Technician Seminar

August 28, 2010
Depression (2 Credits)
Kimball Medical Center
River Road & Rt. 9 South
Lakewood, NJ
6:30PM – 8:30PM – Conference Rooms D & E
Speaker:Diana-Lee Zisa, PharmD
Staff Pharmacist
Kimball Medical Center
Lakewood, NJ
RSVP: Barbara Dixey at: Fax to (732) 776.2542 or Email: dixrx@aol.com

North Chapter

September 23, 2010
Botulinum Toxins
Location: TBA
Time: TBA
Speaker: David Bandola, MD, DMD
Assistant Clinical Professor
Department of Anesthesiology
Division of Pain Medicine
Columbia University Medical Center
New York, NY
RSVP: TBA

October 29, 2010
Medical Safety Symposium
St. Joseph’s Wayne Hospital
224 Hamburg Turnpike
Wayne, NJ
Time: TBA
Speakers: TBA
RSVP: TBA

North Central Chapter

August 24, 2010
Outpatient Anticoagulations: A Focus on Providing Pharmacy Practice Services
(1.5 ACPE Credits)
Wallace Auditorium at Overlook Hospital
99 Beauvoir Avenue
Summit, NJ
Time: TBA
Speaker: Jennifer L. Costello, PharmD, BCPS
Ambulatory Care Clinical Pharmacist
Saint Barnabas Medical Center
Livingston, NJ
RSVP: TBA

Central Chapter

September 2010(Tentative)
Poison Control
Location: TBA
Time: TBA
Speaker: Bruce Ruck, PharmD
Director of Drug Information & Professional Education
New Jersey Poison Information and Education System
Newark, NJ
RSVP: TBA

Quality Improvement in Managing Patients at Risk for VENOUS THROMBOEMBOLISM: INTERVENTIONAL STRATEGIES

A unique, multidisciplinary educational initiative designed to improve care for patients at risk of developing VTE.

Make plans to attend a full-day workshop designed to provide practical strategies for the prevention of VTE. Practitioners – including pharmacists, physicians, and nurses – are encouraged to participate as a team. Expert faculty will share validated methods for VTE prophylaxis, as well as tools to implement therapeutic guidelines and quality improvement measures.

Tuesday, September 14, 2010 9:00 am – 4:15 pm Westin Governor Morris 2 Whippany Road Morristown, New Jersey 07960

Register today at http://www.stopvte.org/workshop.aspx?id=3

NEW JERSEY SOCIETY OF HEALTH-SYSTEM PHARMACISTS

2011
ANNUAL MEETING/EXHIBITION & INSTALLATION DINNER
FRIDAY, APRIL 8, 2011
HILTON EAST BRUNSWICK 3 TOWER CENTER BLVD. EAST BRUNSWICK, NEW JERSEY (732) 828-2000
PLEASE MARK YOUR CALENDAR!

Click this link for the Membership Form.

Get into the Society Spirit and order your state pin today. State pins can be ordered easily through the NJSHP website.

7/14/2010 A bill that would provide coverage of clinical pharmacist practitioner services through Medicare Part B is an important first step, in utilizing pharmacists' unique expertise in managing the medication use system to help improve patient outcomes according to ASHP. The bill, HR 5389, the Medicare Clinical Pharmacist Practitioner Services Coverage Act, was introduced by Representative Martin Heinrich (D-NM).

Senators Kay Hagen (D-NC) and Al Franken (D-MN) have also recently introduced S. 3543, the Medication Therapy Management Expanded Benefits Act, which would increase patient access to pharmacists’ MTM services under Medicare Part D. Of particular interest to health system pharmacy, it would provide for a targeted medication review for Medicare enrollees who are experiencing a transition in care, such as a discharge from a hospital or other institutional setting.

ASHP is encouraged by both legislative proposals as well as provisions in the new health care reform law that provide for an MTM grant program. Collectively they form pieces of the puzzle in attaining recognition of pharmacists as providers of patient care services.

