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<pubDate>Fri, 24 May 2013 14:52:41 GMT</pubDate>
		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/495</link>

			<title>NPTA Office Closed: Memorial Day on 27-May-13 8:30 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/495&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;NPTA Office Closed:  Memorial Day&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130527T133000Z&quot;&gt;27-May-13 8:30 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130527T223000Z&quot;&gt;27-May-13 5:30 PM&lt;/abbr&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/495</guid>

			<pubDate>Mon, 27 May 2013 13:30:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/496</link>

			<title>IV Certification Course on 3-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/496&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;IV Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130603T140000Z&quot;&gt;3-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130604T220000Z&quot;&gt;4-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Course Details&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;The course requirements include:&lt;br&gt;
			- 9 Home Study Modules&lt;br&gt;
			- 2 Days Hands-On Training&lt;br&gt;
			- 8&amp;nbsp;Process Technique Validations&lt;br&gt;
			&lt;br&gt;
			&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1386&quot;&gt;&amp;gt;&amp;gt;Complete Learning Objectives&lt;/a&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;How the Course Works&lt;br&gt;
			&lt;/font&gt;&lt;/strong&gt;Participants must complete nine separate modules of home-based learning, comprised of a reading assignment and comprehensive exam.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s&amp;nbsp;two-day&amp;nbsp;&lt;em&gt;Sterile Product&amp;nbsp;Training Institute&lt;/em&gt;, located at the&amp;nbsp;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot;&gt;NPTA Training Institute&lt;/a&gt; in Houston, Texas.&lt;br&gt;
			&lt;/font&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Home Study Modules&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;&lt;/font&gt;- Introduction to Sterile Products&lt;br&gt;
			- Facilities, Garb &amp;amp; Equipment&lt;br&gt;
			- Aseptic Calculations&lt;br&gt;
			- Properties of Sterile Products&lt;br&gt;
			- Aseptic Technique&lt;br&gt;
			- Sterile Product Preparations&lt;br&gt;
			- Total Parenteral Nutrition (TPN)&lt;br&gt;
			- Chemotherapy&lt;br&gt;
			- Quality Control and Assurance&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Training &amp;amp; Technique Validations&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;&lt;/font&gt;- Aseptic Hand Washing&lt;br&gt;
			- Horizontal Laminar Airflow Hood Care&lt;br&gt;
			- Vertical Laminar Airflow Hood Care&lt;br&gt;
			- Vial Manipulations&lt;br&gt;
			- Ampule Manipulations&lt;br&gt;
			- Hazardous Vial Manipulations&lt;br&gt;
			- Hazardous Ampule Manipulations&lt;br&gt;
			&amp;nbsp;&lt;br&gt;
			&lt;br&gt;
			&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Tuition Fee&lt;/font&gt;&lt;br&gt;
			&lt;/strong&gt;$648 Members&lt;br&gt;
			$698 Non-Members&amp;nbsp;&lt;/font&gt;&amp;nbsp;&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;Please note: This course is non-refundable and non-transferable.&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
			&lt;/font&gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;What&#39;s Included &lt;/font&gt;&lt;br&gt;
			&lt;/strong&gt;Tuition includes: &lt;em&gt;Sterile Products &lt;/em&gt;textbook by Pearson Education, official course binder, two day hands-on training institute, lunch/snacks on both training days,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div&gt;
			&lt;span &gt;&lt;span &gt;&lt;font &gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;CPE Credits&lt;br&gt;
			&lt;/font&gt;&lt;/strong&gt;40.0 Contact Hours/4.0 CEU&lt;br&gt;
			Program Type: Practice&lt;br&gt;
			UAN No: 0384-0000-11-004-H-04-T //&amp;nbsp; 0384-0000-11-004-L-04-T&lt;br&gt;
			0384-0000-11-004-H-04-P // 0384-0000-11-004-L-04-P&lt;br&gt;
			&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;span &gt;&lt;span &gt;&lt;br&gt;
			Re-Release Date: 04-18-2011&amp;nbsp;&amp;nbsp; Expiration Date: 04-18-2014&lt;/span&gt;&lt;/span&gt;
			&lt;div align=&quot;left&quot; &gt;
				&amp;nbsp;&lt;/div&gt;
			&lt;div align=&quot;left&quot; &gt;
				&lt;span &gt;&lt;span &gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;img alt=&quot;&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
	&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/496</guid>

