November 2014 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association NOV. 2014

Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, Pharmacy Audit Disputes Mergers and Acquisitions Commercial, Civil and Criminal Proceedings KAHAN ◆ HEIMBERG, PLC

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 23 Buyer’s Guide

VOL. 77 | NO. 11 NOVEMBER 2014 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

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Trust and Patient Care: An Intern’s Dilemma Medical Marijuana – A Look at Drug Interactions and Side Effects FPA 2015 Elections

NOVEMBER 2014

FPA Calendar 2014-2015

MARCH

NOVEMBER 27-28 Thanksgiving - FPA Office Closed

8-9

DECEMBER 2-3

Florida Board of Pharmacy Meeting

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Law and Regulatory Conference Sarasota

25-26 FPA Office Closed JANUARY 1

FPA Office Closed

Emerging Leaders in Pharmacy Practice Conference Orlando

24-25 FPA Clinical Conference Sandestin 31

FPA election ballots due FEBRUARY

Awards nominations due

Pharmacist Legislative Days and Health Fair Tallahassee

25-26 FPA Committee and Council Meetings Orlando APRIL 3

Good Friday, FPA Office Closed

18-19 FPA Regulatory and Law Conference - Tampa Airport Marriott Tampa 24

Last Day to Submit Resolutions MAY

16-17 Law and Regulatory Conference Jacksonville JUNE 24-25 125th Annual Meeting and Convention St. Augustine

For a complete calendar of events go to www.pharmview.com Events calendar subject to change 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, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2014. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact 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

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 issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

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

Advertisers EPC........................................................................ 2 THE HEALTH LAW FIRM.............................. 18 KAHAN HEIMBERG, PLC................................ 2 MCKESSON....................................................... 24 PPSC...................................................................... 2 PHARMACY BROKER...................................... 8

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 U/F — Art Wharton (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

E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

The President’s Viewpoint SUZANNE KELLEY, FPA PRESIDENT

Celebrating a Grand Tradition: the 125th FPA Annual Meeting and Convention

nniversaries, as well as birthdays, are special dates that we often celebrate with others. For those of us who have broken down and accepted numerous “friend requests,” we receive many alerts notifying us of upcoming birthdays and other special dates. So, let me ask you, do you celebrate your birthday or the birthdays of others? What about wedding anniversaries? What about class reunions? With regard to wedding anniversaries, the 25th wedding anniversary is the “Silver Anniversary,” and often includes gifts made of silver. The 50th wedding anniversary is the “Golden Anniversary” with parties held in honor of the special couple as well as some gifts made of gold. Couples lucky enough to live long enough to celebrate 75 years of marriage get to celebrate their 75th anniversary! This is the “Diamond Anniversary” and as you probably can guess, gifts are often diamond in shape or contain diamonds. What a wonderful milestone to make! With regard to birthdays, some of us prefer to allow this special day to go quietly by. Unfortunately, we may not be so lucky, and celebrations may be held whether we want them or not. We get birthday cards, presents, cakes and so forth to celebrate that special day. Surprise parties can be fun, but often they may not be well received. Special meals are often planned for that “birthday person.” Yummy! Do you like to surprise others on their birthday? I really enjoy doing this. Believe it or not, we have an anniversary coming up. Do you have any idea what anniversary I am referring to? The Florida Pharmacy Association will hold our 125th Annual Meeting

and Convention in St. Augustine this summer. Can you believe this? Were you aware that our association has met that many times? Do you know any of the history with regard to the Florida Pharmacy Association? More on that

The Florida Pharmacy Association will hold our 125th Annual Meeting and Convention in St. Augustine this summer. Can you believe this? Were you aware that our association is that old? subject will be provided at a later date. I took the time to ask the FPA staff what information they had on previous annual meetings. Members of the Florida Pharmacy Association can proudly state that your association has been serving the profession since 1887. The birthplace of our association was at the intersection of Adams and Main Street in Jacksonville. The 51st Annual Meeting and Convention was held in May 1938 at the Hollywood Beach Hotel in Hollywood, Fla. The “Diamond Jubilee” Convention was held at the Americana Hotel in Bal Harbour in May 1965 to celebrate the 75th FPA Annual Meeting and Convention. Some of you may remember the 100th Annual Meeting and Convention, which was held June

Suzanne Kelley 2014-2015 FPA President

27 – July 1, 1990, at the Daytona Beach Marriott in Daytona Beach, Fla. Perhaps you were lucky enough to attend that very special event. Unfortunately, I did not go, but, I can only imagine that it was quite a celebration! So, how are we going to celebrate the 125th Annual Meeting and Convention? I am certainly not going to tell you; however, it will be quite the celebration! Make plans to join us in St. Augustine for this great event! I can tell you this: this year’s convention will be different, and we will be celebrating the fact that this is the Florida Pharmacy Association’s 125th Annual Meeting and Convention. What a coincidence to be meeting in the historical town of St. Augustine. St. Augustine was founded by the Spanish in 1565 and is the nation’s oldest permanently occupied European settlement. Actually, the Timucuan Indians were there first and observed NOVEMBER 2014

2014 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 diligently all year long on behalf of our members.

Terry Gubbins.......................................................................... Chairman of the Board Suzanne Kelly...............................................................................................FPA President Tim Rogers................................................................................................... President Elect Alexander Pytlarz................................................................................................Treasurer Bob Parrado................................................Speaker of the House of Delegates Jackie Donovan...........................Vice Speaker of the House of Delegates Jennifer Raquipo..............................................................Interim Director, Region 1 Michael Hebb........................................................................................ Director, Region 2 Stephen Grabowski........................................................................ Director, Region 3 Linda Lazuka........................................................................................ Director, Region 4 Jason Beattie...................................................................................... Director, Region 5 Luther Laite IV.................................................................................... Director, Region 6 Kimberly Jones................................................................Interim Director, Region 7 Humberto Martinez......................................................................., Director, Region 8 Mitchell Fingerhut......................................................... Interim Director, Region 9 Christine Gegeckas............................................................................. President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair...........................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary.............. Verender Gail Brown, brownvgrx4304@hotmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Member........................................................Cristina Medina, cmmedina@cvs.com Member................................................................Norman Tomaka, FLRX9@aol.com Member........................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu

