Keeping Tabs Volume 8

Keeping Tabs

Volume 8 December 2023

SHORT ARTICLES BROUGHT TO YOU BY PHARMACY STUDENTS AT THE UNIVERSITY OF FLORIDA COLLEGE OF PHARMACY- JACKSONVILLE

Caitlin Young

THE FACE OF DEATH “As soon as the doctor called it, I looked at my preceptor with tears running down my face and ran to the nearest bathroom where I began to sob in silence.”

The Hospital Emergency room It was a beautiful and sunny July morning in Jacksonville, Florida. I remember waking up eager and excited to take on another day at Ascension St. Vincent’s Hospital as a pharmacy intern. I was on my hospital rotation, and it was week two of my 4-week rotation and up to this point, I have loved it. I was blessed with an amazing preceptor that was specially trained in Critical Care, so our days were spent in the chaotic environment known as the ER. Mind you, I’ve only ever been to an ER one time in my life as a child. To to say I was anxious to be working alongside my preceptor in the ER is a massive understatement- I was terrified yet excited of what I may be seeing. My first week went smoothly as I learned the rhythm and flow of the emergency department and I was able to gain experience performing medication reconciliations with various ER patients.

I will admit, the atmosphere was intimidating at first because I know myself to be a stressful and worrisome person, and I knew working in the ED would not necessarily coincide with those traits very well. The ED is a place of pain and suffering and it’s a place that is not for the faint of heart (me.) If you’ve never worked in the ER as a student, you will learn that there are so many moving pieces that make the ER function as a well-oiled machine. You’ll encounter things that you’ve never thought you’d have a front row seat for.

It’s almost like watching Greys Anatomy in real time.

Back to this beautiful morning in July- it was roughly 9 a.m. and my pharmacist and I were sitting at the ED computer talking about the recent admission cases when the dreaded “CODE BLUE” alert was announced over the intercom.

Mind you, I had heard these alerts numerous times when I was a technician working at Mayo Clinic and performing rounds on each floor delivering meds to the med rooms and I knew it meant something bad was happening, but I didn’t realize the extent. I guess ignorance was bliss back then. But this alert was different because I knew that when the patient arrived, they would be right in front me and the continuation of their life would be dependent upon the team around me. As the “code blue” patient was in route via ambulance, my heart sank to the floor. My mind was racing, I felt sick to my stomach, and I became consumed with fear for this man’s life.

I remember I instantly clung to my faith and began praying in my head that he would be okay. The doctors and nurses kept saying out loud that he had been in asystole for 30 minutes and it wasn’t looking good.

As I’m trying to compartmentalize my thoughts and get a handle on my fear and anxiety and muster up the strength to remain as professional as possible, the EMTs burst through the doors wheeling the patient in front of my face on a stretcher and he’s blue.

Upon his arrival and seeing that this man had been without a pulse for a half an hour, life really hit me. If I could slow down time in this precise moment, and pinpoint one of the many emotions flowing through me it would be- in the face of death, you feel instant gratitude for your life and health. It makes you cherish your life that much more. It makes you grateful that you have a pulse, and you get to go home to your loved ones.

Once the man was moved from the stretcher to a bed, my pharmacist had me assist in the room where the doctors and nurses were trying to revive this man who had presumably overdosed. From what I gathered over the ED scanner; the man had been found by his mother in their home with a needle in his arm. The man was shirtless, with jeans on and what looked like work boots. It’s as if he had just gotten off work and was at home with his mother. As he’s laying there lifeless on the bed, my preceptor instructed me to help her prep naloxone and epi for administration.

After countless attempts and what felt like an eternity and where time froze, I heard the doctor call his time of death and this is when I began to question myself. Thoughts like, “Am I cut out for this? How can I handle ever seeing this again? What am I doing here? What if this was my dad lying here? What if this man had a traumatic experience which led him down a path of destruction which ultimately took his young life?”

I’ll never forget this moment.

As soon as the doctor called it, I looked at my preceptor with tears running down my face and ran to the nearest bathroom where I began to sob in silence. I began to pray endlessly that this man would be okay in eternal life and that God may bring comfort to his mother.

