The Official Publication of the Georgia Pharmacy Association
November 2008
Hugh Chancy:
NCPA Willard B. Simmons Independent Pharmacist of the Year
Volume 30, Number 11
www.gpha.org
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16-17
Departments
Hugh Chancy 2008 NCPA Willard B. Simmons Independent Pharmacist of the Year
FEATURE
13 18
ARTICLES
Pharmacy Profile In Leadership
10 10 25 30
New Members PharmPAC Contribution Form Journal CE GPhA Board of Directors
2 2 8 10 14 31 32
The Insurance Trust Meadowbrook® Insurance Group Pharmacists Mutual Companies Michael T. Tarrant Toliver & Gainer PACE Alliance The Insurance Trust
Advertisers
Pharmacy Schools’ News
COLUMNS
4 6
President’s Message Editorial
For an up-to-date calendar of events, log onto
www.gpha.org. The Georgia Pharmacy Journal
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November 2008
PRESIDENTĘźS
MESSAGE
Robert Bowles President
Hugh Chancy – A True Winner On October 13, 2008, I had the privilege of witnessing one of my closest friends receive the NCPA Independent Pharmacist of the Year Award during the Second General Session of the 2008 NCPA Convention in Tampa, Florida. Former GPhA President, Hugh Chancy, was the winner of this award. In my article this month, I would ask that you allow me to invoke a time of presidential privilege.
While he has been very successful in his businesses, the overriding factor that motivates his life is his faith in God. His faith in God allows him to be the husband, father, and son that he is. With a solid foundation in his relationship with God and his family, Hugh is able to operate his businesses successfully and to be a friend to so many people by always demonstrating a caring, loving, and compassionate spirit toward those with whom he comes in contact.
When I chose to run for GPhA Second Vice President, I knew Hugh Chancy. However, I must confess that I knew very little of the professional life, character, integrity, and faith that Hugh possesses. Soon after I was elected Second Vice President, Hugh began to share insights with me that related to the things that were taking place within the GPhA Executive Committee and the Association at large. He was also interested in personal concerns that I might have and would take time to share his insights into these situations. Hugh always made me feel welcome and like I was a valuable member of the Executive Committee.
After I had served on the Executive Committee for five months, our family began a very difficult yet rewarding journey. I remember one Saturday morning during this time, I was about to go into a store in Thomaston. I was
Hugh is a successful businessman and owner of three pharmacies, a wonderful husband to Tina, the proud father of two boys, and the caring son of a mother whom he dearly loves.
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November 2008
feeling discouraged and very low. At that moment, my cell phone rang, and it was Hugh. He was just calling to check on me and to see how my family and I were doing. Unfortunately, in today’s world, not many people are going to take the time on Saturday morning to see how someone else is doing. Hugh was able to quickly determine that I was very low, and his simple, but quick response was, “Can I pray with you?” Those were the best words that I could have heard at that time.
You have become to me the brother that I never had, and I thank you for the impact that you have had on my life.
Congratulations on being named the 2008 NCPA Independent Pharmacist of the Year. Through your receipt of this award, you will have many opportunities to share your love, compassion, concern, and faith with others around you,Thank you for being my dear friend.
It is the overriding spirit of love and concern for others that allows Hugh to be the outstanding pharmacist that he is. Not only was Hugh an outstanding GPhA President, but he is actively involved in his church and weekly Bible study programs, leadership programs, and other community activities. All of these things are accomplished because of his deep abiding faith in God.
On October 13th, Hugh, once again made GPhA proud when he received the 2008 NCPA Independent Pharmacist of the Year award. We must be reminded that he also made his family, church, businesses, and friends proud. Most all of us go through life with few individuals that we can truly call close friends. I am blessed beyond measure for God to have put Hugh Chancy in my life.
Hugh, you are truly a friend to me and one on whom I can always count. You are a friend who will share your insights on issues within GPhA or issues that I might be facing in my personal life. Most of all, you are willing to share your faith, what God is doing in your life, and the difference that He can make in each of our lives.
Congratulations Hugh Chancy on being named the
2008 NCPA Independent Pharmacist of the Year
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November 2008
EXECUTIVE
VICE
PRESIDENTʼS
EDITORIAL
Jim Bracewell Executive Vice President / CEO
None of us is as smart as all of us! Two pharmacists were at a pharmacy conference out west and had a free afternoon in the conference schedule so they decided to hike a trail near the resort where they were staying. A couple of miles into the hike they happened upon a grizzly bear with her cubs. The situation became very dangerous as they realized the bear was about to attack. They tried to think what to do. Should they find a tree to climb? Should they fight the bear? Should they run?
run a grizzly bear!” “I know,” said the first pharmacist, “but I think I can out run you.”
There is a life lesson to be learned from this story. I can tell these pharmacists are not members of the Georgia Pharmacy Association. How do I know? I know because when members of GPhA are confronted with a problem they immediately band together, knowing there is strength and wisdom in working together. One of my most favorite axioms is “None of us is as smart as all of us.”
One pharmacist shouted to the other that they should make a run for it. The other pharmacist shouted back, “I have heard it is impossible to out
It does not matter if the bear is AMP, unfair audits, restrictions on delivering of immunizations, or a new unrealistic regulation. Whatever the bear, no matter how big or how mean, the Georgia Pharmacy Association is there to bring together the talents, the strengths, the knowledge, and political clout of many pharmacists to tame it. If you know a pharmacist that is trying to out run the bear, suggest he or she join GPhA and let’s set about the task of ridding the profession of bear attacks of bears once and for all.
GPhA needs every pharmacist in Georgia to become one unified voice against the challenges of the profession. What better time than now to join. Go to www.GPhA.org see what is happening in your professional association today.
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National Community Pharmacists Association AIP MEMBERS JOIN THE NATIONAL COMMUNITY PHARMACISTS ASSOCIATION Members of Georgia Independent Community Pharmacy Group Join National Independent Community Pharmacy Group
Alexandria, Va. - October 07, 2008 The National Community Pharmacists Association proudly welcomes the Academy of Independent Pharmacy (AIP) and all of its community member pharmacists as members of NCPA.
