Pre-Pharmacy at Penn State Behrend

1. Pre-Pharmacy at Penn State Behrend SC 201: Fall, 2013

2. History of Pharmacy Ancient Origins • Earliest known record of apothecary practice, approximately 2,600 BC • Healers combined roles of priest, pharmacist, and physician • Clay tablets recorded symptoms of illness, prescriptions, and instructions for compounding remedies

3. History of Pharmacy Parallel Development in Several Civilizations China • Emperor ShenNung researched the medicinal value of herbs, testing many of them on himself (2,000 BC) • Wrote the first Pen T-Sao, or native herbal, recording 365 drugs Egypt • Papyrus Ebers (1,500 BCE) • Most important ancient pharmaceutical record - collection of 800 prescriptions; specifically mentions 700 unique drugs

4. History of Pharmacy Development in Several Civilizations India • CharakaSamhitarecorded more than 2,000 drugs (1,000 BC) • Meaning “compendium of wandering physicians,”it was the work of multiple authors Greece • Terra Sigilata, or "sealed earth", was the first therapeutic agent to bear a trademark (500 BC) • Originated in Greece before Composed of sacred clay that was blessed, refined, shaped into uniform tablets, impressed with an official seal, sun-dried, and then distributed commercially

5. History of Pharmacy Development in Several Civilizations India • CharakaSamhitarecorded more than 2,000 drugs (1,000 BC) • Meaning “compendium of wandering physicians,”it was the work of multiple authors Greece • Terra Sigilata, or "sealed earth", was the first therapeutic agent to bear a trademark (500 BC) • Originated in Greece before Composed of sacred clay that was blessed, refined, shaped into uniform tablets, impressed with an official seal, sun-dried, and then distributed commercially

6. History of Pharmacy Greece Theophrastus – “the father of botany” (300 BC) • One of the greatest early Greek philosophers and natural scientists • Observed and wrote extensively on the medicinal qualities of herbs - unusually accurate observations Hippocrates • Greek physician (460 - 377 BC) – “the father of medicine” • Rejected that illness was connected to mystic or demonic forces and positioned medicine as a branch of science • Published more than 70 writings related to the practice of medicine and apothecary

7. History of Pharmacy Development of the Apothecary • In 8th century, Arab practitioners separated the arts of the apothecary and physician • The first apothecaries, or privately owned drug stores, appeared • Traders brought the new system of pharmacy to Europe and Africa

8. History of Pharmacy Development of the Pharmacopeia • The first pharmacopeia, the NuovoReceptario, was published in Florence, Italy, in 1498 • One of the earliest constructive collaborations between the Guild of Apothecaries and the Medical Society • The First Anglo-Saxon Organization for Pharmacists: The Guild of Grocers monopolized trade in drugs and spices • In 1617, King James I formed a separate company for apothecaries

9. History of Pharmacy 18th Century • America’s first female pharmacist, Elizabeth Marshall • America’s first hospital, Philadelphia, 1751 • Founded by Benjamin Franklin • Pharmacy began operations in 1752 • John Morgan, pharmacist and physician • Advocated written prescriptions • Advocated for the independent practice of the two profession • U.S. first Apothecary General, Andrew Craigie • Duties included procurement, storage, manufacture, and distribution of the Army's drugs • Also developed an early pharmaceutical wholesaling and manufacturing business

10. History of Pharmacy 19th Century • America’s first college of pharmacy, the Philadelphia College of Pharmacy • The American Pharmaceutical Association • Founded to meet the needs for better intercommunication among pharmacists • Set standards for education and apprenticeship • Began quality control over imported drugs

11. History of Pharmacy 19th Century William Procter, Jr. ”father of American pharmacy” • Graduated from the Philadelphia College of Pharmacy in 1837 • Operated a retail pharmacy • Served as professor of pharmacy for 20 years • Was a leader in founding the American Pharmaceutical Association • Editor of the American Journal of Pharmacy for 22 years

12. History of Pharmacy 20th Century • The American Council on Pharmaceutical Education • Founded in 1932 to establish standards for pharmacy education • Initially established standards for baccalaureate degree in pharmacy; added the doctor of pharmacy standards as an alternative

13. History of Pharmacy 20th Century • Traditional Era (1900–1930): formulating and dispensing drugs derived from natural sources • Scientific Era (1930–1960): development of new drugs; scientific testing; mass production of synthetic drugs and antibiotics • Clinical Era (1960–1990): pharmacists expected to dispense drug information, warnings, advice, and suggestions to patients

