Thursday, September 21, 2017

I See the Light! – Canadian e-Prescribing Platform on the Horizon

A national e-prescribing system, removing the need to transcribe (and sometimes translate) written prescriptions?

Sounds too good to be true, but Canada HealthInfoway is working hard to make this a reality.

An e-prescribing system works by having the prescription electronically transfer from the physician’s office software, directly into the pharmacy software.  This isn’t a novel idea, with several pharmacies and doctor’s offices already having their own systems in place.  However, Canada Health Infoway is looking to create one national system, called PrescribeIT, to redefine the standard across all pharmacies and clinics.

PrescribeIT has one feature that other e-prescribing systems lack, the ability to communicate to the physician if the prescription has been filled1.  This may seem like a small feature, but doctors have generally been left in the dark, not knowing if their prescriptions are being filled.  Prescribers can become frustrated if they’re unsure the patient’s condition isn’t responding due to inadequate therapy or if the patient is non-adherent. PrescribeIT is a step forward to solving this problem and improving pharmacist-doctor communication.

E-prescribing can be a blessing and a curse to pharmacists.  On one hand, they no longer have to interpret (sometimes poor) doctor handwriting; this job will already be completed by e-prescribing. In a St. Johns study, e-prescriptions had an error rate of 0.66%, and hand written prescriptions 1.33%2.  The caveat is that errors will be far more difficult to catch.   If a doctor accidently inputs the wrong drug or patient into the e-prescribing tool, through a wrong click, it may be impossible to determine if it’s in error.  Therefore, it will be crucial that pharmacists communicate with patients to determine if the medication is appropriate.  This is a practice that pharmacists are already doing, but will now become even more important.

Don’t get too excited yet, as PrescribeIT is only just being trialed at Algonquin Family Health Team and the Muskoka Medical Pharmacy in Ontario1.  It will likely be a few years until we see it rolling out to other Canadian pharmacies.  This is an exciting new technology that will hopefully improve the standard of care in pharmacies.

- Ajay Chahal


References
  1. (n.d.). Retrieved September 20, 2017, from http://www.canadianhealthcarenetwork.ca/pharmacists/news/canadas-first-national-e-prescribing-platform-goes-live-40568
  2. Phillips, J. L., Shea, J. M., Leung, V., & MacDonald, D. (2015). Impact of Early Electronic Prescribing on Pharmacists’ Clarification Calls in Four Community Pharmacies Located in St John’s, Newfoundland. JMIR Medical Informatics3(1), e2. http://doi.org/10.2196/medinform.3541




Monday, September 18, 2017

Painfully Common – Codeine Crisis?

Pain management can be complicated since there is no objective test to assess pain like in hypertension, and pain can be difficult to clearly articulate.  It’s also common for patients to ask for codeine containing products (schedule 2 in Ontario), to manage their pain.  Codeine is metabolized by the CYP2D6 enzyme into morphine, which then exerts its painkilling effects.  Patients metabolize codeine into morphine at different rates, therefore some patients may have a lot of pain relief and others may not experience anything at all.  To complicate things even further, codeine is an opioid that can cause addiction.

These factors contribute to why Health Canada is considering banning all non-prescription codeine1.  Health Canada is most concerned about the addictive potential of codeine, as they’ve noticed a significant number of patients entering rehab programs for non-prescription codeine substance abuse alone1.  From a pharmacist perspective, there are two predominant viewpoints:
  1. Schedule 2 codeine products have an important role in therapy and with the appropriate tools, they can be effectively monitored for abuse.
  2. Schedule 2 codeine products are too unsafe, due to their abuse potential, to be sold without a prescription.
Whether pharmacists can effectively monitor non-prescription codeine depends on the electronic tools available to them in each province.   For example, Alberta pharmacists have access to the patient’s electronic medical record (EMR) called NETCARE. They can use the software to identify when the patient last picked up codeine.  In this situation, schedule 2 codeine products can have an effective role in therapy and may not need to be prescription, since pharmacists are capable of monitoring for abuse.

However, Ontario pharmacists do not have access to an EMR and thus are unable to assess if the medication is being abused.  This can be dangerous since it is impossible to know how much codeine the patient is using.  In this instance, banning the sale of the non-prescription codeine products may be appropriate.

Health Canada should encourage provinces to make the appropriate regulatory changes based on their pharmacy infrastructure.  If the appropriate mechanisms are in place to monitor for abuse, the provinces should trust pharmacists to make the correct judgement to dispense codeine.