There’s a stigma circulating people that abuse and little does anyone know what that person could be going through that led them to the point of no return with drugs. This story has fueled my passion to work within pain management post-graduation.

In this exact moment, I realized that I was not cut out for this work environment. I’m too empathetic and sensitive for it and that’s okay. I’m blessed to have had this hospital rotation, but I know now that my expertise in my profession will be best utilized in more of an ambulatory setting. I know that everyone’s first death encounter hits them hard, but I don’t ever want to witness that again. I salute the doctors and nurses and pharmacists that can see that every day and not let their emotions get in the way of them doing their job. Seeing this young man’s death occur before my eyes forever changed me.

I want to thank you for reading this and allowing me to share this experience with you as it has been, in a way, therapeutic to share this story.

My intent is to shed light on just how crucial pharmacists and the entire healthcare team are and how they are literally superhuman. When my rotation came to an end, I told my preceptor how honorable it was to have her teaching me because it takes a special breed to work within the ED environment. They are truly heroes.

And remember, when you’re struggling with stressors of pharmacy school and life in general, try to bring yourself back to gratitude. We are alive.

I remember going home that day and crying to my dad about how cruel the world is around us. It just shows how little we see of it because we live in a bubble that prevents us from having to see the harsh realities of the world. I felt numb that day and for days to follow. This man, whom was a perfect stranger to me, left an irreversible mark on my heart like a tattoo.

His death wasn’t in vain. His death is a reminder to cherish life and to always count your blessings and another important lesson- never judge those that may be struggling with substance/drug abuse.

MARIAM SABBAGH CHATILA

PAIN CREAMS: REAL OR PLACEBO?

With the rise of compounding medications and the need for pain relief gaining popularity in the pharmacy world, a question arises: Do topical pain relief drugs provide relief to patients, or is it a placebo effect? Does it matter?

During my time as a pharmacist intern at InjuryScripts—a private compounding business that specializes in pain relief creams — I was able to see first-hand the interworks of topical pain relief medications. Every day they were producing numerous pain creams for their patients across the U.S. But what do studies tell us about pain relief creams?

In general, studies for topical pain relief are scarce and that’s due to several reasons, one being that it’s difficult to quantify pain relief and the other being that we already have so much data on oral medications.

Additionally, most studies have a small sample size which lowers their credibility.

In 2015, a study was done comparing oral versus topical gabapentin for nerve pain. Some patients cannot

tolerate

the

systemic

effects

of

oral

gabapentin, therefore topical application is a good alternative treatment. It was found in a retrospective study that there was a significant reduction in pain following continuous use of gabapentin, from 1 month of use to 6 months of use, with no side effects reported. It gave rapid relief when compared with oral titration of gabapentin. Further randomized controlled trials are required to validate these findings. (3) In a 2016 systematic review of five drug studies, a total of 3619 participants, topical Ketoprofen was found to be better than oral Celecoxib (Celebrex) in treating knee osteoarthritis and had less side effects. (4) In a 2017 rapid systematic review by WorkSafeBC Evidence-Based Practice Group, they found that studies for gabapentin, ketamine, lidocaine and tramadol compounds for muscle pain were lacking in evidence

on

their

efficacy/effectiveness,

quality

control was “questionable and potential adverse events cannot be discounted”. They concluded that there is no evidence in these compounds treating pain and further studies are needed on topical drug delivery. (2) In a 2019 study of compounded topical pain creams among patients with localized chronic pain at Walter Reed, the 399 patients did not experience better or faster pain relief compared to placebo after 1 month of treatment, and they concluded that it’s not worth the extra cost compared to approved compounds.

The

study

used

compounds

of

gabapentin,

clonidine

and

neuropathic

pain,

ketoprofen,

ketamine,

lidocaine

for

baclofen,

cyclobenzaprine and lidocaine for nociceptive pain,

and

ketamine,

gabapentin,

diclofenac,

baclofen, cyclobenzaprine and lidocaine for mixed pain. (1) It’s clear that more data needs to come out on the topic of topical compounds for pain relief but should this stop patients from purchasing their own creams until then?

