The Script Issue 46 by CJMarketing

Pharmacy Magazine

FREE INSIDoEu!r

Claim y tary n complimeining PDA tra le! modu

Diabetes Awareness month

Healthy living with diabetes

CORPORATE PUBLICATION FREE â&#x20AC;˘ NOT FOR SALE

How to avoid prescription fraud

World Aids Day 1 December

Issue 46

world diabetes day 14 November

UNDERSTAND DIABETES KNOW THE WARNING SIGNS weight loss

frequent urination

excessive thirst

lack of energy

Diabetes can affect anyone. If left untreated, it is deadly. If you show these signs, seek medical attention now. These signs can be mild or absent in people with type 2 diabetes. See all the warning signs at www.worlddiabetesday.org

www.worlddiabetesday.org

Nr. 12, 4th Street, Delmas PO Box 186, Delmas 2210 Tel: 013 665 1011 Fax: 013 665 4713 Registered: CJ Pharmaceutical Enterprises (PTY) Ltd. VAT Reg. 409 0205 909 Reg: 2001/009972.06 Telesales Anette, Beauty, Secci & Portia [fax] 086 697 9506 email: telesales@cjpharm.co.za

Customer Care Brenda, Ester, Ignitious, Nonhlanhla & Pricilla [fax] 086 589 5983 email: customercare@cjpharm.co.za

Operations Egon Sellner (COO) email: esellner@cjpharm.co.za

Customer Relations Theuns [cell] 072 638 4085 email: theuns.w@cjpharm.co.za

Ridwaan [cell] 072 534 8135 email: ridwaan@cjpharm.co.za

Lynne [cell] 071 472 7522 email: lynne@cjpharm.co.za

Index VIP Days

Important industry days to remember.

Pam [cell] 071 480 5322 email: pam.vc@cjpharm.co.za

Darren Brooks (CMO) [cell] 083 229 5212

email: darren@cjpharm.co.za

Account Queries Debtors : Maritsa

email: maritsa@cjpharm.co.za

Creditors : Sonja

email: sonja@cjpharm.co.za

Buying Department Estelle email: estelle@cjpharm.co.za Christa email: christa@cjpharm.co.za Inventory Manager Erika Oehley

The Role of the Pharmacist in the Care of Patients With Diabetes

The role that a pharmacist can play in the care taking of Diabetic patients

CPR, Know Your Stuff!

Information on CPR and how to implement it

email: erika@cjpharm.co.za

Tech & Data Reporting Werner email: it@cjpharm.co.za Senior Management Christopher Williams (CEO) email: willchem@global.co.za

Chris Williams (MD)

email: chris@cjpharm.co.za

Darren Brooks (CMO)

Prescription Fraud

Become aware of the potential situations where drug diversion can occur and safeguards that can be enacted to prevent this.

email: darren@cjpharm.co.za

Food 22 Diabetic friendly recipes Nr. 7, 4th Street, Delmas PO Box 186, Delmas 2210 [Tel:] 013 010 0091 [Fax:] 086 698 1468 Advertising & Promotions Jan Bester (Marketing Coordinator) email: cjmarketing@cjpharm.co.za

[fax] 086 698 1468 Thea Botes

email: marketing@cjpharm.co.za

PDA - Complimentary Training Module

Module 5 in the series is now available.

When the Big Bugs Bite

A look into the treatment and prevention of malaria

[fax] 086 698 1468 Customer Relations Theuns [cell] 072 638 4085

World Aids Day

Lynne[cell] 071 472 7522

New date shows country may see a decline in new HIV cases

email: theuns.w@cjpharm.co.za

email: lynne@cjpharm.co.za

Ridwaan [cell] 072 534 8135

email: ridwaan@cjpharm.co.za

Pam [cell] 071 480 5322 email: pam.vc@cjpharm.co.za

Darren Brooks (CMO) [cell] 083 229 5212 email: darren@cjpharm.co.za

Account Queries Debtors : Caron email: finance@cjpharm.co.za Magazine Design & Layout Marizelle Geldenhuis (Creative Director) Carl Loggenberg (Graphic Designer) Clarissa van der Linde (Junior Graphic Designer)

About the Cover Every year Diabetes Awareness Month is commemorated on 14 November to raise awareness for the treatment and testing of those living with diabetes. Over 1,2 million South Africans are living with Diabetes while 85% of South Africa diabetics are undiagnosed. The 2014 theme for World Diabetes Day is “Healthy Living and Diabetes” The Script Pharmacy Magazine │November 2014 • December 2014

VIPDAYS

Keep your eye on our calendar for important industry dates. To contribute events to our calendar, kindly email marketing@cjpharm.co.za 03NOV2014 SADC Malaria Week

14NOV2014 World Diabetes Day World Diabetes Day (WDD) is celebrated every year on November 14. The World Diabetes Day campaign is led by the International Diabetes Federation (IDF) and its member associations. It engages millions of people worldwide in diabetes advocacy and awareness. World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization in response to growing concerns about the escalating health threat that diabetes now poses. World Diabetes Day became an official United Nations Day in 2007 with the passage of United Nation Resolution 61/225. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public spotlight. World Diabetes Day is a campaign that features a new theme chosen by the International Diabetes Federation each year to address issues facing the global diabetes community. While the themed campaigns last the whole year, the day itself is celebrated on November 14, to mark the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in 1921. Healthy Living and Diabetes is the World Diabetes Day theme for 2014-2016.

According to the World Health Organisation, about 63 percent of people in the Southern African region are living in areas that are affected by malaria, with pregnant women and children under the age of five being at greater risk. The Southern African Development Community (SADC) countries recognise malaria as a major concern and one of the number one killers and causes of poverty in the region. As a result, SADC countries have become participants to the Abuja declaration of halving malaria deaths by the year 2010 and the millennium development goal of reducing malaria deaths among children under the age of five by two thirds by the year 2015, as part of their interventions. The month of November is the malaria transmission season in the SADC region. Therefore, commemoration of SADC Malaria Week joined by SADC Malaria Day take place in the second week of November every year to coincide with this season. The aim is to raise awareness and promote partnerships in the fight against the disease.

25NOV2014 - 10DEC2014 16 Days of Activism for No Violence Against Woman And Children 16 Days of Activism for No Violence against Women and Children The 16 Days of Activism for No Violence against Women and Children is an international campaign that takes place every year from 25 November (International Day for the Elimination of Violence against Women) to 10 December (International Human Rights Day). The period includes Universal Children’s Day and World AIDS Day.

03DEC2014 International Day of Persons With Disabilities The United Nations Decade of Disabled Persons was held from 1983 to 1992 to enable governments and organizations to implement measures to improve the life of disabled persons all over the world. On October 14, 1992, as this decade drew to a close, the UN General Assembly proclaimed December 3 as the International Day of Disabled Persons. This day was first observed on December 3, 1992. On December 18, 2007, the assembly changed the observance’s name from the “International Day of Disabled Persons” to the “International Day of Persons with Disabilities”. The new name was first used in 2008.

03NOV2014 National Children’s Day The Government of the Republic of South Africa declared the first Saturday of November as the National Children’s Day. The aim of the National Children’s Day celebration is to highlight progress being made towards the realisation and promotion of rights of children.

The Script Pharmacy Magazine │November 2014 • December 2014

The power you need. The ocular comfort patients appreciate. AZARGA® Suspension delivers the efficacy you expect with the comfort patients want.

79.2

of patients who stated a preference preferred AZARGA® Suspension1 – Superior comfort compared to dorzolamide 2%/timolol 0.5%1,2*

†

†Based on patient preference.

Up to

of IOP reduction from untreated baseline in patients with open-angle glaucoma or ocular hypertension3 y Range from 28.4% to 34.9%.

There’s no reason to sacrifice patient comfort. References: 1. Mundorf TK, et al. Brinzolamide/Timolol Preference Study Group. A patient preference comparison of Azarga™ (brinzolamide/timolol fixed combination) vs Cosopt® (dorzolamide/timolol fixed combination) in patients with open-angle glaucoma or ocular hypertension. Clin Ophthalmol. 2008;2(3):623-628. 2. Vold SD, et al. Brinzolamide/Timolol Comfort Study Group. A one-week comfort study of BID-dosed brinzolamide 1%/timolol 0.5% ophthalmic suspension fixed combination compared to BID-dosed dorzolamide 2%/timolol 0.5% ophthalmic solution in patients with open-angle glaucoma or ocular hypertension. J Ocul Pharmacol Ther. 2008;24(6):601-605. 3. Manni G, et al. The safety and efficacy of brinzolamide 1%/timolol 0.5% fixed combination versus dorzolamide 2%/timolol 0.5% in patients with open-angle glaucoma or ocular hypertension. J Glaucoma. 2009;18(4):293-300. *Comparison versus dorzolamide 2%/timolol 0.5% fixed combination in an ocular discomfort assessment2. S4 AZARGA® Eye Drops, suspension. 1 ml of suspension contains 10 mg brinzolamide and 5 mg timolol (as timolol maleate). Reg. No.: 44/15.4/0046. Please refer to package insert for further information. Alcon Laboratories (SA) (Pty) Ltd, P O Box 3198, Randburg, 2125. Tel: (011) 840-2300. August 2014. P-AZA-004-V3. Expiry date: August 2016.

WHERE STRENGTH MEETS COMFORT

Feature Header

The role of the Pharmacist in the care of patients with Diabetes. 6

The Script Pharmacy Magazine â&#x201D;&#x201A;November 2014 â&#x20AC;˘ December 2014

Awareness

The effective delivery of health care requires a partnership between people and their health-care providers. Because of the multidisciplinary nature of diabetes care, this team-based approach is appropriate. Indeed, a multidisciplinary team approach involving people with diabetes and health-care providers, such as nurses, dietitians, pharmacists, and physicians, has been proven to result in lower average levels of blood glucose, a reduction in diabetes complications, and improved quality of life. As vital members of any health-care team, pharmacists can have a significant impact on diabetes care and education. In certain circumstances, pharmacists may be in a position to identify people with diabetes, offer advice on their condition, and encourage them to seek appropriate medical care. Importantly, pharmacists see people with diabetes on average up to seven times more often than other health-care providers and have an important role in the provision of diabetes supplies. This requires pharmacists to offer guidance in the effective use of these products. In recent years, the role of pharmacists in diabetes care has expanded in countries throughout the world.

Pharmacists and education A study into the attitudes of pharmacists in Canada towards diabetes care concluded that “pharmacists agree that they should be part of the health-care team for managing diabetes; should be required to have specialized training to provide primary diabetes care; and, that they have the skills to become diabetes educators”. Indeed, pharmacists can provide motivational and technical support to people with diabetes. The provision of education is one of the pharmacists’ key roles. Because of their easy access to people with diabetes, they are able to answer doubts and queries about the condition itself, offer guidance on the proper use of medications and other supplies. Being able to offer education to people with diabetes and health-care providers on available medications, a pharmacist can become a very useful tool in empowering people to take charge of their condition.

People with diabetes can clearly benefit from improved knowledge in this field, which includes:

• •

how diabetes drugs work how these interact with other medications • the speed and duration of the effects of the drugs – and the factors that affect these Roadblocks. If a pharmacist adequately assesses and monitors people with diabetes, timely referrals can be made to specialist healthcare providers, including ophthalmologists, podiatrists, dietitians, and psychologists. However, finding time to care for people has become a challenge in itself. Indeed, this is one of the principal roadblocks to the extended involvement of pharmacists in diabetes care. Underlying such obstacles is a discord between the way the work of pharmacists is evaluated, and the professional hopes and objectives of the pharmacists themselves. Pharmacists are trained to do more than just dispense drugs - But while productivity continues to be measured in terms of the number of prescriptions a pharmacist fills in, the focus is taken away from any impact on health care.