“NCPA and AIP have shared a long working relationship and we’re so pleased to be joined by all of its members,” said Stephen L. Giroux, RPh, NCPA president. “As the first statewide group to offer NCPA membership to all of its members, we look forward to working with them as leaders in Georgia and continuing to receive their grassroots support on nationwide issues.” AIP Director Jeff Lurey (an NCPA member since 1978) said, “AIP’s partnership with NCPA is a natural process. When you look at what NCPA does at the national level and compare what AIP does at the state level, the similarities are astounding. By partnering with NCPA on this membership campaign, AIP will support NCPA’s national efforts more than ever.” AIP is one of the oldest academies of the Georgia Pharmacy Association and represents independent pharmacists in communities across the state. Many AIP members belong to NCPA and the Academy has now offered membership to all of its members.
NCPA launched a membership campaign in June to reach every independent community pharmacy owner in the United States and get an expanding membership actively involved. The Georgia Pharmacy Association’s Academy of Independent Pharmacy (AIP) was founded in 1993. AIP represents more than 500 independent pharmacies in the State of Georgia. Its mission is to ensure the economic viability and security of independent pharmacy. It addresses the unique business and professional issues that affect independent pharmacy. It also provides educational programs with an emphasis on enhancing the managerial skills of independent pharmacists. Its lobbying efforts extend from the local community level to the State House to the White House. If there is an issue affecting independent pharmacy, AIP is there to protect and defend. The National Community Pharmacists Association (NCPA®) represents America’s community pharmacists, including the owners of more than 23,000 community pharmacies, pharmacy franchises, and chains. Together they represent an $84 billion health-care marketplace, employ over 300,000 full-time employees, and dispense nearly half of the nation’s retail prescription medicines. For more information, visit the NCPA Web site.
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November 2008
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)
Memberʼs 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
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Welcome to GPhA!
The following is a list of new members who have joined Georgiaʼs premier professional pharmacy association! Amy S. Abernathy, C.P.T. Tucker Julie Albright, B.S., R.N. Statesboro Jerrell S. Bailey Douglas Ann M. Burnett, C.Ph.T. Acworth Nekia L. Campbell, J.D., Pharm.D. Atlanta John B. Carroll, R.Ph. Americus Christopher E. Cook Bremen Kelly C. Cravey, Pharm.D. Hawkinsville Kamila A. Curry, Pharm.D. Atlanta Amy C. Grimsley, Pharm.D. Macon Brian Johnson Atlanta Juliet Lima Warner Robins Don K. Richie, R.Ph. Dade City Lauren Riley Atlanta Natalya A. Rozenberg Lawrenceville John Joseph Small Atlanta Shirley T. Travillian Marietta
Financial Planning for Georgia’s Pharmacists
Michael T. Tarrant Independent Strategies and Customized Solutions for Building Wealth & Security 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 Fi nanci al Co rpo rati o n (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.
50 Lenox Pointe, NE Atlanta, GA 30324
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November 2008
UP
COMING
EVENTS
16th YEA
Do you know a future
leader?
R
NOMINATION FORM FOR THE 2009 GPhA NEW PRACTITIONER LEADERSHIP CONFERENCE
April 17-19, 2009
Sea Palms Golf & Tennis Resort, St. Simons Island, GA
The 2008 New Practitioner Leadership Conference is an exceptional opportunity for new practitioners in Georgia to spend time together in a retreat setting to develop organizational skills that will enable both personal and professional growth. A select group of 20 practitioners will be chosen to attend the Conference.
Any pharmacist who is in his/her first 10 years of professional practice is eligible to apply for participation in the Conference. Applicants need not be members of GPhA to apply. Participants are selected by GPhAĘźs Executive Committee based on the following criteria:
(1) Leadership potential; (2) Involvement in college student activities and/or professional organizations; (3) Community activities; (4) Clarity and vision in response to application questions.
I would like to nominate the following individual to attend the 2009 New Practitioner Leadership Conference:
Name: ___________________________________________________________ Designation: ________________
(R.Ph., Pharm.D., etc.)
Works for: ____________________________________________________________________________________
Address: _____________________________________________________________________________________
[ ] Home or [ ] Work _____________________________________________________________________________
________________________________________________ State: ______ ZIP: _____________
Telephone: (Work) (_____) __________________ (Home) (_____) _____________________
(Fax) (_____) ____________________ E-mail: __________________________________________
Nominaed by: _______________________________________________________ Designation: _______________
Address: _____________________________________________________________________________________ ____________________________________________________________State: _______ Zip: ________
Tel. (______) ____________________ E-mail: _______________________________________________________ Please return this Nomination Form to: GPhF, New Practitioner Leadership Nomination Attention: Regena Banks 50 Lenox Pointe, Atlanta, GA 30324 Or, you may FAX this Nomination Form to: 404.237.8435 If you have questions, please contact Regena Banks at GPhF: PLEASE RETURN BY Direct # 404.419.8121 • Email: rbanks@gpha.org JANUARY 30, 2009 Thank you in advance for your assistance.
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UP
COMING
EVENTS
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PHARMACY
PROFILE
IN
LEADERSHIP
Lee Jack Dunn, Jr., R.Ph., Second Vice President of the Georgia Pharmacy Association
What type of pharmacy do you practice and where?
On a sunny day, how do you spend a free afternoon?
Who is your role model/mentor?
What accomplishment are you most proud of?
I am an independent community pharmacist in the North Georgia Mountains, 60 miles north of Atlanta. My pharmacy’s name is Jasper Drug Store. My role model is my father. He opened the pharmacy on July 3, 1952.
What do you enjoy most about your job?
I enjoy helping those people who have to fight for their medical treatment and cannot get help. My staff and I help patients solve their problems. Patients who walk out our door with a smile show us that we have done what we have been taught as pharmacists.
What is the hardest part of your job?
Telling a patient their insurance is not willing to help them, and I cannot help them with their problem either. Saying to them that their problem is between them and their insurance company is unfair and unfortunate.
What advice can you offer someone coming into this profession?
