ACAP
In This Issue… 2 ACAP @ FPA Summer Events
3 Reading Rx 4 Committee Corner 5 Your ACAP Colleagues 7 Announcements & Calendar
8 Check Yourself 11 Check Yourself Answers
Our chapter of ACAP bestows an award known as the Charlie Brown Student Engagement Award to some of the student members of ACAP. This award pays for their membership in ACAP for the following year (or applies as a discount if they are no longer a student). In addition, the member(s) who scores the highest on participation is invited to attend the Florida Pharmacy Association convention as a guest of ACAP. This year two of our student members were awarded the top honor: Stephanie Samuelson, a 3rd year pharmacy student at LECOM and Lucia Murphy, a 1st year pharmacy student at UF. Stephanie shares her experience at the FPA Annual Conference with us! A Student’s Perspective… Going to this year’s FPA Annual Conference as a pharmacy student was priceless, providing me with an experience that was much more than I expected! Held in Ft. Lauderdale this year, the location was right by the ocean. And, on the sandy shores nearby, there were baby sea turtles hatching at night! The hotel itself was gorgeous and had every amenity desired with an excellent staff to assist along the way. The food at the convention was especially the Presidential breakfast on Sunday morning. However, the delicious, best part about the FPA Annual Conference was not the location or the food, but in fact the people that attended and what they had to share. There were pharmacists and students ready to share their experiences, presentations and posters. I have to say, this event is a “must-see” for all! As a student, the FPA Annual Conference allowed me to grow by providing me with multiple occasions to learn and establish new relationships. Every day was jam packed with educational sessions. Each session I attended left me with a better and deeper understanding of the pharmacy profession. As for getting to know others, there were countless of opportunities to network with pharmacists that currently work in a variety of specialties. For example, my favorite experience that the FPA convention offered was a student-mentor meet where students were “assigned” a brand name drug (for example: Prozac) up and pharmacist/mentors were “assigned” a generic name drug (for example: Fluoxetine). We students had to find our generic match! Then we got the opportunity to learn more about the day to day duties of a pharmacist and pick up some helpful tips for becoming a successful pharmacist in the future. I would highly recommend that other pharmacy students make it a point to attend next year’s FPA meeting as they too will find it beneficial, not just to their career but also to their personal lives. I am extremely grateful to have had the chance to attend and special thank you goes out to the members of ACAP for sending me there!
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G (A) ACAP Board members representing at the FPA House of Delegates at the 2016 FPA Annual Conference; (B) Tim Rogers with 2016-2017 FPA President Scott Tomerlin and President Elect Suzy Wise; (C) New FPA President, Scott Tomerlin, sworn in by Tim Rogers; (D) Pirates of the Caribbean Themed President’s dinner;
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(E) Florida Pharmacy Today Cover; (F) Student Networking at FPA conference Career Forum; (G) FPA Student Affairs Council at the Council & Committee Meeting; (H) Student Leaders at the FPA Council & Committee Meeting; (I) The 2016-2017 Pin – Available to purchase
Alachua County Association of Pharmacists September 2016 Newsletter
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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!
Thanks to Stephanie Samuelson for this Reading Rx! Stephanie joined ACAP a year ago. She
has been active on the Newsletter Committee and can sometimes be seen helping at the member sign-in table! Reviewer: Stephanie Samuelson, 3rd year pharmacy student at LECOM (Lake Erie College of Osteopathic Medicine) Title: In the Arms of Elders: A Parable of Wise Author: Willian H. Thomas Genre: Fiction Leadership and Community Building Medical Aspect: Geriatric Care Why I recommend this book: If you enjoy a great story full of adventure for the mind and soul, then this book is for you! Once you start reading, it is hard to put down. The journey of this couple is so detailed that you can imagine and feel yourself right in the middle of it all. Furthermore, this book has provided me with a deeper insight into some of the issues that elderly people face, especially the fact that there is much more to the elderly than just their medical conditions. This insight will help me to first attempt to understand my future elderly patients before simply turning to medication for treatment. Summary: In The Arms of Elders takes real issues that affect the elderly community and places them in the story of a young couple’s journey into a magical place called Kallimos. The author shows how the couple develops during their journey through Kallimos. In the beginning, the couple is introduced as individuals well educated in the field of geriatrics, but with a lack of understanding of some of the most important tenets of caring for elderly people. During their time in Kallimos, the couple learns about the basics needs of the elderly and the three “plagues” that affect them, namely loneliness, helplessness and boredom. Through descriptive stories that the young couple hears from other members of the community, they learn how to help the elderly members of Kallimos to alleviate the pain caused by the three plagues.