			<pubDate>Mon, 03 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/524</link>

			<title>Chemo Certification Course on 5-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/524&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;Chemo Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130605T140000Z&quot;&gt;5-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130605T220000Z&quot;&gt;5-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;div&gt;
		&lt;strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Course Details&lt;/font&gt;&lt;/font&gt;&lt;/strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		The course requirements include:&lt;br&gt;
		&lt;/font&gt;- 10 Home Study Modules&lt;br&gt;
		- 1 Days Hands-On Training&lt;br&gt;
		- 5 Process Technique Validations
		&lt;div&gt;
			&lt;div&gt;
				&amp;nbsp;&lt;/div&gt;
			&lt;div&gt;
				&lt;br&gt;
				&lt;strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Prerequisite&lt;/font&gt;&lt;/font&gt;&lt;/strong&gt;&lt;/div&gt;
		&lt;/div&gt;
		&lt;div&gt;
			&lt;span &gt;&lt;span &gt;Participants must meet one or more of the following requirements:&lt;/span&gt;&lt;/span&gt;
			&lt;ul&gt;
				&lt;li&gt;
					&lt;span &gt;Successful completion or current enrollment in NPTA&#39;s IV Certification Course&lt;/span&gt;&lt;/li&gt;
				&lt;li&gt;
					&lt;span &gt;Successful completion of&amp;nbsp; an ACPE-accredited course on sterile products/aseptic technique&lt;br&gt;
					40 contact hours or more, including both didactic and hands-on training (documentation required)&lt;/span&gt;&lt;/li&gt;
				&lt;li&gt;
					&lt;span &gt;600 hours (or more) of practical experience in aseptic technique/preparing sterile products over the past twelve months. (documentation and a signed letter of attestation from the pharmacy director required)&lt;/span&gt;&lt;/li&gt;
			&lt;/ul&gt;
		&lt;/div&gt;
		&lt;div&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div&gt;
			&lt;a href=&quot;http://www.pharmacytechnician.org/chemo-certification-learning-objectives/&quot;&gt;&lt;span &gt;&amp;gt;&amp;gt;Complete Learning Objectives&lt;/span&gt;&lt;/a&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;How the Course Works&lt;br&gt;
			&lt;/strong&gt;Participants must complete ten separate modules of home-based learning, comprised of a reading assignment and comprehensive exams.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s one-day &lt;em&gt;Hazardous Drugs Training Institute&lt;/em&gt;, located at the&amp;nbsp;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot; target=&quot;_self&quot;&gt;NPTA Training Institute&lt;/a&gt; in Houston, Texas.&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;Home Study Modules&lt;br&gt;
			&lt;/strong&gt;- What are Hazardous Drugs&lt;br&gt;
			- ASHP and Other Guidelines&lt;br&gt;
			- Receipt, Storage, Labeling &amp;amp; Transport&lt;br&gt;
			- Risk Assessment, Controls &amp;amp; Medical Surveillance&lt;br&gt;
			- Biological Safety Cabinets&lt;br&gt;
			- Isolators&lt;br&gt;
			- Personal Protective Equipment&lt;br&gt;
			- Aseptic Technique&lt;br&gt;
			- Decontamination, Waste Disposal &amp;amp; Spill Control&lt;br&gt;
			- Comprehensive Final Exam&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;Training &amp;amp; Technique Validations&lt;br&gt;
			&lt;/strong&gt;- Aseptic Hand Washing &amp;amp; Garbing&lt;br&gt;
			- Decontamination &amp;amp; Deactivation of a BSC&lt;br&gt;
			- Hazardous Liquid Vial Manipulations&lt;br&gt;
			- Hazardous Powder Vial Manipulation&lt;br&gt;
			- Hazardous Ampule Manipulations&lt;br&gt;
			&lt;br&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;strong &gt;Tuition Fee&lt;br&gt;
			&lt;/strong&gt;$498 Members&lt;br&gt;
			$598 Non-Members&amp;nbsp;&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;span &gt;Please note: This course is non-refundable and non-transferable.&lt;/span&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;span &gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/span&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;br&gt;
			&lt;strong &gt;What&#39;s Included &lt;/strong&gt;&lt;strong &gt;&lt;br&gt;
			&lt;/strong&gt;Tuition includes: &lt;em&gt;Safe Handling of Hazardous Drugs &lt;/em&gt;textbook by the American Society of Health-System Pharmacists, online course content access, one day of hands-on training/validations, lunch/snacks on training day,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;div&gt;
				&lt;span &gt;&lt;strong &gt;CPE Credits&lt;/strong&gt;&lt;/span&gt;&lt;br&gt;
				&lt;br&gt;
				&lt;div align=&quot;left&quot;&gt;
					&amp;nbsp;&lt;/div&gt;
				&lt;div align=&quot;left&quot;&gt;
					&lt;span &gt;&lt;img alt=&quot;&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/span&gt;&lt;/div&gt;
				&lt;div&gt;
					&amp;nbsp;&lt;/div&gt;
				&lt;div&gt;
					&lt;span &gt;Contact Hours: 20&lt;br&gt;
					ACPE #s:&amp;nbsp;&lt;br&gt;
					Home /UAN#: 0384-0000-10-003-H04-T /0384-0000-10-003-H-04-P&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
					Live/UAN#:&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; 0384-0000-10-004-L04-T / 0384-0000-10-004-L-04-P&lt;br&gt;
					&lt;/span&gt;&lt;/div&gt;
				&lt;ul&gt;
					&lt;li&gt;
						&lt;span &gt;&amp;nbsp;This program is valid for continuing education until April 22, 2015, whereas the Certification you will receive from NPTA for successfully completing all components of the course does not expire, nor require renewal.&lt;/span&gt;&lt;/li&gt;
				&lt;/ul&gt;
			&lt;/div&gt;
		&lt;/div&gt;
	&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/524</guid>

