SPECIALTY PHARMACIES
PHARMACARE
PRESENTED BY OUR TITLE SPONSOR:
PQ PLUS 2
FEB 2017
IN THIS ISSUE SAMPLE
07-10
PDW 2017, 2018
Get the details from the recent conference in Winnipeg, along with a beautiful photospread of the proceedings. And then a reminder that PDW 2018 will be right here in Edmonton!
COVER Photo credits: Jim Dobie photography
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Shady herbs get shady names.
If you’re basically done with exams, then this is the article for you.
Two new releases go under the microscope.
CAM Corner
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Day in the Life
Summer Routine
Melissa Woo tells us about the post-graduate PharmD.
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Ski Trip 2017
Filistix is on your APSA Discount Card! PQ checked it out.
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Winter in Canada.
You’ve Got to Try This!
Movie Reviews
21
Letter to Editors
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Horoscopes!
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Contest
Editors’ Notes
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Hello, friends, and welcome back! I’m very proud of the issue we put together for February and I hope it’s entertaining for you! Besides the high level of writing, we have the usual assortment of informative and fun articles for you to read while you procrastinate. This time around we had quite an extensive article submitted by one of our colleagues on what might be seen as a controversial topic (Page 21). This
Summer 2016...
Happy New year and welcome back everyone! It’s really good to see all the familiar faces back on campus. I hope everyone had a great break with family and
friends. PQ Plus 2 is back with more exciting and fun articles to read! So make sure to take a look at them when you are taking a study break. I hope this semester is another successful semester for everyone. All the best! - Jasmine Han
is exactly what I would like to see in the magazine - a dialogue going on between PQ and students. - Yusuf Nasihi
CALENDAR February is that month that just seems to appear and then disappear. First you’re just trying to coast it to Reading Week and then, all of a sudden, you’re in your first week of March, with finals exams on your mind.
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Disclaimer: Any opinions or viewpoints published are directly from the contributing authors and do not represent the philosophy or viewpoints of the Faculty of Pharmacy or the University of Alberta.
You can find us on Facebook at PQ PlusTwo or Instagram @pqplustwo
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White coat 2017 SAMPLE
January 19 - The faculty kept you waiting, Huh? CrediT: Jim Dobie Photography
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White Coat Ceremony 2017
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Trade Show
Industry trade show
This is the first time APSA held an event called Industry Trade Show. This event included many pharmaceutical companies who came to introduce and explain some of the existing devices or drugs as well as devices or drugs that are new to the market. This year, we had Pfizer, medela, MERCK, BD, Jamieson, Trudell Medical International, SANOFI, ASCENTISIA, Xenex labs, and McKesson showcase their products. This event was definitely a success for both Mike Song and Jerry Zhang who worked really hard to make this event a reality along with many volunteers who helped this event be possible. In this section, we would like to feature comments from Publication Committee members who participated at the Industry Trade Show. - Jasmine Han, Editor Jasmine Han, 2nd year I really enjoyed the event because it was interactive and informative all together. I think I have never learned so many devices in details but in a manner that is very easy to understand. Even though there were many areas that we haven’t covered yet in class, I was able to follow them. I would definitely go again if the event is held again. 10/10. Danial Khan, 1st Year The event provided a fun exploration into the pharmaceutical industry. The diversity of companies present was a definite highlight of the event, as no two presentations were alike. As our scope expands, this knowledge will become invaluable in our pursuit to meet the increasingly diverse demands of our patients. I am looking forward to the event next year! 11/10 Winnie Lo, 3rd year Attending this event in third year was incredibly rewarding - I knew enough of the medications and conditions discussed that I could see how much the field has
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progressed since we had taken the course. The speakers were concise, informative, and passionate - the free samples were only icing on the cake! I would definitely students to attend next year. Yusuf Nasihi, 2nd year I enjoyed the Industry Trade Show so much that I regret not volunteering to help Mike and Jerry run the event! It was a fun afternoon during which 10-15 minutes meant learning a lot.
Lastly, I have to congratulate Mike and Jerry for the result of their efforts: an innovative and and valuable event that I can only hope becomes a fixture for APSA in the future, like Mr Pharmacy and Blue and Gold.
Often the public view salespeople as insincere, but pharmacists must be able to understand their points of view and gather the most relevant knowledge as possible from them. In particular, I enjoyed the multiple diabetes equipment presentations and I can say I learned a lot from these manufacturers. Even after having dealt with diabetes supplies before, I admit I was not familiar with the needles that patients actually use for subcutaneous insulin injections.
And there was lots of food! Sherry Zhu and Anthony Chan.
