Understanding the role of pharmacists

Pharmacist Amy Schiveley talks with a customer at Lakeview Pharmacy

If your recent flu vaccine was administered at a pharmacy, you have already sampled the expanded role that pharmacists play in our health care today.

A flu shot, though, is just one of many patient-care services pharmacies across the country offer beyond filling prescriptions. From blood pressure tracking to Medication Therapy Management counseling, today’s pharmacists can be a resource for a wide range of information and advice.

In a Medication Therapy Management session, pharmacists can sit down with a customer and go through all of their medications, find out what is working and what’s not, review the purpose of each medication, explain how they work and more, according to Amy Schiveley, managing pharmacist at Lakeview Pharmacy, 516 Monument Square.

Pharmacists already provide some consultation when a customer picks up a prescription, Schiveley said, but MTM sessions take a more in-depth look at the entire medicine profile — including over-the-counter products and supplements — and help the patient better understand what they are taking, why they are taking it and how to take it.

“We go through all of it with a fine-toothed comb,” Shiveley said.

Pharmacists can also help patients understand the risks versus benefits of each medication; explore ways to reduce costs; and work with physicians and insurance companies to figure out what medication options are best for each person, she said.

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Dosage Forms: Introduction to Pharmaceuticals

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This article is a sufficient beginning to know everything about pharmaceuticals. If you are just starting to know about this amazing field, this is a good guide for you.

Drug is the substance used to cure, treat, restore the health state, or optimize a malfunction. Fundamentally, this substance is brought from plants or animals. Rarely, the drug is administered in its primary or crude form. In other words, the drug can be natural, synthetic, or semi-synthetic. The drug’s crude form passes by different processes to give rise to what is called dosage forms.

During manufacturing, the crude drug is called a pharmaceutical preparation. Dosage form is the crude drug in its final form after adding particular characteristics to it. The drug manufacture includes addition of additives; pharmaceutical ingredients.

The additives are mainly non-medicinal substances used for many purposes. They are added to enhance the drug form, quality, and efficacy.

They are used:

As solubilizing agents

For dissolving the drug in a solvent as in the formation of solutions

For dilution

To decrease or optimize concentration

As suspending agents

To suspend solid particles in a solution and form a suspension

As emulsifying agents

To dissolve water in oil or oil in water and produce an emulsion

As thickeners

To harden/thicken creams and ointments

As stabilizers

To maintain the stability of a pharmaceutical preparation

As preservatives

To protect the pharmaceutical preparations from contamination by microorganisms such as bacteria and fungi

As coloring agents

To give the drug a perfect appearance and attractiveness.

As flavoring agents

To hide a bad taste like the bitter taste. Moreover, flavoring agents are used to add a reasonably good taste to the drug and increase its palatability.

Click here to download a PDF with more information

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Congressman and Medical Doctor Phil Roe Presents An Outstanding Obamacare Alternative

Family Research Council discussion of the Republican Study Committee’s alternative to the Affordable Care Act, known as “Obamacare.”

Dr. Phil Roe, the Congressman representing Tennessee’s First Congressional District, will present an overview and answer questions about the RSC’s patient-centered and free market alternative, the American Health Care Reform Act. More information about RSC’s bill can be found here. Because of the federal government’s expansive role in structuring health care’s cost and coverage, this important discussion is relevant to all Americans. Dr. Roe has a valuable perspective as a medical doctor who understands the challenges facing America’s health system today.

Congressman Phil Roe represents the First Congressional District of Tennessee. A native of Tennessee, Phil was born on July 21, 1945 in Clarksville. He earned a degree in Biology with a minor in Chemistry from Austin Peay State University in 1967 and went on and to earn his Medical Degree from the University of Tennessee in 1970. Upon graduation, he served two years in the United States Army Medical Corps. Congressman Roe serves on two Committees, Education and the Workforce, and Veterans’ Affairs, that allow him to address and influence the many issues that are important to the First District students, teachers, veterans and workers.

Click here to watch this presentation on YouTube >>> Congressman Phil Roe: An Obamacare Alternative

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Contrary to Popular Belief Breast Cancer Rates Unaffected by Family History

By Kristina Fiore, Staff Writer, MedPage Today

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.

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CHICAGO — Women ages 40 to 49 with no family history of breast cancer have similar rates of invasive disease as those with familial risk, radiologists reported here, firing yet another salvo at government mammography guidelines.

Among a group of more than 1,000 breast cancer patients, 64% of those with no family history of breast cancer had invasive disease, as did 63.2% of those with family history, a non-significant difference, according to Stamatia Destounis, MD, of Elizabeth Wende Breast Care in Rochester, N.Y., and colleagues.

“We were intrigued and surprised by the data,” Destounis said during a press briefing at the Radiological Society of North America meeting, noting that general wisdom suggests women with a family history are at greater risk of developing the disease than other women.

