January 2010 Florida Pharmacy Journal by Florida Pharmacy Today

JAN. 2010

Make Health Your Resolution

Medical Reserve Corps

Volunteers Building Strong, Healthy, and Prepared Communities

JOIN THE CORPS! Volunteers Needed For H1N1 Mass Vaccination Campaign H MRC units are community-based and function as a way to locally organize and utilize volunteers-medical professionals and others-

who want to donate their time and expertise to augment public health activities throughout the year and to prepare for and respond to emergencies. MRC volunteers become part of a system to supplement existing local emergency and public health resources.

H MRC volunteers include health care professionals such as physicians, nurses, pharmacists, dentists, veterinarians, and

epidemiologists. Other community members such as interpreters, chaplains, office workers, and legal advisors can fill other vital support positions.

MRC Can Enhance Public Health By:

MRC Emergency Preparedness Volunteers:

H Supplementing public health preparedness and response H Improving health literacy H Eliminating health disparities H Helping at community health events

H Bolster public health and emergency response

infrastructures by providing supplemental responders

H Train with local emergency response partners

Log on to - www.servfl.com or contact the Florida Medical Reserve Corps at: 850-245-4746 2 |

Florida Pharmacy TodaY

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 17 Call for Resolutions 18 Poster Abstracts 24 Buyer’s Guide

VOL. 73 | NO. 1 JANUARY 2010 the official publication of the florida pharmacy association

Features

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Make Health Your Resolution Coping with Memory Loss Florida Pharmacists Legislative Days and Health Fair Call for Nominations

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FPA Calendar 2010

the

January 18

Martin Luther King's birthday FPA office closed

30-31 FPA Law & Regulatory Conference Sandestin, FL 31

Election ballots due FEBRUARY

FPA House of Delegates

23 - 25 Pharmacy Legislative Day at the Florida Capital 24

Florida Pharmacists Health Fair

27 - 28 FPA Committee and Council meetings and Board of Directors APRIL 2

FPA Office Closed (Good Friday)

9-10

Florida Board of Pharmacy Meeting Jacksonville

17-18 FPA Clinical Consultant Conference Tampa Airport Marriott

Advisory Council on Pharmacy Practice - Florida Pharmacy Council conference call

Awards nomination deadline

March 2

Florida Legislative Session Begins

10 - 11 2010 NACDS FlyinWashington, DC Washington, D.C. 12 -15 APhA annual meeting Washington, D.C. 15

Legislative session ends MAY NASPA Leadership Conference Austin, Texas

10 - 12 2010NCPA Legislative Conference Washington, DC 26 - 28 ASCP Midyear Clinical Conference Phoenix, Arizona 31

Memorial Day, FPA Office Closed

Deadline to submit resolutions for

For a complete calendar of events go to www.pharmview.com

CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2011 or prior to licensure renewal. *For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact Ranada Simmons in the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www. pharmview.com CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Michael McQuone (850) 906-9333 U/F — Dan Robinson (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

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Florida Pharmacy TodaY

Mission Statements: of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a

peer reviewed journal which serves as a medium through which the Florida Pharmacy Association

can communicate with the profession on advances in the sciences of pharmacy, socio-economic is-

sues bearing on pharmacy and newsworthy items

of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today

Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of

the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s

policies and the management of the Journal’s

fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Associa-

tion members to secure appropriate advertising to assist the Journal in its goal of self-support.

Advertisers Dr. OJO................................................................. 2 FLORIDA DEPT. of HEALTH............................ 2 Healthcare consultants........................ 3 Kahan ◆ SHIR, P.L.......................................... 13 mckesson.......................................................... 9 MEDICAL STAFFING.......................................... 8 PHARMACY PROVIDER SERVICES (PPSC)......................................... 14 philadelphia college.............................. 11 Rx RElief.......................................................... 13

E-mail your suggestions/ideas to dave@fiorecommunications.com

The President’s Viewpoint Guest Columnist Mark Hobbs, Chair, FP-PACCE

Setting the Pace with PACCE!

t the 119th Annual Meeting of the Florida Pharmacy Association, the FP-PACCE held one of the most successful events in our history. Joining close to 100 pharmacists and guests were Florida state representatives David Rivera, Mike Weinstein, Clay Ford, Greg Evers and Alan Hays, who enjoyed an evening of fine wine and friends. We had the opportunity to hear from each of the representatives and give them a contribution to their respective re-election campaigns. It was a great kickoff to a busy political season, and we won’t stop there. But we need your support! What exactly is the PACCE? Florida Pharmacy Political Action Committee of Continuing Existence (PACCE) is an advocacy committee for the profession of pharmacy in Florida without political party affiliation. Your current board members include Theresa Tolle (serving as Treasurer), Joy Marcus, Tom Cuomo, Nick Generalovich, Ken Wisniewski, Val Ingoldsby, Alex Pytlarz, and myself serving as Chair. Its purposes are (1) To promote and strive for the improvement of government by encouraging and stimulating the profession and business of pharmacy and others to take a more active and effective part in governmental affairs; (2) To encourage pharmacists and others to understand the nature and actions of their government, as to important political issues, and as to the records of officeholders and candidates for elective office; (3) To assist pharmacists and others in organizing themselves for more effective political action and in carrying out their civic responsibilities; and (4) To do any and all things necessary or desirable for the attainment of the purposes stated above. Florida Pharmacy Association has as one of its primary goals to be the most

