Document:

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                                                                    Exhibit 10.1

                 FIRST AMENDMENT TO FIFTH AMENDED AND RESTATED
                          LOAN AND SECURITY AGREEMENT
                          ---------------------------

     THIS FIRST AMENDMENT TO FIFTH AMENDED AND RESTATED LOAN AND SECURITY
AGREEMENT (this "Amendment") is made as of March __, 2001, by and among FLEET
CAPITAL CORPORATION, a Rhode Island corporation (the "Lender"), and D&K
HEALTHCARE RESOURCES, INC. ("D & K"), JARON, INC. ("Jaron") and JEWETT DRUG CO.,
a South Dakota corporation ("Jewett") (D & K, Jaron and Jewett are sometimes
hereinafter referred to individually as "Borrower" and collectively as
"Borrowers").

                            Preliminary Statements
                            ----------------------

     A.   Lender, and Borrowers are parties to that certain Fifth Amended and
Restated Loan and Security Agreement dated as of September 30, 2000 (as amended,
restated or renewed from time to time, the "Loan Agreement"). Capitalized terms
used herein and not otherwise defined shall have the meanings given them in the
Loan Agreement.

     B.   D & K and Lender have agreed to amend the provisions thereof relating
to the Fixed Charge Covenant and to allow for regular dividend payments to
shareholders, within the limits and as otherwise set forth herein.

     NOW, THEREFORE, for good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties agree as follows:

     1.   Distributions. The Loan Agreement is hereby amended by deleting
Subsection 8.2.7 [relating to Distributions] in its entirety and replacing it
with the following new Subsection 8.2.7:

          8.2.7 Distributions.  Declare or make, or permit any Subsidiary of
     Borrower to declare of make, and Distributions, except for (a) dividends of
     Jaron to D&K, provided that not less than 5 business days prior to the
     payment of such dividend, D&K shall give Lender written notice describing
     the amount of such dividend, and (b) dividends of D&K in an aggregate
     amount of not more than $1,000,000 in each fiscal year, subject to the
     further compliance with the financial covenants set forth in this Loan
     Agreement after giving effect to such dividend.

     2.   Cash Flow to Fixed Charges. The Loan Agreement is hereby amended by
deleting Subsection 8.3(D) [relating to Cash Flow to Fixed Charges] in its
entirety and replacing it with the following new Subsection 8.3(D):

          8.3(D) Cash Flow to Fixed Charges.  Commencing with the fiscal quarter
     ending March 31, 2001, maintain for each fiscal quarter of Borrowers a
     ratio of Cash Flow to Fixed Charges of not less than 1.3 to 1.0, measured
     as of the end of each fiscal quarter for the immediately preceding twelve
     month period.
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     3.   Definitions. The Appendix to the Loan Agreement is hereby amended by
deleting the definition of Cash Flow in its entirety and replacing it the
following new definition:

          Cash Flow - in any period means EBITDA for such period minus the sum
     of (i) cash taxes paid for such period, (ii) Capital Expenditures paid in
     such period which were not financed, and (iii) dividends declared or paid
     in such period.

     4.   No Claims. Borrowers acknowledge that there are no existing claims,
defenses (personal or otherwise) or rights of set-off or recoupment whatsoever
with respect to any of the Loan Documents. Borrowers agree that this Amendment
in no way acts as a release or relinquishment of any Liens in favor of the
Lender securing payment of the Obligations.

     5.   Miscellaneous. Except as expressly set forth herein, there are no
agreements or understandings, written or oral, between any Borrower and Lender
relating to the Loan Agreement and the other Loan Documents that are not fully
and completely set forth herein or therein. Except to the extent specifically
waived or amended herein or in any of the documents, instruments, or agreements
delivered in connection herewith, all terms and provisions of the Loan Agreement
and the other Loan Documents are hereby ratified and reaffirmed and shall remain
in full force and effect in accordance with the respective terms thereof. This
Agreement may be executed in one or more counterparts, and by different parties
on different counterparts. All such counterparts shall be deemed to be original
documents and together shall constitute one and the same agreement. A signature
of a party delivered by facsimile or other electronic transmission shall be
deemed to be an original signature of such party.

     IN WITNESS WHEREOF, this Amendment has been executed and delivered by the
duly authorized representatives of the parties as of the date first above
written.

                              FLEET CAPITAL CORPORATION

                              By: /s/ Edward M. Bartkowski
                                  ------------------------
                                  Edward M. Bartkowski, Senior Vice President

                              D & K HEALTHCARE RESOURCES, INC.

                              By: /s/ Thomas S. Hilton
                                  --------------------
                                  Thomas S. Hilton, Senior Vice President & CFO

                              JARON, INC.

                              By: /s/ Thomas S. Hilton
                                  --------------------

                                  Thomas S. Hilton, Vice President

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                              JEWETT DRUG CO.

                              By: /s/ Thomas S. Hilton
                                  --------------------

                                  Thomas S. Hilton, Vice President<PAGE>

                                                                    Exhibit 10.2

                              FOURTH AMENDMENT TO
                        RECEIVABLES PURCHASE AGREEMENT
                        ------------------------------

     This Fourth Amendment to Receivables Purchase Agreement, dated as of
February 2, 2001 (this "Amendment"), is among D&K RECEIVABLES CORPORATION, a
Delaware corporation ("Seller"), D&K HEALTHCARE RESOURCES, INC., a Delaware
corporation ("Parent"), BLUE KEEL FUNDING, LLC, a Delaware limited liability
company ("Purchaser"), and FLEET NATIONAL BANK, a national banking association,
as administrator for Purchaser (in such capacity, the "Administrator").

