PQ Plus 2 January 2018

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PQ PLUS 2

ISSUE

4 S p o n s o r e d by P h a r m ac a r e & S c ot i a b an k | |

January

2018


January Issue -Table of Contents

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Table of Contents A word from your PQ+2 Co-Editors Edmonton PDW 2018 Perspectives and experiences from this year’s PDW! A recap of Canada’s largest pharmacy-student conference

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CSHP Banff Seminar 2018 Information about this year’s CSHP 44th annual Banff Seminar

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Mr. Pharmacy 2017 A recap of Mr. Pharmacy

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Therapeutic Tent Talk Feeling under the weather? Treat yourself with this issue’s TTT on cough and cold treatment!

Ethos Ho Hey pharmily! I hope everyone had a restful holidays! This issue of PQ+2 will be short and sweet, as many of our committee members (including myself) were busy learning/partying at PDW. I wish you all best of luck in the new semester. Let’s make this final stretch together to conclude another great school year! If you are interested in writing and submitting articles for PQ+2, please do not hesitate to contact myself or other members of the publishing committee.

David Poon Hello everyone! I hope everyone had a fantastic winter break! I know it’s a bit later into the year, but Happy New Years! It’s hard to believe that 2018 is already here, and I hope everyone has a fantastic year. We have some exciting new articles coming to PQ Plus 2 and we think you are all going to enjoy it. Also, if you ever have any articles you would like to submit, whether it is pharmacy related or not, we would be happy to publish them! PQ Plus 2 magazine is so much more than just a pharmacy magazine. It’s about bringing together the entire pharmacy faulty, fostering a happy and healthy community. It truly is a privilege being able to share our content with readers like yourself. As PQ Plus 2 enters its halfway point, please feel free to provide us suggestions or comments. You can find us on Facebook @PQPlus2. | 2 |


Exploring PDW Through the Eyes of Hannah Kaliel (CAPSI Sr.)

After 3 years of planning and a whirlwind 4

Students arrived at the Edmonton International Airport and were shuttled to the Westin Hotel in days, Professional Development Week 2018 has downtown Edmonton. They then had time before come to a close. PDW 2018 saw 585 students the Opening Gala at the Shaw Conference Centre from all ten Canadian pharmacy schools descend to register for the conference and receive their on Edmonton’s Shaw Conference Centre and Welcome Package. That night, the Tropical Soiree Westin Hotel. Lead by co-chairs Anuvir Bhulthemed Opening Gala, organized by Social Officlar and Diva Niaz, the PDW 2018 Planning ers Stephanie Metzger and Sabrina Lorico, Committee pulled off a virtually flawless confer- was breathtaking. Students did not disappoint as ence packed with educational speakers, social they came dressed in Hawaiian attire and drank events, a health fair, CAPSI competitions and the slushies adorned with tiny umbrellas. Awards inaugural PDW blood pressure clinic at City Hall. were presented, with special mention to last year’s PAM committee co-chairs, Marline Aizouki and Sean Hanson, for their Award of ProfessionHighlights of the conference included: alism for best PAM of 2017 and to Sahiba KhuraDay 1: Wednesday, January 10 na for the IPSF Health Campaign award. | 3 |


Day 2: Thursday, January 11 The day began with an inspiring address by Keynote Speaker Dr. Samantha Nutt. She spoke about her work in war torn countries and her foundation War Child Canada, tailoring the speech to how we, as Canadian pharmacy students, could take the first steps to becoming more informed, engaged global citizens. Education officer Alexandra Spirkina did not disappoint with the rest of the days speaker line-up, including U of A’s own Dr. Nese Yuksel, Dr. Joey Ton and Dr. Pat Mayo. Additionally, students travelled to the University of Alberta’s practice and compounding labs to compete in the OTC, PIC and compounding competitions. Others participated in PDW’s inaugural blood pressure clinic at City Hall, where they engaged the public in discussion surrounding their cardiovascular health. We wrapped up the day with Social Night at Knoxville’s Tavern. Day 3: Friday, January 12 Day 3 continued to be packed with thoughtprovoking speakers, including U of A graduates Helen Marin and Cassandra Woit, who presented talks in French. Health Fair took place in the afternoon, showcasing 30 vendors, as organized by Health Fair officers Katina Woo and Anupreet Dhillon. Students had the opportunity to mingle with pharmaceutical representatives and view research posters presented by students from many schools. The evening found us at a Western Carnival themed Canada’s Next Top Pharmacist, which was personally my favorite social event of the conference. Eight contestants wowed us with their catwalk and talents leaving us cheering and laughing throughout the entire night. Congratula-