14. History of Pharmacy 21st Century • The Pharmaceutical Care Era (current era): practice of pharmacy focused on ensuring positive outcomes for drug-related therapies • Biotechnology: treatment of cancer or cancer-related conditions • Drugs are produced using living organisms such as yeast, bacteria, or mammalian cells • The majority are manufactured through recombinant DNA technology • A human gene capable of triggering specific protein production is inserted into a living organism and cultured in a laboratory • The organism incorporates the gene into its cell structure, and begins producing the desired protein (drug)

15. History of Pharmacy 21st Century • Pharmacogenomics: • Predicts whether a patient will have a severe, negative reaction to a prescribed medication • Simple, rapid DNA test used • May aid in selection of better medications for patient • Still in development

16. What Is Pharmacy? • Responsibilities include a range of care for patients, from dispensing medications to monitoring patient health and progress in order to maximize their response to medication. • Educate consumers and patients on the use of prescriptions and over the counter medications. • Advise physicians, nurses and other health professionals on drug decisions. • Provide expertise about the composition of drugs, including their chemical, biological and physical properties and their manufacture and use. • Ensure drug purity and strength and make sure that drugs do not interact in a harmful way. • Pharmacists are drug information experts ultimately concerned about their patients’ health and wellness.

17. What Are The Work Environments? • Community pharmacies: Approximately 62% of pharmacists work in community pharmacies. These can include independently-owned pharmacies, chain pharmacies, pharmacy departments in food or discount stores, or professional health centers. • Other direct health care facilities: Other practice opportunities exist for pharmacists in hospitals, home health care, nursing homes and extended care facilities, neighborhood health centers, and health maintenance organizations.

18. What Are The Work Environments? • Private industry: Pharmacists are also employed by firms that discover, develop and produce chemicals, prescriptions and nonprescriptivedrugs and other health products. • Government: Pharmacists hold staff and supervisory posts in the US Public Health Service, the Department of Health and Human Services, the Department of Veteran Affairs, the Food and Drug Administration and the Armed Services.

19. What Are The Areas of Specialization? Academic Pharmacy : • Over 3,000 full-time faculty members work in the nation's colleges and schools of pharmacy. • They are involved with teaching, research, public service, and patient care. • Others serve as consultants for local, state, national, and international organizations. • Faculty Shortage survey by AACP: total of 417 vacant teaching posts

20. What Are The Areas of Specialization? Benefits of a Career in Academic Pharmacy • Opportunity to contribute to scientific and clinical knowledge • Freedom to be creative and pursue own interests • Develop an identity within specialty and enhance career • Ability to collaborate with other professionals • Personal satisfaction from training of students, residents, fellows, graduate students

21. What Are The Areas of Specialization? Community Pharmacy: Chain or Independent • ”It's all about people." From helping with aches and pains, to educating patients about sophisticated drug therapies, to helping sick patients cope with their feelings... pharmacists forge relationships with their patients. • For more than 22 years, pharmacists have ranked at or near the top of the Gallup Poll ranking of the "most trusted professionals.” • The pharmacist is their primary source of health information!

22. What Are The Areas of Specialization? Community Pharmacy: Chain or Independent • Strong interpersonal and verbal communication skills • Fast-paced environment, requiring intense focus, organization, and efficiency • The ability to communicate on many levels is key: scientifically with health professionals and simply for patients. • Starting salaries $75,000 a year, with potential for growth. Severe demand is expected to intensify through 2020.

23. What Are The Areas of Specialization? Community Pharmacy: Chain or Independent • Patient Care Opportunities: • Certified to vaccinate patients • Disease state management in areas covering diabetes, high blood pressure, high cholesterol, etc. • They also have many other patient care opportunities, including smoking cessation programs, compounding specialties, herbal and other alternative drug therapies, and screening programs such as those to detect osteoporosis and high cholesterol.

24. What Are The Areas of Specialization? Community Pharmacy: Chain or Independent • Patient Care Opportunities: • Certified to vaccinate patients • Disease state management in areas covering diabetes, high blood pressure, high cholesterol, etc. • They also have many other patient care opportunities, including smoking cessation programs, compounding specialties, herbal and other alternative drug therapies, and screening programs such as those to detect osteoporosis and high cholesterol.