Opportunity knocks It is increasingly recognized that people’s health outcomes can be improved with the intervention of pharmacists. Indeed, there has never been a better time for pharmacists to embrace the concept of pharmaceutical care and enter into partnership with people with chronic health conditions like diabetes. Currently, for people with diabetes in the developed countries, these are the best of times, with the continual development of ever newer and more effective diabetes supplies that can improve care and

quality of life. This represents an excellent opportunity for all those health-care providers who wish to make a difference in the lives of the people in their care. The roadblocks can be removed Editorial Credit Taken from Diabetes Voice (www. idf.org) - Written by Keith Campbell- Keith Campbell is Distinguished Professor of Pharmacy at Washington State University College of Pharmacy, Pullman, USA. The American Diabetes Association’s Standards of Diabetes Care Checklist is available from www.diabetes.org References 1 Schapansky LM, Johnson JA. Pharmacists’ attitudes toward diabetes. J Am Pharm Assoc 2000; 40: 371-7. 2 Cranor DW, Christenson DB. The Ashville Project: Factors Associated with Outcomes of a Community Pharmacy Diabetes Care Program. J Am Pharm Assoc 2003; 43: 160-72.

Things to do in your pharmacy to promote Diabetes awareness and care: •

• •

•

Publish a monthly newsletter with Healthy Eating Tips, Information on medication and disease management. Start a Diabetes outreach program offering blood glucose testing and advice. Weight management programs - Educating your community about the link between being overweight and Type 2 Diabetes is essential. Prevention is always better than cure. Sponsor a family fun walk, an ideal way communicate to younger generations and their parents why staying active is essential for a healthy body and mind.

The Script Pharmacy Magazine │November 2014 • December 2014

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CPR

know your stuff! The use of CPR dates all the way back to 1740, yet even today, most people don’t know how to perform it. Given properly and immediately to sudden cardiac arrest victims, CPR can save lives. Anyone can learn CPR – and everyone should! Sadly, 80 percent of the population may feel helpless to act during a cardiac emergency because they either do not know how to administer CPR or their training has significantly lapsed. This alarming statistic could hit close to home, because home is exactly where 88 percent of cardiac arrests occur. Put very simply: The life you save with CPR is mostly likely to be someone you love. Once you have learned CPR, give 5 people you care about the power to save lives by equipping them to act quickly in a crisis. Don’t be afraid; your actions can only help. If you see an unresponsive adult who is not breathing or not breathing normally, call emergency services and push hard and fast on the center of the chest.

Why learn CPR? • Cardiac arrests are more common than you think, and they can happen to anyone at any time. • Nearly 383,000 out-of-hospital sudden cardiac arrests occur annually, and 88 percent of cardiac arrests occur at home. • Many victims appear healthy with no known heart disease or other risk factors. • Sudden cardiac arrest is not the same as a heart attack. • Sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating. • A heart attack occurs when the blood supply to part of the heart muscle is blocked. A heart attack may cause cardiac arrest. WHO CAN YOU SAVE WITH CPR? The life you save with CPR is mostly likely to be a loved one.

The Script Pharmacy Magazine │November 2014 • December 2014

• Four out of five cardiac arrests happen at home. • Statistically speaking, if called on to administer CPR in an emergency, the life you save is likely to be someone at home: a child, a spouse, a parent or a friend. • Africans are almost twice as likely to experience cardiac arrest at home, work or in another public location than Caucasians, and their survival rates are twice as poor as for Caucasians.

Why take action? • Failure to act in a cardiac emergency can lead to unnecessary deaths. • Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but only 32 percent of cardiac arrest victims get CPR from a bystander. • Sadly, less than eight percent of people who suffer cardiac arrest outside the hospital survive.

Awareness

See a video, save a life

You can prepare yourself to act in an emergency by simply viewing the Hands-Only™ CPR instructional video. A study published in the March 8 issue of Circulation: Cardiovascular Quality and Outcomes showed that people who view a CPR instructional video are significantly more likely to attempt life-saving resuscitation. Hands-Only™ CPR (CPR with just chest compressions) has been proven to be as effective as CPR with breaths in treating adult cardiac arrest victims. CPR is typically administered in cases of cardiac arrest. Signs of cardiac arrest include an absence of heartbeats, blood flow and pulse. When blood stops flowing to the brain, the person becomes unconscious and stops regular breathing.

The ABCs of CPR Airway

•

• •

•

If a person has collapsed, determine if the person is unconscious. Gently prod the victim and shout, “Are you okay?” If there is no response, shout for help. Call 911 or your local emergency number. If the person is not lying flat on his or her back, roll him or her over, moving the entire body at one time. Open the person’s airway. Lift up the chin gently with one hand while pushing down on the forehead with the other to tilt the head back. (Do not try to open the airway using a jaw thrust for injured victims. Be sure to employ this head tilt-chin lift for all victims, even if the person is injured.) If the person may have suffered a neck injury, in a diving or automobile accident, for example, open the airway using the chin-lift without tilting the head back. If the airway remains blocked, tilt the head slowly and gently until the airway is open. Once the airway is open, check to see if the person is breathing. Take five to 10 seconds (no more than 10 seconds) to verify normal breathing in an unconscious adult, or for the existence or absence of breathing in an infant or child who is not responding. If opening the airway does not

cause the person to begin to breathe, it is advised that you begin providing rescue breathing (or, minimally, begin providing chest compressions).

Breathing (Rescue Breathing) Pinch the person’s nose shut using your thumb and forefinger. Keep the heel of your hand on the person’s forehead to maintain the head tilt. Your other hand should remain under the person’s chin, lifting up. • Inhale normally (not deeply) before giving a rescue breath to a victim. • Immediately give two full breaths while maintaining an air-tight seal with your mouth on the person’s mouth. Each breath should be one second in duration and should make the victim’s chest rise. (If the chest does not rise after the first breath is delivered, perform the head tilt-chin lift a second time before administering the second breath.) Avoid giving too many breaths or breaths that are too large or forceful.

•

Using an AED in conjunction with CPR:

•

Circulation (Chest Compressions) After giving two full breaths, immediately begin chest compressions (and cycles of compressions and rescue breaths). Do not take the time to locate the person’s pulse to check for signs of blood circulation. • Kneel at the person’s side, near his or her chest. With the middle and forefingers of the hand nearest the legs, locate the notch where the bottom rims of the rib cage meet in the middle of the chest. • Place the heel of the hand on the breastbone (sternum) next to the notch, which is located in the center of the chest, between the nipples. Place your other hand on top of the one that is in position. Be sure to keep your fingers up off the chest wall. You may find it easier to do this if you interlock your fingers. • Bring your shoulders directly over the person’s sternum. Press downward, keeping your arms straight. Push hard and fast. For an adult, depress the sternum about a third to a half the depth of the chest. Then, relax pressure on the sternum completely. Do

not remove your hands from the person’s sternum, but do allow the chest to return to its normal position between compressions. Relaxation and compression should be of equal duration. Avoid interruptions in chest compressions (to prevent stoppage of blood flow). Use 30 chest compressions to every two breaths (or about five cycles of 30:2 compressions and ventilations every two minutes) for all victims (excluding newborns). You must compress at the rate of about 100 times per minute. Continue CPR until advanced life support is available.

•

If using an AED (Automated External Defibrillation) in the case of a heart attack or cardiac arrest, single shocks should be followed by immediate CPR for two minutes. Heart rhythm checks should be performed every two minutes (or after giving about five cycles of CPR); the AED will provide audible prompts at the appropriate intervals. See AED section for details. If using an AED on a one- to eight-year-old child, use a childdose-reduction system if available. (However, do not use child pads or a child dose on adults in cardiac arrest because the smaller dose may not defibrillate adults properly.)

Taken from The American Hearth Association – CPR Statistics http://www.heart.org/

DID YOU KNOW:

In the 1740s, The Paris Academy of Sciences officially recommended mouth-to-mouth resuscitation for drowning victims and in 1767 The Society for the Recovery of Drowned Persons became the first organized effort to deal with sudden and unexpected death. Then in 1891 Dr. Friedrich Maass performed the first equivocally documented chest compression in humans.

The Script Pharmacy Magazine │November 2014 • December 2014

UNDERSTAND TYPE 2 DIABETES ARE YOU AT RISK? lack of exercise

family history

overweight

unhealthy diet

Diabetes can affect anyone. If left untreated, it is deadly. Seven million people are diagnosed with type 2 diabetes each year. If you think youâ&#x20AC;&#x2122;re at risk, get tested. See all the risk factors at www.worlddiabetesday.org

www.worlddiabetesday.org

diabetes DIABETES:

PROTECT OUR FUTURE www.worlddiabetesday.org

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For more information, contact Estelle van Tonder on Tel: 013 665 1011, Fax: 086 529 1645 or Email: estelle@cjpharm.co.za 12

The Script Pharmacy Magazine │November 2014 • December 2014

Tips on receiving stock to avoid any costly mistakes:

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• Check every invoice number (and the number of boxes and parcels per invoice) individually. (Please don’t just reconcile the total number of boxes / parcels delivered, to the quantities indicated on the POD?) • If our driver is calling the invoice numbers, please ensure that you witness the process and place the verified boxes / parcels to one side. • In the event of a box not being received or if a box is visibly damaged the Receiving Person must immediately declare it - next to the Invoice number on the POD. (Ex. “Box not received”, “Box damaged”) • Once the POD has been signed, and no specific endorsements have been made, CJ Pharmaceuticals cannot be held liable for any boxes/parcels not received. • Please get the driver to counter sign the endorsement. • •

Please take note that the absence of a tick, or a cross, next to the undelivered invoice number cannot suffice as a proper endorsement. As a final check we suggest that you do a count of all the boxes and parcels that were delivered and balance that back to the quantities indicated on the POD.

We trust that the suggestions will enable both parties to solely rely on the POD in case of any future discrepancies or claims.

Thank you, Erika Oehley

Inventory Risk Manager Tel: 013 665 1011 or E-mail: erika@cjpharm.co.za

The Script Pharmacy Magazine │November 2014 • December 2014

Faster, longer-lasting relief from symptoms of burning and irritation associated with dry eye Forms a protective shield over the eyes to provide enduring relief - day or night

Family of Products

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A highly refined Omega-3 supplement for your eyes

Video Refer to package insert for further information. Alcon Laboratories (SA) (Pty) Ltd., P.O. Box 3198, Randburg, 2125 - Tel: (011) 840-2300. August 2014. P-SYS-012-V1. Exp: 08/2016

Awareness

Prescription fraud! You as pharmacist have a personal responsibility to protect your practice from becoming an easy target for drug diversion. You must become aware of the potential situations where drug diversion can occur and safeguards that can be enacted to prevent this diversion.

The purpose of this guide is to ensure that controlled substances continue to be available for legitimate medical and

•

diversion into the illicit market. It is not the intent of this publication to reduce or deny the use of controlled substances where medically indicated. Nothing in this guide should be construed as authorizing or permitting any person to conduct any act that is not authorized or permitted under national or provintional laws. The dispensing pharmacist must maintain constant vigilance against forged or altered prescriptions. The law holds the pharmacist responsible for knowingly dispensing a prescription that was not issued in the usual course of professional treatment.

a biweekly, weekly or even a daily basis. • The prescriber writes prescriptions for antagonistic drugs, such as depressants and stimulants, at the same time. Drug abusers often request prescriptions for “uppers and downers” at the same time. • Patient appears presenting prescriptions written in the names of other people. • A number of people appear simultaneously, or within a short time, all bearing similar prescriptions from the same physician. • Numerous “strangers,” people who are not regular patrons or residents of your community, suddenly show up with prescriptions from the same physician. Characteristics of Forged Prescriptions • Prescription looks “too good”; the prescriber’s handwriting is too legible; • Quantities, directions or dosages differ from usual medical usage; • Prescription does not comply with the acceptable standard abbreviations or appear to be textbook presentations; • Prescription appears to be photocopied; • Directions written in full with no abbreviations;

The patient appears to be returning too frequently. A prescription which should have lasted for a month in

•

prescriber wrote it? When there is a question concerning any aspect of the prescription -

Types of Fraudulent Prescriptions • Legitimate prescription pads are -

•

tious patients. additional amounts of legitimately prescribed drugs, alter the physician’s prescription. Some drug abusers will have prescription pads from a legitimate back number that is answered by an accomplice to verify the prescription. Some drug abusers will call in their own prescriptions and give their own telephone number as a call

•

Computers are often used to create prescriptions for nonexistent doctors or to copy legitimate doctors’ prescriptions. The following criteria may indicate that the purported prescription was not issued for a legitimate medical purpose.

