Managerial Role of a Pharmacist

Chapter Outline

Scope of Pharmacists
Ethics & Professionalism
Community Pharmacy
Pharmacists in Industry
Pharmacists in Regulatory Affairs
Pharmacists Public Heath
Hospital Pharmacy
Clinical Pharmacy

Scope of Pharmacists
Pharmacists have ample source to
work in
Production & manufacturing
Research
&
Development
(R&D)
Quality control (QA)& Quality
Assurance (QA)
Sales & Promotion
Purchasing
&
Inventory
Management
Technical Services
Community Pharmacy
Hospital Pharmacy
Clinical Pharmacy
API Plant & Cosmetic Industry
Pharmaceutical Education
API Plants
Regulatory Affairs
Pharmaceutical Journalism
Consultancy
Ethics & Professionalism
Code of Ethics for Pharmacists
I. A pharmacist respects the
covenantal relationship between
the patient and pharmacist.
Considering the patient-pharmacist
relationship as a covenant means
that a pharmacist has moral
obligations in response to the gift of
trust received from society. In return
for this gift, a pharmacist promises to

help individuals achieve optimum

benefit from their medications, to be
committed to their welfare, and to
maintain their trust.
II. A pharmacist promotes the
good of every patient in a
caring,
compassionate,
and
confidential manner.
A pharmacist places concern for the
well-being of the patient at the
center of professional practice. In
doing so, a pharmacist considers
needs stated by the patient as well
as those defined by health science. A
pharmacist is dedicated to protecting
the dignity of the patient. With a
caring attitude and a compassionate
spirit, a pharmacist focuses on
serving the patient in a private and
confidential manner.
III. A pharmacist respects the
autonomy and dignity of each
patient.
A pharmacist promotes the right of
self-determination and recognizes
individual self-worth by encouraging
patients to participate in decisions
about their health. A pharmacist
communicates with patients in terms
that are understandable. In all cases,
a pharmacist respects personal and
cultural differences among patients.
IV. A pharmacist acts with
honesty
and
integrity
in
professional relationships.
A pharmacist has a duty to tell the
truth and to act with conviction of
conscience. A pharmacist avoids
discriminatory practices, behavior or
work
conditions
that
impair
professional judgment, and actions

that compromise dedication to the

best interests of patients.

balancing the needs of patients and

society.

V.
A
pharmacist
maintains
professional competence.

The Practice of Community

Pharmacy

A pharmacist has a duty to maintain

knowledge and abilities as new
medications,
devices,
and
technologies become available and
as health information advances.

A community pharmacy can broadly

be considered a community-based
pharmacy. The main responsibilities
of a community pharmacy include
compounding,
counseling,
and
dispensing of drugs on prescription
to the patients with care, accuracy,
and
legality.
Appropriate
procurement, storage, dispensing
and documentation of medicines are
within the purview of its professional
responsibilities. It is an important
branch of the pharmacy profession
and
involves
a
qualified
and
pertinent pharmacist. Being closely
in contact with general people, the
community pharmacists should have
the required education, skills and
competence
to
deliver
the
professional
service
to
the
community.

VI. A pharmacist respects the

values and abilities of colleagues
and other health professionals.
When appropriate, a pharmacist asks
for the consultation of colleagues or
other health professionals or refers
the
patient.
A
pharmacist
acknowledges that colleagues and
other health professionals may differ
in the beliefs and values they apply
to the care of the patient.
VII.
A
pharmacist
serves
individual,
community,
and
societal needs.
The
primary
obligation
of
a
pharmacist is to individual patients.
However, the obligations of a
pharmacist may at times extend
beyond
the
individual
to
the
community and society. In these
situations, the pharmacist recognizes
the responsibilities that accompany
these
obligations
and
acts
accordingly.
VIII. A pharmacist seeks justice
in the distribution of health
resources.
When health resources are allocated,
a pharmacist is fair and equitable,

In compliance with the vision of the

community pharmacy section of the
International
Pharmaceutical
Federation, community pharmacists
should~
be expert in pharmaceutical care,
pharmacotherapy, and health
promotion.
be professional communicators
with patients, other healthcare
providers, and decision makers.
deliver good quality in products,
services, and communication.
document their actions and make
descriptions and publications.

