AJP Winter 2023

Arizona Journal of Pharmacy

O

Board of Directors 2022-2023

Officers

President Dawn Gerber

President Elect Kimberly Langley

Past President Darren Clonts

Treasurer Jacob Schwarz

Secretary Nancy Costlow

Director/CEO Kelly Fine

Directors at Large

Community Phillip Ieng Health System Christopher Edwards Technician Melinda Browning Reasol Chino

Ryan Gries Brandy DeChellis Misty Brannon Nina Vadiei

Liaisons

University of Arizona Student Chapter Jose Espinoza

Dean's Designated Representative Nancy Alvarez

Midwestern University Student Chapter Lyndy Abdelsayed

Dean's Designated Representative Michael Dietrich

Creighton University

Student Chapter Sharon Ruditser

Dean's Designated Representative Jane Stein

Legal Counsel

Roger Morris

AzPA Staff

Chief Executive Officer Kelly Fine

Education & Professional Development Dawn Gerber

Events & Strategic Partnerships Cindy Esquer

Membership & Volunteer Services

Hanna Wooldridge

Digital Marketing & Engagement Irma Settle

Administrative Services Melina Esquer

Editor Kelly Fine

Creative Coordinator Irma Settle

The interactive digital version of the Arizona Journal of Pharmacy is available for members only online in your member portal

(480) 838-3385 | admin@azpharmacy.org

Editor's Note: Any personal opinions expressed in this magazine are not necessarily those held by the Arizona Pharmacy Association. "Arizona Journal of Pharmacy" (ISSN 19490941) is published quarterly by the Arizona Pharmacy Association at: 1845 E. Southern Avenue, Tempe, AZ 85282-5831

Dear AzPA (Arizona Pharmacy Association) Members,

It is that time of year to reect on our 2022 accomplishments and look forward to the new endeavors of

In 2022, AzPA successfully transitioned educational events to in-person oerings as the COVID pandemic decreased in intensity, vaccinations became more available, and our supporters were comfortable meeting inperson again AzPA provided three immunization certicate programs and trained 265 pharmacists, pharmacy students, and pharmacy technicians, who are now ready to administer vaccinations when needed Without the engagement, support, and trust of the pharmacy community, AzPA would not be as successful as it has been

On behalf of the AzPA BOD (Board of Directors), we are asking you to continue your much needed support in 2023. The 2023 Arizona legislative session begins January 9, 2023, and now more than ever, Arizona legislators need to hear from Arizona Pharmacy Association members. There are 40 new legislators that need to learn all the profession of pharmacy does for our patients, from their constituents. After January 1, 2023, please nd your legislators’ contact information via https://www.azleg.gov/ndmylegislator/ and contact their oce if you are willing to be a resource when medication and pharmacy related bills are presented. Please take the time to explore https://www.azleg.gov as well. Visit https://apps.azleg.gov/RequestToSpeak/UpcomingAgendas to create an account on the “Request to Speak” system so you are able log in and register your opinion in addition to leaving a comment for committee members, so they know your position on bills. Be an advocate for your profession without leaving your home!

To help educate legislators, Pharmacy Day at the Capital (PD@C) is scheduled for March 28, 2023, so please join Arizona Pharmacy Association to meet and greet Arizona legislators! The more voices that join, the louder AzPA is heard! Check the https://azpharmacy.org/events/pdac/ website for more details.

Lastly, I cannot wait to see everyone at the 2023 Annual Convention. Don’t forget to mark your calendar for Thursday, June 22nd through Sunday, June 25th, at Loews Ventana Canyon Resort in Tucson This live event is going to meet your education and networking needs!

Sincerely, Dawn Gerber, PharmD, BCGP, FASCP, FAzPA AzPA President 2022-2023

Dawn Gerber, PharmD, BCGP, FASCP, FAzPA

Associate Professor of Pharmacy Practice at Midwestern University College of Pharmacy-Glendale, Arizona, earned her Doctor of Pharmacy degree from Drake University, Des Moines, Iowa She completed a pharmacy practice residency at the Creighton University Medical Center, Omaha, Nebraska Dr Gerber is a Board Certied Geriatric Pharmacist (BCGP) and recognized as Fellow of the American Society of Consultant Pharmacists (ASCP) and Fellow of the Arizona Pharmacy Association (AzPA) She collaborates with the Banner Geriatric Medical Fellowship Multidisciplinary Rounds. She teaches geriatric pharmacotherapy topics and the required Complementary and Alternative Medicine course. She has held leadership positions with AzPA, ASCP, and American Society of Health-System Pharmacists (ASHP). She is a Pharmacy Residency Accreditation Practitioner Surveyor with ASHP.

2023!

1stYearPractitioner

Evan Riggert

Jonathan Snyder

2ndYearPractitioner

Welcome New Members

Meagan Duchein

Michele Fabela

Paul R. Sanchez

Victoria Yan

Resident

Fizza Saeed

Lucas Roach

Madeline Green

William Clafshenkel

Pharmacist

Amy Christen

Brian Strang

Brianne Fife

Carolyn Dewart-Wojtanowski

Elizabeth Tucci

Farah Raheem

Hana Pajazetovic

Janelle Vircks

Jin Yu

John Ginniman

Katie Anderson

Kelly Green

Lea Mollon

Liliane Mofor

Mary Theresa Seddon

Melissa DiCamillo

Roseanne Lee

Stephanie Bottorf

Sue Ewing

Vanessa Holton

PremiumPharmacist

Adrienne Begaye

Douglas Clark

John Bouchard

Joscelyn Aquiningoc

StudentPharmacist

Amjad Hmlan

Amy Hou

Angel Saenz

Brianna Foraker

Brooke Hem

Caroline Veevers

Danielle Bauer

Easter Niyongabo

Jackie Tan

Jennyfer Han

Jerry Zeng

John Drennan

Kushal Shah

Leonard Vandekerkho

Marlen Cherop

Megan Grieser

Melvin Ani Miasel Compean

Michael Nunez

Michelle Hanson

Miranda Arzate

Monique Cazares

Nguyen Pham

Nicole Arizechi

Phillip Adilukito

Priscilla Pacheco

Rana Abada

Rasha Matti

Rayshion Nezy

Sahr Binzager

Samantha Rauch

Sania Ali

Savannah Christie Sohyeon Higgs

Stephanie Ashkuri Victoria Frazier

Waseem Alkakoz

TechinTraining

Barbara Porter

Theresa Hanley

Technician

Amy Bollard

Bartley Smith

Benjamin Jones

Lisa Giannini Scott Barlow

Jessica Mo Terrance Clemans

8:15AM - 9:15AM / Let Your Voice Be Heard: A Discussion of Advocacy and ASHP House of Delegates

Christopher Edwards, PharmD, BCPS, FASHP, FAzPA; Mindy Burnworth, PharmD, BCPS, FASHP, FAzPA; Janelle Duran, PharmD, BCPS

Pharmacist Learning Objectives:

1. Describe ways Arizona pharmacy professionals can get involved in advocacy through state and national pharmacy associations

2 Discuss the role of Arizona delegates to the ASHP House of Delegates

3 Discuss the potential impact of selected policies coming before the ASHP House of Delegates in June to the practice of pharmacy in Arizona and to pharmacy personnel

Technician Learning Objectives:

