Al-Ain University of Science and Technology

College of Pharmacy
Orientation to Pharmacy

Lecture Notes
By Dr. Khairi M. Salem 2nd semester 2012-2013

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COURSE DESCRIPTION

This course covers orientation to pharmacy, history of pharmacy, pharmacy profession on local and world-wide, career opportunities for pharmacists, education in pharmacy, college curriculum, with special emphasis on the differences between patient-oriented, and drug oriented education, local and international organizations, information resources in pharmacy, drug literature .It offers an introduction to various drug delivery systems concerning their definition, route of administration, advantages, disadvantages of and an overview on the prescription.
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COURSE OBJECTIVES
1. Orient students to pharmacy as a future career, using examples for comparing the advantages of pharmacy as a profession as compared with other professionals and the essential characters of the different opportunities for pharmacist. Overview the history and development of pharmacy from medicinal herbs to biotechnology using presentations, projects, researches and appropriate illustrations Be familiar with old civilizations in pharmacy with an overview on contemporary pharmacy especially the leadership of USA in clinical pharmacy. Gain the knowledge to illustrate the progress in pharmacy education and its implication on pharmacy profession with special emphasis on patientoriented to pharmacy education using sources on the internet. Interpret, classify and evaluate different pharmaceutical dosage forms with special emphasis on simple drug delivery systems as solutions, syrups, pastilles, pastes and ointments using models of the products and internal inserts. Use available documentations and references to understand the pharmacy ethics and to enumerate the local and international pharmaceutical organizations with a summary of their roles
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2.

3.
4.

5.

COURSE OUTCOMES
1. 2. 3. 4. 5. 6. 7. 8.
4

Discuss the present situation and future of pharmacy as a career. Compare between the different career opportunities for a pharmacist concerning activities, advantages and disadvantages. Evaluate the role of Islam. Ancient Egyptians, Indians, Chinese and Babelions, Greek and Romans on pharmacy profession development. Compare drug-oriented with patient-oriented pharmacy education.. Enumerate the routes of administration of most important medications. Discuss the types, advantages and disadvantages of different dosage forms Define patient compliance with the prescribed medication Discuss the importance of ethics in pharmacy practice
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LEARNING AND INFORMATION RESOURCES

1. Textbook Title:

Pharmacy : An Introduction to the Profession Author: Michael Posey ISBN: 9781582121277 Edition: 2nd Publisher: American Pharmacists Association Year Published: 2009
2. Shargel L. et al (2005). Comprehensive pharmacy Review. Lippincott Williams Philadelphia. USA B. References: 1. Lieberman A. et al (2004). Pharmaceutical Dosage Forms. Marcel Decker. U.S.A. Ansel ,An Introduction to pharmaceutical Dosage Forms 4th Ed. Lea and Febiger Philadelphia. USA

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C.

Internet References

Students are encouraged to visit web sites as a means of learning more about the profession: www.moh.gov.ae/en/ (Ministry of Health-UAE) www.haad.ae/haad/ (Health Authorities Abu Dhabi) www.pharmacist.com (American Pharmacists Association) www.ashp.org (American Society of Health-System Pharmacists) www.aacp.org (American Association of Colleges of Pharmacy) www.amcp.org (Academy of Managed Care Pharmacy) www.ascp.com (American Society of Consultant Pharmacists) www.ncpanet.org (National Community Pharmacists Association) www.npha.net (National Pharmaceutical Association) www.talkaboutrx.org (National Council on Patient Information and Education) www.nacds.org (National Association of Chain Drug Stores) www.phrma.org (Pharmaceutical Research and Manufacturers of America) www.nabp.net (National Association of Boards of Pharmacy) www.fda.gov (Food and Drug Administration) www.pharmacy.ohio-state.edu (OSUs College of Pharmacy)

Instructor Phone Exten. Mobile Course Title Course Code Course type Course Time

Dr. Khairi M. Salem 301 4492416 Orientation to Pharmacy PHRM 131 Compulsory
Lecture : 10-11 Sun Lab.1. MALE: 11-13 Sun. Lab.51. FEMALE: 8.0-10 Wed.

.
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Introduction to pharmacy profession

(Chapters 1,2and 3) Textbook. Pharmacy : An Introduction to the Profession Chapters 1
Definition of relevant pharmacy terms The future of Pharmacy as medical profession Outcomes:
By the end of this chapter the student will be able to: 1. Demonstrate the different terms related to the profession

2.

