The Official Publication of the Georgia Pharmacy Association
February 2009
VIP (Very Involved Pharmacist) Day February 18, 2009 Volume 31, Number 2
www.gpha.org
NEW PLANS – BETTER RATES – MORE BENEFITS in 2009
Look what’s NEW in 2009... Reduced Rates Prescription Drug Coverage Dental and Orthodontic Benefits Guaranteed Issue Term Life Insurance... up to $150,000 with no underwriting requirements
Call or e-mail TODAY to schedule a time to discuss your health insurance needs.
Trevor Miller – Director of Insurance Services 404.419.8107 or e-mail at tmiller@gpha.org
The Georgia Pharmacy Journal
2
February 2009
16
Departments
GPhA Convention Registration Information June 2024, 2009 Ponte Vedra Beach, FL Sawgrass Golf Resort and Spa, A Marriott Resort FEATURE
12 17 20 22 24
ARTICLES
Get “Fresh” for Your Valentine: 10 Ways to Keep Your Breath Fresh
GPhA’s Legislative Update Article & Event Information The 13th Annual Southeastern PRN Conference
10 11 13 14 25 30
New Members GPhA Members in the News Call for Award Nominations GPhF Information Journal CE GPhA Board of Directors
Advertisers 2 2 4 5 7 7 8 9 17 21 24 31 32
The Insurance Trust Meadowbrook® Insurance Group Middle Georgia Relief Services PQC Toliver & Gainer MTM Toolkit Pharmacists Mutual Companies AIP Meeting Annoucement GoodSense Michael T. Tarrant GPhA Career Center PACE Alliance The Insurance Trust
Georgia Pharmacy School News Pharmacy Time Capsule
COLUMNS
4 6
President’s Message Editorial
For an uptodate calendar of events, log onto
www.gpha.org. The Georgia Pharmacy Journal
3
February 2009
PRESIDENT’S
MESSAGE Robert Bowles, Jr. , R.Ph., CDM, CFts GPhA President
For the Love of Our Profession ebruary is the month of love and the need for love of
F
effective if we are committed enough to our profession to speak
our profession is no exception. It becomes more
as one large strong voice. We can help him achieve the goals of
important every year for us to express the love that we
pharmacy by telling our friends and colleagues to join the
have for our profession. Every day that we practice pharmacy,
association. While our numbers are stong it is our goal to have
we have the opportunity to demonstrate our love for our
3,000 members by the end of the fiscal year. You can help us
profession by reaching out to our patients and making a
achieve this goal by asking your friends and colleagues who are
difference in their lives — from taking the time to wrap our
not members to join, or asking your friends and colleagues who
arms around an elderly patient letting them know that we truly
were once members to rejoin. If you are not sure who is or is
care about them to interacting with a young child thus creating
not a member call Kelly J. McLendon, GPhA’s Director of
a lasting impression in that child’s mind of what it was like to go
Public Affairs at 404.419.8116 or email her at
to the pharmacy.
kmclendon@gpha.org. During these times of economic fear and trepidation we must love our profession enough to help it
Our love for our profession can also be demonstrated by being
grow and thrive, or we will all suffer.
involved in the political process and enhancing the opportunities that we have in our practice settings. The
Middle Georgia Pharmacy Relief Services
legislative session began in the state Capitol on January 12. We must remember that as constituents of our elected officials, we do have a voice in the decisions that are made about our
Pharmacy Staffing for: Chain & Independent Pharmacy Clinic & Hospital Pharmacy Specialty & Long Term Care Pharmacy Over 30 years Rx Experience Call 478-552-7220 AL Curry, R.Ph. Email: MidGaPharmRS@aol.com Tennille, GA 31089 www.middlegeorgiapharmacyreliefservices.com
profession. When you receive a call from GPhA to
• • • •
communicate with your elected official, it is important for you to respond quickly and communicate your concerns and how you want your legislator to vote. Representation at the Capitol is critical to the success of pharmacy as a profession. GPhA’s Director of Governmental Affairs is our daily representation at the Capitol. He can only be
The Georgia Pharmacy Journal
4
February 2009
EXECUTIVE
VICE
PRESIDENT’S
EDITORIAL
Jim Bracewell Executive Vice President / CEO
Is Georgia Ready for a Pharmacist in the State Senate? ast week our own Georgia Pharmacy Association member, state Representative Buddy Carter, R.Ph., of Pooler, Georgia, announced his candidacy for state Senate District 01. Current Senator Eric Johnson will not be seeking re-election to the Georgia Senate in lieu of a run for Lt. Governor.
L
What can you do at this early stage of a campaign for an election on 2010? Today you can begin a real list of family, friends, business colleagues, and college friends who may live or work in Bryan, Chatham or Liberty Counties in Senate District 01. This action is a true value to this campaign. We need to get people on board early and committed before the other candidates enter the field. This past national election demonstrated the value of communications via the internet. How many of your list have email addresses? If you would contact your list and ask permission for the campaign to send the updates we could develop a solid base of support for Buddy Carter over the next several months. For those that do not personally know Buddy, they will become acquainted with his background, his experience and his desire to serve the people of this state.
Representative Carter was ready to seize this opportunity to serve in the senate and the Georgia Pharmacy Association is ready to seize this opportunity to put a pharmacist in the Georgia Senate. Do we really want to plan to put a pharmacist in the state senate in 2010 or do we just want to talk about how good it would be for pharmacy if it happened? The best way to predict the future is to create the future. Join your pharmacy friends today and let’s work our plan to put Buddy Carter in the Senate in this next election.
How does “State Senator Earl “Buddy” Carter, R.Ph.” in 2010 sound? The Georgia Pharmacy Journal
6
February 2009
What else can you do if you do not live in Senate District 01? Well in these tough economic times, you should plan a financial budget to provide support for this campaign on a monthly basis. That way you do not have to wait for us to come to you about a big fundraiser. The best way to eat an elephant is one bite at a time. The best way to finance your support for is a monthly pledge to Friends of Buddy Carter for Senate, P.O. Box 222, Pooler, GA, 31322. In respect to the state ethics law, Buddy cannot accept contributions while the Legislature is in session so save your January, February and March contributions and send them to him in April 2009.
Lawyer and Pharmacist Leroy Toliver, Pharm.D., R.Ph., J.D. • Professional Licensure Disciplinary Proceedings • Medicaid Recoupment Defense • Challenges in Medicaid Audits • OIG List Problems • SCX or Other Audits Leroy Toliver has been a Georgia Registered Pharmacist for 34 years. He has been a practicing attorney for 25 years and has represented numerous pharmacists and pharmacies in all types of cases. Collectively, he has saved his clients millions of dollars.
The pharmacists of Georgia came together to support Oren H. “Buddy” Harden, Jr., R.Ph. for the House successfully this fall. We have tasted victory and it is sweet. It is time Georgia Pharmacy Association — go for the prize of a state Senate seat! District 01 in 2010 is our opportunity. Carpe Diem – Seize the day for Pharmacy.
The Georgia Pharmacy Journal
Toliver and Gainer, LLP 942 Green Street, SW Conyers, GA 30012-5310 altoliver@aol.com 770.929.3100
7
February 2009
The Georgia Pharmacy Journal
8
February 2009
AIP Spring Meeting April 25-26, 2009
Sea Palms Resort, St. Simons Island, GA Come relax in the lush oasis that is Sea Palms Resort. Take a walk under ancient live oaks, where the ocean air mixes with a soft marsh breeze. Bike on the beach, play golf, tennis or just relax on your balcony overlooking the island's natural beauty. Sea Palms Resort offers the perfect setting for our AIP Spring Meeting. Our spring meeting will offer continuing education, time to meet with our vendors, an AIP Business Session to discuss issues impacting independent pharmacy, time to network with other AIP Pharmacies and catch up with old friends. Plan on attending and bring your family for a weekend to be remembered. AIP has negotiated a special room rate of $139 (Deluxe) and special pricing on other accommodations (accommodation choices include hotel-style deluxe guest rooms, executive studios with kitchenette and fully furnished one to three bedroom suites with scenic sun deck or screened porch). To guarantee that you receive this special rate and to ensure you get a room please make your reservation as soon as possible. Sea Palms has more amenities than any other property on St. Simons Island and is just minutes from the beach. With twenty seven holes of golf, three swimming pools, three rubico clay tennis courts, a fitness center and sauna, sandpit volleyball court, bike rentals and horseshoes, the recreational opportunities are boundless. We are very excited about this year’s AIP Spring Meeting. We will give you more details as the time nears. Make your plans now to attend.