1 Describe how a pharmacy technician may contribute to ASHP policies

2 Understand how policies may impact pharmacy technicians

9:15AM - 10:15AM / ASHP: A National Perspective on Current Pharmacy Issues

10:45AM - 11:45AM / Focus on Hyperlipidemia: Medication Review

Lauren Rimsza, PharmD; Amy Kennedy, PharmD, BCACP; Alejandro Vazquez, PharmD

Pharmacist Learning Objectives:

1 Describe the mechanisms of action (MOA) of evinacumab and bempedoic acid 2 List the adverse eect proles of evinacumab and bempedoic acid 3 Recall the data that demonstrates the ecacy of evinacumab and bempedoic acid

Technician Learning Objectives:

1 List the new treatment options that are alternatives to statin therapy 2 Discuss the storage requirements, dosage forms, and strengths available for these alternative treatment options

1:00PM - 2:00PM / Focus on Sepsis: Guideline Update

Gabriella Gambadoro, PharmD; Brian Kopp, PharmD, BCPS, FCCM

Pharmacist Learning Objectives:

1 Summarize the role of corticosteroids in managing sepsis

2 Review the goal timing of antibiotics when treating patients with sepsis

3 Dierentiate patients with sepsis who may benet from a uid restricted resuscitation strategy

Technician Learning Objectives:

1 Summarize the role of corticosteroids in managing sepsis

2. Review the goal timing of antibiotics when treating patients with sepsis

1:00PM - 2:00PM / Focus on Hyperlipidemia: Guideline Update

Caroline Adrian, PharmD; Jacob Northrup, PharmD, BC-ADM, CDCES

Pharmacist Learning Objectives:

1 Summarize most recent updates to guideline(s)

2 Review lipid goals and ASCVD risk factors and identify indications for treatment

3 Contrast treatment options for hyperlipidemia based on most recent guideline(s)

Technician Learning Objectives:

10:45AM - 11:45AM / Focus on Sepsis: Medication Review Kathleen Bloomquist, PharmD; Brian Kopp, PharmD, BCPS, FCCM

Pharmacist Learning Objectives:

1 Describe the pathophysiologic basis for hemodynamic instability in septic shock

2 Identify vasopressors that are likely to be of benet in patients experiencing septic shock

3 Identify uids used in resuscitation that are most likely to remain in the intravascular space

Technician Learning Objectives:

1 Identify vasopressors that are likely to be of benet in patients experiencing septic shock

2. Identify uids used in resuscitation that are most likely to remain in the intravascular space

1 Summarize most recent updates to guideline(s)

2 List the rst line medications recommended by the guideline(s) for the treatment of hyperlipidemia

2:00PM - 3:00PM / Focus on Sepsis: Patient Case for the New Practitioner

Jacob Schwarz, PharmD, MBA, BCIDP, BCCCP, BCPS, FAzPA; Christi Jen, PharmD, BCPS, FASHP, FAzPA

Pharmacist Learning Objectives:

1 Apply criteria for sepsis and/or septic shock to a patient case

2 Design an appropriate resuscitation strategy for a hemodynamically unstable patient with septic shock

3 Apply criteria for initiating corticosteroid treatment to a patient case

REGISTRATION OPEN NOW! Learn More at: azpharmacy org/spring2023

2:00PM - 3:00PM / Focus on Hyperlipidemia: Patient CaseWhen Statins Aren't Enough Erin Raney, PharmD, BCPS, BC-ADM

Pharmacist Learning Objectives:

1 Choose treatment goals for hyperlipidemia based on patient specic characteristics

2 Recommend treatment for hyperlipidemia based on patient specic characteristics

3. Monitor treatment outcomes for hyperlipidemia based on patient specic characteristics

2:00PM - 3:00PM / Focus on Sepsis: Medication Safety and the Technician's Role

Christi Jen, PharmD, BCPS, FASHP, FAzPA; Sylvia Gomez, CPhT

Technician Learning Objectives:

1 Describe the consequences of delays in antibiotics when treating patients with sepsis

2 List 4 medications that are truly STAT when treating patients with septic shock

3:15PM - 4:15PM / Focus on Sepsis: Therapeutic Debate

Christopher Edwards, PharmD, BCPS, FASHP; Brian Kopp, PharmD, BCPS, FCCM

Pharmacist Learning Objectives:

1. Critique the evidence for and against a liberal uid resuscitation in early management of sepsis

2 Evaluate the evidence for “maximum” doses of norepinephrine when treating patients with septic shock

3 Evaluate the literature for the use of balanced salt solutions or saline as resuscitative uids in patients with sepsis and septic shock

3:15PM - 4:15PM / Focus on Hyperlipidemia: Therapeutic Debate-How Old Is Too Old? Debating the Use of Statins for Primary Prevention in the Elderly Ariane Guthrie, PharmD, BCPS; Thu Nguyen, PharmD, BCGP, BCPS

Pharmacist Learning Objectives:

1 Evaluate the evidence for initiating statin therapy for primary prevention in older adults

2 Evaluate the evidence for deprescribing statins in persons with advanced age

3 Compare risks and benets of statins for primary prevention in older adults

4:30PM - 5:30PM / Demystifying Pain ManagementOverview of the 2022 CDC Opioid Guidelines Update

Christopher Edwards, PharmD, BCPS, FASHP; Amy Kennedy, PharmD, BCACP

Learning Objectives:

1 Given a patient case, develop a plan to taper the patient o of long-term opioid therapy

2 Evaluate a patient case to determine if co-prescribing of naloxone is appropriate

3 Dierentiate between substances detectable and not detectable on commonly available opioid screening assays

S u n d a y , M a r c h 5 , 2 0 2 3

8:15AM - 9:30AM / Pharmacy Law Update Roger Morris, RPh, JD; Katie Lavigne, JD; Kaitlyn Fydenkevez, JD

Learning Objectives:

1. Describe ramications of recent pharmacy-related court cases

2 List recent changes in Federal Pharmacy Law

9:45AM - 10:45AM / Interstitial Lung Disease Associated with Anticancer Therapy

Farah Raheem, PharmD, BCOP Pharmacist Learning Objectives:

2

3

4

9:45AM - 10:45AM / Immunization Update - Jeopardy Style! Holly Van Lew, PharmD, BCPS, AAHIVP

2

3

J. Edwards, PharmD, BCPS, FASHP , FAzPA AzPABoardofDirectors-HealthSystem

AzPA Health System Special Interest Group (Az-ASHP)

Spring Clinical Meeting - March 4th and 5th

AzPA’s Spring Clinical Conference serves as our ASHP state aliate chapter’s annual meeting, and we are excited to be oering many topics of interest to health systems pharmacists. The content has been designed to engage practitioners of all experience levels. We hope to see you there!

74th Sessions of ASHP's House of Delegates

Please join our delegates for a town hall at the upcoming Spring Clinical Conference! This is your opportunity to weigh in on draft ASHP policy language so that your delegates can better represent you as a member of the Arizona Health Systems Pharmacy community

This year, the 74th House of Delegates reviewed and ultimately approved an unprecedented 44 policies and 6 statements that will help shape ASHP’s approach to issues facing our profession Danielle Kamm, Melinda Burnworth, and I are proud to serve as delegates and assist with this important work We are aided by an impressive roster of alternate delegates, including: Christi Jen, Carol Rollins, Janelle Duran, and Jacob Schwarz.