PDW 2017
PDW 2017 - To Winnipeg and Back By Lynnea Schultz Professional Development Week (PDW) is a conference hosted by Canadian Association of Pharmacist Students and Interns (CAPSI) every year in January. This year it was hosted from January 4 – 7 by the University of Manitoba in Winnipeg. The theme was “Beyond Boundaries”, demonstrating the expanding scope of practice of pharmacists and the great potential we have from here. PDW was a wonderful way to network with people from pharmacy programs at other universities and a great way to start 2017. It was a week filled with amazing people, inspiring speakers, delicious food, and classy, welldecorated events. The conference gave me the opportunity to connect with just under 400 pharmacy students from the 10 pharmacy schools all across Canada, as well as solidify connections with the 73 other people who attended the conference from U of A. PDW consisted of a variety of speakers during the day, and fun events in the evenings. The very first speaker of the conference was Bruce Kirkby, a motivational speaker. He spoke about his crazy
adventures – including crossing a desert on a camel and spending months with his family living in an isolated Buddist community – and gave out inspiring life advice. The keynote speaker of the conference was Deri Latimer. Her story of her struggles in her life tied together with her advice to reimagine events to our benefit were emotional and impactful. Needless to say, she made myself and several of my friends cry. She also read a letter that she wrote from herself in the future to the audience in the future. One of the sentences that was really influential was: “it’s not the grades you got in school, but the people you worked with to get them; it’s not the material possessions you acquired when you started working, it’s the small moments sharing a laugh with a friend or helping someone in need that add the most to your life”. Other speakers spoke about various topics in the world of pharmacy – including veterinary medicine (the speaker brought a dog and a cat!!!), innovative practices, and how to stand out above the rest as an exceptional
pharmacist. In addition to the speakers, there was a Wellness workshop, a CPhA workshop, several CAPSI meetings, and a Health Fair where they gave out tons of cool free stuff! The events at PDW were beautifully decorated and extremely well-done. Lots of wine was consumed and lots of mingling and dancing followed. The Folklarama show on opening night was amazing and it was nice to have a taste of the annual event that happens in Winnipeg in the summer. Canada’s Next Top Pharmacist extremely entertaining and it was awesome to be able to cheer our U of A Mr. Pharmacy, Preston Eshenko, as he sang and danced his way across the stage. Everyone looked so darn good in their formal wear at the closing gala, where there was a 4 course meal, a few speeches, and a lot of dancing. Next year, PDW will be in EDMONTON!!!!! Based on my experience at PDW this year, I strongly encourage everyone to take the opportunity and attend PDW 2018.
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PDW 2017
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PDW 2017
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Now that Professional Development Week (PDW) in Winnipeg is over, the countdown to PDW 2018 in Edmonton begins! Each pharmacy school is given the honor of hosting this four day student conference in their city once every 10 years. We are proud to welcome students from all across the country from January 10th to 13th, 2018 to participate in the 30th annual edition of PDW. PDW 2018 will be held at the Shaw Conference Centre and delegates will be staying at the 4-star Westin Hotel for the duration of the conference. The theme of the conference is "Fueling our Future,” highlighting our goal to empower students as future pharmacists to become leaders in revolutionizing the future of healthcare in Canada. The conference will kick off with a Tropical Soiree themed opening gala, with a special nod to CAPSI’s 50th anniversary, and will close with a Northern Lights themed ball. Throughout the conference, students will be able to check out innovative speaker sessions and panel discussions highlighting all aspects of pharmacy, achieving learning in an environment completely different from the classroom. Students participating in CAPSI compounding, OTC and PIC competitions will have the chance to rank as best in the country. There will also be opportunity for students to network with their future colleagues as well as industry representatives and sponsors at the annual Health Fair, where there is guaranteed to be LOTS of free swag! Several social events also are planned to give students a chance to mix and mingle with students from other schools; these events include the national Canada’s Next Top Pharmacist competition, as well as an event at Knoxville’s Tavern and a skate night. For more information, please visit our website at www.pdw2018.ca and follow us on social media (@PDW2018) for exclusive sneak peeks about everything PDW 2018-related! -Anuvir Bhullar, Diva Niaz PDW 2018 Co-chairs-
Photo courtesy of [Anuvir Bhullar]
CAM Corner
