September 2021 Florida Pharmacy Today

SEPT. 2021

PHARMACISTS’ ROLES AND THEIR EXPANSIONS IN HEALTHCARE SETTINGS

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The Alliance of Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO).

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 Presidential Viewpoint

7 Executive Insight

18 FPA Call for Award Nominations

VOL. 84 | NO. 9 SEPTEMBER 2021 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

10 12 14 16

Pharmacists’ Roles and Their Expansions in Healthcare Settings Drugs in Crime

Welcome Packets Initiative

House of Delegates: Speaker’s Report

SEPTEMBER 2021

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FPA Calendar 2021-2022

Mission Statements: Florida Pharmacy Today Journal

OCTOBER 9 - 12 NCPA Annual Meeting Charlotte, NC 13 - 14 FL Board of Pharmacy Meeting 15

Pharmacy Based Point-of-Care Certificate Training Program Kissimmee

16-17 FPA Midyear Clinical Conference Kissimmee 23

FPA Budget and Finance Committee NOVEMBER

DECEMBER 4-5

FPA Law and Regulatory Conference Via Zoom

15-16 Florida Board of Pharmacy Meeting 24 - 27 Christmas Holiday FPA Office Closed JANUARY 1

New Year Holiday observed FPA Office Closed

11

Florida Legislative Session begins MLK Holiday - FPA Office Closed

11

Veterans Day - FPA office closed

1

14

FPA Board of Directors Meeting

18-19 Legislative Days

25-26 Thanksgiving - FPA Office Closed

31

FPA Election Ballots due

CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours’ LIVE continuing education as part of the required 30 hours’ general education needed every license renewal period. There is a two-hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period.

Pharmacists should have satisfied all continuing education requirements for this biennial period by Sept. 30, 2023, or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by Dec. 31, 2022.

For the Pharmacy Technician Certification Board application, exam information and study materials, please contact the FPA office.

For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.floridapharmacy.org CONTACTS FPA — Michael Jackson (850) 222-2400

FSHP — Tamekia Bennett (850) 906-9333 UF — Emely McKitrick (352) 273-5169

The Florida Pharmacy Today Journal is a peer-reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

Florida Pharmacy Today Board of Directors The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.

Advertisers APMS..................................................................... 2 EPIC....................................................................... 8 KAHAN................................................................. 9 PQC...................................................................... 20 PHARMACISTS MUTUAL.......................... 6, 19

Note: The views of the authors do not necessarily represent the views or NSU — Carsten Evans (954) 262-1300 opinions of the Florida Pharmacy Association, Florida Pharmacy Today or any related entities.

DISCLAIMER

Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association is engaged in rendering legal or other professional services through this publication.

If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

FAMU — Dr. Selika Sampson (850) 599-3301

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FLORIDA PHARMACY TODAY

EMAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

Presidential Viewpoint

BY MICHAEL JACKSON, RPH DANIEL E. BUFFINGTON, PHARMD, MBA, FAPHA; ALYSON LOZICKI, PHARMD; ANDRES ROSARIO, PHARMD CANDIDATE; DANIELLE GRECO, PHARMD CANDIDATE; KIRA OZEGOVISH, PHARMD CANDIDATE

Pharmacists Authorized to Order and Administer COVID-19 Treatment

T

he United States Public Readiness and Emergency Preparedness Act (PREP) authorizes the Secretary of Department of Health and Human Services (HHS) to issue “declarations” which provide liability immunity to specific individuals or entities from loss or harm resulting from medical countermeasures against diseases or conditions that pose a threat to public health. The PREP Act itself was implemented in 2005. There was a specific declaration issued in March of 2020 regarding the COVID-19 global pandemic. Amendments to this declaration have granted pharmacists, pharmacy interns and pharmacy technicians the authority (regardless of individual state restrictions) for COVID-19 testing and vaccinating pediatric and adult patients for communicable diseases beyond COVID-19. The pharmacy profession responded quickly and has played a key role in the fight against this unprecedented pandemic.

As of September 14, 2021, this declaration has been amended nine times and is now in full effect, continuing to expand pharmacy’s scope of practice. Based upon these amendments, licensed pharmacists nationwide are authorized to order and administer select COVID-19 therapeutics orally, subcutaneously or intramuscularly, including monoclonal antibodies with Emergency Use Authorization (EUA) designation by the US Food and Drug Administration (FDA). These therapeutics must be used “in accordance with the FDA approval, authorization, or licensing.” Pharmacy technicians and phar-

macy interns meeting the outlined criteria are also authorized to administer certain COVID-19 therapeutics under the direct supervision of a licensed and qualified pharmacist. These therapeutics must be administered subcutaneously, intramuscularly or orally. A few

States are working to develop policies and procedures for ordering and distribution therapeutics at a state level, however there are logistical elements to keep in mind as we prepare to offer these pharmacy-based services in Florida. states had preemptively implemented executive orders of a similar nature, but this is a major opportunity for pharmacy practice in every state and further articulates the importance and value that pharmacists bring, especially during the current pandemic.

