan HBr Vix Formula 44 *DM should not be given to patient with asthma 15. MUCOLYTIC relieves productive cough with hard and sticky phlegm to reduce the thickness of mucus Ambroxol Ambrolex 30mg cap, OD 75mg tab Bromhexine Bisolvon 8mg tab, 16mg cap Carbocisteine Solmux 500mg cap, chew tab, syr Loviscol cap, susp, drops Robikids syr

16. EXPECTORANT help loosen mucus by making bronchial secretions thinner and easier to cough up, soft, easy to expel Guaifenesin Robitussin 200mg SGC, 100mg/5mL syr Penadryl Exp 17. HEMATINIC increases red blood cell count Ferrous Sulfate *side effect: produces black tarry stools 18. ESCHAROTIC destroys tissues, leaving a scar to a place in contact with Salicylic acid + Duofilm 19. TONIC restores body energy and strength Lipovitan Red bull Revicon ION Extra Joss 20. GALACTOGOGUE increases milk secretion Moringa oleifera Natalac Pro Lacta

OTC VITAMINS AND SUPPLEMENTS Vitamins products essential to help growth and development, digestion, mental alertness, and especially resistance to infection. Counsumer segmentation Kids Vitamins Adult Vitamins Solubility Water Soluble eg. Vit. C Fat Soluble eg. Adek Combination Single Vitamins Multivitamins Supplements items added to the diet to boost overall health and energy and reduce the risks of illness and age-related conditions; mental activities, to support the healing process during illness and disease. Most of these are treated as food and not regulated as drugs are.

Nicole Eileen M. Bagon University of Santo Tomas

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Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

A B1 B2 B3 B5 B6 B9 B12 C D E Sy E Nat H Ca Fe

VITAMINS Retinol To supplement vision Thiamine Nerve supplement Riboflavin Nerve supplement Niacin Nerve supplement Pantothenic Acid Nerve supplement Pyridoxine Nerve & Isoniazid sup Folic Acid Supp in pregnancy Cyanocobalamin Nerve supplement Ascorbic Acid Treatment of scurvy Sunshine Vit Bone development Tocopheryl Ac Skin antioxidant Tocopherol Skin antioxidant Biotin Zinc deficiency Calcium Bone development Iron Blood production

Prescription Written order and instruction of a validly registered practitioner (physician, veterinarian) for the use of a specific drug for a specific purpose Latest, correct data, with complete info WWHAA for Ethical Drugs W Who will take the medicine? How old? W What are the symptoms? How long? H Have you experienced drug/food related allergies? A Action already taken? Have you consulted your doctor? A Attended check-up regularly to check BP? WHOWHO guide for Antibiotic Drugs W Who will take the medicine? How old? H Have you consulted the doctor regarding your condition? (Ask MD Info) O Other medical conditions and allergies that you know? (high risk group) W What are the symptoms? (to asses the customers condition properly) H How long have you been experiencing the symptoms? (to provide proper advise) O Other medicines that you have been taking for the condition? (to prevent therapeutic duplication and drug interaction) PARTS OF A PRESCRIPTION Doctors heading Patients information Prescription date Superscription Inscription Generic name Brand name Dosage Transcription or signa Prescribers signature Prescribers license number ETHICAL DRUGS Cardioavascular drugs Anti-diabetes Thrombolytics (for blood) Anti-cholesterol Endocrine Antibiotics Anti-TB Generics

*Vit E 300 IU synthetically made *Vit E 400 IU naturally made SUPPLEMENTS Slimming Fitrum, Slenda Vigor & Vitality Eduranz, Robust, Erektus Stimulant Whitening Mosbeau, Cosmo Skin, (Glutathione) Metathione, Lucida Anti-oxidants 4G, Gloww Memory Memo Plus Gold, Glutaphos, Enhancer Memo Rx For Blood Ampalaya Plus, Circulan, Circulation Plasmin (Ampalaya) Liver Supp Liveraide (Silymarin) Heart Supp Heartvit (CoQ10) Kidney Supp Kidney Care, Renalin Eye Supp Oplein, Eyeberry Joint Supp Arthricin, Arthro, Power Joints (Glucosamine) Galactogogue Pro Lacta, Natalac (Malunggay) Sleep Aid Sleepasil, Better Sleep ETHICAL DRUGS Requires prescription Refer to WWHAA or WHOWHO (antibiotic) as guidelines for counseling