ASHP Leadership

Congratulations to our very own Dr. Christi Jen on her election to the position of Chair for ASHP’s Section of Clinical Specialists and Scientists. Dr. Jen has dedicated countless hours of service to AzPA and ASHP in the interest of advancing pharmacy practice and bettering patient care. Her leadership in both organizations is truly inspiring. Congratulations Christi and thank you for all that you do!

Az-ASHP Participation - We Want You!

The SIG is actively recruiting new members. If you are interested in getting involved, please sign up using the link below. We meet monthly to discuss issues relevant to health systems pharmacists in Arizona

Sign-Up HERE

I look forward to seeing you on our next Health System Special Interest Group call!

J. Edwards, PharmD, BCPS, FASHP,FAzPA AzPA Board of Directors-Health System

Christopher

Christopher

Looking Forward to Rotations: Perspectives of a First-Year Pharmacy Student

"When considering pharmacy precepting, it can be tempting to focus on the precepting of Advanced Pharmacy Practice Experience (APPE) students and residents. This article presents a candid reection from a rst-year pharmacy student who shares his ideas and apprehensions of his upcoming Introductory Pharmacy Practice Experiences (IPPEs) and also, a glimpse into the thoughts, excitement, and insecurities of a student before their rst rotation, reminding us all how it felt to be in the early stages of our learning."

Janet Cooley & Suzanne Larson

AUTHORS/CONTRIBUTORS

Suzanne Larson, PharmD, Director of Experiential Education, Midwestern University College of Pharmacy

Janet Cooley, PharmD, BCACP, Associate Professor, Director of Experiential Education, University of Arizona College of Pharmacy

Michael Pham, PharmD Candidate, Class of 2025, Midwestern University College of Pharmacy

DISCLOSURE

The author(s) declare no real or potential conicts or nancial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honorarium

FUNDING

This research was not funded

One of the most exciting opportunities that pharmacy students look forward to is rotations As an important element of pharmacy curricula, rotations under the supervision of preceptors occur in dierent types of settings, including community, ambulatory care or acute care, allowing students to gain the hands-on and realworld experience that is essential to become a wellrounded pharmacist. Between expectations, hopes, and apprehensions, what do I expect from my rotations as a rst-year pharmacy student?

The rst year of pharmacy school is dedicated to the foundational, didactic portion of the curriculum, rhythmed with exams, assignments, laboratory, and interview practices We know that at the end of this preparation, we will join our classmates in beginning the next step of our pharmacy education: Introductory Pharmacy Practice Experiences (IPPEs) We are excited to nally experience the “real-world” setting, truly immersing ourselves into the profession of pharmacy and interacting with our rst patients. However, the thought of applying what we have learned in a classroom to real-life practice with actual patients can be daunting

Am I going to be up to the task? Am I going to be good enough? Will I be able to bring some added value to the team? These are some of the questions that I am asking myself as I move closer to the rotation blocks There is an undeniable gap between theory (i.e., what is learned in class) and practice (i.e., what is experienced in patient care), and much of our ability to bridge this gap depends on our self-condence, desire to contribute, adaptability and open-mindedness.

During my rst rotations, I know that I will be hesitant at rst, but I also know that I will gradually gain more assurance Little by little, I will be more condent in what I do and say to patients as the fear of failing the team and the preceptor will slowly be replaced by the fear of failing the patient I expect to become more and more ecient as time goes by Feeling the pressure on our shoulders as we step into rotations is part of the learning process, and every pharmacy student has felt this mix of excitement and apprehension about rotations There is nothing new about it and some preceptors have already seen hundreds, if not thousands, of pharmacy students over the years.

The vast majority go through rotations every year with a positive experience, however, it still represents an important challenge for us rst-years. During rotations, we will have the chance to be supervised by a preceptorpharmacist who will guide us throughout the rotations and allow us to get valuable hands-on exposure to a pharmacist’s duties, tasks, and responsibilities. Our professors have repeatedly told us that pharmacy is a small world where connections do matter and will help you navigate through your career As such, one of my main concerns is leaving a good impression at my rotation sites.

As rst-years, we are eager to demonstrate that we are reliable, resilient, and can adapt to new situations. We are also aware that we are relatively new to the eld, and that we have yet to learn many more important lessons before becoming licensed pharmacists But, despite our known limitations, we are looking forward to giving our best, and

hopefully leaving a long-lasting positive impression on our preceptors We never know what the future might bring, and when we might end up crossing paths again.

Furthermore, the rst rotations for pharmacy students are a symbolic milestone as they bring us closer to becoming pharmacists. We want to give it our best and show that we have the shoulders to represent the profession best one day We will be accompanied by faculty, preceptors, and other mentors that will help us cross these milestones. I hope that my preceptors will be able to challenge me to seek the limits of my comfort zone so that I can learn to approach challenges and obstacles with a dierent perspective

Moreover, I hope my preceptor can listen to my concerns as I walk my rst steps into a pharmacy as a pharmacy student I will, inevitably, make mistakes that I will learn to correct as I move forward, but I do not want to feel like a burden or a liability to the team It will be important for our preceptors to gently correct our mistakes, ensuring safe patient care, and providing important teachable moments. In order to build our self-condence and improve our skills, we are optimistic that our preceptors will be understanding and patient Finally, I hope that they will communicate their expectations and advice on how to perform my duties so that I can acquire and improve more practical knowledge

All in all, introductory rotations are an important and exciting rite of passage that every pharmacy student must experience It is equally as exciting as it is intimidating Hence, rotations are a good way to experience the profession of pharmacy, keep exploring our areas of interest, and challenge ourselves to embody the ideals and traits of a pharmacist

We hope that reading Michael’s reections of his upcoming rotations highlight the great impact that preceptors can have on our most novice learners.

If you’d like to learn more about becoming an IPPE preceptor, reach out to azoee@midwestern.edu or cooley@pharmacy.arizona.edu.

Melinda

Browning

M.S., CPhT, FAPC

AzPA Membership Type:

Civic Center Pharmacy - Scientific Liaison AzPA Board of Directors-Director at Large

Instagram: Facebook: Twitter: LinkedIn:

How long have you been an AzPA member? 3 years

What do you enjoy most about being an AzPA member?

What I enjoy most about being an AzPA member is the community and the mentors that have helped me discover my potential and have helped me grow on this journey. I quickly learned that not all Pharmacy Associations advocate for technicians as strongly as AzPA, and I am beyond thankful for that.

How were you first introduced to the world of pharmacy?

I stepped into a pharmacy for the first time at the age of 16 at Walgreens 24-Hour store at Dobson & Warner in Chandler and haven't looked back. My high school DECA (formerly Distributive Education Clubs of America) teacher, Ms. Kim Frahm, introduced me to the pharmacy world. I went to school half day and worked in the pharmacy half day for a grade. Once I started in the pharmacy, several pharmacists (Chris Meisel and Gay Holliday) took me under their wings and inspired me to go to school and further my career in pharmacy. I have worked as a technician for 24 years in various roles, such as: senior technician, floating technician, and marketing scheduler. Since then, I have moved from a technician into management at Civic Center Pharmacy.

Explain what a typical work day looks like for you.

My current role is in Senior Management at Civic Center Pharmacy, a 25-employee company. Being a small company, I wear many hats, and every day looks different. I lead a team of inside and outside sales reps to ensure our patients and physicians get the best quality custom compounds with premiere customer service. Most days, I am in physician offices, educating them on compounding, regulations, and advocacy efforts.

Occasionally, I have the opportunity to jump in and work in the pharmacy as a technician.

