Introduction To Pharmacy

(Phar 2071)
• For- Phrmacy year II students
• By- kalid H (B.pharm,MSC by Medicinal Chemistry)

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GENERAL BACKGROUND

Evolution of pharmacy (pre-historic pharmacy, antiquity,

the middle ages, renaissance, discoveries and background
of modern pharmacy)

Scope of pharmacy: education and careers

Introduction to the healthcare system in Ethiopia

History of drugs and dosage forms

 Pharmacy in Ethiopia: development, types of pharmacy

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settings.
 Learning Objectives

 At the end of this chapter you will be able to:

• Define the term pharmacy, and describe Scope and
Evolution of pharmacy.
• Identify and describe the health care system of
Ethiopia.
• Explain the History of drugs and dosage forms.
• Explain the development and types of pharmacy
setting in Ethiopia.

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Definition of Pharmacy

• The word ‘Pharmacy’ has two meanings :

General sense – it is a place or shop where drugs or
medicines are sold.
Professional sense – it is the profession, the members
of which deal with drugs.
• The word ‘Pharmacy’ is derived from the Greek word-
pharmakeia, “ use of drugs”
• In Greek, Pharmakon means- Drug

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Definition of Pharmacy

• Pharmacy is the art and science of preparing and

dispensing medications and the provision of drug and
related information to the public.
• It is the study of the science of drugs- Where they come
from? How they act on the body? How to turn drugs into
medicines?
• Pharmacy is the health profession that links the health
sciences with the chemical sciences and it is charged with
ensuring the safe and effective use of pharmaceutical
drugs.

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Definition of Pharmacy

• Pharmacy is a health profession which is concerned

with design of medicine its evaluation, production and
use of medicine that links the health science with the
biological, chemical and medical science.

• Person who practice pharmacy are called pharmacists.

• A pharmacist is one who is educated and licensed to

prepare and dispense drugs and to provide drug and
related information to the public.

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Pharmacists …..

• Pharmacists are healthcare professionals with

specialized education and training who perform various
roles to ensure optimal health outcomes for their patients
through proper medication use.

• Pharmacist are….
a specialist in medications
 a custodian of medical information
a companion of the physician
a counselor to the patient
a guardian of public health
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Pharmacists …..

• Pharmacists are represented internationally by the

International Pharmaceutical Federation (FIP).
• They are represented at the national level by professional
organisationssuch as
• the Royal Pharmaceutical Society in the UK,
• the American Pharmacists Association(APhA)in the USA, &
• The Ethiopian pharmaceutical Association ( EPA ) in Ethiopia.

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How do you become a Pharmacist .

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Scopes of pharmacy

The scope of pharmacy practice includes more

traditional roles such as compounding and dispensing
medications, and it also includes more modern services
related to patient care, including clinical services,
reviewing medications for safety and efficacy, and
providing drug information.

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 Pharmacy Education
• The professional Pharmacy Curriculum
– Bachelor of Science (BS) pharmacy (5 yrs)
– Doctor of Pharmacy (Pharm.D.) (6 yrs)
• Post Professional Pharmacy
– Graduate School
• Master
• Ph.D.
– Residencies
• Pharmacy Practice residencies
• Specialized residencies

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 Pharmacy Education - Curriculum

1. Biomedical Science
2. Pharmaceutical Science
3. Behavioral, Social & Administrative Pharmacy
Science
4. Pharmacy Practice
5. Professional Experience
6. Electives/others

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 Biomedical Sciences
 Anatomy
 Physiology
 Pathophysiology
 Microbiology
 Immunology
 Biochemistry
 Chemistry

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 Pharmaceutical Sciences
• Medicinal Chemistry
• Pharmacognosy
• Pharmacology
• pharmaceutics
• Pharmaceutical analysis

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 Behavioral, Social & Administrative
Pharmacy Science