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 September 2016 Newsletter
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The Continuing Education (CE) Committee is responsible for everything that goes along with CE, most importantly recruiting speakers for our monthly meetings. There are only two members on this committee and we could really use another helping hand! Other responsibilities include details such as making arrangements for the CE presentation to be approved by the Florida Board of Pharmacy for credit and recording who attends the meetings. Our past speakers have included physicians, pharmacists, nurses, dentists, members of law enforcement, physical & occupational therapists, massage therapists and public health specialists. Being a member of the CE committee involves some amount of organization & emailing when making arrangements for speakers. We're always looking for CE ideas from the members. What are you interested in? What would you like to learn about at an ACAP meeting? If you have suggestions for CE or if you are interested in learning more about becoming a member of the CE committee, click HERE or contact either Tim or Valli.
Valli Van Meter
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BA in Humanities specializations in Art History, Renaissance, and the Classics from Florida State University (1983), PharmD from the University of Florida (2004) Board Certified in Ambulatory Care Outpatient pharmacist at Gainesville VA Hospital
Tim Rogers
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Associate of Arts, UF (1972), Bachelor of Science, Pharmacy, UF (1975) Consultant Pharmacist’s License Certified as the following: Surgical Appliance Technician, Orthopedic Appliance Technician, Durable Medical Equipment Provider, Immunizing Pharmacist Pharmacist for UF Veterinary College and for Hometown Pharmacy in Hitchcock’s in Newberry & Alachua
We know you have talents beyond the mortar & pestle. Please share your talents with your ACAP community.
Other committees in ACAP: Scholarship, Education, Budget & Financial, By-laws, Public Relations, Awards, Resolutions, Membership
Alachua County Association of Pharmacists September 2016 Newsletter
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We truly have a diverse membership when you check out our members’ backgrounds, life experiences, work experiences, their thoughts about the profession…Please meet two more members: Pharmacist Mike Sementa and Pharmacy Technician Marilyn Ryan.
Speaking of diversity, Mike Sementa is a retired pharmacist with a pretty diverse and impressive background! He has an MBA in finance, a BS in computer science & a BA in marketing. Mike worked as a financial analyst for many years. In the early 2000’s, he knew his corporation would be laying off people and Mike took the opportunity to explore several options for his future. He took a remedial course in chemistry, really enjoyed it and decided pharmacy would be his next career! He graduated from UF in 2009. Mike has worked both as a nuclear pharmacist, where he enjoyed compounding but not the on-call schedule, and as a staff pharmacist in St. Mary’s Medical Center in Palm Beach, where he enjoyed the clinical challenges. He is licensed as a pharmacist in both Florida & Ohio and also holds an “Authorized User” license for nuclear pharmacy. Here’s more about Mike…
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
67 years old Single with a domestic partner, Cathy Boating, swimming, taking classes and in my past - waterskiing Ben Franklin because I believe him to be the most all-around brilliant historical figure I’ve ever learned about…science, engineering, inventions & a statesman. qualifying & skiing in National Waterski Championship tournaments
MY FAVORITE THING ABOUT BEING A PHARMACIST THE PERSONAL CHARACTERISTIC THAT HAVE BEEN THE MOST HELPFUL TO ME IN MY CAREER IS A FACT ABOUT ME THAT MOST ACAP MEMBERS DO NOT KNOW THOUGHTS I’D LIKE TO SHARE ABOUT PHARMACY OR ACAP:
is the contribution a pharmacist makes toward society. being responsible. People’s lives & health are directly in your hands. When you commit to it, you have to commit completely. I was a competition slalom water skier for 25 years before I went off to pharmacy school. I was also a recreational barefoot skier. The problem with pharmacy is you have an impossible job to do and impossible amount of time to do it. With constant budget cuts you continue to have more job and less time. However, you can’t afford to make any mistakes, not even one, ever.
Alachua County Association of Pharmacists September 2016 Newsletter
MY MOST MEMORABLE EXPERIENCE AS A PHARMACIST WAS
when my pharmacy director bought 24,000 injectable unit doses of midazolam because he got a great price on them! One problem was to figure out where to secure that many doses, but the main problem was that we were only dispensing approximately 50 unit doses a week. So you can imagine how many weeks it was going to take to use 24,000 doses! We ended up driving the IV room crazy for months making midazolam drips with approximately 20 unit doses per IV.
Marilyn Ryan started as a cashier in a pharmacy 18 years ago. She has since become licensed & also nationally certified as a pharmacy technician. Marilyn has worked in community pharmacy and in both inpatient & outpatient pharmacy. But her favorite work experience is her current position with Shands Rehab Vista inpatient pharmacy because it keeps her busy & she says she learns something new every day! She functions as the purchaser for inpatient pharmacy for both the rehab & Vista side of the hospital, the Spine Sport Clinic and the new ECT clinic. Marilyn is one of our newest members of the Board of Directors for ACAP, so be sure to speak with her about any suggestions or questions you might have about ACAP. Here’s more about Marilyn…
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
50 years old Husband Bruce & sons Daniel & Jason Scrapbooking, reading, traveling my parents, because they passed away when I was young, in middle school. As a parent myself now, I cherish the time I have with my family.
