Pharmacy Practice

6th Edition - July 24, 2019
Editors: Jennie Watson, Louise Siobhan Cogan
Language: English
Paperback ISBN:
9 7 8 - 0 - 7 0 2 0 - 7 4 3 0 - 1
eBook ISBN:
9 7 8 - 0 - 7 0 2 0 - 7 4 2 8 - 8

The sixth edition of PharmacyPractice brings the contents completely up to date, reflecting emerging new roles for pharmacists both within the traditional employment areas of… Read more

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The sixth edition of PharmacyPractice brings the contents completely up to date, reflecting emerging new roles for pharmacists both within the traditional employment areas of hospital and community pharmacy, as well as other developing roles supporting the public health agenda, governance, risk management, prescribing and pharmaco-economics.

Cover image
Title page
Table of Contents
Copyright
Preface
Acknowledgements
Contributors
About this book
Section 1. The patient
Chapter 1. Socio-behavioural aspects of health and illness
Introduction
Defining health and illness
Dimensions of health
Determinants and models of health
Behavioural determinants
Environmental determinants
Process of illness
Sick-role behaviour
Decision analysis and behavioural decision theory
The treatment process
Key points
Chapter 2. Socio-behavioural aspects of treatment with medicines
Introduction
Functions of medicines
A societal perspective on the rational use of medicines
Prescribing
Pharmacies and the pharmacy profession
Outcomes of medical treatment
Key Points
Chapter 3. Communication skills for pharmacists and their team
Introduction
Assumptions and expectations
What is communication?
Listening skills
Questioning skills
A model for guiding the pharmacist–patient interview
Patterns of behaviour in communication
Barriers to communication
Conclusion
Key points
Chapter 4. Consent
What is consent?
Different types of consent
Valid consent
How consent is given
Refusal of consent
Capacity
Vulnerable patients
Young people and children
Refusal of consent in competent young people and children
Young people without capacity
Children without capacity
Advance decisions
Emergencies
Key Points
Chapter 5. History taking/gathering information
Communication skills
Barriers to effective communication
Telephone consultations
Calgary–Cambridge guide to consultation skills
Medicines reconciliation
Medication history
Conclusion
Key points
Chapter 6. Concordance
Introduction
What is concordance?
Ethical considerations
The concordance model
The evidence for concordance
Eliciting the patient’s view
Developing rapport with the patient
Providing information
Communicating risk
The therapeutic alliance
Concerns about concordance
Conclusion
Key points
Chapter 7. Advice giving and the pharmacist as a Health Trainer
Advice giving
Patient-centred care
Shared decision-making
Adherence
Health coaching
Motivational interviewing
Calgary–Cambridge guide (see Ch. 3)
Consultation styles
Barriers to communication
The Health Trainer programme
Key points
Section 2. The medicine
Chapter 8. Control of medicines
Introduction
Control of medicines
Supply of medicines
Prescribers
Advertising of medicines
Key points
Chapter 9. The prescribing process and evidence-based medicine
Introduction
The prescribing process
Evidence-based medicine
Key points
Chapter 10. Drug evaluation and pharmacoeconomics
Safety, efficacy and economy
Pre-marketing studies
Post-marketing studies
Pharmacoeconomic evaluation of medicines
Drug utilization review and evaluation
Key points
Chapter 11. Formularies in pharmacy practice
Different types of formularies
Benefits of formularies
Formulary development
Formulary management systems
Key points
Chapter 12. Complementary and alternative medicines
Introduction
Extent of use of CAM
Reasons for use of CAM
Regulation of CAM
Pharmacy and provision of CAM
Efficacy and safety of CAM approaches
The future for complementary medicines
Key points
Chapter 13. Using calculations in pharmacy practice
Introduction
Why are units important?
Comparable sizes of units
Converting between units and measurement systems
Rounding
Sense checking your answer
How to write strengths
Doses and dosing
Calculations involving dilutions
Infusion rates and volumes
Displacement values and volumes
Calculations of kidney function
Pharmacokinetics
Molecular weights
Drugs and their salts
Health economics
Key points
Chapter 14. Veterinary pharmacy
Introduction
Animals, disease and medicines
Definitions
Veterinary Medicines Directorate (VMD)
Legal classifications
Prescribing and supply cascade
Pharmacist advice-giving
Retail sale
Conclusion
Key points
Section 3. The medicine formulation
Chapter 15. Dispensing techniques (compounding and good practice)
Introduction
The working environment and procedures
Equipment
Manipulative techniques
Ingredients
Problem-solving in extemporaneous dispensing
Conclusion
Key points
Chapter 16. Oral unit dosage forms
Introduction
Tablets
Capsules
Other oral unit dosage forms
Key points
Chapter 17. Packaging
Introduction
Primary and secondary packaging
Packaging materials
Closures
Collapsible tubes
Unit-dose packaging
Paper
Patient pack dispensing
Key points
