October 2022 Florida Pharmacy Today

THE MAN IN THE ARENA

NOVEMBER

6 FPA Board of Directors via Zoom

11 Veterans Day

FPA Office Closed

24-25 Thanksgiving

FPA Office Closed

DECEMBER

2 APhA Immunization Certificate Training program Sarasota

3-4 FPA Regulatory and Law Zoom Conference via Zoom

14-15 Florida Board of Pharmacy Meeting Orlando

26-27 Christmas HolidayFPA Office Closed

JANUARY

2 New Years - FPA Office Closed

Mission Statements:

Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a peer-reviewed journal which serves as a me dium through which the Florida Pharmacy Association can communicate with the profes sion on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the pro fession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

Florida Pharmacy Today Board of Directors

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 two-hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period. The Reducing Medication Errors course is needed for pharmacists and technicians.

Pharmacists should have satisfied all continuing education requirements for this biennial period by Sept. 30, 2023, or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by Dec. 31, 2022.

For the 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.floridapharmacy.org

CONTACTS

FPA — Tian Merren-Owens (850) 222-2400

FSHP — Tamekia Bennett (850) 906-9333

UF — Emely McKitrick (352) 273-5169

FAMU — Dr. Selika Sampson (850) 599-3301

NSU — Carsten Evans (954) 262-1300

DISCLAIMER

Note: The views of the authors do not necessarily represent the views or opinions of the Florida Pharmacy As sociation, Florida Pharmacy Today or any related entities.

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 Jour nal 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 ap propriate advertising to assist the Journal in its goal of self-support.

Articles in this publication are designed to provide accurate and authoritative infor mation 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.

The President’s Viewpoint

CAROL MOTYCKA, PHARM.D., CHSE

Thank You For All You Do!

American Pharmacists Month is an excellent time to reflect on the amazing work that phar macists do every day in Florida. From the multitude of practice sites that we work in, pharmacists are a core and essential part of the healthcare team working tirelessly to care for patients in our communities. This past month, we had the opportunity to celebrate phar macists all over Florida and throughout the country.

One great way to bolster recognition of pharmacists is through proclama tions created at local and state levels. In order to request a proclamation from your city regarding American Pharma cists Month, search your local city web page or mayor’s office webpage for an online submission form for the procla mation. You may also contact the of fice directly through a phone call or email if you have difficulty in finding the information. In Jacksonville, our Duval County Pharmacy Association

worked in conjunction with the local ASP-APhA chapter to request a procla mation which was signed by the May or and mailed to the group. The proc lamation is then often disseminated in various ways, helping bolster recogni tion of the excellent work pharmacists do every day.

Our public affairs committee, un der the leadership of Joy Wright, has been working hard to boost our rep resentation in the community as well. They have been hard at work creating member spotlights and posts regarding pharmacists in order to showcase the

Carol Motycka, Pharm.D., CHSE

From the multitude of practice sites that we work in, pharmacists are a core and essential part of the healthcare team working tirelessly to care for patients in our communities.

Executive Vice President, CEO Helen Sairany, ext.200

Director of Continuing Education Tian Merren-Owens, ext. 120

Continuing Education Coordinator Stacey Brooks, ext. 210

Coordinator of Membership Ranada Howard, ext. 110

FLORIDA PHARMACY TODAY BOARD

Chair David Mackarey, Boynton Beach

Vice Chair Matt Schneller, Tampa

Treasurer Eric Jakab, Gainesville

Secretary Julie Burger, Pensacola

Member Aiya Almogaber, Tampa

Member Michael Finnick, Jacksonville

Member Carol Motycka, Jacksonville

Member Teresa Tomerlin, Rockledge

Member Greta Pelegrin, Hialeah

Technician Member Julie Burger, Pensacola

Executive Editor Helen Sairany, Tallahassee

Managing Editor Dave Fiore, Tallahassee

Journal Reviewer Dr. Melissa Ruble

Journal Reviewer Dr. Angela Hill

This is a peer-reviewed publication.

©2022 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 as sumes 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.

great healthcare we provide to patients all around the state. If you would like to nominate a pharmacist to be high lighted, contact member Trey Burry to provide the information. The com mittee is also working on a new Flor ida Pharmacy Association podcast which will be available to pharmacists as well as other healthcare providers, and patients as well. If you have topics you would like to know more about in an upcoming episode, email me your thoughts as I would love to hear from you!

Finally, we continue to provide quality content to our readers and that content often comes from you, the members. If you have an article on a

timely topic to submit, please follow the guidelines for submission avail able at https://bit.ly/3U0UFru. We are always eager to hear from you!