Please call 1.800.841.6268 for reservations (Ask for the AIP room block) Georgia Pharmacy Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
• CE opportunities • AIP Business Meeting • Social and Cocktails with our Partners Registration: (For Planning Purposes Please Fill Out and Return) Member’s Name: __________________________Nickname (for badge): __________________________ GA R.Ph. License No:___________ Pharmacy Name: _________________________________________ Address: _____________________________________________________________________________ Phone:(____)____________ Fax:(____)_____________ E-mail Address: __________________________ Please circle the following: Academy Member? Yes No GPhA™ Member? Yes No **If Spouse/Guest is attending please print his/her name: ______________________________________ Nickname (for badge): ___________________ Is the above guest a member of GPhA? Yes____ No ____
Please Fax Registration to 404.237.8435 The Georgia Pharmacy Journal
9
February 2009
Welcome to GPhA! The following is a list of new members who have joined Georgia’s premier professional pharmacy association! David Anderson, Conyers Haley Anderson, Sylvania Cody Babcock, Martinez Jessica Baker, Jacksonville, FL Heather Barnes, Jacksonville, FL Scott Behrens, Savannah Linda Berger, Savannah Samuel Norman Bird, R.Ph., Macon Angelica Bontilao, Savannah Jeffery Callaway, Savannah Carrie Chestnutt, Valley, AL Dana Chiulli, Gainesville Brian Cohen, Savannah Rebecca Crunelle, Savannah Barrett Andrew Darley, Uvalda John E. Davis, B.S., Waycross Daniel De Arazoza, Savannah Andrea Delapaz, Savannah Pascale Desplaneque, Savannah Nhu Nguyen Do, Savannah Linh Doan, Savannah Heather Drazdowski, Warner Robins Susan Fallahi, Savannah Julie Ann Feltman, B.S., Chatsworth Sidney L. Finn, Ph.D., Savannah Shari Flynn, Kansas City, MO Stephanie Fong, Chandler, AZ Nicole Fowler, Pooler Matthew Fox, Savannah Chasity George, Rincon Roberto Godreau, Hinesville Christina Gomez, Savannah Donya Goodly, Savannah Malissa Harbin, Savannah Kinsley Harrell, Lilburn Claude Hartsock, B.S., R.Ph., Pendergrass Jessica Helton, Savannah Maeve Hines, Savannah Lauren Hogan, Morganton, NC Jeffrey Hogg, Rincon Adrianne Horton, Valdosta Matthew Allen Jacobs, C.Ph.T., Acworth
Phyllis Thompson Johnson, B.S., Hazlehurst
Rachel June, Pace, FL Anne H. Keaton, Kennesaw Kelly Kennedy, Bloomingdale Julya Khapun, Alpharetta Thomas King, Savannah Kimberly Kirby, Young Harris Amanda Kragel, Savannah Mitchell Lee, Savannah Trufa Lemma, Savannah Stanley Roy Lewis, B.S., Houston, TX Ryan Lezer, Savannah Aily Liem, Savannah Marilyn Luk, Savannah Kim Ly, Savannah Paul MacDowell, Savannah Brittani McLeod, Savannah Betty Morris, Birmingham, AL Michelle Motl, Tampa, FL Nhan Ngo, Duluth Duyvy Nguyen, Savannah Thao Nguyen, Norcross Marissa Nolan, Columbus Magan Ogden, Jesup Emi Onuki, Savannah Esther Park, Lilburn Kelvin Park, Savannah Komal Patel, Byron Stephanie Peanasky, Savannah Jeannine Powel, Savannah Allison Powell, Savannah J. Frank Reynolds, Columbus Jessica Rodery, Savannah Kristina Sanford, Columbus Wendy Satterwhite, Graham, NC Kyle Saunders, Savannah Beth Simpson, Savannah Terica Simpson, Savannah Suzanna Singh, Concord, NC Edie E. Smith, B.S., R.Ph., Reidsville Pamela Smith, Savannah Teresa Smith, Savannah
The Georgia Pharmacy Journal
10
Christine Somers, Savannah Barbara Sona, Savannah Charity Speed, Savannah Calandra Stafford, Savannah Luke Stamper, Atlanta Laura Stanford, Savannah Lauren Stansky, Gainesville Deja Stephenson, Savannah Kristin Talbott, Albany, KY Benjamin Thomason, Savannah Shelly Thompson, Pineview Kristopher Tidwell, Savannah Victoria Tootle, Jacksonville, FL Kimberly Tucker, Savannah Jessica Vaughn, Savannah Joni Vickers, Savannah Nicole Wardenski, Iselin, NJ Margarette Westwood, Pensacola, FL Richard Wilhoit, Savannah Charity Wilkerson, Jacksonville Beach, FL Donell Williams, Savannah Rebecca Wise, Guyton Lindsay Wolfe, Savannah
February 2009
GPhA
MEMBERS
IN
Ashley S. Hutchins, Pharm.D., and spouse, Adam Hutchins welcomed son David Wilkin Hutchins on March 13, 2008. Ashley is the daughter of the late David J. Simpson, Jr., R.Ph. Greg Hickman, R.Ph.’s pharmacy Carmichael Drugs has moved into a new 17,000 sq.ft. pharmacy in Monroe, GA with a Hallmark Gold Crown Store, Compounding Lab with viewing window. They are utilizing McKesson PARATA for refills and Fast Movers Robot System, and Design Concepts designed the store’s fixtures. Hugh Chancy, R.Ph., owner of Hahira’s Chancy Drug has been named to the Leadership Georgia Class of 2009. This is an honor bestowed upon 100 Georgian leaders by the Georgia Chamber of Commerce. Azza El-Remessy, R.Ph., Assistant Professor at the University of Georgia, was chosen as a national grant reviewer for the American Heart Association, a post he will hold for the next three years. He has also published two papers, one in Investigative Ophthalmology & Visual Sciences and the other in Molecular Vision. Brad Phillips, Pharm.D., Professor and Head, Clinical and Administrative Pharmacy at the University of Georgia, presented “Clinical Pearls, Don’t Fall Asleep on Resistant Hypertension” at the 43rd American Society of Health System Pharmacists Midyear Clinical Meeting in Orlando. Bill Trinh, South University’s Class of 2009, was awarded the Outstanding Pharmacy Intern/Extern Award at the GSHP Annual Meeting held in Helen, Georgia, on October 25. Dr. Curtis E. Jones, II, R.Ph., was promoted to associate professor and appointed Associate Dean for
THE
NEWS
Administration and Academic Affairs at South University’s College of Pharmacy. Dr. Melissa C. Jones, R.Ph. was promoted to full professor at South University’s College of Pharmacy. Andrea L. McKeever, Pharm. D., Associate Professor of Pharmacy Practice at South University’s College of Pharmacy was recently elected to (GSHP) as the new Southeast Georgia District Director. She was also elected Secretary/Treasurer of the ACCP Drug Information PRN. Michael A. Crouch, Pharm.D., Professor and Chair of the Department of Pharmacy Practice at South University’s College of Pharmacy, received recertification as a Board Certified Pharmacotherapy Specialist with Added Qualifications in Cardiology until 2014. He published 2 articles in Pharmacotherapy 2008 and Formulary 2008 among many other accomplishments. Curtis L. Pickels, R.Ph., was recognized by Mercer University’s College of Pharmacy and Health Sciences for his dedication to the school and for the distinction he brings to his alma mater through his community service.
Tanea Chane, President of the class of 2009; and Neha Nageshrao President of the class of 2011. Laura “Gena” Tyson, Pharm.D. has opened Dogwood Pharmacy in Nashville, Georgia. Herbert W. Hatton, R.Ph., has been named President of the Mercer University College of Pharmacy and Health Sciences Alumni Association. Bill Hankla R.Ph., and Geraldine Hankla, R.Ph., won the “Best in Show” trophy at the Antique and Special Interest Car Show at the Mercer University College of Pharmacy and Health Sciences with their 1951 Studebaker Champion Coupe.