Strange names for strange medicine! By Yusuf Nasihi PQ explored the Natural Medicines Comprehensive Database (NMCD) in order to find the most outrageous names in use for alternative health products. Our modern understanding of what science is originates from a common form of communication among scientists. Sometime during the Enlightenment, several systems of notation were abandoned for new systems which we rely on to this very day – the Periodic Table and the metric system are prominent examples. And so, general curiosity among enthusiasts became focused research, and detailed systems like binomial nomenclature were established. This does not mean, however, that we’ve progressed to the point where everyone now refers to things using the same names. Our globalized world gives us access to foreign products as well as foreign names for things that we were already familiar with. For example, while the binomial system of naming organisms is very successful at categorizing life on Earth, getting everyone to refer to the horse chestnut as Aesculus hippocastanum would be a tall order. While reading these descriptions, please keep in mind this is a general introduction for information purposes only. We
have consulted only one source, Natural Medicines Comprehensive Database. Therefore, this article is not a judgement of whether these natural products are appropriate or inappropriate for any patient. In this article, we explore three plants which have very strange names and see what they are used for in complimentary and alternative medicine. American skullcap (Scutellaria lateriflora) If you’re not quite convinced this plant name is bizarre enough to make it onto this list, some of the alternative names should convince you: mad-dog skullcap, hoodwort, and grande toque. The Natural Medicines Comprehensive Database is also quick to warn us not to confuse the American Skullcap with the Baikal Skullcap, which is a different species! The above-ground parts of the plant are used to make a tea. The conditions that some claim the American skullcap can treat include insomnia, epilepsy, anxiety, hyperlipidemia, cholera, and rabies. There is only evidence for American skullcap’s anxiolytic activity, which is explained by the plant’s flavonoid content. One or more of the five flavonoids, of which baicalin and wogonin are the “principle flavonoids”, are thought to bind to GABA receptors and serotonin receptor 5-HT7. It could be through these receptors that medicinal use of the skullcap has anti-
anxiety effects and sedative effects, respectively. That being said, the NMCD lists American skullcap’s clinical efficacy as having “Insufficient[ly] Reliable Evidence to Rate” with regards to anxiety. This is because there are no available long-term studies of use specifically by those diagnosed with anxiety disorders. Perhaps even more worrying than the direct physiological effects of the medication, which could vary based on the user’s technique in extracting medicinal content from the plant, are possible interactions with patients’ other medications. As expected, based on animal studies, medication with CNS depressant activity taken along with American skullcap would exert an increased effect on the patient. Seeing as how benzodiazepines, for example, are prone to abuse and addiciton, this is something to keep in mind if American skullcap comes up. As for adverse reactions, NMCD says that high doses of American skullcap can cause seizure, twitching of limbs, and confusion, while 100 mg of the extract “does not seem to affect cognition or cause significant sedation.” Products licenced for sale in Canada either have multiple medicinal iingredients or contain only the skullcap extract. And I should also go ahead and dispel the claim that American skullcap has any efficacy treating rabies. If someone has been bitten by a rabid dog, only immediate medical intervention can save them.
PHARMACY QUARTERLY 11 American skullcap. Image used by attribution license from Flickr user mikeumo
CAM Corner Butcher’s broom (Ruscus aculeatus) Natural Medicines Comprehensive Database lists a number of reasons why people take butcher’s broom. But more importantly, butcher’s broom actually gets a “Possibly Effective” grade with regards to treating chronic venous insufficiency. Included as evidence are double-blind, randomized, placebocontrolled trials where subjects had significant improvement in CVI symptoms, such as swelling, itching, and cramping of the legs. The rhizomes, which are the underground portion of the stem, and roots have been shown to contain flavonoids as well as molecules called saponins. Saponins, which have a steroid backbone, activate alpha-adrenergic receptors, leading to noradrenaline release and vasoconstriction. There is also evidence that flavonoids themselves improve CVI symptoms by reducing capillary permeation. Now is a good time to mention that several of the studies mentioned earlier were in fact publications on the efficacy of Cyclo 3 Fort, a common product in Europe which contains root extract of butcher’s broom (150 mg), a flavonoid called hesperidin (150 mg), and ascorbic acid (100 mg). NMCD
does not list any licenced product in Canada which has the same composition as Cyclo 3 Fort. Drug-drug and drug-food interactions are, as always, constant concerns for pharmacists. NMCD mentions “anecdotal evidence” stating that, predictably, butcher’s broom can increase or decrease overall alpha-adrenergic receptor activity when used alongside an alpha-adrenergic receptor agonist or antagonist, respectively. As for the name, PQ found out that Ruscus aculeatus earned this peculiar appellation from the use of the plant’s twigs by butchers to clean cutting boards. Saving the best for last If you received a call at the pharmacy from someone asking about a medicine called “horny goat weed” you might just hang up because it’s clearly a prank. As an assistant, though, you should put the line on hold so your pharmacist can at least attemp to answer such a question. But before you leave it to the pharmacist, you ask the staff around you who are entering and packaging prescriptions: “has anyone heard of horny goat weed?” You only get laughter in response! So you decide to get more information from the
Butcher’s broom. You can see how its twigs might be used for scraping. Image used by attribution license from Flickr user sunshinecity.
