The professional practice of the pharmacist is focused on
the medicines that he/she handles and the outcomes of treatment with such
medicines. Pharmacists must thus have knowledge in the aspects of preventative
and promotive health care, ill health prevention, emergency care and the general
well-being of the community, the economic, legal and logistic aspects relating
to the acquisition, storage and distribution of medicines and be able to advise
the public in this regard.
ln order for the pharmacist to provide or advise on the
choice, initiation, maintenance and termination of various drug therapies for
more general illnesses, he/she must have a basic knowledge of pharmaceutics,
pharmaceutical chemistry, pharmacology and toxicology. Knowledge of the aspects
of professional pharmacy practice will ensure that the principles of
pharmaceutical care are upheld by the pharmacist in practice, namely, the
attitudes, behaviors, commitments, concerns, ethics, functions, responsibilities
and skills of the pharmacist in the provision of medicine therapy with the goal
of achieving definite therapeutic outcomes towards the patient’s health and
quality of life.
The essential areas of pharmacy practice covered in this
section of guidelines are
1. APPLIED PHARMACEUTICS AND
PHARMACEUTICAL CHEMISTRY
2. APPLIED PHARMACOLOGY AND
TOXICOLOGY
3. LAWS PERTAINING TO PHARMACY
PRACTICE
4. APPLIED PROFESSIONAL
PHARMACY PRACTICE & PHARMACY ADMINISTRATION
1. APPLIED PHARMACEUTICS AND PHARMACEUTICAL CHEMISTRY:
The examination in applied pharmaceutics and pharmaceutical
chemistry consists of two parts i.e. section based on pharmaceutics and a
section based on pharmaceutical chemistry. Candidates are allowed for three (3)
hours to complete the examination. The examination is in an open book format
and consists multiple choice questions, although long questions may also be
included where appropriate. Copies of examination papers may be purchased from
Council.
APPLIED
PHARMACEUTICS:
Selected
references:
Pharmaceutics: The
science of dosage form design. Aulton, M.E.(ed)., churchill Livingstone, London,
1988 (ISBN 0-443_03643_8)
Pharmaceutical
Practice: collett, D.M. and Aulton, M.E. (eds)., churchill Livingstone,
London, 1990 (ISBN 0_443-03644_6)
AIMS OF THE
PROFESSIONAL EXAMINATION IN APPLIED PHARMACEUTICS (SYLLABUS)
1 .
Basic
principles of compounding and dispensing
The candidate must be able to
perform
and
have an understanding
of
the following components of compounding and dispensing:
1.1
Calculations
Pharmaceutical calculations dealing with concentration, dilutions & titurations .
1.2
Storage and Stability
·
Chemical kinetics and the role of accelerated
stability testing;
·
The role of temperature, hydrolysis,
solvolysis, photolysis, trace metal catalysis and hygroscopicity in drug and
dosage form stability.
1.3
Containers and closures
·
The ideal requirements of a container or
package;
·
Materials used to manufacture containers and
closures;
·
Child resistant containers;
·
Unit dose packaging.
2. Pharmaceutical preparations
The candidate must have a knowledge and
understanding of the following pharmaceutical dosage forms:
2.1
Solutions
·
The rationale behind using solutions as an
oral dosage form;
·
Aqueous and non-aqueous solution
formulations;
·
Formulation additives;
·
Types of preparations ( oral and non-oral);
·
Stability of solutions;
·
Compounding and manufacturing of solutions;
·
Antiseptic and disinfectant solutions.
2.2
Suspensions
·
The physical properties of a
well formulated suspension;
·
Pharmaceutical applications;
·
Formulation;
·
Stability testing;
·
Compounding and manufacture;
·
Materials used in suspensions;
2.3
Emulsions and creams
·
Emulsion types;
·
Formulation of emulsions,
including emulsifying agents and other additives;
·
Stability and stability testing;
·
Compounding and manufacture;
·
Drug release from emulsions.
2.4
Ointments, pastes and gels
·
Formulation of
dermatological preparations;
·
Microbial contamination and
preservation;
·
Physicochemical criteria for
dermatological preparations.
