Scope, role and responsibilities of community pharmacist

1. HOSPITAL & COMMUNITY
PHARMACY
By Kiran Sharma
KIET School of Pharmacy

2. Definition
Community pharmacy
Community pharmacy means any place under the direct supervision of a
pharmacist where the practice of pharmacy occurs or where prescription
orders are compounded and dispensed other than a hospital pharmacy
or a limited service pharmacy.
Hospital pharmacy
Hospital pharmacy is the organization or department of the hospital to
manage the procurement, storage, preservation, packaging, sterilization,
compounding, preparation, dispensing or distribution of medicine in the
hospital.

3. What is the scope of Communitypharmacy?
 In processing prescriptions- The pharmacist verifies the legality,
safety and appropriateness of the prescription order, checks the patient
medication record before dispensing the prescription (when such records
are kept in the pharmacy), ensures that the quantities of medication are
dispensed accurately, and decides whether the medication should be
handed to the patient, with appropriate counseling, by a pharmacist
 Clinical pharmacy- The pharmacist seeks to collect and integrate
information about the patient’s drug history, dosage regimen
 Patient care- patient drug history, mode of administration,
precautions, advices
 Drug monitoring- as practice research projects, and schemes to
analyze prescriptions for the monitoring of adverse drug reactions
 Extemporaneous preparation- pharmacists engage in the small-
scale manufacture of medicines, which must accord with good
manufacturing and distribution practice guidelines.

4.  Alternative medicines- In some countries, pharmacists supply traditional
medicines and dispense homoeopathic prescriptions
 Checking symptoms of minor aliments- pharmacist can supply a
non-prescription medicine, with advice to consult a medical practitioner if the
symptoms persist for more than a few days. Alternatively, the pharmacist may give
advice without supplying medicine.
 Health care professionals- provide the information as necessary to other
health care professionals and to patients, and use it in promoting the rational use of
drugs, by providing advice and explanations to physicians and to members of the
public.
 Counselor- the pharmacist provides an advisory as well as a supply service to
residential homes for the elderly, and other long-term patients. In some countries,
policies are being developed under which pharmacists will visit certain categories of
house-bound patients to provide the counselling service that the patients would have
received had they been able to visit the pharmacy
 In prophylaxis and health promotion- The pharmacist can take part
in health promotion campaigns, locally and nationally, on a wide range of health-
related topics, and particularly on drug-related topics (e.g., rational use of drugs,
alcohol abuse, tobacco use, discouragement of drug use during pregnancy, organic
solvent abuse, poison prevention) or topics concerned with other health problems
(diarrhoeal diseases, tuberculosis, leprosy, HIV-infection/AIDS) and family planning.

5. Dispensing prescriptions/ Appropriate filling of prescriptions
Reviewing the prescription for correctly spell, label, interactions, right
drugs etc.

6. 3. Rational use of drugs–As common as common
sense?
“The irrational use of medicines is a major problem worldwide. WHO
estimates that more than half of all medicines are prescribed,
dispensed or sold inappropriately, and that half of all patients fail
to take them correctly. The overuse, underuse or misuse of
medicines results in wastage of scarce resources and
widespread health hazards.”
 Patients often come with the belief that
there is "a pill for every ill“
 the prescribers' poor training
 workplace may impose pressures
 aggressive pharmaceutical marketing

7. Diarrhoea
 Here antibacterials are often over-prescribed. While there are many causes
for diarrhea, infective and non-infective, the fact remains that most of them
are self-limiting and require only adequate rehydration.
 In all doubtful cases, a stool examination should be done for ova, cyst, blood
and hanging drop if cholera is suspected.
 Stool culture can be done in the presence of severe and/or bloody diarrhoea,
fever and systemic toxicity.
 Mixed infections" with bacteria and amoeba are never known to occur

8. 4. Ensuring that different treatments are compatible –
action 500 & coldarin increases B.P.
5. Special emphasis on pediatric and geriatric
patients
6. Supervising the preparation of any medicines (not
all are supplied ready made-up by the
manufacturer)
7. Providing OTC (over the counter) Drugs
8. Maintain records and register
9. Interaction with doctors and nurses
10. Proper diet regime – for children, hypertensive patients,
diabetic patients
11. Knowledge about transmitted diseases- HIV,
tuberculosis, diphtheria

9. Nicotine patch
Nicotine gum
Nicotine lozenge
Nicotine inhaler
Nicotine nasal spray
Bupropion (Zyban)- a prescription medication classified as
a type of antidepressant. A sustained-release form of bupropion is
approved for smoking cessation

10. Hygiene, Prophylaxis of diseases, Vaccination and immunization
Proper child care, Proper child education
Right nutrition –
•Slowly reduce the sugar & salt in your diet
•Replace refined carbs with complex carbs such as oatmeal, brown rice
•Check labels and opt for “sugar-free” or “no added sugar” products.
•Don’t replace fat with carbs whole fat yogurt, with low-fat versions
•Eat breakfast & regularly
•Boost energy with quality protein lower risk for obesity, osteoporosis, diabetes
Take "good fat” avoid (Trans fat—the “bad fats”)
Monounsaturated fats are found in foods such as olive oil, avocados, nuts (like almonds,
hazelnuts, and pecans), and seeds (such as pumpkin, sesame).
Polyunsaturated fats include Omega-3 fatty acids, found in fatty fish such as salmon,
herring, mackerel, anchovies, and sardines. Other sources include flaxseed and walnuts.
•Take Vitamin D3, Ca & Mg

11. Vaccines Types
1.Inactivated vaccine- Inactivated but previously virulent, micro-
organisms that have been destroyed with chemicals, heat, radiation,
or antibiotics.
Examples are influenza, cholera, bubonic plague, polio, hepatitis A,
and rabies.
2. Attenuated vaccine- Live, attenuated microorganisms-
active viruses that have been cultivated under conditions that disable
their virulent properties, or that use closely related but less
dangerous organisms
Examples are yellow fever, measles, rubella, and mumps, and the
bacterial disease typhoid.
3. Toxoid vaccines are made from inactivated toxic compounds that
cause illness
Ex- tetanus and diphtheria
4. Protein subunit

13. Human respiratory syncytial virus (RSV) is a syncytial virus that causes respiratory tract infections.

14. Methamphetamine - stimulant drug
Anabolic steroids
Lysergic Acid Diethylamide (LSD)
Cocaine
Heroin
Marijuana
Prescription drugs
15. Alcohol use awareness program
Alcohol advice and harm reduction services
Needle and syringe exchange for people with drug addictions
* Supervised administration of methadone ( synthetic opioid. It is used
medically as a pain medication and a maintenance therapy in people with opioid
dependene) and other substitutes

15. 16. Clinical pharmacy/ patient care
17. Individualization of drug
therapy
18. Monitoring of drug utilization
and pharmacovigilance.
19. Nutrition counseling
20. Health screening
21. Family planning
22. Documentation and research

16. counseling and advising the public on the treatment of minor ailments;
advising patients of any adverse side-effects of medicines or potential
interactions with other medicines/treatments;
preparing dosette and cassette boxes, usually for the elderly but also for
those with memory/learning difficulties, where tablets are placed in
compartments for specified days of the week;
undertaking Medicine Use Reviews (MUR), an advanced service to help
patients understand how their medicines work and why they have to take
them;
monitoring blood pressure, BMR and cholesterol levels;
offering a diabetes screening service;
arranging the delivery of prescription medicines to patients;
managing, supervising and training pharmacy support staff;
budgeting and financial management;
keeping up to date with current pharmacy practice, new drugs and their
uses.