Community pharmacy training

7th
Sem B. Pharm Practice School(BP705PP)
1
Vishal Panday_172230290019 Department of Pharmacology IICP-223
1. Introduction
Pharmacy is the health profession that links the health science with the chemical sciences and it
is charged with ensuring the safe and effective use of pharmaceutical drugs. The scope of the
pharmacy practice includes more traditional roles such as compounding and dispensing
medications, and it also includes more safety and efficacy, and providing drug information. A
community pharmacy is the place where most pharmacists practice the profession of pharmacy.
Community pharmacists usually consist of a retail storefront with dispensaries where
medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with
requirements for storage condition, compulsory texts, equipment etc; specified in legislation.
I was going for practice at Nayati Medical Pvt . Ltd which locate at Mathura. The medical store
is located in hospital campus. Mr. Dharmendra is the HR Manager of the store. He is very
knowledgeable and genuine person. He started his job at medical store 5 years ago. They have 3
different branches in different cities. Only allopathic drugs are sold in medical store. The medical
store dispenses the medicine only with prescription. They are given a 10% discount on all
medicine. They use HISTree software for maintaining records of inventory and daily sale.
Fig.No.1 Nayati Pharmacy

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2. Layout of Store
The drug store arrangements are nearly same as I mentioned in the layout below where I was
going. There are such good arrangements.
In the medical store arrangement of the medicines are based on their alphabetic order, there is
separate cupboard for liquid preparations, injectables, drops, cosmetics, surgical, and class A
medicines.
Refrigerator is also available for thermolabile medicines and vaccines, such as insulin, humogen-
BCG.
Fig.2. Schematic layout of pharmacy
Fig.3. Arrangement of Tablets Fig.4 Arrangement of Liquids

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3. Staffing in Pharmacy
In the drug store there were 4 members. Two pharmacists were there. Bills were prepared by the
Mr. Onkesh. Picking of the drugs were done according to the prescription and dispensing was
done by all staff available there with proper counselling. Those patients requiring special
counselling like dry powder inhaler, nasal spray, pessaries, etc were given special directions and
precaution for the assurance of drug compliance.
● Below mentioned four-member list
A. Mr. Dharmendra
B. Mr. Onkesh
C. Mr. Sumit
D. Mr. Mohit
Workflow in Pharmacy
Collecting of prescription
Picking of drogs
Dispensing of medicines
Making of bills computerized
Payment of bill
Fig.no.5 Flow Chart of Work

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4. Essential Knowledge and Skill Require for Community
Pharmacy Practice
A. Patient Counselling
It refers to the process of providing information, advice and assistance to help patient use their
medication appropriately. The information and advice given by the pharmacist directly to patient
or to the patient’s representative, and may also include information about patient’s illness or
recommended lifestyle changes. The information usually given verbally, but may be
supplemented with written material.
During counselling, the pharmacist should assess the patient understanding about his/her illness
and the treatment, and provide individualised advice and information which will assist the patient
to take their medication in the most safe and effective manner. To provide accurate advice,
information, the pharmacist should be familiar with pathophysiology and therapeutics of the
patient’s diseases.
Good communication skills required to gain the patient’s confidence and to motivate the patient
to adhere the recommended regimen.
• Effective patient counselling aims to produce following results:
✓ Better patient understanding of their illness and the role of medication in its treatment
✓ Improved medication adherence
✓ More effective drug treatment
✓ Reduce incidence of medication errors, adverse effect and unnecessary healthcare cost
✓ Improved quality of the life of the patient
✓ Better copying strategies for medication-related adverse effect
✓ Improved professional rapport between the patient and pharmacist

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B. Communication Skills for Effective Counselling
The counselling process uses verbal and non-verbal communication skills.
Verbal communication skills include language and paralinguistic features such as tone, volume,
pitch, and rate of speech.
Paralinguistics, or the way we say words, accounts for 40% of how a message received, so the
way in which we speak has an impact on patient understanding.
● Language
● Tone
● Volume
● Speed
● Eye contact
● Facial expression
● Body language
● Proximity
C. Medical adherence
It is the extent which a patient’s medication taking behaviour coincides with the intention of the
health advice he or she has been given.
It’s a one of the most important factors that determine therapeutic outcomes, especially in-
patient suffering from chronic illnesses.
Low medication adherence has assumed importance as it seriously undermines the benefits of
current medical care and imposes a significant financial burden on individual patients and the
healthcare system as a whole.
There are many situations in clinical practice where adherence is extremely important for better
therapeutic outcomes. These include:
a. Replacement therapy
b. Maintenance of pharmacological effect
c. Maintenance of serum drug concentrations to control a particular disorder
d. In chronic disease such as diabetes and hypertension
Adherence to treatment and lifestyle changes is the key link between process and outcomes in
medical care.

