Telling Dose Vs Optimizing Dose

#TellingDoseVsOptimizingDose

Morning dose - Till 12 noon

Afternoon - 12 noon to 6pm

Night dose - Before 12 AM

1. That is the unfortunate reality. In India, “dose” is often reduced to instructions like one tablet twice daily, before food or after food. It is treated as a schedule, not as a scientifically individualized quantity.

2.  The deeper meaning of dose—how much exactly this patient needs, based on their physiology, disease state, organ function, and concurrent therapy—is rarely examined.

3. True dose optimization goes far beyond timing. It asks critical questions:

👉 Is the patient’s kidney clearing the drug normally? 

👉 Is the liver metabolizing it efficiently?

👉 Is the body weight appropriate for the standard dose? 

👉 Is the drug reaching therapeutic concentration?

👉 Is the patient elderly, pediatric, critically ill, or on interacting medicines? 

4  Without answering these, giving “one tablet twice daily” becomes a ritual, not rational therapy.

5. Optimization is the science of precision. 

6. Optimization prevents toxicity when the dose is too high and prevents treatment failure when the dose is too low. 

7. Optimization converts prescribing from habit to accountability.

8. In India, timing is emphasized because it is easy to instruct and easy to follow. 

9. Optimization is neglected because it requires measurement, documentation, expertise, and ownership. 

10 Until healthcare formally assigns responsibility for dose optimization—supported by clinical pharmacology services and PharmD professionals—dose will continue to mean frequency, not precision.

11  And that is the difference between giving a medicine and managing drug therapy scientifically.

POV: Bhagwan PS

Does PharmaCare Intervénes With NursingCare

#DoesPharmaCareIntervénesWithNursingCare?

1. No, PharmaCare is the professional responsibility of PharmDs and does not intervene into NursingCare,  it complements it.

2. PharmaCare involves medication reconciliation, therapeutic review, dose optimization, interaction assessment, discharge medication planning, and patient counseling. 

3. These functions require specialized pharmacotherapy knowledge and are the core clinical responsibilities of PharmDs. 

4. This role ensures that every patient receives the most appropriate, safe, and effective medication therapy.

5. NursingCare, on the other hand, focuses on medication administration, bedside monitoring, and observing patient response. 

6. Nurses ensure that medications prescribed and reviewed under PharmaCare are correctly administered and that any clinical changes are promptly reported.

7. Thus, PharmaCare is the clinical domain of PharmDs, and NursingCare is the clinical domain of nurses. Both function collaboratively, not competitively. 

8. PharmaCare ensures medication correctness, and NursingCare ensures medication delivery and monitoring—together ensuring safe, accountable, and high-quality patient care. 

9. This  beings out comete triangular Collaborative support service with the patient in focus.

#MoHFW GoI

#AIPDA 

#APTI

#PharmD

POV: Bhagwan PS

Dose Optimization And Indian Doctors

#DoseOptimizationAndIndianDoctors

1. In India, dose optimization is still not institutionally accepted as a formal, accountable clinical responsibility, even though it is scientifically essential and routinely practiced in advanced healthcare systems. 

2. Prescribing often remains experience-based and generalized, rather than individualized.

3. The same standard dose is given irrespective of patient-specific variables such as age, renal function, liver status, body weight, pharmacogenetic variability, or interacting medicines. 

4. This approach ignores the fundamental principle that the right drug is only safe and effective when given in the right dose for the right patient.

5. The deeper issue is structural, not intellectual. 

6. India’s healthcare system recognizes diagnosis and prescribing authority, but does not formally recognize dose optimization as a defined professional service with legal backing, documentation standards, or accountability frameworks.

 7. Clinical pharmacists, who are trained to optimize dosing through pharmacokinetic and pharmacodynamic assessment, therapeutic drug monitoring, and evidence-based adjustment, are neither empowered nor integrated into routine care. 

8. As a result, dose optimization remains incidental rather than systematic.

9. This gap has consequences. It contributes to adverse drug reactions, therapeutic failure, antimicrobial resistance, prolonged hospital stays, and increased healthcare costs. 

10. Yet these outcomes are rarely traced back to dose appropriateness because dose optimization itself is not formally audited or regulated.

11. Until India formally recognizes dose optimization as a clinical responsibility—supported by law, institutional protocols, and designated professionals such as PharmDs—medication use will remain prescription-centric rather than patient-centric. 

12. True rational drug therapy begins not with selecting the drug alone, but with scientifically optimizing its dose for the individual patient.

#MoHFW GoI

#AIPDA 

#IMA

#APTI

#PharmD

POV: Bhagwan PS

For pharmacy students,. It is an unprecedented opportunity. AI will not replace pharmacists, but pharmacists who use AI will replace those who do not. The future pharmacist will be a combination of clinical expert and digital professional. Those who understand AI will lead healthcare systems, improve patient outcomes, and elevate the profession to new heights.Pharmacy is becoming an intelligent, technology-driven healthcare discipline

#AnIntroductionToAI

 -Dedicated ToPharmacy Students 

For pharmacy students,. It is an unprecedented opportunity. AI will not replace pharmacists, but pharmacists who use AI will replace those who do not. 