“Since there’s no difference in the rate of invasive breast cancer for women in their 40s whether they have a history of breast cancer or not, the recommendation should be that women in their 40s have screening mammography yearly,” Destounis said.
In 2009, the U.S. Preventive Services Task Force recommended against routine screening for women ages 40 to 49, leaving patients and clinicians to make individual decisions based on their risk. Mammograms should start at age 50, the committee said, and be performed every two years.
Yet the American Cancer Society (ACS), the American College of Obstetricians and Gynecologists, and other groups have called for continued screening in this age group, which Destounis said has led to confusion among patients and their doctors.
Still, the debate has shown few signs of letting up, as studies have continued to flood in — some showing that screening women 40 to 49 offers a robust mortality benefit while others have found only a trivial benefit.
Destounis and colleagues reviewed data on all breast cancer patients seen at their clinic between 2000 and 2010, with a total of 1,071 patients ages 40 to 49 treated for 1,116 cancers.
A total of 373 of those had been diagnosed via screening at their clinic; 61% of those patients had no family history of the disease, while 39% did. There were no significant differences in terms of the percentage of patients in either group who had a personal history of the disease.
The investigators also found that similar percentages of patients with and without familial risk had disease that metastasized to the lymph nodes (29.4% of those without versus 31.3% of those with).
“We agree with the ACS, which recommends screening for every woman in her 40s,” Destounis said.
Gary Whitman, MD, of MD Anderson Cancer Center in Houston, who was not involved in the study, told MedPage Today there are “very few mammographers who feel differently about the need to screen all women at 40 years of age.”
Edith Perez, MD, of the Mayo Clinic in Jacksonville, Fla., who also was not involved in the study, noted that it may show that family history isn’t necessarily useful for deciding whether a younger woman may be at greater risk of breast cancer, though this hypothesis would need further testing.

Stop paying for medical tests that don’t improve healthcare


nist.gov image
nist.gov image

by Rosemary Gibson

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The October 19 Health Affairs briefing entitled “Saving Medicare Dollars and Improving Care,” sponsored by the ABIM Foundation and other funders, was a watershed moment in which ideas that would require less spending on health care that would actually improve care for patients were discussed on K Street. This is a great message for patients and, it so happens, for the super committee deliberations a few miles away.

Dr. Nancy Morioka-Douglas, Clinical Professor of Medicine/Family and Community Medicine at the Stanford University School of Medicine highlighted seven often unnecessary things done in primary care, such as EKGs in patients without symptoms, that were identified by the Good Stewardship groupconvened by the National Physicians Alliance.

Later, Dr. Steve Weinberger, Executive Vice President and CEO of the American College of Physicians identified sensible principles to guide the integration of a “less is more” theme in public policy, such as:

  • Avoid interventions that don’t help and may harm
  • Give incentives to physicians and patients to avoid low value care
  • Use payment approaches that are politically feasible, medically appropriate and minimally burdensome
  • Recognize that there will always be exceptions.

The discussion addressed the tip of the iceberg. The next step is to move to the big-ticket items where the literature is quite clear that patients are harmed by back surgeries for which there is no evidence of efficacy, cardiac bypass surgeries that are unwarranted, and duplicative and unnecessary diagnostic imaging that exposes patients to cancer-causing radiation, among many other tests and procedures performed that may cause more harm than good.

We can’t put all of the health care reform burden on patients, even with shared decision-making. Physician leadership is essential. That’s why this meeting will hopefully be the first of many conversations on K Street and on Capitol Hill.

In the end, this is all about good care of the patient. That’s the primary motivation. It’s also true that as a society, we don’t have money to waste. As I wrote in The Treatment Trap, the best way to preserve Medicare is to pay for things that improve health and well-being, and to stop paying for things that don’t. If we don’t get it right, and get it right soon, even the good things will be cut. Let’s act on the wisdom we have that knows the difference.

Rosemary Gibson led national quality and safety initiatives at the Robert Wood Johnson Foundation.  She is author of The Treatment Trap and Wall of Silence: The Untold Story of the Medical Mistakes that Kill and Injure Millions of Americans. This article originally appeared on The Medical Professionalism Blog.

Practical Medicine and Healthcare Information

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I have been a community and hospital pharmacist for over thirty years … trained in clinical pharmacy at one of the largest healthcare centers in the South. I am a consultant pharmacist for Medication Therapy Management (MTM) for the State of North Carolina.

I search the Internet and other sources for information that I think you should be aware of; that should be interesting and important for you to know. When I see something that meets these criteria, I will let you know about it in my next article.

If you don’t see some information that you need and it is within my areas of education and expertise, I will try to post an article or an answer as soon as possible! You can put your request in the “Contact Us” area located above the upper left column on this page.

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Bob Diamond R.Ph Pharmacist