At InjuryScripts, many patients have given their testimonies that these pain relief creams were a miracle treatment for their pain, that this was the only product to finally give them relief after trying countless

other

medications.

According

to

pharmacist Kyle Evans at InjuryScripts, he adds that “The problem with treating pain is that pain is subjective.

Everyone’s

perception

of

pain

is

different and can be changed due to multiple factors. It’s hard to get a good representation of something that is constantly changing.”

Whether these patients experience true pain relief through the chemical mechanism of actions or it’s simply a placebo effect, these patients have improved their quality of life and are happier as a result, and at the end of the day, that is a key goal to providing healthcare.

Only time will tell the future of compounding in the pharmacy world…

Kelli Corona

The Benefits of Building and Maintaining Muscle You’ve heard the phrase “the mitochondria is the powerhouse of the cell”, now get ready for: “muscles are the engines of our bodies”. Muscles are where the metaphorical combustion occurs in your body, or in other words, where energy is released, power is produced, and movement originates.

As we age, our bodies naturally lose muscle mass. This is often followed by a series of physiological problems such as bone density loss, metabolic dysfunction, fat gain, diabetes,

Muscularity has commonly been associated with

heart disease, and all-cause mortality.(1) In fact,

athletic

ever

adults who do not perform resistance exercise

participated in a sport, it’s likely that your training

lose almost 5 pounds of muscle every decade

included

some

before even reaching 50 years old.(2) After 50,

capacity. However, as it turns out, Olympic athletes

this number increases to 10 pounds of muscle

and elite competitors aren’t the only ones who should

loss.(3)

performance regular

and

resistance

if

you

exercises

have in

be concerned with building up their muscle mass.

Research has shown that regular strength training expands much further beyond its applications in sports and physical fitness. The conditioning of our muscles can have a major impact on both physical and mental health alike.

Although knowing this may feel intimidating if you

are

someone

who

doesn’t

regularly

participate in resistance training – it’s never too late! Many studies have shown that muscle mass can still be increased in adults of all ages, including those in their 90s!(4,5) Just take competitive bodybuilder Jim Arrington as an example. At 90 years of age, he is still competing

in

bodybuilding

shows

and

attending the gym three times a week for two hours at a time.(6) He has maintained an appreciable

amount

of

muscle

mass

and

functionality, even at his age, accentuating the vast benefits of regular resistance training. If lifting weights and the gym isn’t really your thing, there is a wide variety of weight-bearing activities that can offer the same types of advantages, such as walking, playing tennis, golfing, hiking, Pilates, and the list can go on and on!

The most important thing is finding an activity that you personally enjoy and can stick with on a consistent basis, which will ultimately confer the most health benefits.

Bone

Density

The

loss

of

muscle

mass,

or

sarcopenia, has been associated with osteopenia.(7) This is especially true for women, who may experience from 1% up to a 3% loss of bone mineral density (BMD) per year if they do not engage in resistance exercise. In one study, resistancetrained subjects increased BMD by 1% during a 12month period(3) and, in another study, resistancetrained subjects who also consumed supplemental protein, calcium, and vitamin D increased BMD by 1% during a 9-month period.(8) It’s important to keep in mind that while resistance exercise can increase BMD, the musculoskeletal effects are relatively site specific, and discontinuing strength training can lead to a reversal of the BMD increase, which emphasizes the need to participate in these activities on a steady basis.(9)

However,

due

metabolism

to

the

which

increase offers

in

around

resting 100

calories/day(13), there is an additional 3,000 calories of energy expenditure. This equates to a monthly total of 5,400 calories, or 1.5lbs of fat.

