June 2016 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association JUNE 2016

PREVENTION OF

MOSQUITO-BORNE DISEASES

“I’M ALWAYS WATCHING OUT FOR MY PATIENTS, BUT WHO’S WATCHING OUT FOR ME?”

WE ARE. We are the Alliance for Patient Medication Safety (APMS), a federally listed Patient Safety Organization. Our Pharmacy Quality Commitment (PQC) program: • • • •

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Call toll free (866) 365-7472 or visit www.pqc.net PQC IS BROUGHT TO YOU BY YOUR STATE PHARMACY ASSOCIATION

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 9 Adherence 31 Buyer’s Guide

VOL. 79 | NO. 6 JUNE 2016 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

10 13 14 19

Community Pharmacists and Interns Should Be Proactive Educating Teenagers on Prescription and Over-the-Counter (OTC) Drug Abuse

Pharmacy Not Immune to Recent Orlando Shootings Prevention of Mosquito-Borne Diseases Oregon’s Health Insurers’ Double-Digit Rate Hikes Foreshadow Bad News for the Florida Healthcare Industry

JUNE 2016

Mission Statements:

FPA Calendar 2016

of the Florida Pharmacy Today Journal

JUNE 29

APhA Diabetes Certificate Program

6/30 - 7/3 FPA Annual Meeting and Convention Ft. Lauderdale JULY 4

Independence Day FPA Office closed

17 - 24 FPA CE at SEA Barcelona, Spain 29 - 31 SE Officers Conference Williamsburg, Virginia

AUGUST 5

FPA Governmental Affairs Council Meeting Orlando

7-10

33rd Southeastern Gatherin’ Conference Destin

9-10

Florida Board of Pharmacy Meeting St. Petersburg

20-21 FPA Committee, Council and Board of Directors Meeting Orlando SEPTEMBER 1

Deadline to receive nominations for President Elect, Treasurer and Board Director

Labor Day - FPA Office closed

10-11 FPA Consultant Conference Miami

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. There is a new 2 hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2017 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2016. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com

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 THE HEALTH LAW FIRM............................... 13 KAHAN HEIMBERG, PLC............................... 19 PHARMACISTS MUTUAL.............................. 12 PHARMACY QUALITY COMMITMENT....... 2

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 is engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use. 4 |

FLORIDA PHARMACY TODAY

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

The President’s Viewpoint TIM ROGERS, RPh, FPA PRESIDENT

The President’s Year in Review and Our Profession

he year has flown by fast, but let me recount some of it and finally comment on the state of the profession. It has been a year of meetings. I have met with independent, chain, healthsystem, academic and clinical pharmacists; technicians; and students. I have met with local, state and national organizations. In the last year or so, I have been to APhA in San Diego, and to their office in Washington; met twice with NCPA; lobbied in Washington and Tallahassee; met with students around the state; met several times with our brethren at FSHP; gone on a few medical missions; and am currently running for state representative. Now, I’m not the only one going to these meetings. Many pharmacists are doing the same thing. Why? Let me tell you a little story. Pharmacy is a very ancient and noble profession. Its roots go back thousands of years. Driven by the desire to help others, early practitioners experimented with different concoctions to see if they would benefit mankind and help to alleviate pain, disease and injuries suffered by others. Sometimes they helped, and sometimes they didn’t. The profession made slow progress until the early 20th century. Finally, the early druggists had new and powerful medicines they could dispense, and that’s what they did. Then, in the early 1970s, when I began practice, we entered the informational era. We became the purveyors of information, such as: when to take your medicine, how to take it, what it was supposed to do, what were the side effects that we might expect, etc. Then we began to learn how the medicines worked, and we are now

armed with additional information. The pharmacy schools began to educate us to better recognize the role that we could fill with knowledge of diseases, how drugs work and which drugs to use for what.

Advancements in our profession are due solely to the efforts that pharmacists with a vision have made. All of this might seem trivial, but the advancements that we have made during my 44 years of practice is amazing, and the near future will be astounding. But this didn’t happen on its own. Advancements in our profession are due solely to the efforts that pharmacists with a vision have made. It is their vision of a pharmacy practice that can provide better medical care to our patients that has enabled us to overcome the obstacles and roadblocks of government and others that would have deterred us. But individuals cannot make the changes we have seen by themselves. They needed to form organizations, such as FPA, and others, in order to have the strength of the voices of many to accomplish their goals.

Tim Rogers, RPh 2015-2016 FPA President

Not everyone can go to all of these meetings and work to make the changes that we have seen and expect in the future. But everyone has an obligation to themselves, their patients, and the practitioners of the future to be involved to the extent that they can in order to ensure a better future. I would like to acknowledge all those who work for a better profession that benefits us and the people we serve. I have been humbled by the efforts that others put out in working for us, both volunteers and our FPA staff, who are the finest and hardest working in the country. n

JUNE 2016

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................................Cristina Medina, Hollywood Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala 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. ©2016, 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 Address: http://www.pharmview.com 6 |

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2015-16 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.

Suzanne Kelley..................................................................................................Board Chair Timothy Rogers..........................................................................................FPA President Alexander Pytlarz.................................................................................... FPA Treasurer Scott Tomerlin...........................................................................................President-Elect Jackie Donovan........................................................................Speaker of the House Carol Motycka................................................................Vice Speaker of the House Thomas Johns......................................................................................... FSHP President Jennifer Raquipo................................................................................. Region 1 Director Michael Hebb.........................................................................................Region 2 Director Tom Cuomo.............................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Robert Parrado...................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director David Mackarey.................................................................................. Region 7 Director Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.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@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.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

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

Rules on Handling Emergencies Need to Change

wice in the month of June, Governor Scott issued executive orders declaring a state of emergency in a total of 34 Florida counties impacted by Tropical Storm Colin and the tragic Orlando shooting. Whenever an emergency is declared by the governor, the pharmacy practice act will change. Consider the following Florida statutes:

of the prescription information required by this chapter and chapters 499 and 893 and signs that order. (e) The dispensing pharmacist notifies the prescriber of the emergency dispensing within a reasonable time after such dispensing.