I am usually playing golf. I also enjoy working in my yard. I have natural rhoderdon and honeysuckle on my property and spend a great deal of time maintaining them. I have a lot to be proud of. When I was in high school, I was told I could not play football after making All-State as a linebacker in Class AA. That same year I went to state in golf. I was also my senior class president, and I thoroughly enjoy bringing everybody together every five years. I was Outstanding Athlete at Reinhardt College. I was fraternity president at Reinhardt College. I got the Most Improved Pharmacist in my senior year at Mercer University’s Southern College of Pharmacy. I was given an award by my high school for helping students and athletes at Pickens High School, but I guess the best accomplishment is helping those people in my hometown who have no concept about their disease states. They have someone to talk to about their diseases and treatments. If I ever feel unwilling to help those folks I need to get out of this profession.
You get out of this profession what you put into it. If you want to count pills and become a robot you can. If this is not what you want communicate with your patients about their health and medication, the result will be a shining example of what the profession of pharmacy is and should be. It is a hard road right now, but times will change, and if pharmacists come together and represent their profession it will grow and shine.
Why would you recommend that someone join GPhA?
GPhA is an organization that is helping resolve issues that are before pharmacists everyday, but it is also helping make pharmacies strong by providing insurance and other helpful benefits for pharmacists and their staffs. GPhA also provides opportunities for networking and sharing of best pharmacy practices.
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PHARMACY
PROFILE
IN
LEADERSHIP
If you could meet anyone (dead or living) who would it be and what would you ask them?
Michael Jordan or Jack Nicklaus, but not for the reasons you might think. I would not talk to them about sports, but I would ask them, “With all of your achievements how can you deal with the ups and downs of your family life?” Then I would talk to the young people of today about how to achieve goals. Many young people today cannot handle it when they do not achieve their goals. Society today is obsessed with achieving quickly and not working hard until goals are met. People forget that the path to achievement is long and the time it takes to travel that path varies from person to person. The achievement is not the prize at the end of the path, but the curves and bumps that it took to get us to the next choice.
some recommendations and told her about a doctor in town who I thought I could recommend. Four days later she came back to see me with a big smile and said “thank you.” I told her that this was just the beginning, and she was going to continue to get better, but that it was going to take time. I also had a lady who came in to my pharmacy right at the end of the day. Her government check had been stolen and she had a bottle which had been filled at Kroger for $4.00, but she had no money for the prescription or to get home. I gave her the medication and some money to get home. She said she would see me on the 10th of the month and pay me, but I told her not to worry.
What do you think has been the most significant change/advancement in pharmacy?
The patient/pharmacist relationship has come a long way from the days of count and pour. I believe we have to do more patient counseling and move away from insurance issues. The involvement of compounding pharmacy is another issue which gets pharmacists out of their comfort zone and makes pharmacy more rewarding. Robert Bowles and I have been talking about going to industry in our hometowns and providing something like the Asheville Project. We have just started talking about this. Hopefully we can get this project started and provide something for our communities and something to retool our thinking about pharmacy.
What five adjectives best describe you? Dedication, Diligence, Determination.
Commitment,
Passion
and
Professionally, if you could change something, what would it be? I would not have to deal with insurance.
When was the last time you did something for someone else and what was it?
A lady came into my pharmacy and said she had been to three doctors and that she had been told by all of them that she had a mental problem. Another lady, who I had helped, told her about me. I received the call and agreed to sit down with this lady for about 30 minutes. The lady was happy because she said nobody would listen to her story, and I listened to what she had to say. I told her about her body and why she was having the problems she was having. I made
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These are my achievements and they are not trophies. 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.
Toliver and Gainer, LLP 942 Green Street, SW Conyers, GA 30012-5310 altoliver@aol.com 770.929.3100
November 2008
SAVE
THE
DATE
December CE Catch-Up Need CE Now – We Have It! Time is running out on the renewal licensure year.
8 Hours of Live CE Take advantage of this last opportunity for live CE from GPhA in 2008. Session topics including Smoking Cessation, HIV/AIDS, Medicare Part D, and Medication Errors.
December 14, 2008 Ramada Plaza 108 First Street, Macon, GA 32101 For room reservations call 478.746.1461.
For details on event programming, speakers, and registration, visit www.gpha.org.
50 Lenox Pointe, NE, Atlanta, GA 30324 Phone: 404.419.8116 Fax: 404.237.8435 E-mail: kmclendon@gpha.org
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Georgia Pharmacy Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
November 2008
GPhA
UPDATE
Hugh Chancy Named 2008 NCPA Willard B. Simmons Independent Pharmacist of the Year Georgia pharmacist, Hugh Chancy has been named The 2008 NCPA Willard B. Simmons Independent Pharmacist of the Year by the National Community Pharmacists Association (NCPA). The announcement was made at the Second General Session of the association’s 110th Annual Convention and Trade Exposition held October 11-15 in Tampa, Florida.
The Independent Pharmacist of the Year award recognizes an independent pharmacist for exemplary leadership and commitment to independent pharmacy and to the community. The award is named in honor of Willard B. Simmons, a former NCPA (then the National Association of Retail Druggists) executive secretary and long-time NCPA Foundation trustee, who exemplified these qualities.
“Hugh Chancy is a very deserving recipient of the 2008 Willard B. Simmons Independent Pharmacist of the Year,” said Stephen L. Giroux, R.Ph., NCPA President and an upstate New York pharmacy owner. “He somehow finds time to serve in leadership capacities with numerous pharmacy organizations, while also owning three highlysuccessful pharmacies that offer a wide variety of niche services from compounding to immunizations. His efforts are widely respected by both his patients and his colleagues.”
Chancy owns three pharmacies in south central Georgia, near the
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Florida line. Currently, he is serving as the President of the Council of Presidents of the Georgia Pharmacy Association. He has also served the Georgia Pharmacy Association as president, chairman of the board, and as a regional president. Chancy also served on the executive committee for the Academy of Independent Pharmacy. He has been honored numerous times for his work in independent pharmacy including Pharmacist of the Year from the GPhA Academy of Independent Pharmacy, Innovative Pharmacy Practice Award from the Georgia Pharmacy Association, the Pharmacy Leadership award from NCPA, and the McKesson Leadership Award.