•

more prescriptions (or in larger quantities) compared to other practitioners in your area.

•

ing.

Prevention Techniques

• • •

Know the prescriber and his or her signature; Know the prescriber’s practive number; Know the patient, and Check the date on the prescription order. Has it been presented to you in a reasonable length of time since the

•

Should there be a discrepancy, the patient must have a plausible reason before the prescription medication is dispensed. Any time you are in doubt, you Although this procedure isn’t fool-

•

be stolen or forged), it does increase the drug abuser’s risk. If you believe that you have a forged, altered, or counterfeited prescription—don’t dispense it—call your local police. If you believe that you have discovered a pattern of prescription abuses, contact your local athorities immediately.

Proper Controls Loose or routine dispensing procedures, without controls and professional cautions, are invitations to the drug abuser. Proper controls against fraudulent prescriptions can best be accomplished by following common sense, sound professional practice, and using proper dispensing procedures and controls. your practice from becoming a source for prescription drug diversion. Become familiar with which drugs are popular for abuse and resale on the streets in your area. Drug abuse prevention must be an Encourage local pharmacists and physicians to develop a network, or at least a working relationship, which promotes teamwork and camaraderie. Discuss abuse problems with other pharmacists and physicians in the community. Most drug abusers seek out areas where communication and cooperation between health professionals are minimal because it makes their work so much easier.

17 - 21 November, is National Fraud Awareness Week

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For every cigarette, there’s a nicorette. * Depends on smoking patterns nicorette® Gum 2 mg: Each piece contains nicotine-resin complex 20% 10,0 mg equivalent to 2 mg nicotine. Reg.No.: P/34/187. nicorette® Gum 4 mg: Each piece contains nicotine-resin complex 20% 20,0 mg equivalent to 4 mg nicotine. Reg.No.: P/34/188. nicorette® Mint Gum 2 mg: Each piece contains nicotine-resin complex 20% 10,0 mg equivalent to 2 mg nicotine. Reg.No.: 30/34/0272. nicorette® Mint Gum 4 mg: Each piece contains nicotine-resin complex 20% 20,0 mg equivalent to 4 mg nicotine. Reg.No.: 30/34/0273. For full prescribing information refer to the package insert approved by the Medicines Control Council. ® Trademark © Johnson & Johnson (Pty) Ltd 2014. Always read the label. Stop smoking aid. Requires willpower. nicorette® contains

nicotine. 12/NIC/11/13/P/JA.

www.nicorette.co.za The Script Pharmacy Magazine │November 2014 • December 2014

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For more information contact : 013 665 1011 or email : customercare@cjpharm.co.za

Laugh a little

IT husband Starting the day with a conversation between a wife and a husband who happens to be a software engineer. Husband: (Returning late from work) “Good Morning Dear, I’m now logged in.” Wife: Have you brought the grocery? Husband: Bad command or file name. Wife: But I told you in the morning Husband: Erroneous syntax. Abort? Wife: What about my new TV? Husband: Variable not found… Wife: At least, give me your Credit Card, I want to do some shopping. Husband: Sharing Violation. Access denied… Wife: Do you love me or do you only love computers or are you just being funny? Husband: Too many parameters… Wife: It was a great mistake that I married an idiot like you. Husband: Data type mismatch. Wife: You are useless. Husband: It’s by Default. Wife: What about your Salary? Husband: File in use… Try after some time. Wife: What is my value in the family. Husband: Unknown Virus

Marketing strategies explained more!! 1. You’re at a party and see gorgeous girl. You get up and straighten your tie, you walk up to her and pour her a drink, you open the door (of the car) for her, pick up her bag after she drops it, offer her ride and then say:”By the way, I’m rich. Will you “Marry Me?” – That’s Public Relations… “ 2. You’re at a party and see gorgeous girl.

She walks up to you and says:”You are very rich! “Can you marry ! me?” – That’s Brand Recognition. ..” 3. You see a gorgeous girl at a party. You go up to her and say: “I am very rich. Marry me!” She gives you a nice hard slap on your face. – “That’s Customer Feedback…” 4. You see a gorgeous girl at a party. You go up to her and say: “I am very rich. Marry me!” And she introduces you to her husband. – “That’s demand and supply gap…” 5. You see a gorgeous girl at a party. You go up to her and before you say anything, another person come and tell her: “I’m rich. Will you marry me?” and she goes with him – “That’s competition eating into your market share…” 6. You see a gorgeous girl at a party. You go up to her and before you say: “I’m rich, Marry me!” your wife arrives. – “That’s restriction for entering new markets…”

Evils of liquor A professor of chemistry wanted to teach his 5th grade class a lesson about the evils of liquor, so he produced an experiment that involved a glass of water, a glass of whiskey and two worms. Professor “Now, class. Observe closely the worms,” said the professor putting a worm first into the water. The worm in the water writhed about, happy as a worm in water could be. The second worm, he put into the whiskey. It writhed painfully, and quickly sank to the bottom, dead as a doornail. “Now, what lesson can we derive from this experiment?” the professor asked. Shyam, who naturally sits in back, raised his hand and wisely, responded, “Drink whiskey and you won’t get worms.”

Side effects A man is cutting sides of a capsule before talking it. His neighbour saw this and asked him, “Why are you cutting the sides of the capsule? He replied, “To avoid side effects.”

Listen the lecture A cop stops a drunk man and asks: Where you going? He replies : “I’m going to listen the lecture about the harm of the drunkenness and alcoholism.” Police cop says : “At night? And who will give a lecture?” My wife and mother-in-law!replies the drunk man.

Rebel DO NOT READ THE NEXT SENTENCE. You little rebel, I like you.

The Script Pharmacy Magazine │November 2014 • December 2014

TREAT DIARRHOEA EFFECTIVELY: KNOW THE FACTS AND RECOMMEND THE NO.1 BRAND (1) Unfortunately there are a few old wives’ tales and myths surrounding the use of Imodium® in treating diarrhoea. For those who still think that diarrhoea is just a ‘bug’ that needs to run its course - think again. Myth 1 It’s best to let diarrhoea run its course to get ‘the bug’ out. Fact: Treating diarrhoea does not keep ‘the bug’ in. Diarrhoea is NOT always a response to get rid of an infection. Therefore treating diarrhoea early will help relieve the symptoms and allow your customers to get on with their lives. Myth 2 It is possible to become addicted to the medicine if it is used frequently. Fact: When used as directed, Imodium® products are nonhabit forming. Myth 3 Imodium® should not be taken together with other medicines because of potential interactions. Fact: When taking Imodium®, only a very small amount of the medicine is absorbed from the digestive tract. There have been no clinically significant drug interactions reported with loperamide, the active ingredient in Imodium®.

Myth 4 If a child has diarrhoea, it’s best to let the condition run its course. Fact: Diarrhoea in children can lead to dehydration. If left untreated this is particularly dangerous as children can dehydrate much faster than adults. Myth 5 An anti-diarrhoeal medicine can slow down or stop bowel movements completely. Fact: When used as directed, Imodium® is designed to help return the intestinal system to normal, as speedily as possible. It works by giving the colon more time to absorb water in the stool, and by restoring normal contractions to the muscles in the small intestine resulting in fewer bowel movements. Myth 6 Diarrhoea caused by stress should not be treated with Imodium®. Fact: Imodium® can be used for non-specific diarrhoea bouts - even those caused by stress. Imodium® has been specially formulated to work with the body to help restore its normal rhythm as rapidly as possible, even when stressed. Myth 7 Taking Imodium® is too extreme a measure in mild bouts of diarrhoea. Fact: Imodium® can be used for non-specific diarrhoea. It helps by slowing down the intestinal system to its normal pace, regardless of the intensity of the diarrhoeal bout. Reference: 1. IMS Data MAT to July 2013. S2 Imodium® Melt tablets. Each tablet contains 2 mg loperamide HCl. Reg. No. 29/11.9/0213. S2 Imodium® tablets. Each tablet contains 2 mg loperamide HCl. Reg. No. H/11.9/152 S2 Imodium® syrup. Each ml contains 0.2 mg loperamide HCL. Reg. No. J/11.9/166. For full prescribing information, please refer to the package insert approved by the Medicines Control Council. ® Trademark © Johnson & Johnson (Pty) Ltd 2013. 01/IMO/02/13/D/JA

The No.1 Brand in Diarrhoea Treatment

(1)

world diabetes day 14 November

UNDERSTAND TYPE 2 DIABETES REDUCE YOUR RISK dancing

brisk walking

cycling

swimming

Diabetes can affect anyone. If left untreated, it is deadly. 30 minutes of exercise a day can reduce your risk of developing type 2 diabetes by 40%.

www.worlddiabetesday.org

Feature Header

Diabetic-friendly

indulges to fall in love with Not all low-carb, low-sugar meals have to be tasteless. Check out this collection of recipes to find a dish perfect for every course.

The Script Pharmacy Magazine â&#x201D;&#x201A;November 2014 â&#x20AC;˘ December 2014

food

1/4 cup fat-free half-and-half 1/2 cup shredded reduced-fat sharp Cheddar cheese

Applesauce Pancakes

Ingredients 1 cup all-purpose flour 1 teaspoon baking soda 1/8 teaspoon salt 2 tablespoons toasted wheat germ 1 cup non-fat buttermilk 1/4 cup unsweetened applesauce 2 teaspoons vegetable oil 1 large egg, lightly beaten Cooking spray Sugar-free maple syrup (optional) Fresh fruit slices (optional) Method: Combine first 4 ingredients in a medium bowl; make a well in center of mixture. Combine buttermilk and next 3 ingredients. Add buttermilk mixture to dry ingredients, stirring just until dry ingredients are moistened. Heat a nonstick griddle or nonstick skillet coated with cooking spray over medium heat. For each pancake, pour 1/4 cup batter onto hot griddle, spreading to a 5-inch circle. Cook pancakes until tops are covered with bubbles and edges look cooked; turn pancakes, and cook other side. Serve with maple syrup and fresh fruit, if desired

Veggie SausageCheddar Frittata

Ingredients Cooking spray 1 green bell pepper, chopped 1 Punnet pre-sliced mushrooms 4 frozen vegetable protein sausage patties, thawed and crumbled 1/8 teaspoon salt 1/8 teaspoon freshly ground black pepper 1 cup egg substitute

Method: Preheat Grill: Place a 12-inch ovenproof nonstick skillet over mediumhigh heat. Coat pan with cooking spray. Add chopped bell pepper and mushrooms; sauté 3 minutes. Add sausage, salt, apepper; reduce heat to medium-low, and cook 1 minute. Combine egg substitute and half-andhalf; carefully pour over sausage mixture. Cover and cook 6 minutes. (Frittata will be slightly moist on top.) Sprinkle with cheese. Place in oven and grill for 1 to 2 minutes or until cheese melts. Cut into 8 wedges.

Beef Kebabs

Ingredients: 1 (1-pound) beef tenderloin 2 teaspoons Worcestershire sauce 1 medium-size green bell pepper, cut into 20 squares 10 cherry tomatoes 10 small mushrooms 2 small yellow squash, cut into 10 slices 1/8 teaspoon black pepper Cooking spray 1/4 teaspoon salt Method: Pre-heat grill. Cut meat into 20 (3/4-inch) cubes. Sprinkle Worcestershire sauce over meat. Thread meat, bell pepper, tomatoes, mashrooms, and squash alternately onto 5 (12-inch) skewers. Sprinkle evenly with black pepper. Place kebabs on grill rack coated with cooking spray; grill, uncovered, 10 minutes or to desired degree of doneness, turning once. Sprinkle evenly with salt. Tip: If using wooden skewers, be sure to soak them in water 30 minutes before threading to keep them from burning during grilling.

Seared Chicken with Avocado

Ingrdients: 1 1/2 teaspoons blackened seasoning 4 skinless, boneless chicken breast halves

1 teaspoon olive oil 1 diced peeled avocado 2 tablespoons chopped fresh cilantro 1 jalapeño pepper, seeded and finely chopped 2 tablespoons fresh lime juice (about 1 lime) 1/4 teaspoon salt 1 lime, cut into fourths Method Sprinkle seasoning on both sides of chicken. Heat oil in a large nonstick skillet over high heat. Add chicken to pan, smooth side down; cook 1 minute or until seared. Reduce heat to medium; cook 3 minutes on each side or until lightly browned. Combine avocado, cilantro, pepper, lime juice, and salt. Squeeze one-fourth lime over each piece of chicken before serving. Serve with avocado mixture.