patient and he responds, “It’s a natural Cialis. I thought a pharmacist would know about it!” Now your scientific instinct kicks in and you want to figure out exactly what you’re dealing with. Wouldn’t a Cialis in plant form be very lucrative!? The Natural Medicines Comprehensive Database says that “horny goat weed” generally refers to a single species, Epimedium grandiflora, also known as Japanese epimedium. On the other hand, the Chinese name “yin yang huo” is used to refer to fifteen different species in the Berberidaceae family. Now we’ve got more questions than answers. But don’t rule out such a scenario playing out in your pharmacy someday! In fact, one of our colleagues from the Class of 2019 told me this story. Rest assured that this is a real plant and, although the name is surprising, the claimed health effects are even more surprising. Introducing horny goat weed (Epimedium grandiflora) Manufacturers have developed techniques to specifically extract estrogens from the leaves of the plant, which also contain flavonoids and glycosides. Not known to spend money on dead-ends, researchers have done some animal studies which have found some therapeutic effects with respect to erectile dysfunction, hypertension, osteoporosis, and even HIV. Animal testing shows the glycosides of horny goat weed might provide hormones, with some evidence for increased secretion of testosterone, as well as growth of the prostate and testes. Now we can tell the name is unusually descriptive of its properties. As for erectile dysfunction in particular, horny goat weed has a phytoestrogen called icariin which inhibits phosphodiesterase-5 (PDE5) and increases the amount of cGMP in cavernous smooth
“Insufficient Reliable Evidence References: muscle cells. This is nearly word1. Therapeutic Research Faculty. to Rate.” One osteoporosis for-word identical to the sildenafil Skullcap. Available from: study involved patients taking a mechanism described on RxTx. One http://naturaldatabase. phytoestrogen-specific extract of study, by Ning et al. (2006), however, therapeuticresearch.com. [Accessed 31 horny goat weed orally with 300 ultimately concluded that horny July 2016]. mg calcium over 24 months. The goat weed cannot replace sildenafil, 2. Therapeutic Research Faculty. result was what is described as a vardenafil, or tadalafil as first-line Butcher’s Broom. Available from: mild decrease in spinal bone loss therapies. But that didn’t stop http://naturaldatabase. compared to placebo. The proposed people in China from using horny therapeuticresearch.com. [Accessed 31 goat weed for hundreds of years for mechanism is as follows: Horny July 2016]. the same purpose! goat weed contains icariin, which 3. Therapeutic Research Faculty. Although many health care upregulates bone morphogenic Horny Goat Weed. Available from: professionals would approach protein-2, which stimulates http://naturaldatabase. someone who is self-treating osteoblasts. therapeuticresearch.com. [Accessed 31 with natural health products with As for post-menopausal July 2016]. concern, the main issue is not that conditions, NMCD mentions a study 4. CPS [Internet]. Ottawa (ON): natural health products have no in which patients took a horny Canadian Pharmacists Association; medicinal worth. Our problem is goat weed water extract QD for six c2015 [updated 2015 MAY 26; cited 2016 months. In comparison to placebo, that a great many natural health JUL 30]. Viagra [product monograph]. patients’ triglyceride and cholesterol products contain multiple medicinal Available from: http://www.elevels slightly decreased and ingredients in non-standard therapeutics.ca. Also available in paper estradiol levels increased. amounts, often above or below the copy from the publisher. Overall, we can see horny therapeutic window, with variation 5. Ning, H; Xin, ZC; Lin, G; goat weed, with its multiple ‘folk between different packages of et al. (2006). “Effects of icariin on indications’ is a troublesome plant. the same product. This brings up phosphodiesterase-5 activity in vitro But it is for this same reason questions not only of efficacy but and cyclic guanosine monophosphate that it can be so appealing to the more crucially, of safety. level in cavernous smooth muscle cells.”. community. Horny goat weed is not an Urology. 68 (6): 1350–4. Regardless of its name, exception to these concerns as horny goat weed is one CAM prolonged QT interval and sudden product that should catch your cardiac death have been reported in attention even if someone only so some users of products labelled as much as mentions it. containing horny goat weed. These products contained ingredients in addition to horny goat weed. So it is unclear if horny goat weed itself is what caused some to experience these conditions. It is nonetheless hard for any health care professional to recommend such a product. The NMCD mentions that the phytoestrogen-specific extract of horny goat weed has been used for up to 24 months with no issues. But users of other formulations have experienced dizziness, thirst, nosebleeds, and vomiting. The NMCD warns that large doses can cause respiratory arrest and spasm. NMCD lists results from human studies for only osteoporosis and Horny goat weed. postmenopausal conditions and Image used by attribution license from Flickr user rates these results as having Leonora (Ellie) Enking. The upper right image is from Flickr user Nicole Lee PHARMACY QUARTERLY 13 and is used through attribution license.