Health Problems in Bangladesh

Difference between public health
and community health
1. Public health is the science and art
of preventing disease, prolonging
life,
and
promoting
health
&
efficiency
through
organized
community efforts.
Community health refers to the
healthy status of the member of the
community to solve the problems
affecting their health & to the totality
of a health care provided for the
community.
2. Public health
community health.

is

part

of

Community heath covers all the

aspect of public health preventive
disease & social medicine.
3.
In
practice,
public
health
components are community water
supply, proper sewage disposal,
good housing etc.
Community health components are
curative, preventive, promotional &
rehabilitative services.
4. For public heath, main objects are
to control physical environmental
and communicable disease.
For Community heath, main objects
are to promote physical, mental,
social wellbeing of the people.
5. Community participation is not
needed in public health

1. Population problems
2. Communicable disease problems
3. Nutritional problems
4. Environmental sanitation problems
5. Health problems.

Manpower Requirement for

Developing Infrastructure of
Community Pharmacy

Doctors: 1person/3500 Population

Pharmacists: 1person/1000
population

Nurses: 1 person/5000 population

Auxiliary nurse: 1 person/5000

population (midwives)

Sanitary Inspectors: 1 person/

10,000 population

Lab. Tech.: 1 person/ 10,000

population

Role of Community Pharmacists

The pharmacist should be recognized
as part of the health team for
pharmaceutical care and primary
health care services provided. This
will involve formal contacts between
hospitals and pharmacists.
In the larger centers, community
liaison
pharmacists
should
be
employed to be involved in all
discharges to ensure:
a)
patients
and
care-givers
understand the medication and the
medication regimen.

b) prescriptions are updated (existing

repeat forms) to reflect the new
medication regimen.
c) there is liaison with community
pharmacists.
In
small
communities,
the
community pharmacist be more
directly involved in the hospital
which would include (but not limited
to)
a) supply of drugs and medical
supplies (where appropriate).
b) maintenance and utilisation of
patient medication profiles.
c)
educating
patients
about
appropriate use and storage of
drugs.
d) developing drug policies and
procedures
for
the
supported
accommodation or home health
service.
e) reviewing and evaluating patient's
drug regimens periodically.
f) providing dose and medication
compliance systems for people living
in supported care or in their own
homes.
g)
participating
in
agency
committees
such
as
utilization
review committee.
h)
giving
in-house
continuing
education
programs
to
other
personnel.
Distribution
medications

and

control

of

Community pharmacist must assess

Appropriate dose for the
patients
Patient
allergy
to
the
medication
or
similar
medication
Potential drug-drug interaction
(both prescription & nonprescription drug)
Contradiction
of
the
medication with the other
disease of the patient have
Appropriate dose scheduling
to maximize effects and
minimize untoward effects

Matching drug
patient profile

profile

with

The pharmacist has been required to

Assure accuracy of dispensing
and labeling
Provide patient with proper
storage of the medication
Advice patient with potential
risks and benefits
Advise patient on how to deal
with missed dose and adverse
events
Assess patients understanding
of the prescription instructions
Shifting
responsibilities
Community Pharmacists

of

Pharmacists are experts in the use of

medicines and must complete a four
year degree and one years practical
training to qualify. It is widely agreed
that better use could be made of
pharmacists skills and knowledge.
Pharmacists are expected to assess
whether a prescription or an overthe-counter medicine is appropriate.
The public appears comfortable with
a pharmacists dual roles of retailer
and healthcare professional. They
offer easier and faster access to
services for people as well as
reducing a GPs workload.
Better use of pharmacists skills
A. Minor ailment schemes
Minor
ailment
schemes
have
included treatment for conditions
such as athletes foot, earache,
constipation, hay fever and cystitis.
The interventions available to a
pharmacist are usually of three main
types:
advice only;
advice
and
supply
of
medicines over-the-counter;
or referral to a GP.
In the Care at the chemist scheme
patients
requesting
a
GP
appointment for minor ailments,