With

this

reduction

in

fat,

particularly

abdominal fat, there is a decreased risk for insulin resistance and potentially metabolic syndrome.(14) A meta-analysis conducted by

Metabolism and Body Fat Muscles can aid in regulating and optimizing your metabolism. At rest, every pound of untrained muscle uses between 5-6 calories per day for proteolysis and protein synthesis.(10) To contrast, every pound of trained muscle uses about 9 calories per day due to the more extensive protein breakdown and repair processes.(11)

Participating

in

weight-bearing

Strasser et al.(15) concluded that strength training can be recommended for both the prevention and management of Type 2 diabetes.

The

American

Diabetes

Association

(ADA)

recommends resistance exercise for all major muscle groups, 3 days/week, progressing to 3 sets of 8 to 10 repetitions each, performed at a higher level of training intensity.(16)

activities causes microtears in the muscular fibers, which then requires a larger energy supply from your body to remodel and make stronger. A single strength training session can increase resting energy expenditure from 5%-9% for 72 hours postworkout. Many studies have shown a 7% increase in your baseline resting metabolic rate after several weeks of regular resistance training.(12) An increase in resting metabolic rate can contribute to lower body fat. Even three 20-minute circuit strength training sessions a week can result in a reduction of 1.5 pounds of fat. If one 20-minute session offers an approximate 200 calories burned, the total monthly energy expenditure directly caused by the training sessions is only 2,400 calories.

Mental Health Annesi and Westcott(17) found that 10 weeks of combined strength and endurance

training

significantly

improved

physical self-esteem, total mood disturbance, depression,

fatigue,

positive

engagement,

revitalization, tranquility, and tension in adults and older adults. Singh et al.(18) found that more than 80% of the previously depressed elderly individuals who performed standard resistance exercise 3 days/week were no longer clinically depressed after completing 10 weeks of the strength training program.

Research

supports

the

influence

of

resistance

training on reducing low-back pain(19), decreasing arthritic

discomfort(20),

and

for

easing

the

symptoms of fibromyalgia(21), as these physical conditions

are

often

associated

with

negative

psychological impact and subsequent reduction in quality of life

Concluding note Those who wish to begin resistance training, regardless of age, sex, or physical condition, should complete a health-screening questionnaire, such as the one recommended in ACSM’s Guidelines for Exercise Testing and Prescription.(24) Those who have two or more of the following risk factors should first obtain guidance from their physician for participation in strength training: Age (men, ≥45 years; women, ≥55 years) Family history of heart disease Cigarette smoking Sedentary lifestyle Obesity (body mass index, ≥30) Hypertension (systolic, ≥140 mmHg; diastolic, ≥90 mmHg) Aging One consequence of aging is a decrease in muscle

mitochondrial

content

and

oxidative

capacity. However, strength training can offset this and slow down this process, as strength training has been shown to increase both things.(22) Melov et al. studied genetic changes in the mitochondrial muscle of older adults after 6 months of standard resistance exercise.(23) The research participants, who had a mean age of 68, were observed to have favorable changes in 179 genes associated with age and exercise performance. After the conclusion of the strength training program, their mitochondrial gene expression was similar to that of moderately active young

adults.

The

researchers

concluded

that

progressive resistance exercise, when performed consistently, can play a role in reversing specific aging factors in skeletal muscle tissue.

Dyslipidemia

(LDL

cholesterol, <40) Prediabetes

cholesterol,

≥130;

HDL

FINDING YOUR PROFESSIONAL SELF INAS MAHDI

When we enter into professional programs, like pharmacy, we are constantly reminded that we have to present ourselves in a professional manner. However, what does it mean to be “professional” and how can we make that transition completely before we graduate pharmacy school? In this article, I am sharing tips and tricks towards finding that professional you. The tips and tricks are things I have learned while being in pharmacy school and working as a pharmacy intern. After all, being a pharmacist is a profession before it is a job.

One of the main ways to start your professionalism journey is to start with how you present yourself. We have all heard the phrase, “dress for the job you want and not the job you have”. Dressing professionally can help boost your confidence and show others that you are serious and excited to be there. In my University of Florida pharmacy school, we are required to dress professionally on the Jacksonville campus. The reason being is that we are in a professional setting, a hospital, and actively running into other professionals and patients.