465.0275 Emergency prescription refill— (1) In the event a pharmacist receives a request for a prescription refill and the pharmacist is unable to readily obtain refill authorization from the prescriber, the pharmacist may dispense: (a) A one-time emergency refill of up to a 72-hour supply of the prescribed medication; or (b) A one-time emergency refill of one vial of insulin to treat diabetes mellitus. (2) If the governor issues an emergency order or proclamation of a state of emergency, the pharmacist may dispense up to a 30-day supply in the areas or counties affected by the order or proclamation, provided that: (a) The prescription is not for a medicinal drug listed in Schedule II appearing in chapter 893. (b) The medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition. (c) In the pharmacist’s professional judgment, the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort. (d) The dispensing pharmacist creates a written order containing all

Twice in the month of June, Governor Scott issued executive orders declaring a state of emergency in a total of 34 Florida counties impacted by Tropical Storm Colin and the tragic Orlando shooting. There is another action that is triggered when a state of emergency is declared related to how insurance plans operate under the rules of the Florida Office of Insurance Regulations. You will not find these laws under any pharmacy practice act laws or administrative rules. These regulations are published in Title XVII under Military Affairs and Related Matters under Florida Statutes 252 (Emergency Management). They are as follows:

Michael Jackson, B.Pharm

252.358 Emergency-preparedness prescription medication refills. All health insurers, managed care organizations and other entities that are licensed by the Office of Insurance Regulation and provide prescription medication coverage as part of a policy or contract shall waive time restrictions on prescription medication refills, which include suspension of electronic “refill too soon” edits to pharmacies, to enable insureds or subscribers to refill prescriptions in advance, if there are authorized refills remaining, and shall authorize payment to pharmacies for at least a 30-day supply of any prescription medication, regardless of the date upon which the prescription had most recently been filled by a pharmacist, when the following conditions occur: JUNE 2016 |

(1) The person seeking the prescription medication refill resides in a county that: (a) Is under a hurricane warning issued by the National Weather Service; (b) Is declared to be under a state of emergency in an executive order issued by the governor; or (c) Has activated its emergency operations center and its emergency management plan. (2) The prescription medication refill is requested within 30 days after the origination date of the conditions stated in this section or until such conditions are terminated by the issuing authority or no longer exist. The time period for the waiver of prescription medication refills may be extended in 15- or 30-day increments by emergency orders issued by the Office of Insurance Regulation. This section does not excuse or exempt an insured or subscriber from compliance with all other terms of the policy or contract providing prescription medication coverage. Why do these regulations need to change? Well, my fellow practitioners, that question can be answered with a series of questions. Why does the governor have to declare a state of emergency to grant you authority to help patients affected by a state-declared emergency? Is it possible that a patient can be experiencing their own state of emergency that is not related to the affected geographic area in the governor’s executive order? How do pharmacists assist those patients who have evacuated from declared disaster areas and are seeking help in regions not included in the governor’s order? The government is efficient at giving public announcements when an executive order is issued declaring a state of emergency, but are similar notices issued when the emergency expires? How will a pharmacy know when to discontinue this expanded authority under 465.0275? While these regulations are designed to assist patients whenever there is a declared state of emergency by the governor, it can be disruptive to pharmacy businesses. When an executive order is issued, the pharmacist has to make 8 |

FLORIDA PHARMACY TODAY

changes to their pharmacy dispensing procedures based upon that order and Florida regulations. That new dispensing authority has a clock that ticks down to an expiration date in which the pharmacist must stop the practice of issuing a 30-day supply. Failure to do so could result in disciplinary action by the Board of Pharmacy. Not only is this disruptive to the pharmacy, the reversion back to stan-

It makes sense to simply remove the need for a governor’s state of emergency and make it permanent to allow pharmacists to dispense a 30-day supply of essential life-sustaining medications when the prescriber cannot be contacted. dard emergency dispensing laws allowing a pharmacist to release a 72-hour supply has to be explained to patients who may be confused as to why the pharmacist is unable to help, especially when the prescribing practitioner is unable to respond to messages from a pharmacy in a timely manner. It makes sense to simply remove the need for a governor’s state of emergency and make it permanent to allow pharmacists to dispense a 30-day supply of essential life-sustaining medications when the prescriber cannot be contacted. This would help with a number of issues, including but not limited to: 1. Patient’s essential life-sustaining therapy will not be interrupted 2. The prescriber of record has additional time to respond to a pharmacy’s request for refill authorization

3. Many insurance issues can be resolved, especially when a patient pays only one copay for a 30-day supply as opposed to having to pay for a three-day supply plus an additional copay for the remainder of the month that the pharmacist may dispense. 4. Pharmacists would not need to make modifications in their dispensing procedures to accommodate a geographic area of Florida 5. There would be no need to make sure this new dispensing authority continued beyond the authorized time period defined in a governor’s executive order 6. Dispensing a 30-day supply of emergency life-sustaining medications would be considered a basic standard of practice that pharmacists have trained and prepared for You may not be aware of this, but during the 2016 legislative session, the FPA floated this idea before members of the House and Senate and there was considerable interest in the issue. This change seems to make sense. Given that Florida is a state in which weather disasters and visitors from out of state are common, it would be appropriate to simply make permanent the pharmacist’s authority to release a onetime 30-day resupply of certain medications when there are no refills. There are many safeguards in place with making this authority permanent, and our physician colleagues by statute are provided adequate information, just as they receive now when dispensing a threeday supply. What do you think? n

While You’re Packing the Sunscreen, Don’t Forget About Your Medications

By Andrew Heinz, PharmD Everyday more than 1.5 million people travel by airplane in the United States. That equates to more than half a billion people annually. As community pharmacists we work hard to help our patients be adherent with their medications at home, but we cannot forget about them when they travel. Whether traveling for business or pleasure, it’s not an excuse to take a vacation from their medications. Typical reasons for non‐adherence while traveling are medications are left at home; medication ran out while still away; medications are in checked luggage that is lost; and patient forgets to take medications due to a different routine or new environment. As pharmacists we can work with our patients to overcome all of these barriers. When packing for a trip we are most concerned with what we will wear, what the weather will be like, and making sure we have enough clothes to last the entire trip. Medications rarely come up in this process. One way to help our patients remember to bring their medications is to have them set a reminder on their cell phone to make sure they have all of their medicine before leaving for the airport. A more personal, but more time consuming way to help our patients could be to send a text reminder before they leave to make sure they don’t forget their medicine.

