ACAP
So, rumor has it ACAP has gotten into the match-making business! In this case, rumor is right! Well…..kind of…sort of right! ACAP is looking to help members
and students explore their options insofar as partnering with the profession.
That is, what kind of professional opportunities exist in the Gainesville “world of
pharmacy” and what kind of opportunity is the “best fit” for you? Are you a
In This Issue…
Speed Dating with a 1 Pharmacist
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4 2 5 2 7 2 7 2 8 2 8
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Reading Rx Committee Corner Your ACAP Colleagues Announcements
and get that license to practice pharmacy? Are you a technician who is entertaining the idea of attending pharmacy school, but not sure what jobs are out there? Or, maybe you’re a practicing pharmacist thinking about making a change and pondering the options. Then “Speed Dating” is definitely for you! Here’s how it works: WHO: All ACAP members who are interested in hearing about different pharmacy professions in our area are invited to attend. WHAT: There will be 6-8 “pharmacy stations” set up with a pharmacist at each station ready to answer questions about his/her job duties, working conditions, the rewards & the challenges. There will also be a time-keeper. Attendees will visit a station, hear a short synopsis of the presenter’s job and have the opportunity to ask questions. The time-keeper will sound the bell after 8
Calendar
minutes, signaling that it is time to move to the next station. This gives attendees the chance to gather a bit of information about many different
Membership Deals
positions, perhaps determining which pharmacy positions warrant further exploration.
Check Yourself Check Yourself Answers
Newsletter Committee: Valli Van Meter, Jessica Gonzalez, Stephanie Samuelson, and Lucia Murphy.
student wondering what exactly you’ll be doing after you take that final test
Submit your suggestions HERE to improve your newsletter.
WHEN/WHERE: The event will take place at the North Central Baptist Church on Tuesday Feb. 14 (yes, Valentine’s Day!) prior to the ACAP meeting. RSVP: You’ll need to RSVP for the Speed Dating event at the same time that you RSVP for the regular ACAP meeting. NOTE: This is not an interview for a job, nor a recruiting event. This is an event to provide information about various pharmacy positions in our area. So, there you have it! What better way to spend Valentine’s Day than Speed Dating with a Pharmacist?
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So many of us enjoy reading…Maybe you read a good book this summer at the beach. Or maybe you stayed inside with a page-turner to escape the heat! If you have enjoyed a book & would recommend it to your peers, please click HERE to let us know. The only requirement for it to appear in this column is that it have some kind of medical interest or medical theme. It can be historical fiction, romance, mystery, sci-fi or research/opinion. Let us know if you’d like to offer up a Reading Rx to the rest of us!
Now, for something completely different! Thanks to Lorraine Mobley for this Reading Rx! Lorraine is a consultant pharmacist and has served on the board of directors for ACAP for many years. Look for her involvement in the “Speed Dating With a Pharmacist, It’s Not What You Think” event!
Reviewer: Lorraine Mobley, R.Ph., C.Ph. Barnes Healthcare, Mobley Pharmacist Services LLC, UF Title: It’s My Pleasure: The Impact of Extraordinary Talent and a Compelling Culture Author: Dee Ann Turner, Vice President, Corporate Genre: Business Development and Company Talent at Chick-Fil-A Culture Medical Aspect: This is not a book specifically about pharmacy or medicine, but rather a book that might be helpful and timely for those of us who own our own businesses or pharmacies or for anyone who could benefit from improving business/customer/personal relationships (which would be everyone I would hope!). Whether we are selling chicken, prescriptions or ourselves, the tenets in this short book will be valuable assets in growing, maintaining or starting your business and creating a corporate culture of compassion and influence. Why I recommend this book: This book has given me many examples of “going the 2nd mile” and making a difference for clients, co-workers and even family and friends. It reinforces that, as a business owner, one must first give to receive. Maintaining a “small company feel” among the guests is a strategic cultural imperative at Chick-fil-A which could be mimicked in any business setting. Those of you know when you go to a Chick-fil-A restaurant, anytime a guest (notice they are not called customers) says “Thank You,” the talent (not called “employee”) is trained to respond “It’s my pleasure.” I have noticed many other companies are starting to use this training, as I have also heard it at various restaurants, such as Cracker Barrel. I have started using this response in my business and personal life and even this slight shift makes a positive impact both on the receiver and giver of any service provided.
