Lecture Notes in Pharmacy Practice

465 Pages·2009·2.87 MB·English

by  Lilian M. Azzopardi

Lecture Notes in Pharmacy Practice

Lecture Notes in
Pharmacy Practice
Edited by
Lilian M Azzopardi
BPharm(Hons), MPhil, PhD, MRPharmS
Associate Professor and Head of Department, Department of Pharmacy, Faculty of Medicine and
Surgery, University of Malta, Msida, Malta
London •Chicago
Dedicated to Captain Pearce for his feline perseverance
in being present during the writing of this book.
Published by the Pharmaceutical Press
An imprint of RPS Publishing
1 Lambeth High Street, London SE1 7JN, UK
100 South Atkinson Road, Suite 200, Grayslake, IL 60030–7820, USA
© Pharmaceutical Press 2010
is a trade mark of RPS Publishing
RPS Publishing is the publishing organisation of the Royal Pharmaceutical Society of
Great Britain
First published 2010
Typeset by New Leaf Design, Scarborough, North Yorkshire
Printed in Great Britain by Cromwell Press Group, Trowbridge
ISBN 978 0 85369 766 4
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, without the prior written permission
of the copyright holder.
The publisher makes no representation, express or implied, with regard to the accuracy of
the information contained in this book and cannot accept any legal responsibility or liability
for any errors or omissions that may be made.
The right of Lilian M Azzopardi to be identified as the author of this work has been asserted
by them in accordance with the Copyright, Designs and Patents Act, 1988.
A catalogue record for this book is available from the British Library.
Contents
Foreword xi
Preface xiii
Acknowledgements xiv
About the editor xv
Contributors xvi
How to use this book xvii
Abbreviations xviii
Part 1 Introduction to Pharmacy 1
1 Historical perspectives 3
2 Pharmacy practice and the healthcare system 9
3 Medicine presentation and administration 13
4 Medicine safety 20
5 Community pharmacy practice 29
6 Dispensing prescriptions 33
7 Health promotion 36
8 Communication skills and patient counselling 39
9 Compliance, adherence and concordance 44
10 Mathematical principles of drug therapy 47
11 Point-of-care testing 54
vi | Contents
Part 2 Clinical Pharmacy and Pharmacotherapeutics 63
12 Pharmaceutical care plans 65
13 Medicine action 70
14 Clinical pharmacokinetics 76
15 Constipation and diarrhoea 80
16 Gastro-oesophageal reflux disease and peptic ulcer disease 86
17 Inflammatory bowel disease and other chronic bowel disorders 92
18 Emesis 97
19 Cardiovascular disorders 101
20 Hypertension 107
21 Ischaemic heart disease 121
22 Congestive heart failure 127
23 Hyperlipidaemia 132
24 Thrombosis 138
25 Allergic rhinitis, asthma and chronic obstructive pulmonary disease 143
26 Schizophrenia 150
27 Mood disorders 157
28 Anxiety disorders 165
29 Sleep disorders 171
30 Eating disorders 178
31 Pain management and fever 184
32 Dementia and Alzheimer’s disease 194
33 Parkinson’s disease 198
34 Anti-infective agents 203
Contents | vii
35 Human immunodeficiency virus infection 216
36 Viral hepatitis 221
37 Thyroid disorders 225
38 Diabetes mellitus 230
39 The menopause and hormone replacement therapy 238
40 Menstrual cycle disorders and contraception 243
41 Genito-urinary disorders 251
42 Cancer chemotherapy and palliative care 256
43 Anaemia and drug-induced blood dyscrasias 264
44 Rheumatoid arthritis 269
45 Osteoarthritis and gout 276
46 Bone disorders 281
47 Skin disorders 287
48 Wound management 295
49 Drug therapy in geriatric patients 299
50 Drug therapy in paediatric patients 304
51 Drugs used in pregnancy and during lactation 311
52 Critical care therapeutics 317
53 Recent advances in pharmacotherapy 321
Part 3 Responding to Symptoms in Community Pharmacy 325
54 Colds and influenza 327
55 The eyes 333
56 Oral and dental problems 340
57 The feet 345
viii | Contents
58 Ear problems 350
59 Musculoskeletal disorders 355
60 Abdominal pain, and perianal and perivulval pruritus 360
61 Travel medicine 367
Part 4 Pharmacy Information and Research 373
62 Pharmacy literature and medical information 375
63 Medical writing 379
64 Research methodology 383
Part 5 Pharmacy Systems 391
65 Primary care health services 393
66 Community pharmacy management 396
67 Hospital pharmacy services 401
68 Formulary systems 406
69 Medicines regulatory affairs 410
70 Quality standards in community pharmacy practice 415
Bibliography 421
Index 423
Foreword
Each of us learned during our secondary school days serious injury and death attributable to drug therapy
that frogs are cold-blooded creatures. By definition, gone awry. Errors of commission and omission in
we came to know that frogs would adapt their body medication use are well documented in the profes-
temperatures to their external surroundings. Through sional and scientific literature. High levels of non-
this process, the metabolic and circulatory systems of adherence are reported. A majority of patients do not
the frog could adjust the temperature of its blood and even get their physicians’ prescriptions filled. Further,
thereby survive the external environment. a high proportion of patients do not respond to drugs
In contrast to the frog, social systems and their in the way that they are expected to respond.
constituents do not adapt so effectively or efficiently. These matters have come to be debated as issues
This is particularly evident in healthcare systems, in public policy. From strengthening the regulatory
owing to continuous global dialogue on access to oversight and approval processes to credentialing
care, organisation of health delivery, financing of physicians in order to prescribe certain drugs, a
healthcare services and products, and assuring safety variety of policy directions to protect patients is
and quality. Few countries have determined perfect being taken around the world. One of these issues
solutions. Some have extreme difficulty adjusting to centres on the beginning and continuing competence
the events of the external environment. In the devel- of health professionals. Some countries are doing
oped world, it is becoming clear that current health- random competence assessments of pharmacists in
care systems may not be sustainable in the future. order to determine whether licences to practise
Major human, fiscal and infrastructure resources are should remain valid. Other nations are requiring
required in the developing and transitional countries pharmacists to maintain dossiers for public inspec-
in order to provide a basic set of essential healthcare tion that attest to their competence. Many hospitals
services to their respective populations. now require advanced credentials in order to take
These phenomena are particularly applicable to responsibility and accountability for expanded
pharmaceutical and biological agents and their use. scopes of practice.
Over 5000 chemical entities are currently in use Like the frog in water that is becoming increas-
aroundtheglobe.IntheUnitedStatesofAmericaover ingly warmer, the profession of pharmacy must adjust
18000drugsandtheirdosageformsareapprovedfor and adapt to an environment that calls for improved
marketing and sales. Large protein substances have patient care and safety in drug therapy. We must
been introduced along with nanotechnological understand our limitations in competence and adjust
targeteddeliverysystems.Complexdrugregimensare our practice accordingly. As we expand our interest in
used daily by patients for acute and chronic condi- partnering with patients and other healthcare profes-
tions. Andagrowingnumberofdrugsarebeingused sionals to assure appropriate outcomes associated
for indications that have not been approved by the with rational drug therapy, we need to continuously
regulatoryagenciesofanumberofcountries. commit our learning of new developments and
Consequent on a dramatic increase in the number clinical findings and controversies in therapeutics.
of drugs and biologicals, coupled with increased That is where Lecture Notes in Pharmacy Practice
utilisation of these agents, it is not surprising that an comes in. Azzopardi and eminent faculty members
increasing number of published reports allude to and practitioners have assembled this text to aid