ARTICLE REVIEW

Cocaine is one of the most commonly used drugs in the US and it has a history of both medical
and illegal recreational use. It is a drug capable of a wide array of effects on physical and
mental health. Research on the teratogenic effects of cocaine began in the early 1980s, and in
1985 research on the effects of cocaine on prenatal development gained widespread attention.
Since then, numerous studies have contributed to information about the detrimental impacts of
maternal cocaine use on embryonic and fetal development. Cocaine has been termed a
teratogen, or an agent that causes defects in fetuses during prenatal development it has a
variety of effects on the embryo and fetus, ranging from various gastro-intestinal and cardiac
defects to tissue death from insufficient blood supply. Cocaine (benzoylmethylecgonine) is an
alkaloid or a nitrogen-based natural compound that occurs in the Erythroxylum coca plant. In the
US, cocaine was presented as a drug with potential local anesthetic properties and was first
sold in 1885 by the drug company Parke, Davis and Company, in Detroit, Michigan. The drug
was sold in the US as an over-the-counter painkiller and antidepressant until 17 December
1914, when the US Congress passed the Harrison Narcotics Tax Act. The Act required that
cocaine and other narcotics be regulated and dispensed only with a physician's order. Under the
Controlled Substances Act of 1970, the US Congress limited public use of cocaine and
categorized cocaine as a Schedule II controlled substance, which would only be dispensed for
medical use with severe restrictions. In a June 1980 article titled "Teratogenic Potential of
Cocaine Hydrochloride in CF-1 Mice," Michael Mahalik, Ronald Gautieri, and David Mann Jr., at
Temple University in Philadelphia, Pennsylvania, reported cocaine's teratogenic potential as
demonstrated by an array of congenital malformations that occur in the offspring of pregnant
mice given 60 milligrams of cocaine per kilogram of mouse tissue. In 1983 David Acker,
Benjamin Sachs, Kevin Tracey, and W.E. Wise, all in the US, drew attention to the possible link
between maternal cocaine use during pregnancy and abrutio placentae, a separation of the
placenta from the uterus during pregnancy, Cocaine users had a higher frequency of
spontaneous abortion, Cocaine works as a central nervous system stimulant by interfering with
the nervous cells' reuptake of norepinephrine and dopamine, which are chemicals involved in
the transmission of neurological signals, or neurotransmitters; slowed reuptake causes levels of
such neurotransmitters to increase in the user. Dopamine accumulation leads to a sense of
ecstasy, increased alertness and energy, heightened sexual stimulation, and reduced fatigue. At
the same time, increased levels of norepinephrine enables cocaine to accumulate at nerve
terminals, which in pregnant women results in the constriction of maternal blood vessels
(vasoconstriction) and in high blood pressure (hypertension) at the site where the uterus and
placenta attach together. This disruption of blood flow to the uterus and placenta may also result
in maternal tachycardia, a condition that manifests in an abnormally high heart rate, an
increased risk for ventricular arrhythmias, and amnion rupture, which in turn causes limb defects
in the fetus. Research on cocaine's effects on the development of fetal brains indicates that
cocaine inactivates cyclin A, a protein that regulates cell division. The inactivation of cyclin A
prevents the development of nerve cells in the fetus women who use cocaine during their
pregnancy often face greater than normal environmental risks, such as poor to nonexistent
prenatal care. Given those factors, researchers can struggle to identify the problems with fetal
development due to cocaine alone, and not to other drugs, environmental factors, or mixtures of
the three. Regardless of these struggles, much research shows that consumption of cocaine
during pregnancy risks the developing embryo and fetus, and that higher level of exposure lead
to increased rates of abnormalities. Pregnancy seems designed to prepare you for life as a
mother. You start making sacrifices nine months before the child is born, so by the time they put
in an appearance you are used to giving things up for them. Pregnant women should always
beware of what they do and what they take, because it always affect their special one inside
their womb.

JISA RIZALE T. YAMAS

BSPH 1-B
FEBRUARY 4, 2015
HISTORY OF THE PHARMACY PROFFESION
Pharmacy is said to be a store where medicinal drugs are dispensed and sold, it is also the
science or practice of the preparation and dispensing of medicinal drugs. Back in Pharmacy
history, since King James I established Western societys first independent pharmacist guild in
England during the early 17th century, pharmacy has held a central role in health care. Initially
known as apothecaries, early community pharmacists prepared and dispensed remedies while
offering front-line medical advice to their customers. Apothecary traditions traveled to the New
World with the English colonists, where they flourished for centuries.
Apothecaries became widely known in the United States as pharmacists nearly 150 years ago,
thanks to Edward Parrish of American Pharmaceutical Association, as it was called at the time.
In an effort to standardize the field, Parrish successfully proposed that members of the national
professional organization consider all the varied pharmaceutical practitioners pharmacists.
Their field formally identified, pharmacists made as well as prescribed medicines and remained
community medical counselors until the 1950s
Federal legislation substantially changed pharmacys role in 1951. With the passage of the
Durham-Humphrey Amendment to the Federal Food, Drug and Cosmetic Act of 1938,
pharmacists, who until then had been able to dispense all drugs except narcotics, needed a
physicians prescription to dispense many medications. Restricted to recommending over-thecounter medications, pharmacists began focusing on dispensing and product safety.
Pharmacys focus began to expand again during the 1980s. A professional movement that
proponents called clinical pharmacy gained momentum, urging pharmacists to take on a vital
role in the American health care system by providing medication expertise to ensure patients
properly and safely use their medications. The movement had gathered considerable steam by