Alachua County Association of Pharmacists February 2017 Newsletter
Summary: The book is written by the Corporate Talent Director of the chicken restaurant franchise, Chick-fil-A. Dee Ann Turner has been recruiting, retaining and sustaining “talent” (their term for employees) for Chick-fil-A for over 30 years. The book provides insight into the creation of a strong corporate culture by following S.Truett Cathy’s (original owner of Chick-fil-A) philosophy. His idea of “servant leadership” not only helped to build a phenomenal profitable business, but also ensured exemplary customer service and an attitude of gratitude for those employed. You would enjoy this book if: If you own a business or work for a company and wish to increase your positive interactions with your clients, co-workers or employees, then this book will serve you well. It is a 140-page how-to manual that is a quick read and packs a lot of useful information into a few pages. Truett Cathy was known to say: “If you help enough people get enough of what they want, you will eventually get what you want.” This book has also inspired me to read some works by S.Truett Cathy himself like “How did you Do it, Truett?” and “Wealth: is it Worth It?”
If you have a book to recommend for the next Reading Rx, click HERE and we’ll get in touch with you!
Alachua County Association of Pharmacists February 2017 Newsletter
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Sandra Buck-Camp: BS Pharmacy 1963 UF Retired from over 50 years of various pharmacy practices including large & small hospitals, community pharmacy (chain & independent), rural clinic pharmacist, traveling pharmacist, forensic pharmacy, home health care Current Position: President of ACAP
The Resolutions Committee
is a committee about which many (or even most?) of us probably know very little. Which is a shame, because this committee can have an impact on each of us! You’ve heard of the phrase “Think globally and act locally?” Well, that phrase applies to the Resolutions Committee! This committee takes ideas from the ACAP membership concerning pharmacy practice, pharmacy laws and regulations, and positions related to health issues. The committee writes up an idea in a “resolution format” which, once approved by our membership, is presented to the Florida Pharmacy Association (FPA) House of Delegates as a request for action. Once a resolution is approved by the FPA House of Delegates, it is then up to the FPA to determine the best way to proceed. It may be to give the resolution to a committee or it may go directly to a legislator or to the Board of Pharmacy. The most recent resolution requests that a pharmacy technician be included on the Florida Board of Pharmacy. So you see, an idea that starts on the local level, like during a discussion around a table at an ACAP meeting, can eventually make its way into pharmacy laws and regulations on a statewide level. Okay…So, it’s not quite “global,” but still, our local ideas and our local action can have statewide results!
Current members of your Resolutions Committee are Sandra Buck-Camp, Jennifer Chen and Bill Garst. So, now you know who to contact if you have an idea that you think could improve the practice of pharmacy!
We know you have talents beyond the mortar & pestle. Please share your talents with your ACAP community.
Jennifer Chen: BS Food Science & Human Nutrition 2009 UF Pharm D 2013 UF Current Position: Mom to Levi (approximately 6 months) Retired (mom time!) from Walgreens in Ocala
Bill Garst: BS Education 1971 West Georgia College BS Pharmacy 1975 Auburn Masters of Public Health 1988 University of South Florida MS Pharmacy 2001 UF Pharm D 2007 University of Colorado Retired from Shands and the VA Currently working part time at the UF Health/Shands Vista/Rehab Hospital
Other committees in ACAP: Scholarship, Education, Budget & Financial, By-laws, Public Relations, Awards, Resolutions, Membership
Alachua County Association of Pharmacists February 2017 Newsletter
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Bill Harbilas been a member of ACAP “on & off over the years” and has recently re-joined because he says he’s been impressed with the organization and the local/state involvement of the ACAP membership! (Thanks, Bill!) He has been a pharmacist for his nearly his entire adult life, since he was 23 years old, inspired to join the profession by a close family friend who owned a pharmacy. Previously Bill taught at UF, worked in smaller hospitals & independent pharmacy and was even a writer/editor for Clinical Pharmacology for a while! Much of his career has been with Shands, where he has worked in several different capacities from being a resident through assistant director. While at Shands, Bill authored the hospital’s first indigent care formulary. He also developed a very successful pre-transplant counseling program which is still used today. Nowadays Bill works in the ambulatory care department and believes ACAP is the pharmacy organization that best supports the am-care environment and his personal pharmacy practice philosophies. Here’s more about Bill… AGE FAMILY HOBBIES IF I COULD HAVE LUNCH WITH ANYONE IN THE WORLD, PAST OR PRESENT, IT WOULD BE OUTSIDE OF MY PHARMACY-ASSOCIATED WORK, I AM MOST PROUD OF
54 years old Wife, Stella, and teenage sons, James (19) & Justin (16) Fishing, running/working out & building bicycles Former Congressman/Presidential Candidate Ron Paul because I believe he had the correct answers to many of our country’s problems.
