The Pharmacist

Pharmacists are healthcare professionals that deal primarily with dispensing medications and managing patient medication regimens. The pharmacist has many responsibilities. The pharmacist fills prescriptions from doctors. The pharmacist also counsels the patient about medication, side effects, and how to use the medication correctly. Another responsibility of the pharmacist is to manage and monitor patient medication profiles. Pharmacists must check for drug interactions, proper prescribing and drug safety. The pharmacist works closely with patients, physicians, and other healthcare professionals to provide medication to the patient.

Roles of the pharmacist:

* Reviewing and monitoring patient medication regimens

* General health advice

* Counseling patients about disease states and medication

* Dispensing medication by prescription

* Counseling patients about the best use of medication

Pharmacists work in a variety of places with many different specialties. Pharmacists are often the first person patients ask for medical advice. With their position in the community and because they are very accessible, pharmacists play a major role in patient care.

Pharmacists work in:

* community pharmacies

* hospitals

* clinics

* pharmaceutical companies

* government offices

Pharmacist specialties include:

* community pharmacists

* hospital pharmacists

* nuclear pharmacists

* clinical research pharmacists

* consultant pharmacist

Now choose the proper answer(s):

1. What is a pharmacist?

1. a person who deals with medication 2. a person who consults patients 3. a person who prescribes medicine 4. a person who works in a hospital

2. What are the two main roles of a pharmacist?

1. side effects and prescriptions review 2. safety and dosage monitoring 3. dispensing medication and managing patient medication profiles 4. checking inventory and ordering prescriptions

3. What are the responsibilities of a pharmacist?

1. counseling patients 2. filling prescriptions 3. managing side effects 4. all of the above

4. Which one isn't a responsibility of the pharmacist?

1. to monitor patient medication profiles 2. to diagnose diseases

3. to fill prescriptions 4. to monitor safety of medication regimen

5. Where do pharmacists work?

1. pharmacies 2. hospitals 3. government offices 4. all of the above

6. Which is not a special field of a pharmacist’ activity?

1.counseling 2.research 3.hospital 4. medical record

7. What does a pharmacist check when checking a prescription? 1. drug interactions 2. drug safety

3. proper prescribing 4. all of the above

8. Which is a medication order?

1. a prescription 2. a medicine side effect

3. a drug interaction 4. a drugstore

8. Why is a pharmacist often the first person patients ask for medical advice?

1. Because they are nice. 2. Because they like questions.

3. Because of their accessibility in the community. 4. Because people like pharmacists.

8. An important role of the pharmacist is to … a patient about medication, medication use, and side effects.

1. counsel 2. fill 3. manage 4. use

4. Group the drugs:

Ointment, pills, capsules, lotion, bandage, serum, powder, tablets, syrup, cream, caplets, vaccine, gargle, jelly, plasters, spray, inhaler, mixture, drops, mustard plasters, cups, patch, IV drip.

Drugs for internal use	Drugs for external use	Drugs for injections

5. Complete the sentences below with the words from the list:

cubic centimeters per cent

double dose ratio

extra length score

half dose teaspoon

junior strength units

milligrams

1. Measure out the ordinary household …………. of cough mixture.

2. If you miss one, you can catch up with a …….. later.

3. Give the child two of the new orange-flavoured, ……… aspirins.

4. He is a big man and needs an ……. analgesic.

5. The drug is very strong: even just a ………. can make you drowsy.

6. Make the solution with 100 …….. of insulin.

7. Make up a suspension in a ……… of 10:1.

8. Put 3.6 ………… of the powder into a litre of water.

9. Make a 20 ……… solution with 20 grams of soluble solid and add enough water to make 100 ml.

10. The patient has a ………. of 9 on the ranking scale for reactions to drugs.

11. Use a syringe with a volume of 25 ……. .

6. Read this little medical joke: During a follow-up appointment, a practice nurse asked a patient how he was getting on with his medication patches. “The doctor told me to put a new patch every six hours and now I’m running out of places to put them,” he said. The nurse asked him to undress and saw that the man had fifty patches stuck on his body. Now write one sentence instructing for using the medication patches so that it could not be misunderstood

7. Discuss these questions:

• Should all medicines be free?