Black Forest Trifle

Ingredients 1 (8-ounce) package chocolate sugarfree, low-fat cake mix (such as Sweet ‘N Low) 3/4 cup water 1 (1-ounce) package chocolate sugarfree, fat-free instant pudding mix 2 cups fat-free milk 1 (16-ounce) package frozen no-sugaradded pitted cherries 2 or 3 drops of red food coloring 2 cups fat-free frozen whipped topping, thawed Sugar-free chocolate curls (optional) Method: Preheat oven to 375°. Prepare cake mix according to package directions, using 3/4 cup water. Let cake cool in pan; remove from pan, and cut into cubes. Prepare pudding mix according to package directions, using 2 cups fat-free milk; chill at least 30 minutes.Thaw cherries, reserving 1/4 cup juice. Combine cherries, juice, and food coloring. Place half of cake cubes in a 3-quart trifle bowl. Spoon half of cherries over cake; spread 1 cup pudding over cherries, and top with half of whipped topping. Repeat layers. Garnish with chocolate curls, if desired (chocolate curls not included in analysis). Cover and chill at least 8 hours.

The Script Pharmacy Magazine │November 2014 • December 2014

CPD Module

MODULE 5

Malaria

Welcome to the fifth CPD module. Continuous education programmes are important to keep you up to date with new developments and can form a significant element of your CPD portfolio. Record your learning and upload it on the SAPC website. PDA wishes to congratulate the top performer in the assessment for the fourth CPD module, Andria Perumal from Eksteen Pharmacy in Barberton, with a score of 100%. Andria will receive the R250 voucher. Well done, Andria!!

PDA continuing professional development programme This section is suitable for use by pharmacists, pharmacist assistants and front shop staff as part of their continuing professional development. After reading this, complete the learning scenarios at the end of this module.

Welcome to Module 5: Malaria About

Malaria is a preventable disease characterised by fever, headache, muscle pain and sometimes vomiting. It is transmitted via the bite of the infected female Anopheles mosquito (interestingly enough: only female mosquitoes bite!); these mosquitoes serve as vectors to Plasmodium parasites, also known as the malaria parasites.

this module

Objectives: At the end of this module, you should be able to: • List and discuss the symptoms of malaria • Describe the lifestyle of the malaria parasite • Discuss various treatment options and prevention strategies for malaria

CPD Module

HEALTH TOPIC

Malaria

The five main species of the Plasmodium genus responsible for malaria in humans are Plasmodium vivax, Plasmodium ovale, Plasmodium knowlesi, Plasmodium malariae and Plasmodium falciparum, the parasite which causes the most severe and serious form of malaria. There are several other species that also infect humans, but with much less severe results. There are 29 Plasmodium species that infect non-human primates, as well as several species that infect birds, rodents and even reptiles. Malaria is most common in Africa, with 80% of the 207 million malaria cases reported in 2012 occurring in the African region. In that same year an estimated 90% of the 627 000 global malaria deaths occurred on the same continent. But what is it that makes malaria so dangerous and often deadly?

Lifecycle of the Plasmodium parasite

Terminology Endemic - Something, such as a disease, that is found particularly in a specific area or place

Merozoites - Replicated sporozoites that are released in circular vesicles in the liver cells and then migrate to the lungs

Species - A group of related individual organisms which resemble one another, can breed amongst each other, but cannot breed with other species

Sporozoites - A number of small, usually infective organisms produced by certain species of organisms.

1. The Plasmodium parasite is transmitted through the bite of infected female Anopheles mosquitoes in the form of sporozoites, which occur in the saliva of the mosquito. The sporozoites enter the blood of the recipient and migrate to the liver. 2. In the liver the sporozoites invade liver cells (hepatocytes) and may remain dormant for 5-16 days, depending on the species of parasite*. After this time the sporozoites replicate and multiply and are then released

from the liver cells, rupturing the liver cell in the process. The replicated sporozoites are released in circular structures called vesicles and are now called merozoites. These circular vesicles migrate to the lungs, where they settle in the small blood vessels of the lungs and burst open to release thousands and thousands of merozoites to enter the blood of the person that was bitten by the mosquito. 3. Upon entering the personâ&#x20AC;&#x2122;s bloodstream, the parasite begins a phase

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of its development that is characterized by the merozoites invading red blood cells (erythrocytes), multiplying within the cells until the cells burst and then re-invading more erythrocytes. This cycle is repeated a number of times and may cause fever in the patient each time the erythrocytes burst and release the merozoites. This cycle may even repeat itself for a number of months, if left untreated. 4. Some of the merozoites may leave the cycle of replicating and invading erythrocytes to enter a cycle of reproduction referred to the sexual reproduction: this happens when merozoites develop into male and female gametocytes, which are the sexual forms of the parasite which also circulate in the bloodstream. 5. When a mosquito feeds on the blood of an infected human, it ingests these gametocytes, starting off the so-called “mosquito stages” of the parasite’s lifecycle. The first phase of these stages is the bursting of infected human erythrocytes within the digestive tract of the mosquito with the subsequent release of the gametocytes; these cells now mature into gametes, which are the mature sexual forms of the parasite. The fusion of male and female gametes produce cells which develop into cells that bury themselves into the wall of the mosquito’s digestive tract. These forms of the parasite are now called oocysts; oocysts can be translated into “cells that carry eggs”. 6. The oocysts then grow and divide to produce thousands of active forms of the parasite (the sporozoites); after about 8-15 days (depending on the species) the oocysts burst to release these sporozoites into the mosquito’s body cavity, from where it travels to the salivary glands, ready to be introduced into another human victim when the host mosquito bites a human to feed on their blood. From here onwards, this lifecycle is repeated as described above*. In some species, the sporozoites can remain in liver cells for extended periods of time, leading to relapses weeks or sometimes months after initial infection.

Symptoms of malaria Because there are more than one species of the Plasmodium parasite that can cause malaria, the symptoms may vary slightly for different infections. There are however, a number of stand-out symptoms for malaria: the symptoms usually follow a pattern characterized by chills, followed by fever and then sweating. Along with the chills, the person may experience headaches, muscle

pain, fatigue and occasionally vomiting and diarrhea. After a few hours the body temperature increases, leaving the skin hot and dry; this is then often followed by a drop in body temperature, coupled with a drenching sweat. It is common for patients to fall asleep during this phase, being drained and tired. Malaria symptoms may appear anything between 10 and 16 days after being bitten; the appearance of the symptoms coincides with the bursting of erythrocytes. When there are large numbers of erythrocytes infected, they may burst at the same time and cause symptoms to occur at regular intervals: every two days for P. vivax and P. ovale, and every three days for P. malariae.

parasite is to prevent mosquito bites with the consistent use of insect, and specifically mosquito repellent. There are numerous variations available on the market.

With P. falciparum the pattern and progression of symptoms can be quite different: a patient will probably feel miserable between attacks and may even die if not treated. One of the main reasons for the severity of the illness is that P. falciparum can infect erythrocytes at any stage of their development, while P. vivax only infects young erythrocytes. The result is that there are much higher numbers of parasites in the blood with a P. falciparum infection, when compared to a P. vivax infection.

Malaria spread and prevalence. According to the World Health Organisation (WHO) the last decade has seen wonderful progress in the prevention and control of malaria in the African region. The WHO reports that malaria mortality rates have dropped by an unprecedented 54% among children under the age of 5 during the years 2000-2012. During this same time period, malaria death rates among the whole population decreased by 49%. This progress has prompted many previously malaria-endemic countries to aim towards the total elimination of malaria.

Treatment options Treatment of malaria involves scheduled medication and close observation. Should any patient enter the pharmacy with symptoms of chills, fever and headaches or body pains, they should be referred to the pharmacist immediately, after which they will probably require a doctor’s visit and subsequent diagnostic tests. Upon confirmation of the diagnosis the physician will prescribe the relevant medication. If a person is bitten by a mosquito, even in areas where malaria is not endemic, the person should be advised not to scratch the bite but rather apply a hydrocortisone cream or an alternative lotion such as calamine or an antihistamine cream.

Prevention At the beginning of this article, we mentioned that malaria is preventable. How can this be achieved? Malaria can be prevented with a combination of the following: • Prophylactic (preventative) medication: these can be taken between 48 hours before and up to 6 weeks after a person plans on entering a malaria area. Refer the person to the pharmacist for these medications. • Mosquito and insect-repellent: another way of preventing infection with the malaria

• Mosquito nets: as mosquito bites occur most often at dawn, dusk or during the night, it is recommended that people sleep under mosquito nets in areas with large mosquito populations, especially if it is also an area where malaria is known to occur. • Protective clothing: cover the arms, ankles and legs with clothing between sunset and sunrise. In the case of malaria, prevention is definitely better and easier than cure!

Strategies to prevent, control and eventually eliminate malaria include: • Prompt and effective treatment with prescription medication, as recommended by the WHO • Use of long-lasting insecticidal nets by high-risk groups • Residual spraying of indoor areas with insecticides to control mosquito populations • Increasing access to rapid diagnostic tests , which can be used to accurately and quickly identify malaria cases and facilitate easy diagnosis With all of the weapons available in the arsenal against malaria, there is no reason for the war not to be won against this preventable, treatable and curable disease! References • Malaria: lifecycle of the malaria parasite, NIH: National Institute of Allergy and Infectious Diseases 2012, accessed 3 October 2014, <http://www.niaid. nih.gov/topics/malaria/pages/lifecycle.aspx > • Fact sheets: Malaria. World Health Organisation 2014, accessed 3 October 2014 <http://www.who. int/mediacentre/factsheets/fs094/en/ > • Health topics: Malaria. World Health Organisation 2014, accessed 3 October 2014 <http://www.who.

CPD Module

Muscle injury from exercise or physically demanding work • The pain tends to involve specic muscles and starts during or just after the activity 44 • Muscle pain can also include muscle spasms and cramps 33

1. Musculoskeletal pain Musculoskeletal pain can be • Acute (having a rapid onset with severe symptoms) or it can be chronic (long lasting) • Localised (affecting a particular area) or it can be widespread PAIN

PAIN

• Muscle spasm can cause ischaemia (damage to SM SPA SM tissue caused by the SPA restriction of blood ow 11) and further tissue damage to surrounding tissues, thus increasing pain 11 • The spasm induces a cycle in which the resultant pain causes further muscle spasm, and the spasm increases the level of pain 22 BR E

2.2 Tendon and ligament pain 3

PA IN TH E CY K A

2 E! CL

1.1 Pain-spasm-pain cycle

1.2 Causes of musculoskeletal pain Injury 33 – Injury or trauma to bones, joints, muscles, tendons, ligaments or nerves. 3,4 Overuse 3,4 – Overuse occurs when a muscle is used too much, too soon and too often. Pain from overuse affects a third of all adults. Lower back pain frequently occurs as a result of overuse.

2. Types of musculoskeletal pain There are many types of musculoskeletal pain, some more common types include 33

2.1 Muscle pain 3,4 • Most frequently related to - Tension - Overuse

Norﬂex and Norﬂex Co for the management of musculoskeletal pain

Low Back Pain; Neck and Shoulder Tension; Tension Headache; Muscular Pain

Norﬂex Tablets

Norﬂex Co Tablets

Often caused by injuries such as sprains

2.3 Neck and shoulder pain 5

The most common cause is injury to the soft tissues including muscles, tendons and ligaments. Pain can be described as: • Sharp but also as dull • Burning • Stabbing Pain can lead to a stiff neck or shoulder and a loss of range of motion. Headache may also result.