A Day in the Life of a PharmD Student Melissa Woo
Photo courtesy of [Melissa Woo]
Melissa is a pharmacist who currently works at an independent pharmacy and facilitates practice labs at the University of Alberta. She graduated from the Faculty of Pharmacy and Pharmaceutical Sciences at the University of Alberta in 2015. Soon after graduating, she enrolled herself in full-time PharmD Program at the University of Alberta where she recently graduated in 2016. In the following pages, she will be talking about what PharmD Program is like at the university of Alberta, her experience, and the benefits she had from being enrolled in the program. So, if this interests you, keep reading! -Jasmine Han, EditorWhat would students expect when they become PharmD students? How is it different from being a pharmacy student? The following is based on my experiences in the full-time program. It may be different from the bridging program and the entry-level PharmD program. You will get to know your class of about 20 students very well, so it's essential to pull your weight for group work. You will also get to know your professors well, and even on a first name basis. Instead of a hierarchical education system where your professor stands in front of the class and lectures to you, PharmD courses use a flipped classroom model. If you want to do well in the program, make sure you participate in class discussions because you get graded on speaking up. Your weekends will be non-existent, since learning objectives for Pharm 503 (Dr. Jill Hall's class) are due Sunday mornings. Enjoy your weekend on Monday and Tuesday nights instead. Compared to pharmacy school, I found the PharmD program to be very busy, stressful, and I have never studied so hard in my life! There was a huge focus on self-directed learning, class participation, and learning how to collaborate with each other. For placements, you will most likely get your first or second choices. Since you will be practicing as a full-fledged pharmacist on placements, your preceptors will expect a lot more from you. They want to see your strong patient care process, decision making skills, and critical thinking skills.
Why would you pursue the PharmD program? How will this affect your future practice? If you are motivated to challenge yourself and practice pharmacy to the full scope of practice, this program will advance your education and provide insight and exposure to what the pharmacy profession can offer. Through this extra year of clinical training, I find that I have provided higher quality services to my patients by learning and becoming familiar with evidence-based clinical practices. This allowed me to offer the most effective and appropriate medication therapy. In addition, I have gained very valuable experiences from various placements which enhanced the following clinical skills: Critical thinking and problem solving skills Effective and efficient communication and collaboration within interdisciplinary teams. This program has also allowed me to hone my presentation skills, and to conduct a research project for my very first time! As a pharmacist, I have learned and grown tremendously from the PharmD Program, and I believe my peers would agree as well. Just as I have found it to be very rewarding and beneficial, I believe that the program will prepare you to be a more experienced, confident, competent, and capable pharmacist in any practice setting, whether you become a community/ambulatory/hospital pharmacist, professor, or take on a leadership position, etc. Remember: what you put into the program is what you’ll get out of it. If you have any questions, please email me at woo2@ualberta.ca. Thanks! Melissa Woo, BScPharm, PharmD
Photo courtesy of [Melissa Woo]
SKIING
By Lynnea Schultz
2017 SKI TRIP to BANFF! By Lynnea Schultz Thanks to 3rd Year Social Representative Kayla Stegmeier, 42 pharmacy students trekked to Banff on January 14 for this year’s ski trip! The ski trip was organized through Backside Tours, who provided transportation, organized hotel rooms, and handed out lift tickets for the ski hills ahead of time. Along with all the pharmacy students, there were 2 tour guides from Backside Tours who kept everyone in line and organized our ski days, and an amazing bus driver who got us there and back safe and sound. Day 1 – Friday, January 13 Yay for a fun bus ride with fellow pharmacy classmates and friends! Boo for the unlicensed bus. The pharmacy kids were pretty tame on the 4-hour bus ride to Banff, playing innocent group games and passing the time by chatting and
telling secrets. A stop in Calgary for food was much needed for many people. But before we knew it, we were back in our comfy, cramped seats on the bus on our way to Banff! We arrived in Banff around 9:30 pm, where we settled into our hotel rooms. After settling in, some people went straight to sleep like the angels they are, while others enjoyed socializing for a while before bed. Day 2 – Saturday The pharm crew set off on the bus at 9 am (which was difficult for some) to Lake Louise Ski Resort! After a quiet 45-minute drive from the hotel to the ski hill, we piled off the bus and prepared ourselves for a day on the slopes! Students of all skill levels conquered the mountain – from
those who just learned to ski to those who think black diamonds are too easy. The weather was sunny and a perfect temperature to ski/ snowboard in. The views were amazing and the snow was pretty decent. After a long, hard day of skiing or snowboarding, a couple of wipe-outs, and maybe a beer in the chalet, the students loaded the bus and we made our way back to the hotel. We dispersed into our hotel rooms, but eventually came back together for some drinks, dancing and socializing at the ionic club in Banff – the Dancing Sasquatch. Pharmacy students know how to party, and the Backside tour guides were even rowdier than the rest of us!
SKI TRIP Day 3 – Sunday Many students were awake bright and early for another day on the slopes, this time at Sunshine Village just outside of Banff. Other students decided that one day of skiing was enough for them, and that waking up early after a night at the Dancing Sasquatch would be too difficult. While some were enjoying the nice views of the mountain as they skied and snowboarded, others were exploring Banff or sitting in coffee shops because it was too cold to actually explore Banff. All students converged at the bus mid-afternoon, prepared for the long journey home. We were lucky to leave with just mild hangovers, some great memories, and no broken bones. The bus ride was significantly quieter than it was on the way to Banff, as most people figured it was prime time to sleep. The Backside tour guides managed to get the DVD player working, so a few movies were shown for those that weren’t napping. After a quick stop in Calgary, and a few hours on the road, we finally arrived back at the good ol’ University of Alberta.