• Can you think of any reasons why it should be illegal to sell medicines online?

• Should pharmaceutical companies be banned from aggressive advertising of new drugs and giving presents to doctors?

8. You’ll read a text about antibiotics. Before reading think and answer the following questions. Start with: I believe… I think… As far as I know…

1. What do antibiotics do? 2. What antibiotics can you name? 3. Do antibiotics help with colds? Explain why. 4. What do you know about bacteria and viruses?

Now read the text and explain the contents to your partner so that s/he could understand it. The partner will ask as many questions as possible about the ideas in the text

Antibiotics

Antibiotics are strong medications that fight infections in the body. There are many classes of antibiotics and they have different effects on bacteria. Some antibiotics weaken the cell walls. Some antibiotics block protein or DNA synthesis. Antibiotics can kill bacteria or stop them from growing. Each antibiotic has specific characteristics and they don’t work against all types of bacteria.

It is important that patients know several things about antibiotics:

• Antibiotics don’t work against viral infections such as colds and the flu.

• Antibiotics don’t work against sore throat and coughs which are generally caused by viruses.

• It is important to finish all of the medication with antibiotics even if you feel better.

If a patient doesn’t finish the prescription, it can be dangerous. Patients usually will feel better after 2 – 3 days. However, the bacteria might not be completely gone. If a patient stops taking his medication, the bacteria may grow, causing the patient to become sick again. Also, the bacteria may become resistant to the antibiotic making it more difficult to fight them.

Problems can occur with antibiotics. If the patient notices a rash, swelling, or any other allergic reaction, he should stop taking the medication and contact his physician immediately. Also, if the patient has problems with nausea or vomiting, he should stop the medication and contact his physician. A more tolerable alternative might be available.

Now find in the text and reproduce the information answering the questions:

1. What do antibiotics do in the body?

2. What ways do antibiotics fight bacteria?

3. Antibiotics don’t work for many common problems. Give some examples.

4. Why is it important to finish your antibiotic prescription?

8. Complete each sentence with a type of medicine:

a painkiller an antihistamine

a sedative a stimulant

an anti-inflammatory medicine an antidepressant

an inoculation a laxative

an antibiotic a dietary supplement

1. …………. kills bacteria and other germs.

2. …………… protects you against infectious diseases.

3. …… relieves pain.

4. …….. reduces swelling.

5. …….. encourages bowel movements.

6. ……… provides a substance that the body lacks.

7. ……. treats allergies.

8. …….. increases activity in the body.

9. ……… reduces feelings of extreme sadness.

10. ……… makes you relaxed and sleepy.

9. Discuss with a partner which type of medicine you could use to treat a person with:

a skin infection, a cut, an insect bite, constipation, loss of sleep, vitamin deficiency, an infectious disease, an allergy, a sore throat, a very high temperature.

HOSPITAL A hospital in Britain or the United States consists of inpatient wards and ambulatory or outpatient care services. When an outpatient consultation is needed the patient comes to the ambulatory or outpatient clinic. If a patient is getting admitted to the inpatient ward s/he can stay in the hospital for several days or weeks of treatment. Some larger hospitals also have Accident and Emergency Departments (A&E - Br.) or an Emergency Room ( EMS⁴ - US).

A patient who is getting admitted is first taken to the triage area (US), or admission department, or reception ward (Br.) where nurses take care of all the necessary procedures. They note general information about the patient: his/her name, age, job title, past medical history and the initial diagnosis made by the referring physician, in the patient’s medical record (case history). Other nurses take note of the patient’s vital signs, help him/her change into a gown and draw blood for any urgent tests.

The admitting physician examines the patient, comes up with an assessment of his/her condition and plan of treatment, identifies the urgency of the case and starts appropriate therapy if necessary, for emergency cases brought by ambulance. S/he also decides which medical service (hospital unit) the patient needs to be admitted to.