tions to U of T’s Jessie for her well-deserved CNTP win! Day 4: Saturday, January 13 The last speaker of the conference was the muchanticipated Michael Landsberg who presented his struggle with mental illness. Over the years, Michael has become a huge advocate for reducing the stigma against those with mental illness through his #sicknotweak campaign. He spoke unapologetically about our responsibility to see mental illness just as we see physical illnesses and to stand up for those who aren’t ready to admit they are struggling. Pharmafacts followed, seeing the schools battle it out over pharmacy trivia. U of T was once again victorious and took away the 1st place finish. PDW 2018 wrapped up with the Closing Gala, beautifully decorated with a Northern Lights theme. Congratulations to all CAPSI competitions award winners – you did the U of A proud! Special thank you to PDW 2018 Planning Committee members not previously mentioned above: Deanna Sosnowski (Sponsorship), Teresa Huszar (Communications), Andrew Jansen (Administration), Angelyn Schultz (Bilingual), Carmen Tetrault (Bilingual), Dylan Moulton (Finance), Priya Samuel (Logistics) and Mark Contreras (CAPSI Jr.), as well as to the countless volunteers from the U of A delegates. All of you made this conference a success! Don’t miss PDW 2019, hosted by Memorial University of Newfoundland in St. John’s, NL from January 9-12, 2019!

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As a first-year student, I really

wanted to know what the hype behind PDW was all about, and I must say I was not disappointed. My experience at PDW has left me with pleasant memories and new friends from Québec. In addition, this conference was an excellent opportunity for me to really bond with my classmates and other students.

in a study to be the nostril, upper lip, and unspoken areas.

Following a busy schedule of attending sessions in the morning, social events in the evening REALLY allowed everyone to loosen up. This really pushed me out of my comfort zone because other than being socially awkward (sometimes), as many of you already know, I also have no idea what I am doing on the dance Over the course of four days, we floor. However, as uncomfortahad a daily schedule of sessions ble as I was, it was still one of including speakers discussing the best decisions I made bemental health, the opioid crisis cause I got to make new friends and, evidence based medicine (so do not be deterred from go(EBM), to name a few. While lis- ing to social events)! tening to the closing speech by Michael Landsberg on mental To anyone contemplating on atillness, I found myself blinking tending PDW in the coming back tears. This was not because years - just go. Here was my reI understood how he felt when flection on my PDW experience: he described depression as “an If there comes a day that I expeinability to feel joy,” but because rience burnout down the road, he spoke with such sincerity. It my memories from PDW 2018 was the fact that he was not only will be one I can look back to as speaking about himself, but also a reminder of what kind of pharthose who cannot speak openly macist I wanted to become. about their mental illness due to fear of ridicule or stigma. These are the same individuals who will come to our pharmacy someday or may be one of us now. While many sessions were on somber topics, there were also breakout sessions providing us with information and updates in the profession. One interesting fact I learned was presented by Joey Ton on EBM. If you run away from bees during the summer (like me) this might be a helpful tip. Apparently, the parts — Grace Ting (Class of 2021) of the body that hurt the most as a result of a bee sting was shown | 5 |

The educational highlights of

my PDW experience was Dr. Pat Mayo’s presentations on the Opioid Crisis and Medical Assistance in Dying (MAID) in addition to Marni Parnas’ presentation on Improving the Experience for Sexual and Gender Minority (LGBTQ) people. Dr. Pat Mayo is a professor in the Faculty of Pharmacy & Pharmaceutical Sciences here at the University of Alberta. He introduced himself by letting us know that all of the pharmaceutical entities he has worked for are no longer in existence except for the University of Alberta. I’m not sure who wouldn’t be captivated by an introduction like that. Dr. Mayo explored the ethical considerations behind two of the most pressing issues in our modern society (Opioid Crisis and MAID) and explained major concepts that were necessary to understand and address them. To be able to condense these content-heavy topics into one hour presentations is a very admirable feat. Marni Parnas is a Senior Advisor of Diversity and Inclusion at Alberta Health Services. She was highly captivating due to the moving reflection of her personal struggles and how they have shaped her identity as a transgender woman. She shared how members of the LGBTQ community continue to be marginalized in vulnerable settings such as within the health care system. It was a wake up call to hear that many LGBTQ individuals are traumatized by previous