States are working to develop poli-

Daniel E. Buffington, PharmD, MBA, FAPhA

cies and procedures for ordering and distribution therapeutics at a state level, however there are logistical elements to keep in mind as we prepare to offer these pharmacy-based services in Florida. We can learn from the states that utilized executive orders, such as Arkansas, Mississippi and Oregon, to learn what has worked best for pharmacies from implementation and business models to optimize the process in Florida. Those states’ protocols were deemed effective by focusing on proper education and training for qualified persons and were aligned with the educational requirements outlined within the PREP Act declaration amendment.

Patient safety was also ensured by developing specific inclusion criteria for patient eligibility, utilizing standardSee Presidential Viewpoint, continued on page 8 SEPTEMBER 2021

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Executive Insight

BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

F

Our Campaign for Provider Status Continues

or a number of years, we have advocated for pharmacists to be recognized as health care providers.

Its not that we are asking for additional authority to do new things, rather it’s just that we need to correct Federal laws that fail to recognize pharmacists for what we can do. The current pandemic has exposed a glaring need for additional health care providers when we are experiencing a shortage. So what is the solution that we need to advocate for?

H.R. 2759/S. 1362 have been filed in the current congressional session to give recognition to pharmacist provider status. These bills are appropriately labeled the Pharmacy and Medically Underserved Areas Enhancement Act. As this article is being prepared, there are 55 co-sponsors in the House and 13 Senate co-sponsors. Florida Congressmen named as co-sponsors to H.R. 2759 include Rep. Gus Bilirakis [R-FL-12], Rep. Val Demings [D-FL-10] and Rep. Darren Soto [D-FL-9]. Senator Rick Scott or Marco Rubio have NOT signed on as

co-sponsors under S. 1362 nor have they supported previous versions of this legislation.

Our Congressional delegation needs to hear from us in order for this proposal to move forward. The issue is that while we can perform the services of a health care provider, there are barriers to payment if our professionis not adequately recognized under the Social Security act similar to most other healthcare professionals. In 2020, Florida adopted significant revisions to the pharmacy practice act defining expanded roles for pharmacists in the managing of patients with chronic as well as non-chronic conditions. These changes clearly reposition our industry for the practice of the future.

So, what can we do to fix this issue? Let’s help give Congress a purpose and ask for their support and cosponsorship of H.R. 2759 and S. 1362.

Our goal is to get every member of the Florida delegation on board advocating for this change. Here is a web site that will get you started with this campaign:

Michael Jackson, B.Pharm

https://actioncenter.pharmacist.com/ campaign/provider-status-for-pharmacists/. If you make contact, share with us what you were told. You can report to us through our “Contact Us” tool on our website. n

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FPA STAFF

Presidential Viewpoint, continued from page 7

Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

ized drug information educational fact sheets, standardized provider notification protocols and tools for management of rare adverse effects.

Continuing Education Coordinator Stacey Brooks, ext. 210

Training and Competency Requirements: This PREP Act declaration amendment includes specific requirements for the training and education that pharmacists, interns and technicians would need to complete to be eligible and qualified providers. Qualified persons must complete a practical training program that is approved by the Accreditation Council for Pharmacy Education (ACPE) which covers: hands-on injection technique, clinical evaluation of indications and contraindications of COVID-19 therapeutics, recognition and treatment of emergency reactions to COVID-19 therapeutics and any additional training required by the FDA. They must also have a current certificate in basic cardiopulmonary resus-

Director of Continuing Education Tian Merren-Owens, ext. 120

Coordinator of Membership TBD

FLORIDA PHARMACY TODAY BOARD Chair....................David Mackarey, Boynton Beach Vice Chair................................... Matt Schneller, Tampa Treasurer.................................... Eric Jakab, Gainesville Secretary............................. Julie Burger, Pensacola Member.........................Michael Finnick, Jacksonville Member....................... Carol Motycka, Jacksonville Member............................Teresa Tomerlin, Rockledge Member...................................... Greta Pelegrin, Hialeah Technician Member..........Julie Burger, Pensacola Executive Editor.......Michael Jackson, Tallahassee Managing Editor...................Dave Fiore, Tallahassee Journal Reviewer........................... Dr. Melissa Ruble Journal Reviewer....................................Dr. Angela Hill This is a peer-reviewed publication. . ©2021 FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today.