effective, proactive, and powerful pharmacy advocacy group in the state. At the same time, we are moving into one of the most significant election cycles in the history of our state. We will see a change in leadership at not only the executive level, but up to half the Senate seats in the state will change hands. It is critical to our profession that we fill these seats with individuals who sup-

Florida Pharmacy Political Action Committee of Continuing Existence (PACCE) is an advocacy committee for the profession of pharmacy in Florida without political party affiliation. port our profession. That is why your money is so critical. Contributions to the FP-PACCE in turn help us to evaluate these candidates and give donations to candidates who will support us in the state legislature. Isn’t it worth at least $1/day to support your profession? How can you help? If you’re interested, I need to hear from you! You can e-mail me at hobbsrx@msn.com. More importantly, make a contribution TODAY! You can send a check directly to FP-PACCE . Or if you choose, you can make a monthly contribution on your VISA or Master Card. n

Mark Hobbs

Levels of giving Levels of giving to the Florida Pharmacy Political Action Committee of Continuous Existence are as follows: Active membership.................. $50.00 Contributing membership...... $100.00 Sustaining membership.......... $250.00 Chamber membership............ $500.00 Capital membership............ $1,000.00 You can make your contribution online under the "shopping" menu item at www.pharmview.com.

J A N U ARY 2 0 1 0

2009/2010 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work deligently all year long on behalf of our members.

Norman Tomaka.....................................Chairman of the Board of Directors Karen Whalen...............................................................................................FPA President Don Bergemann.....................................................................................................Treasurer Alexander Pytlarz..................................Speaker of the House of Delegates Dean William Riffee...................Vice Speaker of the House of Delegates Alexander Pytlarz......................................................................................Speaker Elect Preston McDonald, Director............................................................................ Region 1 Marcus Dodd-o, Director .................................................................................Region 2 Al Tower, Director ..................................................................................................Region 3 Raul N. Correa, Interim Director ................................................................Region 4 John Noriega, Director ......................................................................................Region 5 Chris Lent, Director...............................................................................................Region 6 Kim Murray, Director............................................................................................ Region 7 Joy Marcus, Director...........................................................................................Region 8 Ayala Fishel, Director...........................................................................................Region 9 Peter Iafrate............................................................................................. President FSHP Michael Jackson........................................Executive Vice President and CEO

"Memory Loss" continued from page 15

dementia).

■■ Don’t smoke or abuse alcohol. Ac-

■■

■■ Maintain healthy eating habits.

Florida Pharmacy Today Journal Board Chair Designate....................................... Betty Harris, beejpharm@gmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member...............................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com

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cording to a research report from Harvard Medical School, “Improving Memory: Understanding AgeRelated Memory Loss,” smokers perform worse than nonsmokers in studies of memory and thinking skills. Heavy alcohol use can also impair memory. Get regular exercise. Physical activity may help maintain blood flow to the brain and reduce risk factors associated with dementia.

According to a study published in the Oct. 24, 2006, issue of Neurology, eating vegetables may help slow down the rate of cognitive change in adults. Researchers studied 3,718 residents in Chicago who were older than age 65. Of the types of vegetables, green leafy vegetables had the strongest association with slowing the rate of cognitive decline. Also reducing foods high in saturated fat and cholesterol and eating fish with beneficial omega-3 fatty acids, such as salmon and tuna, may benefit brain health. An NIA-funded clinical trial to test the effects of omega-3 fatty acids in people with AD is now recruiting patients nationwide. Maintain social interactions. Social interaction can help reduce stress levels and has been associated with a lower risk of dementia. In the February 2007 issue of the Archives of General Psychiatry, researchers found that loneliness is associated with an increased risk of late-life dementia. Keep your brain active. Some experts suggest that challenging the brain with such activities as reading, writing, learning a new skill, playing games, and gardening stimulates brain cells and the connections between the cells, and may be associated with a lower risk of dementia.