In Memoriam We are sad to announce the passing of Malcom Forte, Jr., R.Ph. If you have an item that you would like included in the GPhA Members in the News section of The Georgia Pharmacy Journal please email the item to Kelly McLendon at kmclendon@gpha.org or fax it to her attention at 404.237.8435.
The following GPhA members have been named to the 2008-2009 Student Council for Mercer University’s College of Pharmacy and Health Sciences: Hillary Volsteadt, President of ASP; Neelam Patel, President of Kappa Epsilon; Melinda Rowland, President of GSHP; Brial Patel, President Pro-Tem of the class of 2012; Johnathan Hamrick, President of NCPA; Aimee Reinhard President of the class of 2010; Andrea Gauld, President of Phi Lambda Sigma; Janice Hatcher, President of ASCP; Kate Gillette, President of Phi Delta Chi; Chloe Ledford, President of CPFI;
The Georgia Pharmacy Journal
11
February 2009
Pharmacy
News
Get “Fresh” for Your Valentine 10 Ways to Keep Your Breath Fresh by Trevor Miller, Director of Insurance Services - tmiller@gpha.org all it by its fancy name, “halitosis,” and it won’t smell any sweeter. Bad breath is frequently a sign that you’re not keeping up with your oral health. The source of this unpleasant odor is, in most cases, bacteria living on your teeth, gums or tongue. Follow these ten tips for a breath of fresh air:
C
1. Brush your choppers twice each day. Better yet, brush after every meal. If you eat lunch at work or school, keep an extra toothbrush there. Also, be sure to replace your toothbrush regularly. Every few months, swap your brush for a fresh one.
4. Treat your tongue right. Bacteria can gather on the surface of your tongue, so use a soft-bristled toothbrush or a tongue scraper to clean it every time you brush. 5. Tap your inner teenager and chew gum. The act of chewing (sugarless) gum stimulates the production of saliva, which naturally washes away bacteria and food particles. If you suffer from a lack of saliva due to “dry mouth,” a condition sometimes caused by medication, let your dentist know; he or she can help address the problem.
7. Hydrate, hydrate, hydrate. Drink water regularly to keep your mouth moist, and go easy on alcohol and caffeine, both of which are dehydrating. 8. Turn off the tobacco. Smoking and chewing tobacco lead to bad breath. They also increase your risk of a host of serious health problems, from periodontal disease to cancer.
2. Reach between your teeth. Flossing daily helps you remove food particles from between your teeth, where your toothbrush just can’t reach. Flossing also helps keep your gums healthy, preventing periodontal disease, which can also lead to bad breath and the pratice is related to lowering the risk of heart disease. If using regular floss is difficult for you, try one of the many inter-dental cleaners available at pharmacies. 3. Pick up a water pick. Along with floss, a water pick reaches spots your toothbrush can’t, like under your tongue and into the back of your mouth.
6. Don’t fall for the myth of mouthwash. Most mouthwashes merely mask the smell of bad breath and don’t do anything to solve the underlying problem.
9. Take note of what you take in. Certain diets, foods and medications can affect your breath. If your problem doesn’t appear to be oral, make a list of the foods you eat and medications you take. Review it with your dentist, pharmacist or your family doctor to assess the source of the problem. 10. Call in the experts. It’s important to have your teeth professionally checked and cleaned twice a year. Your dentist can give your teeth a thorough cleaning that isn’t possible at home, as well as check for and treat early signs of problems such as cavities or periodontal disease. In rare cases, persistent bad breath can be a sign of a larger health problem. The American Dental Association lists possible medical sources of bad breath, including respiratory infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, and liver or kidney ailments. If your dentist suspects that your breath problem stems from a medical issue, he or she will recommend speaking with your family doctor immediately.
Source - The America Dental Association 2008 The Georgia Pharmacy Journal
12
February 2009
Call for awards nominations... The GPhA Awards Committee is seeking nominations for the following awards which will be presented at the GPhA 134th Annual Convention in 2009. A brief description and criteria of each award is included. Please select the award for which you would like to nominate someone and indicate their name on the form below. Deadline for submitting the completed nomination form is March 9, 2009. Nominations will be received by the Awards Committee and an individual will be selected for presentation of the Award at GPhA’s 134th Annual Convention at the Marriott Sawgrass in Ponte Vedra Beach, FL. Bowl of Hygeia Award (sponsored by Wyeth-Ayerst) Recognized as the most prestigious award in pharmacy, the Bowl of Hygeia is presented annually by GPhA and all state pharmacy associations. Selection Criteria: 1) The nominee must be a licensed Georgia pharmacist; 2) The Award is not made posthumously; 3) The nominee is not a previous recipient of the Award; 4) The nominee is not currently serving nor has served within the immediate past two years as an officer of GPhA other than ex-officio capacity or its awards committee; 5) The nominee has an outstanding record of service to the community which reflects will on the profession.
Distinguished Young Pharmacist Award (sponsored by Pharmacist Mutual) Created in 1987 to recognize the achievements of young pharmacists in the profession, the Award has quickly become one of GPhA’s most prestigious awards. The purpose of the Award is two-fold: 1) The encourage new pharmacists to participate in association and community activities, and 2) To annually recognize an individual in each state for involvement in and dedication to the pharmacy profession. Selection Criteria: 1) The nominee must have received entry degree in pharmacy less than ten years ago; 2) Nominee must be a licensed Georgia pharmacist; 3) Nominee must be a GPhA member in the year of selection; 4) Nominee must be actively engaged in pharmacy practice; 5) Nominee must have participated in pharmacy association programs or activities and community service projects.
Call for nominations GPhA 134th Annual Convention 2009
Innovative Pharmacy Practice Award (sponsored by NASPA/GPhA) This Award is presented annually to a practicing pharmacist who has demonstrated innovative pharmacy practice which has resulted in improved patient care. Selection Criteria: 1) The nominee must have demonstrated innovative pharmacy practice which has resulted in improved patient care; 2) Nominee must be a licensed Georgia pharmacist; 3) Nominee must be a member of the GPhA in the year of selection.
2009 Awards 2009 Bowl of Hygeia
Distinguished Young Pharmacist
Innovative Pharmacy Practice Award
Nominee’s Full Name _______________________________________________ Nickname ___________________ Home Address _________________________________________ City _______________ State _____ Zip ______ Practice Site __________________________________________________________________________________ Work Address __________________________________________ City _______________ State _____ Zip ______ College/School of Pharmacy _____________________________________________________________________ List of professional activities, state/national pharmacy organization affiliations, and/or local civic church activities: ____________________________________________________________________________________________ ____________________________________________________________________________________________ Supporting information: _________________________________________________________________________ ____________________________________________________________________________________________ Submitted by (optional): _________________________________________________________________________ Submit this form completed by March 9, 2009 to: GPhA Awards Committee, 50 Lenox Pointe, Atlanta, GA 30324. Complete this form online at www.gpha.org.
The Georgia Pharmacy Journal
13
February 2009
The Georgia Pharmacy Journal
14
February 2009
The Georgia Pharmacy Journal
15
February 2009
GPhA Convention June 20-24, 2009 Sawgrass Golf Resort and Spa, Ponte Vedra Beach, Florida Register Online Today for...
Preserving the Triad GPhA’s 2009 Convention will be held at the Sawgrass Golf Resort and Spa in June. This is a favorite venue of GPhA members. With quick access to the gorgeous beach, a spacious and luxurious hotel and spa, and delicious food, we are assured a relaxing and educational convention. GPhA offers an “early bird” convention rate through the end of April. Hotel rooms fill quickly so make your reservations now and plan to attend the 2009 Convention. Register online at www.gpha.org. GPhA Registration Type GPhA Member GPhA Member with Spouse or Guest and Student Sponsorship GPhA Member with Spouse or Guest GPhA Member with Student Sponsorship Spouse or Guest Only Registration (Does Not Include CE) GPhA Non-Member GPhA Non-Member with Spouse or Guest and Student Sponsorship GPhA Non-Member with Spouse or Guest GPhA Non-Member with Student Sponsorship
Early Bird $295 $660 $535 $420 $240 $470 $835 $710 $595
Sawgrass Golf Resort and Spa, A Marriott Resort www.sawgrassmarriott.com For Resort Reservations call: 1.800.457.4653 Room Block Expires 5/15/2009 so make your reservations today! Single or Double Room $179 Island Green Villa Suite (1 Bedroom and Full Kitchen) $254
The Georgia Pharmacy Journal
16
5/1-6/1 $320 $710 $585 $445 $265 $495 $885 $760 $620
After 6/1 $345 $735 $610 $470 $265 $520 $910 $645 $645
Convention Registration Fee: includes admittance to CE Sessions, Sunday Opening Dinner, All Refreshments, Exhibits and Entertainment, President’s Reception, Awards Banquet, Coffee/Dessert Reception.