As we begin to turn our thoughts towards Thanksgiving this month, I reflect on how thankful I am to be giv en this opportunity to serve all of you in this great profession. Having Octo ber as American Pharmacists Month provided us with the reminder that we are an essential part of the healthcare team and are recognized in the com munity for our continued hard work and effort. Let’s continue the celebra tion not only in October, but through out the year! n

FLORIDA PHARMACY ASSOCIATION 610 N. Adams St. • Tallahassee, FL 32301 850/222-2400

BE THE MAN IN THE ARENA Thoughts on Life and Leadership

By Helen Sairany, BA, PharmD, MBA, RPh, BCACP FPA Executive Vice President and CEO

MACHU

I am a proud first-generation immigrant from the Kurdistan region of Iraq. I live in Tallahassee, Florida, with my two French bulldogs, SeVay and Jango—the Kurdish names for apple and hero. I hold a bachelor’s degree from Agnes Scott College, a Master of Business Administration from the University of Maryland, and a Doctor of Pharmacy from Northeastern University.

As I reflect on my career path, the constructive feedback received from my peers, learners, mentors and loved ones, and the personal and professional challenges I had to overcome, nothing summarizes my leader ship style better than the famous quote by Theodore Roosevelt, known as the “Man in the Arena.”

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."

— THEODORE ROOSEVELT

Hello to my fellow pharmacy professionals in the Sunshine State! I am so excited to share a little bit about my personal and professional life with you through this piece in Florida Pharmacy Today. Many pharmacists in the country know me as the traumainformed healthcare provider, while others call me the world traveler, the sweaty creative, the author, or the state executive. Whatever I go by, deep inside my heart, I will always be the pharmacist who loves serving and advancing her profession.

My journey to the United States started when I was only 7. At a young age I found a hand grenade in the rubble of my hometown in Iraqi Kurdistan and was desperate to trade it for a bag of candy from a United States Marine deployed in my homeland. With the instability and conflict, my family and I later sought refuge in the United States, hoping for a second chance in the land of unlimited opportunity. In 1996, at 13 years old, I landed in America.

Even though I was living and growing up in the safety of a free country, the next three decades presented numer ous challenges for me. At 13, I was in a new world where ev erything was foreign to me. The United States soon became a new home far away from the home in which I was born and raised.

The challenges in this new home were far too many: learn ing a new language, mastering a new culture, and getting accustomed to a new set of standards, all while also nav

igating life as a teenager. I knew early on that failure was not an option. In other words, I had no choice but to be in the arena, to get my face marred with dust, sweat and blood to achieve my dreams. I have lived in the arena and know the challenges that come with it intimately. I know what it means to show up and have the courage to be seen every step of the way.

I grew up in Clarkston, Ga. Clarkston was, and still is, the home to one of the largest ref ugee populations in the country. I learned how to master English with my fellow refugee neigh bors from Somalia, Bosnia, Vietnam, and other countries. We all had one common goal growing up in the United States, and that was living the American Dream.

The first dream to come true for me was get ting accepted into Agnes Scott College in De catur, Ga. I majored in biology and psychology and held a part-time job at Publix Super Mar ket. While at Publix, I would watch and admire my community pharmacist and her passion for providing individualized care for her patients. I knew becoming a pharmacist would be some thing I would want to pursue after I graduated from Agnes Scott.

I got admitted to Northeastern Universi ty College of Pharmacy for my Doctor of Phar macy. While in Boston, I did not want to limit my experience to pharmacy. I started exploring the world in-between semesters. The more I ex plored the world, the more I realized I wanted something much bigger than the career oppor tunities post-pharmacy school.

As I continued advancing through the semes ters, I knew I wanted something that was in line with my passion for having an impact on patient care, on lives and on the profession. I didn’t know what that was just yet, but I knew I wasn’t quite ready to settle for the options available to me.

So, after graduation, and due to my passion for exploring the world and living overseas, I packed my stuff and left for Iraq. I promised my family that I would serve for one year, not realizing that the one year would extend to three years. You see, I have always had the drive for change. That drive, along with proven organizational leadership and rela tionship-building skills, prepared me to successfully serve in the role of director of quality assurance at Duhok University’s School of Pharmacy in Iraq.

In this role, I took on the task of transitioning the school system from the BS Pharm program to the U.S.-based Pharm.D. curriculum. As part of this process, I presented a business case to the ministry of higher education in Iraq to approve a six-year pharmacy program as a doctoral degree. In addition, I supervised, assessed, and appraised performance and provided my staff with all the tools and resources neces sary to grow in their positions.