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FLORIDA PHARMACY TODAY

Don Pedro Menendez de Aviles and his party of about 1,500 soldiers and colonists set up the first European settlement. Since then, the city of St. Augustine has been under the governments of Spain, Britain and the United States. For those of you who have forgotten your history, Florida became a state in 1845. Let me pass a bit more historical trivia to you by stating that in the late 1880s, St. Augustine had its birth as a resort community. This was due to the arrival of Standard Oil co-founder Henry M. Flagler. He started the Florida East Coast Railway as a transportation system to allow his guests to travel to and from his hotels in St. Augustine, Palm Beach and Miami. So what does all this history of St. Augustine have to do with the Florida Pharmacy Association? We have members of the Florida Pharmacy Association from all areas of Florida, as well as out of state. Why not come to St. Augustine, the oldest city in Florida, to celebrate the 125th Anniversary? This is a great way to spend a few days of your summer with friends and colleagues. There will be a pre-conference course offered on the Wednesday prior to the actual beginning of the 125th Annual Meeting and Convention. Come join us in St. Augustine, where you will encounter innovative continuing education as well as fun activities. I look forward to seeing at this convention in June! n

Pharmacy Today Correction Correction: An article in the September issue, Presidential Donation Challenge, referred incorrectly to Terry Gubbin’s $10,000 donation as the single largest contribution in the Foundation’s history. Julia Hanway, former Florida Pharmacy Today Managing Editor and member of its Board of Directors, generously contributed $10,000 in 2005. Also, Terry’s Student Leadership Scholarship was awarded at Legislative Day in Tallahassee, Fla., not Austin, Texas.

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

Membership Vital Signs

n my article in the July issue of Florida Pharmacy Today, we shared with you our interest in taking the pulse of our member and nonmember stakeholders. We asked you to respond to a survey telling us what was on your mind. Responses were received from stakeholders from Escambia County in the northwest corner of our state to Monroe County at the extreme southern end. While most of the respondents were practicing in the community setting, we had a number of comments from health system groups, home health care providers, long-term care, academia, hospice and consulting, as well as a host of others. Surveys are simply a way to assess or measure public opinion on a product, service or process. Great organizations query their members to measure what is important to them and to also help create or validate the organizationâ&#x20AC;&#x2122;s relevance. This gives an organizationâ&#x20AC;&#x2122;s leadership an opportunity to determine what the members value the most and perhaps which programs or initiatives should be changed, created or discontinued. This survey was sent to 7,873 active email addresses in the FPA member and nonmember database on June 26, 2014. From the data, we can determine that there were 4,145 views of the message sent. We have determined that the link in the email was clicked on 633 times. A custom note broadcasting the availability of the survey was published on the home page of the FPA website along with an appeal to readers of the July issue of Florida Pharmacy Today to take the survey. Our data indicates 450 survey responses were recorded. About 60% of those who responded were male and 40% were female. While we did get a good response from our new and

nearly new practitioners, two thirds of our survey responses came from our stakeholders over the age of 50. Of the 450 responses to our survey, 73% were FPA members. What did we discover? In looking at our member stakeholder vital signs, we learned some things.

It seems that about 88% of our members rate our value for the dues paid at least good or better. While some of our members see the value in the continuingeducation offerings and discounts, others have seen our lobbying efforts as beneficial.

It seems that about 88% of our members rate our value for the dues paid at least good or better. While some of our members see the value in the continuing-education offerings and discounts, others have seen our lobbying efforts as beneficial. Of the 260 responses to the survey question about local unit association membership, nearly one-third were members, even though most counties have no local organization. Over 87% of our members said that the FPA either mostly or completely represents

Michael Jackson, B.Pharm

their values and ideals as a professional. Our members also seem to appreciate our Stat News, website, journal, educational conferences and other related membership services. Approximately 83% of our members visit our website at least monthly. Nearly 82% of our members would either be very likely or extremely likely to recommend our organization to a colleague. Our members were also very vocal on the list of issues that the FPA should be looking at. Many of these issues are already on our radar screen and in our active advocacy program. What do our nonmembers say? While we appear to be providing the support and services that our members are looking for, our interest is primarily on those many pharmacists, pharmacy technicians and student stakeholders who are not current members. In looking at responses from that population, we found diverse reasons for not choosing active membership. They include NOVEMBER 2014 |

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

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair.........................Jennifer Pytlarz, Herndon, Va. Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member....................................Cristina Medina, Hollywood Member................................. Norman Tomaka, Melbourne Member..............................Stuart Ulrich, Boynton Beach Member.......................Don Bergemann, Tarpon Springs Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2014, 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. FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

issues with employment, the cost of member dues, living outside of Florida and, in some cases, simply forgetting to renew. We were amazed to learn that more than 64% of nonmembers somewhat, mostly or completely agreed that FPA represents their values and ideals as a professional, while 25% either didn’t know or didn’t have an opinion. Many of the issues that nonmembers would like for the FPA to consider were very similar to those that our members suggested. Over 65% of our nonmembers would likely recommend our association to a colleague. Surveys are an important tool that every organization has at its disposal. While the results are interesting, and in some cases validate what leadership is thinking, there is still a culture of looking at everything we do to improve service, advocacy and support for our members. We pay dues to an organization and, through its leadership, rely upon good decision mak-

ing on behalf of our profession and our association members. It is possible that we are getting the message to you, the readers of this journal, who are all members of the FPA. We just need to find creative ways to get our message to those who are not FPA members. You can help us by sharing what you think of us with your nonmember colleagues. We will likely begin launching recruitment campaigns to help you with that message. Thank you all for participating in the summer member survey. If you would like to view the complete results of the survey, visit www.pharmview.com to download a copy. n

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Campus Corner MICHAEL2014, JACKSON, RPH BY ANGELA RAYNSFORD, PHARM.D.BY CANDIDATE MERCER UNIVERSITY COLLEGE OF PHARMACY

Trust and Patient Care: An Intern’s Dilemma

s an intern in my last year of pharmacy school, I never know what the day will bring. While rounding last week with a nurse practitioner, I encountered a situation that caused me to stop and think. I was not thinking about side effects associated with a particular medication or potential drug-drug interactions. Instead, I was confronted with an ethical dilemma that required the use of an alternative set of clinical skills. My current rotation is in pain and palliative care. The day of the encounter I was in an inpatient hospice facility standing at the bedside of a fairly young cancer patient. The patient, whom I will call Vicki for the sake of patient confidentiality, was in the hospice facility for detoxification. The plan was to wean her off of a Dilaudid PCA so her pain could be managed with oral analgesics. She was fully ambulatory and eating and drinking with no issues. I was told by the nurse practitioner before entering the room that Vicki was suspected of abusing her medications. We walked into the room and began talking with Vicki to see how she was doing. After a few minutes of conversing, Vicki told us what I strongly believed to be a lie. Her story was carefully crafted. Almost impressively, she rolled out a fabricated tale of how the Xanax she had left under her hospital bed tucked away in her shoe had just disappeared overnight. I thought to myself, could anyone really believe this story? I didn’t. But then again, what if it was the truth? Who was I to judge if this seemingly far-fetched story was or was not the truth? I felt a wall come up as the trust between the patient and me dissolved. I was relieved that the nurse practitioner had been there to handle the whole situation. After all, with the years of experience she had in the clinical setting