In either case, pharmacists must be competent to counsel patients on effective pain management strategies.  RxBriefCase offers an excellent program discussing mild to moderate pain management in primary care:
It will be interesting to see how Health Canada decides to regulate non-prescription codeine and how changes to the legislation will impact patients.

- Ajay Chahal

References
  1. Beeby, D. (2017, September 11). Health Canada aims for prescription-only codeine pills, syrups. Retrieved September 15, 2017, from http://www.cbc.ca/news/politics/codeine-opiate-prescription-health-canada-juurlink-pharmacists-ban-sales-1.4284013


Friday, September 8, 2017

The Elephant in the Room – Obesity Management

Obesity is a tough topic to discuss with patients and many pharmacists may not feel they are adequately prepared to initiate the conversation.  It’s a daunting task because if it is not approached correctly, we risk alienating the patient and possibly making things worse.
  
There are many wrong ways to start the conversation: using scare tactics, generic advice, or guilt. However these approaches have shown not to be effective.1  Instead, start the conversation with an open question, something like “I’m sure you’re aware of how weight can affect your health. Do you have any concerns about your weight and health that you’d like to talk about?1.  This allows the patient to take control of the conversation and voice their concerns at the beginning of the interaction.

Once you’ve spent some time with the patient discussing their concerns, motivation and goals, it’s time to develop a plan.  Too often clinicians will give generic advice like “eat less and exercise more”, which is ineffective advice for a patient who may have already heard that a dozen times. Specific simple interventions are effective ways to help patients get started towards healthier living.   

Here are 10 simple tips that you can suggest to your patients:2
  1. Keep a meal routine - Eat at roughly the same times each day, whether this is two or five times a day.
  2. Go reduced fat - Choose reduced fat version of foods such as dairy products, spreads and salad dressings where you can. Use them sparingly as some can still be high in fat.
  3. Remember to Walk - Walk 10,000 steps (equivalent to 60-90 minutes moderate activity) each day. You can use a pedometer to help count the steps throughout the day.
  4. Pack a healthy snack - If you snack, choose a healthy option such as fresh fruits or low calorie yogurts.
  5. Look at the labels - Be careful about food claims. Check the fat and sugar content on food labels when shopping and preparing food. “Eat Right Ontario” has a great patient resource to help read nutrition labels.
  6. Caution with your portionsDon’t heap food on your plate (except vegetables).
  7. Up on your feet - Break up your sitting time. Stand up for ten minutes out of every hour.
  8. Think about your drinks - Choose water or sugar-free drinks. Unsweetened fruit juice is high in natural sugar so limit it to 1 glass per day (200mL). Alcohol is high in calories so try to limit the amount you drink.
  9. Focus on your food - Slow down. Don’t eat on the go or while watching TV. Eat at a table if possible.
  10. Don’t forget your 5 a day - Eat at least 5 portions of fruit and vegetables a day (400g in total).
If you are interested in learning more on obesity management, stay tuned for my eNewsletter, “Uncomfortably Common – Obesity Management”, which will be sent to rxBriefCase members early next year.  Advancing Practice also offers continuing education, and a Certified Bariatric Educator Exam:

- Ajay Chahal

References
1. Freedhoff, Y., & Sharma, A. M. (2010). Best weight: a practical guide to office-based obesity management. Canada: Canadian Obesity Network.
2. Beeken, R. J., Leurent, B., Vickerstaff, V., Wilson, R., Croker, H., Morris, S., . . . Wardle, J. (2016). A brief intervention for weight control based on habit-formation theory delivered through primary care: results from a randomised controlled trial. International Journal of Obesity, 41(2), 246-254. doi:10.1038/ijo.2016.206



Thursday, August 31, 2017

The Green Lottery – Who Will Distribute Recreational Cannabis?

The Federal government declared July 1, 2018 as the deadline to legalize recreational cannabis. The real tantalizing question is: how will it be distributed? The Provincial governments have the responsibility to make this decision.  Many investors, business owners and corporations are agonizing over this decision because recreational cannabis offers a significant earning potential.  Even pharmacists are eagerly waiting for the decision, as it could help revitalize the profession that has been hit with budget cuts over the past few years. Shoppers Drug Mart has already taken their first step into cannabis distribution by submitting an application to become a licensed medical cannabis distributor.