ZANZIBAR, TANZANIA

During one of my site visits in Duhok, I had a brief en counter with a beautiful 25-year-old Kurdish woman named Bekhal. Without realizing it, Bekhal was going to change the trajectory of my career for the next decade. Bekhal realized she may not live to see the spring of next year. Leukemia, which was ravaging her body ever since she received coun terfeit medication in a hospital in the Kurdish region of Iraq, could kill her.

Bekhal was standing in the courtyard of her house when her father told me about the investigation into the counter feit medication that ruined her chances of being cured of this deadly disease. Just a few days after being given the medica tion in a government hospital, the doctors informed her that recovery within the Kurdish region had become impossible. The father planned to sell his small house and travel with Bekhal to India, searching for a last chance to save his only daughter.

So when my year was ending in Iraq, I returned to the United States to visit my family. However, I shared that I was going to extend my stay in the Middle East. I knew I had a role to play there, among my people, the displaced refugees in Iraq.

I couldn’t think, as many new practitioners and graduates do, about that first important job as a pharmacist upon my return to the United States. I could only think about the life I lived as a displaced refugee. Without a second thought, I chose to move from the safety of my current home in Ameri ca to once again being back in harm’s way in my birth home of Iraq. After all, aren’t we in a profession of caring and giving? What better way for ME to serve than to help desperate and displaced refugees of war in conflict zones?

Every day, I would treat and provide optimum care to little girls with PTSD and those similar to Bekhal’s and started hear ing the wounded inner child in me crying for help, “What about me?” My own flash backs and nightmares became unbearable. Little did I know, the individual who was crying for help was ME.

After three years of service in Iraq and upon my return to the United States, I was diagnosed with complex PTSD from my work at the frontline. The diagnosis was devastating to my family and me. But the diagnosis served as an awakening to an other channel of having an impact. I knew then that I had post-traumatic wisdom to share not only with pharmacists in this country, but the whole world.

Not long after my return to the Unit ed States, I was recruited by the Ameri can Pharmacist Association to develop ed ucation and training for pharmacists in the country. In my role as the director of content development and partnership at

APhA, I developed the educational content associated with certificate training, advanced training and national meetings as well as member benefit programs for pharmacists, phar macy technicians, residents and students. To meet the de mands of the market and the needs of the 64,000 APhA mem bers from all practice settings, I became adept at managing multiple projects at once and developed superior organiza tional skills.

My biggest contribution to APhA was my work address ing suicide prevention, mental health, and combating opioid abuse and misuse. I was honored that my work was recog nized by the Washington Business Journal in 2019 as a ”40 Under 40” leader.

I also developed several funding initiatives, implemented marketing plans, and created and proposed strategies that led to increased membership. Some examples include PharmTalk, PharmTank, trainings on statewide protocols, and the APhA Institute on Substance Use Disorder and Patient Wellbeing.

While at APhA, I was entrusted with additional leadership responsibilities including developing business partnerships and alliances with schools of pharmacy, state association ex ecutives, pharmaceutical companies, and leaders from gov ernment institutions such as the Drug Enforcement Agency, Centers for Disease Control and Prevention, and the Food and Drug Administration. Through these partnerships, I negotiat ed business dealings, revenue sharing activities, roles and re sponsibilities, and drafted legal initiatives for multiple parties.

SUMMIT KILIMANJARO, TANZANIA

After seven years of working for APhA, I transitioned to be come the state executive of South Carolina where I had the priv ilege of working closely with my members to strategize the vi sion and goals for the association. In the short period I have served as the CEO, I was able to double the membership rev enue, rebrand the association’s communication and digital en gagement strategy (which included a new website and member ship management system), and bring in a $250,000 in donations to improve the infrastructure of the SCPhA headquarters.

One of my strengths and passions is staff development. As a supervisor and preceptor, I strive to align opportunities to best utilize the talents of my colleagues. My skills include extracting the untapped abilities and talents of my staff. My duties as a CEO require recruiting, mentoring and manag ing staff members. I have grown my mentorship and super visory roles through constructive feedback, including how to be more effective and engaging. As a result, the Foundation Board of the SCPhA tasked me to develop an Executive Fel lowship in Association Management and Leadership that be gan in July of 2022.

I am now excited to bring my international, national and state experiences to Florida to better serve the needs of phar macists here. I feel my experiences over the years have well prepared me to attend to the needs of pharmacists, pharmacy technicians and learners in Florida.