The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association.

The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board.

FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web address: www.floridapharmacy.org.

Administration training on their website to help increase the number of pharmacists contributing to this effort.

Reporting Requirements: Locations that receive monoclonal antibodies (mAb) are responsible for tracking and reporting serious adverse events to the FDA MedWatch database.

Additionally, information regarding inventory information (e.g., lot numbers, quantity, receiving site, receipt date and product storage) and patient information (e.g., patient’s name, age, disease manifestation, number of doses administered per patient and other drugs administered) must be maintained and available for inspection.

Locations must report mAb utilization through their designated state tracking system or DHHS TeleTracking COVID-19 Portal. Per the most recent update from the Florida Department of Health, HHS Protect will be utilized for inventory tracking.

This PREP Act declaration amendment includes specific requirements for the training and education that pharmacists, interns and technicians would need to complete to be eligible and qualified providers. citation. The American Pharmacists Association (APhA) Pharmacy-Based Immunization Delivery Certificate Training Program already meets the educational and technical training requirements. The Florida Pharmacy Association (FPA) is an authorized provider of the APhA training program.

Florida pharmacists are waiting for further instruction from the state regarding any additional guidelines, application processes and whether they will require pharmacists and interns to be certified immunizers in Florida. APhA is providing free COVID-19 Monoclonal Antibody Assessment &

Product Access and Ordering: HHS has officially transferred responsibility of ordering monoclonal antibodies from a federal level to using state/ territory distribution systems. States are more familiar with understanding where best to ensure patient and community access. HHS has also stated that ordering of mAb’s will no longer be performed by contacting AmerisourceBergen (ABC) directly. A designated amount will be decided by HHS and distributed to states/territories weekly, and will be distributed at each state’s discretion. Shipping quantities will be calculated based on track-

ing weekly reports of COVID-19 cases and related hospitalizations.

New administration sites across Florida will be required to register with the state to start receiving supplies of mAbs [https://fdoh.readyop.com/fs/4cNG/08dd]. New sites will still be required to register for an account through ABC even though orders will not be independently placed through the wholesaler. This wholesaler account number will be neces-

Product Access and Ordering: HHS has officially transferred responsibility of ordering monoclonal antibodies from a federal level to using state/territory distribution systems. States are more familiar with understanding where best to ensure patient and community access. sary when creating a TeleTracking account with HHS Protect.

For existing administration sites, mAbs may be ordered by completing the ordering form from the Florida Department of Health [https://fdoh.readyop.com/fs/4cNI/577f].

Orders must be placed by 5 p.m. on Tuesdays of each week.

In addition, site inventory reports must be sent to HHS Protect by Wednesday each week. Based upon site inventory levels, the wholesaler may adjust the weekly allocation. Site allocations, determined by the Florida DOH, and shipment tracking data are available through the wholesaler’s platform, “ABC Order.” There are current controversies between state and federal agencies as to the plans for more restrictive distribution of mAb supplies by the Biden administration. The primary challenge is to ensure equitable distribution and to avoid nationwide drug shortages.

Reimbursement and Billing: Monoclonal antibody treatments are authorized as vaccines and therefore can be billed as such. However, when mAb treatments are provided free of charge, then billing for the product is precluded. However, reimbursement for administration is currently covered under Medicare Part B and in certain circumstances at the discretion of CMS under Part A. How billing for mAb administration will work when administered by a pharmacist is still in question and will vary based on commercial versus CMS payors.

Additionally, HRSA has expanded its uninsured program to cover these mAb therapeutics to enable patients without

health insurance to receive therapy free of charge. For these patients, like vaccinations, a site must agree that by participating in the HRSA program they will not seek reimbursement from the patient.

Clinical Resources: With the accelerated pace of new drug development, FDA approval, EUA designations and the availability of clinical data, it is critical to monitor for up-to-date and accurate information. We anticipate that Florida’s Department of Health and Board of Pharmacy will release guidance and resources soon, but in the interim this information can be found through the HHS resources: https://combatcovid.hhs.gov/ hcp/resources-clinicians.