Discuss the present situation and future of pharmacy as a career

Definition of relevant pharmacy terms

Pharmacy is the is a health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of drugs and pharmaceuticals The word derives from the Greek word: (pharmakon), meaning "drug" or "medicine The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to Health Care, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacist, therefore, are the experts on drug therapy and are the primary health professionals who optimize medication use to provide patients with positive health outcomes

Medication Therapy management: For centauries, the pharmacists have been paid when they provide medicinal agent to patient When the responsibilities of medicine and pharmacy were separated, the pharmacist concentrated on the art of preparing their medicines prescribed by the physicians( a few centuries ago) The new automated and advanced pharmaceutical industries Limited the pharmacist to practice the profession in this field ( 19th -20th century) start of MTM (2003) Health Care: Effect of aging and the pharmacist role Pharmacist and drug preparations

Chapter 2 Development of Pharmacy in History as Healing profession Outcomes: Illustrate the history of pharmacy from its origins in ancient times through the middle of twentieth century 1. Pharmacy differentiates during the Middle ages:
The separation between pharmacy and medicine in Islamic land. The first pharmacy shop: in eight century in Bagdad
German Frederick II issued an act in1240 that separates the pharmacy profession

2. The European Renaissance : Emerging the association of pharmacists 3. Pharmacy in USA: in the old days and in nineteenth century
1820. USA Pharmacopeia , 1821 the Philadelphia college of pharmacy, new York college of pharmacy 1829. 4. Twentieth
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century pharmacy: improvement of pharmaceutical industry

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Thinking of other practices of pharmacy as patient oriented practices

History of Pharmacy

1. Ancient Egyptian Period:

The ancient Egyptians 3000 B.C . Were expert in using drugs for disease curing. Son was a priest doctor and pharmacist, who prescribe and prepare medicines. The ancient Egyptians used to prepare their medicines and drugs either from biological sources either from animal origin or plant origin. 2. The Mesopotamian Formula: The Babylonian medicine was known through interpretation of a written table known as (Laws of Hamorabi in 772 B.C . The formula contain 250 materials of plant and 180 of animal source which usually mixed with honey or water before administration.: 3. Old Indian Medicine : The aim of the old Indian drugs is to prolong the human life, in 2000 B.C . The drugs obtained from plant materials by pure religious person. The fresh plants were considered to be more effective, after its collection from fertile soil washed with pure water and exposed to sun

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4. Old

Chinless Medicines: Famous in the acupuncture and the Chinese herbal medicine before 1000 B.C. The Chinese thought that for every disease, there must be a drug curing it, and the drug is only provided by nature. Many drugs of plant and animal origin were used and prepared in form of suppositories and ointments or as dry powders

5. The Greek and Romans: Well Known Hippocrates (466 B.C) was familiar with numerous drugs and wrote Corpus Hippocraticum . Alexander the great helped to increase the number of the drugs used at that time. Dioscorides was first to describe the drugs and his work Greek Herbal of Dioscorides included about 5000 medical plats + animal and mineral drugs.
6. Islamic contribution : The Islamic civilization added many scientific terms as Kemia alcohol . Famous Islamic scientist as Abu al Hassan Ibn-Sina (980-1037 A.D). His Book (canon of Medicine) was known as the best written medical test. Ibn Al- Bitar born in Spain in 1197 A.D, he was the best pharmacognosit from fertile soil washed with pure water and exposed to sun, his book Jameulmuffradat contains description of 2000 drugs. Dawood El- Antaki and his book Tazkert Uli Ai- Albab Al- Buiruni and his book pharmacy and medical material
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Chapter 3 Pharmaceutical Care and Medication Therapy Management Outcomes: Discuss the pharmacy profession and the new application of Pharmaceutical care and medication therapy Management 1. Pharmacy (occupation vs profession):
2. Pharmaceutical Care as reprofessionlization : Drug information, Decentralized drug
distribution, pharmacology and Biopharmaceutics

3. The Millis report: Pharmacists for future(1975 AACP)

Development of clinical pharmacy, NAPLEX exam, enhancing the clinical studies in the pharmacy colleges, board of pharmaceutical specialties within APHA 4. Pharm.D

program.

