Duties of a Pharmacist

                           As a professional, the pharmacist has a duty of care to the patient both to supervise the sale of 'over-the-counter' (OTC) drugs which are available only in pharmacies and to dispense safely and correctly drugs which have been prescribed by a doctor. 

                                       OTC drugs may be unsuitable for an individual patient for a number of reasons. If approached for advice, the same duty lies on the pharmacist to counsel, warn, and act reasonably as it does on any prescriber. 

In addition, there is a duty to contact the prescriber if any question about a prescription arises.

List of Price Controlled Drugs (DPCO 1995)

SULPHAMETHOXAZOLE PENICILLINS TETRACYCLINE RIFAMPICIN STREPTOMYCIN RANITIDINE VITAMIN C BETAMETHASONE METRONIDAZOLE CHLOROQUINE INSULIN ERYTHROMYCIN VITAMIN A OXYTETRACYCLINE PREDNISOLONE CEPHAZOLIN METHYLDOPA ASPRIN TRIMETHOPRIM CLOXACILLIN SULPHADIMIDINE SALBUTAMOL FAMOTIDINE IBUPROFEN METAMIZOL (ANALGIN) DOXYCYCLINE CIPROFLOXACIN CEFOTAXIME DEXAMETHASONE EPHEDRINE VITAMIN B1 (THIAMINE) CARBAMAZEPINE VITAMIN B2 (RIBOFLAVIN) THEOPHYLLINE LEVODOPA TOLNAFTATE VITAMIN E NALIDIXIC ACID

GRISEOFULVIN GENTAMICIN DEXTROPROPOXYPHENE HALOGENATED HYDROXYQUINOLINE PENTAZOCINE CAPTOPRIL NAPROXEN PYRENTAL SULPHADOXINE NORFLOXACIN CEFADROXYL PANTHONATES & PANTHENOLS FURAZOLIDONE PYRITHIOXINE SULPHADIAZINE FRAMYCETIN VERAPAMIL AMIKACIN SULPHATE * GLIPIZIDE SPIRONOLACTONE PENTOXYFYLLINE AMODIAQUIN SULPHAMOXOLE FRUSEMIDE PHENIRAMINE MALEATE CHLOROXYLENOLS BECAMPICILLIN LINCOMYCIN CHLORPROPAMIDE MEBHYDROLINE CHLORPROMAZINE METHENDIENONE PHENYL BUTAZONE LYNESTRANOL SALAZOSULPHAPYRINE DIOSMINE TRIMIPRAMINE MEFENAMIC ACID *

Prescriptions Drugs

Prescription drugs are drugs that are not locally available without a physician's prescription. A prescription drug is a licensed medicine which is obtained only by prescription. The prescription drugs are regulated by legislation and different from over-the-counter (OTC) drugs which can be obtained without a prescription. They are also known as non-prescription drugs. 

List of Prescription Drugs

1.    Anti-Convulsant Drugs

2.    Anti-Obesity Drugs

3.    Anti-Angina Drugs

4.    Anti-Fungal Drugs

5.    Anti-Itch Drugs

6.    Anti-Viral Drugs

7.    Anti-Diabetic Drugs

8.     Anti-Asthamatic Drugs

9.      Anti-Hypertensive Drugs

10.    Antibiotics

11.    Anti-Migraine Drugs

12.    Anti-Rheumatic Drugs

13.    Anti-Protozoal Drugs

14.   Tricyclic Anti-Depressant Drugs

15.    Anti-Arrythmic Drugs

16.    Anti-Nausea Drugs

17.    Anti-Parkinson Drugs

18.    Anti-Psychotic Drugs

19.   Muscle Relaxants

20.    Digitalis Drugs

21.    Anti-Gastroesophageal Reflux Drugs

22.    Anti-Retroviral Drugs

23.    Anti-Tuberculosis Drugs

24.    Anti-Ulcer Drugs

25.    Anti-Hemorrhoid Drugs

26.    Anti-Spasmodic Drugs

27.    Anti-Malarial Drugs

28.    Non-Steroidal Anti-Inflamatory Drugs: Some can be bought over the counter; others are available only with a prescription from a physician or dentist.

29.    Immuno-Suppressant Drugs

30.    Anti-Insomnia Drugs

31.    Anti-helminthic Drugs

32.   Central Nervous System Stimulants

33.    Decongestants: Some decongestant products require a physician's prescription but there are also many non-prescription (over-the-counter) products.