                                  BACKGROUND

     1.   Seller, Parent, Purchaser and the Administrator are parties to that
certain Receivables Purchase Agreement, dated as of August 7, 1998, as amended
by the First Amendment to Receivables Purchase Agreement, dated as of December
17, 1998, by the Second Amendment to Receivables Purchase Agreement, dated as of
June 1, 1999, and by the Third Amendment to Receivables Purchase Agreement,
dated as of March 31, 2000 (the "Receivables Purchase Agreement").

     2.   The parties hereto desire to amend the Receivables Purchase Agreement
in certain respects as set forth herein.

     NOW, THEREFORE, in consideration of the premises and other good and
valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereto hereby agree as follows:

     SECTION 1.  Definitions. Capitalized terms used in this Amendment and not
otherwise defined herein shall have the meanings assigned thereto in the
Receivables Purchase Agreement.

     SECTION 2.  Purchase Limit. Section 1.01 of the Receivables Purchase
Agreement is hereby amended by deleting the number "$75,000,000" where it
appears in clause (a) thereof and substituting therefor the phrase "$100,000,000
for the period from February 2, 2001 until April 1, 2001 and $75,000,000 from
and after April 1, 2001".

     SECTION 3.  Dynamic Loss Reserve Percentage. The definition of "Dynamic
Loss Reserve Percentage" that appears in Appendix A to the Receivables Purchase
Agreement is hereby amended by deleting the word "three" where it appears in the
description of the Loss Horizon therein and substituting therefor the word
"two".

     SECTION 4.  Loss Reserve. The definition of "Loss Reserve" that appears in
Appendix A to the Receivables Purchase Agreement is hereby amended by deleting
the number "8%" where it appears in clause (A)(1) thereof and substituting
therefor the number "10%".
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     SECTION 5.  Representations and Warranties. Each of Parent and Seller
hereby represents and warrants that, after giving effect to this Amendment, (i)
the representations and warranties contained in Article VI of the Receivables
Purchase Agreement are true and correct on and as of the date hereof and shall
be deemed to have been made on such date (except that any such representation or
warranty that is expressly stated as being made only as of a specified earlier
date shall be true and correct in all material respects as of such earlier date)
and (ii) no Liquidation Event or Unmatured Liquidation Event has occurred and is
continuing.

     SECTION 6.  Effectiveness. This Amendment shall become effective upon the
receipt by the Administrator of (i) copies of this Amendment duly executed by
Seller and Parent, (ii) the fee required to be paid in connection herewith as
set forth in the fee letter dated as of the date hereof with the Administrator
and (iii) a certificate of the Secretary or Assistant Secretary of each of
Seller and Parent certifying (A) that the certificate of incorporation and by-
laws of such Person previously delivered to the Administrator have not been
amended, except as set forth in such certificate, or revoked, (B) that attached
thereto are resolutions of its Board of Directors approving this Amendment and
(C) the names and true signatures of the officers authorized on its behalf to
execute and deliver this Amendment.

     SECTION 7.  Miscellaneous. The Receivables Purchase Agreement, as amended
hereby, remains in full force and effect. Any reference to the Receivables
Purchase Agreement from and after the date hereof shall be deemed to refer to
the Receivables Purchase Agreement as amended hereby. This Amendment may be
executed in counterparts, each of which when so executed shall be deemed to be
an original and all of which when taken together shall constitute one and the
same agreement. This Amendment shall be governed by, and construed in accordance
with, the laws of the State of New York. Seller, on demand, shall pay, or
reimburse the Administrator for, all of the costs and expenses, including legal
fees and disbursements, incurred by the Administrator or Purchaser in connection
with this Amendment.

                 [REMAINDER OF PAGE LEFT INTENTIONALLY BLANK]
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     IN WITNESS WHEREOF, each of the undersigned has caused this Amendment to be
executed and delivered by its duly authorized officer as of the date first above
written.

                             D&K RECEIVABLES CORPORATION

                             By:  /s/ Thomas S. Hilton
                                      ----------------
                             Name:    Thomas S. Hilton
                                      ----------------
                             Title:   Senior Vice President & CFO
                                      ---------------------------

                             D&K HEALTHCARE RESOURCES, INC.

                             By:  /s/ Thomas S. Hilton
                                      ----------------
                             Name:    Thomas S. Hilton
                                      ----------------
                             Title:   Senior Vice President & CFO
                                      ---------------------------

                             BLUE KEEL FUNDING, LLC, as Purchaser

                             By:  /s/ Bernard J. Angelo
                                      -----------------
                             Name:    Bernard J. Angelo
                                      -----------------
                             Title:   Vice President
                                      --------------

                             FLEET NATIONAL BANK, as the Administrator

                             By:  /s/ Paul Schmieder
                                      --------------
                             Name:    Paul Schmieder
                                      --------------
                             Title:   Vice President
                                      --------------

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