PHARMACY MEDICINE DISPENSING
Pharmacy medicine dispensing is a part of pharmaceutical sciences, the science of preparing medicine dosage forms; inseparably linked to the spirit of pharmacy. It includes all the operations connected with processing pharmaceutical raw materials in order to obtain main medicine.
Foundations of modern pharmacy medicine dispensing were laid by Claudius Galenus – the father of pharmacy, as far back as in 2nd century BC, he manufactured simple concoctions by mixing, etching with wine, macerating etc. They were e.g. tinctures (tincturae), juices (succi), extracts (extracta), infusions (infusa), decoctions (decocta), ointments (unguenta). As the first one, he found that the performance of a medicine depended on its application form. As the matter of fact, he also introduced a distinction between pharmacy and medicine, which cannot exist without each other. Medicine preparation methods developed by Claudius Galenus were valid in Europe for 1500 years after his death. In his honour, modern medicines that are made in accordance with official regulations (pharmacopoeial) are called “galenic preparations”, and those manufactured by pharmaceutical industry are made in “galenic laboratories’. Once, mainly vegetable concoctions were called “galenic preparations. Pharmacy owes its further development to Paracelsus, who elaborated several applications of medical agents, e.g. he advised application of gold compounds in the therapy of venereal illnesses, leprosy and epilepsy.
Over many years of the history of dispensing medicines at “grocer’s shops’ – as pharmacies used to be called in the past, there were made diverse, numerous and very interesting dosage forms, which deserve to be mentioned – at least: healing plum jams – electuaria, healing cigarettes – e.g. antiasthmatic cigarettes, burning herbs, pills – pilulae: e.g. laxative pills – Pilulae laxantes, curing papers: e.g. mustard paper – also according to the Polish Pharmacopoeia III – charta sinapisata, tehriac (used until 18th century), vasogens – e.g. Vasogen jodatum, curing wines – e.g. Vinum album et vinum rubrum, elixiry, mint candies – Rotulae Menthae piperitae, saturated gauzes, e.g. carbolic gauze – Tela cum Phenolo, nasal, conjunctival, aural suppositories and many others.
Earlier (even in the period between the world wars), pharmaceutical raw materials were produced in the so called pharmacy laboratories according to possibilities, and less complicated syntheses to meet the needs of medicine dispensing. Manufacturing pharmaceutical raw materials and preparing medicines in pharmacies required big expenditure of work, specially for drugs – where operations were arduous, e.g. time-consuming preparation of decoctions, extracts, draining phases, maceration and percolation processes etc. (there is a very interesting description of an old and very well developed pharmacy medicine dispensing practice in an autobiographical novel „Pigularz” by Wacław Gąsiorowski).
Pharmacy medicine dispensing is persistently present in pharmacy. The fact is that nowadays, the amount of medicines being prepared at pharmacy (main, officinal and galenic medicines) prescribed by physicians and surgeon’s assistants, and dispensed by pharmacists is lower compared with the past. This is caused by very big growth of pharmaceutical industry. However, the demand of pharmacy-made medicine is indisputably founded.
There are following advantages of pharmacy dispensed medicines:
-possibility of adjusting by physician in a preparation formulation a dose or concentration of an active pharmaceutical ingredient (API) to individual patient needs and taking into consideration patient age, sex and morbidity (e.g. there is very often a need of using an API concentration or dose lower or higher than is available as a ready medicine – e.g. 0,5 % sol. Atropini sulfurici pro usu ophtalmico, 5 % ung. cum Metronidazoli –effective concentration in the treatment of demodicosis or pulv. Papaverini muriatici pro infantibus a 0,08);
-possibility of composing a formulation– of utilising the synergy of the action of APIs (e.g. Erythromycinum et Chloramphenicolum), as well as the antagonism (e.g. Ephedrinum hydrochloricum et Codeinum phosphoricum) and auxiliary action – adiuvans of other ingredients (e.g. Luminalum natrium et Kalium bromatum, Tinctura Polemonii or Sulfur sublimatum et Balsamum peruvianum);
-use of a selected auxiliary ingredient – vehiculum;
-match of a selected medicine dosage form (e.g. ovul. vaginal. cum Ethacridini lactatis or 10% solutio Ichthyoli);
-lack of preservatives, aromatic substances and pigments in majority of recipe medicines – which is a great advantage, especially for patients being prone to allergic reactions;
-their favourable price.
Earlier, many dosage forms were prepared in pharmacy medicine dispensing – because it was needed. There were prepared tablets, pills, and even infusion liquids; recapitulating: these forms, which today are manufactured by pharmaceutical industry.
Nowadays, there is required dispensing of the preparations, which are not available in ready forms for various reasons (economical, having short validity period after preparation) and the ones, which have unique and sometimes complex formulation.
A considerable amount of remedies are applied only in form of pharmacy-made medicines, which are now unavailable as ready industry-manufactured forms, and their application in therapeutics is indispensable and wide, so preparing them in pharmacies is the only solution for them to be used. That are e.g.: unguenta cum Cignolini – one of basic agents in at-home treatment of psoriasis pulveres et solutiones Dionini, Ungunetum Wilkinsoni, solutions of bromine salts, Parma tint or transitory colloidal silver salts solutions, salicylic ointments and many more.
The arsenal of compound recipe medicines, which endeavours at following the need of modern therapeutics, has been changing for many decades and is still changing. In a rather short period, dispensing of antibiotics has developed significantly; many new raw materials were brought to market: e.g. Erythromycinum basicum, Gentamycinum sulfuricum, Nystatinum and others, hormones – the following raw materials are often used: Hydrocortisonum et Prednisolonum. Application of urea – Urea vel Carbamidum in form of an ad usum externum medicine has increased considerably; where, for comparison, earlier, it was applied mainly internally. There are still made Species – herb-teas, included in the Polish Pharmacopoeia VI.
The present Polish pharmacy medicine dispensing sets large requirements in regard of adaptation of facilities to the needs of preparation compounding, and also with regard to the quality of pharmaceutical raw materials. Previous editions of the Polish Pharmacopoeia (PF) – i.e. official lists of monographs on pharmaceutical raw materials, e.g. the Kościuszko Pharmacopoeia of 1794., the Polish Pharmacopoeia I – Farmacopoea Regni Poloniae, Autoritae Ministerii Administrationis Rerum Internarum et Disciplinae Publicae, Edita a Consilio Supremo Snitatis Varsoviae – edited in 1817, Polish Pharmacopoeia II - 1937, the Polish Pharmacopoeia III – 1954, the Polish Pharmacopoeia IV – Volume 1 – 1965, Volume 2 – 1970 - often included scant and sometimes inaccurate descriptions, testing methods for identification and purity assessment. It was caused by inter alia the state of knowledge, and was adequate for the time the previous editions of the Polish Pharmacopoeia appeared.
Next edition of the Polish Pharmacopoeia, beginning from FP V, in five volumes, but also the Polish Pharmacopoeia VI, edited in 2002 with a supplement, contain in-depth descriptions as well as new stringent specifications, the majority of which meet the requirements of the European Pharmacopoeia, and other Pharmacopoeias e.g. BP, DAB.
Present pharmaceutical raw material used for manufacturing medicines by pharmacy medicine dispensing should meet very stringent quality requirements.
There, Pharma Cosmetic assume a role, which endeavour at supplying pharmacies with properly prepared and carefully assorted raw materials of the highest quality – considering pharmacists’ suggestions – especially in respect of organoleptic quality, that comply with respective valid standards of the Polish Pharmacopoeial Monographs and others Pharmacopoeias, including the European Pharmacopoeia that apply for a particular raw material.
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