When traveling, patients may be gone anywhere from a couple days to a couple months and may not think about how many days supply of medication they have before they leave. As their pharmacist, when you hear that a patient will be traveling, start a conversation with them about when they will be traveling, how long they will be away, and how many days of medication they currently have. Helping with refill scheduling and days supply management can ensure that your patient won’t run out of medication while they are traveling. In 2012, more than 22 million bags were delayed, lost or stolen. Always counsel patients to keep their medications in their purse, briefcase, or carry‐on baggage and never pack it in their checked luggage. If patients are concerned about getting their medications through security, especially pain medications in this current abuse heavy climate, offer to provide them with a copy of their original prescriptions for verification. Another helpful suggestion is instead of bringing their entire supply of medication; only bring enough medication for the duration of their trip with an additional three‐day supply buffer for any potential delays in their return. At home we counsel our patients to incorporate taking their medications into some aspect of their daily routine to help with adherence. When traveling, a patient’s environment and daily routine may be very different than when they are at home. So what are they to do? One option is to have them bring along a weekly pill box to fill and use. Another way could be to set daily reminders on their cell phone. Ultimately, many of the adherence tips and tricks we offer our patients at home will work when traveling; we just might have to try different ones for when our patients travel. Being adherent to medications while traveling will help our patients remain healthy and stay happy. Reprinted with permission from National Community Pharmacists Association in the July 2013 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org.

JUNE 2016

Community Pharmacists and Interns Should Be Proactive Educating Teenagers on Prescription and Over-the-Counter (OTC) Drug Abuse By Ogenna Omenugha, Pharm.D. candidate 2017, FPA Intern As a pharmacy student and an intern, I had an opportunit y duri ng my APPE rotation in May to write a n a r t ic le on this topic for everyday practice in community Ogenna Omenugha, pharmacy. ComFPA Intern munity pharmacists and interns are the most accessible healthcare professional globally.1 Every day, we see teenagers come to pharmacies to pick up prescriptions or non-prescription over-the-counter (OTC) drugs. According to an American Society of Health-System Pharmacists (ASHP) statement on The Pharmacist’s Role in Abuse Prevention, Education and Assistance, the abuse, or nonmedical use, of prescription medication has become a prevalent issue. Nonmedical use of prescription drugs among youths aged 12 to 17 and young adults aged 18 to 25 in 2012 was the second most prevalent illicit drug use category, with marijuana being first. The most prescribed medications for teens are attention-deficit/hyperactivity disorder (ADHD) drugs. According to the National Institute of Mental Health, ADHD is “a common mental disorder that begins in childhood and can continue into adolescence and adulthood” and can make it hard for a teenager to do well in school or behave at home or in the community.2 There are two commonly abused types of stimulants, amphetamine and methylphenidate, both of which 10

FLORIDA PHARMACY TODAY

are typically prescribed for teenagers. These stimulants can have different street names, such as black beauties, roses, skippy, speed or the smart drug. According to the National Institute on Drug Abuse, “prescription stimulants are normally taken in pill form, but some people who abuse them crush the tablets and snort or inject them.” This

NONMEDICAL USE OF PRESCRIPTION DRUGS AMONG YOUTHS AGED 12 TO 17 AND YOUNG ADULTS AGED 18 TO 25 IN 2012 WAS THE SECOND MOST PREVALENT ILLICIT DRUG USE CATEGORY, WITH MARIJUANA BEING FIRST. can cause damage to the heart and other organs. Teenagers also abuse stimulants by taking them in ways other than intended, such as taking someone else’s prescription stimulant medication, taking a prescription stimulant medication in a way other than prescribed and taking the prescription stimulant to get high.3 According to the National Institute on Drug Abuse, stimulants have been abused as an “academic performance enhancement;” staying up all night cramming for an exam, for example. The National Survey on Drug Use and Health found that over half of all prescription drug abusers had obtained

the prescription medication from a friend or relative for free, compared to the 3.9 percent who had acquired the medication from a drug dealer or other stranger.4 The National Institute on Drug Abuse has stated that millions of Americans take cough and cold medicines each year to help with symptoms of colds. When taken as instructed, these medicines can be safe and effective. Several cough and cold medicines contain ingredients that are psychoactive when taken in higher-than-recommended dosages, and some teens may abuse the medicine.5 The most commonly abused cough and cold medicines are cough syrups and capsules containing dextromethorphan (DXM). These cough medicines are safe for stopping coughs during a cold, if taken as directed. Consuming more than the recommended amount can produce euphoria – a relaxed pleasurable feeling and dissociative effect – as if you are detached from your body. Teenagers are more likely to abuse these drugs because they are easily accessible without a prescription. Pharmacists and interns encounter problems of abuse among teenagers in our community pharmacies every day. Pharmacists and interns are busy filling prescription drugs in the pharmacy and taking care of other professional duties. They have no time to proactively counsel teenagers on their prescriptions. In years past, it was common for community pharmacists to venture out of the prescription department to assist consumers with their choice of nonprescription drugs, but now there is very little discretionary time to walk with

teenagers or other patients to the OTC department to pick up that cough medicine. They barely have the time to respond to requests for patient consultations requested by consumers picking up prescriptions. We are the expert on medication therapy management; no other health care provider has our knowledge of drugs. I call on community pharmacists

partment of Health to develop a pamphlet related to controlled substances and the precautions regarding the use of pain management medications. The pamphlet should also include the following: ■■ The potential for misuse and abuse of controlled substances by adults and children ■■ The risks of controlled substance de-

SEVERAL COUGH AND COLD MEDICINES CONTAIN INGREDIENTS THAT ARE PSYCHOACTIVE WHEN TAKEN IN HIGHER-THAN-RECOMMENDED DOSAGES, AND SOME TEENS MAY ABUSE THE MEDICINE.5 and interns to be proactive on educating teenagers on prescription and nonprescription (OTC) drug abuse when they stop into your pharmacy to purchase these DXM products or fill a prescription for stimulants. A pharmacist or intern on duty should always counsel teenager(s) on ways to take their medicine. Teenagers have little knowledge on the dangers of medications. ASHP believes that “pharmacists have the unique knowledge, skills, and responsibilities for assuming an important role in substance abuse prevention, education, and assistance.”6 Pharmacists, as health care providers, with the assistance of student interns, should be actively involved in reducing the negative effects that drug abuse among teenagers has on society and health systems. The involvement in your profession, especially in your state association’s legislative action day, will be an opportunity for pharmacists and pharmacist interns to organize a health fair for teenagers and educate them on drug abuse. This can be done in local high schools and colleges in your community. This year, the Florida Legislature revised a law that requires the Florida De-