Indication • Relief of pain due to skeletal muscular spasm

Composition Orphenadrine citrate 100 mg

2.4 Lower back pain Lower back pain is a common problem. 66 Often, no specic cause for the pain can be found. Most lower back pain, however, generally follows injury or trauma to the back. 77 Pain can occur when someone lifts something too heavy or overstretches causing a sprain (tearing or stretching of ligaments) 88, strain (tearing or stretching of muscle bres) 88 or spasm in one of the muscles or ligaments in the back. 77

3. • • • •

• Relief of pain due to skeletal muscular spasm • Relief of mild to moderate pain

Orphenadrine citrate 35 mg + Paracetamol 450 mg

Dosage Adults: 1 tablet 2 to 3 times daily

Adults: 2 tablets 3 to 4 times daily

(orphenadrine citrate + paracetamol)

Goals of treatment

Reduce muscle spasm 99 2,10 Help relieve pain 2,10 2,10 Help restore movement 2,10 10,11 Improvement from impaired function 10,11

(orphenadrine citrate)

Freedom, Flexibility, Function.

References: 1. Beebe FA, Barkin RL, Barkin S. A clinical and pharmacologic review of skeletal muscle relaxants for musculoskeletal conditions. Am J Therap 2005;12:151-171. 2. Reeves RR, et al. Skeletal Muscle Relaxants and Associated Medications for Nonspecific Acute Back Pain. Pharmacy and Therapeutics 2005; 30 (9):518 - 527. 3. Musculoskeletal Pain Cleveland Clinic. [cited 2014 September 3]; Available from URL: http://my.clevelandclinic.org/disorders/musculoskeletal_pain/ hic_musculoskeletal_pain.aspx 4. Vorvick LJ, et al. Muscle aches: MedlinePlus Medical Encyclopedia. [cited 2014 September 3]; Available from URL: http://www.nlm.nih.gov/medlineplus/ency/article/003178.htm 5. Isomer Clinic. Back and Neck Pain. isomerclininc.com. [cited 2014 September 9]; Available from URL: http://www.isomerclinic.com/treatment-and-care-provided-for-back-and-neck-pain.html 6. Shiel WC. Low Back Pain. eMedicinehealth.com. [cited 2014 September 3]; Available from URL: http://www.emedicinehealth.com/low_back_pain-health/article_em.htm 7. Low Back Pain Fact Sheet: National Institute of Neurological disorders and Stroke (NINDS). [cited 2014 September 3]; Available from URL: http://www.ninds.nih.gov/ disorders/backpain/detail_backpain.htm 8. Peters M. British Medical Association A-Z Family Medical Encyclopedia 5th ed. London(UK):Dorling Kindersley; 2008.p.525,710,715,734. 9. Roland MO. A critical review of the evidence for a pain-spasmpain cycle in spinal disorder. Clin Biomech 1986;1:102-109. 10. Bhangle SD, et al. Back pain made simple: an approach based on principles and evidence. Cleve Clin J Med 2009;76(7):393-99. 11. McGuiness BW. a Double-Blind Comparison in General Practice of a Combination Tablet Containing Orphenadrine Citrate and Paracetamol (‘Norgesic’) with Paracetamol Alone. J Int Med res 1983;11(1):42-45. Scheduling status: S2 Proprietary name (and dosage form): NORFLEX CO Tablets. Composition: Each tablet contains 35 mg Orphenadrine citrate and 450 mg Paracetamol. Pharmacological classiﬁcation: A.2.9 (Other analgesics). Reference number: B 1098 [Act 101/1965]; Scheduling status: S2 Proprietary name (and dosage form): NORFLEX Tablets. Composition: Each tablet contains 100 mg Orphenadrine citrate. Pharmacological classiﬁcation: Category: A.2.10 (Centrally active muscle relaxants). Reference number: H 1612. [Act 101/1965]. Name and business address of applicant: iNova Pharmaceuticals (Pty) Ltd, Co. Reg. No. 1952/001640/07, 15e Riley Road, Bedfordview. Tel. No. 011 087 0000 www.inovapharma.co.za For full prescribing information, refer to the package insert as approved by the MCC (Medicines Control Council). Further information is available on request from iNova Pharmaceuticals. IN1066/14

When the stresses of modern life are taking their toll NEW!! SOLAL® CalmLite™

Escape from the stresses of modern life with new CalmLite™ Do you long for languid evenings of relaxation, but struggle to turn-off your racing mind, resist comfort food or avoid falling into your bed in an exhausted heap after a busy day?

Features:

• Patented natural Relora® - only available from SOLAL®. • Combined with Theanine, for further relaxation.

Attributes:

• Proven clinical effects from the first dose. • Non-sedating formula – won’t slow the mind.

Benefits:

• Can be used during a busy work day to remain calm under pressure, or at the end of the day to relax. • Promotes relaxation. • Boosts mood and energy. • Reduces comfort eating.

Which Co-Enzyme 10? SOLAL® Co-Enzyme Q10 New Co-Q10 technology and a higher dose Oil soluble co-enzyme Q10 in LiCaps® for 30% better absorption, to support and maintain heart, brain and cell health.

Features:

• New oil soluble Co-Q10 in LiCaps®, for enhanced absorption.

Attributes:

• 30% better absorbed than conventional Co-Q10. • Antioxidant. • Energising nutrient. • Should be taken by everybody over 30 years of age to prevent deficiency.

Benefits:

• Essential for cellular life, heart and brain function. • Overcome statin-induced deficiency.

SOLAL® Ubiquinol Co-Q10

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Co-Q10. Ultimate form of co-enzyme Q10 slows down aging markers. Better absorption facilitates effective heart and brain protection and anti-aging activity.

Features:

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Attributes:

• 8 times better absorbed than ordinary Co-Q10. • Maintains blood Co-Q10 levels 66% better than ordinary Co-Q10.

Benefits:

• Protects the heart more effectively than ordinary Co-Q10. • Protects the brain more effectively than ordinary Co-Q10. • More effective anti-aging action, slows down aging markers.

www.pdacademy.co.za

Reuterina™ Drops’ superhero strain helps maintain a healthier immune system3,4 Up to 80 % of your child’s immune strength comes from their gut.3 Reuterina™ Drops contains one of the most extensively studied probiotic strains in the world. This once-daily supplement is clinically proven to help boost your child’s immune strength,3,5,6 and relieve infantile colic symptoms,7,8 diarrhoea6,9 and antibiotic associated side effects.4,9 For more information on Reuterina™ Drops, speak to your doctor or pharmacist, or visit www.reuterina.co.za.

ALSO AVAILABLE IN:

Customer Care Line: 0860 84 3237 info@akaciahealthcare.com/www.akaciahealthcare.com Reuterina™ is a trademark of Akacia™ HealthCare (Pty) Ltd. Reuterina™ Drops 5 ml: Each dose of 5 drops contains a minimum of 100 million cfu of Lactobacillus reuteri PROTECTIS®. * cfu = colony forming units at expiry 1. Impact Rx Data: Data on file. 2. Centrix Data: Data on file. 3. Valeur N, Engel P, Carbajal N, Connolly E, Ladefoged K. Colonization and Immunomodulation by Lactobacillus reuteri ATCC 55730 in the Human Gastrointestinal Tract. Appl Environ Microbial 2004; 70 (2) : 1176 – 1181. 4. Weizman Z, Asli G, Alsheikh A. Effect of a Probiotic Infant Formula on Infections in Child Care Centers: Comparison of Two Probiotic Agents. Pediatrics 2005; 115 : 5 – 9. 5. Gibson GR. and Brostoff J. An evaluation of probiotic effects in the human gut: microaspects, 2005. www.foodstandards.gov.uk. 6. Connolly E. Lactobacillus reuteri ATCC 55730 A clinically proven probiotic. Nutrafoods 2004; 3 (1) : 15 – 22. 7. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Lactobacillus reuteri (American Type Culture Collection strain ATCC 55730) versus Simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 2007; 119 :124 –130. 8. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggero R, Roos S. Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial. Pediatrics 2010; 126 : 526 – 533. 9. Lionetti E, Miniello VL, Castellaneta SP, Magistá AM, de Canio A, Maurogiovanni G, Ierardi E, Cavallo L, Francavilla R. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children: a randomized placebo controlled trial. Aliment Pharmacol Ther 2006; 24 : 1461 – 1468.

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FROM THE NO.1 PRESCRIBED PROBIOTIC1,2

CPD Module

Take one once a month every month ... and don’t forget to call us in the morning

PDA CPD MODULES • Refresh your Anatomy Knowledge once a month in only 12 modules • Want your staff to treat your customers better? Enrol them all on the Customer Care Course – only 5 modules • Increase your turnover and add-on sales by Merchandising your pharmacy to perfection – done in 5 modules • Want to become a Drug Wise counsellor - do 9 modules • Immuisation

QUALIFICATIONS • Basic Pharmacist Assistant • Post basic Pharmacist Assistant • Pharmaceutical Sales Representation Course WHERE CREATIVETHINKING MEETS QUALITYTRAINING For more information contact PDA on 013 010 0091 or email: admin@pdacademy.co.za

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What is Hypertension (High Blood Pressure)? Hypertension is one of the most common worldwide diseases afflicting humans and is a major risk factor for stroke, myocardial infarction, vascular disease, and chronic kidney disease. Despite extensive research over the past several decades, the etiology of most cases of adult hypertension is still unknown, and control of blood pressure is suboptimal in the general population. Due to the associated morbidity and mortality and cost to society, preventing and treating

117 76

mm Hg

Read as “117 over 76 millimetres of mercury”

hypertension is an important public health challenge. Fortunately, recent advances and trials in hypertension research are leading to an increased understanding of the pathophysiology of hypertension and the promise for novel pharmacologic and interventional treatments for this widespread disease. Hypertension may be primary, which may develop as a result of environmental or genetic causes, or secondary, which has multiple etiologies, including

renal, vascular, and endocrine causes. Primary or essential hypertension accounts for 90-95% of adult cases and a small percentage of patients (2-10%) have a secondary cause. Hypertensive emergencies are most often precipitated by inadequate medication or poor compliance. Blood pressure is typically recorded as two numbers, written as a ratio like this:

Systolic - The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts). Diastolic - The bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).

What is the AHA (American Heart Association), recommendation for healthy blood pressure? This chart reflects blood pressure categories defined by the American Heart Association. Blood Pressure Category

Systolic mm Hg (upper #)

Diastolic mm Hg (lower #)

Normal

less than 120

and less than 80

Prehypertension

120 – 139

80 – 89

High Blood Pressure (Hypertension) Stage 1

140 – 159

90 – 99

High Blood Pressure (Hypertension) Stage 2

160 or higher

100 or higher

Hypertensive Crisis (Emergency care needed)

Higher than 180

Higher than 110

What is Dyslipidaemia? Cholesterol is a vital biological molecule. In excess of the normal levels of LDL-C, cholesterol accumulates in deposits of atherosclerotic plaque on the walls of the arteries. This, in turn, leads to blockages and interruptions of the circulation. This may result in angina, heart attacks, and possibly death. Hypercholesterolaemia (high levels of cholesterol in the blood), hyperlipidaemia (high levels of fats or lipids in the blood) and dyslipidaemia (imbalance in the lipoproteins

carrying lipids) are all used. We will stick with dyslipidaema. Dyslipidaemia can be primary (genetic and associated with familial disease) or secondary (as a result of lifestyle or other medical conditions). 95% of cases are of the secondary type. There are three major types of lipids carried in apolipoproteins that circulate in the plasma: cholesterol, cholesterol esters and triglycerides. Most dietary fat consists of triglycerides. Triglycerides are composed of glycerol plus three fatty acids.

Triglycerides are a type of fat that is associated with adverse health consequences. Many patients with high cholesterol also have high triglycerides. Triglycerides are carried on the same molecules (lipoproteins) as cholesterol their precise function in the development of atherosclerosis is not known. The treatment for high triglycerides is similar to that for high cholesterol.

Rosvator 5mg, 10mg, 20mg & 40mg

Reference Meena S Madhur, MD, PhD Assistant Professor, Department of Medicine, Divisions of Clinical Pharmacology and Cardiology, Vanderbilt University School of Medicine.