Pharmacists are excited and motivated by the increasing demand for interprofessional services involving COVID-19 testing, vaccination and treatment. Compliments to the pharmacists, interns and technicians who have successfully advocated for and engaged in these advanced patient care service opportunities. Continued pharmacist engagement during the pandemic is a major force in future legislative initiatives. The pharmacy profession has made it abundantly clear that it is ready, willing and able to provide advanced patient care services The FPA will continue to keep the membership updated when more information becomes available. n

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Pharmacists’ Roles and Their Expansions in Healthcare Settings

By Boyada Tep Healthcare is an ever-changing environment and is projected to grow 15% from 2019 to 2029, based on the U.S Bureau of Labor Statistics.1 The more healthcare service is needed, the more the occupation will grow. Within the healthcare system, medication errors are a big concern. The FDA received the report to have more than 100,000 each year, and between 2% and 33% were FPA Intern errors from patients taking medication imBoyada Tep, a P4 pharmacy properly at home.2,3 Some of us would imstudent at Florida mediately think If the patients had asked for A&M University consultation from the pharmacists, these errors could have been prevented. Isn't it? However, if we look a little deeper into the problem, the concern should not come only from the patients but the gap within the healthcare systems. As a future drug expert and a part of the healthcare system, I believe pharmacists must know the expansion of their scope of practices, be trusted, and acknowledged by their patients and colleagues regarding their roles in healthcare settings.

In 2014, a study was conducted on the patients when receiving a new prescription. Among the top three choices, the patients agreed that the pharmacist's roles were to provide the handout about the medications (95%), tell the best way to take the medicines (85%) and check if the dose is correct, or tell about the common side effects (86%).4 These results showed that not many patients were aware of the pharmacists’ roles in the community. Another survey found that most patients preferred to receive both verbal and written counseling. However, leaflets are provided more frequently than written information.5 The leaflets may or may not answer all the questions for the patients. And if the patients are not familiar with the pharmacists, initiation of a conversation will be challenging. Some other patients do not feel comfortable discussing their conditions in public areas (e.g., ED or STD). So patients tend to look for the answers from online resources. These situations offer a chance of medication errors through the introduction of misinformation. Pharmacists can get to know their patients more to improve the situation. When non-familiar patients come in, pharmacists can introduce themselves and start a short conversation on how the patients have been doing with their prescriptions or offer a few minutes for consultation. Pharmacists can also provide the pharmacy phone number and their available time for a private consultation. The convenience of using a local community pharmacy from basic health care services can be beneficial when appointments to see a primary care doctor are hard to come by. Patients are more likely to request health 10

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FLORIDA PHARMACY TODAY

care information when they are aware of their pharmacists’ roles. With more connections and directions, patient’s therapy management can be improved, and errors can also be prevented.

Another survey was conducted regarding the family physician's perception of the importance of community pharmacist function. The surveys response rates were 78.6% from pharmacists and 7.1% from physicians. Both agreed that collaborative practice could improve patient outcomes, and the significant barrier was the lack of time due to dealing with multiple healthcare practitioners.6 However, physicians preferred collaborating with the pharmacists for insurances and patient counseling purposes rather than assisting them in identifying and managing patients’ care plans. This signified the lack of trust in collaboration between pharmacists and physicians. Physicians and pharmacists need to communicate proficiency regarding their busy schedules to improve their partnership. In addition, for the patients to receive better care, the physicians must acknowledge the education and the training that the pharmacists have earned throughout their pharmacy careers. Meaning that the physicians should also agree to work together, share their thoughts, and provide feedback on the pharmacists' recommendations for their patient’s care management.

More roles have been assigned to pharmacists corresponding to the high expectations and the growth of healthcare services. More roles come with more responsibilities and further education. Continued Education from ACPE, Accredi-

conditions, such as influenza, streptococcus, lice, skin condition like ringworms and athlete's foot, as well as uncomplicated minor infections. The minimum requirement for this certification must be established by completing a one-time, 20-hour education course approved by the Board of Pharmacy. The requirements must include addressing patient assessments, point-of-care testing procedures, safe and effective treatment of minor, non-chronic health conditions, and identification of contraindications.8 Knowing that retail pharmacies are primarily between 5 to 10 miles of every consumer, this service will become more convenient for the patients to access their care. For example, the final data from CDC on the flu season between October 1, 2019, and April 4, 2020, showed that at least 740,000 were hospitalized and at least 62,000 died. Because of COVID-19, some patients felt uncomfortable visiting their primary care providers in healthcare settings.9 This caused a delay in their treatments. For influenza, the faster the patients can get the treatment, the better they can reduce the virus’s risk. Oseltamivir (capsuvle/suspension), zanamivir (inhaler), peramivir (injection), and baloxavir marboxil (capsule/suspension) are FDA-approved influenza therapy.10 Oseltamivir, zanamivir, and baloxavir marboxil are available at pharmacies and are most effective within 48 hours with symptoms onset. Under the Florida Statutes, section 465.1895, qualified pharmacists can offer a nasopharyngeal swab test and provide influenza treatment to the patients of physicians that pharmacists had a written protocol with. This quick treatment can reduce hospitalization, financial burden, and mortality rate for patients.