Clip art credit: http://clipart-library.com
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YOU’VE GOT TO TRY THIS BY WINNIE LO
Ahhhh… Filistix – for those days when you can’t muster up the energy to pack your own lunch and you need something that is filling, healthy, and delicious all at the same time. Can’t decide what to get? The PQ team has got your back In You’ve Got to Try This: Campus Edition.
Winnie – post promotion and still talking about food! For me, Filistix is one of those secret guilty indulgences where I “forget” to bring lunch and then want to eat something a little more substantial and flavourful than what I get in the Tim Hortons line. Not only is the chicken a mouthful of savoury deliciousness, but the slaw is a hearty bite of crunchy and healthy vegetables – enough to soothe away the sting of this carb-filled bowl. Fav bowl: “The Classic” Chicken Adobo Alternative? If you’ve already had Filistix three days in a row (and REALLY can’t do a fourth), the Jamaican Beef Patties ($2.99!) in the Education cafeteria are pretty hot. Literally.
Some additional pointers: § You can add some chili oil that they have on the side if you like some extra spiciness to your bowl § They have lid covers for the bowls so that you can save it for later if you don’t have time to finish your lunch or if you are economical like myself and buy a full sized and save half it for dinner order § They have stamp cards and if you buy five bowls (of full or half orders), then you get the sixth one free! § There is also a Filistix location in the Central Academic Building, but from my experiences they don’t give you as much food and they don’t sprinkle the green onions on top, so you’ll want to stick with the ECHA location
Special Guest: Sherry – self-proclaimed Filistix connoisseur I have had so much Filistix since entering Pharmacy because not only is it absolutely delicious, but you actually get a decent amount of food for the cost. Now with the APSA discount card giving 15% off, it gives yet another excuse to get this filling and nutritionally balanced meal. Now for those of you who haven’t had it before, I’ll start off with the composition of a typical Filistix bowl:
Firstly, there is the delicious white jasmine rice on the bottom which is essential for soaking up their delicious sauces that I will talk about later! There is also their classic cold slaw comprised of cabbage seasoned with a sweet, sesame-like sauce topped off with dried cranberries to add an extra bit of sweetness. Following that is their perfectly cooked chicken thighs with crispy skin that gets its flavor from a classic seasoning mix that they sprinkle onto it. Then of course we have their delicious sauces and it is actually strangely satisfying to watch them pour the sauce onto the bowl. The two most common sauces are the “Classic” sauce which is soy sauce based and the “South Pacific” which is a creamy coconut curry sauce. Lastly to top everything off, they’ll sprinkle some green onions to give it a pop of green color and that completes the bowl! So now you know the basics of a Filistix bowl, I’ll talk about their specials that they have each week. Sometimes, it can just be a new flavor of sauce like butter chicken or a teriyaki chicken (which by the way is the absolute best flavor out of all of them but sadly I have only seen once L or sometimes it will be a completely different meat instead of chicken, like braised pork belly or ground pork.
Pro tip: always get the full order – you can split it with a friend or save half and bring it again for lunch the next day! Alternatively, treat your stomach and finish the whole thing (which I can admit is my usual modus operandi).
OK, where can I get some of this? ECHA South, 2ND Floor Engrained Café 10 AM – 3 PM CAB, Lower Level CAB Café 10 AM – 3 PM
PHOTO CREDITS: SHERRY ZHU
MOVIES
SHKRELI
PQ Movie corner Moana Review by Morena Medina In the past few years, Disney has had this recent surge of imaginative, empowering movies, continuing the tradition of the movies we have grown up with such as The Lion King, Aladdin and so forth. However, I’d have to say that the newest addition to the Disney roster, Moana, far exceeded my expectations in a surprising way. On the fictional Polynesian island of Motonui, Moana is primed to be the next chief of her tribe as per her father’s wishes. However, being a descendant of Polynesian voyageurs, she longs to explore the sea beyond the barrier reef. Once the livelihood of her people is threatened, Moana is chosen by the sea itself to restore the Heart of Te Fiti, a stone that gives life, back to its rightful owner, with the shape-shifting demigod Maui in tow. Moana masterfully marks itself as one of the most beautiful Disney movies to date. Keeping in line with the tropical paradise theme, the bright, lush colours of the scenery brings to mind some of those Instagram pictures on the travel accounts I follow. Even when Moana and Maui are surround by nothing by sea, the star-studded night sky itself makes you long to be stranded in the middle of the ocean as well. As for the characters themselves, Moana gives some strong Lilo & Stitch vibes as her design rejects the traditional lithe, tiny-waisted princess appearance for a more beautifully robust look. Maui, being a demi-god, has tattoos that detail the events of his life and also comically serves as his conscience at times.