In your opinion, what is the most rewarding part of practicing pharmacy?

The most rewarding part of practicing pharmacy is making a difference in the lives of the many people we are surrounded by, including the patients and physicians we serve, the teams we lead, and the community we live in. Every day I get phone calls from physicians that say they are thankful for what we do because they were out of options, and we helped them create a custom solution. Our profession is essential for our community's wellness, as we all learned during the pandemic. And being a part of that is extremely rewarding.

How do you give back to the profession?

I give back to the profession in several ways. I am on the AZPA Board of Directors (as the Director at Large for Technicians), an active member of several AzPA Volunteer Committees (Legislative Affairs, Membership Services, and Marketing & Engagement), a Legacy Intern guide, and a Mentor for the AzPA Mentor Connection Program. Also, last year I attended Pharmacy Day at the Capital with AzPA. In the compounding space, I am an active member of the Alliance for Compounding, serving on the Foundation Education Committee and Technician Committee. I also applied to the APC Foundation Board of Directors (status pending). For the last two years, I went to Washington, DC, to advocate for compounding at Compounders on Capitol Hill and was inducted as a Class of 2022 Fellow (FAPC).

What do you enjoy doing in your free time? When I am not working you can find me spending time with my beautiful daughters (ages 7 & 17), playing with my pets (three cats and a Chiweenie dog) or possibly at a 90’s concert.

What's something about you (a fun fact) that not many people know?

I rarely watch TV, but if I do, I binge watch New Girl, and if I were a character in a show, I feel like I would be most similar to Jessica Day.

Abstract

Medical emergencies can occur in any setting and as healthcare providers, pharmacists may be looked to for their expertise in managing medical emergencies that may occur in everyday life. Knowing one's resources, limitations, and surroundings are paramount to safely providing any emergency care. Learning to perform cardiopulmonary resuscitation can better equip any bystander to save a life if they are put in a position to do so Other emergencies have specic actions that can be taken to stabilize the patient, obtain useful information for emergency medical service providers, and initiate treatment using medications and equipment commonly found in the eld.

General Principles

#1 Know your resources

a. Emergency Medical Services (EMS) should be activated as soon as possible for any potentially life-threatening emergencies

b In the United States, dialing 911 from any phone should connect to a local emergency services dispatcher

c Other bystanders can help by doing things such as activating EMS, grabbing supplies, or providing additional information.

#2 Know your limitations

a. Most outpatient facilities lack the drugs, equipment, and personnel to properly care for patients in medical emergencies

pre-hospital, outpatient, bystander, emergency, resuscitation

Keywords

Medical emergencies can occur in any setting, including home, work, school, stores, airports, theaters, and anywhere else people tend to congregate As healthcare professionals, pharmacists may be looked to for expertise in managing life threatening emergencies when encountered in everyday life Pharmacy education on medical emergencies tends to focus on pharmacotherapeutic interventions that can be implemented in the acute care setting. While this is essential information for a pharmacist practicing in the acute care setting, these eorts include the use of resources that are often not available in a setting such as the home, a school, or a community pharmacy

This article aims to familiarize the reader with basic principles that can be applied to any emergency, oers specic recommendations based on current evidence and guidelines for responding to common emergencies using tools and drugs typically available in any setting, and provides resources to learn more advanced skills where applicable.

b The top priority is safe and prompt transport to denitive treatment

c Bystander eorts are aimed at resuscitation and stabilization, but any patient experiencing a medical emergency should be evaluated by EMS as soon as possible.

#3 Know your surroundings

a Always ensure the safety of yourself, your patient, and bystanders before attempting basic rst aid or life support

b Know where to nd emergency response equipment in the locations you typically visit (e.g., work, school, gym) before an emergency happens.

#4 Know how to perform Cardiopulmonary Resuscitation (CPR)

a If patient is unresponsive and has abnormal or absent breathing, CPR should be initiated immediately, regardless of the underlying cause

b Chest compressions should be performed at a rate of 100 to 120 compressions/minute while allowing for full chest recoil, at a depth of at least 2 inches (5 centimeters) deep for adults, around 1/3 of the depth of the chest. ¹

c Recommended compression depth is 1 5 inches for infants, and up to 2 inches (5 centimeters) for prepubescent children ²

d Early initiation of high-quality CPR is the foundation of both Basic Life Support (BLS), Pediatric Advanced Life Support (PALS) and Advanced Cardiac Life Support (ACLS).

e. To better prepare for a variety of emergencies, consider obtaining certication in Basic Life Support from the American Heart Association or the American Red Cross

Specic Emergencies

The previously described principles can and should be applied in every emergency. If the nature of the emergency is known or suspected, the specic recommendations in the following section may be helpful when responding to these emergencies

Suspected stroke

Call 911

Use Cincinnati Prehospital Stroke Scale to assess FAST: unilateral Facial droop (ask patient to smile), Arm drift (ask patient to close eyes and hold both arms straight out), slurred Speech (ask patient to say “You can’t teach an old dog new tricks”).³ Note the Time of symptom onset if available.

If possible, while waiting for medical personnel to arrive, note time of event and obtain a quick medical history that includes medications and allergies.

To learn more, consider obtaining certication in Basic Life Support from the American Heart Association (locate in-person courses near you, or visit https://cpr.heart.org for more information)

Suspected cardiac arrest

If alone, call 911 Use speakerphone, if available, to remain hands-free If help is available, yell for help and have someone else call 911

If patient is unresponsive and has either absent or abnormal breathing (slow, gasping breaths), start basic cardiac life support (e g , CPR)

Determine if automatic external debrillator (AED) is available (never leave patient alone) - if AED is available, turn it on and follow its verbal instructions.

If possible, while waiting for medical personnel to arrive, note time of event and obtain a quick medical history that includes medications and allergies.

To learn more, consider obtaining certication in Basic Life Support from the American Heart Association or the American Red Cross

Suspected acute coronary syndrome

Call 911

If patient is unresponsive and has either absent or abnormal breathing, or develops these symptoms, start basic cardiac life support (e g , CPR)

Have the patient chew aspirin 325 mg (NOT enteric coated). ⁵

Use PQRST to assess pain: P for palliative (what, if anything, relieves pain), Q for quality (“feels like an elephant sitting on chest”), R for radiate (does pain radiate to any area), S for severity (“On a 0 to 10 scale, with 0 being no pain and 10 being the worst pain you’ve ever had in your life, how would you rate your pain now”), T for time (when did the pain start). If it is a heart attack, this assessment may not improve the ultimate prognosis, but it may provide valuable information and may help to calm both you and the patient while you wait for help to arrive

5

If possible, while waiting for medical personnel to arrive, note time of event and obtain a quick medical history that includes medications and allergies.

To learn more, consider obtaining certication in Basic Life Support from the American Heart Association or the American Red Cross

Major trauma

Call 911

Try not to move patient unless in unsafe area (e.g., trac); if patient must be moved, stabilize head and spine as much as possible.

If patient is unresponsive and has either absent or abnormal breathing, or develops these symptoms, start basic cardiac life support (e g , CPR)

Hold direct pressure on sites of obvious bleeding.

Do not remove any impaled objects (may be acting as hemostat).

For extremity injuries with excessive blood loss, consider applying a tourniquet If not available, a makeshift tourniquet can be made from a bandage or shirt (material should be 2 to 3 inches wide) 6

First, expose the wound and then immediately re-apply direct and rm pressure. Tie the tourniquet between the injury and the heart (about 2 inches from the edge of wound) If possible, insert a stick/straight object into knot and turn tightly to secure tourniquet until there is no pulse felt below the tourniquet

If possible, while waiting for medical personnel to arrive, note time of event and obtain a quick medical history that includes medications and allergies.