I want the Florida Pharmacy Association to know that I am also aware of the many challenges facing our profession.

From the broken system that rewards the middleman for ad ministration and rebates while investing very little in the great work pharmacists do for their patients to unbearable work conditions, we have a lot to stand up to. In other words, we have no choice but to be in the arena. The fight is big, but I know the reward is bigger.

If anything, it is a great time for pharmacists to be proud of the great contributions they have made to healthcare by res cuing the world from the pandemic, getting millions and mil lions of shots in arms of patients. With pharmacists being the most accessible and third-most trusted and loved provider by their patient, we have a lot to think about. With the coun try going through a primary care shortage crisis, we have a very good business case to make in filling this gap in health care. The whole world knows that as pharmacists, we are the experts when it comes to medication. That said, we not only need to be enabled, but we need to be supported to perform our role effectively.

Outside of work, I dedicate my time to bringing awareness to trauma and the importance of being an informed health care provider. My work on trauma frequently takes me out side of the U.S., beyond the bounds of the pharmacy profes sion into the fields of education, discrimination, immigration and workers’ rights.

Lake Titicaca, Bolivia

Pilgrim making her rounds in Tibet, China.

Book signing in Clarkson, GA

FPA board members at FPA Annual Convention 2022 in Fort Lauderdale, FL.

My passion for trauma-informed healthcare has been rec ognized both nationally and internationally. I have keynot ed on a wide range of topics related to trauma including, but not limited to, mental health fitness and wellbeing, racial and developmental trauma, addiction, diversity, equity, inclusion and belonging. My recent research on how the pandemic cre ated combat-like trauma for frontline heroes has gotten both national and international attention.

In my free time, I serve as a yoga instructor and a facul ty adviser for the All-Women Blogger’s Club, where I teach young women from the minority communities how to voice their opinions through writing. I also serve as a mentor for countless students, residents and fellows across the country.

I am a proud author of two books. The first one, “Trad ing Grenades for Candy: A Kurdish Refugee’s American Journey” is already out and is about my life story of escap ing war and finding myself in the United States. The second book, “The Traumas We Carry,” which is expected to come out next year, is about normalizing mental health from my own voice and my experiences of living with PTSD. My love for writing started when I blogged about my experiences liv ing with PTSD as a single woman in a male-dominated field in the Middle East.

My greatest passion is traveling the world. Throughout my years of travel, I have embarked on many adventures in cluding trekking in Southeast Asia, summiting Everest Base Camp in Nepal, W circuit in Patagonia-Chile, Machu Picchu and Rainbow Mountain in Peru, and Mount Kilimanjaro in Tanzania. After visiting 80-plus destinations in the world, I have developed an appreciation for a diverse mix of cultures, people and traditions.

In conclusion, it is worth noting that in my journey to be come a trauma-informed pharmacist, a mentor to others, a world traveler, a sweaty creative, an author, and a state execu tive, there were many fears I had to overcome: the fear of un certainty, the fear of the unknown, and the fear of not know ing what I did not know. There was self-doubt, insecurity and anxiety, but there was also growth and opportunity.

My journey of living and thriving in the arena has taught me four life lessons:

1. Being in the arena is never about winning or losing. It is about having the courage to show up and be seen.

2. Being in the arena is about being the “sweaty creative,” the original thinker, and having the courage to be the first to walk an uncharted path.

3. Being in the arena means your face will be marred with dust, sweat and blood. It is not easy. There will be setbacks, failures and obstacles.

4. Being in the arena affords you a level of growth, influence and impact unreachable to those on the sidelines.

So, to thrive in the arena, I ask that you please keep the fol lowing key bullet points in mind:

n Know Your “Why.” Having a “why” means knowing your purpose in life. The same purpose that gets us up in the morning is what will help us look forward to showing up in the arena. When we don’t have a “why,” we will not be motivated to be in the arena and survive the challeng es that come along with being in the arena. If we are not inspired to be in the arena, how can we expect others to show up in the arena with us?

n Have a Trusted Network. Nothing is ever accomplished alone. We need a network of people who believe in us, not de spite our vulnerabilities and flaws but because of them. They know we belong in the heart of the arena. When we fall, they pick us up, clean the dust off our faces and get us back in the arena.

n Have a Worthy Rival. Having a worthy rival is an asset in ad vancing our cause and becoming a better version of our selves. You see, the reason we hate our competitors is because their strength reveals our weaknesses. It is eas ier to direct our negative energy at them than to take a hard look at ourselves. Thriving in the arena is an infi nite game. Instead of focusing on trying to win, our focus should be on mastering the game through learning and developing. Instead of trying to beat our competitors, we should perceive them as another player in the arena who can help us thrive.