Cheryl A. Thompson BETHESDA, MD 13 July 2010—Bristol-Myers Squibb on Monday announced a recall of eight lots of Coumadin 1-mg tablets in blister packs intended for use in hospitals or as samples. Five of the lots are 100-tablet unit dose packs: 8F34006B, 8K44272A, 8K46168A, 9F44437A, and 9K58012B. These lots have an expiration date between June 2011 and November 2012 and were distributed September 2008 through April 2010. The other lots in the recall are 10-tablet blister packs: 9A48931A, 9A48931B, and 9A48931C. These lots were distributed July 2009 through April 2010 by company sales representatives and through a direct-mail sample program to physicians. The company said some of the tablets in the lots may eventually not contain the required amount of isopropanol to maintain warfarin, the active ingredient, in the crystalline state. Amorphous warfarin, according to the labeling for Coumadin, has trace impurities. Hospitals and other purchasers of the 100-count unit dose packs are being asked to return their remaining inventory of the five lots to Stericycle for credit. Stericycle, available at 877-546-0128, is handling all returns of tablets affected by the recall, including the sample packs. Questions about the reimbursement process for the recall should be directed to Bristol-Myers Squibb Customer Service Operations at 800-631-5244 (select option 1, then option 5). At the time of the announcement, the company said it had not received any reports of adverse events related to the isopropanol issue.

Insurance Coverage, Health IT, Pharmacy Technicians Among Issues Considered 7/12/2010 The House of Delegates of the American Society of Health-System Pharmacists (ASHP) considered a number of vital professional issues during its 62nd annual session, including support for minimum hiring standards for pharmacy technicians, interprofessional education and training, and just culture and reporting medication errors. The session was held June 6 and 8 in Tampa, Fla. in conjunction with Society’s Summer Meeting. The House of Delegates, ASHP’s chief policy-making body, consists of 163 voting state delegates (a minimum of two from each state, the District of Columbia, and Puerto Rico), members of the Board of Directors, past presidents of ASHP, chairs of the Society’s sections and forums, and five delegates representing the federal services.

Rosalind Franklin University in Chicago has announced that it will open a college of pharmacy in fall 2011. At that time, the college is expected to enroll its first class of 65 students, pending approval from the Accreditation Council for Pharmacy Education. Students who complete the four-year pharmacy program will graduate with a Doctor of Pharmacy degree. The new college of pharmacy will also feature a student to faculty ratio of approximately 10-1 and hopes to provide multiple opportunities for field learning in private and public health clinics, health systems, and public health agencies in the Chicago to Milwaukee metropolitan corridor as well as in rural settings in northern Illinois and southern Wisconsin. University representatives say the new college will help supply the area with much-needed PharmDs. The school expects to educate a full complement of 260 pharmacy students by 2015. All applicants must complete the Pharmacy College Admissions Test and carry an approved GPA in all prerequisite courses. Approximately 25 faculty, including 14 newly hired professors, will teach incoming students, who will attend classes in the new $5 million Interprofessional Education Center, which is equipped with a state-of-the-art Pharmacy Skills Laboratory.

Results from a recent Pharmacy Technician Certification Board (PTCB) sponsored survey find that pharmacists perceive pharmacy technician certification as an essential component in reducing medication errors, ensuring patient safety, and increasing positive health outcomes. The results were gathered from a random sample of over 3,250 pharmacists serving in a variety of practice settings across the United States. The survey, administered by Drs. Shane Desselle and Michael Schmitt of the University of Oklahoma College Of Pharmacy, shows that pharmacists recognize the value of Certified Pharmacy Technicians (CPhTs) as part of the pharmacy team, with 83 percent agreeing that working with CPhTs allow pharmacists to spend more time on direct patient care. As the population ages and medication regimens become more complex, patient-centered care will play an important role in facilitating safe medication practice. Pharmacy technician positions are expected to increase by 25 percent by 2018 to meet this demand.

