Pharmacy is thescience and practice of discovering, producing, preparing, dispensing, reviewing and monitoringmedications, aiming to ensure the safe, effective, and affordable use ofmedicines. It is a miscellaneous science as it linkshealth sciences withpharmaceutical sciences andnatural sciences. The professional practice is becoming more clinically oriented as most of thedrugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is consideredclinical pharmacy.[1]
The scope of pharmacy practice includes more traditional roles such ascompounding and dispensing of medications. It also includes more modern services related tohealth care including clinical services, reviewing medications for safety and efficacy, and providing drug information with patient counselling.Pharmacists, therefore, are experts on drug therapy and are the primary health professionals who optimize the use of medication for the benefit of the patients. In some jurisdictions, such as Canada and Australia, Pharmacists may be able to prescribe or adapt/manage prescriptions, as well as give injections and immunizations.[2][3]
An establishment in which pharmacy (in the first sense) is practiced is called apharmacy (this term is more common in the United States) orchemists (which is more common in Great Britain, thoughpharmacy is also used).[citation needed] In the United States and Canada,drugstores commonly sell medicines, as well as miscellaneous items such asconfectionery,cosmetics,office supplies,toys,hair care products andmagazines, and occasionally refreshments and groceries.
In its investigation of herbal and chemical ingredients, the work of theapothecary may be regarded as a precursor of the modern sciences of chemistry andpharmacology, prior to the formulation of thescientific method.[citation needed]
The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut.Often, collaborative teams from various disciplines (pharmacists and other scientists) work together toward the introduction of new therapeutics and methods for patient care. However, pharmacy is not a basic or biomedical science in its typical form. Medicinal chemistry is also a distinct branch of synthetic chemistry combining pharmacology, organic chemistry, and chemical biology.
Pharmacology is sometimes considered the fourth discipline of pharmacy. Although knowledge of pharmacology is essential to the study of pharmacy, both disciplines are distinct. Those who wish to practice both pharmacy (patient-oriented) and pharmacology (a biomedical science requiring the scientific method) receive separate training and degrees unique to either discipline.
Pharmacoinformatics is considered another new discipline, for systematic drug discovery and development with efficiency and safety.
Pharmacogenomics is the study of genetic-linked variants that effect patient clinical responses, allergies, and metabolism of drugs.[4]
Pharmacists arehealthcare professionals with specialized education and training who perform various roles to ensure optimalhealth outcomes for their patients through the quality use of medicines.Pharmacists may also besmall business proprietors, owning the pharmacy in which they practice. Since pharmacists know about the mode of action of a particular drug, and its metabolism and physiological effects on the human body in great detail, they play an important role in optimization of drug treatment for an individual.
Pharmacy technicians support the work of pharmacists and other health professionals by performing a variety of pharmacy-related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with medic's offices and insurance companies to ensure correct medications are provided and payment is received.
Legislation requires the supervision of certain pharmacy technician's activities by a pharmacist. The majority of pharmacy technicians work incommunity pharmacies. In hospital pharmacies, pharmacy technicians may be managed by other senior pharmacy technicians. In the UK the role of a PhT in hospital pharmacy has grown and responsibility has been passed on to them to manage the pharmacy department and specialized areas in pharmacy practice allowing pharmacists the time to specialize in their expert field as medication consultants spending more time working with patients and in research. Pharmacy technicians are registered with the General Pharmaceutical Council (GPhC). The GPhC is the regulator of pharmacists, pharmacy technicians, and pharmacy premises.
In the US, pharmacy technicians perform their duties under the supervision of pharmacists. Although they may perform, under supervision, most dispensing, compounding and other tasks, they are not generally allowed to perform the role of counseling patients on the proper use of their medications. Some states have a legally mandatedpharmacist-to-pharmacy technician ratio.
Dispensing assistants are commonly referred to as "dispensers" and in community pharmacies perform largely the same tasks as a pharmacy technician. They work under the supervision of pharmacists and are involved in preparing (dispensing and labelling) medicines for provision to patients.
In the UK, this group of staff can sell certain medicines (including pharmacy only and general sales list medicines) over the counter. They cannot prepare prescription-only medicines for supply to patients.
Physician and Pharmacist, illustration fromMedicinarius (1505) byHieronymus Brunschwig
The earliest known compilation of medicinal substances was theSushruta Samhita, an IndianAyurvedic treatise attributed toSushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
ManySumerian (4th millennium BC – early 2nd millennium BC) cuneiformclay tablets record prescriptions for medicine.[8]
Ancient Egyptian pharmacological knowledge was recorded in various papyri such as theEbers Papyrus of 1550 BC, and theEdwin Smith Papyrus of the 16th century BC.