Who are the potential candidates for cannabis distribution? There are 3 viable options:
  1. Pharmacies
  2. Government owned dispensaries
  3. Privately owned dispensaries
From a clinical stand point there is no competition, pharmacies clearly are the best choice.  It’s logical for the medication experts (pharmacists) to dispense cannabis, especially as so many patients may be taking other medications concurrently that might interact.

However, the provincial governments will want to maximize their earnings. The best way to do this is by distributing cannabis through government owned dispensaries.  The issue with this option is that provincial governments will be too slow to set up distribution locations by the July 1, 2018 deadline.  This is why the Ontario government is considering combining LCBOs (Liquor Control Board of Ontario) with dispensaries.  This idea is absurd from a health care perspective because it encourages combining alcohol with cannabis; however, perhaps from a politician’s point of view, nothing is out of the question (just look at Donald Trump).


The last option, gaining a lot of traction recently, is privately owned dispensaries.  There are a number of illegally operating dispensaries throughout the provinces, which are hoping to legitimize when the provincial legislation passes.   They are already set up to dispense cannabis, which makes them an easy option for the provinces to certify as licensed cannabis distributors.  However, it may be difficult to regulate these dispensaries as many of these locations may not be using ethical business practices.  For those owners currently operating outside of the law, continuing to do so after legislation passes may not be a stretch.

Regardless of the provinces’ decision, pharmacists will need to be prepared to counsel and advise patients on the use of cannabis.

The following continuing education programs are an excellent way to learn more about cannabis:

For Ontario healthcare professionals only, there is a $1,500 government fund to help subsidize continuing education costs.  Therefore if you are a registered Ontario pharmacist, you may be eligible to be reimbursed! Visit Allied Health Fund for more details.

- Ajay Chahal

Thursday, August 24, 2017

The Journey Begins

 Hello rxBriefCase,

I’m excited to start my 5-week rotation with rxBriefCase and experience something completely different from the standard clinical rotations in community and hospital pharmacy clinics.  This is my fourth block, with six more to go until I’m finally finished school!  My previous rotations (block 1 and 2) were at Center of Addictions and Mental Health (CAMH), where I was part of the acute schizophrenia ward and outpatient mood/depression unit.  

Mental health is a topic that I have a passion for, and antidepressants are one of the most commonly prescribed medications in Canada.  Escitalopram was the 5th most commonly dispensed medication in 20131. If you are interested in furthering your understanding of the field, I’d suggest reading: 
  1. "A case of partial treatment response: what next?"
  2. "When treatment for depression doesn't work"
Both of these articles are in the rxBriefCase eNewsletter archive, and discuss therapeutic options in treatment resistant depression.

Having learned a lot about the nuances of communication during my time in hospital and community pharmacy, I’m excited to flip the script and focus on my written communication during my stay with the rxBriefCase team.

Stay tuned for future blog posts!

- Ajay Chahal

References
1. Spolarich, A. E. (2015, April 18). Commonly Prescribed Medications and Managing the Oral Side Effects of Medication Use. Retrieved August 23, 2017, from http://www.sdha.ca/wp-content/uploads/2014/10/Pharmacology-Handout-Dr.-Ann-Spolarich.pdf

Tuesday, July 11, 2017

Medical Abortion: A Woman’s Choice

Abortion has always been a controversial topic. There are very compelling arguments for both sides from all walks of life and professions. Some feel that ending the life of a fetus is still ending a life and it should be a very difficult decision to make and never to be taken lightly. Others feel that women have the right to decide what to do with their own bodies and sometimes bringing a child into a bad life situation will only do the child more harm than good. As a healthcare professional, whether you are pro-life or pro-choice, you are first and foremost pro-patient care.

Mifegymiso is a combination of two pills taken sequentially to induce a medical abortion up to 49 days into pregnancy. It was approved for use in Canada July 2016 but was only available to Canadian women in January 2017 whereas combination drugs of this nature have been available in over 60 countries for several years now. It is important to note that although medical abortion is more accessible and convenient than surgical abortion, it is does not carry less risk. Both methods have risks but if used correctly, this treatment will help so many women exercise their right to choose.

For more on information on this topic make sure to read my eNewsletter coming out soon. Even though it is a grim subject it is so important to educate ourselves on all options for women and learn to not judge or discriminate against people whether you are pro-choice or pro-life.

