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[Edit] See also
History of pharmacy
Professional Further Education in Clinical Pharmacy and Public Health
[Edit] References
^ Clinical Pharmacy Defined (Pharmacotherapy 2008;28(6):816–817)
^ Board Certification in Pharmacy
^ http://www.accp.com/docs/positions/whitePapers/EconEvalClinPharmSvcsFinalkjsedit-gts.pdf
^ Collaborative drug therapy management (CDTM). Pharmacist's Letter/Prescriber's Letter 2009;25(8):250801.
^ http://www.amcp.org/amcp.ark?p=AA22E90C
^ http://www.accp.com/docs/positions/positionStatements/pos2309.pdf
^ a b http://www.ncpharmacists.org/displaycommon.cfm?an=13
[Edit] External links
Academy of Managed Care Pharmacy
American College of Clinical Pharmacy
Board of Pharmacy Specialties
Journal of Clinical Pharmacy and Therapeutics
The British Journal of Clinical Pharmacy
Retrieved from "http://en.wikipedia.org/w/index.php?title=Clinical_pharmacy&oldid=504263214"
Categories:
Pharmacy
Compounding
From Wikipedia, the free encyclopedia
Pharmaceutical compounding (done in compounding pharmacies) is the creation of a particular pharmaceutical product to fit the unique needs of a patient. To do this, compounding pharmacists combine or process appropriate ingredients using various tools. This may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a non-essential ingredient that the patient is allergic to, or to obtain the exact dose needed. It may also be done for voluntary reasons, such as adding favorite flavors to a medication. More recently it has been suggested that some doctors and clinics have turned away from major drug manufacturers and turned to compounding pharmacies because they often charge much lower prices than the major manufacturers.[1]
In October 2012 news reports surfaced of an outbreak of fungal meningitis tied to the New England Compounding Center. [2] At that time it was also disclosed that the U.S. and Massachusetts state health regulators were aware in 2002 that steroid treatments from the New England Compounding Center could cause adverse patient reactions.[3] It was further disclosed that in 2001–02, four people died, more than a dozen were injured and hundreds exposed after they received back-pain injections tainted with a common fungus dispensed by two compounding pharmacies in California and South Carolina.[4]
History
Main article: History of pharmacy
Before mass production of medications became widespread, compounding was a routine activity among pharmacists. Community pharmacists who have experience with compounding techniques are now less common.
Pharmaceutical compounding has ancient roots. Hunter-gatherer societies had some knowledge of the medicinal properties of the animals, plants, molds, fungus and bacteria as well as inorganic minerals within their environment. Ancient civilizations used pharmaceutical compounding for religion, grooming, keeping the healthy well, treating the ill and preparing the dead. These ancient compounders produced the first oils from plants and animals. They discovered poisons and the antidotes. They made ointments for wounded patients and perfumes for customers.
The earliest chemists were familiar with various natural substances and their uses. These drug artisans compounded a variety of preparations such as medications, dyes, incense, perfumes, ceremonial compounds, preservatives and cosmetics. Drug compounders seeking gold and the fountain of youth drove the alchemy movement. Alchemy eventually contributed to the creation of modern pharmacy and the principles of pharmacy compounding. In the medieval Islamic world in particular, Muslim pharmacists and chemists developed advanced methods of compounding drugs. The first drugstores were opened by Muslim pharmacists in Baghdad in 754.[5][6]
The modern age of pharmacy compounding began in the 19th century with the isolation of various compounds from coal tar for the purpose of producing synthetic dyes. From this one natural product came the earliest antibacterial sulfa drugs, phenolic compounds made famous by Joseph Lister, and plastics.
During the 1800s, pharmacists specialized in the raising, preparation and compounding of crude drugs. Crude drugs, like opium, are from natural sources and usually contain several chemical compounds. The compounding pharmacist often extracted these crude drugs using water or alcohol to form extracts, concoctions and decoctions.
Pharmacists began isolating and identifying the active ingredients contained within these crude drug concoctions. Using fractionation or recrystallization, the compounding pharmacist would separate the active ingredients, like morphine, and use it in place of the crude drug. During this time modern medicine began.
With the isolation of medications from the “raw materials” or crude drugs came the birth of the modern pharmaceutical company. Pharmacists were trained to compound the preparations made by the drug companies, but they could not do it efficiently on a small scale. So economies of scale, not lack of skill or knowledge, produced a market for the modern pharmaceutical drug companies.
With the turn of the 20th century came greater government regulation of the practice of medicine. These new regulations forced the drug companies to prove that any new medication they brought to market was safe. With the discovery of penicillin, modern marketing techniques and brand promotion, the drug manufacturing industry came of age. Pharmacists continued to compound most prescriptions until the early 1950s when the majority of dispensed drugs came directly from the large pharmaceutical companies.