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

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

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

History of Pharmacy

Parallel Development in Several CivilizationsChina• Emperor Shen Nung 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

History of Pharmacy

Development in Several CivilizationsIndia• Charaka Samhita recorded 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

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

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

History of Pharmacy

Development of the Pharmacopeia• The first pharmacopeia, the Nuovo Receptario, 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

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

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

History of Pharmacy

19th CenturyWilliam 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

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

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

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)

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

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.

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.

What Are The Work Environments?

• Private industry: Pharmacists are also employed by firms that discover, develop and produce chemicals, prescriptions and nonprescriptive drugs 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.

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


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


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!


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.


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.


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


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.


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.


Federal Opportunities


Federal OpportunitiesUS 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.


Federal OpportunitiesUS Public Health Service


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.


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


Hospital and Institutional PharmacyPharmacist 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.


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.


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.


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 1. Increased use of prescription medications2. Number of people covered by drug

benefits 3. Introduction of expensive new drugs into

the market-place.


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 and

Drug Metabolism• Physical Pharmacy and Biopharmaceutics• Regulatory Sciences


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)

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

http://www.usnews.com/100bestjobs




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.

http://www.pharmacymanpower.com/


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.

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

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!

http://www.aacp.org/

http://www.aacp.org/


For example: Auburn University


Compiled data for all schools:

PCAT

Pharmacy College Aptitude Test (PCAT)

PCAT

Test ContentThere are six content areas measured by the PCAT in seven separate subtests:1. Verbal Ability section measures general, non-scientific word knowledge and usage

using analogies and sentence completion.2. Biology section measures knowledge of the principles and concepts of basic biology,

including general biology, microbiology, and human anatomy and physiology.3. Reading Comprehension section measures ability to comprehend, analyze and

evaluate reading passages on science-related topics.4. Quantitative Ability section measures skills in mathematical processes and the

ability to reason through and understand quantitative concepts and relationships, including applications of algebra, geometry, probability and statistics, pre-calculus and calculus.

5. Chemistry section measures knowledge of principles and concepts of inorganic and elementary organic chemistry.

6. Written Essay sections measure conventions of language skills in terms of sentence formation, usage and mechanics. One is included as an experimental item.

All of the writing prompts state a problem involving a health issue, a science issue, or a social, cultural or political issue. Examinees are asked to present a solution to the problem in their essays. They are scored on how well they write an essay that is a sufficient length to adequately explain a solution to the problem.

College of Medicine School of Pharmacy School of Dental Medicine

LECOM School of Pharmacy


ERIE c/o 2015 BRADENTON c/o 2016TOTAL APPLICATIONS 1678 1650SUPPLEMENTAL APPLICATIONS 1151 1158INTERVIEWS 395 489SEATS AVAILABLE 143 143

Pharmacy Admissions Facts


LECOM Erie Pharmacy Student Profile - Class of 2015

• Average Total GPA 3.48• Average Science GPA 3.36• Average Non-Science GPA 3.65• Average Total PCAT 56.21• Average Age 25• Male/Female 82/61• In/Out of State 56/87


Tuition Repayment (15 years) Estimates:

LECOM AVERAGE HIGHEST

Annual tuition & fees* $24,755 $34,511 $50,305

Total cost $74,265 $138,044 $201,220

Interest (6.8%) $44,398 $82,527 $120,296

Total repayment $118,663 $220,571 $321,516

>85% higherthan LECOM

170% higherthan LECOM

*based on 1st year figures


Multi-State Pharmacy Jurisprudence Exam (MPJE)

*initial attempt


North American Pharmacist Licensing Exam (NAPLEX)

*initial attempt

PharmCAS

• The Pharmacy College Application Service (PharmCAS) is a centralized application service that is used by the majority of colleges and schools of pharmacy. Designed for first-year professional pharmacy degree applicants, PharmCAS offers a simple, efficient process to apply to multiple colleges and schools of pharmacy using a single Web-based application. High school students, B.S. Pharmacy degree graduates, and current student pharmacists who wish to transfer to another pharmacy degree program should contact institutions directly for instructions.

PharmCAS

• www.pharmcas.org

Pharmacy School

Year 1• Imagine yourself as a first-year student pharmacist. You have a course

load that provides an important biomedical science foundation, with much of the material being integrated into a course entitled Drugs and Diseases. In addition, you are beginning to develop important patient care skills in the Contemporary Aspects of Pharmacy Practice course. You will also begin to visit patients to whom you and your team members are assigned to provide patient.

Pharmacy School

Year 2 • You are continuing to expand your knowledge and skills as you

complete the Drugs and Diseases sequence along with courses in Drug Products. You will also learn important principles about developing and managing a pharmacy practice. Your knowledge will also be augmented as you continue to develop specific practice skills and solve patient specific cases.

• You are now also assuming greater responsibility for patient care on your team as you have increasing knowledge that helps you to solve drug-related problems in your patients. First-year student pharmacists now count on you to provide them with assistance and you receive assistance from the third-year student pharmacist and faculty team members. At the end of the second professional year you will complete a milestone examination that will provide you with feedback on your pharmacy knowledge, skills and attitudes, and enable you to assess areas of strength as well as those that need improvement.

Pharmacy School

Year 3 The focus of your third professional year will be a continuous yearlong pharmacotherapy sequence in which you will integrate material from the previous two years as you solve patient care problems. You will do this as a member of a small group of approximately 8 students while working with an instructor who serves as a facilitator (not a lecturer). It will be your group’s responsibility to identify drug-related problems and develop a therapeutic plan to deal with each problem you encounter.

Pharmacy School

Year 3 • As a member of a small group, you are responsible for determining

information that you and your classmates need to know in order to solve various problems, obtaining such information, and teaching it to others in your group. This self-directed learning requires you and others in your group to use drug information resources, medical literature, the Internet, and other technologies to access needed information. You are continuously developing abilities that you will use during the fourth professional year and in the future as a practicing pharmacist.You are also assuming greater leadership responsibilities on your patient care team. Your increased pharmacotherapy knowledge allows you to better solve drug-related problems in your patients, and to assist and mentor the first and second year student pharmacists on your team. You will also complete your second milestone examination.

Pharmacy School

Year 4• During the entire year your primary responsibility is the provision of

pharmaceutical care under the supervision of faculty members. Specifically, your daily responsibilities will involve the following: 1) establishing pharmacist-patient relationships, 2) identifying, resolving, and preventing drug-related problems, and 3) documenting patient outcomes. You are exposed to automation and robotics and you will see how they expand pharmacist opportunities to provide direct patient care.Most of your rotations focus on the management of common illnesses and diseases that pharmacists encounter in a variety of practice settings.

Pharmacy School

Year 4• During your fourth year, you will also make a formal platform seminar

presentation on a pharmacotherapeutic topic and will prepare a poster presentation that will be presented to your faculty and peers. You will also complete your final milestone examination toward the latter part of the year. Having satisfactorily completed all requirements, you will participate in the School’s Commencement Exercises where you will receive your doctoral hood and diploma.

Pharmacy School

Final Outcomes Assessment Having completed Year 4, you must demonstrate that you have achieved the abilities that you started developing when you entered pharmacy school. You have successfully completed a simulation exam that required you to conduct an initial patient work up, identify and resolve drug-related problems and prepare a therapeutic plan for the patient. This process required you to interact with other health professionals, make ethical decisions, and demonstrate self-directed learning skills. Having successfully completed all program requirements, you are recommended for graduation.

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

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