			<pubDate>Wed, 05 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/552</link>

			<title>Compounding Certification Course on 6-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/552&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;Compounding Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130606T140000Z&quot;&gt;6-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130607T220000Z&quot;&gt;7-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Course Details&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	The course requirements include:&lt;br&gt;
	&amp;nbsp;- 10 Home Study Modules with Exams&lt;br&gt;
	&amp;nbsp;- 2 Days Hands-On Training&lt;br&gt;
	&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;How the Course Works&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	Participants must complete eleven separate modules of home-based learning, comprised of a reading assignment and comprehensive exam.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s&amp;nbsp;two-day &lt;em&gt;Pharmaceutical Compounding Training Institute&lt;/em&gt;, located at the &lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot;&gt;NPTA Training Institute &lt;/a&gt;in Houston, Texas.&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Home Study Modules&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	&amp;nbsp;- Introduction to Compounding/Compounding Practices &amp;amp; Considerations&lt;br&gt;
	&amp;nbsp;- Facilities, Equipment &amp;amp; Supplies&lt;br&gt;
	&amp;nbsp;- Quality Assurance &amp;amp; Record Keeping&lt;br&gt;
	&amp;nbsp;- Capsules, Tablets &amp;amp; Powders&lt;br&gt;
	&amp;nbsp;- Lozenges, Troches, Sticks &amp;amp; Suppositories&lt;br&gt;
	&amp;nbsp;- Solutions, Suspensions &amp;amp; Emulsions&lt;br&gt;
	&amp;nbsp;- Ointments, Creams, Pastes &amp;amp; Gels&lt;br&gt;
	&amp;nbsp;- Ophthalmic, Otic &amp;amp; Nasal Preparations&lt;br&gt;
	&amp;nbsp;- Medication Flavoring&lt;br&gt;
	&amp;nbsp;- Veterinary Compounding&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Hands-On Training&amp;nbsp;Labs&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	&amp;nbsp;- Capsules&lt;br&gt;
	&amp;nbsp;- Carbomer Gels&lt;br&gt;
	&amp;nbsp;-&amp;nbsp;Creams&lt;br&gt;
	&amp;nbsp;- Gelatin Troches&lt;br&gt;
	&amp;nbsp;- Lip Balms&lt;br&gt;
	&amp;nbsp;- Medicated Lollipops&lt;br&gt;
	&amp;nbsp;- PEG Troches&lt;br&gt;
	&amp;nbsp;- PLO Gels&lt;br&gt;
	&amp;nbsp;- Solutions&lt;br&gt;
	&amp;nbsp;- Suspensions&amp;nbsp;&lt;br&gt;
	&amp;nbsp;- Suppositories&lt;br&gt;
	&amp;nbsp;- Tablet Triturates&lt;br&gt;
	&amp;nbsp;- Coloring/Flavoring&lt;br&gt;
	&amp;nbsp;-&amp;nbsp;Quality Assurance Methods&lt;br&gt;
	&amp;nbsp;- Record Keeping&lt;br&gt;
	&lt;br&gt;
	&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Tuition Fee&lt;br&gt;
	&lt;/font&gt;&lt;/strong&gt;$648 NPTA Members&lt;br&gt;
	$698 Non-Members &lt;/font&gt;&lt;/font&gt;
	&lt;div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;Please note: This course is non-refundable.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/font&gt;&lt;/div&gt;
	&lt;/div&gt;
	&lt;div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;What&#39;s Included&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
		Tuition includes: &lt;em&gt;Compounding &lt;/em&gt;textbook by Pearson Education, official course binder, two day hands-on training institute, lunch/snacks on both training days,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/font&gt;&lt;/div&gt;
	&lt;div&gt;
		&amp;nbsp;&lt;/div&gt;
	&lt;div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;CPE Credits&lt;br&gt;
		&lt;/font&gt;&lt;/strong&gt;40.0 Contact Hours/4.0 CEU&lt;br&gt;
		Program Type: Practice&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;UAN No. 0384-0000-11-006-H04-T //&amp;nbsp; 0384-0000-11-006-H04-T&lt;/font&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;0384-0000-11-006-H04-P //&amp;nbsp; 0384-0000-11-006-H04-P&lt;/font&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;Re-release Date: 05-11-2011&amp;nbsp; Expiration Date: 05-11-2014&lt;/font&gt;&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		&lt;img alt=&quot;&quot; border=&quot;0&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/552</guid>