2.5
Suppositories and pessaries
·
Absorption of drugs from the
rectum;
·
Formulation and compounding
of suppositories;
·
Drug release from
suppositories and pessaries;
·
Rectal formulations other
than suppositories.
2.6
Powders and granules
·
Advantages and disadvantages
of powdered and granulated products;
·
Types of dispensed
preparations;
·
Preparations requiring
further manipulation at the time of dispensing;
·
Formulation and compounding
of powders and granules.
2.7
Tablets and capsules
·
Advantages of tablets and
capsules;
·
Types of tablets and
capsules;
·
Essential properties of
tablets;
·
Influence of tableting
method on formulation;
·
Tablet excipients;
·
Dispensing of tablets;
·
Sustained release
preparations;
·
Raw materials for gelatin
capsules;
·
Hard and soft gelatin
capsules;
·
specific formulation
requirements of other compressed dosage forms;
·
Bioavailability aspects of
tablets and capsules.
2.8
Therapeutic aerosols
·
Definitions and uses of
therapeutic aerosols;
·
Important physicochemical
properties;
·
Deposition of aerosols in
the human respiratory tract;
·
Design, formulation and
generation of aerosols;
·
Testing of aerosols;
·
Drug absorption and clearance from the
respiratory tract.
2.9
Sterile pharmaceutical preparations
The
compounding and dispensing of sterile pharmaceutical preparations includes microbiology
and preservation, sterilization and aseptic technique, parenterals, opthalmics,
cytotoxics and radiopharmaceuitcals. The candidate should thus have an
understanding of:
·
Sources and incidence of
contamination;
·
Growth and multiplication of
microorganisms in pharmaceutical preparations;
·
Consequences of
contamination;
·
Control of microbial
contamination;
·
Preservation of
pharmaceutical preparations;
·
Microbial standards for
pharmaceutical preparations;
·
Significance of sterility
and sterilization protocols;
·
Methods of sterilization and
sterility testing;
·
Sterilisation controls and
good aseptic technique;
·
Routes and methods of
parenteral drug administration;
·
Bioavailability of drugs
from injections;
·
Formulation, preparation and
sterilization of injections;
·
Closures, packaging and
quality assurance of injections;
·
Methods of administration of
intravenous infusions;
·
Infusion additives;
·
Formulation and preparation
of ophthalmic products;
·
Dispensing of cytotoxic agents;
·
Therapeutic
radiopharmaceuticals;
·
Formulation and facilities
required for the preparation of radiopharmaceuticals;
·
Uses of radio-pharmaceuticals
for diagnostic and therapeutic purposes.
2.10
Modified release drug delivery systems
·
Drug release requirements;
·
Types of modified release
drug delivery systems;
·
Formulation methods to
achieve modified drug release;
·
Advantages of using modified
release drug therapy;
·
Limitations of modified
release delivery systems.
3. Bio-pharmaceutics and pharmacokinetics.
The
candidate must have an understanding of the bio-pharmaceutics and
pharmacokinetics:
3.1
Absorption
·
Mechanisms of drug transport
across the gastrointestinal-blood barrier;
·
Physiological factors
influencing drug absorption from the gastrointestinal tract (GlT);
·
Physicochemical factors influencing
drug absorption from the GIT;
·
Dosage form factors
influencing drug absorption from the GlT.
3.2
Bioavailability
·
The concept of
bioavailability;
·
The concept of bio-pharmaceutics;
·
Assessment of
bioavailability;
·
Representation of
bioavailability data;
·
Absolute and relative
bioavailability;
·
Criteria for valid in vivo
bioavailability testing.
·
3.3
Practical pharmacokinetics
·
Concepts in
pharmacokinetics;
·
Drug distribution.
·
Compartmental models of drug
distribution;
·
Drug elimination;
·
Dosage regimens;
·
Pharmacokinetic influences
on dosage regimen designs;
·
Factors affecting steady
state plasma concentrations of a drug.