These requirements really helped me prepare for other situations where I am expected to dress in business casual outside of school. Professional attire includes making sure clothes remain clean and wrinkle free. It helps carrying around a Tide pen to get rid of stains quickly. Another aspect of professional attire is basic hygiene, smelling nice and having clean breath can go a long way. Finding what professional attire best suits you is challenging and may require trial and error. Different body types, different styles, and different cultures can all impact how you dress professionally.

Another way to carry yourself professionally is by working on your speech. Thinking before you speak can go a long way. Take a second to think about what you're about to say and find ways to make it better. If you ever doubt if something you're about to say may be offensive to some, then don't say it. Be sure to set boundaries when talking to others and set it in a calm and professional way. When typing out emails always start with a greeting and avoid emailing people after work hours or later in the day.

This helps set boundaries for you because the other individual will pick up on the fact that you only email during the day. Most email platforms now have a feature when you can schedule to send your emails. I use that to my advantage and it also helps when I need to edit or add something to the email. Sign your emails with your name, role, and how you can be contacted. Avoid using slang and avoid spelling errors. You never know when that email will resurface.

Besides presenting yourself professionally to people you know, I think it's important to do the same to people you do not know. This is important when using social media. This goes without saying, but make sure the posts you post, like, or share are not considered offensive. Even if you think everyone that follows you is just your friends and won’t find offense to it, don’t do it. Your digital footprint will continue on and can resurface to your future employers and patients. I find that it's best to keep my social media accounts less active and think twice before posting anything. It is also reasonable to keep two accounts, one professional and one also professional but for friends. For example, your main account can include helpful information that needs to be shared with colleagues or anyone that comes across your page. Your other account can be private and you share photos of things like what you ate at a restaurant. With that being said, it is important to find the balance of what you like to share and what your professional opinion means.

Although I have addressed the first question posed in this article, the second question is more challenging. Maintaining 100% professionalism at all times might not be so easy, and even the most skilled among us can falter in difficult situations. Whether it's dealing with a disgruntled employee or a colleague who is not meeting expectations, it can be challenging to maintain a professional demeanor. My advice would be to take a deep breath and give yourself a moment to collect your thoughts before reacting. This will allow you to respond in a measured and thoughtful way, even in the face of adversity.

Being professional might be something that is easier said than done for some, but it is important to always be working towards a more professional outlook of life. Changing a few things about the way you dress, talk, and present yourself can boost your professional journey.

The Vital Role of Taking Breaks SARAH AVANS

As pharmacy students navigating a rigorous and demanding academic program, many of us find that having schedules and to-do lists allows us to stay on top of our day-today lives. From lectures to classes to extracurriculars, our schedules are often pretty full.

However, more often than not, there is one vital component missing from our schedules that is equally as important to a productive day: breaks.

Pharmacy school is inherently challenging. The sheer amount of information to learn and absorb can easily lead to an incessant cycle of studying for hours on end while neglecting important aspects of mental health and self-care. Although at the moment it may seem necessary to put off one extra hour of sleep to get another hour of studying in, it is important to remember neglecting to take breaks does not come without its own consequences. Breaks can act as cognitive reset allowing us to enhance

Getting your body moving is important for the body and the mind alike because exercise is a natural outlet for releasing stress as well as leaving us with clearer mindsets.The great part about physical activity is there is no right or wrong way to do it, just get your body moving.

A healthy body supports a healthy mind.

It is easy to fall into the trap of “cramming”, especially when it seems there are just not enough hours in a day to get it all done. Remember that the burnout that often follows extended periods of non-stop studying will never outweigh the benefits of making time for rest and your mental health.

Another way to incorporate breaks is to include short and regular breaks in your study session. Our brains have a limited capacity for sustained focus and

It is too often as pharmacy students that we accept running on empty as being the norm, when in reality this can quickly become detrimental to not just our academics, but our health as well.

concentration, memory, and the overall efficiency of our studying.

