Pharmacy Practice in Canada

Drug actions in the body can be grouped into two general categories: Pharmacodynamics or what the drug does to the body and pharmacokinetics or what the body does to the drug. Understanding the basics of these processes helps us better understand drug use.

Brand name or proprietary drugs, generic drugs, chemical names. A system of naming is called nomenclature. Learn more about drug nomenclature in this chapter.

More detail on drug pricing and resources available are examined to help understand the costs of drugs in the pharmacy.

Medication errors such as dispensing the wrong drug to a patient or misunderstanding the doctor's instructions on the prescription are two of many possible reasons why a drug error might occur. Professional incompetency will not be tolerated so what can the pharmacy professional do to avoid mistakes? One answer is to always check the DIN. Learn more about a DIN or Drug Information Number in this chapter.

The roles of a pharmacist, pharmacy technician and pharmacy assistant are discussed in this chapter. These roles are defined by law. It is important to know when the pharmacist must be involved in the sales of a drug. It is important to understand which actions in the pharmacy can be delegated by the pharmacist and which cannot.

A prescription is a legal doctor's order for medication that can dispensed by a pharmacist. The instructions on the prescription that include drug name, strength and directions for use is called the inscription. The directions for use on a prescription seem to appear as a code that the pharmacy personnel must decipher. It is called the SIG. Start learning about the SIG in this chapter.

The prescription includes the amount to dispense to the patient. This is called a Mitte. Some prescriptions do not include a Mitte but they must include information that allows the Mitte to be calculated. In the hospital setting a Mitte is not used.

Interchangeability. A patient's prescription lists the Brand name of a drug but the pharmacy dispenses the generic equivalent. Why? Learn about drug interchangeability in this chapter.

A return to pharmacokinetics and pharmacodynamics to examine drug dosing and other factors affecting drug use.

In Canada there are Federal Laws and Provincial/Territorial Laws. Federal Laws affect the entire country. Provincial/Territorial Laws are regional but similar in many respects. In this chapter pharmacy law is introduced with the ODBA or Ontario Drug Benefit Act.

LU means Limited Use. It represents a code for a specific reason for using a drug and is part of the ODBA. A prescriber must include the LU code on a prescription for ODB patients where required.

There are many internet resources available for pharmacy professionals. In this chapter several are discussed.

NAPRA, the National Association of Pharmacy Regulatory Authorities, although not a law in Canada carries the weight of the law. This means pharmacy professionals must follow it. Learn more about NAPRA in this chapter.

Following along with the e-book resource, Pharmacy Laws in Canada, this chapter reviews the pharmacy components of Federal Law.

The Controlled Drugs and Substances Act or CDSA is a Federal Law in Canada. It contains pharmacy-specific parts regarding narcotics and other controlled substances. The information in this law must be mastered by all pharmacy professionals and requires continuous study and review. But this chapter will help you out!

The Ontario College of Pharmacists, OCP, a regulatory agency for pharmacy in the Province of Ontario, provides pharmacy professionals with quality documents on policies, procedures, guidelines and laws. One document in particular is the "Summary of Laws" which is an excellent aid for understanding drug laws in Ontario/Canada. Just make sure to update your version regularly.

Brand name or proprietary drugs: Learn about the significance of dispensing as it relates to the law.

In case you didn't have enough web resources here are a few more valuable ones!

Medication errors and medication incidents, the ISMP and drug incident reporting systems are discussed in this chapter.

Narcotics are drugs of abuse, misuse, addiction and diversion. As such they require laws that are stricter than other prescription drugs. Learn about three categories of narcotics and their prescription/dispensing requirements.

MedsCheck is a Provincial pharmacy program in Ontario that is used to ensure a patient is using the proper drugs. MedsCheck is done by a pharmacist for a patient. This is important for patients using many drugs and for transitions between hospital and home.

Prescription drug or not. This is determined by the National Drug Scheduling Advisory Committee (NDSAC), a part of NAPRA.

The legal definition of a drug is presented in this chapter.

An introduction to pharmacy software.

A summary of drugs used for cardiovascular medical conditions.

What types of information are available to patients about drugs? Learn more in this chapter.

The CPSO website is a valuable resource in the pharmacy. The College of Physicians and Surgeons of Ontario website has a doctor search engine where you can search for a doctor by licence number or search for a licence number by doctor name. This aids the pharmacy when there is a need to contact a doctor as well.

Prescription knowledge and some quick math calculations allow pharmacy professionals to determine Mitte, days supply of drug and repeats on the fly. This is a skill a pharmacy professional must master.

A part of prescription processing in the pharmacy computer software, a patient profile sheet is the working document in the pharmacy. Learn the details in this chapter.

A review of the different types of pain medications.

There are no refills allowed on narcotics, however, there are part-fills. What does this mean? Learn about part-fills in this chapter.

This chapter addresses logged prescriptions, OCP and two legal classifications of pharmacists.

Drugs can interact with food and other drugs and also be affected by disease states in the body. Some interactions are mild but others can be life-threatening. It is important to identify drug interactions with patient medications and have the pharmacist address them immediately.

This chapter is all about D / H x Q.  It is a very useful formula for pharmacy dose calculations.

Many patients have drug insurance policies to cover the costs of their drugs. Learn how to recognize information on an insurance card that is important to the process of adjudication (submitting a drug claim to an insurance company or government).

Many medications can be purchased online or through mail order but not all of these pharmacies are regulated and accredited. Find out how to look for a safe online pharmacy.

After mastering pharmacy math 1 and 2 this chapter allows you to dive deeper into common pharmaceutical calculations.

Compounding is a routine procedure in the pharmacy for preparing medications not available commercially or for patients unable to use solid oral dosage forms. Learn more about non-sterile compounding and discover some great resources.

Mathematical calculations are required when compounding to ensure the correct proportions of ingredients.

A review of the different types of asthma medication and delivery systems.

Wellness products or natural health products are in great demand and pharmacy professionals should be up to date on these non-prescription supplements and the pharmacist alerted in cases of drug interactions.

Get up to date drug information from Health Canada. An excellent resource for all pharmacy professionals.

A review of medications prescribed for migraines.

Two math skills used in pharmacy are ratio and percent strength of drugs. Learn how to easily manage these calculations.

Learn how to calculate doses depending on vial size.

Learn about how prescription repeats or refills are managed in the pharmacy.

Drugs are available in many forms such as tablets, capsules, liquids, suppositories, topicals, injections, inhalants.

The CPS is the Compendium of Pharmaceuticals and Specialities. It is the official guide to all prescription drugs in Canada. It is a source of drug monographs and used as a pharmacy reference.

The medical condition GERD is discussed along with drug treatments. GERD is gastroesophageal reflux disease.

Learn about how prescription transfers are handled in the pharmacy.

It is important to review all prescription drug transfers requests with patients.

Types of depression and the drugs used for treatment are discussed including an overview of the drug mechanism of action.

Blister or compliance packaging aids patients who may be taking many medications and have difficulty following the dosing schedule.

A review of diabetes medications is discussed in this chapter.

Some prescription drugs are not prescribed for the condition they are intended to treat. They may be used for an unrelated medical condition.

A more accurate calculation of a dose may be required for paediatric patients, geriatric patients, patients with disease states or for drugs with narrow therapeutic windows. Doses can be calculated by weight or body surface area to ensure accurate dosing.

Part 2 of dose calculations by weight.

Part 3 of dose calculations by weight.

A review of medications for osteoporosis is discussed.