1989 accreditation by ACPE, 2000 eliminating B.Sc. in pharmacy replaced by Pharm.D

5. Pharmaceutical care in community pharmacies

Till 1990 Pharm. care provided in hospital only, in 2003 US congress approved the MTM for high- risk people elderly and disabled people
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Pharmacy: A branch of Science, technology and art dealing with the following aspects: 1. The Discovery of New Medicaments A. Natural Source B. Animal Source C. Microbial Fermentation D. Mineral and trace elements E. Chemical synthesis or semi synthesis 2. Production of Pharmaceutical Dosage Forms 3. Quality control of Pharmaceutical Dosage Forms 4. Distribution of the formulated Dosage Forms 5. Dispensing of drugs 6. Marketing and promotion
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The Pharmacist and the Pharmacy Careers

Pharmacist must conceive knowleges that improve health services, through the Pharmaceutical Care (PC) which is a necessary element for the Total Health Care (THC) Physicians carry out Medical Care (MC) Pharmacist carry out Pharmaceutical Care (PC) Pharmaceutical Care (PC) : Can be defined as Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patients quality of life Medicaments: Agent used in the prevention, control and treatment of a disease (PCT)

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Pharmacist: A highly qualified person whose profession is pharmacy (practicing Pharmacy ) and may be : 1. Community Pharmacist 2. Hospital Pharmacist 3. Clinical Pharmacist 4. Manufacturing Pharmacist 5. Quality control Pharmacist 6. Research & Development Pharmacist 7. Governmental Pharmacist 8. Marketing Pharmacist 9. Academic Pharmacist
Pharmacist Careers : Community Pharmacist:
Dispensing of Prescriptions ( To Give Drugs According to Prescription ).

The Role Of Community Pharmacist include: 1. Review prescriptions for the following reasons:
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A. B. C. D. E. F. G.

Possible Unaccepted indications Possible dug drug interactions ( Tetracycline with Calcium) Possible dug food interactions ( Tetracycline with Meat) Possible dug smoking interactions Possible contraindications ( Voltaren with Peptic Ulcer) Possible tetratogenic drugs (Danger for fetes) Amino glycosides Possible danger for babes during breast feeding ( Hormones in oral contraceptive) H. Possibility of dose errors ( high or Low dose) 2. Suggest Alternatives on scientific background a. Standard Product is the most effective product as Lanoxin for digoxin, Augmentin for Amox-clav , etc b. If the standard product is not available, the pharmacist must select an alternative which must be bioequivalent Bioequivalent = dosage forms that give similar concentration in blood to the standard product
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3. Improve adherence or compliance :

The proper use of medications according to the regulations given by the prescribed ( nonadherence = 22 88%) Examples as: Changing the dose by increase or decrease Change frequency ( every 6 Hours to every 8 hours) Earlier stop of drugs (use antibiotic for 1-3 days instead of 5-7 days) 4. Purchasing drug Product: ( Effectiveness, Price, needs of patients. 5. Proper storage of drugs ( sera, vaccines and suppositories) 6. Preparation of certain formula( exp. Na bicarbonate - Glycerol )
Advantages: Fresh, decrease Load on manufactures and Utilize pharmacist knowledge

7. Patient Consultant for:

A. B. C. D. E. A. B. Selection over the counter (OTC) as anti-acids and anti-cough drugs for diarrhea, constipation etc Adherence : ensure the using of drug in proper way by the Patient Patient education Good storage condition Refill ( repeat the prescription for diabetes, hypertension etc) Preventive Therapy Non-Pharmacological Therapy

8. Pharmaceutical care 9. Patient Monitoring 10. Arrangement of drug Product According to:
a. b. c. 19 Manufacturing company Pharmacological groups Alphabetical 25 December 2012

11. Computerization

Hospital Pharmacist (HP):

This is the pharmacist working in hospital, including army, police , company etc, Hp activities include the following : A. Administration as chief pharmacist B. Dispensing pharmacist C. Unite Dose preparation D. Purchasing & Storage of Drugs E. Pharmaceutical Care activities F. Manufacturing of certain Pharmaceutical Product G. Included in pharmacy and therapeutic committee. Unit Dose System: The dispensing of each dose (doses) in a special box for in-patient ( Patient well receive at proper time a box containing one tablet , one capsule etc) Pharmaceutical Care : new concept in pharmacist activity which means the participation of the pharmacist in clinical activity by direct or indirect way. Drug information center: a unit containing all facilities (software, CD, internet to answer any
questions about drugs as drug-drug interactions, side effects, contraindicationsetc Patient Education: to give patient full idea about disease, importance of medication and proper use & storage of drug Patient monitoring :For insuring adequate response & avoid adverse reactions

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Industrial Pharmacist :
This is the pharmacist working in pharmaceutical industry, whose activities include the following: 1. Storage of raw material s and finished products 2. Production of pharmaceutical dosage forms 3. Quality control of pharmaceutical dosage forms 4. Research and development of pharmaceutical dosage forms 5. Quality assurance 6. Synthesis of raw material 7. Extraction of natural source ( plant, animal) 8. Biotechnology and genetic engineering industry 9. Manufacturing and quality control of cosmetics