MORE ROLES HAVE BEEN ASSIGNED TO PHARMACISTS CORRESPONDING TO THE HIGH EXPECTATIONS AND THE GROWTH OF HEALTHCARE SERVICES. MORE ROLES COME WITH MORE RESPONSIBILITIES AND FURTHER EDUCATION. Although I've been in pharmacy school for the past few years, my vision for the scope of practices in a pharmacy career is still expanding. Previously, I wasn't aware of the variety of continuing education programs available for pharmacists. I am also learning how challenging it is to vocalize through our association and the concept of acceptance by other healthcare practitioners. This action requires pharmacy professionals to collaborate and voice their opinions in reviewing the gaps within the healthcare system. I'm now conscious, and I am thankful for the opportunity to intern at Florida Pharmacy Association (Tallahassee) for these discoveries. This shall make me look forward to the expanding roles of our professional careers in the future and how I should ready myself to prepare for these changes. The expansion of

the pharmacy career roles will help fill the gaps in the healthcare system. The work of our professional organizations will allow pharmacists to become more reliable resources for their patients and their colleagues.

References

1. Healthcare occupations: Occupational outlook handbook.

U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/ healthcare/home.htm. Published May 14, 2021. Accessed August 17, 2021.

2. Center for Drug Evaluation and Research. Working to reduce medication errors. U.S. Food and Drug Administration. https://www.fda.gov/drugs/information-consumers-andpatients-drugs/working-reduce-medication-errors. Accessed August 18, 2021.

3. 2 SCTM, Team SC, Team SC. Medication errors statistics.

The Checkup. https://www.singlecare.com/blog/news/ medication-errors-statistics/ .Published May 7, 2021. Accessed August 30, 2021.

4. Kelly DV, Young S, Phillips L, Clark D. Patient attitudes regarding the role of the pharmacist and interest in expanded pharmacist services. Canadian pharmacists journal: CPJ = Revue des pharmaciens du Canada : RPC. https://www.ncbi. nlm.nih.gov/pmc/articles/PMC4212442/. Published July 2014. Accessed August 30, 2021.

5. van Beusekom MM, Grootens-Wiegers P, Bos MJW, Guchelaar H-J, van den Broek JM. Low literacy and written drug information: Information-seeking, leaflet evaluation and preferences, and roles for images. International journal of clinical pharmacy. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC5124048/. Published December 2016. Accessed August 30, 2021.

6. Kelly, D. V., Bishop, L., Young, S., Hawboldt, J., Phillips, L., & Keough, T. M. Pharmacist and physician views on collaborative practice: Findings from the community pharmaceutical care project. Canadian pharmacists journal: CPJ = Revue des pharmaciens du Canada : RPC. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3734911/.

Published July 2013. Accessed August 30, 2021.

7. Chapter 465 Section 1865 - 2020 Florida Statutes. https://m. flsenate.gov/Statutes/465.1865. Accessed August 30, 2021.

8. Pharmacy FBof. Pharmacist test and treat certification. Florida Board of Pharmacy. https://floridaspharmacy.gov/licensing/ pharmacist-test-and-treat-certification/. Accessed August 30, 2021.

9. Flu season numbers for 2020/21. Health Hive. https://hive. rochesterregional.org/2020/01/flu-season-2020. Accessed August 30, 2021.

10. Center for Drug Evaluation and Research. Influenza (flu) antiviral drugs and related information. U.S. Food and Drug Administration. https://www.fda.gov/drugs/informationdrug-class/influenza-flu-antiviral-drugs-and-relatedinformation. Accessed August 30, 2021.

SEPTEMBER 2021 |

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Drugs in Crime

By William Garst

In the early 1900s, on the south side of Chicago at a local tavern called the Lone Star Saloon, a well-to-do customer walked in and ordered a drink. The bartender prepared the drink as usual, but covertly included an additional substance to it. He then nodded to the barmaid and prostitute, “Gold Tooth” Mary Thornton, who served it to the unsusWilliam Garst, pecting customer who was soon rendered Pharm.D. unconscious. He was then robbed, and othConsultant er local patrons dumped him in the alley at Pharmacist the back of the Lone Star. After a considerable period of time, the stranger woke, groggy, confused and unable to remember what ha pened. This scenario played out many times, but finally the saloon manager was caught. His name was Michael Finn (nicknamed Mickey) and the substance added to the drink was chloral hydrate. Thus, chloral hydrate knockout drops became known in American vernacular as the “Mickey Finn” or “Mickey” for short.