“Hugh brought an incredible passion for pharmacy and the association during his five years on the Executive Committee. His innate ability to break things down to the basics was always insightful and thought provoking,” said Robert Bowles, current president of the Georgia Pharmacy Association. “We could always count on some saying coming from him. We have characterized these sayings as ‘Hughisms.’ One of these that stands out in my mind was ‘I have already told you more than I know.’ Hugh has been involved in GPhA for many years and will continue to be a resource for others in the future.”
One thing that his peers and friends are especially proud of is that Chancy sat on a panel presentation to discuss Medicare Part D with President Bush. Following that panel in July 2005, Chancy spent the rest of the fall giving seminars and presentations on Medicare Part D.
Locally, Chancy has been involved with the Lowndes County Chamber of Commerce, the Hahira Lion Club, the Hahira United Methodist Church, and the Leadership Lowndes Association.
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November 2008
GEORGIA
PHARMACY
SCHOOLSʼ
NEWS
Pharmacy Schools’ News South’s News:
October 10. Eighteen students volunteered to deliver doughnuts to 56 pharmacies in Savannah and surrounding areas to express our appreciation for all their hard work. South University students and faculty spread out around the city again the next day to participate in a city-wide Health Screening. At seven different pharmacies, we provided blood pressure, blood sugar, and BMI screenings in addition to immunization and heartburn awareness to 180 patients while promoting the theme of American Pharmacists Month to "Know Your Medicine, Know Your Pharmacists."
South University Celebrates American Pharmacists Month
With October being American Pharmacists Month, South University’s GPhA chapter has been quite busy. We started off the month with a Student Outreach Meeting featuring guest speaker Keith Marciniak, APhA’s Group Director of Student and New Practitioner Development. We received great advice from Marciniak regarding school, our careers, and information about the profession of pharmacy in general. He was also kind enough to give our growing chapter tips for improvement. Thank you Keith!
The next day, on October 2, faculty and students of South University attended GPhA’s Fall Regional Meeting at Savannah Quarters Country Club, where they met local area pharmacists. Speaking of which, we also had a Pharmacist Appreciation Day on
The Georgia Pharmacy Journal
Our latest activity was the American Diabetes Association’s Walk on the Wild Side on October 18. South University pharmacy students raised and donated over $500 for ADA. Volunteers also provided screenings to the public and participated in the walk to support the fight against diabetes.
As busy as we were this month, we were not all work and no play thanks to Carter’s Pharmacy,
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November 2008
GEORGIA
PHARMACY
SCHOOLSʼ
Compounding Solutions of Savannah, and Fred’s Pharmacy who sponsored two social events open to the School of Pharmacy. Movie Night was an event where students could sit back and relax with a few snacks and Iron Man. Trivia Night was full of games with pharmacy related trivia where winners received a $50 gift certificate from Olive Garden and a door prize for a free APhA membership.
NEWS
Mercer’s News:
Mercer Celebrates American Pharmacists Month
We plan to end American Pharmacists Month with a big showing in Ft. Lauderdale at APhA’s Midyear Regional Meeting. See you there! UGA’s News:
Dawgtoberfest is Huge Success
Elaine Mebel, center, president of the Academy of Student Pharmacists, shows the Dawgtoberfest ad from the Red and Black student newspaper to representatives of Walgreens, sponsors of the event.
More than 700 people from the University of Georgia and the Athens community attended this year’s Dawgtoberfest: Rx for Good Health event, which took place to mark October as American Pharmacists Month. Organized by students at the College of Pharmacy and sponsored by Walgreens, the health fair included more than 30 exhibits pertaining to health care, ranging from information on HIV-AIDS and breast cancer to cholesterol and blood glucose screenings. Free flu shots also were available to the first 300 people to register.
October was exciting for the Mercer APhA-ASP chapter as we celebrated American Pharmacists Month. The students knew how to celebrate by kicking off the month with a glucose screening at Mercer. The biggest project this month involved Operation Immunization. The committee has collaborated with The Medicine Shoppe of Dunwoody to hold immunization clinics through November. ASP walked all over Atlanta for several causes this month including the Alzheimer’s Associations Memory Walk and Atlanta AIDS Walk. The Patient Education Committee was busy with holding their annual Patient Counseling Competition. It was a success with 16 students competing, of which the winner will represent Mercer nationally. A new way that students promoted the profession of pharmacy was by holding “Meet Your Pharmacist” events for patients at several Kroger locations. Lastly, ASP held a special event to educate students about substance abuse. We had the pleasure of hosting Dr. Glen Hansen as he gave the students of Mercer a lecture about the disease model of addiction.
This year’s event was the largest health fair held since its beginning in 2003.
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November 2008
Pharmacy Time Capsules 2008 (4th Quarter)
1983—Twenty-five years ago: • • •
Orphan Drug Act supporting research and approval of medicines for rare conditions was passed D.A.R.E. (Drug Abuse Resistance Education) was founded in Los Angeles. 94 NDAs were approved; 14 were new chemical entities.
• •
280 NDAs were approved, 20 were new chemical entities. First list of substances generally recognized as safe (GRAS) was published in the Federal Register.
•
The 1933 Lilly Digest reported that 27% of the reporting 402 pharmacies were operating at a loss; 41% reported net profit of 5% or more. Prohibition was repealed under the Blaine Act
1958—Fifty years ago
1933—Seventy-five year ago •
1908—One hundred years ago •
•
Paul Ehrlich, discoverer of Salvarsan (606 or arsphenamine) the first modern chemotherapeutic agent, received the Nobel Prize in Physiology or Medicine. Boys Scouts formed. First group in the United States was formed in 1910.