Executive Insight By Michael Jackson, FPA Executive by michael jackson,Vice RPhPresident/CEO

The Dizzying Pace of Pharmacy Change

o you feel the wind in your face? Does it seem that time is moving faster than you could ever remember? There are a lot of things happening within our profession that have distracted us from our designated mission of providing patient care. This message, though published in the January 2010 issue of Florida Pharmacy Today, is being written during the high point of the debate on health care reform (HCR) during December of 2009. A number of pharmacy issues designed to repair broken public policy are being advocated for in the HCR package. This includes, but is not limited to, the following: ■■ Medicaid pharmacy reimbursement – The federal proposal is to move pharmacy reimbursement away from Average Wholesale Price (AWP) and Wholesale Acquisition Costs (WAC) to Average Manufacturer Pricing (AMP). AMP pricing would likely result in pharmacies dispensing medications to Medicaid patients below their costs. Pharmacy advocates are asking that the current definition of AMP be revised to hold pharmacies harmless. ■■ Pharmacy Benefit Manager (PBM) Transparency – Not much is known about the closed-door negotiations behind the management of the prescription drug benefit. Pharmacy advocates feel that these issues need to be disclosed to payers of health care. ■■ DME Accreditation – Pharmacies that service Medicare Part B patients by providing staple items such as crutches, diabetic supplies and other related items under the Part B program are obligated under current rules to complete an expensive accreditation process. No

■■

other licensed health care provider is required to go through accreditation review. Licensed pharmacies should be exempt from these requirements. Mediation Therapy Management – There has been tons of research and clinical studies showing the value

A number of pharmacy issues designed to repair broken public policy are being advocated for in the HCR package.

■■

of clinical pharmacy services. The spending on prescription drugs in the U.S. is equivalent to the annual budget of some small countries. Much of this spending can be averted if only health care policy on funded programs required pharmacist review within the medical home model. Prescription Drug Importation – The FPA supports laws that prohibit the illegal importation of prescription drugs. Interest in this area is driven by efforts to gain lower pricing from suppliers of prescription drugs from other countries. FPA is working with the national organizations on this issue. At press time, a proposal to allow importation was

Michael Jackson, BPharm

removed from the health care reform draft. Nationally, the discussions on health care reform in many communities have been polarized between the two major political parties. Each has a philosophy on what reform should look like. Weighing in on these issues are the special-interest groups that have a significant financial stake in whatever Congress writes into policy. They are investing unprecedented resources into getting their message on the minds of your representatives in Congress. They are also using local media to tell you what they believe health care reform is or is not. What these special-interest groups cannot do is send someone from your community to Washington, D.C., to represent you. Only you have the power and authority to do that. You also have the ability to send in a replacement if your message is not heard, understood or addressed. To do so means that you need to form a relationship with your representatives in Congress. They should know you J A N U ARY 2 0 1 0

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

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall , ext. 211

Membership Coordinator Ranada Simmons , ext. 110

Educational Services Office Assistant Stacey Brooks , ext. 210 Florida Pharmacy Today Board Chair Designate........Betty Harris, Lighthouse Point Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach Member................. Don Bergemann, don@bceinfo.com Member..................................... Joseph Koptowsky, Miami Member...................................... Jennifer Pytlarz, Brandon Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2010, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax.

by your first and last name. It does not matter if you are an employee pharmacist or an owner pharmacist. Policy making in Washington, D.C. (and in Tallahassee) is resulting in change for your business and professional practice whether you agree with it or not. Consider a recently released white paper report from the National Council on Prescription Drug Programs (NCPDP). According to a chart in that report in 1994 44 percent of prescriptions filled in community pharmacies were paid for with cash. That percentage has declined to 9 percent in 2008 and is dropping by 1 percent per year. Simply put, it means that payment for 91 percent of your prescription business is determined by someone else or a governmental policy. If you want to know more about the final results of health care reform consider attending the annual meeting of the Florida Pharmacy Association in Marco Island, Florida, June 30 through July 4, 2010. It is there that a report on federal health care reform issues will

be shared with meeting attendees. It is also at this meeting that the FPA will debate issues and Association policy during its House of Delegates meeting. Delegates through local unit associations can present proposed policy for review and consideration. Individual members can also submit policy statements for the Association to consider. A call for resolutions and the process has been published in the October 2009 issue of Florida Pharmacy Today and is in this issue as well. Remember that failure to get involved in public health policy making empowers others to determine your future. By the way, don’t forget that pharmacies are required to have in place a fraud, waste and abuse program. Medicare Part D plans are likely to audit you for compliance in this area. The FPA has a program available. For more information, please visit our Web site at www.pharmview.com. n

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Make Health Your Resolution Source: Centers for Disease Control and Preventon

Here are some ways to make health your resolution. Enjoy a new year of healthy possibilities! Five Minutes or Less for Health Weekly Tip: Make Health Your Resolution Take a few minutes to live a safer and healthier life. ■■ Make healthy food choices. Grab a healthy snack on the go, such as an apple, nuts, trail mix, or low-fat cheese. ■■ Be active. Take the stairs instead of the elevator. Park farther away and walk. ■■ Protect yourself from injury and disease. Put on a helmet, sunscreen, or insect repellent. Wash your hands for 20 seconds. ■■ Manage stress. Take short breaks throughout the day. ■■ Make an appointment for a check-up, vaccination, or screening. ■■ Quit smoking. Call 1-800-QUIT-NOW for free counseling on how to quit smoking for good.