• Pharmaco economics
• Pharmacy Communication Skills
• Pharmacy Ethics
• Pharmacy Law
• Biostatistics
• Research Design
• Epidemiology

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 Reasons to choose the Pharmacy
• A vital part of the health care team
• Excellent employment opportunities
• Excellent earning potential ….. Business- comfortable
income.
• A very noble and respected profession

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CAREER OPPORTUNITIES

Hospitals and clinics

• Hospital pharmacists
• Clinical pharmacists
 Community pharmacy ( retail pharmacy )
Wholesale pharmacy
 Government services
 Regulatory affairs
 Drug testing laboratories
 Drug purchasing & distribution
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CAREER OPPORTUNITIES
Pharmaceutical industry
• Production
• Quality control (QC)
• Quality assurance (QA)
• Research & development (R&D)
• Store
• Marketing ( local, global )
• Product management
• Regulatory affairs
• Pharmaceutical sales representative ( PSR )
Pharmacy education ( teaching & research )
Other areas 18
HISTORY OF PHARMACY
The evolution of the profession of pharmacy can be
divided into five historical periods:
1. ANCIENT ERA-The beginning of time to 1600AD
2. EMPIRIC ERA-1600-1940
3. INDUSTRIALIZATION ERA-1940-1970
4. PATIENT CARE ERA-1970-present
5. BIOTECHNOLOGY AND GENETIC
ENGINEERING ERA-The new horizon

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 ANCIENT ERA
• Early humans Used leaves, mud, and cool water to stop
bleeding and heal wounds
• They used these methods by observing how animals
heal their wounds
• Documented experiences of healing onto clay tablets
which provided the earliest known written record.

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 ANCIENT ERA- Documentation

• ANCIENT MESOPOTAMIA • The geographical region

which lies near the Tigris and
Euphrates rivers
• Sumerians-origin of the 1st
Civilization

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ANCIENT ERA
MESOPOTAMIA

• In Babylonia the earliest record of the practice of

pharmacy by the priest, pharmacist, and physician was
kept.
• This is where the science of drugs, organized pharmacy
and medicine had its beginnings.
At some point man began to document healing practices
on clay tablets 2600 B.C.
Clay tablets recorded symptoms of illness, prescriptions,
and instructions for compounding remedies.
Healers combined roles of priest, pharmacist, and
physician

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 Ancient China
• Chinese used herbs.
• Legendary Emperor Shen Nung researched the medicinal
value of herbs, testing many of them on himself,
approximately 2,000 BCE.
• Shen Nung wrote the first Pen T-Sao, or native herbal,
recording 365 drugs.
• In modern times, Shen Nung is still worshipped as the
patron god of Chinese drug guilds.

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Ancient Egypt

• One of the earliest known records written around 1500

B.C. was the Ebers Papyrus named by George Ebers.
• Most important ancient pharmaceutical record
Ebers papyrus, 1550 BC

A collection of 800
prescriptions; specifically
mentions 700 unique drugs

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 Ancient India
• The Charaka Samhita recorded
more than 2,000 drugs
• Written as early as 1,000 BCE
• Meaning “compendium of
wandering physicians,” the
Charaka Samhita was the work
of multiple authors

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Ancient Greece

• Hippocrates.
Greek physician who lived between 460 BCE and 377
BCE.
He was a philosopher, physician and pharmacist.
Known as the father of medicine
Commonly regarded as one of the most notable figures
in medicine of all time
Published more than 70 writings related to the practice
of medicine and pharmacy
• Hippocratic Oath: physicians pledge to “do no harm”
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 Theophrastus

• One of the greatest early Greek philosophers and natural

scientists
• Observed and wrote extensively on the medicinal
qualities of herbs.
• De Historia Plantarum
• De Causis Plantarum
– Many kinds of plant and how they are used in
medicine, how to grow them and many other
observations

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• Dioscorides (40-80 AD)
• “De Materia
Medica” (600
medicinal plants)
• which was used by
medical professionals as
late as the sixteenth
century

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 Galen
• Practiced and taught both pharmacy and
medicine during 130–200 CE
• His principles of preparing and compounding
medicines reigned in the Western world for
1,500 years
• His name still is associated with the class of
pharmaceuticals compounded by mechanical
means: galenicals

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 Ancient Rome
• Mithridates VI developed poisons, preventives, and
treatments around 100 BCE
• Used himself and prisoners as subjects on which to test
poisons and antidotes
• Mithridates-Father of Toxicology-Studied the adverse
effects of plants.