February 2009
GPhA’s February Legislative Update by Stuart Griffin, Director of Governmental Affairs - sgriffin@gpha.org
Pharmacy Benefits Manager Licensure Bill
Immunization
As of December 19, the PBM legislation that we will be introducing in the Senate has been drafted. Senator Lee Hawkins from Gainesville will be the primary sponsor. The bill will do the following:
GPhA and the Medical Association of Georgia have worked diligently to forge a relationship between our organizations. That relationship has created an avenue to respectfully negotiate terms related to legislation regarding immunization.
• License all Pharmacy Benefit Managers in the State of Georgia under the Department of Insurance • Requires a PBM to provide for a surety bond • Creates enforcement of the existing ‘Audit Bill of Rights’ • Provides that a PBM owes a fiduciary duty to the covered individual
We have been working with the Governor’s office to have this bill become a part of the Governor’s legislative agenda. We received a call on January 6 from the Governor’s office stating we were successful in doing this. The Governor’s office will be carrying immunization as a part of his 2009 legislative agenda. Thankfully, this bill will now be thought of as a public health issue (which it is) and not a pharmacist issue.
Georgia pharmacists have done an amazing job contacting their legislators and educating them on the importance of PBM legislation. Please take the time today to call their capitol office in Atlanta to reinforce this same point.
Our goal is to pass this bill in the first weeks of the session so our pharmacists can attempt to salvage a portion of the flu season.
Drug Monitoring
Substitution Bill(s)
This piece of legislation sets up a central automated database of all dangerous drugs dispensed in Georgia. This information is presently collected by pharmacists and legally available to Georgia Drugs and Narcotics agents. The purpose of this bill is to curtail the diversion of controlled substances. No cost to the pharmacist is associated with this program and the database will be accessible to pharmacists and physicians in Georgia.
Many of you remember these bills from last year – epilepsy, immunosuppressant, antipsychotics, etc. These bills would require the patient to only receive name-brand medication that falls into specific disease categories. These bills will be introduced again. Sources say the Alzheimer’s Association will be introducing a similar bill. We have opposed these bills on the grounds that pharmacists would not be reimbursed for the drugs. We are working to find a bill that would take care of the issue at hand without the need for numerous pieces of legislation.
State Representative Ron Stephens, R.Ph., will be the primary sponsor of the Drug Monitoring bill.
Thank You to GoodSense In December, GoodSense gave the Association, free of charge, 350 bottles of 200mg tablets of ibuprofen. Our government affairs department placed a sticker on these bottles that read, “For all of your Legislative Session headaches” and distributed them to all of the Georgia state legislators and their assistants. Compliments have been pouring in from these actions and it looks like we have started a good thing. It is important for the association to continue these types of activities so legislators can be aware of our presence at the capitol. Please patronize GoodSense for their help in these matters and thank them when you have the opportunity.
The Georgia Pharmacy Journal
17
February 2009
GA S PV hE A T UH PE D ADTAET E
Become a part of GPhA’s grassroots team and support your profession!
February 18, 2009
Very Involved Pharmacist Day Georgia State Capital
–– May 12, 2009
Eggs and Issues Breakfast Washington, D.C. Check www.gpha.org and future issues of the Georgia Pharmacy Journal for more information about these and other important upcoming events.
The Georgia Pharmacy Journal
18
February 2009
Help Make GPhA the Most Powerful Grassroots Force in Georgia
2008 2009 Grassroots SignUp Form Please complete and return via fax to GPhA at 404.237.8435 Your Name: __________________________________________________________________ Preferred Address: _____________________________________________________________ City, State Zip Code: ___________________________________________________________ Preferred Phone(s):_____________________________________________________________ Email Address: ____________________________________ Fax: ________________________ How do you prefer to receive legislative information? (Select One) Email Fax Which of the following activities are you willing to perform to assist GPhA’s legislative efforts? Write A Letter Phone Call Personal Visit Testify On A Bill Have you made a financial contribution to the campaign of any legislator in the past 4 years? If yes, please complete the form below. For nature of relationship, indicate how you know the legislator (business, childhood friend, college, church, civic, family, campaign volunteer, etc.). Yes No Your Legislators
*** Confidential - For GPhA File Only *** Legislator’s Name Amount
Nature of Relationship
State Representative: ___________________________________________________________________ State Senator: ________________________________________________________________________ US Representative: _____________________________________________________________________ US Senator: _________________________________________________________________________
The Georgia Pharmacy Journal
19
February 2009
UP
COMING
EVENTS
The 13th Annual Southeastern PRN Conference Held November 14-16, 2008 nother successful Southeastern PRN Conference hosted by the Georgia Pharmacy Foundation and Georgia PharmAssist Committee for the 13th year was held at beautiful Simpsonwood Conference Center in Norcross, Georgia located just north of Atlanta. This conference is a huge success due to the commitment and dedication of two of our members, Jim Bartling, Pharm.D., CAC II, Intervention Coordinator, Georgia PharmAssist Program, and Richard B. Smith, R.Ph., Chairman of the Georgia PharmAssist Program. They have spearheaded this conference from the beginning and are the backbone to its continued success. They are true advocates for those with special needs.
A
conferences to their students. Each student receives a certificate acknowledging their participation in this Conference.
GPhA Chairman, Sharon M. Sherrer, Pharm.D., CDM, the Foundation’s Chairman, John T. Sherrer, R.Ph., and the GPhA’s Executive Vice President/CEO, Jim Bracewell, were in attendance to welcome all the participants, and to thank the exhibitors for their support.
This year’s program included the opening presentation on Saturday by Dr. James D. Vargo, the Medical Director at Ridgeview Institute, discussing “Alcohol Dependence, Diagnosis, Neurobiology and the Clinical Course.” Michael Quigley, R.Ph., Executive Director for the Pharmacists Rehabilitation Organization for Ohio, covered “Relapse Prevention & Professional Monitoring.” Kevin Rich, D.Ph., President of Oklahoma Pharmacists Helping Pharmacists, gave a personal story titled “The Oklahoma Pharmacy Recovery Program & Me – A Personal Journey” that captured everyone’s attention. One of the Pharmacy Recovery Network’s favorite speakers, Merrill Norton, Pharm.D., D.Ph., NCAC II, CCS, Clinical Assistant Professor at UGA, made a presentation on “The Addiction Pharmacy Series: Pain & the Addicted Patient” that was very informative. The Saturday afternoon final presentation was made by Tom House who is a National Compliance Consultant from Louisville, KY. His program was titled “Value of Urine Analysis as an Assessment of Monitoring Tool for Medical Professionals.”
Due to the success of this conference covering 13 years, it is recognized across the country and has attendees coming from across the nation, not just the southeast. One of the most widely known websites with PRN information, www.usaprn.org, promotes this conference and has photos from some of the meetings.
Pharmacy Technicians are encouraged to attend. They also receive CE credits for their participation. This conference is open for anyone who wants to learn more about the disease of addiction. There are a number of attendees who come every year or almost. Many treat the conference as a reunion time, but each year they are amazed at what new information they learn and can’t wait to attend the following year. First-time participants are usually “blown away” by what they learn, and that applies especially to the students.