			<pubDate>Thu, 06 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/497</link>

			<title>IV Certification Course on 10-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/497&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;IV Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130610T140000Z&quot;&gt;10-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130611T220000Z&quot;&gt;11-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Course Details&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;The course requirements include:&lt;br&gt;
			- 9 Home Study Modules&lt;br&gt;
			- 2 Days Hands-On Training&lt;br&gt;
			- 8&amp;nbsp;Process Technique Validations&lt;br&gt;
			&lt;br&gt;
			&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1386&quot;&gt;&amp;gt;&amp;gt;Complete Learning Objectives&lt;/a&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;How the Course Works&lt;br&gt;
			&lt;/font&gt;&lt;/strong&gt;Participants must complete nine separate modules of home-based learning, comprised of a reading assignment and comprehensive exam.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s&amp;nbsp;two-day&amp;nbsp;&lt;em&gt;Sterile Product&amp;nbsp;Training Institute&lt;/em&gt;, located at the&amp;nbsp;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot;&gt;NPTA Training Institute&lt;/a&gt; in Houston, Texas.&lt;br&gt;
			&lt;/font&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Home Study Modules&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;&lt;/font&gt;- Introduction to Sterile Products&lt;br&gt;
			- Facilities, Garb &amp;amp; Equipment&lt;br&gt;
			- Aseptic Calculations&lt;br&gt;
			- Properties of Sterile Products&lt;br&gt;
			- Aseptic Technique&lt;br&gt;
			- Sterile Product Preparations&lt;br&gt;
			- Total Parenteral Nutrition (TPN)&lt;br&gt;
			- Chemotherapy&lt;br&gt;
			- Quality Control and Assurance&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Training &amp;amp; Technique Validations&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;&lt;/font&gt;- Aseptic Hand Washing&lt;br&gt;
			- Horizontal Laminar Airflow Hood Care&lt;br&gt;
			- Vertical Laminar Airflow Hood Care&lt;br&gt;
			- Vial Manipulations&lt;br&gt;
			- Ampule Manipulations&lt;br&gt;
			- Hazardous Vial Manipulations&lt;br&gt;
			- Hazardous Ampule Manipulations&lt;br&gt;
			&amp;nbsp;&lt;br&gt;
			&lt;br&gt;
			&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Tuition Fee&lt;/font&gt;&lt;br&gt;
			&lt;/strong&gt;$648 Members&lt;br&gt;
			$698 Non-Members&amp;nbsp;&lt;/font&gt;&amp;nbsp;&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;Please note: This course is non-refundable and non-transferable.&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
			&lt;/font&gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;What&#39;s Included &lt;/font&gt;&lt;br&gt;
			&lt;/strong&gt;Tuition includes: &lt;em&gt;Sterile Products &lt;/em&gt;textbook by Pearson Education, official course binder, two day hands-on training institute, lunch/snacks on both training days,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div&gt;
			&lt;span &gt;&lt;span &gt;&lt;font &gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;CPE Credits&lt;br&gt;
			&lt;/font&gt;&lt;/strong&gt;40.0 Contact Hours/4.0 CEU&lt;br&gt;
			Program Type: Practice&lt;br&gt;
			UAN No: 0384-0000-11-004-H-04-T //&amp;nbsp; 0384-0000-11-004-L-04-T&lt;br&gt;
			0384-0000-11-004-H-04-P // 0384-0000-11-004-L-04-P&lt;br&gt;
			&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;span &gt;&lt;span &gt;&lt;br&gt;
			Re-Release Date: 04-18-2011&amp;nbsp;&amp;nbsp; Expiration Date: 04-18-2014&lt;/span&gt;&lt;/span&gt;
			&lt;div align=&quot;left&quot; &gt;
				&amp;nbsp;&lt;/div&gt;
			&lt;div align=&quot;left&quot; &gt;
				&lt;span &gt;&lt;span &gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;img alt=&quot;&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
	&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/497</guid>