Nicole Eileen M. Bagon University of Santo Tomas

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Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

Gastrointestinal drugs Genitourinary drugs Respiratory & asthma drugs Neuro/CNS drug Pain management Womens health Hormonal Eye & ear preparation (drops) Dermatological 1. ANTI-SPASMODIC relieves spasms or stomach pain Dicycloverine Bentyl Relestal Mebeverine Duspatulin 2. ANTI-ULCER relieves ulcer on stomach lining Ranitidine Zantac 150, 300mg tab Famotidine H2 Bloc 20, 40mg Omeprazole Omepron 10, 20mg Esomeprazole Nexium 20, 40mg 3. LAXATIVE relieves mild constipation Lactulose Lilac Duphalac Bisacodyl Dulcolax syr *all Rx Glycerine Glydolax syr 4. ANTI-HISTAMINE cures allergy Hydroxyzine Iterax 5. ANESTHETIC temporarily destroys the sensation of pain Lidocaine EMLA cream 6. ANTI-HEMORRHOIDAL cures or shrinks haemorrhoids Diosmin + Hesperidin Daflon Cinchocaine HCl Faktu Hydroxyethylrutoside Varemoid Fte 200mg tab 7. ANTI-HYPERTENSIVE lowers down blood pressure levels Metoprolol Neoblac 50, 100mg Amlodipine Norvasc 5, 10mL Nifedipine Calcibloc 5, 10, 300 D Losartan Cozaar 50, 100mg Telmisartan Micardis 40, 80mg Captopril Capoten 25, 50mg 8. ANTI-DIABETIC decreases elevated blood sugar levels Metformin Glucophage 500, 850, 1g Glimepiride Solosa 1, 2, 3, 4mg Glipizide Minidiab 2.5, 5, 10mg Glibenclamide Euglocon 5mg Nicole Eileen M. Bagon University of Santo Tomas

Gliclazide Diamicron 30MR 80mg Insulin 9. ANTI-HYPERLIPIDEMIC lowers down blood cholesterol levels Simvastatin Zocor 20, 40 Atorvastatin Lipitor 10, 20, 40, 50 Fenofibrate Lipanthyl *Best given at bed time (8:00pm) 10. ANTIBIOTIC kills or inhibits bacterial growth Amoxicillin Amoxil 250, 500mg cap, susp Cefalexin Ceporex 250 Ciprofloxacin Ciprobay 50mg Azithromycin Zithromax Co-amoxiclav Augmentin 375 Co-trimoxazole Bactrinol 11. DIURETIC increases urine output Furosemide Lasix Frusema Spironolactone Aldactone *Mostly associated with hypertension 12. ANTI-INFLAMMATORY relieves inflammation, rheumatism, or pain Mefenamic Acid Dolfenal 500 Naproxen Na Flanax 550 Diclofenac K Cataflam Diclofenac Na Voltaren Meloxicam Moble 75, 15 Celecoxib Celebrex 13. ANTI-VERTIGO & ANTI-EMETIC relieves dizziness (vertigo) and emetic (vomiting) Betahistine Serc Cinnarizine Stugeron Metoclopromide Plasil Meclizine HCl Bonamine (OTC) 14. CONTRACEPTIVE prevents contraception Trust Pill Charlize Lady Diane 35 Anti-acne Althea Anti-acne Daphne Safe for breastfeeding 15. ANTI-ASTHMA relieves or cures asthma Salbutamol Ventolin Terbutaline SO4 Bricanyl Montelukast Singulair 16. ANTI-TB cures TB (pulmonary/primary complex) KIdz Kit 3 Kidz Kit 2 Myrin P Forte Page 6

Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

Eg. My Marvel Taheebo Tea Bi Guer Lai Tea Kancunio Tea Banaha Tea Side effects: Rifampicin Discoloration of urine into red orange Honeymoon Tea Isoniazid Depleted Pyridoxine levels in the DANGEROUS DRUGS body, must be taken with Vit B6 S2 Prescribed Drugs Pyrazinamide Not taken on maintenance phase, RA 9165 causing liver toxicity Pharmaceutical only drugs Ethambutol Not given to children, causing Double locked stationary cabinet blurring of vision S2 License of doctors Streptomycin PDEA form 1-72/Yellow Prescription Myrin Quadtab Tritab TREATMENT PHASING INITIAL PHASE MAINTENANCE (0-2 months) (3-6 months) Children RIP RI Adult RIPE RIE 17. MYOTIC constricts the pupil of the eye Pilocarpine SO4 Isoptocarpine 18. MYDRIATIC dilates the pupil of the eye Atropine SO4 Mydriacyl 19. NEURO/CNS address issues on neurological problems Anti-emetic Metoclopromide Plasil Anti-vertigo Cinnarizine Stugeron Anti-convulsant Carbamezipine Fegretol Anti-depressant Paroxetine Seroxaf Anti-psychotic Haloperidol Serenace Anti-Parkinsons Biperden Neurotonic 20. GENITOURINARY address issues on:
Urinary bladder problem Prostate disorders Pregnancy problems Kidney problems Vaginal anti-infectives

1. SEDATIVE/HYPNOTIC induces sedation or calming effect Zolpidem Stilnox Midazolam Dormicum Alprazolam Xanor 2. TRANQUILIZER/ANXIOLYTIC calms down nervous tension and anxiety disorder Diazepam Valium

3. ANTI-MIGRAINE -

4. DOSAGE FORMATS physical form/appearance of a dose of a chemical compound used as a drug or medication intended for administration or consumption. It could be: A. ORALLY TAKEN 1. Tablet 2. Capsule Types: Spansule Hard gel Soft gel Page 7

21. MUSCOLO/ENDO - address issues on:

Gout Muscoskeletal problems Thyroid disorders

HERBAL PREPARATIONS OTC with proper advise on customers Refused to as Chinese tea, Herbal tea and supplements Nicole Eileen M. Bagon University of Santo Tomas

Overview of Pharmacy, Medicines, & Practice

Review of General Categories and Indication of Drugs

SCT FCT MCT ECT Chew Tab SL Tab XR/ER Tab MR Caplet Effervescent 3 Powder 4 Granule 5 Pill 6 Lozenge 7 Pastille 8 Solution

Sugar coated Film coated Multiple compressed Enteric coated Sublingual Extended release

Potencee Erythrocin Alaxan Tab Dulcolax Kremil Isordil SL Glucophage XR Diamicron MR Advil Hydrite

9 Syrup 10 Suspension 11 Emulsion 12 Gargle medical use 13 Mouthwash aesthetic purpose

B. TOPICALS 1. Ointment oil based 2. Cream water based 3. Gel 4. Patch 5. Lotion 6. Liniment with rubbing C. SUPPOSITORY semi-solid preparation applied for gynecological ailments Rectal (bullet) as laxative, antipyretic Vaginal (pick) for infections Urethral for infections D. PARENTERALS E. NASAL F. INHALATIONAL Nebulizer Rotahaler Diskhaler G. AURAL ears H. OPTHALMIC I. PAINT singaw, creamy consistency liquid

J. DOUCHE cleansing or anti-septic agent K. ENEMA evacuation of bowel Nicole Eileen M. Bagon University of Santo Tomas Page 8