such as earache, nasal symptoms,

and
cough,
were
offered
a
consultation at a pharmacy. 38% of
patients were happy with this option
and thought the arrangement was
convenient. Patients who had not
had the symptoms before preferred
to see a doctor.
B. Supplementary prescribing
Supplementary prescribing, including
repeat prescribing, is a partnership
between a:
GP who establishes a diagnosis and
assesses a patient;
pharmacist or nurse who monitors
the patient and prescribes further
supplies of medicines within an
individual clinical management plan:
patient who agrees to the
supplementary
prescribing
arrangement.
All
pharmacist
supplementary
prescribers must undergo additional
training, including a period of
supervised practice.
Pharmacists in Hospital
Pharmacy
Hospital pharmacy management is a
promising
career
option
for
pharmacists
who
enjoy
the
challenges
presented
by
administrative
work
in
an
institutional
setting.
Hospital
pharmacy managers oversee the
operations of pharmacy departments
and
are
responsible
for
the
departments
professional
and
administrative components. They
ensure that quality pharmaceutical
services are provided according to
accreditation
and
professional
standards. Many hospitals employ a
pharmacist in the role of clinical
coordinator
to
track
therapy
utilization within the institution.
The Role of Pharmacists in the
Hospital Setting
A. Selected types of institutional
practices for pharmacists

Hospitals
Nursing Homes
Long Term and Extended Care
Facilities
Intermediate Care Facilities
Assisted Living Facilities
Correctional Facilities
Behavioral and Mental Health
Facilities
Ambulatory Care Facilities
Home Care Providers

B. Medication
Control

distribution

&

Medication Orders
Formulary Development
Medication Administration
Extemporaneous
Compounding
Compounding Sterile Products
Unit Dose Packaging
Medication Storage
Minimizing Adverse Drug
Reactions
Eliminating Medication Errors
Managing Drug Product
Recalls
Controlling Drug Samples
Cytotoxic and Hazardous Drug
Products
Controlled Substances
Non-Approved Substances
Medication Storage Area
Inspections
Floor Stock
Disaster Services
Counter-terrorism Services
Medical Emergency
Management
Drug Delivery Systems
Automated Dispensing
Machines
C. Facilities,
equipments
&
information resources

Medication Storage
Packaging and Compounding

Cytotoxic and Hazardous Drug

Products
Consultation Space
Office and Meeting Space
Automation/Computerization
Record Maintenance

D. Leadership
management

&

practice

Education and Training

Mission
Support Personnel
Work Schedules and
Assignments
Education and Training
Recruitment
Orientation
Performance Evaluation
Position Descriptions
Policies and Procedures
Operations Manuals
Drug Expenditures
Workload and Financial
Performance
Committee Involvement
Quality Improvement
Laws and Regulations
Patient Confidentiality

E. Optimizing medication therapy

Medication Histories
Medication Orders
Medication Therapy Monitoring
Minimizing Bacterial
Resistance
Collaborative Pharmacist
Consultations
Medical Record
Documentation
Medication Use Evaluation
Medication Use Policy
Development
Pharmaceutical Care Provision
Continuity of Care
Clinical Care Plans
Immunization Programs

F. Drug information & education

Drug Information Requests

Reference Materials for Drugs
Medication Therapy
Monographs
Patient Education
Dissemination of Drug
Information
Pharmacy and Therapeutics
Committee Support /Analysis

G. Research

Policies and Procedures

Distribution and Control
Institutional Review Board
Scientific Contribution
Pharmacy Research
Medical Staff Support
Multidisciplinary Research

Pharmacists in Regulatory
Affairs
(Government/Federal Pharmacy)
Pharmacists in government/federal
pharmacy are employees of local,
state,
or
federal
government
agencies.
These
could
include
government units such as municipal
health
clinics,
state
Medicaid
agencies,
the
Department
of
Veterans Affairs (VA), branches of the
U.S. Military including the Army,
Navy, and Air Force, the U.S. Public
Health Service (PHS), and other
related organizations. The PHS
oversees a number of agencies,
including, but not limited to, the
Coast Guard, the Centers for Disease
Control and Prevention (CDC), the
Food and Drug Administration (FDA),
the Health Resources and Services
Administration (HRSA), the Indian
Health Service (IHS), and the
National Institutes of Health (NIH).
Government /federal pharmacists

may be considered active military or

have
a
civilian
appointment
depending
on
their
place
of
employment and their position held.