health care experiences to the extent that they are afraid to seek care even in emergency situations. Her insights into the lived experiences of LGBTQ people were truly eye opening and her call to action to the future pharmacists sitting in the room to improve these lived experiences was extremely empowering. The personal highlights of my PDW experience was Canada’s Next Top Pharmacist (CNTP) and meeting pharmacy students from across Canada. I was impressed by the diversity of talent at CNTP including singing, dancing, storytelling and even Magic Mike. I met pharmacy students both from the West and East Coast and we had productive discussions about our different scopes of practice. Overall, I am very grateful for all of the experiences I had at PDW and the new connections I made with my fellow pharmacy students.

PDW 2018 was my first PDW

This means that they should be treated in the same compassionexperience. I have to say that I ate way that we would treat any really missed out the previous other patient. We should also be two years and would highly rec- more aware of how they are reommend everyone to go at least ferred to behind the scenes. For once (and with it being in St. example, you wouldn’t introduce John’s next year, it is sure to be me to others as your “caffeinea breath-taking experience). The addicted” PQ writer. As future conference was filled with inspi- pharmacists, we should be more rational speakers, interesting cognisant if we are referring to people to meet, and other party our patients as transgendered experiences that the PQ editors (ex: transgendered patient Marwill not allow me to elaborate on ni in room X as opposed to just further... Marni). However, what they will allow me to elaborate on is what I took away from this conference, particularly Marni Panas’ talk regarding the struggles that members of the LGBTQ community face in the healthcare system. Marni discussed the importance of seeing your patients as a person and to refrain from making assumptions about them and avoid using any preconceived biases to treat them differently. To provide an example, Marni described how a friend with HIV casually mentioned their diagnosis to a physician when it was irrelevant to their chief complaint. The physician slid back in their chair in response, possibly unknowingly, which illustrates how our prior beliefs can negatively impact how we interact with our patients.

In closing, this talk opened my eyes to some of the struggles that Marni and other members of the LGBTQ community have both in their personal life, and within the healthcare system. Marni was very quick to acknowledge that she is fortunate to be part of the “1%” that was able to find individuals that are accepting of her following her transformation. As future health care professionals, it is our responsibility to be treating patients to the best of our capacity regardless of the variable patient factors they present. Hopefully with a commitment to this, we can have more individuals joining Marni as the “1%.

To me, this talk was about how our patients are human beings, and should be treated as such regardless of our view towards members of the LGBTQ community. This means that we should feel comfortable to ask which — Ziqi Wang (Class of 2020) name they prefer to be called (in a similar way one may ask if I prefer to be called Jon or Jonathon), or at the very least, ask — Jonathon Thomson what we can learn about them to (Class of 2019) respect their gender identity and to better treat them as a patient. | 6 |


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We apologize for cutting off some people in the middle of the group photo. See the online version for the complete photo! Thank-you for your understanding.

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Special thanks to our incredible APSA Photographers! Meg De Castro, Eddie Huang, Michael Tiet, Charlotte Yang and Lawrence Woo. | 9 |


Early bird registration (Up until Jan. 31) • $160 for CSHP members • $210 for non-members • After Jan. 31 • $185 for CSHP members • $235 for non-members •