“If you’re against abortion, don’t have one”
-Unknown

Keep an open mind and an open heart. Take care!
-Mena

Wednesday, July 5, 2017

Power over Your Period!

For some girls getting their first period is a rite of passage into womanhood while for others it’s an uncomfortable thing that happened that no one talked about. Lots of changes happen to your body once you start your period and many women have questions and concerns about their period but the right information is hard to find sometimes. Also, some women may find it embarrassing to ask these kinds of questions and therefore prefer to ignore them. Regardless of how you feel about your period every woman should have access to the right information so she can understand her body. Knowledge is power and you’re about to gain a whole lot of power over your period!
  1. Estrogen and progestin are the two main hormones that control your menstrual cycle
  2. Period cramps occur because during your period your uterus contracts to cause the bleeding of your period.  This tightening of the uterus is also what causes the painful cramps
  3. Having been pregnant and birthed a child reduces your risk of having menstrual cramps
  4. PMS goes away once you get your period
  5. Smoking is a huge risk factor for having PMS
  6. Midol® isn’t effective for menstrual cramps or PMS
  7. The time in your cycle that you are most likely to get pregnant is about 9-14 days into your cycle, if your cycle is 28 days. (Day 1 of your cycle is the day you get your period)
  8. It is possible to get pregnant while you’re on your period but the chance is not as high as on other days
  9. Douching is not good for vaginal health
  10. When you have not had your period for a full uninterrupted 12 months and you are otherwise healthy, then you are officially in menopause

Read my MedSchool for You program “Let’s Talk about Your Period” when it’s released in the near future, but for now here are the top 10 facts about your menstrual cycle and everything else that goes with it.

“Here’s to strong women. May we know them. May we be them. My we raise them.”
-Unknown

Thanks for reading. Until next time!

Mena


Tuesday, June 27, 2017

Natural Does Not Equal Safe

What is the number one reason some people choose a natural health product (NHP) over a pharmaceutical one? Safety!

It’s a common misconception that a natural product is safer than a “chemical/synthetic” one. There are several natural substances that are toxic and even deadly, like arsenic, lead and venom, just to name a few. Many people fall into this trap and end up choosing a product that is less effective for one they think is safer but it may not be as safe as they think.
 Recently an article was published in the Canadian Medical Association Journal criticizing Health Canada for its leniency when it comes to approving natural health products. The editor of the journal, Dr. Matthew Stanbrook, was quoted as saying "They simply have to show that someone, somewhere once used this as therapy for something". He went on to claim that manufacturers of NHPs have to stop advertizing  that their products are remedies because they have very little evidence for their actual efficacy.  Furthermore, the director of general of natural and nonprescription health products for Health Canada stated that “Health Canada has the power to recall a bag of chips, but does not have the power to recall an unsafe natural health product”.

There is clearly a big safety and efficacy gap that needs to be filled at Health Canada regarding NHPs. I used to think that even though NHP efficacy was questionable their safety was not, but now I’m not so sure.  Thankfully, Health Canada is currently reviewing the regulations that govern the sale of self-care products, which includes NHPs. All products, whether they are termed “natural” or pharmaceutical should follow the same strict and rigorous testing to ensure our safety.  Just because something is chemical doesn’t mean it isn’t natural and just because something is natural doesn’t mean it’s safe.


Chemistry begins in the stars. The stars are the source of the chemical elements, which are the building blocks of matter and the core of our subject.”
Peter Atkins

Tuesday, June 20, 2017

Want a Glowing Tan? Head to the Lab!

Everyone wants to look tanned for the summer but we’re all afraid of harmful UV rays. Skin cancer is one of the most prevalent cancers in North America so we do our best to prevent it by lathering on the sunscreen and staying out of the sun but this leaves us pale and pasty during shorts and T-shirt season! What are we to do?? Yes, there are spray tans and moisturizers that gradually tan your skin but most of these products make your skin look more orange than a nice bronze color and they can stain your sheets and clothes.

What if you could have a bronze glow without the damaging effects of UV rays or dyeing your skin? Well thanks to Dr. David E. Fisher and his team of scientists, you may be able to in the near future! They found that inhibiting enzymes called SIKs (salt-inducible kinases) activated the pigmentation pathway in the same way as UV radiation would but without the DNA-damaging effects. They went on to develop a superior version of this inhibitor so that it can be better absorbed by human skin. It takes 1-2 days for the skin to “tan” and it lasts a few days.