I felt sure that she must have been confronted with this type of situation many times in the past. I felt confident that she would know how to go about dealing with this patient. I was a little surprised by her response. The nurse listened to the patient and did not question her story. No attempt to defend against the removal of the Xanax from the room was made. If I had been in the room by myself, would I have handled the situation in the same way? Was being non-confrontational with the patient the right thing to do? Standing next to the practitioner, I had no words for the patient at all. How could I provide the best care possible if the patient was not even going to be honest with me? I felt done. I wanted to walk out the door. I felt like the patient was wasting my time. In my interactions with friends and family, lying is something I do not tolerate. I do my best to give people the benefit of the doubt, but I found myself inwardly retreating from this patient given the questionable reliability of her story. I thought to myself, am I letting my personal experiences get in the way of my interaction with the patient? I realized that I could not approach this situation in the same manner as I would in my personal life. I knew that I had to continue to work with this patient. As much as I felt betrayed, I would have to continue to communicate with the patient and help in the management of her medications. I needed to stop and reflect. I tried to put myself in the patient’s shoes. If the patient was telling a lie about the missing controlled medication, it was likely she was doing so because of addiction. I learned about drug dependence and addiction in my curriculum. I recalled previous discussions about addiction and the powerful feelings of pleasure and reward driven by a rush of dopamine into

the system. The physiological basis of addiction could be a possible explanation as to why the patient felt compelled to be dishonest with her health-care providers. Could I really blame the patient for lying if she had a problem with addiction? As I cont inued to explore my thoughts, the mistrust I felt began to fade. The negative emotions I initially experienced were slowly replaced with sympathy for the patient. I became motivated by the opportunity that this real world situation provided to develop my clinical skills. Pulling my rambling thoughts together, I knew what had to be done. I would do the best I could with the information I had. I reminded myself that I could not do anything about that which I had no knowledge. Those things were out of my control. The patient was there to be switched to oral analgesics and to have her symptoms managed. That is what we would do. In retrospect, the experience taught me that the ethical dilemmas that pharmacists encounter are never as simple as you might think. While it is important to provide the best care possible, I also have a responsibility for the safety of my patients. I must be able to trust my patients while at the same time exercise my professional judgment. Maintaining that balance may not be as easy as I had previously imagined. The experience was a good reminder that each patient and situation I encounter as a pharmacist will be unique and will require more than an understanding of information found within a textbook. It requires clinical skill, a caring heart and the desire to make a difference. On that day, I learned that by allowing myself to look past the lies that were able to so quickly cloud my vision, I was able to see the patient and her needs much more clearly. NOVEMBER 2014

Medical Marijuana – A Look at Drug Interactions and Side Effects Courtney Brennan, Fourth-Year Pharm.D. Student, University of Florida College of Pharmacy Marissa Glinton, Fourth-Year Pharm.D. Student, University of Florida College of Pharmacy Carol Motycka, Pharm.D. BCACP, Clinical Associate Professor, Assistant Dean and Campus Director, University of Florida Jacksonville Campus

Courtney Brennan

Marissa Glinton

Carol Motycka, Pharm.D. BCACP

iscussion on marijuana use has been at an all-time high with the recent vote on medical marijuana in Florida and in other states. In Florida, Amendment 2, the Florida Right to Medical Marijuana Initiative, did not receive 60 percent of the vote, which was necessary for it to be added to the State’s Constitution. This amendment would have allowed physicians to legally prescribe medical marijuana to qualifying patients diagnosed with a debilitating medical condition under the state law. As pharmacists, this topic is of much importance because we are the most accessible health care professionals, and as such, there are several issues with which we should familiarize ourselves regarding potential complications of use, just as we would with any other product used for medicinal purposes. As this issue is certain to come up again, we need to familiarize ourselves with are the adverse effects and drug interactions of marijuana. First and foremost, we will discuss the possible shortterm and long-term effects of marijuana use. An article was recently published in the New England Journal of Medicine shedding light on the adverse effects of marijuana use. Brain development is affected with long-term marijuana use or exposure to tetrahydrocannabinol, which is the hallucinogenic active ingredient. Adolescents and young adults particularly, have an increased risk of impaired neuronal connectivity affecting certain brain regions due to long-term marijuana use. Impaired neuronal connectivity can affect alertness, self-awareness and inhibitory control. Although definite causality has not been proven, long-term use has also been associated with increased risk of anxiety and depression.

FLORIDA PHARMACY TODAY

Finally, poor educational outcomes, diminished life satisfaction and cognitive impairments have been observed as effects of long-term marijuana use. These issues appear to be more prominently observed in individuals who begin marijuana use earlier in life. Marijuana use also has adverse effects when used shortterm. Volkow et al. associates found impaired short-term memory and motor coordination, altered judgment, paranoia and psychosis with short-term marijuana use. An increased risk of motor-vehicle accidents caused by significant driving impairment has been linked to immediate short-term marijuana use as well. The issue of addiction with chronic marijuana use has also been studied. It has been found that long-term use of marijuana can lead to addiction and the risk of addiction is increased even more when marijuana use is started early in adolescence. Marijuana has also been called a “gateway drug” and has been linked to enhancing the response to other drugs such as nicotine and alcohol. In addition to side effects, it is important for us to consider the drug interactions, which means we must understand the enzymes responsible for metabolizing exogenous cannabi-

noids, including those found in the herb (marijuana) or resin forms of cannabis and those found in the synthetic products (Marinol and Cesamet). Stout et al. summarized the data, drawing conclusions about the potential for cannabinoids to act as substrates, inhibitors and inducers of various enzymes,

subtherapeutic level. Interestingly, one clinical study also described in the SPC U.K. Summary of Product Characteristics demonstrated no significant change in THC, 11-OH-THC or cannabidiol pharmacokinetic variables when co-administered with omeprazole, a drug metabolized by CYP2C19. Although this is not considered one of the major pathways of metabolism of marijuana, further studies are needed when considering potential drug interactions between medical marijuana and other medications that utilize the CYP2C19 pathway. Stout et al. also looked at two studies that demonstrated a â&#x20AC;&#x153;higher average estimated theophylline clearance in more frequent marijuana smokers,â&#x20AC;? which suggests a possible marijuana-related induction of CYP1A2. However, this may not be due to the cannabinoids themselves, as this effect can also be seen with tobacco smoking. In vitro data suggesting CYP1A2 induction, and evidence of this induction effect from studies using non-smoked forms of cannabinoid, is also lacking. Due to the lack of specific in vivo data on drug interactions, the jury is still out on what types of interactions we, as pharmacists, need to be aware of. The issue of medical marijuana is highly politically charged, but we must take a step back and examine not only the potential benefits of its use, but also the risks, such as side effects and drug interactions, that inevitably accompany any chemical we choose to put into our body. Medical marijuana will remain a hot topic, and we need to be on the forefront of the conversation to be able to better educate our patients.