MY FAVORITE THING ABOUT BEING A PHARMACIST THE PERSONAL CHARACTERISTIC THAT HAVE BEEN THE MOST HELPFUL TO ME IN MY CAREER IS
is working with patients and co-workers who have a good sense of humor! that I seem to shoulder responsibility well. The first pharmacist I ever worked for told me my best characteristic was my propensity to always show up. He would say, “If Billy ain’t here, he’s dead, forget about him”. After many years of thinking about it, I think my tendency to “own” processes that I’m involved in (whether I’m really in charge or not!) has been the most useful to those who have employed me. is that I worked in Los Angeles for 3 years and was working in the inner city during the LA riots in 1992. I believe in my heart that pharmacists belong close to patients. For me, I feel that I can make the most impact on ambulatory patients who want to be healed. When they become frequent fliers in an ICU, it’s too late. With our health care system becoming more public and bureaucratic, many pharmacy positions are drifting away from patient care. This is bad for us. While I know we have a lot of administrative work to do, everyone but the highest-ranking leaders of the largest organizations
A FACT ABOUT ME THAT MOST ACAP MEMBERS DO NOT KNOW THOUGHTS I’D LIKE TO SHARE ABOUT PHARMACY OR ACAP:
my family and our work in our church.
Alachua County Association of Pharmacists February 2017 Newsletter
MY MOST MEMORABLE EXPERIENCE AS A PHARMACIST WAS
should spend time with patients every week. Physicians do that, and they stick together. We should do likewise. immediately following the LA riots. I came into the pharmacy the Saturday after all the action happened. Because I defied corporate orders by coming in (everyone knows you can’t close a pharmacy more than 3 days—ever), I had to bring my new wife to the pharmacy to be my tech! She did great…and even listened to some of the things I said!
Meet Judy A. Vann, pharmacy technician for the past 29 years! Her previous experience includes hospital pharmacy and independent community pharmacy. But for over a decade Judy has served as the pharmacy liaison at Haven Hospice which she says is her favorite work environment thus far in her career. Although she sometimes misses the direct patient contact in the community pharmacy setting, she has found her liaison work coordinating the pharmacotherapy care of hospice patients with physicians, nurses and pharmacies to be both challenging and fulfilling. Judy has been awarded the Star Award at Haven Hospice three times, an especially meaningful award because this comes from being nominated by your peers for going above & beyond in the work place. In addition, Judy is one of our past ACAP Pharmacy Technicians of the Year! Here’s more about Judy… AGE FAMILY HOBBIES IF I COULD HAVE LUNCH WITH ANYONE IN THE WORLD, PAST OR PRESENT, IT WOULD BE OUTSIDE OF MY PHARMACYASSOCIATED WORK, I AM MOST PROUD OF MY FAVORITE THING ABOUT BEING A PHARMACY TECHNICIAN THE PERSONAL CHARACTERISTICS THAT HAVE BEEN THE MOST HELPFUL TO ME IN MY CAREER ARE A FACT ABOUT ME THAT MOST ACAP MEMBERS DO NOT KNOW THOUGHTS I’D LIKE TO SHARE ABOUT PHARMACY OR ACAP:
MY MOST MEMORABLE EXPERIENCE AS A PHARMACY TECHNICIAN WAS
56 years old Domestic partner of 19 years David, two sons Randy and Otto (wife Michelle) Reading, yard sales and decorating Thomas Edison because I think he would be a fascinating person to talk to. my family and friends
is the contribution a pharmacist makes toward society. being honest, having a strong work ethic and treating people the same as I would want to be treated. If you treat people with respect and patience they will appreciate it and will do the same, even when they are having a bad day. is that I have owned two bookstores. Pharmacy is changing and we (pharmacists and techs) have to adapt and change to meet the needs of our patients and better serve them. But, we also need our voices heard as a group that pharmacy is not fast food! We need breaks! And we need enough staff to do our jobs safely for the benefit of our patients and for ourselves. Belonging to organizations like ACAP is one way to help with this and to keep informed on issues. helping get a pediatric patient the medication that was needed.