n Have the Capacity for Existential Flexibility. “Existential flexibil ity” is a term used by Simon Sinek, which he says deter mines how long we can last in the arena. Existential flex ibility is determined by our quickness in responding to the ever-changing market demand. It is our willingness to find a better path to advance our cause because if we stay on the same path, we will eventually become outdat ed and irrelevant. In other words, if we don’t blow up our business to advance our cause, the market will blow it up for us.

n Have the Courage to Lead. Having the courage to lead is one of the hardest things to do in the arena. Being a leader is being the first to show up in the arena, essentially putting a target on your back. A leader puts their needs and in terests aside to invest in the team. A leader gives credit to the team when things go well and accepts responsibility when they don’t.

As your next executive vice president and chief exec utive officer, I have chosen a life of service to you. Meeting your needs and helping you achieve your aspirations are my “Why.” I promise to show up in the arena every day, but I will need your help to stay in the arena. I need each one of you to join me in protecting and advancing the cause of every phar macist, student pharmacist and technician in Florida. Togeth er, we can make the profession of pharmacy and FPA shine on a national platform. Thank you!

Marijuana Use in Patients with HIV

Introduction

Marijuana is the second most widely smoked substance in our society after tobacco, and interest in its medicinal ap plications is growing.1 The effect of marijuana on the human body is complex and not yet fully understood.2 Both chron ic pain and HIV are commonly listed as conditions allowable by state medical marijuana programs. Interests in marijua na for chronic pain in individuals with HIV have increased.3 Patients living with HIV constitute one of the largest groups that consume marijuana for medicinal as well as recreation al purposes. Prospective studies of cannabis in individuals with HIV are limited to the short-term study due to lack of evidence in pain or reduction improvements.3

What is Marijuana?

Cannabis (also called marijuana) is the most commonly used illegal psychoactive substance worldwide. It’s a feder al Schedule 1 drug under the U.S. Controlled Substances Act and its psychoactive properties are primarily due to one can nabinoid: delta-9-tetrahydrocannabinol (THC); THC concen tration is commonly used as a measure of cannabis potency.5 Marijuana use is widespread amongst adolescents from ages 18-25 years old; it is most prevalent among men and those of mixed race. When marijuana is smoked, its active ingredient, THC, travels throughout the body to produce many effects. THC then attaches to cannabinoid receptors on nerve cells in the brain.4 Cannabinoid receptors are in parts of the brain that regulate cognitive functions. Marijuana acutely impairs attention, concentration, memory, associative learning, and

Antonio J. Carrion, PharmD, MPH, AAHIVP, CPh, Briana Journee, PharmD, MBA, AAHIVP, CPh, Estella Gordon, PharmD, Shanell McNeal, PharmD

motor coordination.5 The legal status of marijuana use var ies across the world. The potency of cannabis has increased, which may have contributed to increased rates of cannabis-re lated adverse effects.5

What is HIV?

Human immunodeficiency virus (HIV) weakens the im mune system by destroying important cells that fight disease and infection. There is no effective cure, but with proper treat ment of antiretroviral therapy, HIV can be controlled.6 HIV can result in three stages such as acute HIV infection, clini cal latency (HIV inactivity or dormancy), and acquired im munodeficiency syndrome (AIDS). HIV is currently a disease of greater demographic diversity, affecting 1.1 million people of all ages, sexes, and races, and involving multiple transmis sion risk behaviors.6 African Americans and Hispanic/Lati nos are the leading race/ethnicities who are mostly affected by diagnoses of HIV as well as gay and bisexual men.6

Use of Marijuana in HIV patients

The District of Columbia and 11 states have legalized rec reational marijuana, while 22 states allow for the prescribing of marijuana in medical purposes.12 Marijuana has been rec ognized as an effective treatment of symptoms and medica tion side effects in HIV patients. Results prove that marijua na reduces nausea and vomiting and stimulates the appetite, which leads to weight gain, and causes relief in neuropathic pain associated with HIV.10,12 Disadvantages of marijuana in clude respiratory illness, cardiovascular complications, prob lems with learning and memory, and mental illness.10,12 Long term use of cannabis is a potential risk factor for lung disease, as it contains many of the same toxic constituents present in tobacco smoke.1,7 It is important to avoid marijuana treatment in patients who stem from these complications.