■■ ■■ ■■

3 4 5

Disorder.” NIMH RSS. Web. 27 May 2016. “Prescription Stimulant Medications (Amphetamines).” NIDA for Teens. Web. 27 May 2016. “National Survey on Drug Use and Health (NSDUH-2013).” SAMHSA |. Web. 27 May 2016. “Cough and Cold Medicine (DXM and Codeine Syrup).” Web. 27 May 2016. <https://teens.drugabuse.gov/drugfacts/cough-and-cold-medicine-dxmand-codeine-syrup> “Statement on the Pharmacist’s Role in Primary Care - ASHP.” Web. 27 May 2016. <http://www.ashp. org/DocLibrary/BestPractices/ SpecificStPrimary.aspx>.

pendency and addiction The proper storage and disposal of controlled substances Controlled substance addiction support and treatment resources Telephone help lines and website links that provide counseling and emergency assistance for individuals dealing with substance abuse

When that pamphlet becomes available, we should all use it as part of our educational tools to bring awareness to drug abuse among teenagers. Do not let anyone take your passion away. Practicing pharmacy is your passion, and you have worked so hard get into this profession. I urge pharmacists and interns to be proactive in the community to educate teenagers and eradicate the abuse of stimulant prescriptions and over-the-counter drugs. References

1 Tommasello, Anthony C. “Substance Abuse and Pharmacy Practice: What the Community Pharmacist Needs to Know about Drug Abuse and Dependence.”Harm Reduction Journal 1 (2004): 3. PMC. Web. 27 May 2016. 2 “Attention Deficit Hyperactivity JUNE 2016 |

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Pharmacy Not Immune to Recent Orlando Shootings By Michael Jackson, BPharm, EVP & CEO, Florida Pharmacy Association The city of Orlando took center stage this month when a gunman took the lives of revelers at a local nightclub in what is now one of the deadliest mass shootings in U.S. history. As this article is being prepared, there were a total of 49 deaths and an additional 53 were injured as a result of the shooting. Two of the victims of this tragedy, Stanley Almodovar and Amanda Alvear, were registered Florida pharmacy technicians. Alvear was studying to be a nurse. Governor Rick Scott requested a Federal Disaster Declaration the day after the incident. The Florida Emergency Response Team (ESF-8) activated personnel and began operating from the state Emergency Operations Center. The FPA is an active participant in the ESF-8 program, though we had no role in this incident. Some of the action taken under the state’s response includes the following: ■■ Confirmation that current blood supply is sufficient to meet the needs of the incident. Donors are being encouraged to schedule appointments over the coming weeks to replenish supply. ■■ Disaster behavioral health teams being placed on standby for future deployments ■■ Hospital facilities’ medical and surgical needs are being monitored; however, Orlando Regional Medical Center and the Florida Hospital Orlando are not reporting unmet needs as this article goes to press. ■■ Information was shared by ESF-8 on the availability of Jet Blue Airlines flights to provide transportation to victims or family members of victims impacted by the incident. Pharmacists provide health care services in the public domain and, as such, could encounter situations similar to the incident that occurred in Orlando at any time. Pharmacists in health systems regularly train and prepare for the ultimate disaster scenario. Many institutions have defined protocol and procedures in place to handle major health disasters that are either man-made or natural. This includes the mobilization of resources and staff. The real challenge is what to do when facing an active shooter scenario. How should the staff of a pharmacy respond when there is a serious public safety threat that is unforeseen? An excellent resource on this issue can be found in the Department of Homeland Security (DHS) website. Those resources include recorded webinars that you may want to review with your staff. While the resources at DHS can be helpful, remember that if you are an employee of a health facility or provider, you must follow the procedures that are already in place. Absent those procedures, it is recommended that you engage your administration or management on a proac-

THE REAL CHALLENGE IS WHAT TO DO WHEN FACING AN ACTIVE SHOOTER SCENARIO. HOW SHOULD THE STAFF OF A PHARMACY RESPOND WHEN THERE IS A SERIOUS PUBLIC SAFETY THREAT THAT IS UNFORESEEN? tive plan to safeguard the lives of your staff and any clients that you are serving. We hope to never again have to experience what happened in Orlando.

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1101 Douglas Avenue Altamonte Springs, FL 32714 Telephone: (407) 331-6620 www.TheHealthLawFirm.com

JUNE 2016

Prevention of Mosquito-Borne Diseases Primary Author Charlie W. Colquitt, B.S., Pharm.D., CPh. Associate Professor of Pharmacy Practice Florida A&M University, College of Pharmacy and Pharmaceutical Sciences Tampa Instructional Site Tampa, Fla. Corresponding Author Jessica Warthen, Pharm.D. Assistant Professor of Pharmacy Practice Florida A&M University, College of Pharmacy and Pharmaceutical Sciences Tampa Instructional Site Tampa, Fla. Contributing Author Vonda J. Colquitt, B.S., Pharm.D. Pharmacy Manager Walgreens Pharmacy St. Petersburg, Fla. Charlie Colquitt is an associate professor of pharmacy practice for Florida A & M Universityâ&#x20AC;&#x2122;s College of Pharmacy and Pharmaceutical Sciences. He received a Doctor of Pharmacy degree in 1996 from Xavier University of Louisiana and worked for Walgreens Pharmacy for more than 11 years before deciding to do a general practice pharmacy residency. He completed a PGY1 residency from Bayfront Medical Center Hospital in 2007 and was hired by the Florida A & M University College of Pharmacy. He has worked for FAMU for the past eight years.

FLORIDA PHARMACY TODAY

Introduction International travel to underdeveloped and exotic destinations has increased dramatically. By 2020, it is expected that the number of international travelers will exceed 1 billion, half of that travel being for leisure purposes and 15 percent business related.1 In 2016, many Floridians will travel internationally, especially to places such as South America, because Brazil is hosting the Summer Olympics. Prior to de-

parture for travel, it is widely recommended that international travelers visit the CDC website for updated information or consult with a specialist in travel health. Pharmacists can provide consultations in travel health to many of these travelers who are unaware of the diseases transmitted through bites from mosquitoes in other countries. Some mosquito-borne diseases are Zika virus, West Nile virus, malaria, dengue and chikungunya.