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D. Drug Interactions
All pharmacist working in clinical setting whether dispensing medicines o advice, require a
well-grounded knowledge of drug interaction to prevent harm to patient for medicine
combination.
This is an area in which a pharmacist’s expertise is values by other health professionals and
where a pharmacist’s knowledge of pharmacology can be recognised and appreciated.
Pharmacist play a valuable role in screening for interaction and advising on management when
interaction occur.
This may be at the patient’s bedside, as part of the dispensing process or during sale offer non-
prescription medicine.
A drug is a teratogen if its administration to the pregnant mother, directly or indirectly, causes a
structural or functional change in the foetus or child.
List of teratogenic drugs which should not be dispensed to pregnant women,
• ACE (angiotensin converting enzyme) inhibitors
• Acne medication isotretinoin (Accutane, Retin-A)
• Alcohol ingested chronically or in binges
• Androgens (male hormones)
• Antibiotics tetracycline (Achromycin), and doxycycline (Vibramycin), and streptomycin
• Anticonvulsants (seizure medications)
• Anti-depressant drug lithium (Eskalith, Lithob)
• Antimetabolite/anticancer drugs methotrexate (Rheumatrex) and aminopterin
• Antirheumatic agent and metal-binder (chelator) penicillamine (Ciprimene, Depen)
Note : while counselling a pregnant she should must be provided with knowledge of those
teratogenic drug and other drug interaction which may harm her foetus as well as herself

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5. Purpose of Training
1. To develop a concern for a patient health and welfare and an appreciation for the impact
of a community pharmacist in the healthcare system
2. To faster the development of a responsibility, professional attitude.
3. To develop professional judgement.
4. To develop proficiency in educating patient on health and medication related matters.
5. To learn the value, the importance and application of patient profile.
6. To apply information gained in the didactic education component of curriculum in to
clinical practice.
7. To process prescription and acquire knowledge in the specificity of community pharmacy
management.
8. To provide a variety of exposure to pharmacy operation and to different practitioner
philosophies and problem-solving skills.

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6. Functions
The function of the community pharmacy practice is:
1) Patient Interaction:
It includes securing correct information from patients concerning an accurate and complete
drug history, advising the patient as to proper use and storage of drugs. Moreover, current
Public Health information example information related to cancer, diabetes, heart, sexually
transmitted disease etc; can be obtained. Also, the patient can be monitored through
outcomes assessment.
2) Dispensing of Prescription:
It includes receiving, verification, checking for errors, drug selection, filing, recording
feeling and delivery of prescription to the patient. Besides contacting physicians, instituting
telephone and return Orders and handling of patient records and understanding laws related
to drug types of pricing Strategies and completing all third-party medical reimbursement
are a part of it.
3) Pharmacy Administration:
Inventory control ordering and returning merchandise receiving and pricing drug products
stop arrangements and storage management policies bookkeeping payroll employee policy
complaints correspondence pharmacy layout traffic patterns pharmacy administration.
4) Drug and Product Information:
It includes identifying information about both prescription and non-prescription drugs so
that one can obtain the knowledge of general drugs information, generic and trade name
common doses forms, indications, side-effects, interaction and patient counselling for the
top 200 drugs dispensed.

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7. My Routine Work During Training
I was posted for 3 weeks and 172 hrs at Nayati Medical Pvt . Ltd .it completed between 22 Sep
2020 to 10 oct 2020.time 8am to 6pm daily including Sunday.
On my first day 22 Sep 2020 I checked the arrangement of the drug and understood it and
understood how to dispense medicines.
When time had been spent in drug store, I clearly understood the procedure of dispensing
medicines to patients and how to communicate with them.
❖ Hereby I’m Mentioning the Name of Medicines Which I Had Dispensed
During My Internship Period.
Soliten 5mg Solifenacin (Muscarinic antagonist) 5mg
Nexito L. S Clonazepam(0.25mg) + Escitalopram oxalate(10mg)
Fig.No.6 Nexito L.S Tablet
Fig.No.7 Soliten Tablet