Florida Pharmacy TodaY

New Year’s Day has long been a time for reflection on the personal changes we want to make as we look forward to a happy new year. Health-related goals are popular New Year’s resolutions, but you may not know where to begin. Below, you’ll find ways to get and keep a Healthy You, Healthy Family, Healthy Home, Healthy Community, and Healthy Workplace. Make health your resolution. Healthy You ■■ Make healthy food choices. Grab a healthy snack such as fruit, nuts, or low-fat cheese. ■■ Be active. Try simple things such as taking the stairs instead of the elevator. Be active for at least 2 ½ hours a week. ■■ Protect yourself from injury or disease by wearing a helmet, sunscreen, or insect repellent when necessary. ■■ Make an appointment for a checkup, vaccination, or screening. Know

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■■ ■■

where to go for care if you do not have health insurance. Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer. Be smoke-free. If you think you’re ready to quit, call 1-800-QUIT-NOW for free counseling. Get enough sleep. Remember that sleep is a necessity, not a luxury. Learn health tips that take 5 minutes or less.

Healthy Family ■■ Learn how to be healthy before, during, and after pregnancy. ■■ Reduce auto-related injuries by using seat belts, child safety seats, and booster seats that are appropriate for your child’s age and weight. ■■ Learn positive parenting tips to keep teens safe on the road. ■■ Lower the risk of foodborne illness as you prepare meals for your family.

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Serve healthy meals and snacks. Encourage and support physical activity. Gather and share family health history. Encourage family members to get check-ups and screenings. Make sure they know where to go for care if they do not have health insurance. Get pets vaccinated and keep pets healthy. Add the 5 Minutes or Less for Health widget to your website to get new health tips each week.

Healthy Home ■■ Go green. Reduce, reuse, and recycle. ■■ Install smoke alarms on every floor, including the basement, and particularly near rooms in which people sleep. ■■ Make your home safer to prevent falls among children and seniors.

■■ ■■

Keep cleaning products and medications out of the reach of children. Have an emergency plan and practice it often.

Healthy Community ■■ Make a difference at a local school to prevent childhood obesity. ■■ Sponsor a health event i n your community. ■■ Get your immunizations. ■■ Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer. ■■ Keep water safe for drinking, recreation, and emergencies. ■■ Get tested and treated for sexually transmitted diseases. ■■ Don’t drink and drive or let others drink and drive. ■■ Add a health widget to your website that offers health information to your users.

Healthy Workplace ■■ Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer. ■■ Stay at home if you’re sick. ■■ Participate in or help develop healthy workplace programs and policies. ■■ Implement a smoke-free policy at your workplace. ■■ Take steps to prevent job stress. ■■ Lower work injuries and illness among youth.

GAPCOM_PHARMJour-12-09:Layout 1 12/17/09 10:27 AM Page 1

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PCOM School of Pharmacy – Georgia Campus SHAPING PHARMACY EDUCATION FOR TOMORROW’S LEADERS PCOM is proud to offer a new Doctor of Pharmacy (PharmD) degree. Providing future pharmacists with the tools for community and hospital practices, long-term and managed care consulting, pharmacy management, research and academia. PCOM School of Pharmacy – Georgia Campus is now accepting applications. For more information, e-mail us at PharmDAdmissions@pcom.edu or apply now at www.pcom.edu Philadelphia College of Osteopathic Medicine’s Doctor of Pharmacy program has applied for accreditation status by the Accreditation Council for Pharmacy Education, 20 North Clark Street, Suite 2500, Chicago, IL 60602-5109, 312/644-3575; FAX 312/664-4652, Web site, www.acpe-accredit.org. For an explanation of ACPE accreditation process, consult the Office of the Dean, or ACPE.

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Coping With Memory Loss Consumer Update from the FDA Everyone has mild memory lapses from time to time. You go from the kitchen to the bedroom to get something, only to find yourself wondering what you needed. You can’t find your car keys one day and your reading glasses the next.Lapses such as these are usually just signs of a normal brain that’s constantly prioritizing, sorting, storing, and retrieving all types of information. So how do you know when memory loss is abnormal and warrants evaluation by a health professional? Here are some questions to consider: ■■ Does the memory loss disrupt

daily living? “If memory loss prevents someone from doing activities that they had no trouble handling before—like balancing a checkbook, keeping up with personal hygiene, or driving around—that should be checked,” says John Hart, Jr., M.D., professor of behavioral and brain sciences at the University of Texas at Dallas and medical science director at the Center for BrainHealth.