Samford University’s McWhorter School of Pharmacy continues to include this Conference as part of their curriculum. Dr. Valerie Prince promotes this program and is a big advocate of her students participating. Jim Bartling, Pharm.D., Associate Dean for Student Affairs and Admissions at Mercer University College of Pharmacy & Health Sciences, encourages his students to attend and had a large contingent this year. We are hopeful UGA and Attendees with Exhibitor signs behind them. South will promote future
The Georgia Pharmacy Journal
20
February 2009
On Sunday another favorite speaker, Brian Fingerson, R.Ph., President of Brian Fingerson, Inc., dba KY Professionals Recovery Network, spoke on “AA = A Religion, A Cult or…A Simple Spiritual Program of Recovery.” Chip Abernathy, LPC, CAC, Program Coordinator of Recovering Professionals Services at Ridgeview Institute, presented “Stages of Recovery: Gorski’s Developmental Model of Recovery.” The Georgia Pharmacy Foundation and Georgia PharmAssist Committee want to thank the following Exhibitors and Sponsors for their support of this Conference: GPhA’s Academy of Independent Pharmacy (AIP) Center for Professional Excellence (CPE) Palmetto Addiction Recovery Center QuestHouse, Inc. Ridgeview Institute Talbott Recovery Campus
Southeastern PRN Students
Financial Planning for Georgia’s Pharmacists
Their assistance helped make this Conference possible and is very much appreciated. We also thank each representative who attended the Conference for their contributions to its success! We look forward to seeing you at next year’s Conference.
Michael T. Tarrant Independent Strategies and Customized Solutions for Building Wealth & Security
Standing from left to right: Jim Bartling, Pharm.D.; Richard Smith, R. Ph.; Brian Fingerson, R.Ph.; and Kevin Rich, D.Ph. with Southeastern PRN student. Mark Your 2009 Calendar! Next year’s SE PRN Conference will be held at Simpsonwood on November 13-15, 2009
Financial Network Associates 1117 Perimeter Center West, Suite N-307 Atlanta, GA 30338 • 770.350.2455 mike@fnaplanners.com www.fnaplanners.com
Securities, certain advisory services and insurance products are offered through INVEST Financial Corporation (INVEST), member FINRA/SIPC, a federally registered Investment Adviser, and affiliated insurance agencies. INVEST is not affiliated with Financial Network Associates, Inc. Other advisory services may be offered through Financial Network Associates, Inc., a registered investment adviser.
The Georgia Pharmacy Journal
Should you or someone you know need assistance with an addiction issue, please do not hesitate to call the: PharmAssist Hotline Number (24 hours/7 days a week) 404-362-8185 Your call will be returned as quickly as possible.
21
February 2009
GEORGIA
PHARMACY
SCHOOLS’
NEWS
Mercer University College of Pharmacy and Health Sciences News In January, students of Mercer University's College of Pharmacy and Health Sciences and Georgia Baptist College of Nursing participated in the Health and Wellness Forum hosted by Aetna and the King Center of Atlanta. The King Holiday Theme this year was “Remember! Celebrate! Act! A Day On, Not a Day Off.” The theme reminds us of the importance of Dr. Martin Luther King Jr.'s work, legacy, and his teachings of nonviolence and human rights. It also serves as a reminder that “the holiday is a day on for community service initiatives and programs promoting interracial cooperation, not just a day off from work or school.” The Health and Wellness Forum provided Grady Health Systems, Diabetes Association of Atlanta, and the Fulton County Department of Health and Wellness. The students also provided information and answered questions regarding immunizations, diabetes, deep vein thrombosis, cholesterol and obesity. Mercer University screened over one hundred patients, while the entire event reached over one thousand people of the community. Providing these services was extremely rewarding to all of the students. The health fair ended with the highlight of meeting and screening Dexter Scott King, Dr. King’s nephew and the Chairman, President and CEO of the King Center. information, education and services to empower people in the areas of health, wellness and nutrition to address the disparities in our communities. The Forum specifically addressed childhood obesity, diabetes, HIV/AIDS, and asthma. In the Health and Wellness Fair, Mercer University students provided blood pressure, blood glucose, heartburn and body mass index screenings. Other organizations performed screenings and tests for cholesterol, osteoporosis, skin cancer, vision, hearing, asthma, dental, breast cancer, HIV/AIDS, and lung capacity. These organizations include CDC, Merk & Co., Sickle Cell Foundation, West End Medical Center, Northside Hospital, Morehouse School of Medicine, The Georgia Pharmacy Journal
22
February 2009
GEORGIA
PHARMACY
SCHOOLS’
NEWS
University of Georgia College of Pharmacy News responsible for kidney failure of cats and dogs in the U.S. On February 4-5 the University of Georgia is holding the and more recently for kidney disease in more than 100,000 2009 Mental Health Symposium at the Tate Student children in China. Center Reception Hall. The first day is a Michael Neville, UGA Clinical Associate psychopharmacology update and the second day will focus Professor achieves certif ication on pharmacogenomics. Dr. Michael Neville passed the Board of Pharmaceutical
2009 Mental Health Symposium
James Bruckner, UGA Professor Named as Specialties National Certification Pharmacotherapy in October. Peer Reviewer Dr. James Bruckner has been named to serve as a peer reviewer for “Toxicology of N-Nonane in Jet Fuels” for the Superfund Health Risk Assessment Center of the U.S. EPA.
Exam
in
Timothy Long, UGA Assistant Professor Receives Grant
Dr. Timothy Long received a $10,000 American He also served as one of five national experts to review Association of Colleges of Pharmacy New Investigators “Interim Safety and Risk Assessment of Melamine and its Grant Program award for the proposal “Novel beta-Lactam Analogues in Food for Humans” for the Center for Food Antibiotics for Resistant Bacteria.” Safety, U.S. FDA. Melamine is a chemical contaminant
South University School of Pharmacy News Doctor of Pharmacy Student Recognized as an Outstanding Intern The Outstanding Pharmacy Intern/Extern Award was presented to South University student Bill Trinh, Doctor of Pharmacy Candidate Class of 2009, at the GSHP (Georgia Society of Health-System Pharmacists) Annual Meeting held in Helen, Georgia, on October 25. The award recognizes excellence in future pharmacists. Nominations are presented by preceptors, educators, or any other GSHP member who has had direct contact with an intern or extern who has shown exemplary service in this role.
president, Bill has reorganized the chapter to form committees to assist with fundraising, both for the chapter and the overseas charities, web site development, and membership recruitment leading to increased awareness about the chapter. In addition to his work with the student society, he works as an intern with CVS and with their support helped to organize a heartburn awareness campaign. Dr. Kimberly Tackett is the faculty advisor for the student chapter.
Bill Trinh has been a student chapter president of Society of Health-System Pharmacists. During his time as
The Georgia Pharmacy Journal
23
February 2009
Pharmacy Time Capsules 2009 (First Quarter) 1984—Twenty-five years ago: • Drug Price Competition and Patent Term Restoration passed. The major provisions of the law: o expedited the availability of less costly generic drugs by permitting FDA to approve applications to market generic versions of brand-name drugs without repeating the research done to prove them safe and effective. o provided brand-name companies up to five years additional patent protection for new medicines to make up for time in FDA's approval process. • Schering Corporation budgeted $4 million for first “Ask Your Pharmacist” campaign to encourage the public to ask their pharmacists about their medicines
1934—Seventy-five year ago • The American Pharmaceutical (now Pharmacists) Association headquarters building, the American Institute of Pharmacy, on the National Mall in Washington, DC was dedicated
1959—Fifty years ago • American Hospital Formulary Service launched by American Society of Hospital (now Health-Systems) Pharmacists
One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America's history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org
1909—One hundred years ago • Opium Exclusion Act of 1909 prohibited the importation of opium to the United States. By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH
F l l Sp Full S e e d Ahead Spee
* H YL L Y * LU [ LY
Accelerate your career
Job Seekers Use the Career Center to rev up your job search and put your career in the fast lane Posst your yo ou o urr resume re today $ Post A cess Acc cess premier premi job postings $ Access via email Receive job b alerts ale al $ Receive $ Find your next careerchanging opportunity
Visit the GPhA Career Center www.gpha.org
The Georgia Pharmacy Journal
24
February 2009
Thomas A. Gossel, R.Ph., Ph.D. Professor Emeritus Ohio Northern University Ada, Ohio
J. Richard Wuest, R.Ph., PharmD Professor Emeritus University of Cincinnati Cincinnati, Ohio
Gossel
Wuest
Natural Products: Goldenseal, Gotu Kola, Grapeseed Extract, Green Tea and yellow root, is an herb Today, goldenseal is used to Goals. The goals of this lesson are puccoon, found in the midwestern areas of the treat the symptoms of the common to present information on the claims, mechanisms of action, typical dosages used and other items of interest on natural products and nutraceuticals alphabetically from goldenseal to green tea, and to provide background information for assisting others on their proper selection and use.