InAncient Greece,Diocles of Carystus (4th century BC) was one of several men studying the medicinal properties of plants. He wrote several treatises on the topic.[9] The Greek physicianPedanius Dioscorides is famous for writing a five-volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translationDe Materia Medica (Concerning medical substances) was used as a basis for many medieval texts and was built upon by many middle eastern scientists during theIslamic Golden Age, themselves deriving their knowledge from earlier GreekByzantine medicine.[10]
Pharmacy in China dates at least to the earliest known Chinese manual, theShennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during theHan dynasty and was attributed to the mythicalShennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in theMawangdui, sealed in 168 BC.
In Japan, at the end of theAsuka period (538–710) and the earlyNara period (710–794), the men who fulfilled roles similar to those of modern pharmacists were highly respected. The place of pharmacists in society was expressly defined in theTaihō Code (701) and re-stated in theYōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until theMeiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.[11]
There is a stone sign for a pharmacy shop with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey.[12] The current Ephesus dates back to 400 BC and was the site of the Temple of Artemis, one of the seven wonders of the world.
The advances made in the Middle East inbotany andchemistry ledmedicine in medieval Islam substantially to developpharmacology.Muhammad ibn Zakarīya Rāzi (Rhazes) (865–915), for instance, acted to promote the medical uses of chemical compounds.Abu al-Qasim al-Zahrawi (Abulcasis) (936–1013) pioneered the preparation of medicines bysublimation anddistillation. HisLiber servitoris is of particular interest, as it provides the reader with recipes and explains how to prepare the "simples" from which werecompounded the complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to record his findings in apharmacopoeia, describing a large variety of drugs and remedies for ailments.Al-Biruni (973–1050) wrote one of the most valuable Islamic works on pharmacology, entitledKitab al-Saydalah (The Book of Drugs), in which he detailed the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist.Avicenna, too, described no less than 700 preparations, their properties, modes of action, and their indications. He devoted in fact a whole volume to simple drugs inThe Canon of Medicine. Of great impact were also the works byal-Maridini of Baghdad andCairo, andIbn al-Wafid (1008–1074), both of which were printed inLatin more than fifty times, appearing asDe Medicinis universalibus et particularibus by 'Mesue' the younger, and theMedicamentis simplicibus by 'Abenguefit'.Peter of Abano (1250–1316) translated and added a supplement to the work of al-Maridini under the titleDe Veneris. Al-Muwaffaq's contributions in the field are also pioneering. Living in the 10th century, he wroteThe foundations of the true properties of Remedies, amongst others describingarsenious oxide, and being acquainted withsilicic acid. He made clear distinction betweensodium carbonate andpotassium carbonate, and drew attention to the poisonous nature ofcopper compounds, especially coppervitriol, and alsolead compounds. He also describes thedistillation of sea-water for drinking.[15][16]
InEurope, pharmacy-like shops began to appear during the 12th century. In 1240, emperorFrederic II issued a decree by which the physician's and the apothecary's professions were separated.[17]
There are pharmacies in Europe that have been in operation since medieval times. InFlorence, Italy, the director of the museum in the formerSanta Maria Novella pharmacy says that the pharmacy there dates back to 1221.[18] InTrier (Germany), theLöwen-Apotheke is in operation since 1241, the oldest pharmacy in Europe in continuous operation.[19] InDubrovnik (Croatia), a pharmacy that first opened in 1317 is located inside the Franciscan monastery: it is the 2nd oldest pharmacy in Europe that is still operating.[20][21] In the Town Hall Square ofTallinn (Estonia), there is a pharmacy dating from at least 1422.[citation needed] The medievalEsteve Pharmacy, located inLlívia, aCatalanenclave close toPuigcerdà, is a museum: the building dates back to the 15th century and the museum keepsalbarellos from the 16th and 17th centuries, old prescription books and antique drugs.
Pharmacists practice in a variety of areas including community pharmacies, infusion pharmacies, hospitals, clinics, insurance companies, medical communication companies, research facilities, pharmaceutical companies, extended care facilities, psychiatric hospitals, and regulatory agencies. Pharmacists themselves may have expertise in amedical specialty.