■■ How often do memory lapses oc-

cur? It’s one thing to occasionally

forget where you parked your car, but it’s not normal to forget where you parked every day or to forget appointments over and over. Frequent memory lapses are likely to be noticeable because they tend to interfere with daily living.

■■ What kinds of things are being

forgotten? “It’s normal to forget

the name of someone you just met, but may not be normal to permanently forget the name of a close friend or relative,” Hart says. “It also may not be normal to never remember meeting a person after you have spent a great deal of time with them.” Most people have trouble remembering some details of a conversation, but forgetting whole conversations could signal a problem. Other red flags: frequently re-

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peating yourself or asking the same questions in the same conversation. Are there signs of confusion? Serious memory lapses may cause individuals to get lost in a familiar place or put something in an inappropriate place because they can’t remember where it goes. Putting the car keys in the refrigerator is an example.

■■

■■ Is the memory loss getting

worse? Memory loss that gets progressively worse over time should be evaluated by a health professional.

What Can Cause Memory Loss? Anything that affects cognition— the process of thinking, learning, and remembering—can affect memory. Doctors use a combination of strategies to gain better insight into what’s going on, says Ranjit Mani, M.D., a neurologist and medical reviewer in the Food and Drug Administration’s (FDA’s) Division of Neurology Products. Doctors evaluate memory loss by taking a medical history, asking questions to test mental ability, conducting a physical and neurological examination, and performing blood and urine tests. Brain imaging, using computerized axial tomography (CAT) scans or magnetic resonance imaging (MRI), can help to identify strokes and tumors, which can sometimes cause memory loss. “The goal is to rule out factors that are potentially reversible and determine if the memory loss is due to a more serious brain disease,” Mani says. Causes of memory loss, some of which can occur together, include the following: ■■ Medications. Examples of medications that can interfere with memory include over-the-counter and prescription sleeping pills, over-thecounter antihistamines, anti-anxiety medications, antidepressants, some medications used to treat

■■

schizophrenia, and pain medicines used after surgery. Alcohol and illicit drug use. Heavy alcohol use can cause deficiencies in vitamin B1 (thiamine), which can harm memory. Both alcohol and illicit drugs can change chemicals in the brain that affect memory. Stress. Stress, particularly due to emotional trauma, can cause memory loss. In rare, extreme cases, a condition called psychogenic amnesia can result. “This can cause someone to wander around lost, unable to remember their name or date of birth or other basic information,” Mani says. “It usually resolves on its own.” Depression. Depression, which is common with aging, causes a lack of attention and focus that can affect memory. “Usually treating the depression will improve mood and the memory problems may then also improve,” Mani says. Head injury. A blow to the head can cause a loss of consciousness and memory loss. “Memory loss from head trauma typically stays the same or gradually gets better, but not worse,” Mani says. Infections. People with HIV, tuberculosis, syphilis, herpes, and other infections of the lining or substance of the brain may experience memory problems. Thyroid dysfunction. An underactive or overactive thyroid can interfere with remembering recent events. Sleep deprivation. Lack of quality sleep—whether from stress, insomnia, or sleep apnea—can affect memory. Nutritional deficiencies. Deficiencies of vitamins B1 and B12 can affect memory. Such deficiencies can be treated with a pill or an injection. Normal aging. As part of the normal aging process, it can be hard-

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er for some people to recall some types of information, such as the names of individuals. Mild cognitive impairment. Mild cognitive impairment (MCI) is a condition characterized by a memory deficit beyond that expected for age, which is not sufficient to impair day-to-day activities. Dementia. Dementia is a term used for a condition in which there is increasing impairment of memory and other aspects of thinking that are sufficiently severe to impair day-to-day activities. There are many causes of dementia, but the most common by far is Alzheimer’s disease (AD), in which there is a progressive loss of brain cells accompanied by other abnormalities of the brain. A diagnosis of AD is made by confirming that a patient has dementia and by excluding other conditions, such as brain tumors, vitamin deficiencies, and hypothyroidism.