CPD Module

Feature Header

ASSESSMENT QUESTIONS Please answer the following multiple choice questions on the answer sheet on the next page Once you have completed the answer sheet in ink, Fax it to 086 540 5512. Clear photocopies are acceptable. You may need to consult other information sources to answer the questions. 1. Choose the INCORRECT statement regarding SOLAL® CalmLite™:

a. Contains patented clinically tested Relora® b. Proven clinical effects from the first dose c. Causes drowsiness and slows the mind d. Reduces comfort eating

2. True or False: SOLAL® Ubiquinol CoQ10 is 15 times better absorbed than ordinary Co-Q10 a. True b. False

3. Choose the CORRECT statement regarding SOLAL® Co-Enzyme Q10:

a. Should be taken by children to prevent deficiency b. Is very important to overcome statininduced deficiency c. Is a powder in a unique gelatine capsule d. Should be used by everyone on warfarin 4. Kolorex is indicated to assist in the treatment of systemic fungal infections including Candida albicans. a. True b. False 5. Kolorex comes in sofgel capsules making it easy to swallow and leave no bad taste a. True b. False 6. Kolorex can be taken with or without food? a. True b. False. 7. True or false: Rosvator™ is available only in 5mg, 10mg, 20mg and 30mg a. True b. False

8.True or false: The active ingredient of Diolo™ is Valsartan. a. True b. False 9.True or false: Diastolic pressure measures the pressure in the arteries between heartbeats

a. True b. False 10. True or false: Diolo™ is available in a 80 mg and 180 mg strength a. True b. False 11. True or false: Triglycerides are a type of fat that is associated with adverse health consequences. a. True b. False 12. True or false: Systolic pressure measures the pressure in the arteries when the muscle in the heart relaxes a. True b. False 13. True or false: Reuterina™ Dops are a convenient and easu to administer liquid dosage to treat infantile colica and infectious diarroea a. True b. False 14. True or false: Reuterina ™ Femme is a supplementation that helps to assist and maintain healthy vaginal flora and reduce yeast, bacterial and viral vaginal infections a. True b. False 15. True or false: Reuterina™ helps inhibit disease-causing (pathogenic) bacteria in the gastro intestinal tract, including Helicobacter pylori a. True b. False 16. True or false: Each chew tablet of Reuterina ™ Acute contains a minimum of 100 million colony forming units Lactobacillus reuteri PROTECTIS™production? a. True b. False 17. True or false: Reuterina™ helps reduce the incidence and duration of infectious diarrhoea and diarrhoea associated with rotavirus a. True b. False 17. L. Reuteri, a proven true probiotic11 in Reuterina™ products, which has been clinically shown to help for all of the following except a. Reduce the incidence of common antibiotic related side-effects, including antibiotic associated diarrhoea b. combat infectious diarrhoea and its incidence and duration c. relieve colic symptoms in infants d. Increase decease causing bacteria in the gastro intestinal system

18. True or False: Norflex™ and Norflex Co™ are used for the management of low back pain, neck and shoulder tension, headache and muscular pain a. True b. False 19. The daily dosage for Norflex™ is: a. One tablet twice a day b. One tablet two to three times a day c. One tablet three times a day d. Two tablets, two to three times a day 20. The daily dosage for Norflex™ is: a. One tablet twice a day b. One tablet two to three times a day c. One tablet three times a day d. Two tablets, two to three times a day 21.STÉRIMAR™ BABY-CHILD

“BLOCKED NOSE” nasal spray is not indicated for use in

a.Children aged 3 months and older with nasal congestion caused by sinusitis b.Children under the age of 3 months with nasal congestion c.Children aged 3 months and older with nasal congestion caused by common cold d.Children aged 3 months and older to cleanse the nasal passages to enhance the action of medicated treatments 22.STÉRIMAR™ BABY nasal spray

contains a

a.Hypertonic sea water solution b.Hypotonic sea water solution c.Isotonic sea water solution d.Mildly hypertonic sea water solution 23.STÉRIMAR™ BABY-CHILD BLOCKED

NOSE nasal spray and STÉRIMAR™ BABY nasal spray are both sea water nasal sprays. True or False? a. True b. False

win! Achieve a score of 80% or more and automatically stand a chance to win a R250 giftvoucher. Please note that previous winners of the voucher wil not be eligble to enter the competition for 3 issues (6months) after winning the voucher

Congratulations! You have successfully completed this module. Remember! should you wish to enrol onto any of our courses send us an email 32 The Script Pharmacy Magazine │November 2014 • December 2014 to training@cjpharm.co.za for more information

www.pdacademy.co.za

ANSWER SHEET:

CIRCLE your answers below and send to PDA – fax number: 086 540 5512 or e-mail: training@ pdacademy.co.za. This assessment will be marked and you will be notified of your results and sent a copy of the correct answers. The assessors’ decision is final and no correspondence will be entered into. 1] a b c d 13] a b c d 2]

14]

15]

16]

17]

18]

19]

20]

21]

10]

22]

11]

23]

12]

d Title:

Full Name & Surname:

Pharmacy Name and Address:

Daytime Contact Number:

Date:

Email Address:

PHARMACIST

POST BASIC PA

BASIC PA

FRONT SHOP

I confirm the form submitted is my own work (signature)

M501

World orld AIDS Day 세계 에이즈의 날 AIDS Világnap ía Mundial del Sida Journée mondiale de lutte ontre le Sida La giornata mondiale ell’AIDS Pandaigdigang Araw para sa AIDS Jounen ondyal Batay Kont SIDA 世界艾滋病日 Svetový eň AIDS Světový den AIDS AID Światowy dzień AIDS ế Th giới phòng chống AIDS Welt-Aids-Tag elt-Aids-Tag Ziua internationala SIDA Dia Mundial a AIDS Всемирный день орьбы против СПИДА 世界エイズデイ Световен ен за борба с ХИВ и СПИН αγκόσμια Ημέρα κατά του AIDS Usuku Lomhlaba Wonke onke Lwengculazi Siku ya UKIMW limwenguni imwenguni Всесвітній день боротьби зі СНІДом Feature Header

WORLD AIDS D AY December 1

Working Together 34

The Script Pharmacy Magazine │November 2014 • December 2014

DSS

Awareness

New data shows country may see DECLINE IN NEW HIV CASES Better care and treatment of HIV patients may be putting the country on the road to a decline in infections – and the secret lies in patients’ blood, according to new data. New data released at the recent Southern African HIV Clinicians Conference showed that a much higher percentage of antiretroviral (ARV) patients are receiving HIV viral load tests than previously thought. The results of these tests show that, on average, South Africans on ARVs are better controlling the virus, which may lead to fewer new infections, according to Wendy Stevens, head of National Health Laboratory Services’ (NHLS) National Priority Programmes Unit.

nities than there was previously.” Clinical trial have also shown that people with lower HIV viral loads are less likely to transmit the virus to others, leading Stevens to suggest that growing proportions of patients with viral loads in the hundreds could lead to fewer new infections. She also added that patients are starting ARV treatment much earlier at higher CD4 counts, which measure of the immune system’s strength.

Department of Health 2013 figures argued that fewer than half of all patients on ARVs received a viral load test but Stevens said that viral load tests are under-reported. She added that in 2014, the NHLS has conducted about 2.7 million viral load tests for the country’s estimated 2.4 million ARV patients.

In 2004, South Africa had an ARV CD4

These tests also show that the national proportion of patients with an undetectable – or extremely low – viral load rose steadily between 2004 and 2010. While this proportion dipped in 2011, the latest available data from 2012 shows that 72 percent of ARV patients have undetectable viral loads. Measuring the amount of HIV in a patient’s blood, viral load testing is the quickest and most reliable way to check whether ARV patients are adhering to treatment or have developed ARV resistance. “What’s been interesting is to watch the reduction of community viral loads with time,” Stevens told Health-e News. “What we can say is that there is better wellness and less viral loads in commu-

it was still far below the ARV initiation

count initiation threshold of 200 and the typical patient started ARVs at about a CD4 count of 123. By 2012, national guidelines called for patients to initiate ARVs at a CD4 count of 350. While the average CD4 count of patients starting ARVs had risen to 211, threshold, according to data presented by Stevens on the last day of the conference. The Treatment Action Campaign has called for government to publicly report provincial and district viral load reports to allow civil society to track South Africa’s HIV response. Currently the NHLS generates viral load data at national, provincial and facility levels. It is currently in the process of mapping this data to alert government to poorly performing areas. - Health-e News

Treatment is prevention In 2011, a study conducted in several countries including South Africa found that HIV-positive people who started treatment early and had nearly undetectable levels of the virus in their blood were about 96 percent less likely to pass the virus onto partners. Scientists theorise that earlier HIV treatment and high treatment rates could prevent new infections in communities. MSF’s Eshowe project is looking to take that theory from mathematical models to the real world. To do that, the KZN Department of Health has allowed MSF to start HIV patients on ARVs sooner than national guidelines recommend. About 90 percent of the longtime ARV patients surveyed by MSF in KwaZulu-Natal had levels of HIV in their blood that were undetectable, according to Reid. “Getting on treatment has benefits for the individual, who… will avoid HIV-related diseases,” Reid tells Health-e. “There are also potential benefits of protection of the community because someone with an undetectable viral load is far less likely to transmit the HIV.” “The fact that the KwaZulu-Natal authorities have accepted to partner with MSF to initiate treatment early is a very encouraging sign of their direction in the fight against HIV,” he added. To test its theory that high HIV treatment coverage can bring down new infections in Eshowe, MSF plans to conduct another study in several years.

Service. The Script Pharmacy Magazine │November 2014 • December 2014

Whatever your taste, WE have it...

Now Available at CJ Pharmaceuticals

Supplier List Contact our Buying Agent, Estelle van Tonder: estelle@cjpharm.co.za • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

3M SOUTH AFRICA (PTY) Ltd. ABBOT ACTIVO HEALTH ACTOR PHARMA ADCOCK CRITICAL CARE ADCOCK INGRAM AKACIA HEALTHCARE ALCON ALLERGAN ANMARATE PHARMACEUTICAL ARCTIC ASPEN PHARMACARE ASTELLAS ASTRA ZENECA ATKA PHARMA AUROBINDO AUSTELL LABORATORIES AVID BRANDS S.A.(PTY)LTD BAOBAB HEALTHCARE BAUSCH & LOMB BAYER DIABETICS BAYER SCHERING BEIERSDORF CONSUMER PRODUCTS BENNETT BROTHERS BENNETTS THE CHEMISTS BETA PHARMACEUTICAL BE-TABS PHARMACEUTICALS BIOGARAN BIOSCIENCE BIOSWISS BIOTECH LABS BOEHRINGER BROTHERLY LOVE BRUNEL LABORATORIA BSN-MEDICAL CEDARPHARM COMED HEALTH CREME CLASSIQUE DENTAL WAREHOUSE DEVINO DR REDDY’S ELI LILY ENERGIZER EQUITY PHARMACEUTICALS EVOLABS FLORDIS FOUNTAIN MEDICAL FRESENIUS KABI SA FUTUREHEALTH GABINA HEALTH & BEAUTY GALDERMA GENOP

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

GEOREN PHARMACEUTICALS GLAXOSMITHKLINE SOUTH AFRICA GUIDELINE TRADING GULF DRUG COMPANY HARTMANN GROUP HERBEX HOMEMED HOUSE OF ZINPLEX HUMOR DIAGNOSTIC IMSYSER HEALTH PRODUCTS INCOLABS INOVA JANSEN CILAG JOHNSON & JOHNSONS KENZA HEALTH KYRON LABORATORIES LEE-CHEM LABORATORIES LEVTRADE INTERNATIONAL LISAN INTERNATIONAL LITHA PHARMACEUTICAL LOOCK PHARMACEUTICALS MC’NABS MEDA PHARMACEUTICAL MED-e-HEALTH MEDINOX MEDPRO PHARMACEUTICA MERCK MERCK OTC MICROLIFE MIRREN MNI LIFESTYLE MSD MSD CONSUMER MUNDI PHARMA MYLAN NAMPAK NATIVA NATURAL PRODUCTS NATURAL WELLNESS NOVAGEN PHARMA NOVARTIS CONSUMER NOVARTIS PHARMA NOVO-NORDISK TAKEDA OMEGA LABS ONE FOR ALL SUPPLEMENTS OXYGEN FOR LIFE SA PAKMED SELF MEDICATION PENPHARM SA PEPPINA SALES PERMARK PFIZER LABORATORIES