It has been found that long-term use of marijuana can lead to addiction and the risk of addiction is increased even more when marijuana use is started early in adolescence. and attempted to assign significance to these findings. They concluded that, in vivo, the primary metabolism of THC occurred via cytochrome P450 pathways, mainly 2C9 and 3A4, and that the secondary metabolism of THC metabolites may also occur through the CYP450 pathways (also primarily 3A4 and 2C9), UGT pathways and by epoxide hydrolase. In addition to glucuronidation by several UGT isoforms, cannabinol and cannabidiol (other cannabinoid compounds) also undergo metabolism via CYP2C9 and 3A4, and by CYP2C19 and 3A4, respectively. So, what does this mean in terms of drug interactions when exogenous cannabinoids are administered concomitantly with other drugs utilizing these same metabolic pathways? In reviewing the literature on cannabinoids and their relation to various metabolic pathways, Stout et al. attempted to identify whether these interactions held any clinical significance. However, specific human data are lacking. One clinical study found an interaction between ketoconazole, a known CYP3A4 inhibitor, and oromucosal cannabis extract (Sativex), in which coadministration increased the maximum concentration and AUC of THC by 1.2 and 1.8-fold, respectively, and also increased the maximum concentration and AUC of the THC metabolite (11-OH-THC) and cannabidiol. The UK Summary of Product Characteristics (SPC) for Sativex also describes a study in which marijuana was administered with rifampin, a CYP3A4 inducer. Coadministration with rifampin decreased the maximum concentration of THC by 40% and the AUC by 20%. The maximum concentration of 11-OH-THC was reduced by 85% and the AUC of 11-OHTHC was reduced by 87%. Additionally, the maximum concentration of cannabidiol was reduced by 50% and the AUC reduced by 60%. This suggests that any other product that acts on CYP3A4 could potentially either increase the concentration of cannabinoids to a supratherapeutic concentration, leading to an increase in adverse effects, or decrease the concentration to a

References Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med 2014;370:22192227 Stout SM, Cimino NM. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: A systematic review. Drug Metab Rev 2014;46(1):8695

NOVEMBER 2014 |

2015 FPA CANDIDATES

FPA 2015 Election Information Election will be online at www.pharmview.com

CANDIDATES FOR PRESIDENT-ELECT Dr. Eric Alvarez

Gary Koesten

Dr. Eric Alvarez is a past President of the FPA. A graduate of Florida A&M University of 1975, he received his Pharm.D. from NOVA Southeastern University in 1994. He has been an independent pharmacy owner for 20 years and a Hospital Pharmacy Director for McKesson Medication Management division for eight years at Westchester General Hospital and Southern Winds Psychiatric Hospital from 2001-2009. Dr. Alvarez was credentialed to serve on the Florida Board of Pharmacy and chaired this body in 2006. He is the recipient of numerous awards, among these, the James H. Beal “Pharmacist of the Year” in 1994 and the coveted “Bowl of Hygeia” in 2010. An avid member of the FPA, he has remained active since 1974 and participates in most if not all of the working Councils and Committees. He is active in leadership in his local Interamerican Pharmacists Association and is known for his strong leadership, passion about making pharmacists recognized as Health Care Providers in Florida through sound legislation and making sure pharmacists achieve the duly earned recognition that they are “indispensable anywhere where medications are dispensed.” Dr. Alvarez resides in Miami with his wife, Natalie. “My brothers and sisters in Pharmacy: I’m so excited about this election...I’m so happy that after all these years we have remained in touch and still speak to each other about the ills and joys of our beloved profession. If I win the President-elect position for the second time, it will give me the opportunity to serve you with 40 years of experience in the FPA and will allow me to put into priority and practice what you, my brothers and sisters, have shown me is important to you. Up front, we must increase the pharmacist demand, for this I have a plan. We must derail any attempt to substitute your expertise by any onerous and dangerous changes in pharmacies to technician ratio, for this I have a plan. To continue to work and facilitate to entities such as APhA to develop ways for pharmacists to come of age and become providers, for this I have a plan. I need your vote, let’s get things done and move forward. When you see me, come up and talk to me...I’m all ears. If you’re too shy, write me at eric072950@aol.com.”

Dear FPA members, My name is Gary Koesten and I am honored to be your candidate for FPA President Elect. Let’s work together to keep FPA strong and the profession stronger. I received my B. Pharm. and M.S. Pharmacy Administration from Long Island University. I am also licensed in Florida as a Consultant Pharmacist. My experiences as a pharmacist have included hospital pharmacy, community pharmacy, chain pharmacy, and mail-order pharmacy. I am currently President of Vet Pharm Consulting, Inc. My experiences have given me a broad, balanced insight into the issues that have, and continue to, affect pharmacy. I have been an active member of FPA since 2001. Currently, I serve FPA as Chairman of the House of Delegates Board of Directors. This past year I was Speaker of the House of Delegates. I have been Vice President and a Trustee of the Florida Pharmacy Foundation and a member of the Professional Affairs Council. I served two terms as President of the Broward County Pharmacy Association and remain an active member of the BCPA Board of Directors. I have presented board of pharmacy approved and ACPE Continuing Education programs. I have also participated in Legislative Days in Tallahassee. I see a number of issues that affect us as pharmacists in Florida. These include: 1. Support for HR 4190. Passage of this bill will finally give pharmacists provider status under Medicare and allow for pharmacists to be reimbursed for services for which they cannot currently be paid. Provider status should increase primary care opportunities for pharmacists in areas such as Accountable Care Organizations and Patient-Centered Medical Homes. 2. Increasing membership in FPA. This will empower pharmacists, pharmacy students, and pharmacy technicians to take an active role in furthering the profession through participation in FPA. I was Clinical Affiliate Assistant Professor at Nova Southeastern University College of Pharmacy. I have spent many years supervising pharmacy students and technicians. I know that pharmacy students and phar-