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 Roman pharmacy titles

• Pharmacopeia: Maker of remedies

• Pharmacotritae: Drug Grinders
• Unguentarii: Makers of ointments
• Pigmentarii: Maker of cosmetics
• Pharmacopolae: Seller of drugs
• Aromatarii: Dealers of spices
• Pharmacist of today had not yet evolved

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 The Arabian Influence
• Major advances in this era
• In 8th century, Arab practitioners separated the arts of the
apothecary and physician
 Formularies: The documentation of drug information.
 Arab apothecaries developed new medicines
 They also had different drug forms which are now used:
Syrups, Conserves, Confections and juleps.
 The first Pharmacy shop in the world was in Baghdad about
792 A.D.
 Traveling Muslims brought the new system of pharmacy to
Europe( Spain, France , etc) and Africa

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 Avicenna – The “Persian Galen”
• the Persian, Ibn Sina (about 980-1037 A.D.),
• called Avicenna by the Western world.
• stand for his time
• One of the brilliant contributors to the sciences of Pharmacy
and Medicine
• Pharmacist, poet, physician, philosopher and diplomat,
Avicenna was an intellectual giant, a favorite of Persian
princes and rulers.
• His pharmaceutical teachings were accepted as authority in
the West until the 17th century; and still are dominant
influences in the Orient.
 The Renaissance 1350- 1650 A.D.
(End of the ancient era)
• Pharmacy became separated from medicine.
• Pharmacy Regulation began.
• University education for pharmacists was now
required.
• More and new drugs were imported from the orient.
• New chemicals were introduced.

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 The Empiric era 1600-1940

• The Pharmacopeia became a regulatory tool for pharmacists.

• Benjamin Franklin started the first hospital in 1751.
• It had a pharmacy and the first hospital pharmacist was
Jonathan Roberts.
• 1821 The Philadelphia College of Pharmacy was founded.
• William Proctor-The father of American Pharmacy.
• He devoted his time and attention to the advancement of
pharmacy.
• He owned an apothecary shop.
• The major contribution of pharmacists to science was in the
area of chemistry.

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 The Empiric era 1600-1940
• The father of American pharmacy, William Procter, Jr.
– 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

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 INDUSTRIALIZATION ERA
 The development of manufacturing pharmacy
began.
 Rapid mass production of medicines followed.
 Standardization, biologically prepared products,
complex chemical synthesis, and increased use of
parenteral medications were all part of this period.

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 THE PATIENT CARE ERA
• The beginning of this era concentrated on research to
develop new medicines.
• Research on medications was done.
• New drugs were developed.
• Had a lot of adverse reactions to drugs so drug review
and monitoring resulted.
• Pharmacists began to take a more hands on role in
dispensing medications and patient education.
• problems – Complications like allergic reactions,
multiple drug interactions with other drugs and food.
• Increased the therapeutic duties of patient care in the
pharmacies and hospitals 38
 Biotechnology Era
Present- future
 Research in the area of biotechnology and gene
therapy is being conducted.
 Medications are being produced through recombinant
DNA technology.
 New therapies for cancer, anemia, and hepatitis are
being introduced.

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 Symbol of Pharmacy
 The pharmacy profession has used numerous symbols
over the past centuries.
 These symbols include, but are not limited to,
 the mortar and pestle,
 the Rx sign,
 various alchemical symbols
 the show globe
 the green cross
 the salamander,
 "A" for apothecary (Apotheke), and
 the Bowl of Hygeia. 40
 Symbol of Pharmacy
The mortar and pestle are tools of traditional
pharmacy.