As the FDA prepares to meet to discuss the cardiovascular risks of rosiglitazone on (Avandia) on July 13 and July 14, the American Diabetes Association (ADA) and American Heart Association are reinforcing their current positions regarding the drug. Both groups said that patients should be informed of the new data being published regarding these potential risks. However, Dr. David M. Kendall, the ADA's chief scientific and medical officer, also made sure to point out that, "We encourage patients to not stop taking their medication until they discuss it with their provider." At the upcoming joint meeting of the FDA's Endocrinologic and Metabolic Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee Meeting, panelists may consider the possibility of pulling rosiglitazone from the market.

Camden County College (CCC) in New Jersey has announced it will offer free classes to area veterans to train for employment as pharmacy technicians. The training will be offered at CCC's Blackwood campus in Gloucester Township to veterans of Operation Iraqi Freedom or Operation Enduring Freedom who served in the Army, Navy, Air Force, Marine Corps, Coast Guard, National Guard or Reserves. The U.S. Department of Defense through the Collegiate Consortium for Workforce and Economic Development will provide tuition, fee, and book costs for qualifying veterans. CCC's "Pharmacy Technician Certificate Training" course is designed for prospective students interested in sitting for the Pharmacy Technician Certification Board exam.

Healthcare industry observers have speculated for some time that July may see a decrease in certain measures of patient care at teaching hospitals because new physicians usually start their residencies at this time. However, several recent studies have found no increase in mortality or complications amongst patients undergoing surgery in midsummer. One study of 18,597 patients at Cleveland Clinic found that those having elective heart bypass surgery in July were no more likely to die or suffer major complications than those treated in other months. On the other hand, a study, led by University of California- San Diego Prof. David Phillips, did detect a 10 percent increase in deaths from medication errors among patients hospitalized in July in counties with teaching hospitals. Phillips and his team reviewed 62 million deaths between 1979 and 2006 and focused on 244,388 fatal drug errors. The study found no spike in such deaths outside of hospitals or in counties without teaching hospitals. Additionally, Phillips reports that he found no sign such deaths were decreasing amid rising concerns about patient safety and residents' long work hours (which were cut in 2003). More study is needed, he says, to see if non-fatal drug errors also rise in July.

Researchers have found that acute care U.S. hospitals have varied policies and practices regarding surveillance, decolonization, and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. Despite these differences, however, most hospitals surveyed were consistent with national guideline recommendations. Investigators sent a 61-item questionnaire to the director of pharmacy at each of 263 acute care hospitals, 102 of which responded. Active surveillance culture protocols were in place at 44 hospitals, and nearly 75 percent engaged in key antimicrobial stewardship activities. Only 18 percent of respondents had a formal antimicrobial stewardship team. About one-fourth of the hospitals had MRSA decolonization policies. The survey results showed that vancomycin was the most commonly used antimicrobial for MRSA infections, with linezolid in second place.

Researchers have found that the application of a testosterone gel may be associated with an increased risk of cardiovascular adverse events in certain populations of older men. Their study followed a total of 209 community-dwelling men, 65 years of age or older, with limitations in mobility and a total serum testosterone level of 100 to 350 ng per deciliter or a free serum testosterone level of less than 50 pg per milliliter. These men were randomly assigned to receive placebo gel or testosterone gel, to be applied daily for 6 months. At baseline, there was a high prevalence of hypertension, diabetes, hyperlipidemia, and obesity among the participants. During the course of the study, the testosterone group had higher rates of cardiac, respiratory, and dermatologic events than did the placebo group. A total of 23 subjects in the testosterone group, as compared with five in the placebo group, had cardiovascular-related adverse events. The relative risk of a cardiovascular-related adverse event remained constant throughout the 6-month treatment period. As compared with the placebo group, the testosterone group had significantly greater improvements in leg-press and chest-press strength and in stair climbing while carrying a load.