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macy technicians want to be involved in their profession. They need their voices heard through advocacy and legislation. Student interns are the professions’ future. I need to know there are leadership opportunities and mentors for interns throughout FPA. 3. Removing barriers preventing pharmacists from providing immunization services for all vaccines. Why are we restricted when many other states have no restrictions? 4. Allowing expansion of practice privileges for pharmacy interns to provide immunization services. As students they are trained in immunization technique. Why can’t this be expanded to practice sites in the community? How about interns providing MTM services or other certifications that can enhance patient care? 5. Medical marijuana. I understand there are pros and cons. But based on voter input this November, don’t we want to prevent Florida from becoming another California? 6. Expanding the role of the pharmacy technician and giving input to the Board of Pharmacy regarding the 6:1 pharmacy-technician ratio. The ratio is law. However, let’s understand that supervising more than three technicians is an individual pharmacist issue. Some pharmacists can, some cannot. Is 6:1 valid in a community pharmacy? A mail-order pharmacy? Also, as the role of the pharmacist changes, how can we best utilize our pharmacy technicians? Do we need PTSB certification, not just registration? The above are my priorities. How will I achieve these? I can only do this with your help. I need your voice to be heard. I need your input. I need you to reach out to me with your comments and concerns. Maybe you have other priorities? My email address is: gkoesten@vetpharmconsulting.com. In addition to my leadership roles in the organizations I belong to, I have also had leadership roles in the profession as Prescription Department Manager, Pharmacy District Supervisor, Division Director of Pharmacy, Director of Professional Placement, and Director of Pharmacy Services. FPA is your organization and through your participation and my leadership, if we work together, I am convinced we can succeed to keep FPA strong and our profession stronger. Thank you for your support.

Scott Tomerlin Scott Tomerlin is a Florida licensed Pharmacist. He is the Pharmacy Manager for Walgreens Pharmacy in West Melbourne, FL. and has held that position since 2009. Born and raised in Louisville, KY., Scott is a 2006 graduate of the Mercer University College of Pharmacy in Atlanta, GA. It is there that he met his future wife, Teresa, during their first semester of pharmacy school. Teresa is a Pharmacist for Target Pharmacy. He and his wife have three children: John, Nathan and Isabella. While growing up in Kentucky, Scott was a Boy Scout and achieved the rank of Eagle Scout in 1994. He was very involved in his church and youth group at Crescent Hill Baptist Church, and was a member of the Atherton High School Chamber Singers from 1996-1999, traveling with the group and performing in cities such as Montreal and Quebec City, Canada, Rio de Janeiro and Sao Paolo Brazil and Prague, Czech Republic. Upon graduation from high school, Scott attended the University of Louisville under the Eagle Scout scholarship program where he completed his pre-pharmacy requirements in 2002. Scott was accepted into the Doctor of Pharmacy program at Mercer University and relocated to Atlanta, GA. in 2002. While a student at Mercer University, Scott was elected during his first year of pharmacy school as the Class President in 2002. In 2003, he was elected by the entire student body as the Council of Students President-elect and served as President of the student class body from 2004-05. During pharmacy school, Scott was very involved in several pharmacy associations, including the National Community Pharmacists Association (NCPA), American Pharmacists Association student chapter (APhA-ASP) and was inducted into the Kappa Psi Pharmaceutical Fraternity in 2003, where he served as chapter secretary in 2005. On the national level, Scott was selected by the National Community Pharmacists Association (NCPA) to serve on the Student Regional Council (SRC) in 2005, only one of six pharmacy students selected from a pool of applicants nationwide. During Scott’s fourth year of pharmacy school in 2005, he relocated to Brevard County, Florida to complete his fourth year clinical rotations in his wife’s hometown. Scott has had training in the independent community setting, hospital, ambulatory and nuclear settings. In April 2006, Scott applied for and was selected, along with one other Mercer Pharmacy student, to complete a five-week international rotation in Hiroshima, Japan at the University of Hiroshima. Upon graduation from pharmacy school in 2006, Scott fell in love with Brevard County and decided that it was where he wished to call home. It was here that he discovered the NOVEMBER 2014

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Brevard County Pharmacy Association and its members whom he cherishes as friends and fellow colleagues. In 2005, Scott served as Newsletter Editor of the association publication. In 2008, Scott was elected as President of the Brevard County Association, serving until 2010. He is a past executive committee chairman of the Association 2010-11 and serves as a current active member on the executive committee. While serving as President of the Brevard County Pharmacy Association, he helped lead the Association in earning several FPA awards during his tenure, including Chapter Involvement and Community Services awards. In 2012, Scott was elected by the members of the Florida Pharmacy Association to serve on the Board of Directors as Region 6 Director until the completion of his term in July 2014. He is the recipient of the Distinguished Young Pharmacists of the Year award in 2007 and was inducted into the #1 Club of the Florida Pharmacy Association in 2014 at the FPA Convention, held in Fort Lauderdale, Florida. Scott is a member on the Professional Affairs Council, serving from 2013 until present. In the community, Scott has been involved in the Cocoa Beach chapter of the American Cancer Society Relay for Life booth for the Brevard County Pharmacy Association over the past several years. Scott is a Wolf Scout Den leader for Pack 373 Cub Scouts at Ascension Catholic Church in Melbourne. Scott has also participated in several community fundraisers in the Brevard County Area, including the Cocoa Beach Relay for Life, American Heart Association Heart Walk in Viera, The Brevard County Multiple Sclerosis association annual walk in Viera and Junior Achievement BowlA-Thon in Brevard County. Scott was recognized in 2010 as Pharmacy Manager of the Year. Scott has published three articles in various national journals, including the Journal of Dermatology for Physician Assistants. POSITION STATEMENT: I enjoy practicing Pharmacy and I love being a Pharmacist. My concerns are what is Pharmacy going to look like in the next 5 years, 15 years, 20 etc. I feel as active members of the Florida Pharmacy Association, we have to stand up for what is right in the pharmacy profession and keep the Pharmacist as a valued member in the health care team. The Florida Pharmacy Association is