Mild Cognitive Impairment People with MCI have memory impairments, but otherwise function well and don’t meet the clinical criteria for dementia. Whereas normal memory loss associated with aging may involve forgetting a name, memory loss associated with MCI is more severe and persistent. MCI is often a transition stage between normal aging and more serious problems caused by AD. Most, but not all, people with MCI get worse. According to some studies, each year about 12 to 15 percent of people with MCI develop AD. “Some people never decline in five years and with others, we might see a decline in the third year,” says Reisa Sperling, M.D., associate professor of neurology at Harvard Medical School and director of clinical research at the Memory Disorders Unit at Brigham and Women’s Hospital. “In older people with MCI, if the memory loss is slowly getting worse, the chances of developing AD are about 60 percent to 70

percent.” Research is under way on whether the drugs approved to treat symptoms of AD may help some people with MCI. Scientists hope that some day, accurate and early evaluation and treatment of people with MCI may help prevent further cognitive decline. Alzheimer’s Disease AD is the most common form of dementia in people older than age 65, and affects more than 5 million Americans, according to the Alzheimer’s Association. AD is a progressive, neurodegenerative disease characterized in the brain by abnormal protein deposits (amyloid plaques) and tangled bundles of fibers within nerve cells (neurofibrillary tangles). The biggest risk factors are age and family history. Having a history of serious concussion is also a risk factor. AD gradually destroys a person’s memory and ability to learn, reason, make judgments, communicate, and carry out daily activities. Memory loss

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becomes severe and is marked by disorientation, general confusion, and an inability to recall recent events. A person with mild-to-moderate AD may remember things that happened to them a long time ago, but they might get lost easily in a familiar place. People with AD may also experience changes in personality and behavior, such as withdrawal and suspicion. They eventually experience a loss of speech and movement, incapacitation, and death. Some facts about AD treatment follow: of drug treatments for memory loss focus on people with AD. Five drugs are approved by FDA to treat the symptoms of AD, but there is no cure for the disease.

■■ Most clinical trials

■■

■■ Four drugs are known as cho-

linesterase inhibitors and are thought to work in a similar way. Cognex (tacrine), Exelon (rivastigmine), and Razadyne (galantamine) are approved for mild-to-moderate AD. Aricept (donepezil) is ap-

proved to treat all degrees of severity of the disease—from mild to severe. Cholinesterase inhibitors prevent the breakdown of acetylcholine, a chemical that nerves use to communicate with each other. “These drugs may help delay or decrease the severity of symptoms for a limited time in some people,” says Susan Molchan, M.D., formerly program director for the Alzheimer’s Disease Neuroimaging Initiative project at the National Institute on Aging (NIA), part of the National Institutes of Health. Side effects of cholinesterase inhibitors are gastrointestinal, such as nausea and diarrhea.

■■ Namenda (memantine), approved

for moderate-to-severe AD, is believed to block the action of glutamate, a brain chemical that may be overactive in people with AD. Namenda may help some patients maintain certain daily functions a little longer. Common side effects include dizziness, headache, consti-

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Florida Pharmacy TodaY

■■

pation, and confusion. Sometimes, Namenda is prescribed along with a cholinesterase inhibitor. Behavioral symptoms of AD may include agitation, sleeplessness, anxiety, and depression, which can be treated.

■■ Inhibiting and/or decreasing am-

yloid is an intense area of research because amyloid is the major component of the plaques that develop in the brains of people with AD and is associated with nerve cell death. Drugs called secretase inhibitors are being developed and tested to block beta-amyloid formation. Also under study is immunotherapy against beta amyloid—it’s possible that a vaccine may help reduce deposits of amyloid. NIA is recruiting patients for a study to determine if a type of protein to reduce brain amyloid slows the rate or prevents the decline of dementia in people with mild-to-moderate AD. For more information on the study, known as the Gammaglobulin Alzheimer’s

PPSC can help your independent pharmacy become more efficient and productive through its innovative Work Smarter programs and services. PPSC can help you: ENHANCE operational workflows AUTOMATE dispensing, product returns and Part B billing REDUCE claim resubmissions INCREASE your profits

Partnership Study (GAP), visit the Alzheimer’s Disease Education and Referral Center Web site or call the center at (800) 438-4380. Other Diseases That Cause Dementia ■■ Dementia is diagnosed when two or more brain functions, such as memory and language skills, are significantly impaired, according to criteria set forth by the National Institute of Neurological Disorders and Stroke. In practice, doctors use the same drugs that are used to treat AD to treat some other types of dementia. ■■ Vascular dementia. In people who have vascular dementia, also called multi-infarct dementia, arteries to the brain become blocked or narrowed. As a result, changes in the blood supply to the brain occur or multiple strokes disrupt blood flow to the brain. Symptoms may be similar to those of AD, although they usually occur more abruptly. Treatment focuses on preventing future strokes by controlling risk factors such as smoking, diabetes, and high blood pressure. ■■ Lewy body dementia. This progressive brain disease is caused by a buildup of protein deposits called Lewy bodies. It involves progressive cognitive decline, problems with alertness and attention, recurrent visual hallucinations, and motor problems similar to those seen with Parkinson’s disease, such as rigidity. Treatment aims to control symptoms of the disorder. Antipsychotic medications for hallucinations aren’t typically prescribed because there is a risk of the hallucinations becoming worse. ■■ Parkinson’s disease with de-

mentia. Parkinson’s disease results

from the loss of dopamine-producing brain cells. The primary symptoms are trembling in the hands, arms, legs, jaw, and face; body stiffness; and slowness of movement and impaired balance and coordination. Memory loss sometimes occurs with late-stage Parkinson’s disease. Exelon (rivastigmine), which