Good grades and breaks are not enemies, but instead partners with equal importance to success. One of the most important types of breaks is

overloading it with information will only lead to mental fatigue. Just as muscles get tired after prolonged use, the brain does too. There are many methods out there for incorporating regular breaks such as the Pomodoro Technique, but the important thing is to

Set yourself up for success by welcoming self-care into your routine.

Instead of glorifying a life of constant motion and seeing breaks as a luxury, it is time that they become what they truly are: an essential component of any study session.

physical activity. Long hours of studying often translates into long

find what works for you and stick with it. Presenting information to your brain

periods of sitting, so incorporating physical activity into your schedule is crucial.

in digestible amounts instead of all at once allows you to absorb the information more efficiently.

JESSICA NI

Are We Getting Closer?

Decreased Degrees of Separation

As we age, our journeys introduce us to new faces and names in an everexpanding network. But along with the new introductions we are constantly finding ourselves proclaiming that “it’s a small world.”

Interactions with new people occur all the time but sometimes those people have already been connected to our personal network by a varying degree of separation.1 Frequently it can seem like most interactions lead one person to recognition of the other through a social avenue prior to engagement. This leaves the question: are we getting closer?

The idea of six degrees of separation stems from the 1960s when Stanley Milgram asked people to send a letter to a stranger by using their own network of previous interactions. The letters passed through the hands of six people on average before being delivered to the appropriate person.2

This concept is identifiable today in similar ways but also can present differently and rapidly. For example, fads on TikTok spread bridging from the original poster having a small following, then being shared to a person followed by someone who has thousands of followers- who then spreads the content to a much larger audience. This can allow the interactions to circle back to the original poster in an increasingly short period of time. However, this may still present as a similar degree of separation by their neighbor or family member having been shared the content across the internet, but after six handoffs.

“Conversely, the world of pharmacy is growing each year with new opportunities becoming available all the time. The total number of networks is expanding along with the speed at which information travels. “

There seems to be a decreased

The world of pharmacy may also

degree of separation when

be seen as a smaller total web of

becoming involved in

networks as it is an advanced

specificities. This can be seen

level of career. Conversely, the

when a person takes part in

world of pharmacy is growing

particular activities like sports or

each year with new opportunities

hobbies. Names become known

becoming available all the time.

for their above average

The total number of networks is

performances in special fields of

expanding along with the speed at

the aforementioned. The like can

which information travels.

also happen in the direction of career. When going to school or

Naturally there exists the

becoming part of a trade, it can

requirement for pharmacy

seem like networking potential

students to have a high standard

gets smaller as direction is

of professionalism when

narrowed.

expanding their own network, but

This may just be personal perception as opportunities expand with knowledge and experience gained.

The world can also seem closer given the opportunities fostered by school activities. Students are often given the opportunity to broaden their networks with career fairs, extracurricular activities, and social events which can lead to interactions that seem cyclical in nature. As a student introduces themselves in a school driven event, the person the student may be meeting for the first time could potentially be aware of the student. This can be either positive or negative for the student depending on how the student was portrayed prior to the encounter. These interactions may result in the network physically being smaller in lieu of a school organized event, but they can also be driven by notoriety of the individual.

also when being connected among variable degrees of separation. This specifically applies to when the pharmacy student sets out on introductory pharmacy practice experiences (IPPE) or advanced pharmacy practice experiences (APPE).

These students are expected to hold themselves accountable for always being professional. When a student performs above and beyond in their experiences, they can garner attention unbeknownst to them which can open opportunities later down the road due to the “smaller world” they are enclosed in. The more experiences the student can take part in allows for more opportunities. Their network will exponentially expand internally and externally, drawing the world closer to them.

JESSICA HENSON

The ‘WHY’ BEHIND DRUG SHORTAGES As defined by the Federal Food, Drug, and Cosmetic Act, drug shortages are “a period of time when the demand for a drug exceeds the supply”. Currently, pharmacies around America are being impacted by drug shortages, thereby preventing patients from getting the medications that they need. One of the most requested drugs that is in shortage right now is Oxycodone Hydrochloride and Acetaminophen Tablets. This is a controlled substance narcotic used to relieve severe pain.