The story of chloral hydrate began many years earlier in 1832, when Justus von Liebig synthesized chloral hydrate in his laboratory. Von Liebig was a German scientist who made major contributions to agriculture and biological chemistry.

He was one of the principal founders of organic chemistry and was considered the father of the fertilizer industry.

Chloral hydrate is considered the first sleeping pill because it has very few actions other than causing drowsiness and sleep. However, more than being the first in the class of drugs known as hypnotics, it was the first completely synthesized and widely used drug. Presumably it never existed on earth in any form until it was made in the laboratory, and in the early 1800s, this was a big accomplishment because, up until that time, all drugs were from a natural resource and no one believed that a chemical outside of nature would have effects on a living being.

In the 1850s, it was discovered that chloral hydrate could be converted into a sweet-smelling liquid called chloroform, the fumes of which could render a person unconscious. The substance was used to sedate people for surgery because it could be administered by being inhaled into the lungs. However, it was difficult to use during surgery and too much could be given, resulting in many accidental overdose deaths.

Chloral hydrate is a solid at room temperatures, but quickly dissolves in alcohol to form an easily administered liquid.

Thus, during the 1800s, chloral hydrate became a popular party drug and was known to be the first date rape drug.

Today, chloral hydrate is still available, but only as a compounded medicine (made in a pharmacy) from crystals because it is not produced commercially any longer by a pharmaceutical company. Barbiturates (phenobarbital) in the early 1900s, and benzodiazepines (Valium and Librium type drugs) 12

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FLORIDA PHARMACY TODAY

IN THE 1850S, IT WAS DISCOVERED THAT CHLORAL HYDRATE COULD BE CONVERTED INTO A SWEETSMELLING LIQUID CALLED CHLOROFORM, THE FUMES OF WHICH COULD RENDER A PERSON UNCONSCIOUS. in the 1960s replaced chloral hydrate for use as sedation medications, though as late as the 1990s it was still used in hospitals to sedate children before a procedure. It is rarely used anymore, but when used, must be compounded by a local pharmacy or hospital pharmacy.

In an earlier column, I noted that the difference between a harmful substance and a beneficial medicine is the dose. Too much of the substance is harmful, but the right amount can have beneficial effects. In this case, the difference between a substance used for harm and a beneficial medicine is the intent of the use.

Stay informed and stay healthy.

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Welcome Packets Initiative

By Yania Aguero-Martinez

Yania AgueroMartinez, APhAASP's FPA/ACAP Liaison (2021-2022)

As the start of a new school year steadily approached for the University of Florida College of Pharmacy, their American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP) chapter’s Policy & Advocacy team joined Alachua County Area Association of Pharmacists (ACAP) once again to start putting together welcome packets for the incoming first-years. Our welcome packets were delivered to excited first-year students on their second day of orientation in early August.

The packets included an ACAP-imprinted pen and signed welcome letter from ACAP’s president, a pin and application for the Florida Pharmacy Association (FPA), and a tri-fold brochure detailing professional organizations at the local, state and national levels. Alongside all this great information, we added a variety of snacks and school supplies to get the students started on their first week of pharmacy school.

Some of the goodies included oatmeal packets, protein bars, fruit snack packs, crackers, erasers, paper clips, sticky notes and pens. To make things interesting, we even incorporated 15 free student memberships to ACAP and FPA into lucky students’ welcome packets at random. This was made possible by the Student Engagement Fund (SEF) of

Above: Angela Bundy (UF APhA-ASP Policy & Advocacy Committee Senior Representative), Lucas Zhou (UF APhA-ASP VP of Policy Elect), and Sandra E. Buck-Camp (ACAP President) Right picture: Yania Aguero-Martinez (UF APhA-ASP FPA/ACAP Liaison), Lucas Zhou (UF APhA-ASP VP of Policy Elect), and Angela Bundy (UF APhA-ASP Policy & Advocacy Committee Senior Representative) 14

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ACAP, which actively seeks to support students in their endeavors to advance the career of pharmacy.

This initiative was well-received by the firstyears and helped grow their interest in what ACAP and FPA do locally and at the state level, respectively, for the profession of pharmacy. The welcome packets were referred to by some of the first-years as “so informative” and containing “new information that we did not know about.” We know the importance of policy and advocacy within pharmacy, and this is exactly what we hoped to share with the incoming class through our welcome packets.