			<pubDate>Mon, 10 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/525</link>

			<title>Chemo Certification Course on 12-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/525&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;Chemo Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130612T140000Z&quot;&gt;12-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130612T220000Z&quot;&gt;12-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;div&gt;
		&lt;strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Course Details&lt;/font&gt;&lt;/font&gt;&lt;/strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		The course requirements include:&lt;br&gt;
		&lt;/font&gt;- 10 Home Study Modules&lt;br&gt;
		- 1 Days Hands-On Training&lt;br&gt;
		- 5 Process Technique Validations
		&lt;div&gt;
			&lt;div&gt;
				&amp;nbsp;&lt;/div&gt;
			&lt;div&gt;
				&lt;br&gt;
				&lt;strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Prerequisite&lt;/font&gt;&lt;/font&gt;&lt;/strong&gt;&lt;/div&gt;
		&lt;/div&gt;
		&lt;div&gt;
			&lt;span &gt;&lt;span &gt;Participants must meet one or more of the following requirements:&lt;/span&gt;&lt;/span&gt;
			&lt;ul&gt;
				&lt;li&gt;
					&lt;span &gt;Successful completion or current enrollment in NPTA&#39;s IV Certification Course&lt;/span&gt;&lt;/li&gt;
				&lt;li&gt;
					&lt;span &gt;Successful completion of&amp;nbsp; an ACPE-accredited course on sterile products/aseptic technique&lt;br&gt;
					40 contact hours or more, including both didactic and hands-on training (documentation required)&lt;/span&gt;&lt;/li&gt;
				&lt;li&gt;
					&lt;span &gt;600 hours (or more) of practical experience in aseptic technique/preparing sterile products over the past twelve months. (documentation and a signed letter of attestation from the pharmacy director required)&lt;/span&gt;&lt;/li&gt;
			&lt;/ul&gt;
		&lt;/div&gt;
		&lt;div&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div&gt;
			&lt;a href=&quot;http://www.pharmacytechnician.org/chemo-certification-learning-objectives/&quot;&gt;&lt;span &gt;&amp;gt;&amp;gt;Complete Learning Objectives&lt;/span&gt;&lt;/a&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;How the Course Works&lt;br&gt;
			&lt;/strong&gt;Participants must complete ten separate modules of home-based learning, comprised of a reading assignment and comprehensive exams.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s one-day &lt;em&gt;Hazardous Drugs Training Institute&lt;/em&gt;, located at the&amp;nbsp;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot; target=&quot;_self&quot;&gt;NPTA Training Institute&lt;/a&gt; in Houston, Texas.&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;Home Study Modules&lt;br&gt;
			&lt;/strong&gt;- What are Hazardous Drugs&lt;br&gt;
			- ASHP and Other Guidelines&lt;br&gt;
			- Receipt, Storage, Labeling &amp;amp; Transport&lt;br&gt;
			- Risk Assessment, Controls &amp;amp; Medical Surveillance&lt;br&gt;
			- Biological Safety Cabinets&lt;br&gt;
			- Isolators&lt;br&gt;
			- Personal Protective Equipment&lt;br&gt;
			- Aseptic Technique&lt;br&gt;
			- Decontamination, Waste Disposal &amp;amp; Spill Control&lt;br&gt;
			- Comprehensive Final Exam&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;Training &amp;amp; Technique Validations&lt;br&gt;
			&lt;/strong&gt;- Aseptic Hand Washing &amp;amp; Garbing&lt;br&gt;
			- Decontamination &amp;amp; Deactivation of a BSC&lt;br&gt;
			- Hazardous Liquid Vial Manipulations&lt;br&gt;
			- Hazardous Powder Vial Manipulation&lt;br&gt;
			- Hazardous Ampule Manipulations&lt;br&gt;
			&lt;br&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;strong &gt;Tuition Fee&lt;br&gt;
			&lt;/strong&gt;$498 Members&lt;br&gt;
			$598 Non-Members&amp;nbsp;&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;span &gt;Please note: This course is non-refundable and non-transferable.&lt;/span&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;span &gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/span&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;br&gt;
			&lt;strong &gt;What&#39;s Included &lt;/strong&gt;&lt;strong &gt;&lt;br&gt;
			&lt;/strong&gt;Tuition includes: &lt;em&gt;Safe Handling of Hazardous Drugs &lt;/em&gt;textbook by the American Society of Health-System Pharmacists, online course content access, one day of hands-on training/validations, lunch/snacks on training day,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;div&gt;
				&lt;span &gt;&lt;strong &gt;CPE Credits&lt;/strong&gt;&lt;/span&gt;&lt;br&gt;
				&lt;br&gt;
				&lt;div align=&quot;left&quot;&gt;
					&amp;nbsp;&lt;/div&gt;
				&lt;div align=&quot;left&quot;&gt;
					&lt;span &gt;&lt;img alt=&quot;&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/span&gt;&lt;/div&gt;
				&lt;div&gt;
					&amp;nbsp;&lt;/div&gt;
				&lt;div&gt;
					&lt;span &gt;Contact Hours: 20&lt;br&gt;
					ACPE #s:&amp;nbsp;&lt;br&gt;
					Home /UAN#: 0384-0000-10-003-H04-T /0384-0000-10-003-H-04-P&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
					Live/UAN#:&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; 0384-0000-10-004-L04-T / 0384-0000-10-004-L-04-P&lt;br&gt;
					&lt;/span&gt;&lt;/div&gt;
				&lt;ul&gt;
					&lt;li&gt;
						&lt;span &gt;&amp;nbsp;This program is valid for continuing education until April 22, 2015, whereas the Certification you will receive from NPTA for successfully completing all components of the course does not expire, nor require renewal.&lt;/span&gt;&lt;/li&gt;
				&lt;/ul&gt;
			&lt;/div&gt;
		&lt;/div&gt;
	&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/525</guid>