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Marketing and Promotion of drug products :

In Arab world, Pharmacist is involved in this activity Bylaw, it is not allowed for any one except the pharmacist to work in promotion in UAE, Oman and Saudi Arabia, The promotion activity include: 1) Regular visits to Physician and pharmacist to give presentation on the advantage s of a product 2) Marketing studies 3) Design of promotional aids 4) Participation in conferences

Governmental Activities
As pharmacist in Pharmacy departments in Ministry of Health or general authority for health services which has the following responsibilities: 1. Registration of new drug product and re- Registration of present drug product 2. Licensure to new graduate pharmacist & to non-national pharmacist 3. Licensure to pharmacies & pharmaceutical companies 4. Establish and minter the Drug policies

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Other activities:
1. 2. 3. 4. 5. 6. As researcher in research centers I.e. Sheik Zayed center for medical herbs. Universities Medical Laboratories ( Biochemical and Microbiological) Medicinal Herbs Cosmetic industry Distribution of drug products to pharmacy.

Pharmacist and Public Health:

Prevention of Disease 1. Factors like : smoking , improper diet, less exercise, alcohol, obesity 2. Infectious disease like AIDS 3. Vaccines and sera 4. Nosocomial infections

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Chapter 4 Communication skills in Pharmacy Practice Outcomes: Understand the techniques used to build the relationships and improve health care.
1. Developing the relationship:

2. Listening and effective response: Give complete attention listen , empathic

response , trust

3. Supportive communication: Adherence

4. Patient

counseling: 5. Interacting with physicians 6. Word choice and nonverbal cues

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Chapter 5, Ethics in Pharmacy

A group of behavior or character supposed to ensure the compliance with society principles, which cover Decision making , Competence and caring, Heath professional relationship, Moral rights, Legal rights and Patient rights Code of Ethics: a set of standards , rules , guidelines and values that govern the profession of pharmacy. A pharmacist respect the covenantal relationship between the patient and pharmacist. A pharmacist promotes the good of every patient in caring and confidential. A pharmacist respects the autonomy and dignity of each patient. A pharmacist acts with honesty and integrity in professional relationships. A pharmacist maintains professional competence. A pharmacist serves individual community and social needs 25 25 December A pharmacist seeks justice in distribution of health recourses. 2012

Pharmaceutical Dosage Forms :

Def.: These are product contain one or more active ingredient (drug). And also called Drug delivery system. These dosage forms contains one drug (s) formulated with certain inactive additives (excipients) . Types of Dosage Forms: 1. According to physical state: A. Solid as Granules , Capsules and Tablets B. Liquids as Solutions, Syrup, lotions, drops C. Gas: Aerosols 2. According to the route of administration: A. Oral: oral powder, tablet, capsules, Syrups and oral drops B. Topical: Ointment, creams, lotions C. Rectal : Enemas, Suppositories D. Parenteral: Intravenous (I.V), Intramuscular (I.M),
E.

F. G.
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Interaperitoneal (IP) and Subcutaneous (S.C) Ophthalmic preparations: Drops, Ointments and Creams, Nasal : drops
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Why drug delivery System :

1. To control the Dosing A. Unit Dose Product : Tablet, Capsule, Suppositories and ampoules B. Multiple dose product: syrup C. Unit dose product control dosing much butter 2. To modify the dissolution in GIT 3. To modify taste and order of drugs 4. To improve stability of unstable drugs

The requirements drug delivery System: The Why drug delivery System must be: 1. Convenient for patient: easily swallowed, no bitter taste, good odor, not irritant to stomach 2. It must be stable: light, humidity and temperature 3. It must be therapeutically effective 4. It could be identified 5. It must afford several doses, economic and elegant package
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Assessment of the quality of the product

1. 2. 3. 4. 5. 6. Stability of the product: Solid < semisolid <liquids Dissolution and Absorption: I.V. Solutions <oral liquids <suspension <capsules < tablets. Manufacturing: Tablet < Parenteral Ease of use: Tablet < Parenteral Proper dosing : Tablet < syrup Homogeneity: Liquid Dosage Forms < Tablet.