By: Dennis B. Worthen, Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH
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
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November 2008
October 29, 2008 For Immedia te Release
PRESS REL EASE
John T. She rrer Elected to the Execu National Co tive Commit mmunity Ph tee of the armacists A ssociation
Georgia ph armacist Jo hn T. Sherr the 2008-2 er, R.Ph., h 009 Executi as been ele ve Commit Pharmacists cted to te e of the Na Association tional Com (NCPA). Th made at the munity e announce association ment was ʼs 110th An Exposition nual Conve held Octob ntion and T er 11-15 in rade Tampa, Flo ri da. NCPAʼs Ex ecutive Com mittee repre the country sents pharm in matters im acists all ov pacting pha er rmacists an d their patie Sherrer is a nts. former pres ident of the Association Georgia Ph , a member armacy of National Association C of Health-S ommunity P , A merica Pha ystem Pharm harmacists rmacists As acists and Association sociation, G the Cobb C . He is an eorgia Soc ounty Pharm avid suppo iety Georgia Ph rter of GPh a c e armacy Fou u ti c a l A ʼs P ndation, an harm PAC, the Insuran d vice-chair chairman o ce Trust. H man of the f the e also serv Georgia Sta B e o d a rd from 1993-2 te Board of of Directors 003 as a m Pharmacy. of ember of th e “When Joh n T. Sherre r was born pharmacist. he must ha He possess ve known th es a passio pharmacy, at he wante n and a vis that is unsu d to be a ion, especia rpassed,” s R.Ph., CDM lly for indep aid GPhA P , CFts. “Joh endent resident Ro n has been Georgia an bert Bowles a distinguis d has exhib , J r., hed leader ited the sam Independen in the state e leadership t pharmacy of across the is in good h the ranks o United State ands as Jo f leadership s. hn continue in NCPA.” s to move th ro ugh John gradu ated from M ercer Unive received his rsityʼs South B.S. in Pha ern School rmacy in 19 pharmacy o of Pharmac 77. He is a wner workin y and community g primarily His wife, Sh and indepe out of Kenm aron Sherre ndent ar r, Pharm.D consultant ., CDM, is a Pharmacy in Marietta. pharmacist at Howell M community 2 children, and ill Pharmac Lindsey an y in Atlanta d Thomas. . They have
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November 2008
DISEASE
STATE
AWARENESS
Celebrating
Disease State Awareness
with Your Patients
I
n an effort to encourage patient awareness among your patients, GPhA has compiled a list of awareness opportunities for you and your pharmacies. All of these links will take you to pages containing information and resources free of charge for your utilizations in your settings and with your patients. If you need any help accessing these links please feel free to call Kelly McLendon at 404.419.8116.
DECEMBER
December is Colorectal Cancer Awareness Month. The CDC's Colorectal Cancer Prevention and Control Initiative raises public awareness through the "Screen for Life" campaign, which communicates the importance of regular screening for adults aged >50 years, and "A Call to Action," an education program designed to raise health-care providers' awareness and knowledge about prevention and early detection. CDC also works with partners to support the National Colorectal Cancer Roundtable, a coalition of organizations that educates health-care providers and the public about screening. Finally, CDC funds The Georgia Pharmacy Journal
comprehensive cancer control programs to integrate a full range of cancer control activities, improve community-based education and health promotion, and target at-risk populations. Additional information about colorectal cancer awareness and provider training materials are available from CDC at http://www.cdc.gov/ cancer/screenforlife and http://www.cdc.gov/ cancer/colorctl/calltoaction. December is AIDS Awareness Month. For information about HIV/AIDS Prevention and treatment visit http://www.cdc.gov/hiv/topics/ basic/index.htm. December is National Seasonal Depression Awareness Month. Although the holiday season is usually ripe with joy and excitement, for the half million people suffering from SAD (Seasonal Affective Disorder), this time of the year is anything but happy. The origins of SAD lie in the hypothalamus. There, the shortening of daylight hours and lack of sunlight in winter causes a biochemical imbalance that causes severe depression. Without proper
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November 2008
medical treatment, many of those suffering from American Red Cross at SAD are not able to carry out their day-to-day http://www.redcross.org/. functions. January is Poison Prevention Month. For information to share with your patients visit http://www.poisonprevention.org/materials.htm.
Organizations like the SAD Association work to increase public awareness about the disorder. They seek out those suffering from SAD and offer them counseling, information, and support. For information about this disorder visit http://www1.nmha.org/infoctr/factsheets/27.cfm.
JANUARY
January is National Blood Donor Month. Blood is traditionally in short supply during the winter months due to the holidays, travel schedules, inclement weather, and illness. January, in particular, is a difficult month for blood centers to collect blood donations. A reduction in blood donations can put our nation’s blood inventory at a critical low. There are ways you can help to increase the blood supply this winter: • Give Blood • Organize a Blood Drive • Volunteer at Your Local Blood Center
January is Cervical Cancer Awareness Month. Cervical cancer affects approximately 10,000 women in the United States each year. Cervical cancer is the second most common type of cancer for women worldwide, but because it develops over time, it is also one of the most preventable types of cancer. Deaths from cervical cancer in the United States continue to decline by approximately 2 percent a year. This decline is primarily due to the widespread use of the Pap test to detect cervical abnormalities and allow for early treatment. Most women who have abnormal cervical cell changes that progress to cervical cancer have never had a Pap test or have not had one in the previous three to five years.
For patient information visit http://www.nccc-online.org/patient_info/ cervical_cancer.html.
For more information, visit the American Association of Blood Banks at http://www.aabb.org/content or contact the The Georgia Pharmacy Journal
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November 2008
GPHA
MEMBERS
IN
THE
NEWS
Susan Kane Receives Distinguished Alumnus Award From the University of Georgia
Lambda Sigma. After graduation she became a pharmacist with Publix Supermarkets, serving in various capacities including her current position as pharmacy manager, pharmacy territory pharmacy supervisor from 1999-2007 and liaison with three pharmacy schools. She is a member of the American Pharmacy Association’s certified Train the Trainer Immunization Program and is certified in immunizations, cholesterol screening and bone density screening.
Susan will be Grand Marshal for the College’s commencement on May 2, 2009.
Susan Kane receives Distinguished Alumnus Award from Dean Svein Øie.
GPhA member Susan McMillan Kane of Jacksonville, Florida, has been named the Distinguished Alumnus of the University of Georgia College of Pharmacy for 2008 by the University of Georgia.