Marijuana use and HIV treatment outcomes among PWH receiving care at an Urban HIV Clinic

Marijuana is most prevalent among people with HIV (PWH) and this study was conducted to examine the relation ships between frequency of marijuana use and antiretroviral therapy (ART) adherence and viral suppression in 1,377 pa tients enrolled in the Johns Hopkins HIV Clinical Cohort (JH HCC). The study was categorized into no use of marijuana, no use within the last three months, monthly use or less or weekly/daily.8 Multivariable analyses and other independent variables of interest, alcohol use, other drug use, and depres sive symptoms were conducted using generalized estimating equations to account for repeated measures. In this study, the average patient age was 51 years old and majority of the pa tients were African American and male. Half of the study’s population (51.7 percent) reported use of marijuana at least once in their lifetime, 20 percent reported marijuana use in the prior three months and nearly 10 percent of weekly (3.6 percent) or daily use (6.2 percent). Of those who used mar ijuana in the prior three months (n=277) 49 percent report ed weekly/daily use (18 percent weekly use, 31 percent daily use), and 51 percent used monthly or less.8 The resulted out

HUMAN IMMUNODEFICIENCY VIRUS (HIV)

comes indicated that marijuana use did not appear to impact HIV treatment outcomes or independently effect ART adher ence or viral suppression, but alcohol, other drug use, and depressive symptoms are negatively associated with poorer HIV treatment outcomes.

Effect of Cannabis Use on Human Immunodeficiency Virus DNA During Suppressive Antiretroviral Therapy

This study was conducted to investigate the effects of can nabis use, with or without other drugs, on the decay and tran scriptional activity of the HIV reservoir during suppressive ART; more closely on cellular HIV DNA and HIV RNA. The study yielded four groups: no drug use; cannabis use only; use of drugs other than cannabis; and use of both cannabis and other drugs.9 A linear mixed-effects regression model was generalized to detect the relationship of cannabis and other drugs on two outcomes during ART: (1) changes in HIV DNA levels, and (2) cell-associated HIV RNA transcripts.9 Among all participants, fixed effects were included in the fi nal model to test whether the outcome changed over time. The study evaluated 206 blood samples from 48 men who have sex with men (MSM). Of the 48 individuals, 10 (21 per cent) reported no drug use, 5 (11 percent) reported use of can nabis only, 16 (33 percent) reported use of drugs other than cannabis, and 17 (35 percent) reported use of cannabis and other drugs. At the time of ART initiation (P = 0.04), cannabisonly users had strikingly greater HIV DNA levels, but there after experienced a faster HIV DNA decay, compared to those with no drug usage.9 Participants who used other drugs had comparable levels of HIV DNA at ART (P = 0.41 and 2.65 P = 0.66) initiation and during ART (P = 0.43 and P = 0.76), com pared to those with no drug usage.9 Overall, the use of can nabis was affiliated with a faster decay of HIV DNA, but no substantial impact on cell associated HIV RNA transcription or cellular activation during suppressive ART. However, the usage of other drugs was associated with expanded CD8 T cell activation and cellular HIV RNA transcription during ART.9 To conclude, the outcome effects of cannabis on HIV DNA was not perceptible when cannabis was used in combi nation with any other drugs, underlining the interaction be tween drug use and viral infections.

WEAKENS THE IMMUNE SYSTEM BY DESTROYING IMPORTANT CELLS THAT FIGHT DISEASE AND INFECTION. THERE IS NO EFFECTIVE CURE, BUT WITH PROPER TREATMENT OF ANTIRETROVIRAL THERAPY, HIV CAN BE CONTROLLED.

Role of a Pharmacist

Pharmacists partake in health promotion campaigns on a wide range of health-related topics, and particularly on drugrelated topics or topics concerned with other health problems. Participate in the education of local community groups in health promotion on disease prevention.10 Discuss the knowl edge and expertise to provide detailed information on med icines to members of the health professions and the public.

The pharmacist’s role in therapy management has progressed and developed to ensure patients and other medical profes sionals achieve optimizable goals. Pharmacists’ engagement in care of HIV+ patients has improved patient outcomes, in cluding compliance, decreased medication errors, significant increases in CD4 cell counts, and higher rates of viral sup pression.11 In preventative measures of drug resistance, a pharmacist plays a vital role in the selection of potent ART regimens, alternative therapy or dosage adjustments, moni toring adverse effects, drug-drug interactions, and patient ed ucation.11

Conclusion

Marijuana is widely consumed in the United States and strikingly in individuals diagnosed with human immuno deficiency virus. HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifical ly the CD4 cells, often called T cells. Over time, HIV can de stroy so many of these cells that the body can’t fight off infec tions and disease. Studies show that marijuana use in HIV patients didn’t indicate any negative outcomes with antiret roviral therapy. When appropriately prescribing and moni toring, marijuana can provide benefits towards the patient’s quality of life. However, those who used other independent variables such as alcohol or other drug substances indicated negative outcomes in ART therapy. While substantial prog ress has been made in prevention and treatment of HIV, this virus remains a persistent problem for the United States and countries around the world. As further studies are being con ducted, medical or recreational marijuana will benefit better outcomes with newer treatments.