Objectives. At the conclusion of this lesson, successful participants should be able to: 1. exhibit knowledge of the claims, mechanisms of action and typical dosages for natural products and nutraceuticals presented; 2. select from a list, the synonyms for these products; and 3. demonstrate an understanding of information that can be used when discussing these products with consumers. GOLDENSEAL
Goldenseal (Hydrastis canadensis), also known as eye balm, eye root, goldenroot, goldsiegel, ground raspberry, hydrastis, Indian dye, Indian plant, Indian tumeric, jaundice root, orange root, turmeric root, warnera, wild curcuma, yellow Indian paint, yellow paint, yellow
United States along the Ohio river valley running up into the northeastern parts of the country. While it is indigenous to the U.S., it is now cultivated in many other areas of the world. Goldenseal is a horizontal bright yellow plant with knotty and twisted rhizomes (creeping underground stems) out of which root fibers grow. These are the medicinal parts of the herb. They are harvested in the autumn, air dried and ground for use. The taste is very bitter and its odor is strong and disagreeable. The plant received its name from the goldenyellow scars on the rhizomes. When they are broken, the scars resemble the gold wax letter seals used in Colonial days. The coloration comes from the large amounts of the yellow alkaloid berberine, which is one of the constituents of goldenseal. Other bioactive components of goldenseal include canadine, canadaline and hydrastine. American Indians used goldenseal root as a diuretic, tonic, insect repellent, and for irritated and inflamed eyes. They also used it to treat arrow wounds and to make a yellow dye.
cold, flu, whooping cough and other upper respiratory infections, chronic fatigue syndrome, colitis, constipation, diarrhea, dysmenorrhea and excessive menstrual flow, flatulence, gastritis, gonorrhea, hay fever, hemorrhoids, jaundice, liver disease, loss of appetite, malaria, peptic ulcer disease, post-partum bleeding, urinary tract infections and vaginitis. Topically, goldenseal is used as a mouthwash for sore gums and irritation of mucosal tissue. It is used on the skin for acne, eczema, infections, itching, rashes, seborrhea, ulcers and infections, including ringworm and herpes. In the eye, it is used for inflammation, conjunctivitis and redness. Goldenseal is used in the ears for earache and tinnitus. In homeopathic medicine, goldenseal is used for treatment of bronchitis, digestive problems and irregular menstruation. There is a traditional belief that goldenseal can be used to affect the outcome of urinalysis for illicit drugs by being ingested prior to testing or adding it to the urine sample after collection. It is reported to be commonly detected in
Volume XXVI, No. 10
The Georgia Pharmacy Journal
25
February 2009
urinalysis in drug screening programs. This concept dates back to a novel, Stringtown on the Pike, written in the mid 1800s in which goldenseal bitters are mistaken for strychnine in a simple alkaloid test by an expert witness in a murder trial. It is of some interest that the novel was one of several authored by a prominent pharmacist of his day, John Uri Lloyd. He was also a founder of the Cincinnati College of Pharmacy, cofounder of the American Pharmaceutical Association, the “Father of eclectic pharmacy” and developer of the extensive line of “Lloyd’s Specifics.” For historical perspective, eclectic pharmacy was the systematic collection and testing of substances (mostly herbs and plants) of potential medicinal value and selecting the best and most desirable for treating complaints and diseases. Eclectic pharmacy bridged the gap between leeches, strong laxatives and unproven remedies and today’s scientific- and chemical-based therapeutic practice. Proponents of the use of goldenseal claim that its components inhibit the growth of several microorganisms, including Chlamydia trachomatis, Shigella dysenteriae, Salmonella paratyphi, Klebsiella, Mycobacterium tuberculosis and Helicobacter pylori. Berberine is reported to have choleretic (bile-stimulatory), hypotensive, antisecretory and sedative effects. Detractors of its use report that the alkaloids of goldenseal are poorly absorbed when given orally and might not reach adequate concentrations in the body to produce significant pharmacologic activity. Conversely, proponents of the use of goldenseal state that the fact they are detectable in urine attests to their absorption and systemic activity. When taken orally in appropriate doses for short-term use in adults, goldenseal appears to be safe. However, very high doses may rarely cause nausea, anxiety, depression, seizures and paralysis. Goldenseal is contraindicated for use
during pregnancy and lactation. Berberine reportedly crosses the placenta and may harm the fetus. Kernicterus has developed in newborn infants exposed to goldenseal. It also can be excreted in breast milk. The traditional dose of goldenseal is 250 to 500 mg of extract (standardized to 5 percent hydrastine three times a day. Also, 500 mg to 1 gram of dried rhizome three times a day has been used.
GOTU KOLA
Gotu kola (Centella asiatica, C. coriacea), also known as brahmabuti, brahma-manduki, centella, centellase, divya, hydrocotyle, idrocotyle, Indian Pennywort, Indian water navelwort, khulakhudi, madecassol, mandukaparni, manduk parani, mandukig, marsh penny, talepetrako, thick-leaved pennywort, tsubo-kusa, tungchian and white rot, is a slender creeping plant that grows in swampy areas of India and Sri Lanka, southern China, Madagascar, South Africa, the southern U.S., Mexico, Columbia, Venezuela, eastern South America and the South Sea Islands. The medicinal portions of gotu kola are the dried above ground parts, the fresh and dried leaves, and its stem. Highly used in Indian and Chinese medicine, the plant is harvested throughout the year and dried in the sun. People take gotu kola to reduce anxiety, depression and fatigue; to improve intelligence and memory; to enhance circulation, decrease edema and treat varicose veins; as an aphrodisiac as well as a contraceptive; and to increase longevity. It has been used to treat symptoms of the common cold and the flu, abdominal pain, anemia, asthma, cholera, diabetes, dysentery, diarrhea, epilepsy, gastric and peptic ulcers, gastritis, hepatitis, indigestion, jaundice, leprosy, pleurisy, peripheral artery disease, sunstroke, tonsillitis, shingles and urinary tract infections. Topically, gotu kola is used for wound healing and to reduce scarring. In homeopathic medicine,
gotu kola is used for skin diseases associated with itching and swelling, and to reduce inflammation of the uterus. Gotu kola has several constituents that are thought to have pharmacologic activity. These include asiatic acid, madecassic acid, asiaticosides A and B, various essential oils, flavonoids and flavone derivatives. There is evidence, but not conclusive proof, that gotu kola might bind with cholecystokinin in the intestine and GABA receptors in the central nervous system. Cholecystokinin is a hormone liberated by the intestinal mucosa on contact with entering gastric contents. It stimulates the gallbladder and the secretion of pancreatic juices. This would provide gastrointestinal and digestive effects. GABA (gamma aminobutyric acid) is the principle inhibitory neurotransmitter in the central nervous system. If gotu kola does significantly bind with GABA receptors, this could provide antianxiety, sedative, analgesic and anticonvulsant activity. There are proponents of its use who believe that gotu kola might protect neurons in the brain from beta-amyloid (the substance thought to destroy neurons in the hippocampus, which leads to memory loss) toxicity and thus have a role in treating patients with Alzheimer’s dementia. There are reports suggesting that constituents of gotu kola seem to speed up wound healing, have antiinflammatory effect, improve connective tissue remodeling by increasing fibroblast (cells in connective tissue that form collagen) activity, increasing epithelial cell turnover and decreasing capillary permeability. It has been proposed that gotu kola might increase the collagen content within arterial plaque. Since plaque with low collagen content are structurally weak and linked to an increased risk of rupture and embolism, gotu kola might help stabilize arterial plaque. Proponents further state that there is preliminary evidence that it may have a
Volume XXVI, No. 10
The Georgia Pharmacy Journal
26
February 2009
strengthening effect on the gastric mucosal lining and suppress free radical damage, thus providing useful preventative and therapeutic effects on gastrointestinal ulcers. Taken in recommended doses, gotu kola is usually welltolerated. However, there are reports of gastrointestinal upset and nausea. Rarely, hepatotoxicity has been associated with its use. When used topically, gotu kola can rarely cause allergic contact dermatitis. The typical oral dose of gotu kola is 60 mg of its extract two to three times a day. One percent creams have been used topically for wound healing.