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
feeling like I make a difference in helping people feel healthy.
THOUGHTS I’D LIKE TO SHARE ABOUT PHARMACY OR ACAP: MY MOST MEMORABLE EXPERIENCE AS A PHARMACY TECHNICIAN WAS
my family. My husband & I have been married for 31 years & have raised two happy successful young men.
that I like to learn new things, enjoy meeting new people & I can adapt to change. my husband & I have recently discovered cruising! I love to explore new places! The only bummer is there are more places in the world to visit than I have the money or PTO time to go!! I look forward to working on the board with ACAP and helping to make our meetings educational & fun! it was very hard in the retail outpatient setting to see patients that could not afford their medicine walk away and leave it behind at the counter. I would refer them to needy meds web site, but that still didn't help them immediately.
Alachua County Association of Pharmacists September 2016 Newsletter
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Bill Garst recently retired from his position as Associate Chief of Pharmacy with the VA. He reports that he enjoys NOT getting up so early in the morning!
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Jennifer Chen, immediate Past President of ACAP, and her husband have a baby boy! Levi Chen is a healthy 6 lbs 1oz bundle of joy. Congratulate them when you see them.
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Aiming to improve your membership registration experience with more payment options. You can now pay membership with your credit card (small convenience fee applied) during this upcoming 2016-2017 membership year!
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Would you like to save time during membership registration? Apply for membership online to skip the paperwork line during the first ACAP meeting on September 13th. Here is the application ->Click HERE. Membership is granted once a membership application is submitted and dues collected.
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.
Alachua County Association of Pharmacists September 2016 Newsletter
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The following questions are drawn from the Continuing Education presentations from the past four ACAP meetings: • Feb 2016 – Med Errors, Dr. Scott Tomerlin, Pharmacist, President Elect , Florida Pharmacy Association • Mar 2016 – Eye Need to Understand Ocular Medications, Dr. Shephali Patel and Dr. Wendy McGonigal, Optometrists, VA • Apr 2016 – Navigating Opioid & Benzodiazepine Use: Pros, Cons & Deal Breakers, Dr. Michelle Stammet, PGY2 Resident Pain/Palliative Care, VA & Dr. Brianna Morabito, PGY2 Resident Psychiatry, VA • May 2016 – Managing Health Care Policy Changes that Affect Patient Care , Dr. Michael Jackson, Pharmacist & CEO Florida Pharmacy Association
Alachua County Association of Pharmacists September 2016 Newsletter
1) Elements of a robust CQI (Continuous Quality Improvement) program include all of the following EXCEPT: a) Documentation of a QRE (Quality Related Event) which includes a description of the event, how it was discovered and disposition of both the patient & the provider, so that the appropriate punitive action can be taken against the guilty party. b) Recognition of contributing causes of negative QREs such as interruptions, look-alike-sound-alike names, fatigue & verbal orders, just to name a few. c) A review of QREs at least every 3 months. d) Education of staff on ways to prevent negative QREs such as questioning illegible prescriptions, strange therapy or high doses. 2) Which of the following is an example of a positive QRE (Quality Related Event)? a) A technician positively identifies a teenager who is shoplifting condoms in the pharmacy. b) A patient mentions to a technician that she is taking the OTC allergy medicine (Claritin/loratadine) recommended by her doctor, but is still struggling with nasal congestion, her only allergy symptom. The tech remembers from a previous ACAP CE presentation that a nasal spray would probably be more helpful. The tech asks the patient to speak to the pharmacist about possible solutions. The pharmacist recommends OTC Flonase (intranasal fluticasone) in place of Claritin, which the patient agrees to try. At the next visit, the patient happily thanks both the technician and the pharmacist for their help because now she can breathe! c) A pharmacist questions a very high dose of short-acting insulin (93 units prior to meals) on a hand-written prescription. She calls the provider’s office. It is discovered that the intended dose was 39 units. The numbers were
accidentally transposed. d) All of the above 3) All of the following are true about Dry Eye Syndrome EXCEPT: a) Dry Eyes can be caused by the eye not actually closing all the way resulting in increased evaporation of tears, by environmental conditions such as wind or ceiling fans or excessive air conditioning or by certain meds such as antihistamines, hormone replacement therapy and decongestants. b) There are over 100 different brands of OTC therapies for Dry Eyes which include aqueous tears, oil-based artificial tears, gels, ointments and Restasis. c) The water-based & oil-based artificial tear products are generally recommended for daytime use, with the oil-based products being the longer lasting of the two, while the gels & ointments are more viscous and are usually reserved for bedtime use or for the most severe cases. d) Restasis is only available by prescription and can take up to six months to get the full effect of the treatment.
