Pharmacists dispense drugs prescribed by physicians and other health practitioners and provide information to patients about medications and their use. They advise physicians and other health practitioners on the selection, dosages, interactions, and side effects of medications. Pharmacists also monitor the health and progress of patients in response to drug therapy to ensure safe and effective use of medication. Pharmacists must understand the use, clinical effects, and composition of drugs, including their chemical, biological, and physical properties. Compounding—the actual mixing of ingredients to form powders, tablets, capsules, ointments, and solutions—is a small part of a pharmacist’s practice, because most medicines are produced by pharmaceutical companies in a standard dosage and drug delivery form. Traditionally, most pharmacists work in a community setting, such as a retail drugstore, or in a healthcare facility, such as a hospital, nursing home, mental health institution, or neighborhood health clinic.

Pharmacists in community and retail pharmacies counsel patients and answer questions about prescription drugs, including questions regarding possible side effects or interactions among various drugs. They provide information about over-the-counter drugs and make recommendations after talking with the patient. They also may give advice about diet, exercise, or stress management, or about durable medical equipment and home healthcare supplies. They also may complete third-party insurance forms and other paperwork. Those who own or manage community pharmacies may sell non-health-related merchandise, hire and supervise personnel, and oversee the general operation of the pharmacy. Some community pharmacists provide specialized services to help patients manage conditions such as diabetes, asthma, smoking cessation, or high blood pressure. Some community pharmacists are also certified to administer vaccinations.

Pharmacists in healthcare facilities dispense medications and advise the medical staff on the selection and effects of drugs. They may make sterile solutions and buy medical supplies. They also assess, plan, and monitor drug programs or regimens. They counsel patients on the use of drugs while in the hospital, and on their use at home when the patients are discharged. Pharmacists also may evaluate drug use patterns and outcomes for patients in hospitals or managed care organizations.

Pharmacists who work in home healthcare monitor drug therapy and prepare infusions—solutions that are injected into patients—and other medications for use in the home.

Some pharmacists specialize in specific drug therapy areas, such as intravenous nutrition support, oncology (cancer), nuclear pharmacy (used for chemotherapy), geriatric pharmacy, and psychopharmacotherapy (the treatment of mental disorders with drugs).

Most pharmacists keep confidential computerized records of patients’ drug therapies to ensure that harmful drug interactions do not occur. Pharmacists are responsible for the accuracy of every prescription that is filled, but they often rely upon pharmacy technicians and pharmacy aides to assist them in the dispensing process. Thus, the pharmacist may delegate prescription-filling and administrative tasks and supervise their completion. They also frequently oversee pharmacy students serving as interns in preparation for graduation and licensure.

Increasingly, pharmacists pursue nontraditional pharmacy work. Some are involved in research for pharmaceutical manufacturers, developing new drugs and therapies and testing their effects on people. Others work in marketing or sales, providing expertise to clients on a drug’s use, effectiveness, and possible side effects. Some pharmacists also work for health insurance companies, developing pharmacy benefit packages and carrying out cost-benefit analyses on certain drugs. Other pharmacists work for the government and pharmacy associations. Finally, some pharmacists are employed full time or part time as college faculty, teaching classes and performing research in a wide range of areas.

Pharmacy aides help licensed pharmacists with administrative duties in running a pharmacy. Aides often are clerks or cashiers who primarily answer telephones, handle money, stock shelves, and perform other clerical duties. They work closely with pharmacy technicians. Pharmacy technicians usually perform more complex tasks than do aides, although, in some States, the duties and titles of the jobs overlap. (See the statement on pharmacy technicians elsewhere in the Handbook.) Aides refer any questions regarding prescriptions, drug information, or health matters to a pharmacist. (See the statement on pharmacists elsewhere in the Handbook.)

Aides have several important duties that help the pharmacy to function smoothly. They may establish and maintain patient profiles, prepare insurance claim forms, and stock and take inventory of prescription and over-the-counter medications. Accurate recordkeeping is necessary to help avert a potentially dangerous drug interaction. Because many people have medical insurance to help pay for the prescription, it is essential that pharmacy aides efficiently and correctly correspond with the third-party insurance providers to obtain payment. Pharmacy aides also maintain the inventory and inform the supervisor of stock needs so that the pharmacy has the vital medications for those who need them.

Pharmacy technicians help licensed pharmacists provide medication and other healthcare products to patients. Technicians usually perform routine tasks to help prepare prescribed medication for patients, such as counting tablets and labeling bottles. Technicians refer any questions regarding prescriptions, drug information, or health matters to a pharmacist. (See the statement on pharmacists elsewhere in the Handbook.)

Pharmacy aides work closely with pharmacy technicians. They are often clerks or cashiers who primarily answer telephones, handle money, stock shelves, and perform other clerical duties. (See the statement on pharmacy aides elsewhere in the Handbook.) Pharmacy technicians usually perform more complex tasks than do pharmacy aides, although, in some States, their duties and job titles overlap.

Pharmacy technicians who work in retail or mail-order pharmacies have varying responsibilities, depending on State rules and regulations. Technicians receive written prescriptions or requests for prescription refills from patients. They also may receive prescriptions sent electronically from the doctor’s office. They must verify that the information on the prescription is complete and accurate. To prepare the prescription, technicians must retrieve, count, pour, weigh, measure, and sometimes mix the medication. Then, they prepare the prescription labels, select the type of prescription container, and affix the prescription and auxiliary labels to the container. Once the prescription is filled, technicians price and file the prescription, which must be checked by a pharmacist before it is given to a patient. Technicians may establish and maintain patient profiles, prepare insurance claim forms, and stock and take inventory of prescription and over-the-counter medications.

A license to practice pharmacy is required in all States, the District of Columbia, and U.S. territories. To obtain a license, one must graduate from a college of pharmacy accredited by the American Council on Pharmaceutical Education (ACPE) and pass an examination. All States require the North American Pharmacist Licensure Exam (NAPLEX), and all States except California require the Multistate Pharmacy Jurisprudence Exam (MPJE). Both exams are administered by the National Association of Boards of Pharmacy. Pharmacists in California must pass the California Pharmacy Jurisprudence Exam in lieu of the MPJE. In addition to the NAPLEX and MPJE, some States require additional exams unique to their State. All States except California currently grant a license without extensive re-examination to qualified pharmacists already licensed by another State. In Florida, reexamination is not required if a pharmacist passed the NAPLEX and MPJE within 12 years of his or her application for license transfer. Many pharmacists are licensed to practice in more than one State. States may require continuing education for license renewal. Persons interested in a career as a pharmacist should check with State boards of pharmacy for details on examination requirements and license transfer procedures.