Susan has been an active and enthusiastic supporter of the College since her graduation, giving generously of her time and resources. She has been a member of the Alumni Council since 1998 and was President in 2002 and has been a regular participant at White Coat Day, the Pinning Ceremony and Homecoming. She has also served on the VisionPlus Board since 2000 and is a Presidents Club member, a Heritage Society member and founder of the Susan McMillan Kane Professional Enhancement Fund. She has also been active in the Georgia Pharmacy Association, as a member of the Board of Directors, Chair of the Committee on Student and Academic Affairs and member of the Government Affairs Committee, the Public Affairs Committee, the Student Track Programming Committee for the GPhA Convention Planning Committee, the Membership Committee and the Team GPhA Membership Drive. She has been President and member of the Board of Directors of the Academy of Employee Pharmacists, a PharmPAC Supporter and a GPhA/APhA career exhibitor. She was named Academy of Employee Pharmacists Outstanding Member of the Year for 2000 and GPhA Distinguished Young Pharmacist for 2002.
During college she was President of the Academy of Student Pharmacists, President and Vice President of Lambda Kappa Sigma and an active member of Phi
The Georgia Pharmacy Journal
Pharmacotherapy Principles & Practice, edited by Marie Chisholm-Burns, received the American Medical Writers Association Distinguished 2008 Medical Book Healthcare Professionals Award. Chapter authors include: Beth Phillips, Brad Phillips, Dianne Williams, J. Russell May, Tommy Johnson and Bill Wade. Azza El-Remessy, Assistant Professor at the University of Georgia, published a book chapter, “Cellular and Molecular Mechanisms of Retinal Angiogenesis” in Retinal and Choroidal Angiogenesis, edited by John S. Penn, Ph.D., and published by Springer.
Tommy Johnson, Clinical Associate at the University of Georgia, invited lecturer at Kennesaw State University for the Getting into Diabetes Education continuing education program, “Medications and Diabetes,” invited lecturer for “Diabetes 101 Program – Type 1 Medications” in Gainesville, Georgia and invited to present the “Pharmacist/Certified Diabetes Educator’s Prospective on Gaps in Care” at the National Quality Forum Diabetes Workshop in Washington DC.
Keith Herist, Clinical Associate Professor at the University of Georgia passed the credentialing exam for the AAHIVE designation. This is a new credentialing program enabling HIVspecialized Pharm.D.s. Physicians, nurse practitioners, and physicians have always been eligible in prior years and they earn AAHIVS, which stands for “HIV Specialist.” This new AAHIVE designation, for Pharm.D.s only, is from the American Academy of HIV Medicine, and stands for “HIV Subject Matter Expert.” The credential is valid for calendar year 2009 and 2010.
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November 2008
Gossel
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
Autism and Its Treatment: Goal.
The goal of this lesson is to explain autism with focus on its pathogenesis, clinical characteristics and confirmation, and treatment.
Objectives. At the conclusion of this lesson, successful participants should be able to: 1. recognize historical events concerning autism, and differentiate each component of the autism spectrum disorders from one another; 2. select important principles that characterize autism and the principles that govern its clinical confirmation and management; and 3. identify specific nonpharmacologic and pharmacologic measures that are reported to modify signs and symptoms of autism. Autism (autistic disorder) is a complex, chronic and serious neurodevelopmental disorder that affects normal functioning of the brain, impacting development in the areas of social interaction and communication skills. The most common of the pervasive developmental disorders, autism affects an estimated one in 150 births in the
Wuest
A Primer for Pharmacists
United States. With the number growing at a startling rate of 10 to 17 percent per year, its prevalence could reach four million Americans within a decade. Occurring in all racial, ethnic and socioeconomic groups, autism is four times more likely to occur in males than in females. Additional information on autism can be found in the online resources listed in Table 1.
Background
In 1943, child psychiatrist Leo Kanner of the Johns Hopkins Hospital published the first description of “autistic disturbances of affective
Table 1 Representative sources for information on autism
The American Academy of Pediatrics The Autism Society of America Autism Speaks, Inc. First Signs, Inc. The Organization for Autism Research National Library of Medicine and the National Institutes of Health National Institute of Mental Health National Institute of Child Health and Human Development
The Georgia Pharmacy Journal
contact.” Kanner thus introduced the term infantile autism, or autism into the English language, which defined three symptom patterns: (1) abnormal development of social reciprocity; (2) failure to use language for communication; and (3) desire for sameness, as seen in repetitive rituals or intense circumscribed interests – symptoms that were later termed Kanner’s triad. About this same time, Austrian pediatrician Hans Asperger, based on his study of 400 children, described a milder form of the disorder that became known as Asperger’s Disorder (Asperger Syndrome).
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www.aap.org www.autism-society.org www.autismspeaks.org www.firstsigns.org www.researchautism.org www.nlm.nih.gov/medlineplus/print/ autism.html www.nimh.nih.gov www.nichd.nih.gov
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Autism is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR), the primary diagnostic reference for mental health professionals in the United States. It is one of the five pervasive developmental disorders (PDDs), more commonly referred to as autism spectrum disorders (ASDs). Each disorder is characterized by varying degrees of impairment in social interactions, communication skills and restricted, repetitive and stereotyped patterns of behavior. (Table 2) It is not uncommon for more than one of these disorders to coexist in the same family.
Pathogenesis
Although there is no known single cause for autism, it is generally accepted that it follows some abnormality in brain structure or function. Brain scans reveal differences in the shape and structure of the brain in children with autism compared to those without. Research is ongoing in investigating possible links between heredity, genetics and medical pathology. There appears to be a pattern of autism or related neurological disabilities in many families. Medical researchers have identified a variation in a gene that may increase the risk for developing autism, especially when the variant is inherited from mothers rather than fathers. The gene, CNTNAP2, encodes a protein that facilitates communication between brain cells through chemical signals and appears to play a role in brain cell development. Inheriting the gene variant does not imply that a child will inevitably develop autism; rather, it means that a child may be more vulnerable to developing the disease. Other research suggests that a cluster of unstable genes may interfere with normal brain development, resulting in autism.