The FDA requires manufacturers to notify them of changes in production to help mitigate shortages. Additionally, drug shortages are publicly posted on the ASHP website, along with reasons for the shortage. For Oxycodone, almost all the available strengths are being affected by a shortage. Each company that produces this product can provide a reason for shortage, but many did not. So, what is the real reason that Oxycodone is so hard to come by?

A possible explanation could be due to economics. According to Pharmacy Times, there is “extreme price competition among generic manufacturers”. A lower price competitor entering the market can force older manufacturers to leave or shift to different medications. This leads to drug shortages because the new companies can not support the entire market on its own.

Additionally, the shortage could be due to the lack of ingredients. Pharmacy Times states that over 80% of APIs (active pharmaceutical ingredients) and raw materials come from overseas. The products have become reliant on imports which can cause delays beyond control.

So, how do we fix drug shortages and supply our patients with the medications that they need? In the end, it all boils down to economics. A possible solution can be seen in the manufacturers. If the manufacturers are paid enough to make a profit, they will continue to make an adequate amount of drugs, according to FDA strategies to prevent and respond to drug shortages.

They even state going as far as utilizing a “price support” system for critical drugs to encourage manufacturers to keep producing them.Hopefully, Oxycodone will be easier to access for the patients that need it soon. It is hard to predict when the drug shortage will be over or why it even happened in the first place. Regardless, drug shortages have major impacts on patients across the nation and need to be eliminated as soon as possible. The world of pharmacy is heavily impacted by economics, and it is important to remember that the needs of the patient are critical.

HOW TO: MANAGE STRESS IN PHARMACY SCHOOL AND BEYOND By: Payton Evans

Stress is a normal response to any perceived threat found in the environment. Acute stress or short-term stress can boost energy, motivation, and memory. However, if stress is not managed, it can become detrimental in the long run. Obviously, being pharmacy students, we are continuously reacting to stress whether we are on our APPE rotations or there is a big exam coming up. It is important that we work hard, but we also need to make sure that there are outlets for the stress that is constantly over our heads. Chronic stress impairs the person’s ability to mount a strong immune response which leads to increased morbidity. Long-term stress can increase chances of sickness, sleeping problems, depression, high blood pressure, and lots more.

Since it is almost impossible to avoid stress while in pharmacy school and later on whenever we start working, it is crucial that coping mechanisms for stress are discovered. Also, it is important to have healthy outlets to relieve stress as well. I am going to go through some ways that I have found to relieve stress in a healthy way and give some ideas that you may have never thought about.

1. Going Outside Sure, there may be days where you are so overwhelmed and feel like there are not enough minutes in a day. One way that I have found is that during these days, just going outside can seem so small but have a profound effect on your overall health. Stepping outside can reduce anxiety, stress, and depression. I have found that my favorite place to go is the beach. Since living in Florida for more than half my life, I have found that the beach is my safe haven. There are days when I will go to the beach and just read a good book. Other days, I will take a nice walk or watch the sunrise/sunset. I also love to boogie board and snorkel which leads to the next way to manage stress.

2. Physical Activity Physical activity is imperative whenever it comes to relieving stress. It is important for your overall health as well. According to the CDC, being physically active can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscle, and improve your ability to do everyday activities. Also, being physically active on a regular basis can reduce your risk of depression and anxiety. It can also help you sleep better which are all ways in which stress can be alleviated and not become debilitating. I have found that even if there is not much time in a day, even just going for a quick walk helps to get the blood pumping and helps to relieve stress. It is crucial that in order to stick to physical activity, make sure to pick physical activities that you enjoy and match your abilities. I enjoy going on walks, working out at the gym, and swimming. There are many activities that can be enjoyed while staying physically active.

3. Crocheting This final activity is something that has helped to relieve stress in my own life. If you are someone who has to always be doing something, this is one activity that can potentially help with anxiety and stress. While crocheting, I am able to keep my hands busy while focusing my mind on the project that I am working on. Crocheting has helped me to minimize the effects of stress in my life. I am able to find a positive outlet for my stress and anxiety which has been imperative for my mental health. Crocheting is something that I personally enjoy. However, others may find that this is not their niche. There are other crafting activities that you can do.