Liquid Dosage Forms:

Formulation: important role of industrial pharmacist, which carried out in R&D , it means the selection of the additives used to change the active ingredient to the required dosage form. 1. For liquid dosage form there is a need for a solvent to dissolve or suspend the active ingredient. 2. A flavoring agent is used to cover unpleasant odor 3. A sweating agent is used to cover unpleasant taste 4. A coloring agent is used to give attractive color 5. A preservative to avoid microbial growth, 6. A stabilizer to ensure and enhance stability
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Advantages: 1. Homogenous in content i.e. no different in dosing. 2. Easy for administration i.e. for children and in sore throat 3. No need for disintegration as tablet or dissolution as tablet and capsule 4. Less irritant for stomach. Disadvantages: 1. Taste and odor problem. 2. Less stable. Needs preservative to avoid microbial growth. 3. Less stable due to the water presence, needs antioxidant and colored container to avoid direct effect of sunlight. 4. Heavy bottles difficult to carry and storage. 5. Parenteral or eye drops require sterility 6. Improper dosing , since they are multi dose form
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Solvents:

Water Advantages: 1. Cheep. 2. Wide rang of solubility 3. Inert: no chemical or pharmacological action 4. Colorless, odorless, tasteless and neutral Disadvantages: 1. A medium for degradation process. 2. Dissolve sugars and proteins ( cause bacterial growth & fermentation) 3. May contain minerals or bacteria Types of water: 1. Tap water: A. It contain minerals and microbes B. Boiled then cold water may show microbial growth C. Not permitted to use in Liquid dosage forms
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2. Purified Water: A. Water free from total solids >10 ppm B. Prepared by distillation or ion exchange resins
C. Ion Exchange Resins are used to remove minerals dissolved in water.

Steps involved in water purification using IER: 1. Cation Exchange Resins (AH+) remove cations ( Na+, K+, Ca++, Mg++, Fe++ ..etc AH+ + Na+ ClA Na+ + HCl 2. Anion Exchange Resins (BOH-)remove anions (as Cl-, SO4 and NO3) BOH- + H+ ClB Cl- + H2O 3. Loaded anions (B Cl-)are recharged by alkaline B Cl- + Na+ OHB OH + NaCl 4. Resins are washed by water to remove NaCl 5. Resins are disinfected by formalin from time to time. 6. Not used for sterile products.
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3. Water for injection: A. Free from Bacteria. B. Free from Pyrogen C. Free from minerals, total solids >10 ppm.
D. E. Used for sterile products Sterile water may be found up into 1 liter container.

4. Bacteriostatic Water for injection: A. All the property listed under water for injection. B. Contains a bacteriostatic agent at specific concentration. C. Used for vials or multiple dose products.
D. Volumes must not exceed 30 ml.

Ethyl Alcohol: A. Free from Bacteria. B. Free from Pyrogen C. Free from minerals, total solids >10 ppm.
D. 1. 2. 3. Used for sterile products More specific for dissolving certain materials ( not dissolve sugars, gums and proteins. Kills Microbes Used to extract Alkaloids and glycosides

Ethyl Alcohol; Advantages :

Disadvantages: Volatile, Affects CNS, Liver, GIT etc ( the solvent not accepted by Islam efforts should be carried out to replaced )
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Glycerol; Advantages : 1. Not volatile. 2. Not toxic1 Disadvantages: 1. Hygroscopic 2. Dissolve gums, albumins and tannins Co-Solvency: 1. Means the use of 2 solvents to enhance the solubility of certain reagent. 2. Examples as : Water/ Glycerol and Ethanol / Water Hydrotrophy: The use of certain solutes ( sodium benzoate or sodium salicylate to dissolve other material as cholesterol. Soulbilization: 1. Vitamin D is insoluble in water, used as aqueous drops for children. 2. It is required in the form of aqueous drops of children 3. To enhance its solubility Soulbilization is required. 4. This involve the using of surfactant SLS, polysorbate 80 to solubilize the 5. A specific concentration is used. 6. Improve both stability and stability and bioavailability of drugs.
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Flavoring Agents: 1. Overcome the problems of the drug taste.. 2. Bitter taste as drotaverine HCl (antitussive) is covered by Cocoa 3. Acid taste is covered by citrus, cinnamon 4. Flavors are either soluble or insoluble in water 5. Some flavors are used to expel gases in flatulence or improve digestions Avoid the crystals building in kidney and as mild antibacterial agents Sweeting Agents: 1. Sucrose: a. Favor the growth of microbes at low concentration. b. Sucrose is soluble in water 2:1 c. The concentration of its solution in water is 66% d. At 66% it prevent s the growth of micro-organisms e. Contraindicated in diabetes and obesity 2. Saccharin: a. It is synthetic , 500 sweeter than sucrose, used for diabetes, not carcinogenic in proper dose 3. Aspartame a. It is 120-280 sweeter than sucrose. b. Consists of two amino acid molecules. 35 25 December 2012 c. It decomposes in presence of water ( provided in tablet ( solid form)