			<pubDate>Wed, 12 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/553</link>

			<title>Compounding Certification Course on 13-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/553&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;Compounding Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130613T140000Z&quot;&gt;13-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130614T220000Z&quot;&gt;14-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Course Details&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	The course requirements include:&lt;br&gt;
	&amp;nbsp;- 10 Home Study Modules with Exams&lt;br&gt;
	&amp;nbsp;- 2 Days Hands-On Training&lt;br&gt;
	&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;How the Course Works&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	Participants must complete eleven separate modules of home-based learning, comprised of a reading assignment and comprehensive exam.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s&amp;nbsp;two-day &lt;em&gt;Pharmaceutical Compounding Training Institute&lt;/em&gt;, located at the &lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot;&gt;NPTA Training Institute &lt;/a&gt;in Houston, Texas.&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Home Study Modules&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	&amp;nbsp;- Introduction to Compounding/Compounding Practices &amp;amp; Considerations&lt;br&gt;
	&amp;nbsp;- Facilities, Equipment &amp;amp; Supplies&lt;br&gt;
	&amp;nbsp;- Quality Assurance &amp;amp; Record Keeping&lt;br&gt;
	&amp;nbsp;- Capsules, Tablets &amp;amp; Powders&lt;br&gt;
	&amp;nbsp;- Lozenges, Troches, Sticks &amp;amp; Suppositories&lt;br&gt;
	&amp;nbsp;- Solutions, Suspensions &amp;amp; Emulsions&lt;br&gt;
	&amp;nbsp;- Ointments, Creams, Pastes &amp;amp; Gels&lt;br&gt;
	&amp;nbsp;- Ophthalmic, Otic &amp;amp; Nasal Preparations&lt;br&gt;
	&amp;nbsp;- Medication Flavoring&lt;br&gt;
	&amp;nbsp;- Veterinary Compounding&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Hands-On Training&amp;nbsp;Labs&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	&amp;nbsp;- Capsules&lt;br&gt;
	&amp;nbsp;- Carbomer Gels&lt;br&gt;
	&amp;nbsp;-&amp;nbsp;Creams&lt;br&gt;
	&amp;nbsp;- Gelatin Troches&lt;br&gt;
	&amp;nbsp;- Lip Balms&lt;br&gt;
	&amp;nbsp;- Medicated Lollipops&lt;br&gt;
	&amp;nbsp;- PEG Troches&lt;br&gt;
	&amp;nbsp;- PLO Gels&lt;br&gt;
	&amp;nbsp;- Solutions&lt;br&gt;
	&amp;nbsp;- Suspensions&amp;nbsp;&lt;br&gt;
	&amp;nbsp;- Suppositories&lt;br&gt;
	&amp;nbsp;- Tablet Triturates&lt;br&gt;
	&amp;nbsp;- Coloring/Flavoring&lt;br&gt;
	&amp;nbsp;-&amp;nbsp;Quality Assurance Methods&lt;br&gt;
	&amp;nbsp;- Record Keeping&lt;br&gt;
	&lt;br&gt;
	&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Tuition Fee&lt;br&gt;
	&lt;/font&gt;&lt;/strong&gt;$648 NPTA Members&lt;br&gt;
	$698 Non-Members &lt;/font&gt;&lt;/font&gt;
	&lt;div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;Please note: This course is non-refundable.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/font&gt;&lt;/div&gt;
	&lt;/div&gt;