■■

is approved for mild-to-moderate AD, is also approved by FDA for the treatment of dementia with Parkinson’s disease. Frontotemporal dementia. This type of dementia is associated with the shrinking of the frontal and temporal anterior lobes of the brain. Symptoms involve either impulsive or listless behavior, and may include socially inappropriate behavior. Some forms of frontotemporal dementia consist of progressive loss of language functions. No treatment has been shown to slow the progression. Antidepressants and behavior modification may improve some symptoms. Huntington’s disease. This inherited brain disorder causes uncontrolled movements, loss of memory and other cognitive problems, and emotional disturbance. Some early symptoms are mood swings, depression, and difficulty learning new things and remembering facts. Medications help control emotional and movement problems.

■■ Creutzfeldt-Jakob disease (CJD).

In the early stages of this rare, degenerative brain disorder, people may experience failing memory, behavioral changes, lack of coordination, and visual disturbances. Mental impairment becomes rapidly more severe as the illness progresses. There is no drug to cure or control CJD, but some drugs may help with symptoms.

Resources for Coping Coping with memory loss can be frustrating for both the person affected and family members and caregivers. Some families use memory aids to help quality of life, such as color coding and labeling items in the home with safety notes and directions for use, and using alarms and talking clocks to keep track of time and remember medication doses. Families also may experience anger, exhaustion, irritability, and other symptoms of caregiver stress. ■■ Alzheimer’s Association. Resourc-

es of the Alzheimer’s Association include an online message board; a

24/7 toll-free number; information on legal, financial, and living-arrangement decisions; and referrals to local community programs. Services include CareFinder, an interactive tool to help you choose home and residential care providers, and Safe Return, a program that helps when a person with AD or a related dementia wanders and becomes lost.

■■ Alzheimer’s Disease Education

and Referral Center. A service of

■■

NIA. Information specialists can answer questions and offer free publications on home safety tips, caregiving tips, and information on the diagnosis and treatment of AD and related disorders, and ongoing research. A joint NIA and FDA effort maintains the Alzheimer’s Disease Clinical Trials Database. Family Caregiver Alliance. This alliance offers online discussion groups and caregiver information in English, Spanish, and Chinese, as well as fact sheets, including the Caregiver’s Guide to Understanding Dementia Behaviors.

Can Memory Loss Be Prevented? There is no conclusive evidence that the herb ginkgo biloba prevents memory loss. And research has shown that the combination of estrogen and progestin increased the risk of dementia in women older than age 65. So what can you do to prevent memory loss? Clinical trials are under way to test specific interventions. While those tests are being conducted, you may want to consider hints from animal and observational studies of promising approaches. These steps are already beneficial in other ways and may help reduce the risk of developing memory problems. ■■ Lower cholesterol and high blood

pressure. A number of studies in

recent years have suggested that vascular diseases—heart disease and stroke—may contribute to the development of AD, the severity of AD, or the development of multi-infarct dementia (also called vascular

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Florida Pharmacy TodaY

CALL FOR RESOLUTIONS TO THE 2010 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in March 2010 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is March 15, 2010! PLEASE NOTE THIS DEADLINE.

The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification Or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: (please type and use double spacing) Title of Resolution Name of Organization Whereas

, and

Whereas

Therefore be it Resolved (that the FPA or Subdivision of FPA)

Contact name and phone #: Problem: Intent:

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CALL FOR ABSTRACTS FOR POSTER PRESENTATIONS For Florida Pharmacy Students

FLORIDA PHARMACY ASSOCIATION 120TH ANNUAL MEETING AND CONVENTION

June 30 - July 4, 2010 Marco Island Marriott Resort, Golf Club & Spa ♦ Marco Island, Florida Poster Session: Friday, July 1, 2010, 4:30-6:00PM

The FPA Poster Presentations are open to PHARMACY STUDENTS ONLY. Complete and submit this COVERSHEET for each abstract submission. Submissions must be received no later than Monday, May 3, 2010. Abstracts will NOT be accepted after this date. Mail or E-mail this application along with the abstract submission to: Tian Merren Owens, MS, PharmD, Director of Continuing Education Florida Pharmacy Association 610 N. Adams Street Tallahassee, FL 32301 tmerren@pharmview.com

PLEASE TYPE

Contact Information: Presenter's Name (MUST BE A STUDENT):________________________________________________________________

□ Entry Level Pharm.D. □ Post B.S. Pharm.D. Address: ________________________________________________________________________________________