References

1. Wenger DS, Crothers K. “Marijuana Smoking in Men with HIV Infection: A Cause for Concern.” EClinicalMedicine, 8 Feb. 2019, doi.org/10.1016/j.eclinm.2019.01.016.

2. Charron, Catherine B, and Janice Leung. “The Safety and Efficacy of Marijuana in Persons Living with HIV.” AIDS Reviews, Permanyer Publications, www.aidsreviews.com/ resumen.php?id=1482.

3. Merlin, Jessica, et al. “Palliative Care: Issues in HIV/AIDS in Adults.” Edited by R Sean Morrison and Jane Givens, UpToDate, www.uptodate.com/contents/palliative-careissues-in-hiv-aids-in-adults

4. Gorelick, David A. “Cannabis Use and Disorder: Epidemiology, Comorbidity, Health Consequences, and Medico-Legal Status.” UpToDate, www.uptodate.com/ contents/cannabis-use-and-disorder-epidemiologycomorbidity-health-consequences-and-medico-legal-status/ contributors.

5. “Cannabis: Uses (Medical), Effects & Warnings.” Drugs.com, www.drugs.com/illicit/cannabis.html.

6. “About HIV/AIDS.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Dec. 2019, www.cdc.gov/hiv/basics/whatishiv.html.

7. Lorenz, David R., et al. “Effect of Marijuana Smoking on Pulmonary Disease in HIV-Infected and Uninfected Men: A Longitudinal Cohort Study.” EClinicalMedicine, vol. 7, 2019, pp. 55–64., doi:10.1016/j.eclinm.2019.01.003.

8. Sinha, Sagarika, et al. “Marijuana Use and HIV Treatment Outcomes among PWH Receiving Care at an Urban HIV Clinic.” Johns Hopkins University, Elsevier Inc., 1 Nov. 2017, jhu.pure.elsevier.com/en/publications/marijuana-use-andhiv-treatment-outcomes-among-pwh-receiving-care.

9. Antoine, et al. “Effect of Cannabis Use on Human Immunodeficiency Virus DNA During Suppressive Antiretroviral Therapy.” OUP Academic, Oxford University Press, 10 May 2019, academic.oup.com/cid/ article/70/1/140/5487786.

10. “ASHP Publishes Guidelines on Pharmacist Involvement in HIV Care.” Home, 10 Mar. 2016, www.pharmacist.com/ article/ashp-publishes-guidelines-pharmacist-involvementhiv-care.

11. Tseng, Alice et al. “Role of the Pharmacist in Caring for Patients with HIV/AIDS: Clinical Practice Guidelines.” The Canadian journal of hospital pharmacy vol. 65,2 (2012): 125-45. doi:10.4212/cjhp.v65i2.1120

12. Myhre, James, and Dennis Sifris. “HIV and the Benefits of Medical Marijuana.” Verywell Health, Verywell Health, 4 Jan. 2020, www.verywellhealth.com/medical-marijuana-forhiv-4129028.

House of Delegates Speaker’s Report 2022

Alexander Pytlarz, PharmD Speaker of the House 2022-2023

This past July, at FPA’s 132nd Annual Meeting and Convention, members, FPA local unit associations, and FPA House of Delegate members gathered at the Harbor Beach Marriott to meet, discuss, and advocate for the profession of phar macy. It was another successful meeting.

The House of Delegates convened to discuss new business and review five submitted resolutions. Of those, one was adopted, two were referred to committee, and two were rejected. There was also one FPA Bylaw change approved by the House.

I would like to recognize outgoing House of Delegates board member Barbara Beadle and Jeanette Connelly for their time and dedication serving the House and its member ship. Due to a vacancy of the vice speaker, Eric Larson will again serve as the board’s chair. We are excited to have new members to our board and House. Josh Pullo was elected vice speaker, and Dustin Williams and Neil Barnett were elected House of Delegates directors.

