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Pharmaceutical Practice
For Elsevier
Commissioning Editor: Pauline Graham, Ellen Green
Development Editor: Carole McMurray, Hannah Kenner
Project Manager: Gail Wright
Designer: Stewart Larking
Illustration Manager: Merlyn Harvey
Illustrator: Paul Bernson, Robert Britton
Pharmaceutical Practice
FOURTH EDITION
Edited by
A. J. Winfi eld BPharm PhD MRPharmS
Formerly Chairman, and Visiting Professor, Department of Pharmacy Practice,
Faculty of Pharmacy, Kuwait University, Kuwait
J. A. Rees BPharm MSc PhD Certifi cate in Health Promotion
Senior Lecturer, School of Pharmacy and Pharmaceutical Sciences, The University of
Manchester, Manchester, UK
I. Smith BSc(Hons) ClinDip FHEA MRPharmS
Boots Teacher Practitioner, The University of Manchester, Manchester, UK
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2009
© 2004, Elsevier Limited. All rights reserved.
© 2009, Elsevier Limited. All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, without the prior permission of the Publishers. Permissions may be sought
directly from Elsevier’s Health Sciences Rights Department, 1600 John F. Kennedy
Boulevard, Suite 1800, Philadelphia, PA 19103-2899, USA: phone: (+1) 215 239 3804;
fax: (+1) 215 239 3805; or, e-mail: healthpermissions@elsevier.com. You may also
complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by
selecting ‘Support and contact’ and then ‘Copyright and Permission’.
Fourth edition 2009
Third edition 2004
Second edition 1998
First edition 1990
ISBN 978-0-443-06906-2
International edition ISBN 978-0-443-06909-3
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notice
Knowledge and best practice in this fi eld are constantly changing. As new research and
experience broaden our knowledge, changes in practice, treatment and drug therapy
may become necessary or appropriate. Readers are advised to check the most current
information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method
and duration of administration, and contraindications. It is the responsibility of the
practitioner, relying on their own experience and knowledge of the patient, to make
diagnoses, to determine dosages and the best treatment for each individual patient, and
to take all appropriate safety precautions. To the fullest extent of the law, neither the
Publisher nor the Editors assumes any liability for any injury and/or damage to persons
or property arising out of or related to any use of the material contained in this book.
The Publisher
Printed in China
ontent
s
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
About this book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xvii
Section 1 Pharmacy practice and society . . . . . . . . . . . . . . . . . . . 1
1 The role of pharmacy in health care . . . . . . . . . . . . . . . . . . . . . . . 3
Christine M. Bond
2 Models of pharmacy practice within healthcare systems . . . . . . . . . . .17
Judith A. Rees
3 Socio-behavioural aspects of health and illness . . . . . . . . . . . . . . . .25
K. Hannes Enlund
4 Socio-behavioural aspects of treatment with medicines . . . . . . . . . . . .41
K. Hannes Enlund
5 Pharmacy and public health . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Roger Walker
6 Types of patient charges for medicines and their impact. . . . . . . . . . . .63
Ellen Schafheutle
7 WHO and the essential medicines concept . . . . . . . . . . . . . . . . . . .71
Marthe M. Everard
Section 2 Governance and good professional pharmaceutical practice . . . 79
8 Clinical governance – an overview. . . . . . . . . . . . . . . . . . . . . . . .81
Simon J. Tweddell
9 Risk management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
Darren M. Ashcroft
10 Continuing professional development and fi tness to practise . . . . . . . . .95
Raminder Sihota
11 Audit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Janet Krska
12 Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Richard C. O’Neill
13 Communication skills for the pharmacist . . . . . . . . . . . . . . . . . . . 123
Judith A. Rees and Isobel J. Featherstone
v
Contents
14 Relationship with other members of the healthcare team . . . . . . . . . . 137
Felice S. Groundland
15 Record keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Mary Zargarani
Section 3 Pharmacy prescribing and selection of medicines . . . . . . . . .153
16 Access to medicines and prescribing – introduction . . . . . . . . . . . . . 155
Jason Hall
17 The prescribing process and evidence-based medicine . . . . . . . . . . . 163
Jason Hall
18 Formularies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Janet Krska
19 Drug evaluation and pharmacoeconomics . . . . . . . . . . . . . . . . . . 185
Janet Krska and Dyfrig A. Hughes
20 Complementary/alternative medicine . . . . . . . . . . . . . . . . . . . . . 199
G. Brian Lockwood
21 Routes of administration and dosage forms . . . . . . . . . . . . . . . . . 211
Arthur J. Winfi eld
22 Prescribing for minor ailments . . . . . . . . . . . . . . . . . . . . . . . . . 219
Paul Rutter
23 Information retrieval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Parastou Donyai
Section 4 Dispensing and related pharmaceutical practice activities . . . . .261
24 The prescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Ian Smith
25 Dispensing techniques (compounding and
good practice) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Judith A. Rees
26 Pharmaceutical calculations . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Ivan O. Edafi ogho and Arthur J. Winfi eld
27 Packaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Derek G. Chapman
28 Labelling of dispensed medicines . . . . . . . . . . . . . . . . . . . . . . . 315
Judith A. Rees
29 Production of sterile products . . . . . . . . . . . . . . . . . . . . . . . . . 323
Derek G. Chapman
30 Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Arthur J. Winfi eld
vi
Contents
31 Suspensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Arthur J. Winfi eld
32 Emulsions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Arthur J. Winfi eld
33 External preparations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
Arthur J. Winfi eld
34 Suppositories and pessaries . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Arthur J. Winfi eld
35 Powders and granules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387
Arthur J. Winfi eld
36 Oral unit dosage forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393
Arthur J. Winfi eld
37 Inhaled route . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
Peter M. Richards
38 Parenteral products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411
Derek G. Chapman
39 Ophthalmic products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
R. Michael E. Richards
40 Specialized services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447
Graham J. Sewell
41 Parenteral nutrition and dialysis . . . . . . . . . . . . . . . . . . . . . . . . 467
Lindsay Harper and Liz Lamerton
42 Radiopharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 483
David Graham
43 Storage of medicines and waste disposal. . . . . . . . . . . . . . . . . . . 493
David R. Bethell and Judith A. Rees
44 Communication skills – role of the pharmacist in giving advice
and information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501
Judith A. Rees
Section 5 Pharmacy services and monitoring the medicine-taking patient . . . 515
45 Collection and delivery services . . . . . . . . . . . . . . . . . . . . . . . . 517
Karen Rice
46 Concordance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 523
Marjorie C. Weiss
47 Monitoring the patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Alison Littlewood
48 Services for vulnerable patients . . . . . . . . . . . . . . . . . . . . . . . . 547
Victoria Crabtree
49 Substance use and misuse. . . . . . . . . . . . . . . . . . . . . . . . . . . 559
Jenny Scott
vii
Contents
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .577
Appendix 1 Medical abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 579
Megan R. Thomas
Appendix 2 Latin terms and abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . 585
Arthur J. Winfi eld
Appendix 3 Systems of weights and measures . . . . . . . . . . . . . . . . . . . . . . 589
Arthur J. Winfi eld
Appendix 4 Presentation skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591
R. Michael E. Richards and Megan R. Thomas
Appendix 5 Key references and further reading . . . . . . . . . . . . . . . . . . . . . . 599
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 613
viii