In the future, the team will be conducting toxicity studies, and then they hope to move onto clinical trials. Ultimately, they strive to develop a compound that can be added to sunscreenJ
and be used regularly; tanning and skin protection all in one! If it turns out to be safe I’m definitely going to try it


-        Mena

References:

Friday, June 16, 2017

RxBriefCase: the Pharmacy Student’s Perfect Study Buddy

Happy Friday everyone!

I’ve almost completed my first week at mdBriefCase and it’s been great! Looking forward to the next 4 weeks! J

A couple of days ago I was chatting with some of my friends about their pharmacy placements and all of them said the same thing, “I need to go over my notes because I forgot a bunch of stuff that we learned in class”. For example, a customer asked one of my friends about allergy medications and which one she should take but since we covered that topic almost 2 years ago it’s kind of hard to remember. But luckily for us there’s rxBriefCase! All we have to do is log on and click on the topic we need a refresher on and voila! We are saved from the embarrassment of not being able to answer a question and our patients are the better for it. 

Unfortunately there is one issue…. Most of my pharmacy class doesn’t know about rxBriefCase! Before I started my APPE rotation here I didn’t know about it either. Having this resource would have helped a lot for our medication management classes as well as our pharmacy summer placements. But now I’m spreading the word! I posted a link to rxBriefCase to my pharmacy classes’ facebook page so that we can all take advantage of this knowledge source.

rxBriefCase is a valuable resource to have; it’ll help us get through our APPE rotations and continue being a great resource throughout our careers. Register now and gain access to a wealth of clinical knowledge for free! You also get continuing education credits for each program you complete.

“The goal of education is the advancement of knowledge and the dissemination of truth” - John F. Kennedy

Take care everyone!


Mena

Monday, June 12, 2017

10 Things About Me

Hi There!

My name is Mena, I’m a fourth year pharmacy student from the University of Toronto and mdBriefCase is my second APPE placement. I’m so excited to get started and try something new! J

Since I’m new I thought I would introduce myself with 10 random facts about me:
  1. For most of my life I wanted to be an astronaut. Unfortunately, at the age of 21 I went to an amusement park for the first time and realized I had bad motion sickness …. So I realized the astronaut thing wasn’t going to happen!
  2. I speak 3 languages; English, French and Arabic
  3. Shopping is both my happiness and downfall
  4. Sci-Fi and fantasy are my favorite genres of movies/shows/books
  5. I got married last summer! 
  6. I used to be a Sagittarius but recently I found out that I’m actually an Ophiuchus, which is the 13th astrological sign that most people don’t know about. If you were born between November 29th and December 17th then you are actually not a Sagittarius but an Ophiuchus… weird!
  7. I love learning about molecular pathways especially when related to the mechanism of action of medications
  8. I believe the Universe is infinite
  9. Red wine is my favorite drink (preferably from California)
  10. I love to cook but I love to eat even more!

Until next time!


-        Mena

Thursday, May 4, 2017

And that’s a wrap!


I’ll start off with a very generic line of “it seems like it was only yesterday that I started my rotation..” But in all honestly, it truly feels as if 5 weeks flew by in a blink of an eye.

With just 2 days left into finishing my final rotation, I wanted to express my biggest gratitude for the amazing team at mdBriefCase. It’s been a pleasure working with everyone in developing the contents for the eNewsletter, MSFY and my final presentation. Special thanks to Cassandra and Mike!

I came into this rotation with minimal understanding of what continuing education is and what role it plays for a practicing healthcare professional. However, the past 5 weeks has taught me not only what CME is but also the process of how a CME program is developed and accredited. It’s been an eye-opening experience to be able to learn all the various aspects of continuing education.
As mentioned in my previous blog post, the main initiatives I took part on at mdBriefCase included the following:
  • eNewsletter “Resistant Head Lice: A Real Head Scratcher”
  • MSFY “Heartburn: A Burning Sensation”

Although these contents are not yet live, be sure to be on the lookout in the next couple weeks rxPASSPORT and MedSchool For You: Pharmacy Corner!