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

PHARMA DYNAMICS PHARMA NATURA PHARMACEUTICAL ENTERPRISES PHARMACHEM PHARMACEUTICAL PHARMACO DISTRIBUTORS PHARMAMARK PINNACLE PHARMACEUTICALS PORTFOLIO PHARMACEUTICALS PRO DISTRIBUTORS PROCTER & GAMBLE QUALITY SUGARS RANBAXY RECKITT BENCKISER PHARMA REITZER PHARMACEUTICALS REVLON ROCHE DIAGNOSTIC ROCHE PRODUCTS (PTY)LTD ROLFE LAB SA NATURAL PRODUCTS SAM NUTRITIONALS SANDOZ SA SANOFI AVENTIS SANOFI PASTEUR SCHICK SERVIER LABORATORIES SG CONVENIENCE GAUTENG SLIMBETTI SMITH & NEPHEW SOLAL TECHNOLOGIES SPECPHARM SPORT AND HEALTH TECH STAR CHOICE (IMMUNADUE) TARA PHARMACEUTICAL TARGUARD SA TECHNICON LABS TELEGENIX TEVA PHARMACEUTICAL TFD (REDBUL) TIBB HEALTH SCIENCES TIGER BRANDS TOPAZ (SKIN PHD) ULTIMATE SPORTS NUTRITION VALIDUS MEDICAL VAN DYK PHARMACEUTICAL VIKELEKA HERBAL VITAL HEALTHCARE WATSON PHARMACEUTICAL WINTHROP WINTROP PHARMACHOICE XS HEALTH YIWIEDA TRADING

Blood Pressure Monitor Arm IntenseCare

R235 60

Revite Super B Injection Tabs 30s

R57 90

Blood Pressure Monitor Wrist IntenseCare

Revite Omega-3 1000mg Caps 90s

R6195

R225 00

Nebulizer Replace Nebset IC00 IntenseCare

R2187

Revite Vit-T-Go Sachets 20s

R6195 Nebulizer Compressor IntenseCare

R284 41

Revite Super B Injection Fizzy eff tabs10s

R34 55 Now available at CJ Pharmaceuticals

All prices excluding VAT For more inquires Fax to 086 671 3949 or Email to telemarketing@cjpharm.co.za

direct sales

COSMETRIX Quality grooming & beauty accessories now available from CJ Pharmaceuticals! Nail-care • Make-up Applicators & Sponges • Shower Caps • Foot-care

CJ Customers!! You can also order online at www.cjpharm.co.za

PLACE YOUR ORDER PHARMACY NAME CJ ACCOUNT NUMBER

DATE

AUTHORISED BY CODE

SIGNATURE DESCRIPTION

INCL. VAT

RSP

124579

COSMETRIX 3 WAY NAIL BUFFER 130030

R 23.54

R 29.90

124578

COSMETRIX 4 WAY BUFFING BLOCK 130029

R 24.45

R 34.90

124574

COSMETRIX BLACK HEAD REMOVER 130020

R 13.97

R 18.90

124580

COSMETRIX CALLUS & CORN REMOVER 130032

R 35.28

R 49.90

124581

COSMETRIX CALLUS REMOVER 130034

R 30.67

R 32.90

124582

COSMETRIX CLEANSING SPONGED 2PK 130038

R 25.02

R 34.90

124571

COSMETRIX CLIPPER FINGERNAIL 130007

R 13.97

R 18.90

124572

COSMETRIX CLIPPER TOENAIL 130008

R 20.98

R 32.90

124585

COSMETRIX CUTICLE TRIMMER 130048

R 9.06

R 12.90

124586

COSMETRIX EYESHADOW APPLICATOR 10 130051

R 22.69

R 24.90

124583

COSMETRIX FOUNDATION SPONGE 3PK 130041

R 13.97

R 18.90

124584

COSMETRIX FOUNDATION WEDGE 4PK LRG 130043

R 20.98

R 26.90

124575

COSMETRIX MANICURE SET 130023

R 41.95

R 59.90

124589

COSMETRIX NAIL BRUSH 132001

R 15.85

R 22.90

124576

COSMETRIX NAIL SHAPER 2PACK BLUE 130026

R 17.67

R 26.90

124577

COSMETRIX PROFESSI NAIL SHAPERS 2 130027

R 24.45

R 34.90

124590

COSMETRIX SHOWER CAP DISP 3PK 132004

R 11.97

R 18.90

124570

COSMETRIX TWEEZERS SCISSOR 130005

R 18.75

R 29.90

124587

COSMETRIX TWEEZERS SLANT TIP 130072

R 13.97

R 18.90

124588

COSMETRIX TWEEZERS SQUARE TIP 130073

R 13.97

R 18.90

ORDER

Fax this order to 086 671 3949 or email to: telemarketing@cjpharm.co.za prices subject to change without prior notice. While stocks last.

For more information regarding these or any other products available from us speak to your CJ Representative Lynne[cell] 071 472 7522 email: lynne@cjpharm.co.za Ridwaan [cell] 072 534 8135 email: ridwaan@cjpharm.co.za Theuns [cell] 072 638 4085 email: theuns.w@cjpharm.co.za Pam [cell] 071 480 5322 email: pam.vc@cjpharm.co.za

You can also order online at www.cjpharm.co.za, existing customers only!

direct sales

FREESTYLE Quality Hair Accessories now available from CJ Pharmaceuticals

Detanglers • Barrel Brushes • Hard Cushion Brushes • Bobbi Pins • Travel sizes also available!

CJ Customers!! You can also order online at www.cjpharm.co.za

PLACE YOUR ORDER PHARMACY NAME DATE

CJ ACCOUNT NUMBER AUTHORISED BY CODE

SIGNATURE DESCRIPTION

INCL. VAT

RSP

124599

FREESTYLE BRUSH CUSHION TRAVEL FS442

R 29.58

R 49.90

124602

FREESTYLE BRUSH DETANGLER PINK FS447

R 46.80

R 89.90

124603

FREESTYLE BRUSH DETANGLER PURPLE FS448

R 46.80

R 89.90

124606

FREESTYLE BRUSH FIZZ CONT TRAVEL FS464

R 26.85

R 49.90

124604

FREESTYLE BRUSH HARD CUSHION FS461

R 37.16

R 65.90

124605

FREESTYLE BRUSH HARD CUSHION TRAVEL FS462

R 26.51

R 45.90

124600

FREESTYLE BRUSH PADDLE FS443

R 45.09

R 75.90

124601

FREESTYLE BRUSH PADDLE TRAVEL FS444

R 32.49

R 49.90

124597

FREESTYLE BRUSH ROUND LRG FS423

R 36.71

R 65.90

124598

FREESTYLE BRUSH ROUND TRAVEL FS424

R 29.53

R 49.90

124595

FREESTYLE BRUSH THERM ROUND LRG FS421

R 49.59

R 75.90

124596

FREESTYLE BRUSH THERM ROUND MED FS422

R 49.59

R 75.90

124591

FREESTYLE BRUSH VENT FS401

R 40.24

R 65.90

124593

FREESTYLE BRUSH VENT MEGA FS403

R 55.80

R 74.90

124594

FREESTYLE BRUSH VENT TRAVEL FLARE FS404

R 26.11

R 39.90

124592

FREESTYLE BRUSH VENT TRAVEL FS402

R 24.62

R 49.90

124607

FREESTYLE HAIR CLIPS BLACK 20 FS150

R 10.20

R 10.90

Fax this order to 086 671 3949 or email to: telemarketing@cjpharm.co.za prices subject to change without prior notice. While stocks last.

ORDER

direct sales

PRETTY BABY Quality Baby Products and Child Safety Accessories Assorted Bottles • Teats • Dummies • Sippers • Feeding Bowls & Cutlery • Cabinet Locks • Socket & Corner Protectors and much more! View full range online at www.cjpharm.co.za

PLACE YOUR ORDER PHARMACY NAME CJ ACCOUNT NUMBER

DATE

AUTHORISED BY CODE

SIGNATURE DESCRIPTION

INCL. VAT

RSP

124558

PRETTYBABY BABY ON BOARD SIGN 2105

R 13.91

R 16.90

124534

PRETTYBABY BOTTLE GRIPPER 250ML 1004

R 38.48

R 49.90

124537

PRETTYBABY BOTTLE PICTURE 125ML 1028

R 22.69

R 29.90

124535

PRETTYBABY BOTTLE PICTURE 250ML 1021

R 26.62

R 36.90

124536

PRETTYBABY BOTTLE PRINT HAND 250ML 1023

R 37.79

R 49.90

124566

PRETTYBABY BOWL NON SLIP ASST 2257

R 32.26

R 44.90

124547

PRETTYBABY BOWLS WITH LIDS SET 4 1110

R 28.90

R 34.90

124557

PRETTYBABY CABINET LOCK 2PACK 2104

R 17.84

R 24.90

124555

PRETTYBABY CORNER CUSHION 4PACK 2102

R 16.19

R 19.90

124550

PRETTYBABY CUP N/SPILL HANDLE W/LID 1155

R 31.81

R 49.90

124608

PRETTYBABY DIAPER BAG NB004

R 13.57

R 19.90

124554

PRETTYBABY DOOR FINGER PROTECTOR 3 2101

R 16.53

R 19.90

124560

PRETTYBABY DRYING RACK 2191

R 56.77

R 69.90

124539

PRETTYBABY DUMMY LARGE ASST 1042

R 15.14

R 19.90

124538

PRETTYBABY DUMMY REGULAR MED ASST 1038

R 15.16

R 19.90

124540

PRETTYBABY DUMMY SMALL ASST 1056

R 15.22

R 19.90

124545

PRETTYBABY FORK & SPOON PLASTIC 1105

R 34.37

R 45.90

124552

PRETTYBABY H/BRUSH AND COMB SET ASS 2092

R 20.29

R 29.90

124563

PRETTYBABY H/CHIEF THEETHER CHARACT 2194

R 54.04

R 74.90

124562

PRETTYBABY HANDKERCHIEF W/TEETH ASS 2193

R 40.48

R 54.90

124559

PRETTYBABY HANGERS PACK 3 ASST 2190

R 18.35

R 24.90

124546

PRETTYBABY KIDDY PLATE PRINTED ASST 1107

R 21.15

R 29.90

124561

PRETTYBABY MINI BLANKIE ASST 2192

R 62.36

R 89.90

124556

PRETTYBABY MULTIPURPOSE LOCK 2PACK 2103

R 15.16

R 19.90

ORDER

For morePRETTYBABY information regarding these or any other products available 124567 N/SPILL CUP W/LID ASST 20015 R 39.56 R 49.90 from speak Representative Fax thisus order to 086to 671your 3949 CJ or email to: telemarketing@cjpharm.co.za prices subject to change without prior notice. While stocks last.

Lynne[cell] 071 472 7522 email: lynne@cjpharm.co.za Ridwaan [cell] 072 534 8135 email: ridwaan@cjpharm.co.za Theuns [cell] 072 638 4085 email: theuns.w@cjpharm.co.za Pam [cell] 071 480 5322 email: pam.vc@cjpharm.co.za

CJ Customers!! You can also order online at www.cjpharm.co.za

In short:  What are you allowed to return?

 Damages from CJ Pharmaceuticals  Picking Errors/Shorts  Expired/Short dated stock from CJ Pharmaceuticals  Order Errors (Remember: Only if reported within 48 hours/ 2 days of receipt)

 What are we not allowed to return?    