This includes knitting, coloring, painting, drawing, and so much more.

Navigating Pharmacy School: Why You Should Join Org’s Annemarie Rodriguez

It's time to talk about one of the best parts of pharmacy school: organizations. As a student pharmacist, being actively involved in professional organizations is a major stepping stone towards a successful time in the program, and further down the line, our career. While the idea of joining can seem stressful and time-consuming, if done in moderation students can benefit greatly- both personally and professionally.

One of the main advantages in joining organizations is networking! We all hear it all the time- pharmacy is a small world.

Networking allows you to connect with your peers, faculty members, and professionals in all fields of pharmacy. The connections you make can help create a supportive community and allow for the exchange of knowledge, insight, and experiences as fellow healthcare providers.

Building a strong network is crucial to our career development and can open the doors to residencies, research projects, and potential job opportunities.

From my personal experience, I can't recommend reaching out enough! I’ve been able to join multiple research projects and have had many shadowing opportunities presented just by reaching out to people on campus!

Professional organizations also offer a wealth of educational resources that supplement our academic curriculum. All organizations provide access to seminars, workshops, and conferences that enable student pharmacists to deepen their understanding of pharmaceutical sciences while staying informed about advancements in the field.

Additionally, they provide us with a plethora of volunteering opportunities, allowing us to strengthen ties with the community and provide them information or perform tests on them- such as blood pressure and glucose readings.

Being engaged in these associations help grow leadership and teamwork skills, which are qualities that are valued in our profession (no matter the path you take).

All organizations provide opportunities for students to take on leadership roles, organizing events, and participating on committees. Over the summer I had the incredible opportunity to go to Washington D.C. with APhA. At the convention I was able to expand my communication skills by having to interact with people I had never met before. It sounds scary, but now it's one of my favorite memories of my time in school (so far). These experiences help not only build confidence, but also help us to work on and strengthen the soft skills that are necessary for effective collaboration in the classroom and workplace.

Finally, the greatest advantage: they allow you to take a break. Getting a doctorate is not easy and it's not meant to be. Due to how rigorous the curriculum can be, it's understandable if all you want to do is study! However, studying cannot be all you do because most people will burn out very quickly.

By being involved you get to make more friends, go out to social events, and take a pause to go be a human and relax.

Joining an organization is not a mandatory part of being in the program and it is possible to get through school without being involved. However, by getting involved you get to enhance your time here and you're able to open a lot more doors for yourself and for your future.

The Jax Campus Crossword Puzzle 1 2

3

4

5

6 7

Across

Down

2. A large body of water that the Jacksonville campus is famous for

1. Our awesome academic coordinator

3. America runs on

2. 10th floor

4. Pharmacy students run on

4. Some exams are held here and there is no room to place your stuff

5. Student organizations hold lots of meetings

6. We struggle with finding this before class

here 7. Student hang out spot between classes

Big shoutout to the talented writers and editors!

THE FACE OF DEATH CAITLIN YOUNG PAIN CREAMS: REAL OR PLACEBO? MARIAM SABBAGH CHATILA

THE BENEFITS OF BUILDING AND MAINTAINING MUSCLE KELLI CORONA FINDING YOUR PROFESSIONAL SELF INAS MAHDI THE VITAL ROLE OF TAKING BREAKS SARAH AVANS ARE WE GETTING CLOSER? DECREASED DEGREES OF SEPARATION JESSICA NI THE WHY BEHIND DRUG SHORTAGES JESSICA HENSON HOW TO: MANAGE STRESS IN PHARMACY SCHOOL AND BEYOND PAYTON EVANS NAVIGATING PHARMACY SCHOOL: WHY YOU SHOULD JOIN ORG’S ANNEMARIE RODRIGUEZ

EDITORS KENDRICK PANOCH LINDSAY SOLANO JESSICA NI

EDITOR-IN-CHIEF INAS MAHDI

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