the time federal legislation once again intervened, this time in the form of the 2003 Medicare
Prescription Drug Improvement and Modernization Act. The law opened up tremendous
opportunities for drug therapy and information services by mandating that patients covered by
the act receive counseling when they purchase medications. Pharmacists are stepping up to
fulfill the mandate, answering questions and offering advice to patients about both prescription
and over-the-counter medications.
Pharmacist is a person who is professionally qualified to prepare and dispense medicinal drugs
and so the practice of pharmacy is coming full circle. Pharmacists are assuming increasingly
critical roles in modern health care teams, providing direct patient care and advocacy. What
does that mean for patients? It means pharmacists are there to help improve their health.
Without a doubt, pharmacists are the most accessible health care professionals in every
community. They provide education, medication management and responsive service to
patients. Patient-centered care is our tradition and our history, as well as our future.

http://embryo.asu.edu/print/4701
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1.
In an era of rapid change in health care delivery, the pharmacy profession is
experiencing significant growth and development. Although pharmacists represent a
traditional health profession with ancient roots, they are often viewed with
considerable ambiguity and uncertainty by those outside of the profession.
Traditionally, pharmacy was regarded as a transitional discipline between the health
and chemical sciences and as a profession charged with ensuring the safe use of
medication. In the early 1900s, pharmacists fulfilled the role of apothecary
preparing drug products secundum artem (according to the art) for medicinal use.
By the 1950s, large-scale manufacturing of medicinal products by the
pharmaceutical industry, and the introduction of prescription-only legal status for
most therapeutic agents, limited the role of pharmacists to compounding,
dispensing and labelling prefabricated products. In response, by the mid-1960s
pharmacists had evolved toward a more patient-oriented practice and developed
the concept of clinical pharmacy. The current transition involves an expansion of the
scope of pharmacy practice and, in some jurisdictions, the assumption of the
authority to prescribe medications in defined situations. Various prescribing models
for pharmacists have previously been developed internationally 4,5 and have been
advocated for within Canadian hospitals. In Alberta, the approval of the Pharmacists
Profession Regulation to the Health Professions Act (May 2006) has resulted in an
expanded scope of practice for pharmacists, including the privilege to prescribe
Schedule 1 drugs and blood products and to administer medications for
subcutaneous and intramuscular injection. The Pharmacy and Drug Act (October
2006) specifically defines the new standards for pharmacy practice. The second
category of the pharmacist prescribing model is referred to as initiating/managing
drug therapy. This type of prescribing will be limited to pharmacists on the clinical
register of the Alberta College of Pharmacists who have successfully completed a 5step process to demonstrate the requisite competencies within the context of
professional education and training, experience, collaborative relationships and
practice setting. In this category, authorized pharmacists will be permitted to assess
patients and to determine the need to initiate drug therapy. An orderly transition
and constructive evaluation of this new role for pharmacists will be necessary to
convince skeptics of the explicit benefits for patient care achieved by the Alberta
model for pharmacist prescribing and for future Canadian models.
2.prehisoric
Paleopharmacological studies attest to the use of medicinal plants in pre-history.
The earliest known compilation of medicinal substances was the Sushruta Samha, an
Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text
as preserved dates to the 3rd or 4th century AD. India has a great history of medicine and
patient care. Great Indian philosophers who did remarkable service to the world by writing
medical books are Sushrutha muni (Sushrutha Sanhitha),Charaka Muni(Charaka

Sanhitha),Sharngadara Muni(Sharngadara Sanhitha). Those 2 books are the pioneering books

of Ancient Indian Ayurvedic knowledge.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay
tablets record prescriptions for medicine
3.
He's probably right, the future of pharmacy is not what it once was; in some ways it's depressed,
in some ways it has even more potential.
The pharmacist-as-pill-dispenser model is not as strong as it once was. Many people in retail
pharmacy feel that they are increasingly marginalized and mistreated by their employers.
Definitely they're being asked to do a lot, and in many cases the stuff they're doing is not the
stuff they were trained to do in pharmacy school - I get the sense some of them feel there's a bit
of a bait-and-switch going on.
On the other hand, I believe the pharmacist-as-medication-expert model has serious legs - if
pharmacists can mobilize to promote their unique and incredibly valuable understanding of
medications and their interactions, and develop themselves as patient educators, there's a lot of
potential there. I think pharmacists have a big role to play in evidence-based medicine and
quality improvement, two big powerful concepts in healthcare right now (both in hospitals and in
other healthcare organizations - insurers, governments, etc.).

JISA RIZALE T. YAMAS

BSPH 1-B
FEBRUARY 4, 2015