Our 2022-2023 FPA House of Delegates Board of Directors:

n Chair of the House Board – Eric Larson

n Speaker – Alexander Pytlarz

n Vice Speaker – Josh Pullo

n Director – Darcy Vaugh (term ends 2023)

n Director – Dustin Williams (term ends 2024)

n Director – Neil Barnett (term ends 2024)

The 2023 133rd FPA Annual Meeting and Convention in Marco Island, Florida is scheduled for July 5 – July 9, 2023. We plan to have our House of Delegates meeting on Thurs day, July 6, convening both sessions of the House in one day. Please be on the lookout for the deadlines to register as a del egate and submit resolutions for next year’s meeting.

Thank you for allowing me to serve as your 2022-2023 House of Delegates Speaker. It is an honor.

Alexander Pytlarz

CALL

APhA Foundation and NASPA Bowl of Hygeia

Awarded to a pharmacist for out standing community service above and beyond professional duties. The use of the following selection criteria is required:

n The recipient must be a Florida li censed pharmacist and member of the FPA.

n The recipient must be living. Awards are not presented posthu mously.

n The recipient has not previously received the award.

n The recipient is not currently serv ing nor has he/she served within the immediate past 2 years on its award committee or an officer of the association in other than an ex officio capacity.

n The recipient has compiled an out standing record of community ser vice, which, apart from his/her specific identification as a pharma cist 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 Flori da licensed pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years.

Criteria:

n The recipient must be a Florida li censed pharmacist and a member of the FPA.

n The recipient has rendered out standing service to pharmacy within the past five years.

Technician of the Year Award

Awarded annually to a Florida pharmacy technician who is recog nized for his/her outstanding perfor mance and achievement during his/ her career.

Criteria:

n Candidate must be a member of the Florida Pharmacy Association for at least 2 years.

n Candidate must have demonstrat ed contributions and dedication to the advancement of pharmacy technician practice.

n Candidate must have demonstrat ed contributions to the Florida Pharmacy Association and/or oth er pharmacy organizations.

n Candidate must have demonstrat ed commitment to community ser vice.

n Candidate is not a past recipient of this award.

R. Q. Richards Award

This award is based on outstand ing achievement in the field of phar maceutical public relations in Florida.

Criteria:

n The recipient must be a Florida registered pharmacist and a mem ber of the FPA.

n The recipient has displayed out standing achievement in the field of pharmaceutical public relations in Florida.

Frank Toback/AZO Consultant Pharmacist Award

Criteria:

n Candidate must be an FPA mem ber, licensed with the Florida Board of Pharmacy as a consultant pharmacist in good standing.

n Candidate should be select ed based on their outstanding achievements in the field of consul tant 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:

n A minimum of five years of active involvement in and contributions to the local association and FPA.

n Candidate must have held office at local level pharmacy association.

n Member in good standing for a pe riod of at least five years in the FPA and must have served as a member or chairman of a committee of the association.

n Candidate must have been active ly involved in a project that has or could potentially be of benefit to members of the profession.

Pharmacist Mutual Companies Distinguished Young Pharmacist Award

Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy: Criteria:

n Licensed to practice for nine (9) years or less.

n Licensed to practice in the state which selected.

n Participation in national pharmacy association, professional programs and/or community service.

IPA Roman Maximo Corrons Inspiration & Motivation Award

Interamerican Pharmacists As sociation created this award to hon or the memory of Roman M. Corrons who inspired and motivated count less pharmacists to participate active ly and aspire to take on leadership roles in their profession. Roman was always there with guidance and sup port that motivated pharmacists and encouraged visionary leadership, ap proachable active membership and succession planning. This award rec ognizes the motivators among us who inspire others to continue to advance

the profession.

Criteria:

n The recipient must be a Florida li censed pharmacist and a member of the FPA.

n Candidate should motivate others to excel within the profession by encouraging them to be leaders.

n Candidate is not necessarily an as sociation officer, but guides, sup ports and/or inspires others.

n A brief description on the candi date’s motivational/inspirational skills must accompany the nomi nation.

The Jean Lamberti Mentorship Award

The Jean Lamberti mentorship Award was established in 1998 to hon or those pharmacists who have taken time to share their knowledge and ex perience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

Criteria:

n The recipient must be an FPA mem ber.

n The recipient must serve as a role model for the profession of phar macy.

Upsher Smith Excellence in Innovation Award Awarded to honor practicing phar macists who have demonstrated inno vation in pharmacy practice that has resulted in improved patient care.

Criteria:

n The recipient has demonstrated in novative pharmacy practice result ing in improved patient care.

n The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association.

n Qualified Nominee: A pharmacist practicing within the geograph ic area represented by the Associa tion.

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2023