FLORIDA PHARMACY TODAY

YOUR VOICE, as it works and advocates on behalf of your profession! With so many obstacles and challenges that the health care system is facing today, Pharmacists play a critical role in improving patient outcomes as well as saving overall health care costs. We have a responsibility as Pharmacists, Pharmacy Technicians and Student Pharmacists to educate society on the role of Pharmacy and why it is a necessary piece of the whole health care system. This includes being involved in political issues affecting pharmacy practice and maintaining a laser focus on our priorities. This is what I hope to accomplish and advocate for as your next President of the Florida Pharmacy Association: 1. Grow FPA Membership amongst Pharmacists, Technicians, Student Pharmacists and all other practices 2. Promote and Achieve National Pharmacist Provider Status/HR 4190 and similar legislation 3. Support expanded Pharmacist-provided immunization services 4. Support Intern administered immunizations 5. Support current FPA policy on tech-to-pharmacist ratio 6. Support regulation of PBM practices 7. Defend against further reimbursement cuts to pharmacies and pharmacy services 8. Advocate for student pharmacists 9. Work with local, state and national legislators on pharmacy and patient care issues 10. Seek funding for MTM and other pharmacy services 11. Advocate for the advancement of Pharmacy in the health care setting 12. Continuation of a strong association and development of future leaders and fresh ideas Together, with your help, we can do great things. I ask for your vote as your next President-elect of the Florida Pharmacy Association to make this happen. I am passionate about our profession and feel our best days are ahead of us if we maintain the spirit and reach beyond to promote Pharmacy and the practice we have all worked so hard to preserve. Please feel free to email me (stomerlin@cfl.rr.com) with any questions or comments. Let’s work together and build an even stronger association! It would be an honor to have your vote to make this happen! “One Goal, One Passion, The Advancement of Pharmacy”

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CANDIDATE FOR TREASURER Alexander Pytlarz FPA Member Since October 2002 Alexander earned his Pharm.D. from the University of Pittsburgh. He is currently a pharmacist at The Compounding Center in Leesburg, Virginia. In addition, Alexander provides consulting services to community pharmacists/pharmacies who plan to start, grow or expand their current pharmacy offerings to include compounding and/or long-term care services. Alexander has been actively involved in advocating and working for pharmacy associations for many years. After graduation, Alexander completed an Executive Residency in association management where he assumed the position of Executive Resident for the American Society of Consultant Pharmacists (ASCP). During his residency, Alexander was exposed to all aspects of association management from meeting planning to lobbying on Capitol Hill. Alexander’s involvement in association work didn’t end after the year-long residency. Upon relocating to Florida he continued advocacy work with ASCP and quickly became active within the Florida Pharmacy Association (FPA). Over the years Alexander has been selected to chair and serve on multiple committees and councils including the Legislative Committee and Organizational Affairs Council. In addition, Alexander has served on the FPA Budget and Finance committee for more than four years, and most recently he was elected and served as the FPA Speaker of the House of Delegates and subsequently served as Chairman of the Board of Directors for the FPA House of Delegates. POSITION STATEMENT: Greetings, fellow Floridians who share a passion for the pharmacy profession! It is with great honor to be considered a candidate for Treasurer of the Florida Pharmacy Association. Having served on various committees and elected positions for the FPA, including membership on the Budget and Finance Committee for four years, I feel my past involvements within the Association have prepared me for the great challenge and reward of serving as Treasurer of the FPA Budget and Finance committee. As the FPA Treasurer, I will work closely with leadership and other members within the Association to ensure that the financial future of the FPA is viable and able to support the Association and its endeavors for the long-term. Considering the challenges of membership growth, the ever-increasing expenses and the current economic state of the nation which is affecting many aspects of our professional and personal lives, my hope is to maintain a positive outlook and provide financial guidance to the Association in order to help combat these challenges. Together with the leadership and As-

sociation members, I will strive to focus on the future. I believe my professional leadership experiences have provided me the knowledge, skills and networks to make the necessary financial decisions to help keep the FPA strong during my term and beyond. It would be an honor and privilege to serve as your FPA Treasurer, and I ask for your vote.

REGION 1 Jennifer Chen FPA Member Since 2009 Jennifer Chen grew up in Fort Lauderdale, Florida and moved to Gainesville, Florida to attend the University of Florida. She graduated with her bachelor’s in Food Science and Human Nutrition in 2009 and Doctor of Pharmacy in 2013 from University of Florida College of Pharmacy. She just recently married her husband Simon. LOCAL ASSOCIATION ACTIVITIES: She has been active in the Alachua County Association of Pharmacists since she was a pharmacy student and now currently serves as Vice President/President-Elect. She currently works as a compounding pharmacist for Walgreens in Marion County. FPA ACTIVITIES: She has been an active member of FPA since her first year of pharmacy school, serving on the professional affairs council from 2009-2014, professional affairs chair in 2013, and currently serving as a member of the Organizational Affairs Council and interim BOD for Region 1. She was the first student to serve as chair in the FPA. In her community she advocates for the homeless and those in need through Christian organizations. She is currently part of the Alachua County Medical Reserves Corp and responds to disaster emergencies and health precautions for large events. POSITION STATEMENT: Pharmacy is changing and we want it to change for the better – for increased job opportunity, for provider recognition, and for improved patient care. It takes all pharmacists, technicians, students, and our patients to advocate for the changes we need to see in our profession. I would greatly appreciate the opportunity to serve the Florida Pharmacy Association in the capacity as Director of Region 1 to broaden the scope of pharmacy, to encourage action and communication from pharmacists in Region 1 to be the voice of the future of pharmacy, and strengthen the profession as a whole.

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REGION 3 Stephen Grabowski FPA Member Since October 1985 Stephen Grabowski, MBA, BPharm, CGP, FL-ASCP, is the President of Senior Medication Management Consulting, LLC. Prior to his current position, he worked in various capacities over 29 years in Pharmacy including community, Chief Financial Officer of an independent chain, director of pharmacy in a hospital, consultant pharmacy practice and also as director in a long-term care setting. He was also a regional compliance officer and facilitated various projects in long-term care. Stephen received his pharmacy degree from the University of Iowa in 1983 and MBA from Aurora University in 1989. State association activities include serving as a member of the Organizational Affairs Council and as a member of the Florida Chapter of the American Society of Consultant Pharmacists. In this capacity he has served as the Liaison to Florida Pharmacy Association for the past eight years. He is currently the treasurer for the Florida Pharmacy Today Journal Board. He is licensed in Florida, Indiana and Illinois. POSITION STATEMENT: Pharmacy is dynamic. Over the past three decades, my practice change is constant as yours has been. Who would have guessed what our profession has evolved into. Our profession has become highly specialized in many disciplines. We need to become one talking voice in our dealings with our regulatory agencies and extend our hand out to other organizations in Florida (hospital, community, independents, long-term care, etc.) as to create a more powerful presence. As we meet the needs of our society (patients), let us be the ones who let others know where we have been, where we need to go and how we should get there. Thomas E. Cuomo FPA Member Since 1984 Thomas “Tom” Cuomo is an alumnus of St. John’s University College of Pharmacy and Allied Health Professions and has been a registered pharmacist for 40 years. He is licensed in New York, is currently licensed as a registered pharmacist and consulting pharmacist in Florida since 1981. Tom has practiced as an independent pharmacist owning his own pharmacy, working as a community pharmacist in a retail setting and practicing as a consulting pharmacist both for a chain and now independently. He is also certified to immu16