25. What Are The Areas of Specialization? Consultant pharmacy • Discipline where pharmacists provide a broad spectrum of administrative, distributive and clinical services to nursing homes, community-based care, adult day care, correctional facilities and individuals living in their own homes. • Experts in geriatric medication management

26. What Are The Areas of Specialization? Consultant pharmacy • "Let's see if I can get this straight," says Linda Smith, leaning forward toward the burly 45-year- old. "You do your blood sugar reading and then you take your multivitamins and vitamin E and Garlique about an hour later. Then you take the lactulose in between. Then you're taking the Glucotrol XL, your diabetes medicine. • "Then do you also take your blood pressure medicine at that time -- the Vasotec or enalapril? And you take the Elavil in the evening for the pain in your heel?" • Caudle takes off his wire-rimmed glasses, rubs his eyes. Three years ago he stopped a 27-year smoking habit, but now he looks like he'd like to light up.

27. What Are The Areas of Specialization? Consultant pharmacy • "I feel like I'm on so many medications. I feel like I'm on a pill for everything," Caudle says. He's concerned that he may end up like his father, who also had diabetes and died a few years ago of a heart attack. "I think that's one of the reasons my father passed away. . . . At the end he was taking 30 to 40 pills a day." Just as any good physician would, Smith listens with empathy. But she's no doctor. She's a pharmacist who, after more than 25 years working for others, struck out on her own about two years ago. She's reinvented herself as an independent pharmacy consultant -- a pharmacist who counsels patients for a fee.

28. What Are The Areas of Specialization? Federal Opportunities

29. What Are The Areas of Specialization? Federal Opportunities US Public Health Service • Overseen by the Surgeon General, the U.S. Public Health Service Commissioned Corps is a diverse team of more than 6,500 highly qualified, public health professionals. Driven by a passion to serve the underserved, these men and women fill essential public health leadership and clinical service roles with the Nation’s Federal Government agencies.

30. What Are The Areas of Specialization? Federal Opportunities US Public Health Service

31. What Are The Areas of Specialization? Hospital and Institutional Pharmacy • Increased number of pharmacists now practice in hospitals, nursing homes, extended care facilities, neighborhood health centers, and health maintenance organizations. • Opportunity for direct involvement with patient care. • Serve as an authoritative source of drug information for physicians, nurses, and patients. • They are responsible for systems that control drug distribution and are designed to assure that each patient receives the appropriate medication, in the correct form and dosage, at the correct time.

32. What Are The Areas of Specialization? Hospital and Institutional Pharmacy • Maintain records on each patient, using them not only to fill medication orders but also to screen for drug allergies and adverse drug effects. • Includes specialized areas, including nuclear pharmacy, drug and poison information, and intravenous therapy. • Bring other expertise including finance and budgeting, personnel administration, systems development, and planning. • Approximately 38,000 licensed pharmacists work on a full or part-time basis in hospitals or nursing homes. Pharmacist Participation in Hospital Rounds Can Reduce Medication Errors • "Drug-related morbidity is costly to society. Drug-related problems (DRPs) have been associated with between 6% and 28% of hospital admissions in studies in the United States, and the annual costs associated with preventable drug-related morbidity have been estimated to be $177.4 billion in the United States and $10.9 billion in Canada... Studies in hospital and clinic settings have shown that pharmacists (usually with PharmDs or other advanced training) can improve prescribing and patient outcomes and decrease hospital and prescribing costs."1 • Seventy-eight percent fewer preventable adverse drug events (ADEs) occurred among patients in a hospital’s general medicine unit when a pharmacist participated in weekday medical rounds, researchers recently reported in the Archives of Internal Medicine.2An article in the American Journal for Health System also demonstrated improved patient care outcomes due to increased pharmacist involvement on rounds. From May 1-31, 2000, a clinical pharmacist actively participated in daily rounds (including follow up) involving 19 medical services in a 600-bed academic medical center. Results were compared to a control group with less pharmacist interaction and follow up. When a • pharmacist participated in the daily medical rounds, medication errors were reduced by 51%. The number of patients without a medication error was 40% in the intervention group, compared to 22.9% in the control group. Nearly 80% of the patients in the control group had a medication error, the study found. It noted that the mean length of stay, cost and mortality nearly double for patients with adverse drug reactions.3

33. What Are The Areas of Specialization? Hospital and Institutional Pharmacy Pharmacist Participation in Hospital Rounds Can Reduce Medication Errors • Drug-related problems have been associated with between 6% and 28% of hospital admissions in studies in the United States, and the annual costs associated with preventable drug-related morbidity have been estimated to be $177.4 billion in the United States • Studies in hospital and clinic settings have shown that 78% fewer preventable adverse drug events occurred among patients in a hospital when a pharmacist participated in weekday medical rounds • When a pharmacist participated in the daily medical rounds, medication errors were reduced by 51%. Nearly 80% of the patients in the control group had a medication error, the study found.