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To be honest, the songs themselves are weren’t very much memorable, but a couple stand out as being thematic without being too overbearing (keep in mind, I never actually watched Frozen but somehow still managed to learn all the words to Let it Go). Overall, I think Moana does a great job of demonstrating the value of honouring the past, while still looking towards the future, in the typical Disney style. A must-see for all Disney lovers, and if you’re embarrassed of going to watch it by yourself, borrow your kid cousin for the evening. It’s worth it.
Moonlight Review by Danial Khan Moonlight follows Chiron, an African-American man, through youth, adolescence and adulthood. The film explores themes of intimacy, family and belonging in present day Miami. Each scene invites the audience to realize the dissidence in various aspects of Chiron’s life complex life, which includes his struggle with self-worth and identity, culminating in the incredible transition the character undergoes by the end of the film. Even in moments of absolute silence, Moonlight has something poignant to say. Amazing supporting performances from Naomi Harris (Skyfall), singer-songwriter Janelle Monáe and Oscar favorite Mahershala Ali elevate this powerful film.
Clip art: ClipArtFest.com and Dreamatico.com ; Moana is the property of Disney. Moonlight is the property of A24.
Question to Editors
An anonymous perspective on the future of pharmacy “Are pharmacists really that important in the medical care of a patient?” Hint: We are not important at all. And it hurts to say that. Why did we spend the better part of a decade earning a license that is spat upon and stepped upon? Pilots risk peoples’ lives if not regulated, but pharmacists aren’t important enough to spend resources on. Yes, pharmacist mistakes cost lives. The child who overdosed on Risperidone. The mix up between Accutane and Accupril, the drug interaction between mercaptopurine and allopurinol. However the sheer statistics of actual mistakes… are hidden. It looks like despite the fact that pharmacists are working 12 – 14 hour shifts the rate of error is …. unknown. For the sake of argument let’s say there was a 50% rate of error, which is absolutely unacceptable, and changes will be made. Essentially you’re paying someone to be an overpriced proof reader. Plain and simple. If a robot with a pharmacy degree and license just followed the physician orders to the letter they will never be wrong. Many, many pharmacists have practiced like this for their entire careers, and had no clue that aspirin takes away the protective properties of a coxib, or that long term PPIs are bad. Above image is from YouTube user CGPGrey.
They just follow the orders mindlessly. If pharmacists were, today, to be replaced by ScriptPro filling machines, e-prescribing, and online electronic mail order companies… would there be a difference? No. There wouldn’t be. “What if the physician makes a therapeutic mistake?” The machine will respond: “error cannot fill. Please verfiy” – just like a pharmacist generally would. “But a machine cannot recommend alternatives like a real pharmacist can!” Many physicians will ignore a pharmacist, or the pharmacist doesn’t bother sending a recommendation, or the physician isn’t smart enough to understand what the pharmacist recommends, or doesn’t trust the pharmacist, or the pharmacist doesn’t know enough about the drug/ condition/ patient to recommend anything at all. Let’s ask the real questions, pharmacist to pharmacist. What can we do that is absolutely necessary that no other profession can do? Medication management – no: “Pharmacists are at the mercy of the prescribing doctor. Send the most talented, smartest, PharmD up to the middle of nowhere with a doctor that graduated in 1930 and see how far you would get in providing evidence based medicine” Dispensing – maybe: Legally
only pharmacists can dispense. But if for some reason that legal right is taken away from us…. then we are in a world of hurt. It is the only privilege we have left and other industries would love to rip it from us. Doctors love dispensing. I’ve had patients who see their physician every month because their doctor will give them a month supply of physician samples of expensive drug. They will never get it from the pharmacy anymore. Inhalers? Come every month! Expensive Blood Thinner? Every month! Pain meds? Every month! It’s frustrating to see physicians undermining pharmacists by essentially doing backdoor dispensing and actually talk trash about pharmacists like, “don’t go to the pharmacy because they will overcharge you. Come every month and you can get this free while the government pays for the clinic visit.” Machines can theoretically replace us. And no amount of ethics will help. We have to provide a singular service that is totally irreplaceable. The problem is that with technology and Google, our information is essentially obsolete. The smartest 10% of pharmacists in this country can’t hold a candle to Google and anti vaxxers who get their info from the world wide web. If we don’t change, the world won’t need us anymore. Turn the page for a response...