34.    Anti-Coagulant Drugs

35.   Bone Disorder Drugs 

36.    Infertility Drugs

37.    Topical Antibiotics: Some topical antibiotics are available with a prescription only.

38.   Diuretics

39.    Vasodilators: In the forms used for treating high blood pressure (tablets or injections), these drugs are available only with a physician's prescription.

40.   Blood Viscosity Reducing Drugs

41.   Beta-Blockers

42.   Corticosteroids

43.   Benzodiazepenes

44.   Cephalosporins

45.    Expectorants: Some products that contain are available only with a physician's prescription

46.    Sulphonamides

47.    Calcium Channel Blockers

48.    Gout Drugs

49.    Antihistamines: Some Anti-histamine products are available only with a physician's prescription.

50.    Pencillins

51.   Barbiturates

52.   Laxatives

53.   Ace-Inhibitors

54.    Anti-Anxiety Drugs

55.   Urinary Anti-Infectives

56.    MAO Inhibitors

57.    Opioid Analgesics

58.    Bronchodilators

59.    Opthalmic Antibiotics

60.    Smoking Cessation Drugs: Some products are available only with a prescription.

61.    Protease Inhibitors

62.    Anti-Depressant Drugs

63.   Alpha1-Adrenergic Blockers

64.   Tetracyclines

Non-Prescription Drugs

Non prescription drugs are drugs that are sold over the counter, which means they are sold without a prescription from a doctor. These drugs are sold directly to the consumers as compared to prescription drugs, which requires a prescription. They are also referred as the over-the-counter (OTC) drugs. In the United States, there are more than 80 therapeutic categories of non-prescription drugs, ranging from weight control drugs to anti-acne to analgesic drugs and many more. These drugs are easily available in local chemists as well as in general stores, supermarkets, gas stations, etc.


Regulations of OTC Drugs


In many countries, OTC or non-prescription drugs are selected by a regulatory agency so as to check the ingredients that are used in the making of drugs are safe and effective when used without a doctor's advise. These non-prescription drugs are usually regulated by active pharmaceutical ingredients (APIs), not final products. This implies that the governments allow drug manufacturers the right to formulate ingredients, or combinations of ingredients, to make proper medicinal mixtures. Regulations related to who is authorized to dispense these drugs, to where they are to be sold, and whether a prescription is required vary considerably from country to country. In India. all the drugs that are not included in the list of prescription drugs are considered as non-prescription drugs (or OTC drugs).


Types of OTC Drugs or Non-Prescription Drug List


      1.      Anti-Hemorrhoid Drugs

2.      Topical Antibiotics: Some topical antibiotics are available without a prescription

3.      Cough Suppressants

4.      Anti-Acne Drugs

5.      Non-Steroidal Anti-Inflammatory Drugs: Some can be bought over the counter; others are available only with a prescription from a physician or dentist.

6.      Antispetics

7.      Analgesics

8.      Decongestants: Some decongestant products require a physician's prescription but there are also many non-prescription (over-the-counter) products.

9.     Asprin

10.  Vasodilators: Some Vasodilators such as Minoxidil are sold without prescription.

11.   Antacids

12.   Expectorants: Many expectorants are available without a physician's prescription.

13.   Anti-Fungal Drugs

14.    Anti-Histamines: Some can be bought without prescription.

15.    Anti-Gas Agents

16.    Smoking Cessation  Drugs: Many drugs can be bought over the counter, without prescription.

Characteristics of Non-Prescription Drugs

      Non prescription drugs usually have these characteristics:

      ·        The benefits of these drugs outweigh their risks.

      ·        There is low chances for misuse and abuse.

      ·        Consumer can use them for self-diagnosed health conditions.

      ·        These drugs can be adequately labelled.

      ·        There is no requirement of health professionals for the safe and effective use of the product.