34. What Are The Areas of Specialization? Informatics • Combination of the pharmacy practice environment and information technology • Pharmacy informaticists work collaboratively with other health care professionals to ensure that appropriate systems are in place to support an informed practice environment. • These systems include e-prescribing, computerized prescriber order entry (CPOE), electronic medical records (EMR), bar code dispensing and administration systems, and automated dispensing cabinets.

35. What Are The Areas of Specialization? Informatics • All PharmD programs are required to provide pharmacy informatics education. Some programs provide elective and experiential pharmacy informatics education. • Graduates can also pursue additional education and training through residencies, fellowships, and graduate school. • Employed by hospitals, information systems companies that support acute and ambulatory care, governmental agencies, colleges of pharmacy, knowledge vendors (First DataBank, Multum, etc.), and a variety of other opportunities.

36. What Are The Areas of Specialization? Managed Care Pharmacy • Managed care is an organized approach to health care delivery that seeks to improve the quality and accessibility of health care—including medication therapy—in cost-effective manner. • Pharmaceutical expenditures have grown more rapidly than any other component in the health care system as a result of • Increased use of prescription medications • Number of people covered by drug benefits • Introduction of expensive new drugs into the market-place.

37. What Are The Areas of Specialization? Pharmaceutical Sciences/Industry • Direct involvement in the development and clinical testing of new pharmaceuticals and drug delivery methods • Analysis and Pharmaceutical Quality • Biotechnology • Clinical Pharmacology and Translational Research • Drug Design and Discovery • Formulation Design and Development • Manufacturing Science and Engineering • Pharmacokinetics, Pharmacodynamics andDrug Metabolism • Physical Pharmacy and Biopharmaceutics • Regulatory Sciences

38. What Are The Areas of Specialization? What is the Difference Between a Pharmaceutical Scientist and a Pharmacist? • Pharmaceutical scientists are typically involved in the development of new drugs: discovery, drug delivery systems, drug absorption, distribution, metabolism, and elimination characteristics. They spend most of their time doing research in a laboratory or office setting. • On the other hand, pharmacists work with existing drugs, patients, and other healthcare practitionersto optimize patient care and drug use. They often work face-to-face with physicians (drug selection and use)and patients (best use of medications)

39. What Are the Job Prospects? US News and World Report #3 Pharmacist • Excellent job prospects and a solid average salary. • Possessors of a Pharm.D can anticipate nearly 70,000 available jobs this decade—the brunt in physician offices, outpatient care centers, and nursing homes. To see the complete list of 100 best jobs: usnews.com/100bestjobs

40. What Are the Job Prospects? Why? • Estimated need for pharmacists to fulfill care and distributive roles in 2020 is 417,000; shortfall in supply estimated at 157,000(Knapp, DA, Am J Pharm Ed 2002;66:421-9) • Aggregate Demand Index continues to show imbalance between supply and demand (Knapp, KK, http://www.pharmacymanpower.com) • Pharmacists report “excessively high” workload(Schommer, et al. J Am. Pharm. Assoc. 2006:340-7) • Number of elderly will double from 2000-2030; # of prescriptions per patient is markedly higher for those over 65.

41. What Are the Job Prospects? Why? • Salary Outlook: median annual salary for a pharmacist was $113,390 in 2011. • The field's best-compensated areas include residential mental health or rehabilitation facilities and consulting services.

42. Reasons to Choose Pharmacy? Personal Abilities of a Pharmacist • Genuine interest in people and medicine • High ethical standards and the ability to meet the pharmacy’s demands for judgment, dependability, and conscientious performance • Strong attention to detail • An ability to communicate well with patients and healthcare providers • Emotional stability, calm mind, decision making ability and etiquettes to deal with variety of people

43. Preparing for Pharmacy School Best Resource by far! http://www.aacp.org Complete compendium of all pharmacy school requirement, class statistics and graduation rates. More complete than for any other pre-health profession!

44. Preparing for Pharmacy School For example: Auburn University

45. Preparing for Pharmacy School For example: Auburn University

46. Preparing for Pharmacy School Compiled data for all schools:

47. Preparing for Pharmacy School Compiled data for all schools:

48. Preparing for Pharmacy School Compiled data for all schools:

49. Preparing for Pharmacy School Compiled data for all schools:

50. PCAT Pharmacy College Aptitude Test (PCAT)