Pharmacy in China
in China involves the activities engaged in the preparation, standardization and dispensing of drugs, and its scope includes the cultivation of plants that are used as drugs, the synthesis of chemical compounds of medicinal value, and the analysis of medicinal agents. Pharmacists in China are responsible for the preparation of the dosage forms of drugs, such as tablets, capsules, and sterile solutions for injection. They compound physicians', dentists', and veterinarians' prescriptions for drugs. Pharmacological activities are also closely related to pharmacy in China.
There are two main streams of pharmaceutical practice in China, traditional Chinese medicine and modern pharmacy. Hospital and community pharmacies are responsible for the dispensing of medicinals used for both streams of pharmaceutical practice.
Around fifty colleges of pharmacy offer pharmacy education, half of which provide a Western medicine approach and the other half traditional Chinese medicine. Both types of colleges offer a four-year curriculum with options for specialization. Graduate study is also available. Most graduates work in hospital pharmacies. Hospital pharmacies participate in the bulk manufacture of drugs and parenteral fluids. A bulk dispensing system is used by some hospitals; individual patient doses are dispensed in others.
Recently, clinical pharmacy services in China have been developed and training courses begun. Curricula with specialization in clinical pharmacy have also been established by colleges of pharmacy.
It is anticipated that through increased awareness of the potential contribution of pharmacists in China's health-care system, more opportunities for educating pharmacists would be made available to meet the vast need of the country. Development of clinical pharmacy services have also been expected to improve the quality of care provided.
Ancient history
The beginnings of pharmacy in China are ancient. According to legend, Shennong who sought out and investigated the medicinal value of several hundred herbs. He reputed to have tested many of them on himself, and to have written the first Pen T-Sao, or native herbal, recording 365 drugs. He is said to have tasted hundreds of herbs to test their medical value.The most well-known work attributed to Shennong is The Divine Farmer's Herb-Root Classic. This work is considered to be the earliest Chinese pharmacopoeia. It includes 365 medicines derived from minerals, plants, and animals. Shennong is credited with identifying hundreds of medical herbs by personally testing their properties, which was crucial to the development of traditional Chinese medicine.
Still worshiped by native Chinese drug guilds as their patron god, Shennong conceivably examined many herbs, barks, and roots brought in from the fields, swamps, and woods that are still recognized in Pharmacy today. The "bagua" is a mathematical design symbolizing creation and life. Medicinal plants include podophyllum, rhubarb, ginseng, stramonium, cinnamon bark, and, ma huang, or Ephedra.
Separation of prescribing from dispensing
Unlike the prevailing practice in other, particularly Western countries, the duties of the pharmacist and physician are not entirely separated. Chinese doctors are allowed to dispense drugs themselves and the practice of pharmacy is sometimes integrated with that of the physician, particularly in traditional Chinese medicine. The idea of separating the two professions has been debated as the trend for specialization has increased in the health sciences. Other countries such as South Korea, Japan and Taiwan have successfully separated the jurisidications to legally separate the practice of prescribing from the practice of dispensing. That legislation has also specified that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments. Possible reform for this area is being considered by the Chinese regulatory authorities.Pharmacist role
Since the economic reform period of the 1980s, the development of the Chinese pharmaceutical industry has led to the introduction of new and effective drug substances. It also changed the role of the pharmacist. The scope for extemporaneous compounding of medicines was much diminished and with it the need for the manipulative skills that were previously applied by the pharmacist to the preparation of bougies, cachets, pills, plasters, and liquids. Pharmacists continue, however, to fulfill the prescriber's intentions by providing advice and information; by formulating, storing, and providing correct dosage forms; and by assuring the efficacy and quality of the dispensed or supplied medicinal product.In the future, pharmacists are expected to become more integral within the health care system. Rather than only dispensing medication and other routine duties, pharmacists are to be involved more in patient care with their particular knowledge and skills.
Hospital pharmacy
Since 1949, health care in China has improved. The number of hospitals has increased. While medicines previously were scarce, China now produces approximately 75 percent of the drugs it needs. China has a long history of traditional medicine; although there are attempts to integrate the concepts of traditional and Western medicine, the practices are still segregated. All hospital pharmacies in China have the responsibilities to guarantee the safe and effective use of drugs within the hospital and to do research. Even though Chinese factories manufacture many pharmaceutical products, the hospital pharmacy must manufacture many more.Hospitals have established Agreed Prescription programs, whereby drugs are manufactured in large batches, repackaged, and distributed to other hospital pharmacies in the area if needed. Quality is assessed chemically and by modern techniques when equipment is available. Most large hospitals now have automated facilities to manufacture sterile solutions. Each hospital has a medical supply committee that supervises the procurement of medical supplies and the reasonable use of drugs.
A government resolution mandates that every hospital pharmacy do research. A primary focus of their research is the integration of traditional and Western medicine. Concepts of traditional and Western medicine are taught in separate pharmacy schools. Most pharmacy undergraduate programs are four years, but some schools recently changed to five years. Challenges for hospital pharmacists in China have been to develop the theoretical and technological knowledge of pharmacy, and to expand the scientific and technical information system that is necessary to do research.
Education
The course of instruction leading to a Bachelor of Science in pharmacy extends at least four years. The first and frequently the second year of training, embracing general education subjects, are often provided by a school of arts and sciences. Many institutions also offer graduate courses in pharmacy and cognate sciences leading to the degrees of Master of Science and Doctor of Philosophy in pharmacy, pharmacology, or related disciplines. These advanced courses are intended especially for those who are preparing for careers in research, manufacturing, or teaching in the field of pharmacy.Since the treatment with drugs encompasses a wide field of knowledge in the biological and physical sciences, an understanding of these sciences is included for pharmaceutical training. The basic four-year curriculum in the colleges of pharmacy, for example, embraces physics, chemistry, biology, bacteriology, physiology, pharmacology, and many other specialized courses. As the pharmacist is engaged in a business as well as a profession, special training is provided in merchandising, accounting, computer techniques, and pharmaceutical jurisprudence.
Subjects:
- Clinical pharmacy
- Pharmacy practice
- Pharmaceutical care
- Pharmacy administrative sciences
- Pharmacotherapy
- Pharmacoeconomics
- Pharmacogenetics
- Pharmacogenomics
- Pharmacoepidemiology
Development of pharmaceutical education
Higher education of traditional Chinese pharmacy
Traditional Chinese pharmacy has had a history of thousands of years. The scientific therapeutic effects of traditional Chinese materia medica have attracted great attention both at home and abroad. In the recent 20–30 years there has appeared a tendency to "return to nature" owing to the toxic and side effects of chemical medicines and the drug-induced diseases caused by them. On the other hand, the traditional Chinese medicine and pharmacy have attracted more attention because of the difficulty in searching for and synthesizing new compounds. Only by modernization of traditional Chinese materia medica can its use become global. The modernization of traditional Chinese materia medica means studying the theories and the basic content of traditional Chinese pharmacy applying the knowledge of modern science and technology. The information on Chinese materia medica should be expressed in modern scientific indexes, terms, and include standardized methods of quality measurement and modernized forms of medicines. The task of higher education of traditional Chinese pharmacy is to train high-level personnel to fulfill the modernization of traditional Chinese pharmacy.There are five specialties of traditional Chinese pharmacy and 38 programs in China. These specialties have training targets, core courses and job orientations. All specialties have two common characteristics in their core courses: the basic theories of traditional Chinese medicine, traditional Chinese pharmacy and preparations of traditional Chinese materia medica; and attention to teaching basic knowledge of modern science that includes advanced mathematics, computer application, mathematical statistics, physics, physical chemistry and analytical chemistry.