INTERNATIONAL TRAVEL TO UNDERDEVELOPED AND EXOTIC DESTINATIONS HAS INCREASED DRAMATICALLY. BY 2020, IT IS EXPECTED THAT THE NUMBER OF INTERNATIONAL TRAVELERS WILL EXCEED 1 BILLION, HALF OF THAT TRAVEL BEING FOR LEISURE PURPOSES AND 15 PERCENT BUSINESS RELATED.1

Mosquitoe-Borne Viruses Zika is a flavivirus originating in the Zika forest in Uganda.2 The Aedes species mosquito (an aggressive daytime biter) transmits the virus. The virus has also been shown to be present in semen, but the risk of sexual transmission is low.2 The Center for Disease Control and Prevention (CDC) issued a Level 2 alert on Jan. 15, 2016, advising pregnant women to consider postponing travel

Table 1

TO DATE, AREAS ENDEMIC WITH ACTIVE ZIKA VIRUS TRANSMISSION ARE BRAZIL, BOLIVIA, PARAGUAY, VENEZUELA, THE CARIBBEAN ISLANDS, CENTRAL AMERICA AND MEXICO.

This RNA virus can infect the central nervous system (CNS) of various hosts, causing severe neurologic disease.4 WNV usually resolves without incident, and only about 20 percent of patients will develop West Nile fever. One percent of those infected will develop meningitis, encephalitis and acute flaccid paralysis. The incubation period for WNV is usually two to 14 days, but can be as long as 21 days.4 Typical symptoms include malaise, loss of appetite, nausea, headache and fever. Currently, there is no specific treatment for WNV. Until effective treatment is available, prevention is the best way to manage the virus. Malaria is a protozoan infection spread by the Anopheles mosquito vector in endemic areas. Malaria has undergone significant changes in morphology over the past 100 years and has evolved into a drug-resistant pathogen, killing 1 million children yearly.5 Of the

to countries with ongoing Zika virus transmission. To date, areas endemic with active Zika virus transmission are Brazil, Bolivia, Paraguay, Venezuela, the Caribbean islands, Central America and Mexico. The virus infection usually is asymptomatic or causes mild illness, such as fever, rash, muscle pain, joint pain and conjunctivitis. Severe clinical manifestations include neurological and autoimmune-like illness, particularly Guillain-Barre syndrome (GBS) and congenital neurological malformations.2 Eighty percent of Zika infections are asymptomatic and most of the remainder are self-limited.2 No specific antiviral treatment is available and care is supportive, with symptoms usually resolving in seven days. Severe GBS cases require intensive care treatments. Preventive measures are the important key to limiting mosquito-borne diseases. West Nile Virus (WNV), a member of the Flaviviridae family, is most commonly found in West Asia, Africa, Europe and the Middle East.3 Birds are a reservoir for the virus; however, the Aedes and Ochlerotatus mosquito species bite infected birds and transmit the virus to human and animal populations.4

NON-PHARMACOLOGICAL MOSQUITO BITE PREVENTIVE METHODS ■■

Choose a hotel or lodging with air conditioning or screens on windows.

■■

Sleep under mosquito bed nets if outside or in a room not well screened.

■■

Wear long-sleeved shirts and long pants.

■■

Eliminate or avoid standing water in or around your area of stay. ●●

Recommended for all travelers

Reference 10, 11

The disease is endemic in the tropical areas of Central and South America, Africa, the Middle East, the Indian subcontinent, Southeast Asia and Oceania. Many cases of malaria can be treated effectively with oral medication. Since 2000, prevention and control measures have reduced malaria mortality by more than 25 percent globally and by 33 percent in Africa.6 The choice of chemoprophylaxis depends on drug resistance patterns in the country being visited.6 Generally, prophylaxis starts one week prior to arrival and continues through four weeks after leaving the endemic area. Drugs used are atovaquone-proguanil, mefloquine and doxycycline. Chloroquine can also be used but is restricted to Caribbean, Central America and parts of the Middle East due to chloroquine-susceptible malaria.6 Dengue is the most significant mosquito-transmitted viral disease in terms of mortality. It is transmitted by Aedes

MALARIA HAS UNDERGONE SIGNIFICANT CHANGES IN MORPHOLOGY OVER THE PAST 100 YEARS AND HAS EVOLVED INTO A DRUG-RESISTANT PATHOGEN, KILLING 1 MILLION CHILDREN YEARLY.5 four species of malaria, Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae and Plasmodium vivax, P. falciparum is the most serious because, if unrecognized and untreated, it can be fatal.5 The parasite grows in the bloodstream and can produce symptoms that develop from six to eight days to several months after infection. It can cause severe end-organ damage, including renal failure, acute respiratory distress syndrome and coma, if untreated.

aegypti (worldwide) and the Aedes albopictus (United States, Asia, Latin America and Caribbean) mosquitoes. Dengue fever, also known as “breakbone fever,” is characterized by fever, rash and severe muscle/joint pain.7 The most severe form, dengue hemorrhagic fever, includes the aforementioned symptoms as well as hemorrhagic fever and shock. The fatality rate of dengue hemorrhagic is 50 percent without treatment.7 The clinical manifestations of feJUNE 2016

ver and macular rash last one to seven days, followed by decreased fever for one to two days. Dengue fever has no definitive treatment. The primary goal is supportive therapy to maintain fluid and electrolytes. Oxygen, antipyretics (use acetaminophen only because aspirin and NSAIDs have anticoagulant properties) and pain medications are also required for treatment.7 Preventative control of mosquitoes by screening and using insect repellents is the most effective measure against dengue. Chikungunya is a flaviviral infection transmitted to humans by Aedes aegypti and Aedes albopictus.8 Chikungunya is indigenous to tropical Africa and Asia with outbreaks from areas that adjoin the Indian Ocean, South India, Reunion Island, Europe, Caribbean Islands and United States (South Florida).8 Often considered the “arthrogenic” virus, attack rates can be as high as 50 percent.8 This mosquito-borne disease may cause long-term arthralgias present four months after onset. Infected people experience mild leukopenia and, less commonly, thrombocytopenia. The Rh-negative population seem to be immune. Treatment is largely supportive with NSAIDs. Chloroquine may be useful for managing refractory arthritis. Monoclonal antibodies and prophylaxis with specific Chikungunya immunoglubins may be useful in cer-

