NEW JERSEY SOCIETY OF HEALTH-SYSTEM PHARMACISTS

2012

ANNUAL MEETING/EXHIBITION & INSTALLATION DINNER

FRIDAY, APRIL 20, 2012

HILTON EAST BRUNSWICK 3 TOWER CENTER BLVD. EAST BRUNSWICK, NEW JERSEY (732) 828-2000

PLEASE MARK YOUR CALENDAR!

North Chapter

September 21, 2011
Topic: Examining The Options For Insulin Delivery
Location: Valley Regency
1129 Valley Road
Clifton, NJ
Time: 5:30 pm – 8:15 pm
Speaker: Damian Peters, PharmD, Certified Consultant Pharmacist
Graduate of Rutgers University College of Pharmacy
RSVP: http://www.mycecenter.com
1. Click on the orange colored Registration button that says: "Click Here To Register For CE Programs"
2. Click on the Register link for the program you wish to attend
3. Please make sure you are selecting the correct program

November 18, 2011
Topic: Medication Safety Symposium
Location: St. Joseph's Wayne Hospital, Meyer Conference Room
224 Hamburg Turnpike
Wayne, NJ
Time: TBA
Speakers: Several Presenters on the Program

Central Chapter

September 20, 2011
Topic: Medical Marijuana: Legitimate Medicine or “Reefer Madness”?
Location: CentraState Medical Center
901 West Main Street
Freehold, NJ
Time: TBA
Speaker: Timothy Reilly, PharmD, BCPS, FASCP
Clinical Pharmacist
University Medical Center at Princeton
Princeton, NJ
Clinical Assistant Professor
Ernest Mario School of Pharmacy
Rutgers, The State University of New Jersey
Piscataway, NJ

Southern Chapter

September 27, 2011
Topic: Drug Diversion in Hospital Pharmacy: What you need to know!
Location: Cooper University Hospital
3 Cooper Plaza (suite 400-401)
Camden, NJ
Time: 5:00pm-8:00pm
Speakers: Angelo J. Cifaldi, RPh., Esq.
Partner Wilentz, Goldman & Spitzer
Woodbridge, NJ
Adjunct Associate Professor of Pharmacy Law
Ernest Mario School of Pharmacy
Rutgers, The State University of New Jersey
Piscataway, NJ
&
Satish V. Poondi, RPh, Esq.
Associate, Wilentz, Goldman & Spitzer PA
Woodbridge, NJ

October 27, 2011
Topic: TBA
Location: Virtua Center for Learning
1200 Howard Blvd. Suite 100
Mount Laurel, NJ
Time: 5:30pm-8:30pm
Speakers: Quinn Czosnowski, PharmD, BCPS
Assistant Professor of Clinical Pharmacy
Philadelphia College of Pharmacy
University of the Sciences

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[September 1, 2011, AJHP News] Kate Traynor SILVER SPRING, MD 12 August 2011—Advisers to FDA overwhelmingly supported the agency’s first steps toward establishing new standards to assess the bioequivalence of generic and innovator drugs that have what is known as a narrow therapeutic index (NTI).

During a July 26 meeting in Silver Spring, Maryland, members of FDA’s Advisory Committee for Pharmaceutical Science and Clinical Pharmacology showed unanimous or near-unanimous support for a proposed definition of NTI drugs, new statistical methods to determine bioequivalence, and the tightening of standards for determining drug potency.

According to FDA’s proposed definition, NTI drugs are those "where small differences in dose or blood concentration may lead to serious therapeutic failures and/or adverse drug reactions." By serious, FDA means that the adverse reaction is "persistent, irreversible, slowly reversible, or life-threatening."

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[September 1, 2011, AJHP News] Kate Traynor BETHESDA, MD 12 August 2011—Meaningful regulatory and legislative changes are needed to ensure the safety of drugs that enter the U.S. supply chain, according to a report from the Pew Charitable Trusts’ Health Group.

After Heparin: Protecting Consumers from the Risks of Substandard and Counterfeit Drugs states that the onus should be on drug makers to ensure that all product ingredients are acquired and processed in ways that fully comply with good manufacturing practices—including ingredients obtained outside of the United States. Documentation identifying all suppliers should be available to FDA on request, and country-of-origin statements should appear on finished drug products, according to the report.