GRAPESEED EXTRACT
Grapeseed (Vitis vinifera), also known as activin, calzin, enocianina, European wine grape, flame grape, leucoanthocyanin, muskat, oligomeric proanthocyanidins, oligomeric procyanidins, OPC, PCOs, petite sirah, proanthodyn, procyanidolic oligomers and sultanas, is indigenous to southern Europe and western Asia. However, it is cultivated in most temperate regions of the world. The medicinal portions of grape plants are considered to be the leaves, fruit and flowers. Grapeseed extract, the most used and studied portion, is generally obtained as a byproduct of wine production. Although wine has been a beverage ingested by humans for millennia, the use of grapeseed extract for medicinal purposes is a relatively recent event. Its popularity increased in the Western World with the French using it to treat venous and capillary disorders such as retinopathies, venous insufficiency and vascular fragility. This has been reported to be the result of what has been called the French Paradox. The observation has been made that even though the French have a high dietary intake of fatty foods, this is not associated with a higher occurrence of atherosclerosis and other cardiovascular diseases seen elsewhere in Europe and North America. Allegedly, this is due to their
high intake of wine and wine byproducts. Grapeseed extract is used in folk medicine for preventing cardiovascular diseases, atherosclerosis, cerebral and myocardial infarction, hemorrhoids, hypertension, peripheral vascular disease and varicose veins. It is also used for the complications of diabetes, such as neuropathy; allergic rhinitis; age-related macular degeneration, poor night vision; to improve wound healing; and to prevent dental cavities, cirrhosis of the liver, cancer and the breakdown of collagen. The therapeutic activity of grapeseed extract is attributed to its component proanthocyanidins, which are members of a group of compounds called flavonoids. These substances are claimed to have a wide variety of effects, including antioxidant, vasodilatory, antilipoperoxidant activity and antiplatelet aggregation properties, all of which would be helpful in treating heart disease. Proanthocyanidins are responsible for producing the red color of grapes. The red varieties of grapes reportedly provide greater antioxidant activity than the white or blush categories, with red wines containing approximately 10 times more proanthocyanidins than white wines. Other flavonoid constituents of grapeseed extract include catechin, kaemferol (aka kaempferol), myricetin and quercetin. Catechin reportedly can inhibit low-density lipoprotein oxidation, and the others have antioxidant activity as well. Catechins might inhibit allergeninduced histamine release from mast cells. Flavonoids also appear to decrease superoxide production, increase nitric acid release from platelets and increase the levels of antioxidants, such as alphatocopherol (vitamin E) from storage in the body. Claims are made that grapeseed proanthocyanidins may produce greater protection against reactive oxygen species, free-radical induced
lipid peroxidation and DNA damage than combinations of vitamin C and vitamin E, with or without betacarotene (vitamin A). Grapeseed extract is well tolerated, with no adverse events reported at a higher level of occurrence than those seen with placebo. The typical dose of grapeseed extract for treating chronic venous insufficiency using commercially available products is 75 to 300 mg daily for three weeks followed by maintenance doses of 40 to 80 mg daily. For cardiovascular protective effects, 150 to 300 mg of proanthocyanidins from grapeseed extract is suggested.
GREEN TEA
Green tea (Camellia sinensis, C. thea, C. theifera, Thea bohea, T. sinensis, T. viridis), also known as Chinese tea, epigallo catechin gallate, and Japanese tea, is a large evergreen shrub native to eastern Asia. Although originally cultivated in China, the tea plant is now grown in extensive amounts for commercial purposes in Argentina, India, Indonesia, Japan, Kenya, Malawi, Pakistan, Sri Lanka and Turkey. The tea plant has leathery, dark green leaves and fragrant, white flowers. The dried, cured leaves of green tea have reportedly been used medicinally for more than 5,000 years to promote digestion, improve mental faculties, decrease flatulence and regulate body temperature. It is no news bulletin to state that other than water, tea is the most widely ingested beverage around the world, with the exception of the United States, where coffee has become the most popular beverage. Elsewhere, tea is used at meals, ceremonies, celebrations and relaxation time. What is not generally known is that the three major types of tea, black, green and oolong, do not differ in the species of plant on which the leaves grow. Rather, the difference is in the way the leaves are processed after they are harvested. Black and oolong tea are produced by fermenting and
Volume XXVI, No. 10
The Georgia Pharmacy Journal
27
February 2009
oxidizing the young tea leaves. Black tea is fully fermented and oolong tea is partially fermented. Green tea is produced by steaming fresh leaves at high temperatures. This inactivates the oxidizing enzyme components, leaving the polyphenol flavonoid content intact (i.e., catechin, epicatechin, epigallocatechin, and gallocatechin). Green tea has approximately six times he antioxidant activity as the other two types. All three types of tea contain similar amounts of caffeine, theobromine, theophylline and tannins until they are commercially processed. Green tea is taken to improvemental alertness and cognitive performance. The CNS stimulant effect of green tea is due to its caffeine content, which averages 2 to 4 percent, or 10 to 80 mg per cup, depending on how much tea is used and how long it is brewed. It is also used as a diuretic; in combination with other herbs for appetite suppression; and to treat diarrhea, stomach disorders, vomiting and headache. It has also been used to reduce the risk of breast, colon, gastric, lung, prostate and skin cancer, and to treat solid tumor cancers. Other uses include treating cardiovascular disease, chronic fatigue syndrome and Crohn’s disease, diabetes, hypertension, kidney stones, migraine, and Parkinson’s disease. Topically, green tea has been used as a wash to soothe sunburn, as a poultice for “bags” under the eyes, as a compress for tired eyes and headaches, and to stop bleeding from the socket after tooth extraction. In homeopathic medicine, green tea is used to treat agitation, cardiac and circulatory conditions, depression, headache and stomach complaints. In Indian medicine, green ea preparations are used for cardiac pain, diarrhea, loss of appetite and migraine. In Chinese medicine, green tea is used to treat diarrhea resulting from digestive problems, malaria, migraine and nausea. It has also been used in China as a cancer preventative.
There is little doubt that in most people, consumption of green tea (and any other caffeinated beverage) will increase mental alertness and improve cognitive performance. There is evidence that combining caffeine-containing beverages with glucose as “energy” drinks may improve mental performance better than placebo or either caffeine or glucose alone. There is some, but inconclusive, evidence that drinking green tea may reduce the risk of bladder, esophageal, gastric and pancreatic cancer, as well as breast and ovarian cancer recurrence. Drinking green tea on a daily basis seems to lower cholesterol and triglyceride levels, as well as the risk of hypertension, and to help prevent or delay the onset of Parkinson’s disease. But, none of the studies reporting these effects meet the rigorous standards needed for FDA approval of such claims. There is insufficient reliable evidence that consuming green tea lowers the risk of developing diabetes, lung cancer, ischemic heart disease and death after myocardial infarction, or that it is useful for weight reduction in obese individuals. Other pharmacologic activities attributed to caffeine include increased release of dopamine; decreased airway resistance along with stimulation of respiration; decreased gamma aminobutyric acid (GABA) and serotonin signaling; positive inotropic and chronotropic effects on the heart; elevation of both diastolic and systolic blood pressure (but not in chronic users); and a diuretic effect. The proposed mechanism of action of the polyphenol flavonoids contained in green tea include an antimutagenic effect that may protect DNA, inhibit tumor cell proliferation, cause cell cycle arrest and cancer cell death. Animal research suggests these components may do this via reactive oxygen species formation and mitochondrial depolarization. Polyphenol flavonoids are
claimed to reduce cellular adhesiveness of bacteria associated with dental disease. Further claims are made that they prevent skin damage and cancer caused by ultraviolet radiation by means of their antioxidant effect. Although some individuals cannot tolerate green tea and those with conditions adversely affected by caffeine should avoid it, there is a lack of reports of clinical toxicity from daily consumption of moderate amounts of green tea. However, there are reports of excessive CNS stimulation (such as dizziness, insomnia, agitation, restlessness, tremors, fatigue, confusion), nausea, vomiting, abdominal bloating and pain, upset stomach, flatulence and diarrhea resulting from ingestion of large amounts of green tea or high doses of green tea extract, equivalent to five or more liters of tea per day. Large doses of caffeine can also cause massive catecholamine release leading to irregular heartbeat, metabolic acidosis, hyperglycemia and ketosis, headache, anxiety, ringing in the ears, hypokalemia, respiratory distress and chest pain. Having reported all this, it should be pointed out that the daily consumption of moderate amounts of green tea seems to cause no health problems. The typical doses of green tea vary significantly, ranging up to 10 cups per day. The commonly used dose consumed for medicinal purposes in tea-drinking nations is around three cups per day using one teaspoonful of powdered tea in eight ounces of boiling water. This would provide 240 to 320 mg of polyphenol flavonoids.
