Re: What chemical principles and procedures does a pharmacist use?

Through perhaps the Korean War in this country, the primary job of a 
pharmacist was to fill prescriptions written by doctors using their 
knownledge of what is usually called "materia medica", the chemicals, 
drugs and objects used to treat specific diseases or conditions.  This 
involved in most cases actually making up the medicine from a combination 
of one or more ingrediants and putting those ingrediants into a form to be 
taken by some route of ingestion (oral, rectal, etc.).  Pharmacists 
traditionally actually made up the medicines at the time of dispensation.  
Because of this, they had to have a great deal of knowledge about medicine 
and especially about drugs.  A pharmacist has a specialized degree taking 
usually 4 years.

However, their role has changed dramatically within the last 40 years, 
primarily because of the growth in "prepared" drugs.  Pharmacists rarely 
actually make up medicines anymore, probably much less than 1% of those 
prescribed.  Essentially, the picture of a pharmacist counting pills is 
relatively accurate.  It is becoming increasingly evident that the 4 years 
of specialized training is not necessary for this task.  Pharmacists have 
an additional role now however.  Because of the huge number of drugs 
(>22,000 currently on the market), there is the very high likelihood of 
drug-drug interactions or adverse effects from a drug.  Moreover, because 
of the specialization of medicine, many patients are receiving 
prescriptions and treatments from more than one doctor at the same time. 
Both from their own knowledge and the use of computer databases therefore, 
the pharmacist has become a "filter" who often knows all the drugs and 
treatments a patient is receiving.  The pharmacist can therefore spot 
likely drug interactions and ward the patient and/or the doctor.  They can 
often offer some basic instruction in what effects to look for should 
there be a problem.  This is also contained in many cases by a printout 
that accompanies each prescription.  

The role of the pharmacist as a professional, essentially as well educated 
in pharmacology and drugs as the physician is in medicine has changed.  
The degree of education needed in the past is not necessarily needed now 
or in the future.  But it is quite unclear what role the pharmacist will 
play in 10-20 years as medicine changes, both because of advances in 
medical practice and changes in health insurance plans, managed care, etc.