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8/10/2011 The Food and Drug Administration (FDA) will hold a public workshop on September 26 to get feedback on how the Agency is addressing drug shortages.

The meeting will allow stakeholders, including professional societies, patient advocates, industry, consumer groups, and others, to discuss the causes and impact of drug shortages as well as potential solutions for preventing or mitigating shortages. ASHP has been invited to participate in the day-long session.

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Hospital Pharmacists' Study Demonstrates Impact of Shortages 7/11/2011 Increasing drug shortages are impacting patient care and increasing costs to the nation’s health system, according to a new study released today by the American Society of Health-System Pharmacists (ASHP). The study, Impact of Drug Shortages on U.S. Health Systems, was conducted in partnership with the University of Michigan Health System, and published online by the American Journal of Health-System Pharmacy, ahead of the October 1 print date.

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The University of South Florida College of Pharmacy (USFCP) has been awarded preliminary accreditation by the Accreditation Council for Pharmacy Education (ACPE). The school's inaugural class of 50 students is scheduled to begin study at the USF campus in Tampa on August 15. However, the program will eventually move to the new USF Polytechnic campus being created in nearby Lakeland. The 2011-2012 Florida budget has allotted $35 million in funds for the new campus. The funding reportedly survived budget cuts as part of the state's efforts to meet its growing need for pharmacists. According to the Pharmacy Manpower Project, the present demand for pharmacists in Florida and nationwide is between being in balance with the need and having a moderate demand. That balance is not expected to last, because 37.1 percent of pharmacists were older than 55 in 2009, and the percentage of pharmacists working part time has increased. USF officials say they are hopeful the new program, which is expected to eventually enroll 400 students, will help maintain the balance.

The greater Houston area–based Methodist Hospital System has developed a new program that allows its facilities to share pharmacy services. The system, which includes Texas Medical Center and four community hospitals (Willowbrook, West Houston, Sugar Land, and San Jacinto), has a capacity of 1,656 beds and more than 12,000 employees. Hospital officials say their efforts to develop the new pharmacy services model has been successful for several reasons, including the system-wide standardization of including formulary/therapeutic interchanges, ADC configurations, and crash cart contents; enterprise-wide pharmacy inventory management and logistics software; good relationships with ADC engineer and drug wholesalers; support from senior administration; and shared vision between pharmacy and supply chain departments. Despite the benefits, implementation of the system did come with some unforeseen process changes. For example, workflow had to be redesigned to support Pyxis MedStation system refills for multiple facilities. The pharmacies also had to ensure the timing of medication deliveries would meet the needs of both pharmacy and nursing staff. Such close coordination did take some fine tuning, but the pharmacies were able to overcome the hurdles they faced through constant communication and the development of a shared culture. At this point, the shared pharmacy services model has been operating for approximately eight months, and is on track to meet or exceed projected savings. Once the medication inventory costs were charged back to West Houston, the net cost-avoidance savings was $400,949 for the first quarter of 2011, with an annualized savings projected at $968,723 in the first year alone—and a five-year projected cost-avoidance savings of $2,712,758.

The Accreditation Council for Pharmacy Education (ACPE) has granted continuing education accreditation to the National Comprehensive Cancer Network (NCCN) through June 2013. Under the terms of this approval, the NCCN will be accredited to provide pharmacists with educational programs based on its Guidelines in Oncology. NCCN already offers a number these programs both in Web-based and live formats.

The FDA has approved updated drug labels for pioglitazone-containing medicines to include safety information that the use of pioglitazone (Actos) for more than one year may be associated with an increased risk of bladder cancer. This change follows the an FDA review of data from a five-year interim analysis of an ongoing, ten-year epidemiological study. The five-year results showed that although there was no overall increased risk of bladder cancer with pioglitazone use, an increased risk of bladder cancer was noted among patients with the longest exposure to pioglitazone, and in those exposed to the highest cumulative dose of pioglitazone. The FDA is also aware of a recent epidemiological study conducted in France which suggests an increased risk of bladder cancer with pioglitazone. Based on the results of this study, France has suspended the use of pioglitazone and Germany has recommended not to start pioglitazone in new patients.