Coloring Agents: To select a coloring agent: 1. Only use colors approved by FDA 2. Colors are used for psychological factors as antidepressants, confidence as syrup or for identification as tablets and capsule 3. Natural colors (caramel) are better than synthetic ones (tartrazines). Tartrazines is not used due to allergy 4. Insure stability of the color Preservative: Agents used to prevent the growth of microbes found in or added to the container during the use of medicine. The preservative should have the following requirements: Safe, Soluble and Stable Compatible with all ingredients. Dont interact with container or cover Examples of Preservatives: Benzoic Acid 0.1-0.2% , Sodium benzoate 0.1-0.2% , Methyl Paraben & Propyl Paraben 0.1-0.2% Phenyl mercuric nitrate 0.002-0.01%
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Stabilizers: Agents used to enhance stability: 1. Degradation occurs due to: a. Oxidation( in presence of water, O2 or Air) b. Hydrolysis ( in presence of water at specific pH) 2. Factors favoring degradation (light (sun), Heat (hot weather) catalyst) 3. Factors used to control Hydrolysis: a. Use of dry powder followed by reconstitution just before use. b. Use solvents such as glycerin and propylene glycol. c. Formulate at pH at which least degradation takes place. d. Store at low temp. not more than 25 oC . 4. Factors used to control Oxidation: a. Use dry powder b. Avoid direct exposure to Air. c. Use antioxidant and chelating agent d. Adjust pH. e. Protect from light (amber glass) Aromatic Water: 1. A saturated aqueous solution of volatile oil as peppermint or volatile substance as menthol. 2. Preparation:
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2. Preparation: a. Distillation: Plant source (flowers) is mixed with water followed by steam distillation. b. Solution: agitation of volatile substance with water for Hr. followed by filtration. c. Dispersing agent: As solution, but in presence for a dispersing agent (talc) to decrease mixing time. d. Solublization: To use solubilizing agent for quick and complete dissolution. e. Dilution: to mix concentrated water or spirit with water. 3. Examples are : rose water, caraway water and cinnamon water 4. Used as flavoring agent, addition of a salt as NaCl or KCl may lead to salting out, i.e. separation of volatile oil. Solution: May be internal as syrups , drops and suspensions or external as lotions Spirits: Alcoholic or hydro-alcoholic solutions of volatile substances that contain 50-90 % alcohol. By using high % of alcohol-insoluble material in solution. Tincture: Alcoholic or hydro-alcoholic solution of vegetable substances that contain around 20% alcohol. Syrups: oral liquid dosage form contain sugar as Sweeting agents. Formulation: a. Drug or drugs. b. Solvent (water). c. Preservative: To prevent growth of microbes and as antioxidant d. Flavoring agent ; to cover unsuitable taste as: peppermint, banana, lemon etc e. Sweeting agent to improve the taste of solution as sugar, saccharin.
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f. Coloring agent: of volatile substance with water for Hr. followed by filtration. g. Sesiqutering agent: as ethylene diamine tetra a acetic acid (EDTA) h. Solubilizing agent: as surfactants used to solubilize drugs. . Suspension: LDF consist of finely divided drug (s), which are insoluble in
solvent (water) Advantages:

To cover the bitter taste and avoid degradation Sustaining the release of active ingredients Improving the stability of the formulation

Precautions:

Patient must shake the bottle before use Parenteral suspension are not allowed to be injected I.V (avoiding Thrombophlebitis = inflammation of a vein) Topical suspension are called Lotions e.g. Calamine lotions Formulation: The suspension should contain a suspending agent (hydrocolloids) which
39 has the following properties : Help the suspension of the particles, to avoid quick precipitation Increase water viscosity Support growth of microorganism 25 December 2012