Apharmacy (also known as achemist inAustralia,New Zealand and theBritish Isles; ordrugstore inNorth America;retail pharmacy in industry terminology; orapothecary, historically) is where most pharmacists practice the profession of pharmacy. It is the community pharmacy in which the dichotomy of the profession exists; health professionals who are also retailers.
Community pharmacies usually consist of a retail storefront with a dispensary, where medications are stored and dispensed. According to Sharif Kaf al-Ghazal, the opening of the first drugstores are recorded byMuslim pharmacists inBaghdad in 754 AD.[13][22]
Pharmacies withinhospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues, and pharmacists in community pharmacies often have more complex business and customer relations issues.
Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) andpatient compliance issues (in the hospital and at home), many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency, sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy.
For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care,emergency medicine, toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics,herbal medicine, neurology/epilepsy management, pediatrics, neonatal pharmacists and more.
Hospital pharmacies can often be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients includingtotal parenteral nutrition (TPN), and other medications are given intravenously. That is a complex process that requires adequate training of personnel,quality assurance of products, and adequate facilities.
Several hospital pharmacies have decided tooutsource high-risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology and the potential impact of medications and pharmacy services on patient-care outcomes and patient safety require hospital pharmacies to perform at the highest level possible.
Pharmacists provide direct patient care services that optimize the use of medication and promotes health, wellness, and disease prevention.[23]Clinical pharmacists care for patients in allhealth care settings, but the clinical pharmacy movement initially began insidehospitals andclinics. Clinical pharmacists often collaborate withphysicians and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They often participate in patient care rounds for drug product selection. In the UK clinical pharmacists can also prescribe some medications for patients on theNational Health Services (NHS) or privately, after completing a non-medical prescribers course to become an Independent Prescriber.[24]
The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to dispensing and administration to the patient. The review process often involves an evaluation of the appropriateness of drug therapy (e.g., drug choice, dose, route, frequency, and duration of therapy) and its efficacy. Research shows that pharmacist led strategies reduce errors related to medication use.[25] The pharmacist must also consider potential drug interactions, adverse drug reactions, and patient drug allergies while they design and initiate a drug therapy plan.[26]
Since the emergence of modern clinical pharmacy, ambulatory care pharmacy practice has emerged as a unique pharmacy practice setting. Ambulatory care pharmacy is based primarily on pharmacotherapy services that a pharmacist provides in a clinic. Pharmacists in this setting often do not dispense drugs, but rather see patients in-office visits to manage chronic disease states.
In the U.S. federal health care system (including the VA, the Indian Health Service, andNational Institute of Health (NIH)) ambulatory care pharmacists are given full independent prescribing authority. In some states, such asNorth Carolina andNew Mexico, these pharmacist clinicians are given collaborative prescriptive and diagnostic authority.[27] In 2011 the board of Pharmaceutical Specialties approved ambulatory care pharmacy practice as a separate board certification. The official designation for pharmacists who pass the ambulatory care pharmacy specialty certification exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the initials BCACP.[28]
Compounding involves preparing drugs in forms that are different from the generic prescription standard. This may include altering the strength, ingredients, or dosage form.[29] Compounding is a way to create custom drugs for patients who may not be able to take the medication in its standard form, such as due to an allergy or difficulty swallowing. Compounding is necessary for these patients to still be able to properly get the prescriptions they need.
One area of compounding is preparing drugs in new dosage forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicatedlollipop that contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead.
Another form of compounding is by mixing different strengths (g, mg, mcg) of capsules or tablets to yield the desired amount of medication indicated by thephysician,physician assistant,nurse practitioner, orclinical pharmacist practitioner. This form of compounding is found at community or hospital pharmacies or in-home administration therapy.
Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies.
Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work innursing homes, but are increasingly branching into other institutions and non-institutional settings.[30] Traditionally[where?] consultant pharmacists were usually independent business owners, though in the United States many now work for a large pharmacy management company such asOmnicare,Kindred Healthcare orPharMerica. This trend may be gradually reversing[citation needed] as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services.
The main principle of consultant pharmacy was developed by Hepler and Strand in 1990.[31][32]
Veterinary pharmacies, sometimes calledanimal pharmacies, may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill the pharmaceutical needs of animals. Because the needs of animals, as well as the regulations onveterinary medicine, are often very different from those related to people, in some jurisdictions veterinary pharmacy may be kept separate from regular pharmacies.
Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients.
Airman 1st Class Breanna DeMasters and Staff Sgt. Giovanni Fiorito, 332nd Expeditionary Medical Group pharmacy technicians, fill prescription medication for patients, Oct. 7, Joint Base Balad Iraq.