3Easy Steps

Step 1: Obtain a CJW reference number • •

Fridge products Products without a CJW reference Products not in original packaging or spoilt products Products damaged at the pharmacy

In case of a box short received

Have available: invoice, batch & expiry dates of products Phone CJ Pharmaceuticals customer care on (013) 665-1011

1. Immediately indicate on the POD “box not received” 2. Report to Customer Care on (013) 665-1011 immediately 3. Record the name of the Customer Care Consultant for reference purposes 4. The Customer Care Consultant will give feedback by close of business

Step 2: Pack stock correctly & securely

In case of a product(s) short received

•

1. Indicate the products short received on invoice with your contact details 2. Report short to Customer Care by faxing applicable invoice through to 086 589 5983 3. CJW reference will only be supplied on receipt of fax 4. Credit will only be passed subject to an investigation with the aid of our security video recording also within 48 hours Feedback will be given with regards to your query within 48 hours of receipt of a CJW reference number

• • •

Only pack stock indicated on CJW reference Use Protective Packaging material Place liquids in a plastic bag before placing inside box Include the invoice & write CJW refrence number on the box

Step 3: Hand the signed pink CJW reference and stock to CJ’s driver Sign pink CJW reference slip with following information • Released by: Pharmacy • Collected by: Driver

Enduring 24-hour IOP control Travoprost is the only full agonist at the FP receptor1 • Enduring IOP reduction beyond 24-hours2 • IOP reductions are sustained regardless of AM or PM dosing preferences3

Killian Webb 1815

S4 TRAVATAN® Eye Drops, solution. Travoprost 40 µg/ml. Reg. No. 36/15.4/0333. Please refer to the package insert for further information. Alcon Laboratories (SA) (Pty) Ltd, P O Box 3198, Randburg, 2125 – Tel: (011) 840-2300. August 2014. P-TRA-002-V3. Expiry date: August 2016.

1. Whitson JT. Travoprost – a new prostaglandin analogue for the treatment of glaucoma. Expert Opin Pharmacother 2002; 3(7): 1-13. 2. Dubiner HB, Sircy MD, Landry T, et al. Comparison of the diurnal ocular hypotensive efficacy of travoprost and latanoprost over a 44-hour period in patients with elevated intraocular pressure. Clin Ther 2004;26(1):84-91. 3. Konstas AGP, Mikropoulos D, Kaltsos K, et al. 24-hour intraocular pressure control obtained with evening- versus morning-dosed travoprost in primary open-angle glaucoma. Am Acad Ophthalmol 2006;113:446-450.

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When the Big Bugs Bite Malaria is one of the leading causes of deaths around the world, but there is hope. Here is a bit of information on the treatment and prevention of malaria

Awareness

Malaria is caused by parasites that are transmitted to people through the bites of infected mosquitoes. Malaria is caused by Plasmodium parasites that are spread to people through the bites of infected Anopheles mosquito vectors. Of the five parasite species that cause malaria in humans, Plasmodium falciparum is the most deadly.

Half of the world’s population is at risk of malaria Every year, 3.4 billion people are at risk of malaria. This leads to about 207 million malaria cases (with an uncertainty range of 135 million to 287 million) and an estimated 627 000 malaria deaths (with an uncertainty range of 473 000 to 789 000). People living in the poorest countries are the most vulnerable.

Every minute, a child dies from malaria In 2012, 90% of the world’s malaria deaths occurred in Africa and about 460 000 African children died before their fifth birthdays.

Malaria mortality rates are falling Increased malaria prevention and control measures are dramatically reducing the malaria burden in many places. Malaria mortality rates have fallen by 42% globally since 2000 and by 49% in the WHO African Region.

Early diagnosis and prompt treatment of malaria prevents deaths Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. Access to diagnostic testing and treatment should be seen not only as a component of malaria control but as a fundamental right of all populations at risk.

Emerging artemisinin resistance is a major

concern Parasite resistance to artemisinin, the core compound in WHO-recommended combination treatments for uncomplicated malaria, has been detected in 4 countries of south east Asia: Cambodia, Myanmar, Thailand and Viet Nam. However, artemisinin-based combination therapies remain highly effective in almost all settings, as long as the partner drug in the combination is locally effective.

losses in high-burden countries In high-burden settings, malaria can trap families and communities in a downward spiral of poverty, disproportionately affecting marginalized and poor people who cannot afford treatment or who have limited access to health care.

Malaria Treatment

The full potential of indoor residual spraying is obtained when at least 80% of houses in targeted areas are sprayed. Indoor spraying with insecticides kills the mosquito vector and is effective for 3–6 months, depending on the insecticide used and the type of surface on which it is sprayed. Longer-lasting forms of insecticides are under development.

Malaria can be a severe, potentially fatal disease (especially when caused by Plasmodium falciparum) and treatment should be initiated as soon as possible. Patients who have severe P. falciparum malaria or who cannot take oral medications should be given the treatment by continuous intravenous infusion. Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include: • chloroquine • atovaquone-proguanil (Malarone®) • artemether-lumefantrine (Coartem®) • mefloquine (Lariam®) • quinine • quinidine • doxycycline (used in combination with quinine) • clindamycin (used in combination with quinine) • artesunate In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.

Pregnant women are particularly at risk of malaria

How to treat a patient with malaria depends on:

Sleeping under longlasting insecticidal nets protects against malaria These nets provide personal protection against mosquito bites. They can be used as protection for people most at risk of malaria, such as young children and pregnant women in high malaria transmission areas. The nets are effective for three to five years, depending on the model and conditions of use. According to the World malaria report 2013, 86% of people with access to a net use it.

Indoor residual spraying is the most effective way to rapidly reduce malaria transmission

Pregnant women are at high risk of dying from the complications of severe malaria. Malaria is also a cause of spontaneous abortion, premature delivery, stillbirth and severe maternal anaemia, and is responsible for about one third of preventable low-birth-weight babies. WHO recommends intermittent preventive treatment for pregnant women living in areas of high malaria transmission. Malaria causes significant economic

• • • • • •

The type (species) of the infecting parasite The area where the infection was acquired and its drug-resistance status The clinical status of the patient Any accompanying illness or condition Pregnancy Drug allergies, or other medications taken by the patient

The Script Pharmacy Magazine │November 2014 • December 2014

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Credit and Returned Goods Policy Dear Valued Customer - At CJ Pharmaceuticals we endeavour to provide you with the best service at all times. Accepting returned stock and passing a credit is part of that service. We would like to provide you with fair and practical guidelines. No credit exists until a credit note is issued by CJ Pharmaceuticals and no deduction, or adjustment to any invoice may be made by the customer except on the basis of a credit note. Before any product is returned to CJ Pharmaceutical Enterprises a CJW reference number must be obtained from our Customer Care Department. When returning liquids, place all the liquids in a plastic bag, before placing the products in a box. CJ Pharmaceuticals will only accept returns if the batch of the products are directly from CJ Pharmaceutical Enterprises. Products must be returned in full, unopened, undamaged, original packaging. Pharmacies must provide adequate documentation (invoice number, batch and expiry) to ensure that it is CJ Pharmaceutical Enterprises products.

ing errors. You will be issued with a CJW reference number and the product is to be returned. A credit will be issued upon receipt of the product

Acceptable Returns

Criteria applicable:

Product may be returned for credit under the following conditions: 1. Picking Errors 2. Visible Damage 3. Concealed Damage 4. Expired Goods 5. Customer Ordering Error 6. Shortages

Picking Errors: Immediately contact the Customer Care Department and report any Picking Errors. You will be issued with a CJW reference number for the product to be returned

Visible Damage: Any visible damage should be noted on the POD upon receipt of the order. Immediately contact our Customer Care Department for a CJW reference number

Concealed Damage: Immediately contact our Customer Care Department and report any concealed damage noted upon receipt of your order or within 48 hours. Our Customer Care Department will issue you with a CJW reference number as soon as we receive the stock a credit will be processed

Expired Goods: Stock received from us, nearing expiring date will be taken back according to the specific Supplier policy (Copy of Supplier Returns Policy will be attached) and provided it is from the same batch number received from us. If Better Dated stock was bought we cannot except expired stock back. Product must be in original, sealed, full unopened container. Product must have a batch number and expiration date

Customer Ordering: Immediately contact our Customer Care Department and report any customer order-

Shortages: Our policy in this case is purely based on our mutual trust relationship. We have recently introduced additional procedures and controls in order to improve our precision in this regard. Shortages must be reported within 48 hours upon receipt of stock to our Customer Care Department. Customer Care Department will give the information through to our Security Department for the CCTV footage to be viewed for the shortage. Feedback with regards to the query will be given before 48 hours after the call has been logged • Once the content of a box or parcel is checked against the invoice and any discrepancy is found ( items short or damaged), we request that it is reported to our Customer Care Department within 48 hours • Box Short - a reference number (CJW number) must be obtained from our Customer Care Department – 013 665 1011 • Once you have received a reference number (CJW number), our delivery team will present a collection manifest (CJW) (white and pink copy) to collect the stock • No stock will be collected without the pink copy (CJW) of the Collection Manifest attached to the goods – please also attach a copy of the applicable invoice • When the stock arrives at the warehouse it will be checked - the invoice with the pink copy of the collection manifest will be taken to our Customer Care Department for a credit to be passed • An authorised return must be returned within 48 hours from the receipt of a CJW reference number • A valid CJW reference number and invoice must accompany all returns for proper credit • Credit is based on the original purchase price • Credit will be issued in the form of a Credit Note • We require proof of purchase (invoice) of all products returned for credit

Non-returnable Items:

• Products without a CJW reference number (unauthorized returns) • Products with more than six (6) months remaining shelf life • Products retained more than twelve (12) months and if better dated stock was purchased. • Private Label products or repacked goods

• Products with missing label or with missing batch number and expiration date • Products broken, marked or with price stickers • Products sold on a non-returnable basis • Products damaged/deteriorated due to improper handling or storage • Products not purchased directly from CJ Pharmaceutical • Fridge items • Overstock, unless agreed by the CEO in writing We would like to suggest the following procedures when receiving stock: 1. Check every invoice number (and the number of boxes and parcels per invoice) individually.(Please don’t just reconcile the total number of boxes / parcels delivered, to the quantities indicated on the POD?) 2. If our driver is calling the invoice numbers, please ensure that you witness the process and put the verified boxes / parcels behind you. 3. In the event that a box has not been received or that the box is damaged the Receiving Person must immediately declare it - next to the Invoice number on the POD. (Ex. “Box not received”, “Box damaged”) 4. We cannot be held liable for any shortages or damages, unless the POD is specifically endorsed. 5. Please get the driver to counter sign the endorsement! 6. Once the POD has been signed, NO CREDIT can be passed for any delayed claims for damaged or short boxes / parcels. 7. Please take note that the absence of a tick, or a cross, next to the undelivered invoice number cannot suffice as a proper endorsement 8. As a final check we suggest that you do a count of all the boxes and parcels that were delivered and balance that back to the quantities indicated on the POD. 9. It is regretted that we cannot entertain credits for boxes not delivered, unless the POD is endorsed accordingly We trust that the suggestions will enable both parties to solely rely on the POD in case of any future discrepancies or claims. CJ Pharmaceuticals may at its discretion, make exceptions to the Return Goods Policy based on extenuating circumstances. All returns must be made according to this Return Goods Policy. Thank you

Erika Oehley

Inventory Risk Manager

EXCLUSIVE PROMOTION!!

Fax: Email:

Ordered By:

ORDER FORM

Pharmacy Name:

Tel No:

Aluminium Snap Frames

Offer Valid While Stocks Last Product

Price

A1 Aluminium Snap Frames for 594mm x 840mm pages

R255.00

A2 Aluminium Snap Frames for 420mm x 594mm pages

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A3 Aluminium Snap Frames for 297mm x 420mm pages

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A4 Aluminium Snap Frames for 210mm x 297mm pages

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Your order

FAX ORDERS TO: 086 698 1468

All prices are exclusive of VAT For any further enquiries regarding the above please contact Thea 013 010 0091 or email marketing@cjpharm.co.za

tools THE RIGHT

We might live and work in a digital age, but the humble business card

the Name badge is an important visual ally, allowing your clients to know who you are by connecting their experience with your brand.

Order Form

For Quotes contact Thea on 013 010 0091 or marketing@cjpharm.co.za Name: Business details: Tel:

Cell: Fax:

Email: Order :

Name Badges

Business Cards

Corporate Gifts

Other Order

We also do: posters, magazines (small & large quantities), Self-inking stamps,

Killian Webb 1816

Because patients with moderate to severe glaucoma need powerful IOP reduction

Start with

The Power of Success S4 DUOTRAV® Eye Drops, solution. Travoprost 40 µg/ml + Timolol 5 mg/ml. Reg. No. 40/15.4/0511. Please refer to the package inserts for further information. Alcon Laboratories (SA) (Pty) Ltd, P O Box 3198, Randburg, 2125 – Tel: (011) 840-2300. August 2014. P-DUO-005-V3. Expiry date: August 2016.