BILLIONS OF PEOPLE AROUND THE WORLD ARE AT RISK FROM MOSQUITO-BORNE VIRUSES WHEN TRAVELING ABROAD. MOSQUITOES SPREAD ALL OF THE AFOREMENTIONED VIRUSES AND MANY OTHERS. TRAVELERS SHOULD BE INFORMED ABOUT MOSQUITO BITE PREVENTION AND BE AWARE OF COUNTRIES AFFECTED BY THESE VECTOR-BORNE DISEASES. tain populations. To date, no vaccine is available and prevention relies on avoidance of the mosquito vectors to reduce transmission. Mosquito Bite Prevention for Travelers Billions of people around the world are at risk from mosquito-borne viruses when traveling abroad. Mosquitoes spread all of the aforementioned viruses and many others. Travelers should be informed about mosquito bite prevention and be aware of countries affected by these vector-borne diseases. Not all mosquitoes are the same. Different mosquitoes spread different viruses and bite at different times of the day. The Aedes aegypti and Aedes albopictus, which spread the Chikungunya, Dengue and Zika virus, primarily bite during the day, but can also bite at night.9 The Culex species spreads the

West Nile virus and bites from evening to morning but typically do not bite at night.9 The CDC has travel advisory information to guide the public on nonpharmacological methods (Table 1) and pharmacological products (Table 2) to prevent mosquito bites.10 Specific precautions should be followed when applying insect repellent products (Table 3). Insect repellents should be chosen based on the amount of time needed for protection.11 How long a product works depends on the concentration of the active ingredient. Active ingredients applied to the skin are DEET, picaridin, oil of eucalyptus and IRS3535. Permethrin is not applied to skin but only to clothes and bed netting. Conclusion Over the past two decades, pharmacists have become more involved in the provision of travel medicine services in

Table 2 PHARMACOLOGICAL MOSQUITO BITE PREVENTIVE PRODUCTS Active ingredients

Some Brand Name Examples

DEET

Off®, Cutter®, Sawyer®, Ultrathon®

Picaridin, (also known as KBR 3023, Bayrepel, and icardin

Cutter Advanced®, Skin So Soft Bug Guard Plus®

IR3535

Skin So Soft Bug Guard Plus Expedition®, SkinSmart®

Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)

Repel®

■■ ■■ ■■ ■■ ■■

Insect repellent brand names are provided for information only. Use an Environmental Protection Agency (EPA)-registered insect repellent with one of the listed active ingredients. All EPA-registered insect repellents are evaluated to make sure they are safe and effective DEET is the most widely used product and, at a lower concentration of 10 percent, can be used in children at least 2 months old. DEET is not recommended for use in pregnant or lactating women. The EPA recommends non-pharmacological mosquito bite preventive methods. OLE should not be used on children younger than 3 years old.

Reference 10, 11 16

FLORIDA PHARMACY TODAY

Table 3 TIPS FOR SAFE USE OF INSECT REPELLENTS ■■

Do not use repellents under clothing, or on cuts, wounds or irritated skin.

■■

Do not apply repellents to eyes or mouth. Apply lightly around ears.

■■

Do not spray repellent of face. Spray on hands first then apply to face.

■■

Do not allow kids to handle repellents. Parent should apply on their hands first, then put on child.

■■

If you or your child get a rash or other bad reaction from insect repellent, stop using the repellent, wash the repellent off with mild soap and water and call a local poison control center for further guidance.

■■

Avoid heavy application. If a thin film does not work, apply a bit more.

■■

After returning indoors, wash treated skin with soap and water.

■■

Never put permethrin on skin. Apply permethrin only to clothing, bed nets, or other fabrics according to directions on the product label.

■■

Do not apply insect repellent to cats or dogs. Talk to your vet about options for pets.

Reference 10, 11

INSECT REPELLENTS SHOULD BE CHOSEN BASED ON THE AMOUNT OF TIME NEEDED FOR PROTECTION.11 HOW LONG A PRODUCT WORKS DEPENDS ON THE CONCENTRATION OF THE ACTIVE INGREDIENT. ACTIVE INGREDIENTS APPLIED TO THE SKIN ARE DEET, PICARIDIN, OIL OF EUCALYPTUS AND IRS3535. a variety of settings. Pharmacy companies have adopted pre-travel questionnaire forms that include sections for traveler’s information, medical history, immunization history and travel itinerary.12 A typical question in the travel itinerary section is “Do you plan to visit rural areas (areas with animal/insect/ mosquito-borne disease risk)?”12 Due to the ease of accessibility with many convenient locations, long hours of operations and the ability to immunize and counsel patients on mosquito bite preventive methods, pharmacists have moved to the forefront of being travel health consultants. References

1. Seed SM, Spooner LM, O’Conner K, Abraham GM. A multidisciplinary approach in travel medicine: the pharmacist perspective. Journal of Travel Medicine 2011; Volume 18 (Issue 5): 352-354. 2. Lucey DR, Gostin OL. The emerging zika pandemic: enhancing

preparedness. JAMA 2016. Doi:10.1001/jama.2016.0904. 3. Hunter A, Denman-Vitale S, Garzon L et al. Global infections: recognition, management and prevention. The Nurse Practitioner. 2007; Vol 32(2): 3441 4. Ambizas E, Ambizas A. West nile virus. US Pharmacist. 2012; 37(8): 31-34. 5. Day N. Malaria. In: Eddleston M, Davidson R, Brent A, Wilkinson R, eds. Oxford Handbook of Tropical Medicine. 3rd ed. New York, NY: oxford University Press; 2008:31-65 6. Malaria. Quick Medical Diagnosis and Treatment Website. http:// accessmedicine.mhmedical.com. famuproxy.fcla.edu Published 2016. Accessed February 19rd 2016. 7 Dengue. Quick Medical Diagnosis and Treatment Website. http:// accessmedicine.mhmedical.com. famuproxy.fcla.edu Published 2016. Accessed February 23rd 2016. 8. Chikungunya Fever. Quick Medical Diagnosis and Treatment Website. http://accessmedicine.mhmedical. com.famuproxy.fcla.edu. Published 2016. Accessed February 29rd 2016.

9. Bernstein AS. Climate change and infectious disease. In Harrison’s Principle of Internal Medicine. 19th ed. http://accessmedicine.mhmedical. com.famuproxy.fcla.edu. Published 2016. Assessed February 22nd 2016 10. CDC’s Division of Vector-Borne Diseases Web site. http://www.cdc.gov/ features/StopMosquitoes.htm. Published October 20, 2013. Accessed February 22, 2016. 11. Therapeutic Research Center. Recommendations for the use of insect repellents. www.pharmacistsletter. com. Published July 2010. Accessed February 22, 2016. 12. Walgreens Pre-Travel Questionaire Form. Walgreens Pharmacy Website. http://www.walgreens.com/images/ pdfs/Pre-Travel-questionnaire.pdf. Accessed March 10, 2016.