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Thyronorm Thyroxine(50mcg) or Levothyroxine
Flazole Ofloxacin (200mg) + Ornidazole (500mg)
Telma Telmisartan(40mg)
Kufstil Syp Guaifenesin (50mg) + Bromhexine (8mg) + Chlorpheniramine
Maleate (2mg) + Dextromethorphan Hydrobromide (10mg)
K-Fresh Eye Drops Carboxymethylcellulose sodium
Tiova Rota Caps Tiotropium(18mg)
Dytor 10 Torsemide(10mg)
Criticold Plus syp. Chlorpheniramine Maleate (2mg/5ml) + Paracetamol
(250mg/5ml) + Phenylephrine (5mg/5ml)
Actapro Acotiamide(100mg)
Signoflame Acelofenac(100mg) +Paracetamol(325mg)
+Sarratiopeptidase(15mg)
Neurobion Forte Tab.. Vitamin B complex with Vitamin B12
Kineto-Dp Cap.. Diclofenac(50mg) +Serratiopeptidase(15mg)
Pantocid-D Domperidone(10mg) +Pantoprazole(20mg)
Tobacin Drops Tobramycin (0.3%w/v)
Esogress-40 Esomeprazole(40mg)
Esomefa-20 Esomeprazole(20mg)
Mucaine-Gel Oxetacaine(10mg/5ml) + Aluminium Hydroxide(0.291gm/5ml)
+ Milk of Magnesia(98mg/5ml)
Maxxcet Tab. Cetirizine(10mg)
Unispas Tab. Dicyclomine(10mg) + Mefenamic Acid(250mg)
Ns 0.9% Infusion Sodium chloride (0.9%w/v)
Enraiz Pro Onco Low protein supplement
Aten-50 Atenolol(50mg)
Atorva-40 Atorvastatin(40mg)
Folvite 5mg Tab. Folic acid(5mg)
Drotin-Ds Drotaverine(80mg)
Glycomet 500 Sr Tab. Metformin(500mg)
Table No.1 The Name of Medicines Which I Have Dispense During My Internship Period

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Unispas Tab. Dicyclomine(10mg) + Mefenamic Acid(250mg)
Ns 0.9% Infusion Sodium chloride (0.9%w/v)
Enraiz Pro Onco Low protein supplement
Aten-50 Atenolol(50mg)
Atorva-40 Atorvastatin(40mg)
Folvite 5mg Tab. Folic acid(5mg)
Drotin-Ds Drotaverine(80mg)
Glycomet 500 Sr Tab. Metformin(500mg)

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8. Here Is the Information About Some Devices and Medicines.
1. Oximeter
•The pulse oximeter observes a rapid
measurement of oxygen saturation level in
body without using needles or taking a
blood sample.
2. Digital Thermal Scanner
• It scans the infrared heat that is
naturally emitted from the body to
excess body temperature.
• These two devises show more demands during this covid-19 pandemic
situation.
Fig.no.8 Oximeter
Fig.no.9 Digital Thermal Scanner

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3. Insulin Pen
• This insulin pens are used for
injecting insulin in human body, it
has more efficiency.
• It is easy to operate and has more
patient compliance.
• 4-6 mm needle is used for injection
purpose.
4. Sibagem Inj.
• It is a class of antimetabolite drug it also
shows very good activity in stopping or
slowing growth of cancer cell in human
body.
• It also used in treatment of,
 Urinary bladder cancer
 Ovarian cancer
 Breast cancer
 Pancreatic cancer
Fig.No.10 Insulin Pen
Fig.No.11 Sibagem Injection

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5. Xarelto-20
• Xarelto 20mg Tablet is a
known as an anticoagulant or
blood thinner.
• It helps prevent and treat
blood clots.
• It is used to reduce the risk of
stroke and heart attack.
• It prevents and treats clot formation in the veins of your legs, lungs, brain and
heart.
6. Jardiance-25
• Jardiance 25mg Tablet is used to
treat type 2 diabetes mellitus.
• It helps control the high blood
sugar levels seen in diabetes.
• This reduces the chances of
serious complications of diabetes
and also helps prevent heart
disease.
Fig.no.12 Xarelto Tablet
Fig.No.13 Jardiance-25 Tablet

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7. Brintellix-10
• Brintellix 10mg Tablet is a
medicine prescribed to treat
depression in adults.
• It belongs to a group of
antidepressants known as
serotonin modulator and
stimulator (SMS).
• This medication helps to improve mood and energy levels, and reduce sadness
and feelings of worthlessness in people with depression.
8. Fabiflu
• FabiFlu Tablet is an antiviral
medicine.
• It has recently been approved for
the treatment of mild coronavirus
disease (COVID-19).
• It inhibits an enzyme called RNA
polymerase that helps the virus
make more copies of itself.
• This way it decreases the viral load in the body.
Fig.No.14 Brintellix-10 Tablet
Fig.No. 15 Fabiflu Tablet