Thank you again for the amazing opportunity. J


Boo

Friday, April 28, 2017

Hidden Dangers of Drug-Food Interaction

Whether you’re picking up a new antibiotic from the pharmacy or renewing your cholesterol medication, you often get counseled by the pharmacist regarding certain drug-food interactions. Many people are aware that these interactions exist – but just how real and serious is this issue?
The main mechanism behind drug-food interaction is dependent on how the body breaks down the medication. Enzymes known as the cytochrome P450 enzymes allow the body to metabolize and gradually degrade the medications after administration. Certain foods are able to inhibit or potentiate the action of these enzymes. This in turn can lead to too much drug in the body (i.e. increased side effect or toxicity) or too little drug in the body (sub-therapeutic effect). Other interactions between medications and certain foods can take place by hindering with the absorption of the medication or by amplifying the existing side effects of the medication.
Many different food groups interact with medications. While I am unable to give a comprehensive list of all the interactions, I’ll mention few that are worthwhile to know about.
  1. Grapefruit juice: Grapefruit juice is one of the most notorious offenders for causing drug-food interactions. Grapefruit juice inhibits a major subtype of P450 enzyme that metabolizes cholesterol medications such as atorvastatin, lovastatin, and simvastatin. Blood pressure medication such as amlodipine is also affected by this interaction. By inhibiting the enzyme, grapefruit juice allows the medication to stay in the body for a longer duration and increases the possibility of experiencing side effects. Drugs that interact with grapefruit juice should not be taken together within the same 24 hour period since the inhibition of P450 enzyme by grapefruit juice leaves a long-lasting effect.
  2. Alcohol: The interaction between alcohol and medications doesn’t necessarily involve the CYP P450 enzymes but mostly on the effect of the medication. For instance, any medications that can cause drowsiness or sedation can be worsened if taken alongside alcohol. These medications include antihistamines, muscle relaxants and even some painkillers. Although this interaction may not diminish the efficacy of the medications, it is best to separate t
    heir administration to avoid serious side effects.
  3. Dairy products: This category extends beyond just dairy products but also encompasses calcium or iron supplements. The major concern regarding dairy products is with thyroid medication (i.e. levothyroxine) and certain antibiotics known as the fluoroquinolones. Dairy products and mineral supplements hinder the absorption of these medications and lower their efficacy. These medications should be spaced out by minimum 1 hour before or 2 hours after dairy products are consumed. 

If you’re unsure about your medications and whether it interacts with certain groups, check out a great online resource from FDA and be sure to ask your pharmacist on your next visit!


Boo

Friday, April 21, 2017

Half way done!

Three weeks went by in a blink of an eye. After receiving few ‘urgent’ reminders from my faculty to complete the midpoint evaluations, I thought this would be the perfect time to recap everyone about what I’ve been up to so far.

Overall, my tasks during the 5 week rotation at mdBriefCase can be broken down to 2 main categories: 

  1. Critical appraisal of one of the CCCEP-accredited eCME program on http://www.rxbriefcase.com
  2. Content development for practicing pharmacists and patients.

For my critical appraisal, I chose the eCME on Considerations in the Selection of Pharmacotherapy for ADHD. I am in the midst of analyzing the various aspects of the program as well as the national participation report to find key strengths and weaknesses. I’ll be presenting on my findings towards the end of my rotation.

In terms of content development, I’ve been knee-deep in writing an eNewsletter, which will be sent out nation-wide to practicing pharmacists across Canada. Although my draft is not yet finished and available for viewing, past eNewsletters can be found at rxPassport. I’m also working on a mini Q&A on the patient education portal, MedSchool For You: Pharmacy Corner.

Last but not least, I’ve been given the lovely opportunity to complete the Certificate-level training of my choice on Advancing Practice. I chose to go over the diabetes education program since this will be a handy-dandy review before I start practicing as a pharmacist.

No complaints so far! Looking forward to spending 2 more exciting weeks at mdBriefCase!

- Boo


Thursday, April 13, 2017

Is my EpiPen safe to use?

On April 1st, 2017, Pfizer Canada issued a voluntary recall of one lot of both EpiPen auto-injector and EpiPen Jr. auto-injector.  The recall decision was made after two confirmed international reports of the devices failing to activate. The company stated that more than 100,000 products which may be affected by this recall were distributed across Canada.

EpiPen auto-injectors are indicated for emergency treatment of severe allergic reactions (anaphylaxis) for patients with high risk. After the administration of EpiPen, patients are advised to seek immediate medical attention or proceed to the nearest ER.