Cont.. Suspending agent (hydrocolloids) properties : Mostly anionic except methyl cellulose which is neutral The anionic suspending agent are incompatible with cationic drugs and agent. Support growth of microorganism Examples as: Acacia 35% dispersed in water, Tragacanth 6%, methyl cellulose and sodium carboxymethyl cellulose (CMC). Clays : other example of suspending agent which, Form gel like structure Anionic in nature Examples as: bentonite and veegum which are silicates that are anionic in aqueous dispersion. Emulsion: LDF consist of two phase system in which one phase is oil (internal) is dispersed in a second phase (external phase) as water using emulsifying agent as gum or acacia called W/O or O/W emulsions Purpose of emulsion: Increase drug solubility Increase drug stability Prolonged drug action ; increase bioavailability as with I.M injection Improve the taste. Improve appearances for topical preparations.
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Emulsifying agent : are used to lower the surface tension between oil and water, examples as; Natural : acacia, gelatin and methyl cellulose . Synthetic agents : anionic as soaps and cationic as benzalkonium chloride or nonionic as polysorbate 80. Oral Drops : These include: vitamin C, Vitamin D, Multivitamin, cardiovascular and antihistaminic drops They must supply with droppers to calculate the dose. Support growth of microorganism Similar to syrups in formulation and production. Accurate dose should be carefully measured. And the container should be closed after measuring the dose.
Oral Mixture: LDF consist of combination of more than one drug, dissolved in water or aromatic. These oral solutions used for many medical purposes as: hypnotic ( phenobarbitone sodium), Decongestant (phenylephrine) and antihistaminic as (chorpheiramine maleate)
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External Solution:
Mouth washes; These are solutions used for cleaning and disinfecting of the mouth and oral cavity. Contain solvent as glycerin to dissolve active ingredients and prolog its action in mouth Examples of disinfectant detergent agents are hexitidine , cetyl pyridium chloride etc Flavor is a must for mal-odor of mouth or halitosis. Examples of flavor are clove, menthol, thyme oil. Douches : Aqueous solutions directed into cavity or part of the body for cleanings and antiseptic effects on eye, nose, pharynx, urethra or vagina . Powder or tablet douches are mixed with warm water before use. Gargles : Aqueous solution intended to come in contact with throat for the longest time for antiseptic and cleaning actions. Povidine-iodine, potassium chlorate, and potassium permanganate are used for treatment of bacterial phyaygities or tonalities Must mixed with warm water before use. Must not swallowed. Frequent use 4-6 times daily Nasal Drops: external aqueous solution applied inn the nasal cavity as decongestant (phenylephrine) in common cold cases, stop hemorrhage ( Adrenaline) 25 December 2012 42 Dropper is required for dosing

Solid Dosage Forms:

Powders: Limited number of pharmaceutical powders e.g. talc or other cosmetic powders, the particle size of the powder should be suitable for the intended use. Granules : Effervescent granules contain drug (s) with sodium bicarbonate, citric acid, tartaric acid and sugar. When granules are mixed with water CO2 is evolved and covers the bitter taste. Capsules: A solid dosage form which can be classified into: 1. Hard gelatin Capsule: in which a solid powder or granules of drug are enclosed in a gelatin shell. Preparation of Hard gelatin Capsule: Include Preparing the formulation , selecting the appropriate capsule, filling the capsule shells, and cleaning and polishing of the filled capsule. Empty hard capsule shells are made from a mixture of gelatin, colorants and opacifying agent as titanium dioxide. Sizes of capsules are available in verity of sizes ranged from 000 to 5 (600 to 30 mg.).
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2. Soft gelatin Capsule: (soft gels) in which semisolid or oily liquids are closed inside completely sealed gelatin shell. Properties of Capsules : elegant shape, easily swallowed, mask the bad taste and odor ensure stability and rapid absorption. Soft gels are more efficient in these characters. Pastilles: These are not swallowed but kept in mouth until dissolved slowly to produce their action in buccal cavity. Their taste and odour must be acceptable. They contain agents allowing for slow dissolution e.g. gelatin. They are used for antiseptic, aesthetic or anti-inflammatory effects. Tablet: very common and most popular dosage form examples are: compressed, Multiple compressed, Repeat action, Delayed action or Sustained release, Flash, Coated, sublingual, buccal and Effervescent
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Advantages:
Produced easily (Complete automation to produce millions of tablets /day) Very stable( No water , coated) . Mask the unpleasant taste (film coated) Avoid irritant action in stomach (enteric coated tablet) dissolve in duodenum not in stomach. Control release (sustained release tablet) Unit Dosing and convenient for storage and transport. It has various shapes ( round, oval, caplet .. etc.)

