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Pharmacy: From Guesswork to Laboratory Precision

25 Sep 2015 by Teresa Meek

The International Pharmaceutical Federation (FIP) is celebrating World Pharmacists Day (Sept. 25) in a decidedly modern way, calling on members to upload their photos onto a “Twibbon” Tweet and share their celebrations on Facebook.

The ancient profession has come a long way. Pharmacy dates back at least to the Sumerians, who used licorice, mustard, myrrh — and opium — to treat pain in 4000 B.C.

The ancient Egyptians also used drugs, and called the person who administered them a “pastophor.” A papyrus dating from 1500 B.C. lists 875 prescriptions and 700 drugs in use.

The ancient Chinese documented the use of plant-based drugs as early as 2000 B.C. In Greece, Theophrastus, known as the father of botany, wrote of the medicinal power of herbs.

Professionalizing drug administration

But it was the Arabs, building on Greek tradition, who first separated apothecaries and their duties from those of physicians. European countries, influenced by Arabic traditions, created the first public pharmacies in the 17th century.

A pharmacy was included in America’s first hospital, which opened in Philadelphia in 1751. The United States Pharmacopeia — the country’s first national book of drug standards — was published in 1820, and in 1852, the American Pharmaceutical Association was established.

Despite the new standards, however, preparation of plant-based drugs was not uniform until late in the 19th century, when alkaloidal assays and other techniques were devised to ensure even quantity and quality.

Distributing medicine to patients got a lot easier after French pharmacist Stanislas Limousin invented the medicine dropper, the oxygen bottle, and a sterile vial that hermetically sealed liquid drugs against bacteria and other contaminants.

Penicillin — a major breakthrough

In 1928, after returning from a vacation in Scotland, Dr. Alexander Fleming noticed that a mold, Penicillium notatum, had contaminated petri dishes in which he was growing colonies of Staphylococcus bacteria. He was amazed to find that the mold had inhibited growth of the bacteria, though he didn’t realize the full significance of his discovery at the time.

He later wrote, “When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first antibiotic, or bacteria killer. But I guess that was exactly what I did.”

Penicillin was soon put to work killing bacteria and knocking out infections. But there was not enough supply to distribute it widely — it took 2,000 liters (60,000 ounces) of Fleming’s mold culture to treat a single patient. In the 1930s, British scientists built on Fleming’s work using similar but not identical molds, which eventually led to mass production of the “miracle drug.”

Fleming and the British scientists were jointly awarded a Nobel Prize in 1945.

Big pharma and new techniques

Pharmaceutical research intensified in the 1930s and 1940s, and drugs began to be manufactured on a large scale. Today, revenues for the global pharmaceutical industry are reported at $300 billion a year.

Through massive investment in research, pharmaceutical companies are inventing new drugs to treat diseases like cystic fibrosis, cancer, celiac disease and Crohn’s disease. They are learning how to increase drugs’ bioavailability through timed release, inhalation and even the use of nanoparticles.

Unlike their pioneering ancestors, who guessed at doses and sometimes experimented on themselves, today’s pharmacists are experts in medication delivery. A recent study found that when the medical teams of patients treated for high blood pressure included a pharmacist, blood pressure control improved, and the patients’ risk of stroke decreased by 23%.