The content of this lesson was developed by the Ohio Pharmacists Foundation, UPN: 129-999-09-002H01-P. Participants should not seek credit for duplicate content.
Volume XXVI, No. 10
The Georgia Pharmacy Journal
28
February 2009
dâ|Ê
Natural Products: Goldenseal, Gotu Kola, Grapeseed Extract, Green Tea
6. The popularity of using grapeseed extract increased in the Western World with the French using it to treat all of the following ailments EXCEPT: a. retinopathies. c. vascular fragility. b. sleep disorders. d. venous insufficiency.
1. All of the following are synonyms for goldenseal EXCEPT: a. centella. c. hydrastis. b. ground raspberry. d. Indian tumeric. 2. The coloration of goldenseal comes from its large content of the alkaloid: a. atropine. c. hydrastis. b. berberine. d. Indian tumeric.
7. Proanthocyanidins are members of a group of compounds called: a. alkaloids. c. flavonoids. b. cyanides. d. prostaglandins.
3. The systematic collection and testing of plants of potential medicinal value and selecting the best for treating complaints is called: a. organic pharmacy. c. homeopathic pharmacy. b. naturopathic pharmacy. d. eclectic pharmacy.
8. The three major types of tea (black, green, oolong) come from: a. the same species of tea plant. c. three different species of tea plant. b. two different species of tea plant. d. more than a dozen different species of teaplant.
4. The medicinal portions of gotu kola include all of the following EXCEPT the: a. fresh leaves. c. roots. b. stems. d. dried leaves.
9. Which type of tea has the greatest antioxidant activity compared to the other two types? a. Black c. Oolong b. Green
5. There is evidence, but not conclusive proof, that gotu kola might bind with which of the following substances in the body? a. Pepsinogen c. Hydrochloric acid b. Intrinsic factor d. Cholecystokinin
The Georgia Pharmacy Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Natural Products: Goldenseal, Gotu Kola, Grapeseed Extract, Green Tea Volume XXVI, No. 10 GPhA Code J09-02 Program Number: 142-999-09-002-H01-P CE Hours: 1.5 (0.15 CEUs) Release Date: 2/5/2009 Expiration: 10/15/2011
10. One of the pharmacologic activities attributed to caffeine includes increased release of: a. serotonin. c. dopamine. b. gamma aminobutyric acid. d. acetylcholine.
1. Select one correct answer per question and circle the appropriate letter below using blue or black ink (no red ink or pencil). 2. Members submit $4, Non-members must include $10 to cover the cost of grading and issuing statements of credit. Please send check or money order only. Note: GPhA Members will receive priority in processing CE. Statements of credit for GPhA members will be mailed within four weeks of receipt of the course quiz.
1. 2. 3. 4. 5.
A A A A A
B B B B B
C C C C C
D D D D D
6. A 7. A 8 A 9. A 10. A
B B B B B
C C C C C
D D D D
Mail completed quiz to: GPhA, 50 Lenox Pointe NE, Atlanta, GA 30324 A passing grade of 70% is required for each examination. A person who fails the exam may resubmit the quiz only once at no additional charge. Please check here if you are indicating a change of address ______
Phone # __________________
Name ________________________________________ License Number(s) and State(s) ____________ Address _____________________________________________________________________________ City ____________________________________________________ State __________ Zip __________ How long did this program take to complete? ________________________________________________
The Georgia Pharmacy Journal
29
February 2009
2008 - 2009 GPhA BOARD OF DIRECTORS
The Georgia Pharmacy Journal Editor: Jim Bracewell jbracewell@gpha.org
Managing Editor & Designer: Kelly McLendon kmclendon@gpha.org The Georgia Pharmacy Journal® (GPJ) is the official publication of the Georgia Pharmacy Association, Inc. (GPhA). Copyright © 2009, Georgia Pharmacy Association, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including by photocopy, recording or information storage retrieval systems, without prior written permission from the publisher and managing editor. All views expressed in bylined articles are the opinions of the author and do not necessarily express the views or policies of the editors, officers or members of the Georgia Pharmacy Association.
ARTICLES AND ARTWORK Those who are interested in writing for this publication are encouraged to request the official GPJ Guidelines for Writers. Artists or photographers wishing to submit artwork for use on the cover should call, write or e-mail the editorial offices as listed above.
SUBSCRIPTIONS AND CHANGE OF ADDRESS The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is distributed as a regular membership service, paid for through allocation of membership dues. Subscription rate for nonmembers is $50.00 per year domestic and $10.00 per single copy; international rates $65.00 per year and $20.00 single copy. Subscriptions are not available for non-GPhA member pharmacists licensed and practicing in Georgia. The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is published monthly by the GPhA, 50 Lenox Pointe NE, Atlanta, GA 30324. Periodicals postage paid at Atlanta, GA and additional offices. POSTMASTER: Send address changes to The Georgia Pharmacy Journal®, 50 Lenox Pointe, NE, Atlanta, GA 30324.
ADVERTISING Advertising copy deadline and rates are available at www.gpha.org upon request. All advertising and production orders should be sent to the GPhA headquarters as listed above.
www.gpha.org
Print: Star Printing - 770.974.6195
The Georgia Pharmacy Journal
Position
Sharon Sherrer Robert C. Bowles Eddie Madden Dale Coker Jack Dunn Jim Bracewell Burnis Breland Hugh Chancy Judy Gardner Keith Herist John McKinnon Andy Rogers Tommy Whitworth Alex Tucker Tony Singletary Renee Adamson Bill McLeer Shobhna Butler Bobby Moody Pam Marquess Larry Batten Alissa Rich Chris Thurmond Marshall Frost Ken Eiland Rusty Lee Liza Chapman Debbie Nowlin Tim Short Michelle Bishop Hillary Volsteadt John T. Sherrer Michael Farmer Pat McPherson
Chairman of the Board President President Elect First Vice President Second Vice President Executive Vice President/CEO State at Large State at Large State at Large State at Large State at Large State at Large State at Large Region One President Region Two President Region Three President Region Four President Region Five President Region Six President Region Seven President Region Eight President Region Nine President Region Ten President Region Eleven President Region Twelve President ACP Chairman AEP Chairman AHP Chairman AIP Chairman APT Chairman ASA Chairman Foundation Chairman Insurance Trust Chairman Ex Officio - President, GA Board of Pharmacy Ex Officio - Chairman, GSHP EX Officio Mercer Ex Officio Mercer ASP Ex Officio South Ex Officio South ASP Ex Officio UGA Ex Officio UGA ASP
Cynthia Pangburn Gina Ryan Meagan Spencer Rusty Fetterman Rebecca Cubbedge Brian Buck Walter Williams
GPhA HEADQUARTERS 50 Lenox Pointe, NE Atlanta, Georgia 30324 Office: 404.231.5074 Fax: 404.237.8435
Name
30
February 2009
2UN WITH THE BULLS $ON T BE CONTENT TO WATCH FROM THE SIDELINES 0ACE !LLIANCE OFFERS YOU THE CHANCE TO MAKE YOUR PHARMACY A PROSPEROUS BUSINESS ONE THAT STAYS AHEAD OF THE GAME 7E KNOW WHAT IT TAKES TO SURVIVE !FTER ALL WE HAVE BEEN RUNNING AHEAD OF THE BULLS FOR YEARS 0LUS TEAMING UP WITH 0ACE BENEFITS THE 'EORGIA 0HARMACY !SSOCIATION 3O STOP WATCHING FROM THE SIDELINES *OIN THE GROUP OF YOUR PEERS WHO WANT TO CONTROL THE DESTINY OF THEIR BUSINESSES IN ORDER TO PROSPER 4HIS IS YOUR CHANCE TO TAKE THE BULL BY THE HORNS #ONTACT 0ACE !LLIANCE TODAY
Sid Anderson s WWW PACEALLIANCE COM sanderson@GPhA.org Toll Free 1.888.871.5590
The Georgia Pharmacy Journal
31
February 2009
Georgia Pharmacy Journal速 50 Lenox Pointe, N.E. Atlanta, Georgia 30324