PHARMACY AND HEALTH
CARE
CHAPTER ONE
Learning Objectives
 Understanding of basic history and development of





the use of medicines.
Understanding the role of natural drugs.
Understanding the role of scientific discovery.
Knowledge of major developments in modern
pharmacy.
Knowledge of basic environments of pharmacy
practice.
Understanding the importance of computers to
pharmacy.
Origins
 In earliest times, medicine was based on magic and
religion.
 Ancient people believed that demons were the cause
of illness.
 They knew nothing about bacteria and viruses and
tended to assume that any medical problem they did
not fully understand must, at least in part, be caused
by demons.
Ancient Egypt
Imhotep
2640 BC
 Imhotep is considered a founder
of ancient Egyptian medicine. He
performed surgeries and used
established methods for
examining, diagnosing, and
treating patients. Like other
healers during this time,
spiritual beliefs were an
important part of his practice.
Ancient
Greece
Hippocrates
460 BC
Hippocrates was a Greek philosopher and
mathematician born in 460 BC on the island of
Cos, Greece. He developed a number of ideas
about the way in which the body worked. These
ideas were extremely important in the switch
from supernatural to natural forms of
medicine. Hippocrates’ arguments were based
upon principles of science. This was a change
in how people viewed health.
He became known as the founder of medicine
and was regarded as the greatest physician of
his time.
 Asclepius was a Greek hero who
The Greek God
of Medicine
Greek Mythology
later became the Greek god of
medicine and healing.
 Asclepius used the knowledge of
surgery, the use of drugs, love
potions and incantations to heal.
 According to mythology, Asculapius
had a number of children including
Hygieia, the goddess of health (from
whose name comes the word
"hygiene") and Panaceia, the
goddess of healing (from whose
name comes the word "panacea" for
a universal remedy).
Natural World
 Besides looking to the supernatural, ancient man
also looked to the natural world for medical answers.
 Early man knew that plants and other natural
materials had the power to treat or relieve illness.
 Sumerians (4000 BC) used about 250 natural
medicines derived from plants, many are still used
today.
Early Chinese
Medicine
Emperor Shen Nung
Around 3000 BC, Emperor Shen Nung is said to
have begun eating plants and other natural
materials to determine which were poisonous
and which were beneficial.
One of the first known practitioners of “trial and
error” drug testing.
Established 365 “herbs” that could be used for
health treatment.
Nature’s Medicine
 Malaria– disease caused by a protozoan parasite.
Symptoms include fever, chills, nausea, flu-like
illness, and, in severe cases, coma, and death.
In the 1820’s the first effective treatment for malaria
came from the bark of a Peruvian tree, which
contains quinine.
 The first anesthetic—Indians of the Andes chewed
coca leaves for their medicinal effects. When chewed,
coca acts as a mild stimulant and suppresses hunger,
thirst, pain, and fatigue. In 1884 it was used as a
local anesthetic by Carl Koller, aViennese surgeon.
Nature’s Medicine
 Nature’s Aspirin—
Hippocrates and Dioscorides both wrote about the
pain relieving ability of the bark of a white willow
tree. In the 1800’s, more than 2,000 years later, the
active ingredient in the willow bark, salicylic acid,
was made by chemists. This lead to the
development of Acetylsalicylic acid (aspirin) and this
medication would eventually became the most
widely used drug in the world.
The 20th Century
 In 1900 the average person lived into their early 50’s
(I would be in my last years ) But by the year 2000
the life expectancy rose to age 77.9 in the United
States and is getting higher. 
 The growth of hospitals, advances in treatment of
disease, and improved medical technology, better
understanding of nutrition and health, and the rapid
increase in the number of effective drugs and
vaccines have all contributed to this change in
improved life experience.
The 20th Century
 A major factor in the increased health and life
expectancy seen in this century was the dramatic
growth in pharmaceutical medicine.
 After the success of using salicylic acid from willow
bark became and increased interest in creating manmade or synthetic medicine.
Living Longer
 In 1929, Alexander Fleming, a doctor and researcher
at St. Mary's Hospital in London, England, published
a paper on a chemical he called "penicillin", which he
had isolated from a mold, Penicillium notatum.
Penicillin, Fleming wrote, had prevented the growth
of a neighboring colony of germs in the same petri
dish.
 Dr. Fleming was never able to purify his samples of
penicillin, but he became the first person to publish
the news of its germ-killing power.
Living Longer
 Howard Florey, Ernst Chain and Norman Heatley
expanded on Fleming's work in 1938, at Oxford
University. They and their staff developed methods
for growing, extracting and purifying enough
penicillin to prove its value as a drug.
 1942, Pfizer Pharmaceutical Company was able to
develop a method for mass production of the drug.
 A period of intense research and discovery in the
field of antibiotics began.
The 20th Century
 With the increasing availability of powerful drugs,
their regulation became more important than ever.
 Patenting new discoveries is an important part of
pharmaceutical development process since it protects
against illegal copying of the discovery.
 Leaders and governments had to regulate the use of
medicinal drugs because of their effect on the
population’s health.
 Standards for distribution and use had to be made.
1906 Pure Food and Drug Act
 First government attempt to establish consumer
protection in the manufacture of food and drugs.
 Required all drugs marketed in the United States
meet minimal standards of strength, purity, and
quality.
 Demanded that drug preparations containing
morphine have a labeled container indicating the
ingredient morphine.
 Established first two references– United States
Phamacopoeia (USP) and National Formulary (NF)
Tragic Event
A need to revise the 1906 Food and Drug Act arose in 1937
with a tragic incident involving the drug Sulfanilamide.
Sulfanilamide was a drug commonly used to treat
streptococcal infections. It was produced in tablet and powder
forms, but not in a liquid form that would have been easier for
children to take. The S.E. Massengill company decided to
develop a liquid form of Sulfanilamide. Massengill’s chief
chemist and pharmacist, Harold Cole Watkins, found that
diethylene glycol was a good medium for the elixir
Sulfanilamide. The new substance had a nice appearance and
a pleasant taste. What Watkins did not realize was that
diethylene glycol, which is more commonly known as
antifreeze, is a deadly poison. Unfortunately, the existing law
did not require any kind of pharmacological studies proving
that a drug is safe, and 240 gallons of Elixir Sulfanilamide
went on the market.
Tragic event
The people who took this drug, many of them
children being treated for sore throats, suffered
tremendously before they eventually died. They were
ill between one and three weeks, and experienced
stoppage of urine, severe abdominal pain, nausea,
vomiting, stupor, and convulsions. The pain was
severe and unrelenting, and eventually 107 people
died.
Food and Drug Administration (FDA) 1938
 Established more specific regulations to prevent