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nize in the State of Florida, certified to administer adult CPR and is a certified smoking cessation specialist. He is currently enrolled and will be completing his classes to be certified to deliver Medication Therapy Management by October 2014. Tom was the FPA president in 2002-2003, the FPA Speaker of the House of Delegates, FPA Regional Representative Region 8, Vice-President for Pinellas County Pharmacist Society and on many committees for the FPA. He is also involved locally with elected officials about pharmacy issues. POSITION STATEMENT: The time has come for all pharmacists practicing in all sectors of our profession not to complain about conditions but to get involved so that we can make the changes and reclaim our profession. We must do this with legislators who can help us to put regulations or other measures in place to correct the improper use of our professional expertise. We must all get involved to enhance patient care in every corner of this nation. We can’t do this by being divided. We have to be one.

REGION 5 Bob Parrado, R.PH. FPA Member Since 1998 Registered pharmacist in Florida for 40 years, past officer of Hillsborough County Pharmacists Association; Independent Community Pharmacy: Owner, Medical Tower Pharmacy, Tampa 19 years; Chain Community Pharmacy: CVS/pharmacy 2000 – 2009; Current President of Parrado Pharmacy Consultants; Appointed to Florida Board of Pharmacy by Gov. Jeb Bush December, 2000 STATE ASSOCIATION ACTIVITIES: FPA PresidentElect 2011, FPA President 2012, Chairman of the Board of Directors 2013, Vice Speaker of the FPA House of Delegates and Current Speaker of the FPA House of Delegates. Appointed to Florida Board of Pharmacy by Gov. Jeb Bush December, 2000; Elected Chair of Florida Board of Pharmacy January 2004 – December, 2004; Re-Appointed to Florida Board of Pharmacy November, 2004; Chair 2005, Consumer Relations Committee, Florida Board of Pharmacy; R.Q. Richards Award for Outstanding Achievement in the Field of Pharmaceutical Public Relations 2007 from the Florida Pharmacy Association. Attended many local, state and national meetings, conferences and conventions on topics of drug diversion, drug abuse and misuse, counterfeiting and internet diversion sponsored by Florida Pharmacists Association, National Association of Boards of Pharmacy, National Association of Chain Drug Stores, and The Federation of State Medical Boards LOCAL ASSOCIATION ACTIVITIES: Past Officer Hillsborough County Pharmacists Association; Member Flor-

2015 FPA CANDIDATES

ida Pharmacists Association Member of the Florida Board of Pharmacy, 2001 – 2009, Chair 2004 Member National Association of Boards of Pharmacy; Expert Witness for: U.S. Attorney, Palm Beach County on Internet Pharmacy cases State of Florida Department of Health, DEA, Miami and Orlando offices, and many Attorneys in Florida; Close working relationship with drug diversion specialists for Tampa Police Department, Hillsborough County Sheriff’s Office, DEA and FDA PHARMACY RELATED ACTIVITIES: Lions Club: Medical Humanitarian Mission to Merida, Mexico 1983; Rough Riders: Tampa Member eight years Social and Community Service organization; Rough Riders Medical Humanitatian Mission to Havana, Cuba 2002; Alcalde (Mayor) Association of Ybor City: Alcalde 1997 and 1998; President 1998 through 2005; Purpose of organization is to promote History and Culture of Ybor City; Judeo Christian Coalition Clinic (Free clinic for indigent population); Volunteered as Pharmacist for over 20 years; Speaker at various Church and Assisted Living Facilities on topics of Prescription drugs, vitamins, nutritional supplements and importance of proper drug compliance; Hillsborough County Health Care Plan Advisory and Study Committee POSITION STATEMENT: It is my position as Region 5 Director to uphold all the bylaws of the FPA and to bring order and sense to a system that relies deeply on communication between the FPA and all its members. I intend to continue with the age-old tradition of an open door policy to all members and sister organizations. I will tirelessly promote the FPA with all agencies in government as well as non-political entities that could impact our place in history and I intend to share all information I can gather with the pharmacists and pharmacy technicians in Region 5. Melissa Ruble FPA Member Since 2013 Melissa is a current Assistant Professor in the Pharmacotherapeutics and Clinical Research department at the University of South Florida College of Pharmacy. Prior to her role at USF, she helped establish an emergency medicine pharmacist position at St. Anthony’s in St. Petersburg, Fla. During her three years at St. Anthony’s she worked as an Emergency Medicine Clinical Pharmacist with an emphasis on medication reconciliation, discharge counseling, and acute care management (CODE blue, STEMI, Stroke alert, etc.). Melissa received her degree from Shenandoah University in Winchester, VA in 2009 and went on to complete her PGY1 at

Tampa General Hospital in Tampa, FL. Since becoming a member of FPA, Melissa has shown her dedication towards the organization by serving as the advisor/liaison for the USF student chapter as well as being active through her volunteer efforts. She volunteered at the 124th Annual Meeting and Convention as the patient counseling event coordinator, judge of the FPA NASPA/NMA Student Pharmacist Self Care Championship, student mentor, and poster evaluator. She also participated in the Florida Pharmacists’ Health Fair at the Capitol and currently serves as a delegate for FPA. Melissa is also an active member of the American Society of Health-System Pharmacists, Florida Society of Health-System Pharmacists (Emergency Preparedness Committee member), the American College of Clinical Pharmacy (Chair elect CODE Committee member), Kappa Epsilon, and Phi Lambda Sigma (USF Alumni Coordinator). POSITION STATEMENT: Although I have only been a member of FPA for a short time, my enthusiasm and passion for this organization has shown through my volunteer efforts and insistence to make a difference through my participation in FPA. As an educator I am always looking for ways to involve and teach others how to be become more holistic pharmacists. If elected to the position of director I will incorporate the ideas of the group to further promote pharmacy and encourage future and current pharmacists to become active in their profession. I continue to encourage my students to become involved in an organization not so that it looks good on paper but to truly make a difference. I believe that I can do this for our district and, given the chance, I can bring a refreshing and passionate leadership style that listens to its members and strives for excellence. It is an honor to be nominated for such a great district and I ask you to please vote for me and feel confident that we can make a difference together!