3.4
Therapeutic drug monitoring
·
Guidelines for therapeutic
drug monitoring;
·
Sample collection;
·
Pharmacokinetic drug
profiles;
·
Population pharmacokinetics;
·
lnfluence of disease states
on pharmacokinetics.
APPLIED PHARMACEUTICAL CHEMISTRY (SYLLABUS)
selected references:
Other texts of similar content that will provide excellent background reading for candidates include:
AnalyticalChemistry: Principles and Techniques., Hargis, L.G. Prentice Hall, NJ. 1997
The Organic chemistry of drug design and drug action, RB Silverman, Academic Press, lnc London,
Other suitable texts on instrumental analysis and drug identification should also be consulted.
1. The basic principles of organic pharmaceutical chemistry and structure-activity relationships that influence drug actions.
Candidates should have an understanding of:
· The principles of organic chemistry, the structures of organic compounds and the reactions of organic functional groups in the synthesis of organic compounds of pharmaceutical importance and structure determination of unknown compounds;
· Principles of quantitative and qualitative chemical analysis of substances of pharmaceutical importance;
· Organic medicinal and pharmaceutical compounds with special emphasis on the correlation of structural, physico-chemical and chemical properties with biological activity, drug sources, mechanisms of drug action, drug design and selectivity, drug incompatibility and drug interactions;
· Drug structures and structure-activity relationships, mechanisms of action and other factors that influence drug action within specific drug classes.
2. General principles in molecular mechanisms of drug action
Candidates should have an understanding of:
AIMS OF THE PROFESSIONAL EXAMINATION IN PROFESSTONAL PHARMACY PRACTICE (SYLLABUS)
1. Dispense and ensure the optimal use of medicines prescribed to the patient
APPLIED PHARMACEUTICAL CHEMISTRY (SYLLABUS)
selected references:
Principles of Medicinal Chemistry. 4'h Edition. Foye, W.O, Lemke, T.L. & Willams, D.A. Willams & Wilken Publishers, 1995 (ISBN-0683-0332309)
Textbook of Organic, Medicinal and Pharmaceutical Chemistry. Delgado, J.N & Remers,W.A. (Eds)
LippincotlRaven, 1998 (ISBN 397-51583-9)
AnalyticalChemistry: Principles and Techniques., Hargis, L.G. Prentice Hall, NJ. 1997
The Organic chemistry of drug design and drug action, RB Silverman, Academic Press, lnc London,
1992
Burgers medical and drug discovery, 5th Edition, Wolff ME ed (ISBN 0471575607)
1. The basic principles of organic pharmaceutical chemistry and structure-activity relationships that influence drug actions.
Candidates should have an understanding of:
· The principles of organic chemistry, the structures of organic compounds and the reactions of organic functional groups in the synthesis of organic compounds of pharmaceutical importance and structure determination of unknown compounds;
· Principles of quantitative and qualitative chemical analysis of substances of pharmaceutical importance;
· Organic medicinal and pharmaceutical compounds with special emphasis on the correlation of structural, physico-chemical and chemical properties with biological activity, drug sources, mechanisms of drug action, drug design and selectivity, drug incompatibility and drug interactions;
· Drug structures and structure-activity relationships, mechanisms of action and other factors that influence drug action within specific drug classes.
2. General principles in molecular mechanisms of drug action
Candidates should have an understanding of:
·
The general principles of drug
action and the pharmacological activities of drugs with the major focus on the
molecular mechanisms of drug action.
3.
Analysis of substances of pharmaceutical
importance
Candidates should be
able to describe the application of physical methods used in the identification,
separation and structure determination of organic compounds, such as:
- Weight analysis
- Volumetric analysis including neutralization, precipitation analysis & complexometry.
- Mass spectroscopy.
- Thin-layer, column, and gas-liquid chromatography
- Infrared, ultraviolet, nuclear-magnetic resonance spectroscopy.
4. The
actions of drugs in biochemical terms
Candidates should have
a thorough understanding of, and be able to interpret the actions of drugs, where
relevant, in biochemical terms, including:
·
The structures, functions
and transformations occurring within living cells in terms of established chemical
principles;
·
The structures and functions
of biopolymers, nucleic acids and proteins;
·
The metabolism and
regulation of cellular processes.