To learn more, consider taking Stop the Bleed training oered by The American College of Surgeons (visit: https://www stopthebleed org)

Seizures/Syncope

Call 911, unless it is obvious that the person fainted (without injury during the fall) and the event is over within a couple of minutes (note the time of the event).

If patient is unresponsive and has either absent or abnormal breathing, or develops these symptoms, start basic cardiac life support (e g , CPR)

If feeling faint, have patient lie down or at least lower their head. If patient loses consciousness, lower the patient to the ground with their head turned to the side and cushioned if possible (may not be with seizure). Clear the immediate area (move furniture if possible) Loosen tight clothing Remove any objects that might injure patient during movement, including eyeglasses Consider hypoglycemia if diabetic (give milk, juice, non-diet soft drink, or 1 to 2 teaspoons of sugar or honey if able to drink).

If possible, while waiting for medical personnel to arrive, note time of event and obtain a quick medical history that includes medications and allergies

Severe Allergic Reactions

Call 911

If patient is unresponsive and has either absent or abnormal breathing, or develops these symptoms, start basic cardiac life support (e.g., CPR).

Foreign Body Airway Obstruction in Children

If universal choking sign (hand by throat) in responsive child greater than 1 year of age, use abdominal thrusts (a k a Heimlich); if airway obstruction in responsive infant (less than 1 year of age), use back blows (series of 5) and chest thrusts (series of 5)

If unresponsive, perform basic life support measures (e.g., looking for obvious foreign material that can be dislodged, opening airway, and providing rescue breaths). Continue methods to expel object(s) (e g , thrusts), and call 911

To learn more, consider obtaining certication in Basic Life Support from the American Heart Association or the American Red Cross.

Drowning

Remove patient from water as soon as possible

If patient is unresponsive, give two rescue breaths (tilt head back, pinch patient’s nose, and deliver one breath per one second) and immediately initiate CPR If patient vomits during resuscitation, turn patient on side to expel with nger/cloth, and continue basic life support.

If second rescuer is available, have them call 911 immediately, otherwise call 911 after about 2 minutes of CPR

Call 911.

Overdose

If patient is unresponsive and has either absent or abnormal breathing, or develops these symptoms, start basic cardiac life support (e g , CPR)

2 8 9

If patient has slow breathing, central nervous system depression, pinpoint pupils, or is unresponsive, administer naloxone if available If using intranasal naloxone (Narcan®), tilt patient’s head back and spray deep into either nostril. Do not prime the product, and do not attempt to reuse the same delivery system as intranasal Narcan® is single-use only.

7

If an epinephrine autoinjector is available, follow the instructions to administer an intramuscular (IM) injection in anterolateral thigh While waiting for EMS, assess scene for cause of reaction (e g , food allergy, venomous sting, or bite) Prevent ongoing exposure if possible

Attempt to determine substances ingested, including quantity, dose, timing of ingestion, but use caution if looking through patient belongings to avoid potential needlestick injuries

Hypoglycemia

Discussion

If patient is awake, alert, and oriented, administer milk, juice, non-diet soft drink, or 1 to 2 teaspoons of sugar or honey if able to drink Recheck glucose levels every 15 minutes and continue providing glucose/carbohydrates until glucose is at least 70 mg/dL

10

Call 911 if patient has decreased level of consciousness or is unresponsive, if available administer glucagon 1 mg subcutaneous injection.

Suspected heat stroke

Call 911 if patient has mental status changes or is unconscious with hot, dry skin

In heat stroke, the body’s temperature control system fails with temperatures above 40º C (104º F). ⁴ Patients with heat stroke are often unable to drink cool water or electrolyte-containing uid. Move patient to cool, shaded area and spray or sponge patient with cool water Can cover patient with wet cloth until dry, then replace

Heat exhaustion occurs prior to heat stroke In contrast, patients with heat exhaustion may have cold/clammy skin. For heat exhaustion, move patient to cool, shaded area and spray or sponge with cool water. Attempt to have the patient drink cold water or electrolyte containing solutions. Call 911 if patient begins vomiting, has mental status changes, becomes unconscious, or if symptoms persist beyond one hour

Hypothermia

Call 911

If patient is unresponsive and has either absent or abnormal breathing, or develops these symptoms, start basic cardiac life support (e.g., CPR).

This article outlines basic principles for responding to emergencies outside of the acute care setting as well as specic strategies that can be utilized for common emergency situations The goal of this article is not to serve as a substitute for Basic Life Support training and certication, but rather to remind readers of key features of these training programs.

Recommendations found in this article are aligned with current recommendations from the American Heart Association’s Basic Life Support guidelines, the American College of Surgeon’s Stop the Bleed Campaign, and other resources dedicated to empowering bystanders to initiate rescue eorts in emergency situations

This article does not provide an all-inclusive list of emergencies and does not discuss management of these patients beyond initial stabilization and resuscitative eorts. The intent of this article is to provide guidance to pharmacists who may encounter emergency scenarios in their daily life, and as such, provides recommendations on what should be done in resource-limited settings

Pharmacists may nd themselves in situations where prompt initiation of early resuscitative eorts can be the dierence between life and death for the person experiencing the life-threatening event. Knowing how to respond to emergencies in general and knowing what steps to take in specic scenarios can help better equip the pharmacist to provide this type of care

While waiting for help, move patient indoors or to a warmer setting if possible Replace cold/wet clothes with dry/warm clothes, or wrap patient in blankets Warm the patient’s core (trunk/abdomen) rst, rather than extremities (hands/feet). Do not warm patient too rapidly (immersing patient in warm water) and try to not allow extremities to refreeze.

11

1) When responding to any emergency outside of the hospital, which of the following should be considered the highest priority?

A. Activating emergency medical services by dialing 911

B Checking a ngerstick blood glucose

C Establishing intravenous access to administer medications

D Notifying the patient's emergency contact

2) Which of the following statements about performing cardiopulmonary resuscitation (CPR) on an adult patient is most accurate?

A Compressions should be performed at a rate of 100-120 compressions per minute

B Compressions should be stopped every 6-10 seconds to deliver 2 rescue breaths

C CPR should only be performed after an automatic cardiac debrillator (ACD) has evaluated the patient's heart rhythm

D CPR should only be performed by someone with a current Advanced Cardiac Life Support (ACLS) certication

3) When evaluating a patient suspected of having an acute ischemic stroke using the acronym "FAST", the "S" stands for which of the following?

A Severe symptoms

B. Slow to respond

C Speech

D Sudden onset

4) While walking down the street, you hear someone calling for help. You respond and nd a person who has been stabbed in the abdomen. The handle of the knife is visible and protruding from their abdomen. Which of the following would be the best course of action?

A. Apply a tourniquet above the site of the wound using the patient's shirt

B Call 911 immediately, obtain a quick medical history while waiting for EMS to arrive

C. Perform gentle reassurance to the patient and walk away

D Remove the knife, apply direct pressure to the wound

5) While having dinner at a restaurant, someone begins having a severe allergic reaction including facial swelling and respiratory distress. Which of the following would be the best course of action?