Alachua County Association of Pharmacists February 2017 Newsletter
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We lost one of the pillars of the pharmacy community in October with the passing of William Gresham, founder of Gresham Drugs in Gainesville in1953 and civic leader for over 50 years. Your Award Committee is beginning its annual quest to gather nominations for Pharmacist of the Year and Technician of the Year. See the February 2016 edition of the ACAP Recap for details on the awards. If you’d like to nominate a pharmacist or technician, CLICK HERE. Legislative Days are March 13, 14 & 15. CLICK HERE if you’d like to receive more information on going to Tallahassee with your ACAP colleagues. The March ACAP meeting will be held on the first Tuesday of the month, March 7th, to accommodate Legislative Days. Tim Rogers will be opening a pharmacy (Grace Pharmacy) to be located at Grace Marketplace. The projected opening date is April 2017. The pharmacy will be open 4 hours a day, Monday through Friday and will be staffed by volunteer pharmacists and UF pharmacy students. The Pharmacy will not handle controlled drugs and all medications will be free of charge to qualifying indigent and homeless patients. Time is looking for the following items to be donated: pharmacy shelves, pharmacy counter, desktop/laptop computer, pharmacy software and any other helpful items. The February ACAP meeting will be preceded by the “Speed Dating With a Pharmacist – It’s NOT What You Think” event. See Page 1 for details. The April ACAP meeting will be our Second Annual Bring-A-Friend special! See details on page X The May ACAP meeting will be our Membership Special meeting! See details on page x. Do you have an announcement to share? New baby, job promotion, job opportunity, weddings, etc? Click HERE to send in an announcement for the next issue. Be sure to include a phone number and email in case we need to contact you!
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Tuesday Sep 12, ACAP Meeting – ADHD Diagnosis and Treatment Tuesday Sep 27, ACAP Board Meeting Tuesday Oct 11, ACAP Meeting – Validation of Prescriptions for Controlled Substances. This course meets the Florida Board of Pharmacy requirement. Tuesday Oct 25, ACAP Board Meeting
*Note: Topic subject to change without notice. Look for your monthly email notification with the most current details.
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Board meetings are open to see behind the scenes of ACAP. If you are interested in attending a board meeting, please contact us HERE Would you have a speaker to suggest or a CE topic suggestion you would like to see? Please let us know HERE.
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What a deal! This spring ACAP has two special offers for pharmacists, technicians & students.
April is our Second
Annual Bring-A-Friend meeting.
Bring a pharmacist, technician or student with you to the meeting. The guest will receive dinner and two hours of CE at no charge! The guest should bring his or her license so that we can report the CE. And, when you RSPV for yourself, you’ll need to RSVP for your guest as well so that we order enough food for everyone…. …Then the
May
meeting is our Membership Special meeting! If you are a new member joining in
May, you’ll get one free meeting. Think of it as getting ten meetings for the price of nine! Returning members are encouraged to renew their membership in May as well. It will cut down on the rush-n-fuss of signing up at the September meeting in the fall.
