Introduction to Clinical Pharmacology
The medicinal use of herbs, also called botanicals, is also increasing across the United States. This increased use of herbal remedies may possibly be as a result of disenchantment with traditional western medicine on the part of some. However, the use of botanicals can create new problems for the patient and the Paramedic. Many patients who are taking herbal remedies are confounding their medical treatment with the addition of untested herbal preparations which can cause unpredictable consequences. Therefore, Paramedics should know the effects of some of the more common botanicals and their potential interaction with the drugs that the Paramedic would be administering (Table 29-3). It is important that the Paramedic list all herbal products along with over-the-counter and prescription medicines on the patient care report.
Observant Paramedics may note the presence of teapots, pots and pans, and the like and ask the patient questions about herbal remedies. Methods of botanical administration include potable infusions (boiling water over the top of the herbs and immediately drawing off the solution), decoction (bringing water to a boil then steeping the herbs like one would a tea-bag and drinking the resulting solution) and cold maceration (letting herbs steep in cold water).
Sources of Drug Information
A pharmacopeia is a list of the drugs commonly used in a country. The first U.S. Pharmacopeia was published in 1820 as a guide to apothecaries who collected plants and flowers and for physicians who compounded their own remedies.10 Typically, a group of physicians, pharmacists, and other professionals, create a pharmacopeia.
The United States Pharmacopeia (USP) drug reference is created by an independent nongovernmental science-based public health organization called the United States Pharmacopeia. The United States Pharmacopeia is made up of over 1, 000 scientists, practitioners, and representatives from various colleges of medicine and pharmacy who set the standards for medication manufacturing in the United States. This group of physicians, pharmacists, and scientists meets every five years, at the United States Pharmacopeial Convention, to discuss and adopt recommendations presented from the internal Council of Experts (COE) regarding new drugs to be added to the United States Pharmacopeia listing. The National Formulary (NF), another drug reference, is a manual that lists medications which are approved for prescription. It contains specific chemical information that is more helpful to the pharmacist and manufacturer than the physician. Today, the U.S. Pharmacopeia (USP)—as well as the National Formulary (NF), which is part of the USP—is recognized by the Federal Drug Administration and contains the standards of purity, dose, formula, and other information for drugs. The USP is, per the Federal Food, Drug, and Cosmetic Act (2 U.S.C.321), the authority for drug manufacturing in the United States. The USP is a two-volume text. The first volume includes all prescription medications and the second volume includes all over-the-counter medications.
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Introduction to Clinical Pharmacology, 7e
Pharmacist Provider Status — Pharmacy Times
In 2000, North Carolina was able to pass legislation that created a clinical pharmacist practitioner (CPP). We were able to work with the medical director for Medicare's Fiscal Intermediate to allow a CPP to bill for medical care as a provider.