The day starts early in the hospital. Nurses take patients’ vital signs, take urine and gastric (digestive) juices samples, administer medications (pills and other oral drugs). They also give patients injections and IV (intravenous) infusions, perform wound care (including changing wound dressings after surgery) and other procedures as prescribed by doctors. Dayshift and nightshift nurses are always within reach to assist a patient or call a doctor.

Doctors see their patients during daily morning ward rounds. They listen to patients’ complaints, examine them and follow up on their progress.. Later they discuss their patients at a conference. Doctors can prescribe a special diet or order a diagnostic investigation test, such as CT (computer tomography), MRI (magnetic resonance imaging), X-ray, ultrasound scan, ECG (electrocardiogram). When the time comes, the doctor fixes the date of the patient’s discharge.

Words to be remembered:

Inpatient – стационарный больной; outpatient – амбулаторный больной; inpatient ward – стационарное отделение; ambulatory = outpatient care service – служба (отделение) амбулаторной помощи; admit to – принимать в; get admitted to - быть принятым в; several – несколько; accident – несчастный случай; emergency – критическая, чрезвычайная ситуация; triage area – место «сортировки» больных при поступлении в больницу в США, то же, что admission department = reception ward – приемный покой в Британии; take care of – заботиться о, care – уход, забота, медицинская помощь; note = take notes of – отмечать письменно, записывать; general – общий; medical history – анамнез; initial – первоначальный; vital signs – жизненно-важные признаки; (hospital) gown – больничный халат; draw blood – брать (вытягивать) кровь – take blood; urgent – срочный, urgency - неотложность; assess – оценивать, assessment – оценка; appropriate = proper – надлежащий; ambulance – машина скорой помощи; unit – отделение; gastric = digestive juice – желудочный (пищеварительный) сок; administer – назначать и применять назначенное; IV (intravenous) infusion – внутривенное вливание, give an IV infusion – ставить капельницу; perform – выполнять; change – менять, переодевать; shift – смена; within reach – в пределах досягаемости; ward round – обход палат; ward – палата; follow up – следить длительно; order – заказывать, order an investigation or a test – назначить исследование или тест; ultrasound scan - УЗИ.

1. a) Give an opposite to each of the following words:

internal -

outpatient -

in-patient wards –

inner –

breathe in –

exhale –

upper –

improper –

discharge –

out of reach

dayshift

b) Fill in the gaps with the correct word(s) from the list above:

1. At … … patients come to see the doctor.

2. At … … … doctors come to see the patient.

3. A GP⁵ can palpate … organs to check their size and shape.

4. Drugs should always be kept … of children.

5. Ointment and cream are for … use only.

6. He is well now and can be … from the hospital.

7. Phonendoscope is a … instrument to listen to a patient’s heart.

8. When listening to the lungs the doctor asks to … … and hold the breath.

9. Phonendoscope intensifies the sound produced by the lungs when the patient … ... and out.

10. When a person is ill the … layer of the tongue may be coated.

2. a) Give synonyms to the following:

admitting physician

hospital unit

ambulatory service

an urgent case

draw blood for test

triage area

stay in hospital

prescribe treatment

apply mustard plasters

carry out procedures

note in the medical record

GP

receive a sick-leave

case history

determine

digestive juice

medication

b)Replace the underlined word phrases with their synonyms:

1. The doctor administered me this medicine.

2. The patient had his gastric juice taken for a test.

3. Has the nurse carried out the procedure?

4. Yesterday she remained at home because she had a stomachache.

5. My physician referred me to have blood taken for a test.

6. Did you administer mustard plasters to your back?

7. The patient was brought to the reception ward.

8. The admitting doctor examined the emergency case.

9. The nurse noted the patient’s vital signs in the medical record.

10. I need the outpatient care unit.

11. She got the blood test findings.

3 Make up questions in response to the following phrases using the words given in brackets. Let your classmate answer it:

1. In the hospital patients are not allowed to take the medicines themselves. (Why?)

2. A hospital in Britain or the United States consists of two departments. (What?)

3. Doctors can prescribe a special diet or order a diagnostic investigation test, such as electrocardiogram, computer tomography, ultrasound scan. (Why?)