A Give 100 mg of oral diphenhydramine

B Give 20 mg of oral famotidine

C Perform an emergency cricothyroidotomy using a pen or straw

D Use epinephrine autoinjector in the anterolateral aspect of the thigh

6) Which of the following should be performed if you suspect a person has overdosed on an unknown substance?

A Contact the local poison control center at 800-222-1222

B. Have the patient drink 250 ml of 2% or whole milk

C Induce vomiting through digital stimulation of the gag reex

D Leave the person alone to "sleep it o" and check on them in a few hours

1. Panchal AR, Bartos JA, Cabañas JG, et al Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Circulation 2020;142(16 suppl 2):S366-S468 doi:10 1161/CIR 0000000000000916

2. Topjian AA, Raymond TT, Atkins D, et al. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation. 2020;142(16 suppl 2):S469-S523. doi:10 1161/CIR 0000000000000901

3. Kothari RU, Pancioli A, Liu T, Brott T, Broderick J. Cincinnati Prehospital Stroke Scale: reproducibility and validity Ann Emerg Med 1999;33(4):373-378 doi:10 1016/s0196-0644(99)70299-4

4. Glazer JL. Management of heatstroke and heat exhaustion.Am Fam Physician 2005;71(11):2133-2140

5. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction) [published correction appears in Circulation 2005 Apr 19;111(15):2013].Circulation. 2004;110(5):588-636. doi:10 1161/01 CIR 0000134791 68010 FA

6. Galante JM. Using Tourniquets to Stop Bleeding.JAMA. 2017;317(14):1490 doi:10 1001/jama 2015 8581

7. EpiPen. Prescribing information. Accessed June 19, 2022. www accessdata fda gov/drugsatfda docs/label/2008/019430s044 lbl pdf

8. Vanden Hoek TL, Morrison LJ, Shuster M, et al. Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):S829-S861. doi:10 1161/CIRCULATIONAHA 110 971069

9. Narcan. Prescribing information. Accessed June 19, 2022. www accessdata fda gov/drugsatfda docs/label/2015/208411lbl p df

10. American Diabetes Association. 6. Glycemic Targets:Standards of Medical Care in Diabetes-2021 Diabetes Care 2021;44(Suppl 1):S73-S84 doi:10 2337/dc21-S006

11. American Red Cross How to Identify and Treat Hypothermia and Frostbite Accessed June 15, 2022 https://www.redcross.org/get-help/how-to-prepare-foremergencies/types-of-emergencies/winter-storm/hypothermiaand-frostbite html

Retirement Blindspots

Weallhaveour“bluesky”visionsofthewayretirement shouldbe,yetourfuturesmayunfoldinwayswedonot predict.So,asyouthinkaboutyour“secondact,”youmay wanttoconsidersomelifeandfinancialfactorsthatcan suddenlyarise.

Youmayendupretiringearlierthanyouexpect.Ifyou leavetheworkforceat“full”retirementage(FRA),whichis 67forthosebornin1960andlater,youmaybeeligibleto claim“full”SocialSecuritybenefits.Workinguntil67may beworthwhilebecauseitwillreduceyourmonthlySocial Securitybenefitsifyouclaimthembetweenage62and yourFRA.¹Now,domostAmericansretireat67?Not accordingtotheannualsurveyfromtheEmployeeBenefit ResearchInstitute(EBRI).InEBRI’s2020Retirement ConfidenceSurvey,16%ofpre-retireesexpectedtoretire betweenages66-69,and31%thoughttheywouldretire atage70orlater.Therealityisdifferent.Insurveying currentretirees,EBRIfoundthatonly6%hadworkedinto theirseventies.Infact,70%percentofthemhadleftwork beforeage65,and33%hadretiredbeforeage60.²

Youmayseeretirementasanextensionofthepresent ratherthanthefuture.Thisisonlynatural,aswealllivein thepresent–butthefuturewillarrive.Thecostsyouhave toshoulderlaterinretirementmayexceedthoseatthe

startofretirement.Asyoumayberetiredfor20or30 years,itiswisetotakealong-termviewofthings.

Youmayhaveahealthinsurancegap.Ifyouretirebefore age65,whatdoyoudoabouthealthcoverage?Youmay shoulder100%ofthecost.Lookingforward,youmay needextendedcare,anditseemstogetmoreexpensive eachyear.Wealthyhouseholdsmaybeableto“selfinsure”againstextendedcare,butmanyotherhouseholds struggle.InGenworth’s2020CostofCareSurvey,the medianmonthlycostofasemi-privateroominanursing homeis$7,738.InCalifornia,itis$9,023;inFlorida, $8,803.³Supposeyoubecomedisabledorseriouslyill, andworkingisoutofthequestion.Howdoyoumake endsmeet?

Agemaycatchuptoyousoonerratherthanlater.You maystayfit,active,andmentallysharpfordecadesto come,butifyoubecomementallyorphysicallyinfirm,you needtofindpeopletotrusttomanageyourfinances.

Youcouldbealoneoneday Asanyonewhohasever livedalonerealizes,asinglepersondoesnotsimplylive on50%ofacouple'sincome.Keepingupahouse,or evenacondo,canbetoughwhenyouareelderly.Driving canbeaconcern.Ifyourspouseorpartnerisabsent,will

Thisseries,PharmacyandtheLaw,ispresentedbyPRISMWealthAdvisors,LLCandtheArizonaPharmacyAssociation throughPharmacyMarketingGroup,Inc.,acompanydedicatedtoprovidingqualityproductsandservicestothepharmacy community.

Retirement Blindspots Cont.

therebesomeonetohelpyouinthefuture?

Thesearesomeoftheblindspotsthatcansurpriseusin retirement.Theymayquicklyaffectourmoneyandquality oflife.Ifyouagewithanawarenessofthem,youmay havetheopportunitytomanagetheoutcomebetter.

Citations

1.SocialSecurityAdministration,December1,2020

2.EmployeeBenefitResearchInstitute,December1, 2020

3.GenworthCostofCareSurvey,March30,2020

PatRedingandBoSchnurrmaybereachedat800-2886669orpbh@berthelrep.com

RegisteredRepresentativeofandsecuritiesand investmentadvisoryservicesofferedthroughBerthel Fisher&CompanyFinancialServices,Inc.Member FINRA/SIPC.PRISMWealthAdvisorsLLCisindependent ofBerthelFisher&CompanyFinancialServicesInc.

ThismaterialwaspreparedbyMarketingPro,Inc.,and doesnotnecessarilyrepresenttheviewsofthepresenting party,northeiraffiliates.Thisinformationhasbeen derivedfromsourcesbelievedtobeaccurate.Pleasenote -investinginvolvesrisk,andpastperformanceisno guaranteeoffutureresults.Thepublisherisnotengaged inrenderinglegal,accountingorotherprofessional services.Ifassistanceisneeded,thereaderisadvisedto engagetheservicesofacompetentprofessional.This informationshouldnotbeconstruedasinvestment,taxor legaladviceandmaynotbereliedonforthepurposeof avoidinganyFederaltaxpenalty Thisisneithera solicitationnorrecommendationtopurchaseorsellany investmentorinsuranceproductorservice,andshould notberelieduponassuch.Allindicesareunmanaged andarenotillustrativeofanyparticularinvestment.