JUNE 2016

FPA Increasing the IQ of your Smart Phone Enhancing your 2016 FPA Convention Experience

The FPA, working with Gather Digital out of North Carolina, will be bringing a new app to The FPA, working with Gather Digital out of North Carolina, will be bringing a new app to the the Annual Meeting and Convention. This app includes an array of features for Annual Meeting and Convention. This app includes an array of features for Attendee networkAttendee networking and participation. Convention will tobe able to send ing and participation. Convention registrants will be able toregistrants send messages fellow attendees messages to fellow attendees leading up to and during the event. Those attending the leading up to and during the event. Those attending the annual meeting will be able to compose annual will be able to compose and the send notes to other logged‐in attendees and sendmeeting notes to other logged-in attendees within special Messages button. You will even be within the special Messages button. You will even be able to share photos of your able to share photos of your convention experience. The Photos section in the app has a feature convention experience. The Photos section in the app has a feature that allows you to that allows you to view, post, and comment on photos posted by the conference planners and felview, post, and comment on photos posted by the conference planners and fellow low attendees! There will also be session evaluations and CE-credit earning survey opportuniattendees! There will also be session evaluations and CE‐credit earning survey ties throughout the event, all accessed easily through the app agenda. Need the conference handopportunities throughout the event, all accessed easily through the app agenda. Need outs? We will put them right at your fingertips in your smart phone. Preregistration for the annual the conference handouts? We will put them right at your fingertips in your smart meeting has closed; however, you can register on site. You will only be able to use the app if you phone. The convention is just a few short weeks away with the registration deadline of are registered for the annual meeting. The FPA will be raffling a free night’s stay at a future date at Friday, June 10, 2016. Register for the annual meeting today and see how technology the Marriott Harbor Beach for all convention registrants that upload a photograph in the attendee can make #FPA2016 an exceptional experience. profile of the convention app. We are looking forward to a great convention.

FLORIDA PHARMACY TODAY

Oregon’s Health Insurers’ Double-Digit Rate Hikes Foreshadow Bad News for the Florida Healthcare Industry By Kala Shankle, B.S., J.D., The Lockwood Law Firm

Health insurance premiums in the individual market are on the rise across the nation, and Oregon’s recently published rate requests telegraph how bad things might get for providers and consumers in all states. At the heart of the rising premiums for individual plans is the turbulent relationship between the Patient Protection and Affordable Care Act (colloquially known as “Obamacare”) and insurance companies providing plans in individual states. Under Obamacare, insurance companies cannot turn away consumers for preexisting conditions. This requirement has forced many state insurance companies to underwrite healthcare plans in the individual market with higher premiums just to maintain their financial status quo. Before insurance companies can charge higher premiums to individual policyholders, the insurance companies must propose changes to any premiums to state regulators. State regulators must then review and approve changes to any premiums to ensure they adequately cover costs without being too high or too low. Oregon is one of the first states to release these proposed premium rates for the upcoming year. According to ACASignUps.net, Oregon insurers are requesting to boost premiums by 15 to 32 percent next year. Providence Health Plan, the largest provider of individual plans, wants to raise rates by 29.6 percent for next year. These higher rate requests in Oregon demonstrate to state regulators how volatile the insurance market has become in the wake of Obamacare. What’s more troubling is that these premium hikes are not necessarily a complete solution. Companies like Moda, once the leader of the individual market with the lowest rates and biggest market share, shrank this year after a 25.6 percent rate

hike and is selling assets in an attempt to stabilize its finances. LifeWise Health Plan of Oregon has announced it will exit the market as competition has put pressure on its bottom line and diminished its ability to attract a critical mass of customers. Oregon’s early figures are not glitches in the insurance industry that are specific to just the Oregon market. Recent rate request publications from New York, Maine, Maryland, Florida and Washington state prove otherwise. Based on data from Florida officials earlier this month, 15 health insurers are looking for an average premium increase of 17.7 percent, doubling the increase approved by regulators last year. As premiums continue to climb, FPA and state regulators will be closely monitoring the situation in Oregon to determine the impact that double-digit premium increases will have on the health care industry in the state of Florida.

A Pharmacist And A Lawyer Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, DEA Investigations Mergers and Acquisitions Pharmacy Risk Assessment/Management Evaluations KAHAN ◆ HEIMBERG, PLC

Pharmacist Attorney Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney

STATEWIDE REPRESENTATION 561-392-9000 bkahan@kahanlaw.com 2300 N.W. Corporate Blvd., Suite 123 Boca Raton, FL 33431 The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.

JUNE 2016

HELP SUPPORT THE ADOPT-A-STUDENT PROGRAM Florida Pharmacy Association (FPA) 126th Annual Meeting & Convention June 30-July 3, 2016 Marriott Harbor Beach Resort & Spa – Ft. Lauderdale, Florida Again this year, students from Florida Colleges of Pharmacy will be “Adopted” for the FPA Annual Meeting and Convention. Pharmacy students will benefit from the interaction with practicing pharmacists, learn first hand how FPA actually operates and how they can become involved in their chosen profession. As you remember, college students are on a tight budget and most of them cannot afford to attend convention. Here is how you can help! Be a Bronze, Silver or Gold Sponsor! The donation amounts are Bronze ($150), Silver ($250), and Gold ($500) Level Mentor Sponsors and will help offset the costs of the AAS program. You also have the option to give any amount you prefer. The FPA offers Adopted students complimentary registration, which includes tickets to the Exhibit Hall, Student Luncheon, Awards Banquet, President’s Breakfast, hotel accommodations for 3 nights at the host hotel, and special programs designed for them. Your generous support of the FPA’s programs and services are keys to our success in advocating for our profession, supporting our pharmacy students and promoting quality patient care services. Thank you for giving back to your profession. Make a contribution yourself, ask your local unit association or get together with friends to Adopt-A-Student. Remember, these are the future leaders of pharmacy! Mentor Program. Each of the adopted students will be assigned a pharmacist who may invite them to attend meetings, CE programs, and share their knowledge and pharmacy experience with them. If you plan to attend the convention and would like to be a mentor, please contact the FPA office. Please donate online or complete the form below and fax or mail with your check to: Florida Pharmacy Association 610 North Adams Street Tallahassee, FL 32301 Fax: (850)561-6758 Please make your check payable to the Florida Pharmacy Foundation Sponsor Name: _________________________________________________________________________ Address: ______________________________________________________________________________ City: _______________________________________ State: __________ Zip: _______________________ Phone: ____________________________________ Amount of Contribution: _______________________ Charge to the following (please circle): AMEX