4. The nurses on duty gave patients intramuscular and intravenous injections and all the prescribed remedies. (When?)

5. Medicine is made in various forms convenient to use, (What forms..?)

6. It is important not to confuse one drug with another. (Why?)

7. Every pack of medicine has something to mark it. (How?)

8. Nurses take patients` vital signs. (What signs..?)

9. The ward doctors examine their patients during the daily rounds. (Where?)

10. Before using the medicine the patient must know well that he is taking the proper drug and in the necessary dosage. (Why?)

4. Complete the following sentences:

1. The patient comes to the ambulatory or outpatient clinic when he …..an outpatient consultation.

2. The nurse on duty filled in the patient`s…… .

3. The ……of the person was quite obvious even without an examination.

4. In hospital doctors see their patient during their….. .

5. Hospitals in Britain or in the United States consists of….. .

6. Doctors listen to patients` complaints, examine them and ... … .

7. Nightshift and dayshift nurses are always within reach to …… .

8. Nurses also give patients injections, perform wound care including …… .

9. Some patients are to follow a diet to relieve ….. .

10. Doctors of the reception ward also decide which medical service the patient needs to be …… .

5. Fill in the gaps with the correct verb tense form (active or passive):

1. Different drugs for intramuscular and intravenous injections (to sell) at a chemist`s.

2. A person usually (to go) to a chemist`s shop when he (need) a medicine.

3. Yesterday my mother went to a pharmacy and (buy) a small box of medicine with a blue label on it.

4, A physical examination (to be) important to know the prognosis of the disease.

5. Last month my sister (to admit) to the inpatient ward because she was severely ill.

6. This emergency case (to examine) on admission.

7. All the general information about the patient is to (to note) in the medical record.

8. After the nurse (to take the vital signs) of this urgent case she told the doctor her findings.

9. The ultra-sound scan was necessary as it was (to confirm) the diagnosis.

10. Instrumental investigations (to order) by the doctor to diagnose the case more carefully.

6. a) Complete the test results with the phrases below

abnormally high low-pitched medium-sized precancerous slightly alkaline slower than average

1. You can hear a _________ diastolic murmur between heartbeats.

2. Analysis shows an __________ number of WBCs in the sample drawn from the vein.

3. We did a mid-stream collection and found a ___________ pH of 8.0.

4. A ________ ventricular rate of 69 bpm indicating possible myocardial infarction.

5. We’ve had a look inside the duodenum and identified a ________ colony of H. pylori.

6. The Path lab’s analysis of the sample says that you have a _________ mole on your mid-upper back.

b) Match each completed result in test above with the one below

1. Acidity of urine d. Blood test

2. Biopsy e. ECG / EKG (heart)

3. Auscultation f. Endoscopy

7. a) Scan the text and say in a few words what it is about

Bacteriological Laboratory

In spite of immunization and effective treatment by modern drugs infectious diseases are still a major cause of illness and death worldwide. Recognizing microorganisms responsible for diseases is an essential step in the diagnosis and treatment of infectious illnesses. Tests to identify microorganisms play an increasingly important role in medicine today. All traditional tests performed in the bacteriological laboratory can be divided into two main groups: direct and indirect. The first method is microscopy, in which highly magnified images of microorganisms are produced so that they can be detected. Microscopy can be performed on any type of samples from the body, such as blood, urine, sputum or any other material withdrawn from the patient. Different microscopes are used to reveal different microorganisms. Bacteria are usually identified with light microscope. Viruses, which are much smaller than bacteria, are examined with a more powerful electronic microscope.

Sometimes test samples are taken and investigated immediately during the surgery, for example, to reveal bacteria causing the patient’s condition.. However, a sample often contains so few organisms that they cannot be identified easily. In such cases the microorganisms may be grown (cultured) to increase their number before microscopy.

Most samples are stained before a microscopic investigation to demonstrate the microorganisms they contain (for example, with Gram stain). When the samples are prepared different types of microorganisms can be recognized by their size, shape and color.