The FDA has issued a warning that treatment with chronic, high doses (400-800mg/day) of fluconazole (Diflucan) during the first trimester of pregnancy may be associated with a rare and distinct set of birth defects in infants. This risk does not appear to be associated with a single, low dose of fluconazole 150mg used to treat vaginal candidiasis. Based on this information, the pregnancy category for fluconazole indications (other than vaginal candidiasis) has been changed from category C to category D. The pregnancy category for a single, low dose of fluconazole has not changed and remains category C.

The FDA has approved ticagrelor (Brilinta) to reduce cardiovascular death and myocardial infarction in patients with acute coronary syndromes (ACS). Based on studies when used in combination with aspirin, the drug has been approved with a boxed warning that aspirin does above 100 milligrams per day decrease the effectiveness of the medications. The boxed warning also indicates that ticagrelor increases the risk of significant, sometimes fatal, bleeding. The most common adverse reactions reported by people taking the drug in clinical trials were bleeding and dyspnea. Ticagrelor was also approved with a Risk Evaluation and Mitigation Strategy (REMS) that requires AstraZeneca to conduct educational outreach to physicians to alert them about the risk of using higher doses of aspirin. In addition, the drug will be dispensed with a Medication Guide that informs patients of the most important information about the medication.

Hospitals are rushing to implement computerized physician order entry (CPOE) systems as part of their efforts to achieve meaningful use, and while selecting the right CPOE system is important, experts say that technology should not be the first step in the process. Before hospitals deploy CPOE, experts say that pre-identified order sets are necessary to ensure integration with provider workflow. They believe a solid governance plan should be formulated first, as it will guide order set selection, speed up development and prevent duplication. Michigan-based Memorial Healthcare began by getting the support of executives, then appointing a CPOE administrator to manage deployment and determine the order in which the order sets would be created. The initial order set is drafted by the CPOE administrator, physicians and pharmacists before being reviewed by the order set development team and approved by the departmental medical staffs and the medical executive committee. Instituting this governance plan reduced the time to develop a single order set to eight weeks from six months or more.

Nosocomial infections in hospitals often involve the hand-hygiene practices of healthcare workers (HCWs). Researchers recently examined risk judgment from the individual differences in knowledge levels and health beliefs among HCWs in the United States. The investigators assessed knowledge levels with questions taken from published questionnaires, and the HCWs assessed the risks of pathogen transfer in different situations. The HCWs reported lower risk assessments for touching surfaces than touching skin, according to the researchers. Individual differences, such as knowledge level and internal health locus of control, influenced their risk assessment. The data used to describe the individual differences of HCWs regarding hand hygiene may be used to create targeted interventions and products, the authors conclude.

The FDA has warned that the use of linezolid (Zyvox) and a list of 29 psychiatric medications may result in an increased risk of potentially fatal serotonin syndrome. For this reason, the agency recommends patients stop taking these medications when treated with linezolid. The warning was based on deaths reported to the FDA's adverse events database. The current labeling for linezolid already includes the potential for serotonergic interactions and the risk of serotonin syndrom. Linezolid manufacturer, Pfizer, says that it monitors all relevant safety information for the drug, and has not detected any new safety signals related to these drug interactions.

According to a survey conducted by Cedars-Sinai Medical Center, 75 percent of hospital pharmacists and nurses say they try to avoid physicians who are difficult to work with, even if they have a question about medication orders. "Often, surgeons get hired on the basis of their knowledge, training and technical accomplishments," says Andrew S. Klein, a surgeon and the director of the Cedars-Sinai Comprehensive Transplant Center. "But operating rooms are social environments where everyone must work together for the patients' benefit. When a surgeon, who is in the position of power, is rude and belittles the rest of the staff, it affects everything." The findings from Cedars-Sinai reflect a similar commentary in the Archives of Surgery, which argued that physician behavior can affect quality of care and healthcare costs. The commentary can be accessed at http://archsurg.ama-assn.org/cgi/content/extract/146/7/774