Chapter 18. Solutions
Introduction
Solutions for oral dosage
Solutions for other pharmaceutical uses
Expression of concentration
Formulation of solutions
Oral syringes
Diluents
Key points
Chapter 19. Suspensions
Introduction
Pharmaceutical applications of suspensions
Properties of a good pharmaceutical suspension
Formulation of suspensions
The dispensing of suspensions
Key points
Chapter 20. Emulsions
Introduction
Pharmaceutical applications of emulsions
Emulsion types
Formulation of emulsions
Dispensing emulsions
Key points
Chapter 21. External preparations
Introduction
Types of skin preparation
Ingredients used in skin preparations
Preparation of external preparations
Semi-solid preparations
Transdermal delivery systems
Disadvantages
Key points
Chapter 22. Suppositories and pessaries
Introduction
Suppository bases
Preparation of suppositories
Containers for suppositories
Shelf-life
Labelling for suppositories
Patient advice
Key points
Chapter 23. Powders and granules
Introduction
Powders for internal use
Powders for external use
Key points
Section 4. The specialized pharmacy product
Chapter 24. Production of sterile products
Introduction
Sterile product production
Premises
Environmental control
Isolators
Environmental monitoring
Aseptic preparation
Testing for sterility
Key points
Chapter 25. Parenteral products
Introduction
Administration procedures
Products for parenteral use
Formulation of parenteral products
Units of concentration
Special injections
Large-volume parenteral products
Key points
Chapter 26. Ophthalmic products
Introduction
Anatomy and physiology of the eye
Formulation of eye drops
Antimicrobial preservatives
Preparation of eye drops
Labelling of containers
Instillation of eye drops
Formulation of eye lotions
Formulation of eye ointments
Preparation of eye ointments
Ophthalmic inserts
Contact lenses and their solutions
Contact lenses
Hard lens solutions
Soft lens solutions
All-purpose solutions
Advice to patients
Key points
Chapter 27. Inhaled route
The role of the pharmacist
Introduction
The inhaled route
Inhaled medicines used for asthma and COPD
Long-acting beta2 agonists (LABAs)
The peak flow meter
Types of inhaler device
Key points
Chapter 28. Parenteral nutrition and dialysis
Introduction
Provision of nutritional support
Indications for TPN
Assessment of the patient in hospital
The nutrition team
Components of a TPN formulation
Compounding of TPN and HPN formulations
Compounding of HPN formulations by commercial companies
Potential complications arising during compounding and administration of TPN formulations
Addition of medicines to a TPN or HPN bag
Administration of TPN/HPN formulations
Potential problems for HPN patients
Metabolic problems
Catheter-related complications
Psychological and social problems
Training for HPN patients
Services provided by home-care companies
Support services provided for HPN patients
The British Parenteral Nutrition Group
Introduction to kidney disease and dialysis therapy
Community dialysis teams
UK Renal Pharmacy Group
Key points
Chapter 29. Radiopharmacy
Introduction
Radionuclides used in nuclear medicine
Principles of 99mTc-radiopharmaceutical production
Principles of 18F-fluoro deoxy-glucose (18F-FDG) production
Facilities required for the production of radiopharmaceuticals
Radiation protection in the radiopharmacy
Key points
Chapter 30. Specialized services
Introduction
Cancer chemotherapy
Occupational exposure risks
Provision of a pharmacy-based chemotherapy preparation service
Centralized intravenous additive service (CIVAS)
Infusion stability and shelf-life assignment
Key points
Chapter 31. Appliances
Introduction
Wound dressings
Urinary incontinence
Stoma
Graduated compression hosiery
Trusses
Other types of hernia
Key points
Section 5. The pharmacy safety process
Chapter 32. Clinical governance
Introduction
Clinical governance
Quality: Three main elements for improving quality in the NHS
Clinical governance and pharmacy
Professional governance and regulation procedures in pharmacy
When things go wrong
Key points
Chapter 33. Risk management
Introduction
Human error models
Risk management tools
Risk to patients in the pharmacy setting
Developments in health policy
National patient safety agency (NPSA)
The risk management process
Conclusion
Key points
Chapter 34. Standard operating procedures
Introduction
Background to SOPs
Regulations
Reducing risk to patient safety
Content of the SOP
Non-conformance
Examples of SOPs
Key points
Chapter 35. Audit
Introduction: what is audit?
Relationship between practice research, service evaluation and audit
Types of audit
What is measured in audit?
The audit cycle
Setting standards
Learning through audit
Key points
Chapter 36. Information retrieval in pharmacy practice
Introduction
Where does information exist and how can it be retrieved?
Directory of useful websites
Bookmarking
Searching the internet
Effective use of search engines
The sequence of information
Information services
Summary care records
Conclusion
Key points
Chapter 37. Control of health professionals and their staff
Introduction
Healthcare regulation systems
The work of regulatory bodies
