Thursday, December 22, 2016

A Different Way of Writing

Throughout pharmacy school, the PharmD curriculum has encouraged a critical, systematic way of thinking. Naturally, our documentation skills, whether it be patient care plans or position papers, is structured and almost formulaic by design.

Before arriving at RxBriefCase, I dove into the wild and wonderful world of research at St. Michael’s Hospital. Within the first few days, I realized that this rotation was an immense literary feat, and my first real exposure to writing abstracts, manuscripts and a scientific protocol. Each project had its stylistic quirks, including strict word limits, required headings and specifications for formatting, defined by research journals and scientific bodies. As an example, the study protocol I created needed to follow evidence-based criteria outlined by SPIRIT, an international organization that aims to enhance the quality of clinical trial protocols. 

Now that I have settled in at RxBriefCase, I have been tasked with the creation of an eNewsletter, a critical appraisal of an eCME, a module for MedSchoolForYou and periodic updates on the pharmacy student blog. So far, these have been excellent opportunities to reflect on my writing skills (and that of others), to refine the ability to communicate succinctly and to develop patient/provider-friendly education, albeit challenging at times.

Regardless of the type of writing I encounter, a few things remain tried and true: 
1.     Landscape- know what information is out there; your work should be novel or inform change
2.     Assess- review samples of published work to identify how your piece should be written
3.     Target- be mindful of your audience and select words appropriately
4.     Edit- constantly revise, as this guides your development
5.     Reference- always cite your sources!

Have a safe and happy holiday!


Thursday, December 15, 2016

Pinky and the Brain

In response to a rising number of deaths, the U.S. Drug Enforcement Administration (DEA) has labelled U-47700, also known by its street name ‘Pink’, as a Schedule I product under the Controlled Substances Act.1 As of November 2016, at least 46 deaths around the U.S. have been associated with the use of Pink. This includes two 13 year-old boys, who tragically overdosed on Pink obtained from teens who had ordered it online.2

Pink was previously developed in the 1970s as a potential analgesic alternative to morphine. Today, amidst a global opioid abuse crisis, it has concerningly re-surfaced as a new synthetic opioid. With principal manufacturing occurring overseas, Pink’s composition, purity and exact effects are unknown, and it is often encountered with other illicit substances, such as heroin and fentanyl. Furthermore, it can appear in a number of different forms (e.g. powders, tablets), or may be marketed as other prescription products by producers. Evidently, any quantity of Pink could be fatal.

Reports indicate that Pink’s potency is up to 8-fold that of another highly abused opioid, heroin.2 As a class, opioids bind to the mu-opioid receptors in the brain, which mediate biochemical responses associated with pleasure and reward. In the event of an opiate overdose, the body’s central nervous system is unable to regulate basic bodily functions. This can lead to slowed breathing, a decline in body temperature and a loss of consciousness. Overdosed persons may also become cyanotic, myoclonic and develop seizures. 

Naloxone, an opioid antagonist, can be used to reverse the effects of various opiates. As of June 24, 2016, naloxone was designated as a Schedule II product, enabling individuals to obtain this potentially life-saving drug from their local pharmacy without a prescription.3 Despite its proven ability to prevent opioid-related deaths, the efficacy of naloxone for Pink overdoses remains unclear. 

In light of the above, where do pharmacists fit in? As one of the most accessible, front-line health practitioners, pharmacists have the ability to recognize the signs of opioid addiction, monitor safe opioid use and refer patients for help. Now, with the advent of naloxone availability in community pharmacies, pharmacists also have a valued role in the safe distribution of and training for naloxone. For more information, please visit the following sites: CAMH, the Drug and Alcohol Helpline and The Works.



1.    United States of America Drug Enforcement Administration. DEA Schedules Deadly Synthetic Drug U-47700. November 2016. Available: (accessed December 12, 2016).
2.    CBS News. Police: 2 Utah 13 year-old boys died from dangerous, new synthetic drug ‘pink’. October 2016. Available: (accessed December 12, 2016).

3.    Ministry of Health and Long Term Care. Ontario naloxone program for pharmacies. August 2016. Available: (accessed December 12, 2016).

Friday, December 9, 2016

Shots, Shots, Shots!

On December 1, 2016, a great advancement was made to Ontario pharmacists’ scope of practice. Dr. Eric Hoskins, Minister of Health and Long-Term Care, announced that Ontarians will be able to access a broader range of vaccines through their community pharmacy.

Effective December 15, 2016, the amended regulations under the Pharmacy Act will permit pharmacists to vaccinate patients over five years of age against 13 more diseases. These include a number of travel vaccines, including hepatitis A and B, Japanese encephalitis, typhoid and yellow fever. Furthermore, pharmacists will be able to administer the herpes zoster (shingles), meningococcal, pneumococcal and rabies vaccines. A complete list of authorized vaccines can be found here.

Prior to this change in legislation, Ontario pharmacists were only able to administer the annual influenza vaccine, as part of the Universal Influenza Immunization Program (UIIP). Following the implementation of UIIP in 2012, over 1.8 million flu shots have been provided in Ontario pharmacies. This authority will now be expanded to trained pharmacy students and interns.

As demonstrated by the success of UIIP, leveraging the skills, training and knowledge of pharmacists through vaccination programs has benefited patients, and the Ontario healthcare system immensely. In addition to improving immunization rates, pharmacist involvement will increase patient access and convenience by minimizing the need to book vaccination appointments with their primary health provider. Moreover, due to the temperature-sensitive nature of many vaccines, on-site administration will minimize or eliminate stability-related safety issues.

All Ontarians are encouraged to ask their local pharmacist about the availability of various vaccines and any associated costs. Since the majority of vaccines are not publicly funded, patients may be required to pay out of pocket for both the product and its administration.


For more information, please visit:

OPA Today. “Pharmacists to Provide Travel Vaccinations to Ontario Patients.” December 2016. Retrieved from <> on December 7, 2016.

Ministry of Health and Long-Term Care. “Making More Vaccines Available in Pharmacies.” December 2016. Retrieved from <> on December 7, 2016.

Tuesday, December 6, 2016

To my colleagues at RxBriefCase

Hello and welcome to my first blog entry as the newest member of the RxBriefCase team! As a 4th year pharmacy student at the Leslie Dan Faculty of Pharmacy, I am currently on my 7th block of advanced practice rotations. I currently work in both a community and a hospital pharmacy, and have a role as a teaching assistant for international pharmacy graduates at the Faculty.

Despite being on clinical placements, I have maintained my involvement in several extracurricular activities. These include the Seniors Outreach at the University of Toronto, acting as the Marketing Directors for both the Pediatric and Antimicrobial Stewardship Societies, and most recently, the Pharmasave Business Plan Competition.

From my previous clinical rotations, I have gleaned valuable insights into the areas of pharmacy operations, critical care and research. This research rotation enabled me to develop several quality improvement initiatives, a research protocol and a case series. In addition, I was able to refine my critical appraisal and scientific writing skills, which I aim to apply during this rotation.

Due to the unique nature of this placement, I am excited to learn more about the various CME platforms offered by RxBriefCase, the CCCEP accreditation process, and the opportunities to develop the eNewsletter for pharmacists and other healthcare professionals, the Expert Modules for patients, and the critical appraisal of an eCME.

Lastly, a big thank you for the warm introduction to the rest of the team by my preceptors Cassandra and Janet. I look forward to working closely with everyone over the next 5 weeks!