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9. Istavel
• Istavel 50mg Tablet is a
medicine used to treat type 2
diabetes mellitus.
• It is used together with a
healthy diet exercise to control
blood sugar levels.
• This helps to prevent serious complications of diabetes like kidney damage
and blindness.
10. Neosurf
• It restores surfactant activity, in
neonates with NRDS(It is a
serious medical condition where a
new born baby's lungs cannot
provide their body with enough
oxygen. NRDS is also known as
hyaline membrane disease, infant
respiratory distress syndrome or
newborn respiratory distress
syndrome.), thereby decreasing
alveolar surface tension, thereby
improving gaseous exchange, and
promoting lung compliance.
Fig.No.16 Istavel Tablet
Fig.No.17 Neosurf Injection

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Cosmetics
1. Sensodyne
• Sensodyne is a daily toothpaste specially
formulated to relieve and protect against
tooth sensitivity. and it is the
recommended toothpaste brand for
sensitive teeth.
2. Aloe vera gel
• It contains antioxidants, enzymes, Vitamins A
and C, and it is highly anti-inflammatory.
• It can help to treat burns, acne and dry skin.
• Chang added that when it comes to acne, Aloe
Vera works best on superficial surface acne
rather than cystic or deeper acne.
Fig.No.18 Sensodyne
Fig.No.19 Aloe Vera Gel

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3. Johnson’s Baby Lotion
• This medication is used as a moisturizer to
treat or prevent dry, rough, scaly, itchy skin
and minor skin irritations (e.g., diaper rash,
skin burns from radiation therapy).
• Emollients are substances that soften and
moisturize the skin and decrease itching and
flaking.
4. Baby Soap
• A baby soap will perfectly moisturize the
skin of your baby and make it soft and
supple. It is free from chemicals and harsh
ingredients.
• Its real and organic ingredients will make
your baby's skin softer and smoother.
5. Vaseline Lotion
• This medication is used as a moisturizer to
treat or prevent dry, rough, scaly,
itchy skin and minor skin irritations (e.g.,
diaper rash, skin burns from radiation
therapy). Emollients are substances that
soften and moisturize the skin and decrease
itching and flaking.
Fig.No.20 Johnson’s Baby Lotion
Fig.No.21 Baby Soap
Fig.No.22 Vaseline Lotion

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Surgical Products
1. Bactigras
• Bactigras is an antiseptic, soft
paraffin dressing which soothes and
protects the wound whilst helping to
reduce wound infection and
inflammation.
• It has low adherence and allows the
wound to drain freely into an absorbent
secondary dressing.
2. Ultrefine Needles
• Used with the appropriate injection
technique, the BD Ultra-Fine 4mm
Pen Needle with Easy Flow
Technology.
• it ensures medication is injected to
the correct skin depth over 99.5
percent of the time, at all injection
sites.
Fig.No.23 Bactigras Patch
Fig.No.24 Ultrafine Needles
Fig.No.25 Sterile Needle

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Covid-19 Pandemic Most Essential Items
1. PPE Kit
• Personal Protective Equipment kit is one such safety essential that will minimize
the risk of your body contact with the virus by covering all parts of your body.
Fig.No.27 PPE Kit

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2. N95 Mask & Face Shield
• The CDC reports that prolonged N95 mask use (including between patients) can
be safe for up to 8 hours, and encourages each user to review each manufacturer's
recommendations prior to following this strategy.
• Current guidelines encourage wearing a face shield over the N95 to decrease the
chances of soiling the mask.
3. Sanitizer
• Dettol hand sanitizer kills 99.9% of germs
instantly, without water.
• Use anytime, anywhere and it leaves hands
refreshed.
• Use as often as required.
Fig.No.28 N95 Mask Fig.No.29 Face Shield
Fig.No.30 Sanitizer

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9. Conclusion
During my 3-week internship period in pharmacy, I came to know that the role of pharmacist is
very crucial in a community pharmacy.
Throughout my training period I was able to acquire knowledge on the system of drug
procurement in community pharmacy, dispensing of drugs and counselling techniques of medical
appliances.
To be a trainee in pharmacy was indeed an honour for me.
❖

Community pharmacy training

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