Maintaining a register of members
Registration of non-UK healthcare professionals
Recognition and accreditation of pre-registration qualifications
A code of practice
A formal system of reporting registrants and dealing with FtP issues
Key Points
Chapter 38. Continuing professional development and revalidation
Introduction
Continuing education
Continuing professional development
Recording CPD
Revalidation
Conclusion
Key points
Section 6. The role of pharmacy in health care
Chapter 39. The role of pharmacy in health care
Introduction
The changing role of pharmacy
The extended role of the pharmacist
The profession
The NHS drugs budget
The NHS workforce
The current and future roles of pharmacists
Pharmacy education
Continuing education and continuing professional development
Conclusion
Key points
Chapter 40. Ethics – the theory
Introduction
Morals, values and ethics
Ethical theories
Principlism and the four ethical principles
Principlist ethics and research
Morals and law
Applied and professional ethics
Ethical issues in health care
Ethics and pharmacy
The virtuous pharmacist
Conclusion
Key points
Chapter 41. Ethics in practice and ethical dilemmas
Introduction
Standards for pharmacy professionals
What is an ethical dilemma?
A legal issue or an ethical dilemma?
Ethical decision-making processes
Is making ethical decisions always a comfortable process?
Is there always a right answer?
Can you justify what you have chosen to do?
What is the difference between inaction and no action?
Can you ask someone else’s opinion?
Can someone else make the decision for you?
Can someone else force you to make a decision?
Dilemmas to consider
Key points
Chapter 42. Public health
Introduction
What is public health pharmacy?
Wider determinants of health
Lifestyle determinants of health
Changing habits and lifestyle
Conclusion
Key points
Chapter 43. Structure and organization of pharmacy
Introduction
Global organizations
Organization of pharmacy at a national level
Structure of the NHS in the UK
Pharmacy in the UK
Conclusion
Key points
Chapter 44. Inter- and intra-professional working with the healthcare team
Introduction
Who are the team within a pharmacy department?
What are the required qualifications?
Definition of the roles within the pharmacy team
Intra-professional working
Inter-professional working
Inter-professional working within education
Inter-professional education and collaborative working within healthcare
Important qualities required to enhance collaborative working
Fostering inter-professional collaboration
Conclusion
Key points
Section 7. The patient, their medicine and beyond
Chapter 45. The prescription
Introduction
Information required on a prescription
Types of prescription forms
Routine procedure for dispensing prescriptions
Clinical and legal checking of the prescription
Assembly of the product and labelling
Information sources
Key points
Chapter 46. Patient charges for medicines and their impact on access
Introduction
Types of cost sharing arrangements
Protection mechanisms and exemptions
Impact of cost sharing on drug use and health outcomes
Impact of cost sharing on patients and healthcare professionals
The role of community pharmacies
Conclusion
Key points
Chapter 47. Routes of administration and dosage forms
Introduction
Routes of administration
Dosage forms
Administration of oral liquid medicines
Key points
Chapter 48. Labelling of dispensed medicines
Introduction
Standard requirements for labelling dispensed medicines
Quantity and multiple packs
Instructions for use
Additional labelling requirements
Legal requirements in certain circumstances
Labels for vulnerable patients
Errors in labelling
Key points
Chapter 49. Monitoring the patient
Introduction
The Medicines Use Review (MUR) and Prescription Intervention Service and the New Medicine Service (NMS)
Carrying out an MUR
The New Medicine Service (NMS)
Key points
Chapter 50. The role of the pharmacist in medicines optimization
What is medicines optimization?
A short history
Structures to support medicines optimization
Taking medicines optimization forward
Key points
Chapter 51. Public health and pharmacy interventions
Introduction
Access
Healthy living pharmacies
Services
Smoking cessation
Cardiovascular checks
Alcohol intake screening
Services for drug-user clients
Screening for chronic disease
Treatment and prevention of infectious disease
Public emergency support
Sexual health services
Conclusion
Key points
Chapter 52. Substance use and misuse
Introduction
Substances that are used and their effects
Why do people use psychoactive drugs?
The harms relating to psychoactive drug use and dependence
Legislation
The management of drug use and dependence
Service providers
Pharmaceutical care
Needle and syringe programmes
Use of pharmacotherapies in drug dependence
Pharmaceutical dispensing services
Key points
Appendices
Appendix 1. Abbreviations and terms used in this book
Appendix 2. Medical abbreviations
Appendix 3. Latin terms and abbreviations
Appendix 4. Key references and further reading
Index

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Jennie Watson

Louise Siobhan Cogan