APPLIED PHARMACOLOGY
AND TOXICOLOGY:
Selected references:
Pharmacology. 4th
Edition. Rang, H.P., Dale, M.M. & Ritter, J.M., (2000). Churchill Livingstone,
Edinburgh. ( ISBN 0443 059748 or 0443 059942)
Other texts of similar
content that will provide useful background reading for candidates include:
A Textbook of Clinical Pharmacology, 5th Edition.
Ritter, J.M., Lewis, L.D. & Mant, T.G.K. (1999) Arnold, London. ( ISBN
0-340-705930)
Basic and clinical Pharmacology. 7th Edition. Katzung,
B.G., Appelton & Lange, Norwalk, Connecticut, (lSB N 0-83S5-0538-4).
Pharmacology. 2nd Edition. Mycek, M.J., Harvey, R.A., &
champe, p.c., (part of Lippincott's lllustrated Review series), Lippincott-Raven,
phitadetphia. ( tsBN 0- 397-51567_79)
Pharmacotherapy: A Pathophysiologic Approach. 3'd Edition.
Dipro, R.L., Talbert, p.E., yee, G.c., Matzke, G.R., Posey, L.M., Appelton &
Lange, Norwatk, connecticut, (tsBN 0-8385_7926_0)
South African Medicines Formulary. sth Edition.
Gibbon, C.J. (2000). Health & Medical publishing Group of the South African
Medicat Association. (tsBN 0-g75098-31-3)
AIMS OF THE PROFESSIONAL EXAMINATION IN APPLIED PHARMACOLOGY AND TOXICOLOGY (SYLLABUS)
1.
Basic principles
of pharmacology and toxicology
Candidates should have
an understanding of:
·
The underlying principles of
pharmacology and toxicology;
·
Pharmacodynamics;
·
Pharmacokinetics;
·
Drug metabolism;
·
Drug evaluation;
·
Drug interactions.
2.
Actions of drugs on various body systems
Candidates
should have a thorough knowledge of the pharmacological classification of drugs
and the actions of these drugs on body systems including:
·
Autonomic drugs;
·
Cardiovascular drugs;
·
Drugs with important actions
on smooth muscle;
·
Drugs that act on the
central nervous system;
·
Drugs with important actions
on blood, inflammation and gout;
·
Endocrine drugs;
3.
Specialized drug actions including chemotherapeutic drugs
Candidates
must have a sound knowledge and understanding of the effects of specialized drug
actions including:
·
The principles of
antimicrobial drug actions;
·
Antimicrobial therapy, modes
of action and therapeutic indications;
· Anti-fungal agents;
·
Antiviral chemotherapy and
prophylaxis;
·
Drugs with limited
indications;
·
Urinary antiseptics,
disinfectants and other antiseptics;
· Anti-parasitic, anti-protozoal
and anti-helmintic drugs;
·
Cancer chemotherapy;
·
lmmuno-pharmacology.
4.
Vaccines and other biological products
Candidates should have
an understanding of:
·
Vaccines and immune
globulins;
·
Other complex biologic
products.
5.
Toxic effects of drugs prescribed for use by the patient
Candidates must have a
thorough knowledge of the toxicology of drug therapy to enable successful pharmacist
intervention in appropriate situations in pharmacy practice:
·
Basic principles of
toxicology;
·
Chelators and heavy metals;
·
Management of the poisoned
patient.