tampering with drugs, foods and cosmetics.
All labels must be accurate and include generic
names.
All new products must be approved by the FDA
before public release.
“Warning” labels must be present on certain
preparations.
Prescription and non prescription drugs must be
shown to be effective as well as safe.
1970 Controlled Substance Act
 Established by the Drug Enforcement





Administration (DEA).
Set much tighter controls on specific groups of drugs:
those that were being abused by society.
Isolated the abused and addicting drugs into five
levels, or schedules, according to their degree of
danger.
Demanded security of controlled substances.
Set limitations on the use of prescriptions.
Each prescriber of these substances had to register
with the DEA and obtain a DEA registration number.
The Drug Industry
 The discovery of new drugs requires a major
investment of time, research and development.
 Bringing new drugs to the market is a long and
difficult process in which the vast majority of
research does not produce a successful drug.
 Once a useful drug is created, it must undergo
extensive testing and approval before it can be made
available to the public.
 The length of time from the beginning of
development through testing to FDA approval is
often more than 10 years.
Pharmacy Today
 A “prescription” drug is one that has been ordered or
“prescribed” by a physician or other licensed
prescriber to treat a patient.
 The pharmacist has consistently been rated as one of
the most highly trusted professionals in the U.S.
 Pharmacists give patients advice and provide
information about the medications they take, both
prescribed and over-the-counter.
 Pharmacists make recommendations about less
expensive generic substitutes for a prescribed drug
Pharmacy Today
 Education-- To become a pharmacist, an individual
must have earned a Doctor of Pharmacy (PharmD)
degree from a college of pharmacy, pass a state
licensing exam, and perform an internship working
under a licensed pharmacist.
 Between 1999 and 2005 the number of new
prescriptions filled increased by 24.4% while the
number of pharmacists increased by only 14.8%
Economic Trends
 From 1970 to 2000, the cost of health care in the
U.S. rose over 1,500 percent! And just from 20002005 cost rose an estimated 48%, to a total of
$2.016 trillion.
 Government, industry and consumers are looking for
ways to control the costs of care.
 Drugs are a small piece of overall health care
expenses, but they must be included in the effort to
cut costs.
Pharmacy Settings
 Primary environments for a pharmacist and
pharmacy technician are:
Community pharmacies
Hospitals
Mail order business
Long-term care facilities
Managed care
Home care
Computers in Pharmacy
 Pharmacy use powerful computerized tools that help
productivity.
 Computerized pharmacy management systems put
customer profiles, product, inventory, pricing and
other essential information within easy access. They
also automate elements like label printing, inventory
management, stock reordering, and billing.
Terminology
 Synthetic with chemicals, combining simpler
chemicals into more complex compounds, creating a
new chemical not found in nature as a result.
 Pharmacology the study of drugs—their
properties, uses, application, and effects.
 Materia medica generally pharmacology, but also
refers to the drugs in use.
Terminology
 Pharmacopeia an authoritative listing of drugs and





issues related to their use.
Pharmaceutical of or about drugs: also, a drug
product.
Panacea a cure-all
Antitoxin a substance that acts against a toxin in the
body; also, a vaccine containing antitoxins, used to fight
disease.
Antibiotic a substance which harms or kills
microorganisms like bacteria and fungi.
Human genome the complete set of genetic material
contained in a human cell.