Pregnancy or delivery problems and environmental factors (e.g., viral infections, metabolic imbalances and exposure to environmental chemicals during pregnancy) are also being studied. Is there a causative role for vaccines? Many studies over the years have looked at the possibility that vaccines are a cause of autism. Autistic characteristics have been described in some children within a few weeks of receiving a vaccine. Until 1999, vaccines intended for infants to protect them against diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), and hepatitis B contained thimerosal (a mercury-based preservative). Today, with exception of some influenza vaccines, none of the preparations used in the United States to protect preschool-aged children against 12 infectious diseases contain thimerosal. The MMR (measles, mumps, rubella) vaccine, varicella (chickenpox), inactivated polio, and pneumococcal conjugate vaccines do not and never did contain thimerosal. The U.S. Institute of Medicine (IOM) conducted a thorough review on the issue of identifying a possible link between thimerosal and autism. The IOM report, released in May 2004, stated that there was no link. At this time, there is no conclusive scientific evidence that any component of a vaccine or combination of vaccines causes autism.
Characteristics
Characteristics (i.e., signs/ symptoms) of autism may be evident as early as four months of age. In a few cases, after developing normally, a child regresses into autism. Clinically, neurological abnormalities usually dominate the symptomatology. At the same time, it is emphatically true that intelligence diversity is a major aspect of autism. It has been reported that while approximately three-fourths of patients with autism may be mentally retarded, the IQs of persons with
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autism may range from severe impairment to intellectually gifted. Impaired social interaction is the hallmark feature of autism. Table 3 lists common characteristics. Parents are usually the first to notice symptoms of autism. Early in infancy, a baby with autism may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time. A child with autism may appear to develop normally for a period, only to withdraw and become indifferent to social interaction. They may fail to respond to their name and often avoid eye contact with other people. They have difficulty interpreting what others are feeling because they don’t understand social cues, such as tone of voice or facial expressions, and they don’t watch other people’s faces for clues about appropriate behavior. They lack empathy toward others. Many children with autism engage in repetitive movements such as rocking their head or torso and twirling their hair between fingers, or in self-abusive behavior such as biting or head-banging. They also tend to start vocalizing later than children without autism. Some speak in a high-pitched, or flat, robot-like voice, or in “sing-song” fashion (regular or monotonous rising and falling intonation) about a narrow range of favorite topics. Many children with autism have an increased threshold to pain, but are abnormally sensitive to sound, touch, or other sensory stimulation. These reactions may contribute to behavioral symptoms such as resistance to being cuddled or hugged. Children with autism appear to be at higher risk for certain comorbid (concomitant but unrelated) conditions, including fragile X syndrome (the most common inherited form of mental retardation) and tuberous sclerosis (a rare, genetic disorder that causes benign tumor growth in the brain and other vital organs), as well as epileptic
November 2008
seizures, Tourette syndrome (characterized by presence of multiple physical [motor] tics and at least one vocal [phonic] tic), learning disabilities, and attention deficit disorder. For reasons that remain unclear, about one-third of children with autism develop epilepsy by the time they reach adulthood. While persons with schizophrenia may show autistic-like behavior, symptoms usually do not appear until their late teens or early adulthood. Most persons with schizophrenia also experience hallucinations and delusions, neither of which are associated with autism. Autism symptoms often improve with treatment and with age. Some autistic children can lead normal or near-normal lives as they grow older. Children whose language skills regress early in life, usually before three years of age, appear to be at risk of developing epilepsy or seizurelike brain activity. Some children with autism may become depressed or experience behavioral problems during adolescence. Persons with autism score consistently low on instruments that measure life skills. The life outcomes of autistic adults range from complete dependence on others to (rarely) successful employment. People with autism typically die early, with death most often coming from seizures, nervous system dysfunction, drowning or suffocation (at a rate exceeding three times the general population). As mentioned earlier, epilepsy occurs in at least one-third of persons with autism. The death rate due to epilepsy is approximately 24 times higher than that of epileptic patients without autism.
Confirmation of Autism
There is no medical test for autism. Physicians rely on a core group of behaviors to diagnose autism: • difficulty in making friends with peers; • inability to initiate or sustain conversation with others;
• impairment or absence of imaginative and social interaction; • unusual, stereotyped or repetitive use of language; • patterns of interest that are abnormal in intensity or focus; • preoccupation with a particular object or subject; and • rigid adherence to established routines or rituals. While some screening instruments rely solely on parental (or caregiver’s) observations, others rely on a combination of notes from both parent and physician. Since autism is a complex disorder, a comprehensive evaluation requires a multidisciplinary team including a neurologist, psychiatrist, psychologist, speech therapist and other professionals who have experience in diagnosing children with ASDs. Team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Autism can often be detected as early as 18 months. Increases in the number of autism cases in the United States may be the result of improved diagnosis and changes in diagnostic criteria.
Differential Diagnosis. Children with some symptoms suggestive of autism, but neither qualitatively nor quantitatively sufficient to permit a diagnosis of classical autism, may be diagnosed with pervasive developmental disorder-not otherwise specified (PDD-NOS) (Table 2). Children with autistic behaviors whose language skills are well developed may be diagnosed with Asperger’s disorder. Children who develop normally, and then suddenly deteriorate between three and 10 years of age and show marked autistic behaviors, may be diagnosed with childhood disintegrative disorder (CDD). Girls with autistic symptoms may be suffering from Rett syndrome, a gender-linked genetic disorder characterized by social withdrawal, regressed language skills and hand wringing.
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Table 2 Common characteristics of persons with autism
A child or adult with autism might: • not play “pretend” games • not look at objects when another person points at them • not have an interest in others • avoid eye contact • want to be alone • have trouble understanding other people’s feelings or talking about their own feelings • prefer not to be held or cuddled • appear to be unaware when other people talk to them but respond to other sounds • be very interested in people, but not know how to relate to them • repeat or echo words or phrases • have trouble expressing their needs using words or motions • repeat actions over and over • have trouble adapting to a changing routine • have unusual reactions to the way things smell, taste, look, feel or sound • lose skills they once mastered Adapted from www.cdc.gov/ncbddd/ autism/actearly/autism.html
Treatment
Although treatment has improved greatly over the past several decades, there is neither a cure for autism nor single approach to therapy. The primary goals are to minimize the core features and associated deficits, maximize functional independence and quality of life, and alleviate family distress. Options may include behavioral and communication measures, drug therapies and complementary approaches. Behavioral and Communication Measures. Numerous programs target the range of behavioral, social and language difficulties characteristic of
November 2008
autism. Some focus on reducing problem behaviors and teaching new skills. Others focus on teaching children how to communicate more effectively with other people or how to act appropriately in social situations.