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Registration for the 44

th Annual

Banff Seminar is now open! The Banff Seminar is a three-day conference between the Western branches of the Canadian Society of Hospital Pharmacists held in none other than gorgeous Banff, Alberta. It features a wide range of educational events and networking opportunities for pharmacy professionals and students. This year’s theme is Pharmacy in the Inform@tion Age, with the focus being how pharmacists can make the best use of rapidly advancing technology in their practice. Talks include Sean Spina on “Delivering #Healthcare in the 21st Century” and Dee Mangin speaking about “Conflicting Interests? Commercial Influence and the Medical Professions”. The keynote presentation will be held by none other than the founders of BodyBreak, Hal Johnson and Joanne McLeod who will speak about “Motivating Patients to Keep Fit and Have Fun: The Story Behind BodyBreak”. Also featured is an interactive Jeopardy! session by Adrienne Lindbland and Tina Korownyk about the Tools for Practice program, a biweekly evidence summary. It’s sure to be an interesting weekend with talks by pharmacists who have lots to share about their practice. There will also be many opportunities to relax and get to know your fellow attendees! Early-bird registration is open until January 31st. For CSHP student members the early bird price is $160, and for non-members it’s $210. After January 31st the price for student members is $185, and for nonmembers it’s $235. If you aren’t a member of CSHP, now’s a great time to get involved! The membership runs from January 1st to December 31st, 2018 and is only $65.10. By signing up you qualify for the student member rates and almost break even on the membership, not to mention all the other benefits of a membership such as staying connected and up to date with hospital pharmacy practice. For more information on the Seminar and its events you can visit the official site at www.cshp.ca/banffseminar-2018. If you have any questions please feel free to email me at gursanga@ualberta.ca or the CSHP Chair, Peter at vanherk@ualberta.ca. Hope to see you there! Gursangat Sidhu CSHP Communications Committee Student Representative | 11 |


Revisiting Mr. Pharmacy

On December 2, 2017, the members from the Backstreet Boys class of 2018-2021 preformed in the annual Mr. Pharmacy pageant at the Myer Horowitz Theatre. They captured the audience through dance, music and humour.

We would like to thank everyone involved in planning Mr. Pharmacy for making it a huge success. In support of men’s health, the Mr. Pharmacy campaign fundraised an astonishing $34,000. We can’t wait to see what is in store for next year!

MC DISASTER This year we were taking away by our two wonderful MCs. Both Aman and Megan did a fantastic job! Now, if only Aman stopped whining that he deserved to win Mr. Pharmacy 2016. To Aman we say, “thank-you for playing, but please try again.” And Megan, oh Megan. We will never look at punny jokes the same way again. Ever. Thank-you for that.

Connor White What a performance! *clap* *clap* You made me feel things that I never thought I could feel again. You inspired me to start playing the piano. So far, I learned how to play Mary Had a Little Lamb, but watch out! Someday I will surpass you and when I do, everyone stay tuned for Mr. Pharmacy 2079. | 12 |

Scott Dyer Scott channelled his inner Jimmy Kimmel by creating a talk show, within a show. This seemed like a scene from Inception, so I left the show midway to go buy a fidget spinner. I spun that thing once before throwing it in the trash. Only then I realized that what I was watching was real.


Lawrence Woo I’ve been to a few Mr. Pharmacy events back in my days, but never had I seen someone cook sushi in front of a live audience before. This was unheard of! “Absolutely brilliant and mad”, as guest judge Gordon Ramsay would say. P.S. We would like to thank Lawrence for not burning down the Myer Horowitz Theatre as he torched the salmon.

Teddy Yoo When you go to enough Mr. Pharmacy events, you begin to realize that at some point in the night, things get a bit freaky. In 2017, we thank Mr. Yoo for one of the most entertaining and [insert adjective here] performances of all time. I tried to forget your performance, but that bright red hair still burns strong in my memories.

Carlo Tipan The class of 2019 had a comedic performance by the class keener, Carlo Tipan. Along with his squad Alec Huard and Sean Henry, created a skit on what a typical communications lab is like (it certainly hits close to home). Carlo’s hypnotic dance moves and voice put the audience in awe and touched the hearts of many ladies (and Ethos).

Jordan Turba Jordan’s performance reminded me of the movie “The Karate Kid.” Instead of his mentor being a kung-fu master, Dr. Brocks is a master of guitar playing, moustaches, and pharmacokinetics. An inspiring performance that teaches us the importance of strong teacher-student bonds. | 13 |

Dimitri Kachenyuk Fourth year student and winner of Mr. Pharmacy blew us away with his rapping and dancing. Big “D” had us going all night with his command and mastery of the English language. Santa’s little helpers showcased Dimitri’s dancing talents and his all-natural figure. Big “D” will always have a place in our hearts.

Steven Quan Steven was not afraid to show us that he is Taylor Swift’s number one fan. His pharmacy remix video and T-swift shirt set the bar really high for other hardcore Swifties. Steven’s fantastic performance put teardrops on all our guitars. But behind this gentle contestant was a beast in the basketball court.


