Day 4: Overview History Of US Pharmacy Flashcards
(42 cards)
What is a generic or alternative source manufacturer?
It’s ones that waits until a drugs patent expires and they rush to the generic form to market and they make their money off of making generic drugs
What is a research intensive manufacture?
It’s a larger company that spends a lot of money on research for the discovery of novel drugs
What were the general government themes in pharmacy before the 1950s?
Few laws that regulated (pharmacists had a lot of freedom to practice)
Few laws regulated drug manufactures (there was a free market to develop new products)
Fun fact: pharmacists were not commissioned officers in WWI and WWII (implied the government didn’t respect pharmacy)
What is the Food Drug and Cosmetic act of 1938?
It was a law that established drug safety prior to they would be approved
Needed an NDA
**Came into place because a drug company put a sulfa antibiotic into draino and gave it to kids which ended up killing them
**sometimes death is the only thing that motivates change in laws
How was pharmacy education before the 1950s?
Before 1928 it was only an apprenticeship but it was soon turned into a 4 year bachelors degree
California started to adopt a 6-year degree
- *this was frowned on by some school because the resources to run a 6 year program were higher
- *also employees didn’t want it because it would cause a demand for higher wages
What was the first pharmacy association that represented pharmacists?
American Pharmaceutical association
*created in 1852
What is the importance of the soda fountain?
It was a place that people could go to socialize and meet with people as well as pick up drugs. It made the pharmacists a figure and a place people wanted to go
**this built respect for the profession
What is the focus of community pharmacy before 1950?
Dispensing is the focus of practice
Dispense it correctly, quickly and accurately (just dispense what the dr wrote for no questions)
How was hospital pharmacy before the 1950s and what did they think of community pharmacy?
They are only really found in the largest and most established hospitals but not found in each one
**Some hospital pharmacists thought they were better than community pharmacy (even tho studies found most didn’t preform pharmacists duty and more management type jobs)
***this lead to the creation of the ASHP which started a war between hospital and community pharmacy and made a rift in the profession
What was the 1951 amendment to the 1938 Food, Drug, Cosmetic act?
It dived drugs into prescription and nonprescription status
Also had to obtain consent of prescriber for refills
**also meant that you now needed an RX in order to get a drug
Was the change of pharmacy education to the 5-year program in the 1950s welcomed or not?
Not it was a compromise that pleased no one
Why was hospital pharmacy in the 1950s preferred over community?
They worked shorter hours and they had a better scope of practice
Could teach in nursing schools
Could work on committees
How did a change in pharmaceutical manufacturing in the 1950s change the role of pharmacists?
Also were community or hospital pharmacists able to control manufacturers in the 1950s?
There was an increase in mass production. This meant that pharmacists were not compounding as many products as before
**community pharmacists could not stop laws that supported manufacturers (this means that they couldn’t get formularies and generic substitutions of products)
***Hospital pharmacies were able to do that and could make formularies and use generic substitutions (allowed them control over cost as well as ability to pick which drugs were used)
What was the role of community pharmacy in the 1950s? What was the primary duties they preformed? What was the APhA code of ethics say>
it was the count and pour era
Compounding drugs was disappearing and the practice was becoming more commercialized
Also prescription volume doubled
**The APhA code even said that the role of the pharmacist was to just fill the drug and not question what the doctor wrote for
What was the 196 amendment to the food, drug, cosmetic act?
It added that manufacturers not only had to prove the drug was safe but also that it had EFFICACY!!!
What’s the difference between efficacy of a drug and if its effective?
For a drug to be proved efficacious its done in controlled setting and is regulated greatly
If its effective that happens in real world examples, and not everything is controlled as perfectly as in the efficacy trails
What was the importance of Medicare and Medicaid programs being passed in the 1960s?
Was a major expansion into health care system
Low income patients can now have access to drugs
*****ONLY hospital pharmacies directed by RPhs were eligible for Medicare reimbursement
How was pharmacy education changing in the 1960s?
It was starting to shift from being science based, even tho most teachers were still physical scientists, to shifting to being more clinical aspects of the profession
How was community Pharmacy in the 1960s and how did the APhA codes of ethics change?
The count and pour era continues
**new grads were not finding many opportunities to apply the info that they have learned
***dispensisng still ruled the day and third part programs were staring to be created
APhA code of ethics: RPh should hold the health and safety of the patient first before everything else
How was hospital pharmacy changing in the 1960s?
It was developmenting more into clinical pharmacy practice
**like Vanco dosing and stuff
They were moving beyond providing drug information and drug dosing and expanding their roles
Worked on patient profiles (making sure they had all the meds together of each place that the patient was being seen
What was the importance of Nixon signing Health Mainteance Organization (HMO) act of 1973?
It put HMOs in place in order to try and control the costs of health care and improve quality
What was the significance of consumer movement of the 1970s?
It lead to consumers causing repeals of laws against generic product selection
The pharmacists and the consumer became allies against the drug companies
**Patient interest in self-care is growing
What was the change that happened in the 1970s to pharmacy educations?
Pharmacy stated to become more diverse (more women and minorties)
Also the curriculum was changing leading to the Pharm. D programs, programs are becoming more clinically oriented
What was community pharmacy changing in the 1970s? As well as hospital pharm?
Changes were happening for community
They start to market themselves as consultants
Increase use of computers
Increasing use and review of patient profiles
Hospital:
Continues to expand and go on rounds and do clinical PK as well as manage dosing