LAWS PERTAINING
TO PHARMACY PRACTICE
Selective references:
The pharmacist is required to
be cognizant of all legislation relating to pharmacy practice including the Pharmacy
Act, 1974 (Act 53 of 1974) as amended, the Medicines and Related Substances Control
Act, 1965 (Act 101 of 1965) and other relevant acts. A compendium of laws has
been prescribed as the principal reference for the Test in the laws pertaining
to pharmacy practice:
PSSA Compendium of Laws and Regulations Relating to Pharmacy Volume
1,2A01 published by Butterworths. The compendium is available from Butterworths
Publishers at Tel: 031 - 268 3007 (Customer Services) or Toll free number 0800 00
4493, Butterworths Publishers, P O Box 4, MAYVILLE, 4058, e-mail address: contact@butterworths.co.za,
Pharmacy Amendment Act, 1997 (Act 88 of 1997). Government Gazette No
18525, 12 December'1 997;
AIMS OF THE PROFESSIONAL EXAMINATION
IN THE LAWS PERTAINING TO PHARMACY PRACTICE (SYLLABUS)
The candidate must have
a thorough knowledge and understanding of the following enactments and regulations
thereto:
. Pharmacy Act, 1974 (Act 53 of
1974) as amended, including the "Ethical Rules";
·
Medicines and Related
Substances control Act, 1965 (Act 101 of 1965);
·
Hazardous Substances Act, 1973
(Act 15 of 1973);
·
Relevant extracts of the Liquor
Act, 'l 989 (Act 27 of 1989);
·
Relevant extracts of the Foodstuffs,
Cosmetics and Disinfectants Act, 1972 (Act 54 of 1972);
·
Relevant extracts of the Fertilizers,
Farm Feeds, Agricultural Remedies and Stock Remedies Act, 1947 (Act 36 of 1947);
·
Relevant extracts of the Health
Professions Act, 1974 (Act 56 of 1974) as amended;
·
Relevant extracts of the
Nursing Act, 1978 (Act 50 of 1978) as amended.
APPLIED
PROFESSIONAL PHARMACY PRACTICE AND PHARMACY ADMINISTRATION
Selected references:
lntroduction to Business Management, 5th Edition., Cronje, du Toit &
Motlatla
Communication Skills in Pharmacy Practice, 3'o Edition., Tindall, W.N.
, Beardsley, R.S & Kimberlain, C.L. Lea & Febiger, Philadelphia,1994
AIMS OF THE PROFESSIONAL
EXAMINATION IN PHARMACY ADMINISTRATION (SYLLABUS)
1.
General management principles
The candidate must
have an understanding of the following components of basic management principles:
·
Basics of business management;
·
Planning, implementing and
managing operational plans and projects;
·
leadership and teamwork in the
management process;
·
Control and planning in the management
process cycle;
·
Management principles
involved in the procurement, storage and distribution of medicines
·
And other pharmaceutical
products;
·
Basic principles in record
keeping, statistical methodologies and research methods to ensure optimum
medicine supplies to the patient and/or community.
2.
The functional management of an organization.
The candidate must have an understanding
of the following components of functional management principles:
·
Basics of marketing
management including marketing concepts and objectives;
·
Managerial tasks in marketing
management including planning, organizing, providing leadership and controlling
marketing efforts;
·
Marketing strategies
including the environment, target markets, utilizing marketing information and
marketing instruments in marketing strategies.
3.
Financial management relating to pharmacy practice
The candidate must have an understanding
of the following components of financial management principles:
·
Nature and meaning of financial
management including environmental factors that influence financial management;
·
Basic concepts and techniques
in financial management including financial analysis and ratios, planning and
control;
·
Concepts of assets,
liabilities, debtor control and stock control;
·
Short and long term
financing of stock and other assets;
·
Management of assets and the
principles and implementation of budgeting techniques;
·
Financial implications of
procurement, storage and distribution of medicines.
4.
Human resource management
Candidates are required to have
a thorough knowledge and understanding of human resource management and human
resource utilization:
·
Key concepts of human
resource management function;
·
Human resource management
functions within the pharmacy including human resource
·
Recruitment, maintenance,
activities and utilization;
·
Basic principles in training
and development of human resources;
·
Managing workplace
performance of pharmacy personnel.
5.
Communication
Candidates
must have an understanding of:
·
Basic principles in
communication and the provision of information;
·
Communication techniques,
including the ability to apply technological advances in communication in the
procurement and distribution of medicines;
·
Effective communication
techniques between colleagues, other health care professionals and patients.