If the direct identification is impossible serologic methods are used. They are usually applied when a rapid diagnosis is needed or for diagnosing persistent infections (e.g. HIV infection), or to confirm the patient still has the immunity to a previous infection (such as rubella). This test is based on the reaction with antigen and antibody. Antigens and antibodies cannot be observed separately, but when they join together they form a large clump that can be seen by naked eye. The sample that is to be tested is added to the antibody-coated beads. If the suspected microorganism is present in the patient`s sample his antibodies will attach to the antigens beads, producing visible clumping.

Although the clumps of antigen and antibody may be seen without a microscope, the test may be made more sensitive by adding a fluorescent or radioactive marker to either the antigens or the antibodies before testing.

Words for better understanding:

In spite of – несмотря на

sample – проба, небольшое количество, взятое для образца

clump – слипаться в комок

suspect - подозревать

b) Answer the questions:

1. .Why are bacteriological tests administered by doctors?

2. .What equipment is needed to perform a bacteriological test?

3. .What is the difference between direct and indirect bacteriological methods?

4. .What kind of samples may be used for testing?

5. .How is it possible to improve examining samples and identification of a pathogenic agent?

6. . What is the basis of serological methods?

7. . When are serologic methods used?

8. . In what cases is it necessary to stain samples?

9. . How can a serological test be made more sensitive?

2. Complete the sentences:

1. .All common bacteriological tests can be divided......

2. .The bacteriological tests can be performed on any......

3. .To increase the number of detected microorganisms....

4. .Testing for antibodies is used when.....

5. .Antigen tests may be made more sensitive.......

6. .In spite of effective immunization and vaccination…

7. . The type of a microscope used to identify bacteria is…

8. . Viruses can be seen only with … because…

9. . Sometimes a serological test is necessary to confirm …

10. . Visible clumps are produced when …

8. Translate into English:

1. В стационарном отделении больницы пациенты остаются на лечении несколько дней или недель.

2. Пациенты приходят в амбулаторное отделение, чтобы получить консультацию врача или какую-то процедуру.

3. При госпитализации в присемном отделении медсестра записывает общую информацию о пациенте в его историю болезни.

4. Медсестры также фиксируют основные признаки жизнедеятельности организма госпитиализируемого больного и передают их врачу.

5. Принимающий врач осматривает пациента, доставленного скорой помощью, и решает, в какое отделение (службу) больницы он должен быть доставлен.

6. Больные в критическом состоянии получают немедленное лечение.

7. Медсестры работают посменно, чтобы всегда быть в пределах досягаемости больного.

8. Медсестры больницы делают инъекции, ставят капельницы, берут желудочный сок для анализа.

9. Различные анализы крови, мочи и другие помогают врачу поставить правильный диагноз.

10. Во время своего обхода палат врачи измеряют давление и пульс у пациентов с заболеваниями сердца.

11. УЗИ позволяет контролировать деятельность органов брюшной полости.

12. Этому больному сделали ЭКГ и обнаружили у него увеличение правого желудочка сердца.

9. Read the list of various tests given below and explain why a doctor has ordered them. Try to give more reasons

Model: X-ray– Doctor ordered X-ray of lungs to exclude pneumonia in the patient.

X-ray, CT, ultrasound scan, MRI, digestive juice test, blood test, urine test, ECG

Creative Thinking Situations

OUT-PATIENT DEPARTMENT

1. According to the rules of the Ministry of Public Health in our country every citizen of Russia is served by the local polyclinic of his residential community. A special document with the information about the patient is constantly kept there. A British journalist, Ms. Smith, is interested. Give her a complete description of the medical record explaining when, how, and by whom it is filled in.

2. There are many doctors including local physicians, surgeons, neurologists, otorhinolaryngologists, radiologists, ophthalmologists, gynecologists, and others working at the polyclinic. Discuss with a young American doctor the working conditions of various specialists, advantages and disadvantages of their duties or work schedule.