The FDA is warning that unapproved use of the malaria drug quinine sulfate (Qualaquin) to treat night time leg cramps has resulted in serious adverse events and prompted the manufacturer to develop a Risk Evaluation and Mitigation Strategy (REMS) aimed at educating healthcare professionals and patients about the potential risks. Quinine sulfate is not FDA-approved to treat or prevent night time leg cramps. A review of reports submitted to the FDA’s Adverse Event Reporting System (AERS) between April 2005 and Oct. 2008 found 38 U.S. cases of serious side effects associated with the use of quinine. Quinine use resulted in serious and life-threatening reactions in 24 cases, including low level of platelets in the blood (thrombocytopenia) and hemolytic uremic syndrome/thrombotic thrombocytopenic purpura, a blood disorder that results in clots in small blood vessels around the body that can be accompanied by kidney impairment. In some patients, the side effects led to permanent kidney impairment and hospitalization; and two patients died. Most of the patients reporting serious side effects took the drug to prevent or treat leg cramps or restless leg syndrome. The REMS requires that patients be given a Medication Guide explaining what quinine is and is not approved for, as well as the potential side effects of the drug. The company is also required to issue a Dear Health Care Provider Letter warning of the potential risk of serious and life-threatening blood-related (hematologic) reactions.

The Walter Reed Army Medical Center/National Naval Medical Center (WRAMC/NNMC) Pain Service is optimizing pain care for soldiers. The Army has partnered with the Navy, Air Force, and Veterans Association in the Defense and Veterans Pain Management Initiative (DVPMI)--which is aimed at treating pain in all stages, from injury through rehabilitation. Col. Kevin Galloway, AN--chief of staff for a pain management task force assembled by the Army last year to review DVPMI's strategies and progress--explains that the movement of soldiers from one place to another poses a unique challenge for pain treatment, necessitating a synchronized approach to decrease variability and increase consistency. The WRAMC/NNMC Pain Service uses a multimodal, multidisciplinary approach to treating pain, including epidural blocks and low-dose infusions of the anesthetic ketamine, ultrasound-guided continuous nerve blocks, nonsteroidal anti-inflammatory drugs, opiods, anticonvulsants, antidepressants, trigger point and epidural injections, and spinal cord and peripheral nerve stimulators. "With these techniques, we are trying hard to avoid the 'soldier's disease,' where war-injured troops get hooked on morphine," explained Col. Chester Buckenmaier, MD, chief and program director for WRAMC/NNMC's acute and regional pain service. "We you use just one drug to manage pain, people can get into trouble." The psychological side of pain is also addressed. Approximately 11,000 patients are treated annually at two state-of-the-art centers staffed by a team of physiatrists, anesthesia providers, psychiatrists, behavioral health specialists, primary care physicians, pharmacists, case managers, and specially trained pain nurses. Also included in the military's fight against pain is active research into both the relationship between combat and pain, and multicenter clinical trials on pain therapies. As a result, the Pain Service has created the Regional Anesthesia and Analgesic Tracking System (RATS), the largest database of combat casualty pain.

In 2008, about 1 million people went to the emergency room for the abuse of prescription and over-the-counter (OTC) medications, the same number of people who went to the ER for the use of illegal substances. These figures are part of new data released by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC). Between 2004 and 2008, the number of ER visits for non-medical use of prescription medications rose by 111 percent, growing from 144,644 to 305,885, according to data from more than 200 hospital ERs. Earlier this year, the American Journal of Preventive medicine published a study that found that hospitalizations for abuse of prescription drugs such as oxycodone (OxyContin) and acetaminophen and hydrocodone (Vicodin) grew 65 percent between 1999 and 2006. The rise in ER visits for legal drug abuse has coincided with a rise in prescriptions for painkillers and other controlled medications, which suggests that most of the ER patients had obtained the drugs legally.