Drugs under Schedule C & C1

SCHEDULE C [Rule 23, 61 and 76 and Part X]
BIOLOGICAL AND SPECIAL PRODUCTS

Sera. Solution of serum proteins intended for injection. Vaccines for parenteral injections Toxins. Antigen. Antitoxins. Neo-arsphenamine and analogous substances used for the specific treatment of infective diseases. Insulin. Pituitary (Posterior Lobe) Extract. Adrenaline and Solutions of Salts of Adrenaline. Antibiotics and preparations thereof in a form to be administered parenterally. Any other preparation which is meant for parenteral administration as such or after being made up with a solvent or medium or any other sterile product and which— requires to be stored in a refrigerator; or does not require to be stored in a refrigerator. Sterilized surgical ligature and sterilized surgical suture. Bacteriophages. Ophthalmic preparations. Sterile Disposable Devices for single use only. SCHEDULE C (1) [Rule 23, 61 and 76] OTHER SPECIAL PRODUCTS Drugs belonging to the Digitalis group and preparations containing drugs belonging to the Digitalis group not in a form to be administered parenterally. Ergot and preparations containing Ergot not in a form to be administered parenterally. Adrenaline and preparations containing Adrenaline not in a form to be administered parenterally. Fish Liver Oil and preparations containing Fish Liver Oil. Vitamins and preparations containing any vitamins not in a form to be administered parenterally. Liver extract and preparations containing liver extract not in a form to be administered parenterally. Hormones and preparations containing hormones not in a form to be administered parenterally. Vaccine not in a form to be administered parenterally. Antibiotics and preparations thereof not in a form to be administered parenterally. In-vitro Blood Grouping Sera. In-vitro Diagnostic Devices for HIV, HbsAg and HCV

Precautions to be taken while taking Medicines

Precautions for Safe Use of Drugs

• Always take medicines as per advice and prescribed by Doctor.
• Always purchase medicines from license seller.
• Always check the Expiry date before purchasing a medicine.
• Always ask for bill on purchase of medicine .
• Always keep the medicines away from sun light and heat.
• Always store the medicines as mentioned on the label for e.g. cool place or refrigerator as required.
• Always keep medicines out of reach of children.
• Beware of false of misleading advertisement.
• Do not use medicines internally when labeled for “External use only”.
• Always remove the labels of used medicine and cosmetics before throwing away ,so as to prevent misuse for spurious medicines and cosmetics.
• Do not purchase cosmetics from Hawkers .
• Do not purchase medicines /drugs stamped as For Hospital Use/ For ESIS Hospital.

To stay safe, always tell your doctor, pharmacist, or other health care provider about the products you are taking, including:

-- Herbal remedies,
-- Non-prescription medicines, and
-- Prescription drugs.

• "blood-thinning" drugs
• Or suffering from cancer ,HIV or life threatening conditions.
• Bring either a list or the products with you to your doctor's appointment.
• If you are taking a prescription medication, do not take an herbal remedy or dietary supplement for the same condition without telling your doctor.
• Only take the recommended quantity listed on the label.

To make sure you use medicines safely and effectively

• Keep a list of all medications that you take (prescribed drugs, non prescription medicines, ayurvedic homeopathic drugs, etc.) and medicines that you cannot take due to allergic reactions, and share those with your doctor.
• Tell your health care provider how you actually take your medication, especially if this is different from the originally prescribed directions.
• Learn the names of the drug products that are prescribed and given to you, as well as their dosage strength and schedules.
• Ask if you should avoid certain foods, beverages, other medicines, or activities while you are taking the drug.
• Ask for any written information available on the drug product.

Beware while taking Over the Counter medicines or non prescription medicines

• All medications, even those sold without a prescription, have the potential to cause harm.
• Taking more than the recommended dose can cause serious adverse effects, such as stomach bleeding, as well as liver or kidney problems.
• Adverse reactions due to non prescription medicines can sometimes occur even when patients follow instructions exactly.
• The use of non prescription drugs might interfere with the effect of certain prescription medications .
• Patients should tell their physician and pharmacist about all the medications, including vitamins and herbal supplements, they are taking to help avoid potentially dangerous drug interactions.
• "Natural" or drugs from Herbal source does not necessarily mean "safe."

Do not Split pills/ tablets for saving money.

• Consumers, often split pills to save money, but doing so can disrupt essential properties of the medications.
• The time-release property of certain medications may be destroyed when a pill is cut, reducing the medication’s safety.
• The pills are made with a protective coating to mask the bitterness and prevent nausea, if the tablet is split an upset in stomach may result if the coating is broken.

Always ask your doctor whether it is safe to split the pill. 

Safe use of Narcotic and Psychotropic Drugs

• Always purchase Narcotic and Psychotropic drugs on prescription of registered medical practitioner.
• Always take the dose as directed by the physician.
• Do not take excess dose.
• Keep the narcotic drugs away from children.