PHARMACY QUARTERLY 21
Editor’s Response Definition of Luddite 1. A member of any of the bands of English workers who destroyed machinery, especially in cotton and woollen mills, which they believed was threatening their jobs (1811–16). 2. derogatory A person opposed to increased industrialization or new technology: ‘a small-minded Luddite resisting progress’ Source: https://en.oxforddictionaries.com/ definition/luddite
Editor’s Response Thanks for your message, anonymous. I have often thought about what automation will do to society and predictions for the 21st century fascinate me. I would like to start off with discussing this part of your essay: the pharmacist’s working conditions. The fact that some pharmacist have to work 12-hour shifts with no breaks means there is already something wrong with the business. Clearly, more automation would actually help pharmacists then. As is usually argued, automation would let a pharmacist do other things with his or her time, like counsel or accept prescriptions. Indeed, it is my opinion that prescription intake might best be handled by a pharmacist. The drop-off of a prescription is not a trivial part of the process. You implied that pharmacists used to be expected to simply dispense what was written on the prescription. Perhaps that was true in the past. Today, a pharmacist has the legal obligation to determine if a medication is appropriate for the patient and so acts as a verifier of the prescriber’s
22 PHARMACY QUARTERLY
assessment. Although some patients and their prescriptions might be ok to be dispensed by even a lay dispenser, you and I both know how complicated certain patients can be. We all know an elderly patient who is taking nine medications and could probably do without at least two of them. As for availability of work for pharmacists in an era of automation, I have to say this: we are, at the end of the day, intellectuals. If an AI that can match clinical decision making were to be developed, the availability of work for pharmacists will be the least of our concerns. That may seem like a strawman argument or ‘changing the goalposts,’ but we should keep in mind that policymakers around the world are at this very moment trying to come up with ideas for organizing society once a significant portion of the population cannot compete with technology. They have serious concerns about how human beings will exist in a world where they can’t work. Meanwhile all the automated services will depend on use by those same human beings.
Prominent YouTuber CGPGrey perhaps said it best when he compared 21st century automation to the impact of the automobile in the 20th century (see ‘Humans Need Not Apply’). CGPGrey basically said that the invention of the car did not give horses the opportunity to move on to better jobs. They became irrelevant. in the 21st century, will the unemployed masses move on to the so-called ‘creative jobs’ that robots can’t do? Perhaps what we should ask is ‘will pharmacists be affected before or after other occupations?’ When automation moves in, will there be a window of time before AI is able to handle the entire role of a pharmacist? Perhaps many pharmacists will move on to research while a select few continue to control the mechanized pharmacies. - Yusuf Nasihi, Co-editor P.S. The luddite definition above is not directed towards you. Judging from my written response I do not think you would get this idea anyway. I only wanted to emphasize that this is an old problem.
Image Credit: https://ferrebeekeeper.wordpress.com/tag/luddite/
BY DANIAL KHAN Love is in the air! Don’t worry about falling head over heels in love or a special someone taking your breath away... if you break something or go into cardiac arrest, luckily we go to school right by a hospital.
Carrie Fischer was a lifelong advocate for mental health issues as she suffered from bipolar disorder. After her death, her ashes were placed in an urn resembling a Prozac pill.
Keep those googly eyes off the cute classmate who sits near the front of class and on the APSA Facebook page, where important info is posted regularly!
Don’t know where to take your special someone on Valentine’s day? Look on the back of your APSA membership card for great (and economical) places to go eat! Smart and Sexy!
Alone on Valentine’s Day? Who cares! Spend some time loving the most important person to your life… yourself! Spa day for one!
There is no such thing as a “love potion” folks. Consent in important.
This month, you will meet the person of your dreams. He or she will be funny, smart… but… uh oh… you just saw him/her take food from a “Lunch and Learn” and leave L
Try something new this year. Draw anatomically correct hearts on all your Valentine’s Day cards. I want to see detail on those right atriums.
Roses are red, Viagra is blue, Those pills help you get started, Not that I personally knew…
“You are very special You're special too Everyone is special This I know is true When I look at you…”
The Taj Mahal was built by a king for his dead wife. Think about that as you’re picking out a dinky box of chocolates and lifeless card to give to your supposed love.
Pharma Pick-up Line: “Baby, do you come with a Standard Operating Procedure? ‘Cause I want a procedurally consistent approach to turning you on.”
VALENTINE SCRAMBLE CONTEST
Need some pharmacy advice to woo that cute classmate in the dispensary? Don’t worry we have you cov – or maybe not? Looks like all of our medications are mixed up! Can you unscramble the following medication names that could give you a boost in your love life? Maybe some of these (modified) song lyrics will help you
LOANPOPOLRR But since we touched, I just know that my heart’s beating faster
TACNLIOFEUS PLEASE DO NOT WRITE DIRECTLY ON THE PQ
And you~~~ leave me breathless
EADILIFLSN Try to tell you yes, but my body keeps telling you no
CIVLORAYC No don’t you kiss me, no, no, not with those lips
LAIRPETOAMCS When she says no…
Submit your answers for all the medication names by private messaging us on Facebook before: Tuesday, February 14th at MIDNIGHT The first person to get all 5 words correct will win a Tim Horton’s gift card to take that special person out on a first coffee date!
PLEASE DO NOT WRITE DIRECTLY ON THE PQ
figure out what they are…