Pharmacists in Regulatory body

of Bangladesh
A. Pharmacy Council of Bangladesh
(PCB)
An Autonomous Organization that
can provide scope for the graduate
pharmacists. The council can be
considered
as
the
controlling
authority of pharmacy education and
practice.
The Main objective of the Pharmacy
Council of Bangladesh is to regulate
the practice of Pharmacy throughout
Bangladesh. In addition to this the
pharmacy council performs the
following activities:
1.
Approve
examinations
in
pharmacy for the purpose of
qualifying persons for registration as
pharmacists;
2. Prescribe the subjects in which
approve examinations shell be held;
3. Approve the course of study and
practical training in pharmacy for the
purpose of admission to approval
examinations;
4. Prescribe the condition and
procedure
for
admission
of
candidates
to
and
approved
examination;
5. To lay down the standard of
teaching to be maintained by the
institutions conducting the approved
courses
of
study
6. Prescribe the equipments and
facilities to be made available to the
students;
7. To recognize degree or diploma in
pharmacy for the purpose of

registration
as
pharmacist
8.
Undertake
inspections
of
institutions
which
conduct
any
course of study in pharmacy and of
the
teaching
imparted
and
examinations held by them;
9. Prepare and maintain registers of
pharmacists and apprentices in
pharmacy;
10. To register pharmacists and grant
certificates
of
registration;
11. Hold examinations for the
purpose
of
registration
as
pharmacists;
and
12. Undertake such other activities
as it may be empowered or required
to do by the council under this
ordinance.

B. Directorate of Drug Administration

The Directorate General of Drug
Administration under the Ministry of
Health
&
Family
Welfare,
Government of the People's Republic
of
Bangladesh,
is
the
Drug
Regulatory Authority of the country.
This Directorate supervises and
implements all prevailing Drug
Regulations in the country and
regulates all activities related to
import, procurement of raw and
packing materials, production and
import of finished drugs, export, sale,
pricing, etc. of all kinds of medicine
including those of Ayurvedic, Unani,
Herbal and Homoeopathic systems.
Its mission is to ensure that the
common people have easy access to
useful, effective, safe and good
quality essential and other drugs at
affordable price.
The responsibilities of this
organization are as follows :

a. To ensure the quality, safety,

efficacy and usefulness of all kinds of
drugs and
medicines including
Homeopathic, Unani, Ayurvedic and
Herbal drugs which are produced ,
imported and marketed in the
country and also exported to
overseas.
b. To make essential drugs available
and affordable to the common
people of the country.
Major Function of DGDA
o

Evaluation of the proposals of

new projects of all systems of
medicines.

Issue and renewal of

manufacturing licenses.

Issue and renewal of retail and

whole sale drug licenses.

Registration and renewal of drug

products.

Fixation of price and certification

of price for drug products.

Inspection
of
establishments

Approval of block list for the

import of raw- and packaging
materials.

Approval of indent for import of

finished drugs.

Surveillance
pharmacovigillance activity

Prosecution of cases in the drug

courts and other courts

Issue of export licenses, FSC (Free

Sales Certificate), GMP (Good
Manufacturing
Practices)

drug

pharmaceutical

and

Certificate & CPP (Certificate for

Pharmaceutical Products.)
Clinical Pharmacy
Clinical pharmacy is the branch of
Pharmacy where pharmacists and
pharmaconomists provide patient
care that optimizes the use of
medication and promotes health,
wellness, and disease prevention.
Clinical pharmacists and clinical
pharmaconomists care for patients in
all health care settings but the
clinical pharmacy movement initially
began inside hospitals and clinics.
Clinical
pharmacists/pharmaconomists often
collaborate with physicians and other
healthcare professionals.
A Clinical Pharmacist is in charge of
providing various services to the
Division Director, such as taking part
in continuing education programs for
Medical staff, health care services,
and Pharmacy students, advising
physicians on drug usage and dose
control in hospitals and clinics, and
assisting the Division Director in his
everyday duties.
Role of Pharmacists in Clinical
Pharmacy
Traditional
pharmacists
fill
prescriptions for patients prescribed
by health care professionals. Clinical
pharmacists observe and treat
patients in all health care settings
and conduct research to further
pharmaceutical care and advance
the treatment and prevention of
disease. Clinical pharmacists work
independently to evaluate and
recommend
such
therapeutic
therapy as intravenous nutrition,
oncology,
nuclear
pharmacy,
geriatric, and psychiatric pharmacy.
Pharmacists
usually
keep
computerized records of patients'