Military pharmacy is a different working environment to civilian practise because military pharmacy technicians perform duties such as evaluating medication orders, preparing medication orders, and dispensing medications. This would be illegal in civilian pharmacies because these duties are required to be performed by a licensed registered pharmacist.[33] In the US military, state laws that prevent technicians from counseling patients or doing the final medication check prior to dispensing to patients (rather than a pharmacist solely responsible for these duties) do not apply.
Pharmacy informatics is the combination of pharmacy practice science and applied information science.[34] Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or forhealthcare information technology vendor companies. As a practice area and specialist domain, pharmacy informatics is growing quickly to meet the needs of major national and international patient information projects and health system interoperability goals. Pharmacists in this area are trained to participate in medication management system development, deployment, and optimization.
Specialty pharmacies supply high-cost injectable, oral, infused, or inhaled medications that are used for chronic and complex disease states such as cancer, hepatitis, and rheumatoid arthritis.[35] Unlike a traditional community pharmacy where prescriptions for any common medication can be brought in and filled, specialty pharmacies carry novel medications that need to be properly stored, administered, carefully monitored, and clinically managed.[36] In addition to supplying these drugs, specialty pharmacies also provide lab monitoring, adherence counseling, and assist patients with cost-containment strategies needed to obtain their expensive specialty drugs.[37] In the US, it is currently the fastest-growing sector of the pharmaceutical industry with 19 of 28 newlyFood and Drug Administration (FDA) approved medications in 2013 being specialty drugs.[38]
Due to the demand for clinicians who can properly manage these specific patient populations, the Specialty Pharmacy Certification Board has developed a new certification exam to certify specialty pharmacists. Along with the 100 questions computerized multiple-choice exam, pharmacists must also complete 3,000 hours of specialty pharmacy practice within the past three years as well as 30 hours of specialty pharmacist continuing education within the past two years.[39]
Pharmacodynamics: the study of the cellular and molecular interactions of drugs with theirreceptors. Simply "What the drug does to the body"[41]
Pharmacokinetics: the study of the factors that control the concentration of drug at various sites in the body. Simply "What the body does to the drug"[42]
Pharmacognosy: the study of medicines derived from natural sources.[45]
As new discoveries advance and extend the pharmaceutical sciences, subspecialties continue to be added to this list. Importantly, asknowledge advances, boundaries between these specialty areas of pharmaceutical sciences are beginning to blur. Many fundamental concepts are common to all pharmaceutical sciences. These shared fundamental concepts further the understanding of their applicability to all aspects ofpharmaceutical research anddrug therapy.
Pharmacocybernetics (also known as pharma-cybernetics, cybernetic pharmacy, and cyber pharmacy) is an emerging field that describes the science of supporting drugs and medications use through the application and evaluation of informatics and internet technologies, so as to improve thepharmaceutical care of patients.[46]
The wordpharmacy is derived fromOld Frenchfarmacie "substance, such as a food or in the form of a medicine which has a laxative effect" fromMedieval Latinpharmacia fromGreekpharmakeia (Ancient Greek:φαρμακεία) "a medicine", which itself derives frompharmakon (φάρμακον), meaning "drug,poison,spell"[47][48][a] (which is etymologically related topharmakos).
In theWestern world there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs.
In contemporary time researchers and health policy analysts have more deeply considered these traditions and their effects. Advocates for separation and advocates for combining make similar claims for each of their conflicting perspectives, saying that separating or combining reducesconflict of interest in the healthcare industry,unnecessary health care, and lowers costs, while the opposite causes those things. Research in various places reports mixed outcomes in different circumstances.
In 2022 theOrganisation for Economic Co-operation and Development (OECD) proposed that pharmaceutical companies should be required to collect and destroy unused or expired medicines that they have put on the market in order to reduce public health risks around the misuse of medicines obtained from waste bins, the development of antimicrobial resistant bacteria from the discharge of antibiotics into environmental systems and "economic losses" from wasted healthcare resources. Potentially harmful concentrations of pharmaceutical waste has been detected in more than a quarter of water samples taken from 258 rivers around the world. OECD recommend that medicines should be collected separately from household waste and that "marketplaces and redistribution platforms for unused close-to-expiry-date medicines" should be set up. Such extended producer responsibility schemes are already running in France, Spain and Portugal.[50]
Pharmacists now go on rounds with doctors and have more patient interaction.