City, State, Zip: ___________________________________________________________________________________ Telephone No: _____________________E-Mail Address: _________________________________________________ Abstract Title: ____________________________________________________________________________________ Poster Type:

□Clinical Research □Basic Science Research □Translational Research (Basic Science and Clinical Research)

Primary Author: __________________________________________________________________________________ (Students must be listed first to be considered for the Award. Presenter will be notified by mail of acceptance). Co-Author(s): _________________________________________________________ Student

□YES □NO

Awards:

Posters will be eligible for 1st, 2nd, and 3rd place prizes to be presented at Convention. (Only one prize is given for each winning poster)

Free Registration:

Three entry level students from each Florida College of Pharmacy will be eligible for a complimentary Florida Pharmacy Association Convention Student registration. (Student Registration does not include CE or hotel accommodations) I am interested in being considered for this registration:

College:

⁪ □YES

⁪ □NO

_____________________________________________________________________________

ABSTRACT FORMAT The abstract form submitted should be the equivalent of one page. The abstract should include: Title (Include authors’ names and name of College of Pharmacy), Purpose, Methods, Results, and Conclusions. Abstracts will not be accepted if it is not in this format. Do not include figures or graphs.

Please direct all questions and concerns to:

Tian Merren Owens ♦ (850) 222-2400 ext. 120 ♦ tmerren@pharmview.com DEADLINE DATE: MONDAY, MAY 3, 2010 18

Florida Pharmacy TodaY

Florida Pharmacists Legislative Days and Health Fair

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Florida Pharmacists Legislative Days and Health Fair

Florida Pharmacy TodaY

Florida Pharmacists Legislative Days and Health Fair

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C a l l

f o r

Pfizer Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award. ■■                 on its award committee or an officer of the association in other than an ex officio capacity. ■■   has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the "Pharmacist of the Year." The criteria established for this award is that the recipient be a Florida registered pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years.

Criteria:

■■   must be a Florida reg-

istered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years.

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

Florida Pharmacy TodaY

N o m i n a t i o n s ■■

■■

Candidate must be a member of the Florida Pharmacy Association for at least 2 years. Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice. Candidate must have demonstrated contributions to the Florida Pharmacy Association and/or other pharmacy organizations. Candidate must have demonstrated commitment to community service. Candidate is not a past recipient of this award.

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

Criteria:

■■  recipient must be a Florida reg-

istered pharmacist and a member of the FPA. ■■   has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award

Criteria:

■■ Candidate must be an FPA member,

registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy. DCPA Sidney Simkowitz Pharmacy Involvement Award

Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida.

F P A

Criteria:

■■ A minimum of five years of active

involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession. Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine (9) years or less. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria:

A W A RDS

2 0 0 9 - 2 0 1 0

The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination.

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

The Jean Lamberti Mentorship Award

Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria:

■■

The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and ex-

■■ The recipient must be an FPA mem-

ber.

■■ The recipient must serve as a role

model for the profession of pharmacy.

vative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association. Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association.

Innovative Pharmacy Practice Award

■■ The recipient has demonstrated inno-

Deadline FOR NOMINATIONS: February 28, 2010 F P A A W A RDS N OMI N A TIO N F ORM I am pleased to submit the following nomination:

Nominated by:

Name:

Address:

Date Submitted: Signature:

For the following Award: (Nomination Deadline February 28, 2010)  Bowl of Hygeia Award  James H. Beal Award

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

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  Academy of Pharmacy Practice Practitioner Merit Award  The Jean Lamberti Mentorship Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  Innovative Pharmacy Practice Award  Technician of the Year Award

Mail nominatons to: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2010

J A N U ARY 2 0 1 0

Buyer’s Guide florida PHARMACY TODAY

ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

Support Our Advertisers! Use the “Buyer’s Guide” PHARMACY RESOURCES

PHarmaceutical WHOLESALER

PPSC Retail Pharmacy Purchasing Program (888) 778-9909

McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Dean Pedalino (800) 642-1652 Mobile: (727) 460-1855

TEMPORARY PHARMACISTs – STAFFING

INSURANCE

Medical Staffing Network (800) 359-1234

Meadowbrook Workers Comp Insurance Endorsed by FPA (800) 825-9489

HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652

Rx Relief (800) RXRELIEF

LEGAL ASSISTANCE Kahan ◆ Shir, P.L. Brian A. Kahan, R.Ph., and Attorney at Law (561) 999-5999

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 487-4441 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm Drug Information Center Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK 1-800-282-3171 http://ora.umc.ufl.edu/ pcc/fpicjax.htm National Community Pharmacists Association 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org Recovering Pharmacists Network of Florida (407) 257-6606 “Pharmacists Helping Pharmacists”

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt. 24

Florida Pharmacy TodaY