drug therapies to prevent negative

drug
interactions.
Clinical
pharmacists
instruct
pharmacist
technicians in the proper procedures
for filling prescriptions, counseling
patients,
and
contacting
pharmaceutical
companies
and
health care facilities.

develop yearly training plans, and

rollout the programs accordingly.
Production

Pharmacists in Industry
Marketing

Managing a group of brands

through
innovative
and
challenging business strategies to
enhance market demand for a
sustainable business growth.
Challenges will include launching
new global brands in the local
market, developing strategic and
operational
business
plans,
implementing and monitoring
marketing
activities
of
the
allocated
product
range
to
achieve the business objectives in
terms of sales & profitability.

Sales
Evaluation of effectiveness of sales
force activities, analyzing sales in the
context of various criteria including
calls, contacts, potential accounts,
territory potential, market share, etc.
Close coordination with the sales
force members throughout the
country is highly recommended.
Sales Training

To enhance the capability of the

sales force through providing
functional as well as behavioral
training programs.
To
facilitate
and
coordinate
relevant training programs for
knowledge and skill development
of the sales force. You will also
need to identify training needs,

Establish strategic manufacturing

instruction followed by WHO
cGMP
Prepare daily production plan and
directs the implementation of
TQMS
Expert in current and emerging
manufacture
Monitor smooth manufacturing
environment
to
ensure
company`s quality objectives are
met.
Leads audits or inventory as
needed to support business and
compliance objectives.
Leads
investigation
programs
which assess risks for nonconforming product or operations
and develops appropriate action
plan including system correction
or improvement of operations to
minimize
future
risks
in
manufacturing process
Make recommendations regarding
long-range resource planning,
budgeting and restructuring to
meet market demand.

Quality Control/IPC
Analyzing finished or in-process
products (human & animal) within
the plant target and also of raw and
primary
packaging
materials.
Maintaining data records and filling
up product trend card as per
requirement.
You
will
provide
analytical support for investigation.
Commercial/Supply
Chain/Logistic
Design supply chain scenarios to
meet financial goals and demand
requirements, implement, and
maintain
the
demand
and
operations planning for raw

materials, packaging materials,

excipients.
Oversight of all supply functions
supporting for the company
including
shipping,
receiving,
materials
management,
&
planning.
Responsible
for
business
processes
using
SOP
and
accurately managed the Master
Data
of
site
manufacturing
operations.

end
view
of
enhancing
productivity and efficiency
Reviews
and
suggests
changes/enhancements,
if
necessary on policies, procedures
and guidelines affecting the
branches;
Liaises with principal and other
departments in various branches
concerns and vice versa;
Provides
support
in
the
management and control of A/R,
operating expenses, inventory
and in warehousing activities;

Distribution

Technical Services

Exploring
Machines,
Services

Managing
Sales
&
Service
Contract with the Suppliers

Preparing
weekly
assessment
report on market need & its
fulfillment.

Preparing documents for technical

& commercial bidding.

Attending technical & commercial

meeting with different business
houses.

Visit to suppliers/or vendors for

strengthening business relation.

To assist the Branch Managers in

all
areas
affecting
branchs
operation and administration;
To review with BMs and ensures
proper implementation of policies,
procedures and guidelines;
To conduct customer visits with
the Branch Managers, whenever
necessary for feedback, to listen
to and address concerns and to
establish
good
rapport
and
maintain professional business
relationships;
To
formulate
standards
for
productivity and efficiency of
branches
and
monitors
the
achievement of these standards
in consonance to overall company
objectives;
To prepare incentive programs
and projects to boost the morale
of the branch employees with the

New
Sources
of
Equipments
and