Therapeutic Tent Talk Featuring Jonathon Thomson & David Poon

Have you ever been camping in the winter and caught a nasty

cold? We sure haven’t. Whether you’re 500 kms deep in the Boreal forest or partying it up at a PG Christmas party, you are at risk of getting sick. In case you were wondering how exactly to treat the common cough & cold continue reading. DISCALIMER! Although topics discussed will be targeted to pharmacy students of all years, practice to your competence level. This article is not intended to be a replacement for a therapeutics course. The purpose of this article is to supplement knowledge and provide basic background information to the selected therapeutic topic. | 14 |


The etiology of the common cold is typically

caused by the rhinovirus and other respiratory viruses. Hence, antibiotics will not help reduce the duration and severity of a cold. Not all bugs needs drugs! Cough and cold products found over the counter contains drugs that simply reduce the symptoms a patient experiences rather than curing their cold. Goals of therapy Alleviate symptoms, prevent complications of the infection. S - Sore throat (days 1-2); nasal congestion/ discharge (days 3-4); cough (days 4+); headache; malaise, lethargy, fever. C - describe the severity of symptoms and if it is impacting daily activities. Is the cough productive? Is there blood in the cough? H - has this happened in the past? What medication or non-pharmacological remedy was used? Children may have up to 7 colds/year and adults 3 colds/year. O - when did you first experience symptoms? The duration of symptoms may determine if it is the common cold or something else that requires further investigation, such as influenza, asthma, etc. L - which parts of the body is affected? This will determine whether or not the patient should be using a combination product, or something else that is individualized to treat their symptoms. A - what makes the cough & cold worse? Avoid triggers (smoke, dust, mould, pollutants, allergens). R - what makes the cough & cold better? See pharmacological and non-pharmacological options below. Red flags require further investigation and a referral to a physician. High fever (>40.5°C) or a fever (>38.5°C) for over 72 hours, infant <3 months of age with a fever, severe headache, neck pain/stiffness or photophobia, difficulty breathing, presence of respiratory diseases (e.g. asthma or COPD), prolonged nasal congestion (>7 days) with purulent discharge and facial or maxillary pain, presence of cough for > 3 weeks, severe throat pain with difficulty and/or painful swallowing, and signs of dehydration.

gle Tylenol #1 tablet. We do not recommend the use of Tylenol #1 to treat the common cold due to the health risks of opioids. 2. Expectorants, such as guaifenesin act by reducing the viscosity of sputum and promote coughing to clear secretions in the airways. Similar to antitussives, expectorants also lack efficacy. Sufficient hydration and air humidity may be similar to or more efficacious than expectorants. 3. Antihistamines containing anticholinergic properties (first generation only), such as diphenhydramine, chlorpheniramine, doxylamine, triprolidine treat sneezing and rhinorrhea. 4. Nasal decongestants such as phenylephrine, pseudoephedrine, and ephedrine for 3-5 days to avoid rebound vasodilation (rhinitis medicamentosa). Combination products generally contain acetaminophen and one of the above medication classes. Be mindful that the recommended maximum dose of acetaminophen is 4 grams/day, which include all sources of acetaminophen (Tylenol®, Percocet®, etc.). In fact, extra strength formulations of cough and cold products only contain higher amounts of acetaminophen (or expectorant), meaning that these selections might put some individuals at an increased risk for acetaminophen toxicity. However, acetaminophen (along with NSAIDs) have their place in treating cough and cold by alleviating pain from a sore throat or a fever if present. To differentiate between the common cold and flu, visit: https://www.canada.ca/en/public-health/ services/publications/diseases-conditions/is-it-coldor-flu.html Children In 2008, Health Canada issued a report to manufacturers to re-label their products to avoid children under 6 years of age consuming such products. Evidence of effectiveness is lacking in this population as well as reports of children being overdosed that led to hospitalisations and even death. Non-pharmacological Treatments Wash your hands frequently, avoid triggers, bed rest, healthy diet, adequate hydration, flu shot, smoking cessation.

References Pharmacological Treatments 1. Antitussives (cough suppressants) includes dex- 1. Acute Cough CTC from Rxtx tromethorphan and codeine. These products are 2. Heikkinen, T., & Järvinen, A. (2013). The common cold. The Lancet, 361(9351), 51-59. commonly used, however have little efficacy in upper respiratory tract infections. Dextromethorphan is very commonly found in combination products. Codeine is cough suppressant, but in higher doses than what is found in a sin| 15 |


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