The future pharmacist will be a combination of clinical expert and digital professional. 

Those who understand AI will lead healthcare systems, improve patient outcomes, and elevate the profession to new heights.

Pharmacy  is becoming an intelligent, technology-driven healthcare discipline. 

Students who embrace AI today will become the leaders of tomorrow’s pharmacy practice

Now, briefly let us see AI utility sector wise.

Artificial Intelligence is no longer a future concept in pharmacy. It is already influencing every stage of a drug’s life cycle—from manufacture to patient care. 

For pharmacy students, learning AI is becoming essential to remain relevant, effective, and professionally empowered..

I. 1.  In,#DrugLogistics, AI ensures the right medicine is available at the right time and place by analyzing consumption patterns and disease trends, 

2. it predicts demand accurately, prevents shortages, reduces expiry losses, and maintains proper storage conditions, especially for temperature-sensitive medicines.

Ii. 1. In #clincalpractice , AI strengthens patient safety and clinical decision-making.

    2.  It can detect drug interactions, inappropriate doses, and contraindications, and assist in dose adjustment, optimization and medication review. 

  3. This helps pharmacists provide faster, safer, and more Patient - Centered  care.

Iii. 1  In #DrugManufacturing, it helps in  manufacturing layout designing,

      2.  AI helps create efficient, safe, and compliant production facilities.     

     3. By analyzing workflow, equipment placement, material movement, and regulatory requirements, 

    4  AI can design optimal plant layouts that reduce contamination risk, improve productivity, and ensure smooth process flow.

    5. It can simulate different layout models, identify bottlenecks, and recommend improvements before actual construction.

    6.  This saves cost, enhances GMP compliance, and ensures efficient, high-quality drug manufacturing from the very beginning. Prevents sunk investment.

IV. 1. #Production AI improves efficiency, consistency, and quality of formulation, monitors production in real time, predicts equipment failures, reduces waste, and helps optimize formulations. 

  2.  It also accelerates drug development and ensures compliance with quality standards.

V. In #DrugTesting and quality control,   

    1. AI enhances accuracy and reliability.

  2.  It analyzes laboratory data quickly, detects deviations, and predicts drug stability and shelf life.   3.  This ensures only safe and effective medicines reach patients.

VI. 1. In #DrugMarketing, AI enables scientific and need-based distribution.

  2.  It analyzes disease trends and prescribing patterns, helping ensure medicines reach the right regions. 

3.  This improves supply efficiency and supports informed healthcare communication.

4. In retail pharmacy, AI improves dispensing safety and efficiency. 

5.  It checks prescriptions, maintains patient medication records, and helps pharmacists counsel patients better. 

6. Besides it helps in management of inventory,

VII. 1.  It strengthens the pharmacist’s role as a healthcare provider.

     2.  In post-sale services, AI supports ongoing patient care and safety. It helps monitor adverse drug reactions, improve adherence, and evaluate treatment outcomes. Pharmacy care continues beyond dispensing.

3. In drug recall, AI enables rapid identification and withdrawal of defective batches. It tracks distribution instantly, allowing faster recalls and protecting patients. This improves accountability and public safety.

Thus, AI is transforming pharmacy into an intelligent and patient-focused profession. Pharmacy students who learn and use AI will lead the future of healthcare, while those who ignore it risk becoming outdated.

POV: Bhagwan PS

Pharmacist And His Status

#PharmacistAndHisStatus

In India, pharmacy was never positioned as a decision-making profession. 

Doctors were given authority to diagnose and treat; advocates were given authority to argue and represent. Pharmacists were largely confined to dispensing and compliance. 

Authority creates identity, and identity creates respect. When authority is limited, perception also becomes limited.

Education expanded — D.Pharm, B.Pharm, M.Pharm, Pharm.D — but professional identity did not evolve at the same pace. 

Many graduates complete degrees without clarity about their independent responsibility in patient care. 

Without defined clinical territory, policymakers see pharmacists as supportive rather than strategic stakeholders.

Yet the issue is not entirely external.

Pharmacists often divide themselves — retail vs hospital, industry vs clinical, diploma vs degree. Instead of one identity, 

There are comparisons and hierarchies. 

Doctors and advocates may have specializations, but they defend one collective identity as Doctor and Advocate 

Pharmacy has struggled to build that unified professional culture.

Visibility, Doctors appear in public health debates. Advocates shape constitutional discussions. 

Pharmacists, despite being medication experts, rarely occupy policy or media platforms. 

When a profession does not project its value, regulators feel little urgency to expand its role.

There is also the commercial shadow. 

Community pharmacy operates within trade licensing systems, so society often sees the shop before the science. 

When internal compromises occur — proxy attendance, absentee registrations, fee undercutting — credibility weakens further.

Doctors and advocates earned respect not just through knowledge, but through solidarity, legal authority, and assertiveness. 

They protect their professional space collectively.