Drug Therapies. At present, there is no medication that directly improves the core signs of autism. However, some can help control individual symptoms. Agents most commonly employed in autism include antidepressants (especially SSRIs), used in 20 to 25 percent of patients; neuroleptics (especially second-generation antipsychotics), 10 to 15 percent; stimulants, 10 to 15 percent; alpha agonists, 10 percent; and anticonvulsants, 5 to 10 percent.
Risperidone. The FDA approved risperidone (Risperdal) for the symptomatic treatment of irritability in autistic children and adolescents. The targeted behaviors under the general heading of irritability include aggression, deliberate self-injury, temper tantrums and quickly changing moods. No restrictions on prescribing or use in autism have been put into place to-date. Risperidone’s effectiveness in the symptomatic treatment of irritability associated with pediatric autistic disorders was established in two eight-week placebo-controlled trials in 156 patients aged five to 16 years of age. Outcomes demonstrated that children on risperidone achieved significantly improved scores for specific behavioral symptoms of autism compared to children on placebo. The most common side effects included drowsiness, constipation, fatigue and weight gain. While efficacy has been demonstrated, concern remains about the misuse potential of risperidone and other antipsychotic drugs as a form of long-term chemical sedation, particularly with the most intellectually disabled children who may be the most likely to experience adverse drug effects.
The overwhelming view, however, is that if antipsychotic drugs are used appropriately, they can have a positive role in the management of aggression associated with autism.
Complementary Approaches. In the absence of specific medical interventions for autism, parents and some healthcare professionals may choose complementary (i.e., alternative) therapies, such as art or music therapy; dietary restrictions including the elimination of gluten, sugar, chocolate, preservatives and food coloring; vitamin and mineral supplements; herbal remedies; or sensory integration, which focuses on reducing a child’s hypersensitivity to touch or sound. Almost one-third of autistic children regularly receive a complementary therapy. Various surveys indicate that only 36 to 62 percent of caregivers who treated their autistic children with complementary therapies had informed the child’s primary care physician. Parents and caregivers should be encouraged to seek additional information when they encounter claims such as: • treatments based on overly simplified scientific theories, and those supported primarily by case reports or anecdotal data rather than carefully designed studies; • therapies claimed to be effective for multiple different, unrelated conditions or symptoms; • claims that children will respond dramatically and some will be cured; and • treatments that are said to have no potential or reported adverse effects.
behavioral interventions, can have a dramatic impact on reducing the symptoms of autism. Sadly, it is estimated that only 50 percent of autistic children are diagnosed before kindergarten.
Summary and Conclusions
Autism is a lifelong neurobiologic disorder that adversely affects quality of life. Early diagnosis of autism is often elusive. Its imprint on afflicted young people is so unique that the course of the disorder is difficult to predict in individual patients. In view of anticipated patterns of earlier identification and more proactive treatment of autism in years to come, the burden of autism on the health care system will continue to increase. The content of this lesson was developed by the Ohio Pharmacists Foundation, UPN: 129-000-08-007H01-P. Participants should not seek credit for duplicate content.
Early Treatment. Individuals with autism won’t outgrow it, but they can learn to function within the confines of the disorder, especially if treatment begins early. Early intervention is defined as treatment provided to children from birth to age three years. Research has clearly shown that early treatment, which consists of intensive, individualized
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November 2008
Quiz
Autism and Its Treatment: A Primer for Pharmacists
1. In the U.S., autism affects an estimated one in: c. 15,000 births. a. 150 births. b. 1500 births. d. 150,000 births.
7. All of the following are included in the core group of behaviors physicians use to diagnose autism EXCEPT: a. difficulty feeding and dressing oneself. b. inability to sustain conversation with others. c. preoccupation with a particular object. d. rigid adherence to established routines.
2. The term autism has been defined as all of the following symptom patterns EXCEPT: a. abnormal development of social reciprocity. b. failure to use language for communication. c. desire for sameness. d. inability to perform mathematical tasks.
8. Girls with some autistic symptoms who also exhibit social withdrawal, regressed language skills, and hand wringing are most likely suffering from: a. Asperger’s disorder. b. childhood disintegrative disorder. c. pervasive developmental disorder not otherwise specified. d. Rett syndrome.
3. According to the Table listing Major characteristics of pervasive developmental disorders, autistic disorder has an onset of: a. <12 months of age. c. <36 months of age. b. <24 months of age. d. <48 months of age. 4. The U.S. Institute of Medicine has stated that: a. there is a link between thimerosal and autism. b. there is no link between thimerosal and autism.
9. The most common therapeutic agents employed to treat autism are the: a. neuroleptics. c. stimulants. b. anticonvulsants. d. antidepressants.
5. It has been reported that approximately three-fourths of patients with autism may be: a. intellectually gifted. b. mentally retarded.
10. Common characteristics of persons with autism include all of the following EXCEPT: a. avoiding eye contact. b. begging to be held or cuddled. c. having trouble adapting to a changing routine. d. repeating actions over and over.
6. By the time they reach adulthood, about one-third of children with autism develop: a. schizophrenia. c. epilepsy. b. hallucinations. d. delusions.
The Georgia Pharmacy Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Autism and Its Treatment: A Primer for Pharmacists
Volume XXVI, No. 7 GPhA Code J08-11 Program Number: 142-999-08-007-H01-P CE Hours: 1.5 (0.15 CEUs) Release Date: 11/5/2008 Expiration: 07/15/2011
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 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) ____________
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November 2008
2008 - 2009 GPhA BOARD OF DIRECTORS
The Georgia Pharmacy Journal Editor: Jim Bracewell
Name
jbracewell@gpha.org
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
Managing Editor: Kelly McLendon
kmclendon@gpha.org
The Georgia Pharmacy Journal® (GPJ) is the official publication of the Georgia Pharmacy Association, Inc. (GPhA). Copyright © 2008, 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.
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Position
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 Region Two Region Three Region Four Region Five Region Six Region Seven Region Eight Region Nine Region Ten Region Eleven Region Twelve 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
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Sid Anderson sanderson@GPhA.org Toll Free 1.888.871.5590
November 2008
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