 The mortar and pestle has long been used as a pharmaceutical

symbol in Britain and on the European mainland, and is still
widely employed as a pharmacy shop sign in Scotland.
 The mortar and pestle are tools of traditional pharmacy, hence
their use as an easily recognizable visual motif.
 The mortar and pestle symbol shown here is a stylized
Scandinavian version
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 Symbol of Pharmacy
• The recipe sign appears at the start of prescriptions.
• Although universally accepted as an abbreviation of
“recipe” (Latin for ‘take thou’), it has also been
suggested that it is the astronomical sign of the planet
Jupiter.

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 Symbol of Pharmacy

• The Green Cross was first introduced as a pharmaceutical symbol

in the continental Europe in the early 20th century as a
replacement for the Red Cross.
• The Red Cross, previously used by some medical institutions and
by continental pharmacists, was adopted by the International Red
Cross in 1863, necessitating the need for an alternative.
• The Green Cross was not used in Britain until 1984, when it was
adopted by the Royal Pharmaceutical Society of Great Britain .

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 Symbol of Pharmacy

Bowl of Hygeia

• The bowl with a snake coiled around it is called the bowl of

Hygeia with the serpent of Epidaurus, and is a variant on the
above.
• Hygeia was Aesculapius’s daughter and a Greek Goddess of
health.
• Her symbol was a serpent drinking from a bowl.
• The vessel is usually depicted with a long stem and a shallow,
wide bowl as seen here.
• It also is considered suitable for pharmacy.
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 Symbol of Pharmacy

Bowl of Hygeia

 The Bowl of Hygeia is the most widely recognized

international symbol for the profession of pharmacy
today.
 Now the bowl represents a medicinal potion, and the
snake represents healing.
 Healing through medicine is precisely why pharmacy
has adopted the Bowl of Hygeia symbol.

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 Symbol of Pharmacy
Bowl of Hygeia
 Different reasons….
• The serpent/ snakes signifies wisdom and symbolizes
guardianship.
• It was a symbol of wisdom, immortality and healing in Middle and
far Eastern cultures far older than that of ancient Greece,
• Because snake venom helps sick people, it was associated with the
healing.
• The bowl stands for medicinal mixture used for healing.
• The American Pharmaceutical Association adopted the Bowl of
Hygeia as its symbol to represent the pharmacy profession in 1964.

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Pharmacy in Ethiopia: development, types
of pharmacy settings

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Health care system in Ethiopia
– Started in the16th century (Atse Lebnadengel)
 Joao Bermudes, portuguese barber-surgeon, 1520
-1526

– Emperors Yohannes
 Vaccination

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 Modern Medicine in Ethiopia…

• Emperor Menelik II (1889-1913)

– Russian Red Cross mission (1896)
– 1900 the first hospital established in Addis Ababa
– Modern health care was considered as a privilege
to the royal family prior to the establishment of
this first hospital
– Office dealing with health created in 1908 G.C in
the ministry of interior 49
 Modern Medicine …
• Expansion During Emperor Hailesellasie I
– Reforms in economic and social conditions
including health service expansion
– Twelve hospitals and 35 clinics
– This drive was interrupted during the brief
occupation of Ethiopia by the Italians.
– 1935 – 1941:
• Italians converted all health service facilities into
army medical clinics for use of the military
– As the result the benefit to the population was
insignificant
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health care structure during the Derg Rule

CENTRAL

REFERAL

REGIONAL HOSPITAL

Rural/Medium Hosp
Health centre (HC) per 50,000 pop.

Health Stations (HS) per10,000 pop.

Community Health service (CHS) per 1,000 pop.