DISCOVER

MASTERCARD

VISA

Account #:_____________________________________Security Code: ________ Exp. Date: __________ Signature: _____________________________________________________________________________ q Yes, I would like to serve as a Mentor. q Contact me with more information on Mentoring. Contributions to the Florida Pharmacy Association Foundation are tax deductible as a charitable contribution for federal income tax purposes. Consult your CPA for complete details. 20

FLORIDA PHARMACY TODAY

JUNE 2016

FLORIDA PHARMACY TODAY

Continuing eduCation Code KeY: gCe = general RC = Recertification Consultant teCH = technician Stu = Student JUNE 2016

ELLED CANC

Continuing eduCation Code KeY: gCe = general RC = Recertification Consultant teCH = technician Stu = Student 24

FLORIDA PHARMACY TODAY

JUNE 2016

Join us for a fun-filled night at the awards ceremony! DRESS UP AS YOUR FAVORITE PIRATE/PIRATESS! 7 - 10 PM 26

FLORIDA PHARMACY TODAY

Continuing eduCation Code KeY: gCe = general RC = Recertification Consultant teCH = technician Stu = Student

JUNE 2016

The Florida Pharmacy Association (FPA) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Up to 23 contact hours are available upon successful completion of attendance and evaluation forms. Statements of continuing pharmacy education credit will available for you to download and print in four weeks. The FPA is also a Florida Department of Health approved provider of continuing education for pharmacists. This is an ACPE application based activity (*) and an ACPE knowledge based activity. Speakers have no relevant financial relationship to the activities.

FLORIDA PHARMACY TODAY

JUNE 2016

FLORIDA PHARMACY TODAY

florida BUYER’S GUIDE 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 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

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

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

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

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.

RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”

JUNE 2016

Mental Health

Meeting Location

33rd Annual Southeastern Gatherin’ 3 Sandestin Golf & Beach Resort (Village of Baytowne Wharf) 9300 Emerald Coast Pkwy West Destin, FL 32550

Conference

Call 800-320-8115, Group Code 23L7W8 by July 15, 2016 for Reservations

August 7-10, 2016 0166

Hotel Information: FPA room rates range from $159—$249 plus tax and fees. Sandestin requires a one night’s room deposit to be received within 10 days after a reservation is made. Cancellations must be made 7 days prior to arrival date in order to receive a refund. Check in time is 4:00pm. Check out time is 11:00am. All room rates include complimentary resort transportation; two bicycles per unit for up to fours of usage daily; one hour per day of tennis court time; one hour per day usage on either a canoe, kayak, or boogie board. Resort fee covers self parking, WiFi in the Baytowne Conference Center, and reservation processing services. ADA Regulations: The FPA complies with ADA requirements. Please contact the office in advance of the meeting for any needed technical assistance. Cancellation Policy: If cancellation is made in writing 30 days or more prior to the program, a refund will be made, minus a $10 service charge; if less than 30 days, a refund will

be made, minus a $50 service charge. Cancellation requested in writing less than 10 days prior will result in credit for another FPA CE program, valid for one year.

Policy on Industry Support: The FPA adheres to the US Food and Drug Administrator’s policy on industry supported educational activities. The FDA policy requires, among other things, that we conduct the educational program supported by any corporate educational grants independently and without control by the grantor of the program’s planning, content or execution. Furthermore, the programs must be free of commercial bias for or against any product. Tax Deduction: The expense of continuing education, when taken to maintain and improve professional skills is tax deductible. Please contact your accountant for complete details.

4 WAYS TO REGISTER ONLINE: www.pharmview.com PH: 850-222-2400 MAIL: 610 N. Adams Street, Tallahassee, FL 32301 FAX: 850-561-6758 REGISTRATION FORM Pre Registration Deadline: Friday, July 22, 2016 Name ___________________________________________________________________________________ Address __________________________________________________________________________________ City ______________________________________ State __________________ Zip ___________________ Phone (work) ____________________________________ (home) ___________________________________ EMail Address ______________________________________________________________________________ FL Lic# (PS)__________________________ (PU) ____________________ (RPT) _______________________ NABP e-profile number ______________________________ DOB (MM/DD) _______________________________

FULL REGISTRATION FEES  FPA Member  Non Member  Member Tech  Non Member Tech  Southeastern Gatherin’ T-Shirt (included)

Includes all CE, Exhibits, Final Night Party and a TShirt. Exhibit Hall and Final Night Party tickets will be provided only upon request during the pre-registration process and placed in your packet.

Before July 22 $250 $310 $140 $175

After July 22 $290 $350 $170 $195 Size:_______

 FPA Member  Non Member  Member Tech  Non Member Tech

After July 22 $160 $200 $105 $115

Guest Registration includes Exhibits, Final Night Party and a TShirt.

 Guest (NAME)___________________________

$120 = $ __________

 Children (Ages 5–12)

______@

$60 = $ __________

 Exhibit Hall Pass

______@

$30 = $ __________

 Final Night Party

______@

$65 = $ __________

 Southeastern Gatherin’ TShirts Size:_______

______@

$15 = $ __________

TOTAL

$ _______

PRINTED BOOKLETS - CE HANDOUTS Printed booklets for our CE “Handouts: will no longer be available onsite at the conference. The “Handouts” will be posted on our website www.pharmview.com the week of the conference for you to print out and bring with you to the meeting. Printed booklets of the “Handouts” are available for $25.00 each.

I would like a printed, hard copy booklet: $ __________ Amount $ ___________ $ ___________ PAYMENT METHOD TOTAL ENCLOSED $ ________ $ ___________ $ ___________  Check (To: FPA) AMEX Discover  MasterCard Visa

DAILY EDUCATION REGISTRATION (6 CREDIT HOURS) Before July 22 $150 $190 $75 $90

OPTIONAL FEES - Separate Fees Apply

Amount $ ___________ $ ___________ $ ___________ $ ___________

Select the day you will attend: Sunday Monday Tuesday Wednesday

Account #________________________________________ Security Code _____ (REQUIRED)

Exp. Date ______ Billing Address ______________________________________ Signature ______________________________________________________ Children under the age of 18 are not allowed in CE programs.