Our aim for the brochure that we included was to introduce the students to the various professional organizations in their reach while breaking them down by level of impact and the populations their resolutions directly affect. Overall, we hoped to generate more interest from the incoming Gainesville campus students, encouraging their involvement early on – as they are the future of pharmacy.

This initiative has already created such interest and, as a team, we will continue to motivate all pharmacy students to learn more about policy and advocacy through various events and activities.

SEPTEMBER 2021

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House of Delegates: Speaker’s Report Alexander Pytlarz, PharmD Speaker of the House of Delegates

This past July, at FPA’s 131st Annual Meeting and Convention, members, FPA local unit associations and FPA House of Delegate members gathered at the Marriott Sawgrass Resort to meet, discuss and advocate for the profession of pharmacy. It was another successful meeting.

The House of Delegates convened to discuss new business and review two submitted resolutions. Of those, one was adopted. An additional resolution, submitted after the deadline, was discussed, and ultimately referred to FPA’s Educational Affairs Council. There was also one FPA Bylaw change approved by the House.

I would like to recognize outgoing House of Delegate Board members, Gary Koesten, House of Delegates, Chair, and Kathy Petsos, House of Delegates, Director, for their time and dedication serving the associations and its membership. Eric Larson will serve as the Board’s new Chair. We are excited to have two new members on our Board: Kim Jones, Vice Speaker, and Darcy Vaugh, Director.

Our 2021-2022 FPA House of Delegates Board of Directors: Chair of the House Board – Eric Larson Speaker – Alexander Pytlarz Vice Speaker – Kim Jones Director – Barbara Beadle (term ends 2022) Director – Jeanette Connelly (term ends 2023) Director – Darcy Vaugh (term ends 2024) The 2022 132nd FPA Annual Meeting and Convention at the Marriott Harbor Beach Resort in Ft Lauderdale, Florida is scheduled for July 7 through 10, 2022. We plan to have our House of Delegates meeting on July 7, convening both sessions of the House in one day. The deadline for registering as a delegate is Wednesday, June 8, 2022. Resolutions for next year’s meeting should also be submitted to the FPA Office by Wednesday, May 11, 2022. Any items of new business to be discussed at the meeting should be submitted to the FPA Office by Wednesday, June 8, 2022.

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The following represent resolutions presented during the 2021 House of Delegates and their action item: 2021-1 Write in Candidate Choice for the FPA Election Procedure THEREFORE, BE IT RESOLVED that the FPA modify their governing documents to allow write-in alternate selections whenever there are not at least two candidates put forward through the nominating process and/or recruited by FPA leadership.

There was a motion that was properly seconded to adopt this resolution.

Resolution Adopted Resolution Approved by the Board of Directors ■ ■ ■ ■

Staff Recommendation – Refer to Organizational Affairs Council Consider revision to FPA Bylaws Article XIII Section 2 (Procedures for Election) or Consider revision to FPA Bylaws Article XIII Section 1 (Nominating Committee) or Consider revision to Model Election Guidelines in Leadership Duties document (Recommended)

2021-2 Remove Residency Requirement THEREFORE, BE IT RESOLVED, that the non-residency language for holding an elective office be removed from the FPA governing documents.

Based upon an oral call for a vote on this issue, the Speaker was unable to determine the position of the House. A division of the House was ruled on by the Speaker and a standing vote count was facilitated.

There was a motion to not adopt this resolution.

Resolution not adopted on standing count

ITEM OF NEW BUSINESS (SUBMITTED AFTER THE DEADLINE FOR RESOLUTIONS) 2021-3 Student Affairs Council responsibilities for student track professional development and education THEREFORE, BE IT RESOLVED, the Florida Pharmacy Association support the Student Affairs Council taking lead responsibility in designing and directing educational and professional development programming (student education track) and coordinating implementation with the Education Affairs Council and the Director of Continuing Education.

Consideration for this resolution required the House to suspend its rules to allow for a hearing. Upon approval of the House, the rules were suspended.

There was a motion to refer this item of new business to the Educational Affairs Council Motion to refer this resolution to the Educational Affairs Council adopted.

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Staff recommendation – This policy statement should be reviewed by the Educational Affairs Council and report provided back to the House of Delegates at the 2022 annual convention.

The following represents the proposed changes to the FPA bylaws introduced by the FPA Board of Directors and adopted by the House of Delegates:

laws, dues structure and process for election of officers to be presented to the Board of Directors for approval. The Academy bylaws shall not be in conflict with the constitution and bylaws of the Association.

Each Academy may elect to develop an account within the FPPC. Contributions from Academy members, if specified, shall be placed into their respective accounts. The Academy Board of Directors shall be responsible for allocation of funds.