This event was of particular significance since Epipen has been the lone defender against anaphylactic reactions with the nation-wide recall of Allerject back in 2015. Although the incidence of the defect is extremely rare, it may pose a serious impact on patients who rely heavily on the efficacy of EpiPen.  

Image result for epi penDespite the recall, Pfizer recommends patients to keep the existing product until they can secure the replacement EpiPen. Product Replacement Instructions can be found here.

Before using your Epipen, follow these 3 simple steps to ensure safe/effective EpiPen use:
  1. Always check the expiration date (generally 1-2 years from time of purchase)!
  2. Examine the window of the EpiPen to make sure the solution is clear and free of any discoloration.
  3. Remember the instructions:  “blue to the sky, orange to the thigh”

References:

CBC news. “Canadian Patients wait longest to see family doctor.”  January 20, 2014.
Retrieved from http://www.cbc.ca/news/health/us-epipen-recall-1.4051059 on April 13, 2017.
Epipen. “Frequently asked questions.” 2015. Retrieved from http://www.epipen.ca/en/about-epipen/frequently-asked-questions on April 13, 2017.
Government of Canada. “Pfizer Canada recalls two lots of EpiPen/EpiPen Jr auto-injectors (0.3mg and 0.15mg epinephrine) due to possible device failure.” April 01, 2017. Retrieved from http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2017/62872a-eng.php on April 13, 2017.
Pfizer. “How do I exchange my recalled EpiPen auto-injector?” April 01, 2017. Retrieved from http://www.pfizer.ca/node/7656 on April 13, 2017.

Tuesday, April 4, 2017

Hello...it's me

Greetings from the newest addition to the mdBriefcase team. 

My name is Hyeyoon and I’m a fourth year pharmacy student currently here on APPE placement for the next 5 weeks. I wanted to introduce myself to the team and to the blog as I will be contributing new posts from time to time in the upcoming weeks.

I'm extremely excited for my time here at mdBriefcase as it's my very last block before graduating and moving out into the real ‘adult’ world. This is a special time for me as not only am I finally graduating after years and years of school but it's also the transitional time prior to obtaining my license. I'm currently preparing for my licensing exam which takes place in a month’s time.
Some interesting facts about me:
  • I have 50 succulents and cactii all growing in my home.
  • I am an avid lover of coffee and an even bigger addict for sleep/hibernation.
  • My last name is BOO!
  • I’m currently in the midst of growing my very own mushroom farm (in a box).
The majority of my previous experiences are from community pharmacy environments (Shopper's Drug Mart, Loblaw Pharmacy; You name it -- I’ve been there).  Practicing in community pharmacies holds a special place in my heart as I love interacting with patients on a daily basis.


I'll be sharing my insights about the practice and interesting topics in pharmacy very soon. Stay tuned for new updates!

Friday, March 31, 2017

Farewell!

It’s my last day here at mdBriefCase already. During my 5 weeks, I’ve worked on various projects that helped me develop my writing and presentation skills.

I wanted to share my experience about these projects to provide some insight and suggestions for future students.

Project
My responsibilities
Suggestions for future students
eCME critical appraisal
·         Critically appraise “Pharmacists Improving Treatment Adherence & Patient Outcomes in AD”
·         Present and discuss finding to team members through 20 minute PowerPoint presentation
·         Be critical. Don’t be afraid to point out things you dislike
·         Become an expert on the topic yourself

eNewsletter
·         Write an eNewsletter that would be distributed to many pharmacists across Canada
·         See “4 Simple Steps to Deprescribe Benzodiazepines
·         This is not an essay!
·         Tell a story that pharmacists can relate to in order to make an impact
MedSchoolForYou Q&A
·         Develop answers to frequently asked questions on a medical topic of choice
·         Customize information to patients
·         See “When Every Breath Counts – Asthma in Children

·         Keep the language simple
·         Think about what the patients are interested in (Probably not pharmacokinetics of drugs)

Blogs
·         Contribute to the pharmacy student blog
·         Write about my experiences and insights on pharmacy practice and healthcare
·         Be creative, funny, quirky
·         Share YOUR thoughts


Although my rotation with rxBriefcase has come to an end, I know that rxBriefcase will continue to be a valuable asset through my journey of life-long learning. 

I would like to thank everyone at mdBriefcase for all the opportunities I’ve been given. The writing support and freedom of expression I received here was phenomenal. I’m sure future students would thoroughly enjoy this rotation as much as I did.

Kevin