Rick G Schnellmann, PhD Dean, University of Arizona College of Pharmacy

Researchers Develop Drug to Treat Alzheimer's Disease in Down Syndrome Patients

When a baby is born, each cell in his or her body contains 23 pairs of chromosomes or 46 chromosomes in total, with half coming from each parent. At least, this is the case most of the time

Yet, the biological machinery responsible for assuring proper chromosome distribution sometimes goes awry This can result in a range of serious genetic diseases, the most common of which is Down Syndrome In this case, an extra copy of chromosome 21 is inherited from one parent. The condition is also known as Trisomy 21

In addition to an array of physical abnormalities, virtually all Down Syndrome patients develop Alzheimer's disease, usually between the ages of 40 and 50 There are no available treatments to prevent or mitigate the progression to Alzheimer's disease for these individuals.

Now, researchers have developed a drug they hope may successfully block the development or advancement of Alzheimer's disease in Down Syndrome patients. The drug acts by decreasing the levels of DYRK1A, a particular type of enzyme known as a kinase, which is overexpressed in Down Syndrome patients.

Research on the drug, known as DYR533, was conducted at the the University of Arizona R. Ken Coit College of Pharmacy and BIO5 Institute, in partnership with the Biodesign Institute in Phoenix.

"Generating a completely original small molecule drug and bringing it from bench to bedside, in particular for central nervous system indications, is a signicant achievement in terms of innovation and perseverance," said co-inventor Christopher Hulme, a professor in the Coit College of Pharmacy's Department of Pharmacology and Toxicology and a member of the BIO5 Institute "The group is poised to complete preclinical development by 2025 when we look forward to human trials in patients with Down Syndrome and Alzheimer's disease."

Hulme and Arizona State University researcher, Travis Dunckley, founded a startup company to push the new drug through additional studies and develop it for human use

The company, Iluminos Therapeutics, LLC, has received a three-year, $3.5 million federal Small Business Technology Transfer grant to test the latest iteration of the drug to prove it ready for clinical trials The grant comes from the National Institutes of Health Small Business Programs, also known as America's Seed Fund.

If successful, the drug will be a medical milestone for those with Down Syndrome It also may represent a new approach to the treatment of late onset Alzheimer's disease, the most common form of dementia in the general population The methodology may eventually be applied to other neurodegenerative diseases as well.

One Step Closer to Real-World Impact

The design of the new drug was completed over a 10year period by Hulme, an industry trained medicinal chemist with expertise in developing drugs that inhibit the function of kinases.

Kinases are important regulatory enzymes in the body, which add chemicals known as phosphates to other proteins This process of phosphorylation is critical to many life processes, playing a vital role in embryonic development. In Down Syndrome, however, an overphosphorylation of critical proteins can induce classic hallmarks of Alzheimer's disease

Hulme co-invented drug compound DYR533 with Travis Dunckley, research professor at the ASU-Banner Neurodegenerative Disease Research Center and a UArizona alumnus, and Christopher Foley, a former graduate student in the UArizona Department of Chemistry and Biochemistry

By using small molecules that help inhibit the DYRK1A kinase, the researchers have demonstrated that their unique compound dramatically slows the onset of Alzheimer's disease pathology in animal models of the disease

To bring the potential drug candidate a step closer to having real-world impact for patients, the team worked with Tech Launch Arizona, the UArizona oce that commercializes inventions stemming from academic research, to patent the invention on behalf of the university. The inventing team then worked with TLA to launch Iluminos and license the technology to the startup in 2017

"This is a huge accomplishment for the Iluminos team," said Bruce Burgess, TLA director of venture development "Being awarded an STTR grant is a signal that this technology and this startup team are on the right path and well on their way to advancing a technology that would provide signicant benet to patients suering from neurodegenerative disease "

Because the new drug targets multiple pathways of neurodegeneration, it could potentially be much more benecial than existing drug therapies, which typically target just one symptom, often after Alzheimer's disease has already irreparably ravaged the brain

While Iluminos Therapeutics intends to focus its development eorts on both Down Syndrome and Alzheimer's disease, additional studies suggest that, due to how the drug inhibits and decreases levels of the kinase DYRK1A, it has high potential for possible utility as a treatment for Type 1 Diabetes and in general anti-aging through DNA repair mechanisms

UA Global Campus Partnership Offers Pathway for MBA to Alumni

The rst programmatic partnership between the University of Arizona (UArizona) and the University of Arizona Global Campus (UAGC) will launch between the Doctor of Pharmacy (PharmD) program at the UArizona R Ken Coit College of Pharmacy and the Master of Business Administration (MBA) program at UAGC.

The ocial launch took place during the Coit College of Pharmacy Homecoming celebration Dr Maja Zelihic, Dean of the Forbes School of Business and Technology® at UAGC and Department Chair Dr Jorge

Cardenas were present to provide more information to PharmD alumni and answer their questions

"Senior Vice Provost Dr. Iris Laerty, Dean Zelihic, and the UAGC team are wonderful partners, and I am so excited to bring this unique educational opportunity to our alumni at a reduced cost," said Dr Rick Schnellmann, Dean of the R. Ken Coit College of Pharmacy. "This collaboration will help our graduates broaden their skillsets and set them on a path for greater career advancement "

"I applaud Dean Schnellmann's vision and commitment to his students. He is forward thinking in recognizing how a Forbes School of Business and Technology® MBA poises PharmD students for next generation leadership in the Pharmacology eld," said UAGC Sr. Vice Provost Dr. Iris Laerty. "I'm proud to support this endeavor, recognizing its promise for both UArizona and UAGC collaborations in the future "

This partnership provides an easier and more aordable path for UArizona Doctor of Pharmacy alumni to pursue their MBA They can save time by applying completed PharmD credits and transferring them to the UAGC MBA to receive up to nine credits.* In addition, this MBA program will save them up to $7,560 Additional savings on tuition and fees may apply

"With our shared commitment to the University of Arizona community, we are excited to oer Doctor of Pharmacy graduates a cost-ecient opportunity to earn their MBA," said Dean Zelihic. "The University of Arizona PharmD alumni can now discover a challenging, rich, and relevant Forbes School of Business and Technology® MBA program that aligns with the Forbes brand, one of the most respected names in the business world."

LEARNMOREABOUTTHE PROGRAMANDAPPLYTODAY!

*Thetransferabilityofcreditsissubjecttothe UniversityofArizonaGlobalCampustransfer creditpoliciesandrequiresthesubmissionof officialtranscripts.Theofficialtranscriptswillbe evaluatedtodeterminethecreditsthatwill officiallyapplytowardaUAGCdegree program.

Midwestern University College of Pharmacy

Mitchell R. Emerson, PhD Dean, Midwestern University College of Pharmacy

We have a lot to celebrate as we wrap up a busy Fall and get ready for the new year.

In October, the college hosted a variety of events in celebration of National Pharmacy Month These educational and fun events culminated in a fantastic Pharmacy Carnival that highlighted the various roles of the pharmacist on the health care team Many thanks to the Student Government Association (SGA) for hosting this month-long celebration.

We hosted and connected with hundreds of alumni, preceptors, and friends at our annual Alumni and Friends Reception held in conjunction with the ASHP Midyear Clinical Meeting in Las Vegas. In addition to the reception, our college students and colleagues were busy at the Clinical Skills competition and presenting many posters and presentations during the meeting Special recognition goes to Dr. Salfee Bhathal (CPG 2022), Dr. Eldo Joseph (CPG 2022), and their mentors Dr. Kellie Goodlet and Dr. Michael Nailor, who were awarded the 2022 ASHP Foundation Student Research Award

Thank you to everyone who joined us and to our awesome faculty and students!