For pharmacy to command respect, three shifts are essential: 

 i. Internal unity, 

 ii.Clear professional role definition, and 

iii. Visible demonstration of patient impact.

Perhaps the deeper question is not why regulators fail to recognize pharmacists —

but whether pharmacists have fully recognized their own collective strength.

When that recognition becomes firm, external respect will follow.

#CDSCO, #DCD, #PCI #IPA #AIPDA #APTI #Pharmacists

POV: Bhagwan PS

Pharma Career Sans Authority

#PharmaCareerSansAuthority 

There is nothing like Pharma career!

1 A professional carrer that deals with sick needs legal authorization, legal empowerment with defined eligibility criteria cannot be called a healthCare professional.

2. High-sounding themes, glossy brochures, inaugural lamps, keynote speeches…But without supportive and empowering Act and Rules, they are like screen play.

3. Pharmacy events often speak about clinical excellence, patient-centric care, expanded roles, pharmacovigilance leadership, antimicrobial stewardship, and healthcare innovation. 

- The vision is impressive. The intent is inspiring. Yet, if the legal framework does not clearly authorize, protect, and mandate these roles — the enthusiasm remains confined to conference halls.

4. A profession that deals with medicines and patients cannot grow on motivation and degrees. 

It grows on:

👉 Clear statutory scope of practice 

👉 Defined clinical authority

👉 Mandatory pharmacist presence

👉 Enforceable standards

👉 Protection against encroachment

👉 Accountability backed by law.

Without that, events risk becoming ceremonial rituals

  — intellectual celebrations disconnected from ground reality.

In my own experience as a hospital pharmacist, I know this well: 

👉 Unless the Act empowers the pharmacist to intervene, document, prescribe within scope, or be structurally integrated into care pathways, even the most brilliant clinical discussions remain aspirational.

👉 Professional growth is not built by slogans.

👉 It is built by legislation, enforcement, and institutional will.

Events can ignite thought.

But only strong, supportive rules can institutionalize change.

Otherwise, we are only applauding potential 

— without creating power.😢

#Pharmacist 

#PCI #IPA #AIPDA #APTI

PoV: Bhagwan PS

#Pharmacist - Kaha ka? - Neither for Industry nor for Healthcare, but for Pharmacare - pov: Bhagwaan PS ,modified by: Samrat Paul

#Pharmacist - Kaha ka?

    - Neither for Industry nor for Healthcare, but for Pharmacare

Pharmacists in India face a stark reality: 

There is no exclusivity for them in pharmaceutical industry, R&D, or marketing. Except Diploma Pharmacists graduates and even Clinical Pharmacists with PharmD have no slots to serve in Healthcare

Then, what for these courses are conducted to ruin the life of young aspiring Pharmacists?

 With thousands of colleges producing an overwhelming number of graduates each year, industry is not a viable source of employment.

Shockingly, the IPC which is a conglomeration of IPA, IGPA, APTI, IHPA and PCI has never considered this issue to evolve a solution, inspite of repeatedly voicing the need. 

Irony is IPC wants huge number of Pharmacists from various streams to attend and participate in various activities! but seldom addresses their issues since 1968.

Adding to this crisis are restrictions in our very laws:

Drugs & Cosmetics Act, 1940 does not grant pharmacists exclusive rights in manufacturing, R&D, or marketing; wholesale drug licenses can go to non-pharmacists; even in retail, ownership lies with anyone, with pharmacists reduced to mere signatories. Clinical roles such as counseling or therapy monitoring are not mandated at all.

Pharmacy Act, 1948 is confined largely to registration. Unlike doctors or nurses, pharmacists have no statutory role in patient care. Dispensing is mandatory only on paper—weak enforcement allows rampant proxy practice. Education provisions remain outdated, failing to orient graduates to healthcare needs.

This legal framework leaves them in “Na ghar ka, na ghat ka”—neither industry-recognized nor healthcare-anchored. Yet authorities, academicians, and faculty remain indifferent, even as NAAC delists pharmacy from Health Sciences.

The way forward lies in restructuring. We need intellectually smart teachers to shape smart pharmacists. 

Healthcare is the only sector with infinite potential to absorb all category of Pharmacists —from dispensing to logistics to clinical pharmacy which all together is PharmaCare support to healthCare.

Every hospital unit requires at least one clinical pharmacist and one or two chief pharmacists, besides diploma pharmacists. To make this a reality, pharmacy must be firmly recognized as a Health Science, with education restructured to produce competent professionals.

Since PCI has taken up the task of Updating the B. Pharm Curriculum it should seriously consider to incorporate all activities required to support HealthCare under PharmaCare.

Further, the Profession needs a Supportive laws. Hence, a separate law "#PharmacyPracticeRegulationAct should be legislated that empowers  the Pharmacist with due Accountability. This will eradicate the menace of Certificate renting, Absentee Pharmacist, Corruption arising out of this violation. 

#PCI

#APTI

#IPA

#IPC2025

#Pharmacist 

#Industry 

#Healthcare

POV: Bhagwan PS