PROFESSIONAL
PHARMACY PRACTICE
Selected references
. South African Medicines
Formulary. 4th Edition. Medical Association of South Africa in cooperation with
the Pharmaceutical Society of South Africa;
. MIMS Medical Specialties. Recent Edition, MIMS publishers,
Pretoria
. MIMS Desk Reference (MDR).
Recent Edition, MIMS publishers, pretoria.;
· The Merck Manual of
Diagnosis and rherapy. 16th Edition. Merck & co. lnc. Rathway.
· MIMS Self-medication Guide. Recent Edition, MIMS publishers,
pretoria;
· Handbook of Nonprescription Drugs. 1Oth Edition. American
Pharmaceutical Association, Washington,D.C.;
· Martindale. The Extra
Pharmacopoeia. 32nd Edition, The Pharmaceutical Press. London;
· Daily Drug Use. Talmud, J.,
6th Edition. Tincture Press. Cape Town;
· Pharmacy Practice. Greeff,
O.B.W., Pharmaceutical Society of South Africa, Braamfontein;
· Pharmacist lnitiated Therapy,
1993. Dekker, A., Dreyer,A., Smit, R. Juta publishers. Cape Town
· English/Afrikaans
Dictionary.
· Other texts of similar
content include Minor Illness or Major Disease C. Edwards and , C. Symptoms in
Pharmacy, by A. Blenkinsop.
AIMS OF THE PROFESSIONAL EXAMINATION IN PROFESSTONAL PHARMACY PRACTICE (SYLLABUS)
1. Dispense and ensure the optimal use of medicines prescribed to the patient
The candidate must have a thorough knowledge and
understanding of the following aspects of dispensing and the provision of
medicines to a patient or caregiver including, inter alia:
·
Prescription reading;
·
Pharmacist medication
reviews and intervention;
·
Labeling and dispensing of
medicines;
·
Calculation of doses for
adults, children and infants;
·
. Providing emergency
supplies of medicines;
2.
Safe, rational and appropriate use of medicines
The candidate must have a thorough knowledge
of medicines and the effects of medicines to ensure the optimal use of
medicines by the patient including, inter alia:
·
Drug interactions;
·
Side-effects of prescribed
medicines;
·
Effects of polypharmacy in
medicine therapy;
·
Correct use and storage of
prescribed medicines;
·
Medicines used during
pregnancy and breast-feeding;
·
Medicines used in young
children and the elderly.
3.
Health care education and information
The candidate must have a thorough knowledge
of the actions and effects of medicines in health care to provide information
and ensure the optimal use of medicines by the patient including, inter alia:
·
lnformation
on the correct storage and supply of drugs, medicines and chemicals;
·
Appropriate drug therapy for individual
patients;
·
Correct use of prescribed and non-prescribed
medicines;
·
Drug interactions and side-effects of drugs;
·
Use of medicines during pregnancy,
breast-feeding and the aged;
·
Advice on the use of therapeutic goods and
appliances;
·
Counselling and educating patients
on the promotion of good health and reduction of incidence of illness;
·
Non-drug management,
including no treatment and/or referral to other health care professionals;
·
Maintaining healthy
lifestyles and disease prophylaxis.
4.
Essential clinical services including screening and referral
services
The candidate must have a thorough knowledge and
understanding of the aspects of treatment, referral, screening and education in
primary health care and public health campaigns including, inter alia:
·
Blood pressure testing;
·
Cholesterol screening tests;
. Diabetes and blood glucose
screening tests;
·
Pregnancy testing;
. Urine analysis, where
appropriate;
·
First aid measures, where
appropriate
5. Principles of pharmaceutical care
The candidate must have an understanding of
the aspects of the outcomes of therapy and the design, implementation and monitoring of pharmaceutical plans including inter alia:
·
Promoting and contributing
to rational drug use;
·
Designing, implementing and participating
in pharmaceutical care plans in drug therapy
. Selection and drug usage;
·
Monitoring and assessing the
drug therapy of patients;
·
Evaluating drug usage and optimizing
health outcomes;
·
Providing drug information to
patients, caregivers and other health care professionals to ensure the optional
use of medicines;
·
Participating in therapeutic
and drug utilization review committees.