The Fall quarter is in full swing, as our Class of 2023 are mid-way through APPEs and preparing for residency applications and interviews while counting the days

rd

until graduation in May The Class of 2025 enters their 3 quarter, and the Class of 2024 is leading our SGA and outreach.

In Spring, we’re looking forward to hosting and bringing everyone together on campus for an Alumni/Student mentoring event. Look for more details in early 2023. We’re also excited to host APhA in March 2023 in downtown Phoenix with our Alumni and Friends Reception and more Please be on the lookout for more details.

We are looking forward to catching up with all of you and connecting at a future event If you're ever back in the Glendale area, please reach out and stop by the campus. So much has changed, but still remains the same welcoming place Thank you to Dr. Ushani (Lincoln) Bowman, CPG 2007 who recently stopped by

If you’ve recently moved or relocated, please ensure we have your updated contact information. Please email updates to your Manager of Alumni Relations, Kimberly Hastings at KHastings@midwestern edu

Like us on Facebook: Midwestern University-College of Pharmacy

Follow us on Twitter: @MWUpharmacy

Follow us on Instagram: @MWUpharmacy

Happy Holidays from the College of Pharmacy at Midwestern University!

Flu Shot Season Is Here - What Is Needed for Audit?

COVID-19 has forced a signicant increase in the number of vaccinations pharmacies do daily With this increase also comes additional audits PAAS National® frequently sees PBMs audit for all vaccinations, including inuenza Now is the time to check that you have all documentation in place for this year’s u shot season

• A signed order from an authorized prescriber or

• A signed protocol that is up to date and includes specic vaccination(s) to be administered- When using a protocol, create a placeholder prescription with all prescription elements

• Required to be given to patient prior to each administration

• Be sure you have the most current VIS forms

• Name of vaccine administered

• Lot and Expiration Date of vaccine given

• Site of administration (i e right arm)

• Signature or initials and title of person administering

• What VIS form was given

• Form can be used as proof of receipt on audit

VAR and VIS forms, and information regarding what the CDC requires for health care providers to record, can be found on the CDC website.¹

PAAS Tips:

• Check dates and vaccines on your protocols to ensure they are up-to-date

• Have current VIS forms printed for each vaccine you administer

• Have VAR forms printed and educate all sta on how to complete the forms

• All vaccines should be submitted using days’ supply of “1”

• All vaccines administered with protocol should be submitted with origin code of “5” (pharmacy created)

• Be sure correct quantity is billed, typically 0 5 mL, may need to consult with software vendor for guidance

• Keep vaccine documents stored in a system that makes access easy in case of an audit

References: https://www cdc gov/vaccines/hcp/admin/document-vaccines html

PAAS National® is committed to serving community pharmacies and helping keep hard-earned money where it belongs Contact us today at (608) 873-1342 or info@paasnational.com to see why membership might be right for you. By Trenton Thiede, PharmD, MBA, President at PAAS National®, expert third party audit assistance and FWA/HIPAA compliance. Copyright © 2022 PAAS National, LLC.

AzPA Legislative Aairs Update

Update Your Legislative District

Help us with target campaigns by updating your LD (Legislative District) in your AzPA prole Due to legislative redistricting, several areas have altered legislative districts. Click Here to nd your legislative district. You can log into your member portal by clicking here.

Get to know your State Legislators

Using your district number from Step 1, identify your state legislators Note: Each Arizona district (1-30) has 2 elected Representatives and 1 elected Senator https://www azleg gov/

Get to know your Federal Legislators Click Here

Representatives

• David Schweikert (R) Re-elected

• Eli Crane (R)

• Ruben Gallego (D) Re-elected

• Greg Stanton (D) Re-elected

• Andy Biggs (R) Re-elected

• Juan Ciscomoni (R)

• Raúl Grijalva (D) Re-elected

• Debbie Lesko (R) Re-elected

• Paul Gosar (R) Re-elected

Federal Senators

• Kyrsten Sinema (D)

• Mark Kelly (D)

https://www senate gov/states/AZ/intro htm

Donate to PharmPAC

AzPA utilizes its political action funds carefully and wisely to provide support to legislators and candidates who are supportive of the pharmacist’s role in delivering patient care. PharmPAC plays an essential role in improving the advocacy eorts within the profession of pharmacy in Arizona. Our ability to interact with key legislators is vital and allows us to keep our issues visible and top of mind at the state capitol. The advancement and protection of the profession of pharmacy depends on all of us Donate to PharmPAC by clicking here

Pharmacy Day at the Capitol | March 28 1700 West Washington Street, Phoenix, AZ 85007 (Arizona State Capitol)

This event oers pharmacy professionals the opportunity to connect with each other over issues important to the pharmacy profession while bringing those issues to the attention of our state legislators

Purpose:

• Meet with state legislators to discuss current issues relating to pharmacy and health care.

• Highlight the advanced patient care services pharmacists provide throughout our community.

• Network with our pharmacists, students, and technicians to help raise awareness about our profession

Our joined voices can make a dierence. Save the Date!

Dianne McCallister

AzPA Lobbyist

Kelly Fine AzPA CEO

Ken Bykowski AzPA Legislative Aairs Committee Co-Chair

Mark Boesen AzPA Legislative Aairs Committee Co-Chair

Arizona State Board of Pharmacy Update

Mailing Address: P O Box 18520 Phoenix, AZ 85005

Physical Address: 1110 W. Washington St., Suite 260, Phoenix, AZ 85007

Board Members Meeting MeetingDate Submission Deadline

February7,2023

ComplaintReview

BoardMeeting February15-16,2023 January6,2023

ComplaintReview March28,2023

BoardMeeting April5-6,2023 March3,2023

DEA Prescriptions Q&A (added October 27, 2022)

Schedule II CS Prescriptions

Board sta are receiving calls and emails inquiring about the continued ability for pharmacists to document certain information on prescriptions for Schedule II controlled substances (CS), such as patient address.

21 Code of Federal Regulations (CFR) 1306.05(A) A.R.S. 362525

A federal law enacted in 2019 required all federal agencies to undertake review of various informal guidance documents As a result of this review, Drug Enforcement Administration (DEA) removed informal guidance from its website concerning changes to prescriptions for Schedule II CS The National Association of Chain Drug Stores issued a letter on June 17, 2022, describing a private phone call with DEA ocials. The letter indicated that, despite DEA’s historical guidance permitting pharmacist annotations to Schedule II CS prescriptions, all prescriptions for Schedule II CS must now arrive at the pharmacy with all elements required by 21 CFR 1306.05(A) in nal form. NABP is sharing the attached guidance document from DEA which addresses changes pharmacists may make to Schedule II paper prescriptions. DEA will provide guidance documents to DEA-registered pharmacies via email A Prescriptions Q&A is also posted on the DEA Diversion website

In the meantime, please direct any questions regarding this matter to: DEA Oce of Diversion Control, Liaison and Policy Section ODLP@dea gov (571) 362-3260

Note for Arizona Candidates for Licensure

NABP conrms eligibility to sit for the NAPLEX and MPJE for candidates seeking licensure in Arizona See the NAPLEX/MPJE Application Bulletin for details on related fees and processes. If you are transferring your license to Arizona, you must pass the MPJE prior to submitting your Licensure Transfer application Visit the MPJE section of the website to nd out more about taking the MPJE and the eligibility process for this state.

Need to verify a license, permit, or application?