Members of the Academy shall be members in good standing with the Florida Pharmacy Association.

I also want to take a moment to give congratulations to the following FPA-affiliated organizations for being recognized in six categories of service to their members.

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Community Service – Alachua County Association of Pharmacists Membership – Dade County Pharmacy Association Public Relations – Duval County Pharmacy Association Legislative Involvement – Alachua County Association of Pharmacists Continuing Education – Brevard County Pharmacy Association Association Involvement – Dade County Pharmacy Association

Thank you for allowing me to serve as your 2021-2022 House of Delegates Speaker. It is an honor.

Alexander Pytlarz

Article IV – Subdivisions (Section 5) Academy of Pharmacy Practice. There shall be an Academy of Pharmacy Practice composed of sections. These sections shall be recommended by members of the Academy and approved by the Board of Directors. The purpose of these sections of the Academy is to provide a forum for the exchange of ideas and to provide representation for Association members with differentiated pharmacy practice and business interests. The Academy is entitled to 2 delegates to the FPA House of Delegates.

The Academy of Pharmacy Practice shall have a Board of Directors composed of the Chairperson and Chairpersonelect of each section and a Chairperson and Chairperson elect of the Academy. The Academy shall establish their bySEPTEMBER 2021

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C A L L

F O R

APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■ The recipient must be a Florida licensed pharmacist and member of the FPA. ■ The recipient must be living.

Awards are not presented posthumously.

■ The recipient has not previously received the award.

■ The recipient is not currently serving nor has he/she served within the immediate past 2 years on its award committee or an officer of the association in other than an ex officio capacity.

■ The recipient has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist reflects well on the profession.

James H. Beal Award Awarded to the “Pharmacist of the Year”. The criteria established for this award is that the recipient be a Florida licensed pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years.

Criteria: ■ The recipient must be a Florida licensed pharmacist and a member of the FPA. ■ The recipient has rendered outstanding service to pharmacy within the past five years.

Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/ her career.

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N O M I N A T I O N S Criteria: Candidate must be a member of the Florida Pharmacy Association for at least 2 years.

■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

■ Candidate must have demonstrated contributions to the Florida Pharmacy Association and/or other pharmacy organizations.

■ Candidate must have demonstrated commitment to community service.

■ Candidate is not a past recipient of this award.

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R. Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida.

Criteria: ■ The recipient must be a Florida registered pharmacist and a member of the FPA. ■ The recipient has displayed outstanding achievement in the field of pharmaceutical public relations in Florida.

Frank Toback/AZO Consultant Pharmacist Award Criteria: ■ Candidate must be an FPA member, licensed with the Florida Board of Pharmacy as a consultant pharmacist in good standing.

■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy.

DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession

F P A

of pharmacy in Florida.

Criteria: ■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■ Candidate must have held office at local level pharmacy association.

■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association.

■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.

Pharmacist Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy: Criteria: ■ Licensed to practice for nine (9) years or less.

■ Licensed to practice in the state which selected.

■ Participation in national pharmacy association, professional programs and/or community service.

IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance

A W A R D S the profession.

Criteria: ■ The recipient must be a Florida licensed pharmacist and a member of the FPA. ■ Candidate should motivate others to excel within the profession by encouraging them to be leaders.

■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others.

■ A brief description on the candidate’s motivational/inspirational skills must accompany the nomination.

2 0 2 1 - 2 0 2 2 The Jean Lamberti Mentorship Award The Jean Lamberti mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates.

The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

Criteria: ■ The recipient must be an FPA member.

■ The recipient must serve as a role model for the profession of pharmacy.

Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care.

Criteria: ■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care.

■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association.

■ Qualified Nominee: A pharmacist practicing within the geographic area represented by the Association.

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2022 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Name:

Address:

Date Submitted: Signature:

FOR THE FOLLOWING AWARD:  Bowl of Hygeia  Beal and Powers Award  R. Q. Richards Award

Please describe briefly the nominee’s accomplishments, including why you feel he or she should receive this award. (Attach additional sheets if necessary.)

 Frank Tobak/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacist Mutual Distinguished Young Pharmacist Award  Jean Lamberti Mentorship Award  IPA Roman Corrons Inspiration & Motivation Award  Upshur Smith Innovation Pharmacy Practice Award  Technician of the Year Award

SUBMIT NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 FOR A LISTING OF PAST AWARD RECIPIENTS GO TO WWW.FLORIDAPHARMACY.ORG AND SELECT THE “AWARD” MENU ITEM DEADLINE FOR NOMINATIONS IS FEBRUARY 28.

SEPTEMBER 2021

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