3. The work schedule of every local physician includes consulting hours and going out to calls to visit those patients who are really seriously ill and that’s why can’t go to the polyclinic themselves. Your British colleague, MD, wants to know: “What about the job of your local physician? How many days and hours a week does he work with his patients at the polyclinic and how much time does he spend on medical documentation?”

4. Patient Anna Belox aged 54 complained of a bad pain in the left side of the chest. She breathed heavily and became pale. The chest pain was associated with physical exertion. General weakness and poor appetite accompanied the condition. You are working with an English resident. Discuss the following issues with him. What specialist should examine her? What should the medical examination start with? What instrumental investigation can the patient be referred to?

5. Radiography is the use of radiation in the diagnosis. It involves exposing a part of the body to a small dose of radiation to produce an image of the internal organs. Organs with high density such as ribs and spine appear white or light grey on the image, but lung tissue appears dark. Before some types of X-rays patients are given a special liquid called a contrast medium. Write a paragraph for a medical textbook in English explaining what instructions should be given the patient to make a chest X-ray correctly.

IN-PATIENT DEPARTMENT

1. “There are a few things about your lifestyle we would address. Perhaps you could think of cutting down on the amount you are drinking. Giving up smoking would help a lot. You should try to avoid tight clothing, sitting in deep armchairs and bending, especially after meals,” – said the ward doctor to the patient at his discharge from the hospital. What department is the patient leaving?

2. Patient Games Watkins was treated at the hospital. His temperature was taken every morning, he was given the prescribed medicines, his blood pressure was measured regularly. He was also given the intramuscular injections of vitamin B6 and some intravenous injections to improve the immune system. What health care worker ordered the above-mentioned procedures? Who of the hospital staff carried out the administrations?

3. Patient Sandra Savage aged 7 was playing in the garden quite actively and fell down. She impaired her right upper extremity. There was a deep bleeding wound on the lateral surface. The ambulance carried the little patient to the hospital. What specialist of which department should examine her?

4. A 53-year old woman with incurable muscular dystrophy flew to Switzerland hospital to end her life as assisted dying is legal in this country. Opponents of euthanasia argue that legalization of this procedure in hospitals would lead to abuse and does not allow such patients to die with dignity. What’s your opinion on the problem?

5. Sam Samur is a hospital physiotherapist. She works mainly with patients who have conditions or injuries affecting the lower extremities such as fractures, torn ligaments, and cartilage tears. Most of her patients are referrals from other departments in her hospital. Will you describe a routine working day of this specialist?

CHEMIST’S SHOP

1. There are different types of medication the usage of which is chosen according to many reasons. So creams are more acceptable cosmetically being less visible. Ointments are greasier than creams and have a thicker texture. Pastes are stiffer preparations which contain more powdered solids. Lotions are liquid and used mostly in hairy areas. Try to give the same comparison chain to the following remedies: tablets – capsules - pills, solution – syrup – spray.

2. Any label of the drug contains a lot of useful information: the name of it, the ingredients, the directions for administration, the dosage to be taken, the possible side-effects, the limitations, and some other necessary points. Do you personally always read everything up to the very end? Why?

3. In our country a chemist’s shop sells a wide range of non-prescription medicines and other products such as cosmetics. Should there be any limitations on what can be bought at the chemist’s?

4. Any label of the drug contains a lot of useful information: the name of it, the ingredients, the directions for administration, the dosage to be taken, the possible side-effects, the limitations, and some other necessary points. Think, reply to the following questions and explain your answer. Which items are more important for doctors and what parts should be studied by consumers mostly?

5. “I am going to be a mother in some months, you know. And I would like to prepare everything beforehand. What kind of remedies can you recommend to buy now in order to have them available at home?” - said a young woman to a pharmacist at the chemist’s. What would you advise her?

1 Like, e.g. I had my TV fixed – мне починили телевизор

2 GP – general practitioner –врач общей практики

3 Profile – совокупность параметров; medication profile – совокупность лекарств для лечения данного больного и данного состояния

4 EMS – Emergency Medical Service

5 GP – general practitioner, a physician