REGION 7 David “Chachi” Mackarey FPA Member Since 2007 David grew up in Scranton, PA and moved to South Florida in 1988 after graduating from Duquesne University School of Pharmacy in Pittsburgh, PA. He has been practicing retail pharmacy since then for such major retail companies as Walgreens, Publix, Target, and currently CVS in Delray Beach, FL. David is currently the President of the Palm Beach County Pharmacy Association, beginning in 2008, and prior to that as President-elect from 2006-08, and member since 2000. He has represented Palm Beach County Pharmacy Association as a delegate for FPA since 2007, as well as being a major inNOVEMBER 2014

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fluence in the increase of the association’s membership from 300 to over 500, as well as not raising dues the last four years. He has also helped create a link with local Palm Beach Sheriff’s Office, local DEA Office, and our members to keep everyone updated and informed on important drug-related information. David recently served as FPA Chairman of House of Delegates from 2011-14, as well as a current member on the FPA Membership Committee, under the leadership of current President Suzanne Kelley. POSITION STATEMENT: My experience, knowledge, and background as FPA delegate and President of Palm Beach County Pharmacy Association for the last seven years allows me to bring forth to FPA the ability to help increase membership, become the best advocate for our profession by utilizing our contacts/connections, and bringing the pharmacy profession to the long awaited next level, higher status, and proper recognition that it deserves and demands. Now more than ever the pharmacy profession needs more activity with more members; which begins with you and I being more active members. Your support is greatly appreciated…. thank you! Sincerely, David “Chachi” Mackarey

Representing Pharmacists, Pharmacies and Health Providers throughout Florida & the U.S. • • • • • • • •

DEA Hearings Contract Review DOH Investigations Disciplinary Matters Sale of Pharmacy Administrative Hearings Licensure Problems Forfeiture Defense

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George F. Indest III, J.D., M.P.A., LL.M. Retired JAGG officer, licensed in Florida, Louisiana, and Washington, D.C., Board Certified by the Florida Bar 30+ Years of experience, LL.M. from G.W.U.

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REGION 9 Mitchell Fingerhut Member Since 1976 Mitchell Fingerhut Pharm.D.; MSCIS; MBA-HA. Is President and CEO of Clinical Rx, Inc. which is a provider of Renal consulting services. He is also a Clinical Pharmacist with US Medical Supply, Inc. Much of his professional career has been split between hospital and independent pharmacy practice. He graduated Brooklyn College of Pharmacy and did a Clinical internship at Maimomodies Hospital and Medical Center in Brooklyn, NY. Mitchell also attended the University of Miami and received an MBA in Health Care Administration and a Master’s of Science in Computer Information Systems. He also completed a Health Care Residency in Healthcare Administration where he successfully completed a Certificate of Need. He received his Pharm D from Nova Southeastern College while working full time as director of two local hospitals. Mitchell has been on the Board of Directors of Broward County Pharmacy Association since 1985 and has been president and chairman of the board. He has held various positions with the Florida Pharmacy Association such as vicechairman and chairman of the Home Health Care section of the Academy of Pharmacy Practice, Advisory Board of Pharmacy Provider Service Corporation, Legislative Committee and Board of Director of Region 10 and currently Region 9. He was appointed to the Legislative Committee of APHA from 2009 to 2011. POSITION STATEMENT: It is a great honor to be nominated as a candidate for the Board of Directors of the Florida Pharmacy Association. I believe my prior positions with county, state and federal Pharmacy associations will prepare me to better serve the Pharmacists of Reg ion 9. I believe that Pharmacy should be of one united voice instead of community, hospital, and institutional. That is why I have continuously supported Broward County Pharmacy Association, Florida Pharmacy Association, and the American Pharmacy Association. We need one voice when we deal with regulatory agencies, legislators, and other health care providers. I believe that our patients need direction and input from Pharmacists so that they can optimize their medication therapies. That is why I help pass Pharmacist Ordering Labs when I was chairman of the Home Health Care section of the Academy of Pharmacy Practice. I also strongly support Pharmacy provider status with Medicare and other national health insurances. It will be my honor and privilege to serve Region 9 again, and that is why I ask for your vote.

FPF THANKS SUPPORTERS As the year comes to a close, the Florida Pharmacy Foundation wishes to thank all its generous contributors for helping to impact the lives of pharmacy students and pharmacists throughout Florida. We especially recognize our largest single contributors since inception. 2014 Terry Gubbins, FPA President Student Leadership Scholarship: $10,000 2005 Julia Hanway, Former Florida Pharmacy Today Managing Editor & Member of its Board of Directors FPF Scholarship Fund: $10,000 Your contribution makes a difference!

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C A L L APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award. ■■               two  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 registered 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: ■■ Candidate must be a member of the Florida Pharmacy Association for at least two years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

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F O R

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■■ 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 registered 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. 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 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: ■■ 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. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

F P A

A W A R D S

Criteria: ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association. Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association.

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Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community. The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applications will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed

■■

■■ ■■

at prescription drug abuse Involvement of other community groups in the planning and implementation of prevention programs Innovation and creativity in the creation and implementation of prevention activities Scope/magnitude of prescription drug abuse efforts Demonstrated impact of prescription drug abuse prevention efforts

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2015 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Address:

Date Submitted:

FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2015)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award  Technician of the Year Award

Signature: 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  IPA Roman Maximo Corrons Inspiration & Motivation Award  The Jean Lamberti Mentorship Award  Upsher Smith Excellence in Innovation Award  Cardinal Generation Rx 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, 2015

NOVEMBER 2014

CALL FOR RESOLUTIONS TO THE 2015 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2015 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is April 24, 2015! 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:

Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758

FLORIDA PHARMACY TODAY

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.

PHARMACY RESOURCES Abbott Diabetes Care Hernan Castellon (305) 220-0414 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law 561-392-9000 Fried Law Office, P.A. Dennis A. Fried, M.D., J.D. (407) 476-1427 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620

PHARMACEUTICAL WHOLESALER

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller, BPharm, CPH (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029

TEMPORARY PHARMACISTS – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029 Rx Relief (800) RXRELIEF

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

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.

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 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 (800) 222-1222 www.fpicn.org 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”

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