Disadvantages:
Possible variability in dissolution. Possible degradation

Characteristic of an ideal Tablet:

Free from defects and contain the labelled dose. Stands mechanical stress during transport. Stable and achieves the required absorption.
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Formulation: Active ingredient (s) Diluents: filling agent used to make the required size as lactose. Binder: used to promote granulations and compact of granules as CMC. Distentegrant: agent used to facilitate disintegration as starch. Lubricant: reduce the tablet and the die of tablet machine as magnesium stearate. Glidant: Promote the flow of the granules. Other agents as coloring, flavoring, dissolution control coating agents. Semi- Sold Dosage Forms: 1. Ointments: Semisolid preparations intended for external use, applied as: Emollient to render skin soft Protection from sun, and chemicals. Treatment of skin diseases. Vehicle for medications
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Formulation: Active ingredient (s) Ointment base as: 1. Oleaginous base (anhydrous and insoluble in water base). 2. Absorption base (can absorb water) . 3. Emulsion base as w/o or o/w emulsions and 4. water soluble base are anhydrous and water soluble base. Advantages: Direct targeting of medications. Ease of administration. Various functions. 2. Suppositories: Solid or Semi- Sold Dosage Form intended to be inserted in Rectum, rectal Supp. A bullet like shape for adults 2g. For children smaller size. Vagina are oval shape weigh around 5 gm. and Urethra : Typically long , around 60 mm. Long and 4-5 mm in diameter. Formulation: Active ingredient (s) + Suppository base as cocoa butter (theobroma oil, M. range 33-35oC) or other combinations of fat and waxes bases. Advantages: Needed for Quick evacuation of stool. Direct targeting of drugs as in Haemorrhoids disease. More suitable for children and used for patient cannot swallow. Various functions and have different shapes and sizes.
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Pharmacy Education Over the past four decades there has been a trend for pharmacy practice to move away from its original focus on medicine supply towards a more inclusive focus on patient care. The role of the pharmacist has evolved from that of a compounded and supplier of pharmaceutical products towards that of a provider of services and information and ultimately that of a provider of patient care. Increasingly, the pharmacists task is to ensure that a patients drug therapy is appropriately indicated, the most effective available, the safest possible, and convenient for the patient. By taking direct responsibility for individual patients medicine-related needs, pharmacists can make a unique contribution to the outcome of drug therapy and to their patients quality of life. The new approach has been given the name pharmaceutical care. The most generally accepted definition of this new approach is:" Pharmaceutical care is the responsible provision of drug therapy for the purpose of

achieving definite outcomes that improve a patients quality of life.

A growing number of pharmacy education programs prepare students for nationally certified pharmacy certificates. These health care certificates authorize pharmacists to directly oversee patients' drug therapy in place of or in addition to a primary care physician.
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A change in pharmacy education and a new learning approach

Pharmacists stand at the interface between research and development, manufacturer, prescriber, patient and the medicine itself. WHO has called for greater involvement of pharmacists in the general health care system and wider use of their broad academic background.

In its statement of policy, FIP says that the changes in the pharmacists role must be reflected in the basic and continuing education of pharmacists,40 with a greater focus on student learning. The new paradigm for pharmacy requires that pharmacists are far more than experts in pharmaceutical chemistry and pharmaceutics. They have to understand and apply the principles behind all the activities necessary to manage drug therapy. In 1999, the European Association of Faculties of Pharmacy (EAFP) proposed a shift during the pharmacy study program from laboratory-based sciences to practice and clinical sciences The movement towards the patient care approach has occurred to varying degrees in some countries such as the UK and the USA. It encompasses care in its widest application, i.e., the opportunity for pharmacists to change and improve patient outcomes as integral, active members of the patient care team.
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Pharmacy education : College of Pharmacy Mission: The College serves UAE and the region by preparing outstanding, highly competent and motivated pharmacists to meet the health care needs of the society, improve delivery of essential pharmacy services, ensure human health through optimization of using effective, safe and economic drug therapy and enhance pharmaceutical industry, especially in areas of continued-education, services and researches. The college serves the students by offering an educational program based on best pharmacy practice, professional practice experience and educational environment aligned with Needs of the society. College Goals: 1. Provide students a highly advanced educational program which offers knowledge in pharmacy practice and pharmaceutical industry. 2. Prepare pharmacists with pharmacy practice and pharmaceutical industry skills that ensure competency and superiority. 3. Prepare pharmacists with professional skills that optimize interaction with health care providers, patients and society. 4. Prepare pharmacists capable of understanding the most advanced technologies.
Graduation Requirements Biomedi cal Sciences 20 Pharmaceuti cal Sciences Clinical Sciences Social, behavi oral & ad 5 Profession al Practice Experience s 23 Total Cr. Hours 158 25 December 2012

General Education 33 50

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Thank You

Khairi M. Salem. B.Pharm. PhD Associate Prof. in pharmaceutical analysis

51 25 December 2012