In the coming decades, pharmacists are expected to become more integral within thehealth care system. Rather than simply dispensing medication, pharmacists are increasingly expected to be compensated for their patient care skills.[51] In particular,Medication Therapy Management (MTM) includes the clinical services that pharmacists can provide for their patients. Such services include a thorough analysis of all medication (prescription, non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system.[52][unreliable source?]
This shift has already commenced in some countries; for instance, pharmacists inAustralia receive remuneration from theAustralian Government for conducting comprehensive Home Medicines Reviews. In Canada, pharmacists in certain provinces have limited prescribing rights (as in Alberta and British Columbia) or are remunerated by their provincial government for expanded services such as medications reviews (Medschecks in Ontario). In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights and this is because ofpharmacy education. They are also being paid for by the government formedicine use reviews. In Scotland, the pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for controlled drugs, when the patient is unable to see their doctor, as could happen if they are away from home or the doctor is unavailable. In the United States, pharmaceutical care orclinical pharmacy has had an evolving influence on the practice of pharmacy.[53] Moreover, theDoctor of Pharmacy (Pharm. D.) degree is now required before entering practice and some pharmacists now complete one or two years of residency or fellowship training following graduation. In addition,consultant pharmacists, who traditionally operated primarily innursing homes, are now expanding into direct consultation with patients, under the banner of "senior care pharmacy".[54]
In addition to patient care, pharmacies will be a focal point for medical adherence initiatives. There is enough evidence to show that integrated pharmacy based initiatives significantly impact adherence for chronic patients. For example, a study published inNational Institute for Health (NIH) shows "pharmacy based interventions improved patients' medication adherence rates by 2.1 percent and increased physicians' initiation rates by 38 percent, compared to the control group".[55]
^Its earliest attested form in Greek could be theMycenaean𐀞𐀔𐀒,pa-ma-ko, written in theLinear B syllabic script and found on thePY Un 1314 tablet; this tablet is also found listed as PY Vn 1314 or PY Sb 1314.[49]
^Reference, Genetics Home."What is pharmacogenomics?".Genetics Home Reference.Archived from the original on 19 December 2016. Retrieved20 November 2019.
^World Health Organization.World Health Statistics 2011 – Table 6: Health workforce, infrastructure, and essential medicines. Geneva, 2011. Accessed 21 July 2011.
^"Member organizations".FIP. Open Publishing. 9 September 2019.Archived from the original on 1 January 2021. Retrieved17 November 2020.
^ISBN978-1409441656 Medicine and Pharmacy in Byzantine Hospitals: A study of the extant formularies (Medicine in the Medieval Mediterranean) 1st Edition by David Bennett
^Titsingh, Isaac. (1834)Annales des empereurs du Japon, p. 434.
^"PBase.com".www.pbase.com.Archived from the original on 13 September 2009. Retrieved6 September 2019.
^abHadzovic, S (1997). "Pharmacy and the great contribution of Arab-Islamic science to its development".Medicinski Arhiv (in Croatian).51 (1–2):47–50.ISSN0025-8083.OCLC32564530.PMID9324574.
^Shane, RR (15 August 2012). "Translating health care imperatives and evidence into practice: the "Institute of Pharmacy" report".American Journal of Health-System Pharmacy.69 (16):1373–1383.doi:10.2146/ajhp120292.PMID22855102.S2CID590168.
^Yap KY, Chuang X, Lee AJ, Lee RZ, Lim L, Lim JJ, Nimesha R (2009). "Pharmaco-cybernetics as an interactive component of pharma-culture: empowering drug knowledge through user-, experience- and activity-centered designs".International Journal of Computer Science Issues.3:1–13.
^"PY 1314 Vn + frr. (Cii)".DĀMOS: Database of Mycenaean at Oslo.University of Oslo.Archived from the original on 16 March 2014. Retrieved16 March 2014.Raymoure, K.A."pe-re".Minoan Linear A & Mycenaean Linear B. Deaditerranean. Archived fromthe original on 12 October 2013. Retrieved16 March 2014."The Linear B word pa-ma-ko". Palaeolexicon. Word study tool of ancient languages.Archived from the original on 16 March 2014. Retrieved16 March 2014.
Pharmacy Consulting Services | McKesson – A landmark study in hospital pharmacy performance based on an extensive literature review and the collective experience of the Health Systems Pharmacy Executive Alliance.
International Pharmaceutical Federation (FIP) Federation representing national associations of pharmacists and pharmaceutical scientists. Information and resources relating to pharmacy education, practice, science and policy
%2c_speaks_to_Dr_110228-A-GV060-946.jpg)