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 The current health care system
• The health care delivery system is guided by a
National Health Policy (NHP) which was issued in
September1993 and a Health Sector Development
Program (HSDP) as of 1990 E. C. (1997/ 98 G. C.).
• The HSDP, which was designed for a period of 20
years with rolling five−year programs, has provided a
long−term plan framework for the heath sector.

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 The current health care system
• The focus of health delivery system is expansion and
improvement in the quality of care and is guided by the
following components of HSDP at all levels.
 Health service delivery & quality of care
 Facility rehabilitation & expansion
 Human resource development
 Strengthening pharmaceutical services
 HMIS- health management information system
 Health care financing
 Monitoring and Evaluation

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 The current health care system
• The Ministry of Heath is the major provider of health
care followed by the private sector, Non−Governmental
Organizations (NGOs) and other governmental
organizations.
• To date public provision of health care account for 80%
whilst the remaining 20% is shared between the private-
for-profit and NGO sectors.
• Each of the Regional States and the two Administrative
States has a Regional Heath Bureau (RHB), Zonal
Heath Departments and District Health Offices.

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Ethiopian Health Tier System
1. Primary level health care:
Health post
Health center
Primary hospital
Urban Health center for 40,000 people
2. Secondary level health care:
General hospital
3. Tertiary level health care:
Specialized hospital

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 Ethiopian health tier system
Specialized
Hospital Tertiary level health care
3.5 – 5.0
Million

General hospital Secondary level health care

(1000000-1500000) people
Primary hospital
60000-100000
Health
Health center
center Primary level
15000-25000 health care
40000 Health post
3000-5000

Urban Rural
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 The Pharmaceutical Sector
in Ethiopia.
• The pharmaceutical sector is guided by a National Drug Policy
(NDP), which was developed in 1993 G.C., in-line-with the
national health policy.
• One of the major objectives of the policy is to meet the
country’s demand of essential drugs and to systematize the
supply, distribution and use of safe, effective and quality drugs.
• In mid-2007, the Pharmaceutical Fund Supply Agency (PFSA),
the former PHRMID was created with a larger mandate: to
supply the entire country with both Program and Essential
drugs, as well as serve as the distribution entity for vaccines,
other health facility supplies, and laboratory equipment

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 The Pharmaceutical Sector
in Ethiopia.
• The pharmaceutical sector is regulated by the Food,
Medicine & Health care Administration and Control
Authority proclamation No. 661/2009 which was
promulgated on 13 Jan, 2010 G.C.

• Following the passage of this proclamation, the former

“DACA” changed to an autonomous regulatory body
known as “FMHACA) which became operational since
january 2010 G.C.

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 Pharmacy Education in Ethiopia

• Archival sources in the Federal Ministry of Health

indicate that modern pharmacy education in Ethiopia
began by training of medical auxiliaries under the
auspices of the Ministry of Interior within the
compound of Menilik-II hospital in 1943.
• The first four students that successfully completed
their training were awarded “Hospital Dispenser
Certificate” in June 1944.
• EPA was formally established (by 40 pharmacists)
and legally registered in 1974 G.C.

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 Pharmacy Education in Ethiopia

• Presently, various public and private educational

institutions offer pharmacy training at degree, diploma
and certificate levels .
• Moreover, postgraduate programs at masters and PHD
levels are being offered in different disciplines of
Pharmacy at Addis Ababa University.

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The Oath of a Pharmacist

• At this time, I vow to devote my professional life to

the service of all humankind through the profession
of pharmacy.
• I will consider the welfare of humanity and relief of
human suffering my primary concerns.
I will apply my knowledge, experience and skills to
the best of my ability to assure optimal drug therapy
outcomes for the patients I serve.
I will keep abreast of developments and maintain
professional competency in my profession of
pharmacy.

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The Oath of a Pharmacist

• I will maintain the highest principles of moral, ethical

and legal conduct.
• I will embrace and advocate change in the profession
of pharmacy that improves patient care.
• I take these vows voluntarily with the full realization
of the responsibility with which I am entrusted by the
public.

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