The following questions are drawn from the Continuing Education presentations from the past four ACAP meetings: • Sep 2016 – Attention Deficit Hyperactivity Disorder, Dr. Nikhil Rao and Dr. Anand Patel, Child and Adolescent Psychiatry Fellowship, University of Florida, Department of Psychiatry • Oct 2016 – Resolving Red Flags: Allowing Patients to Legally Obtain their Lawfully Prescribed Medications, Robert M. Parrado, BPharm., R.Ph, President & CEO of Parrado Pharmacy Consultants, Inc. • Nov 2016 – Dual Anti-Platelet Therapy: How Long is Too Long?, Dr. Lieth Quffa, Pharmacist, Cardiology Fellow, North Florida South Georgia VA Medical Center • Dec 2016 – Insomnia, Dr. Scott Tomerlin, Pharmacist, President, Florida Pharmacy Association
Alachua County Association of Pharmacists February 2017 Newsletter
1) Many conditions can mimic the hyperactivity, the impulsivity and/or the lack of attention associated with ADD or ADHD. All of the following are diagnostic considerations for ADD/ADHD in children EXCEPT: a) Asthma, sleep apnea & severe sinusitis can all lead to symptoms which mimic ADD/ADHD, most likely due to limiting or impairing the brain’s oxygen supply and/or ability to sleep. Without deep sleep, children can struggle with daytime sleepiness, concentration & memory. b) Epilepsy, especially absence seizures which present as “zoning out,” can mimic lack of attention. The child is “missing chunks of time” during the seizures and so may ask repeated questions about school lessons or may frequently appear to be daydreaming. c) ADD/ADHD can be caused by overstimulation from too much time in front of computer screens, TV screens, cell phones, etc., especially screens with blue spectrum light which impairs melatonin production. d) Symptoms of Anxiety Disorder can mimic the hyperactive component of ADHD because anxiety can cause unease in the body which in turn can cause tremors, muscle tension & a need to move. Furthermore, anxiety can “turn on” the limbic system of the brain (associated with fear & emotions) and “turn off” the frontal portion of the brain (associated with concentration, focus & logical decision-making). e) Neglect and poor parenting skills in the home environment can result in ADHD-like symptoms. Children learn self-regulation and the ability to organize their thoughts & actions through the adults in their lives. Poor self-regulation can present like ADHD.
2) There is a large body of evidence showing that people with ADHD are at risk for a number of bad outcomes (impulsive crime, violence [victim and perpetrator], substance use, unemployment, dropping out of school). There’s a growing body of evidence that stimulants can prevent or ameliorate these outcomes. Which of the following is NOT true regarding using stimulant medications such as Adderall (amphetamines) & Ritalin (methylphenidate) to treat children who have been diagnosed with ADD or ADHD? a) The most common side effects are headache, loss of appetite, stomach ache and insomnia and the most serious side effects are cardiac arrhythmias & risk of addiction to the stimulant drug. b) The MTA study showed best results (decrease in symptoms) for patients who get medication combined with Intensive Behavioral Treatment (parent training, child-focused treatment, and school based intervention) compared to medication alone. (68% vs 56%) c) While therapy and skills development can play an adjunctive role, it cannot replace the normalization of brain chemistry that can only be achieved through stimulants. d) There is some evidence that being on stimulants more consistently and for longer as a child may reduce the likelihood of needing them as an adult and may reduce risk of stimulant abuse as an adult.
Alachua County Association of Pharmacists February 2017 Newsletter
3) For a Gainesville, Florida pharmacist filling a prescription for a controlled substance, a “Red Flag” would be all of the following EXCEPT: a) A legible prescription written on counterfeit-proof paper for a fairly large supply of Xanax (alprazolam) produced after a patient asks about “zanny-bars.” b) A prescription written for month’s supply of Oxycontin (sustained action oxycodone) by a Shands/UF oncologist for a patient with a Valdosta, Georgia driver’s license. c) Anything that causes the pharmacist to question if the drug is prescribed for a legitimate medical purpose. d) A prescription written for #30 MSContin (continual release morphine sulfate) by a local dentist for prn use. 4) All of the following are true about filling controlled substance prescriptions in Florida pharmacies EXCEPT: a) A prescription for a controlled substance written by a physician’s assistant or nurse practitioner from another state is valid in Florida if that prescriber is licensed to prescribe controlled substances in their state. b) If a patient (or patient’s representative) refuses to cooperate with the pharmacist (answering questions about the prescription &/or the medical condition, providing identification, etc.) then the pharmacist can legally refuse to fill the prescription. c) A pharmacist may refuse to fill a prescription if he/she judges the prescription to be invalid, that is to say, the medicine is not being prescribed for a legitimate medical purpose. d) Before refusing to fill a prescription for a controlled substance, the pharmacist may attempt to resolve concerns about the validity of the prescription, but this is considered a courtesy, not legally required.