4) All of the following are true about Red Eye EXCEPT: a. Red Eye can be caused by allergies, contact lenses, virus, bacterial infection, injury and/or fungus. b. Viral Red Eye usually start in one eye, but can spread to both and is generally treated with supportive care, artificial tears, cold compresses and perhaps a mild steroid for symptomatic relief. c. Allergy-related Red Eye is usually in one eye only and requires immediate attention from an eye care professional. d. Compared to hard contact lenses, soft contact lenses have a higher risk of causing CLARE (Contact Lens Associated Red Eye). But, it can
usually be avoided with good contact hygiene. 5) All of the following are true about benzodiazepine therapy (such as Valium/diazepam, Xanax/alprazolam, Ativan/lorazepam, Restoril/temazepam, Klonopin/clonazepam) EXCEPT: a) Benzos can provide rapid relief from anxiety and may be helpful while waiting for SSRI (Selective Serotonin Reuptake Inhibitor) therapy to take effect, but they are not recommended for longer than 4-6 weeks at a time. b) Benzos are not considered an optimal therapy for depression and may actually contribute to depression after long term use. c) Benzos can be useful for treating insomnia, but CBT (Cognitive Behavioral Therapy) may be more effective for long term benefits. d) Used together, chronic benzo use combined with chronic opioid therapy appears to improve outcomes for patients suffering with both PTSD (Post Traumatic Stress Disorder) and chronic pain. 6) All of the following are true about opiate/opioid use (such as oxycodone, hydrocodone, hydromorphone, fentanyl, morphine, methadone) EXCEPT: a) Hyperalgesia is a decreased pain response, thought to be induced by opiate/opioid use and is also known as “tolerance.” b) Some of the recommendations from the CDC’s March 2016 Opioid-Prescribing Guidelines in Primary Care Recommendations are to use nonpharmacological & non-opioid therapy
rather than opioid or benzo therapy for chronic pain whenever possible. c) It may be time to consider discontinuing opioid therapy if there is no improvement in function, if there is no pain relief with increased dose, if there is evidence of addictive behavior and/or if the risks of continued therapy outweigh the benefits. d) Of the deaths from benzo overdose in the US, approximately 75% also involved opioid use. 7) All of the following are true about legislative concerns of the Florida pharmacy community EXCEPT: a) Tim Rogers could be the first pharmacist in the Florida Senate since 2000 b) There is currently no identified role for pharmacists in any Florida bills regarding cannabis legislation because federal law considers tetrahydrocannabinol (THC) to be a C-I drug, so it is still illegal and the FPA (Florida Pharmacy Association) policy is to wait until the conflict with federal law is resolved before introducing any bills regarding pharmacy’s role with this drug. c) If you are dispensing dextromethorphan in your pharmacy, you must now check ID if the patient appears to be over 25 years old, because the law now prohibits dispensing this medicine to anyone except minors. d) Failure to get involved in health care policy-making empowers others to determine your professional future.
Alachua County Association of Pharmacists September 2016 Newsletter
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1) B, C & D are elements of a CQI. A is not entirely true because a CQI program is not to be used for punishing anyone. Rather, it is used to help discover the causes of problems that can lead to medical errors so that action can be taken to find solutions to avoid repeat med errors. 2) B is the correct answer. In this case the pharmacy staff intervened when they became aware of the patient’s unresolved symptoms. Suggestions were made which were helpful to the patient resulting in a positive QRE. 3) B is not true. A, C & D are all true. B is true except that Restasis is not available OTC. 4) A, B & D are true. C is not true. Allergy-related Red Eye is usually in both eyes and can generally be treated with an OTC product such as Alaway/Zatidor/ketotifen. 5) A, B & C are true. D is not true for numerous reasons such as benzos are not effective for the core symptoms of PTSD and may actually worsen them; PTSD takes a long time to treat but tolerance may develop to benzos after 3 months; and, concomitant chronic opioid and chronic benzo use does not appear to improve outcomes for either PTSD or chronic pain. 6) A is the correct answer. Hyperalgesia is an increased (not decreased) pain response, thought to be induced by opioid use. It is not the same thing as tolerance, which is a decreased response to the drug’s pain-relieving effects over time, followed by a loss of pain-relieving efficacy. 7) A, B & D are true. C is false because the law now prohibits dispensing dextromethorphan to anyone under the age of 18 years.
Alachua County Association of Pharmacists September 2016 Newsletter