5) Which of the following is NOT TRUE regarding Dual Anti-Platelet Therapy (DAPT): a) DAPT refers to using two medicines to prevent the blood from clotting b) DAPT refers to using warfarin (Coumadin) twice daily to prevent platelets from forming clots around a stent c) DAPT refers to using aspirin + a member of the P2Y12-inhibitor class d) Members of the P2Y12-inhibitor class include clopidogrel (Plavix), prasugrel (Effient) and ticagrelor (Brilinta) 6) Which of the following is NOT TRUE?: a) After stent placement, DAPT is usually recommended as life-long therapy because the risk of blood clots far outweighs the risk of bleeding. b) After stent placement, DAPT is usually recommended for only 12 months because the evidence for continued use is inconclusive at this time. c) Diabetes, chronic kidney disease and advanced age are risk factors both for bleeding while on anti-platelet therapy and for forming a blood clot after stent placement. d) Dr. Lieth Quffa suggests that when we talk to patients about their statin, we encourage them to think of the statin as “heart medicine” in addition to “cholesterol medicine” because the statins appear to provide more cardiovascular benefits than simply lowering cholesterol.
Alachua County Association of Pharmacists February 2017 Newsletter
7) All of the following are recognized as causes of insomnia EXCEPT: a) Pharmacologic causes such as decongestants, central nervous system stimulants, alcohol, nicotine and caffeine. b) Psychiatric causes such as depression or bipolar disorders. c) Situational causes such as stress over life situations (loss of job, loss of a family member or other anxietyprovoking situations). d) Listening to Circadian Rhythm, a percussion band purported to specialize in lullaby music, but recently discovered to actually contribute to insomnia.
better. d) Exercise such as 20-30 minutes of walking per day
8) All of the following are true about melatonin EXCEPT: a) It is a hormone whose production & suppression is tied to our exposure to light and darkness. b) The body’s melatonin production can be increased by exposure to “blue light” from a computer screen while lying in bed. c) It is available as an over the counter dietary supplement and has been proven to help alleviate insomnia. d) Light Therapy helps to re-set the patient’s circadian rhythm, partly by suppressing melatonin production, via exposure for at least 60 minutes per day, preferably shortly after waking.
9) Options to help with insomnia include all of the following EXCEPT: a) Acupuncture by a professional b) Practicing good sleep hygiene such as avoiding daytime napping & avoiding alcohol, caffeine or nicotine close to bedtime c) Combining the pharmacologic sleep agents zolpidem (Ambien), temazepam (Restoril), doxylamine (Unisom) and valerian root, because more is always
Alachua County Association of Pharmacists February 2017 Newsletter
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1. C is not true. While it is true that too much screen time, especially before bed, may contribute to insomnia which may cause daytime sleepiness & difficulty with focus and concentration, screen time does not cause ADHD. A, B, D & E are all true. These and other possible diagnoses & conditions must be ruled out before ADD/ADHD can be diagnosed. 2. A is correct answer. All of the “A” statement is true EXCEPT for the risk of addiction. There is evidence that early treatment of ADHD with stimulant medication actually decreases the risk of stimulant abuse as an adult. B, C & D are all true. 3. B is the correct answer. While an out-of-state driver’s license might cause some question, it is not unreasonable at all for a patient with a rare cancer to come from Valdosta, Georgia to Gainesville, Florida for specialty care from Shands/UF oncology. A is a red flag because of a patient asking about meds using the “street” name. C is true – anything that causes a pharmacist to question the validity of the prescription is a red flag. D is a red flag because it would be considered unusual for a dentist to write for a long-acting narcotic AND it would not be sound medical practice to use a long-acting narcotic on a prn basis. 4. D is the correct answer. It is untrue because the pharmacist IS LEGALLY REQUIRED to attempt to resolve concerns about the validity of a controlled substance prescription prior to refusing to fill the prescription. A, B & C are all true. 5. B is not true. We made this one up! A, C & D are true. 6. A is not true. The evidence shows that there is increased mortality associated with longer duration of DAPT. B, C & D are true. 7. D is the correct answer. Circadian Rhythm is not a band (as far as we know). In this instance, it refers to the sleep-wake cycle over approximately 24 hours in humans. A patient’s circadian rhythm can be “thrown off” by various conditions such as shift work, travel across time zones and exposure to excessive periods of light or dark. A,B &C are true. 8. B is the correct answer. Melatonin production in the body is actually diminished by the “blue light” emitted from electronic screens, so using our cell phones, tablets & computers at bedtime may contribute to insomnia. A, C & D are true. 9.
C is the correct answer. Each medication listed can be used to treat insomnia, but the combination is definitely not recommended, especially zolpidem and temazepam, both being controlled substances and both working on the GABA receptor. A, B & D are true.