	&lt;div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;What&#39;s Included&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
		Tuition includes: &lt;em&gt;Compounding &lt;/em&gt;textbook by Pearson Education, official course binder, two day hands-on training institute, lunch/snacks on both training days,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/font&gt;&lt;/div&gt;
	&lt;div&gt;
		&amp;nbsp;&lt;/div&gt;
	&lt;div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;CPE Credits&lt;br&gt;
		&lt;/font&gt;&lt;/strong&gt;40.0 Contact Hours/4.0 CEU&lt;br&gt;
		Program Type: Practice&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;UAN No. 0384-0000-11-006-H04-T //&amp;nbsp; 0384-0000-11-006-H04-T&lt;/font&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;0384-0000-11-006-H04-P //&amp;nbsp; 0384-0000-11-006-H04-P&lt;/font&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;Re-release Date: 05-11-2011&amp;nbsp; Expiration Date: 05-11-2014&lt;/font&gt;&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		&lt;img alt=&quot;&quot; border=&quot;0&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/553</guid>

			<pubDate>Thu, 13 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/498</link>

			<title>IV Certification Course on 17-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/498&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;IV Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130617T140000Z&quot;&gt;17-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130618T220000Z&quot;&gt;18-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Course Details&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;The course requirements include:&lt;br&gt;
			- 9 Home Study Modules&lt;br&gt;
			- 2 Days Hands-On Training&lt;br&gt;
			- 8&amp;nbsp;Process Technique Validations&lt;br&gt;
			&lt;br&gt;
			&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1386&quot;&gt;&amp;gt;&amp;gt;Complete Learning Objectives&lt;/a&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;How the Course Works&lt;br&gt;
			&lt;/font&gt;&lt;/strong&gt;Participants must complete nine separate modules of home-based learning, comprised of a reading assignment and comprehensive exam.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s&amp;nbsp;two-day&amp;nbsp;&lt;em&gt;Sterile Product&amp;nbsp;Training Institute&lt;/em&gt;, located at the&amp;nbsp;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot;&gt;NPTA Training Institute&lt;/a&gt; in Houston, Texas.&lt;br&gt;
			&lt;/font&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Home Study Modules&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;&lt;/font&gt;- Introduction to Sterile Products&lt;br&gt;
			- Facilities, Garb &amp;amp; Equipment&lt;br&gt;
			- Aseptic Calculations&lt;br&gt;
			- Properties of Sterile Products&lt;br&gt;
			- Aseptic Technique&lt;br&gt;
			- Sterile Product Preparations&lt;br&gt;
			- Total Parenteral Nutrition (TPN)&lt;br&gt;
			- Chemotherapy&lt;br&gt;
			- Quality Control and Assurance&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;&lt;strong&gt;Training &amp;amp; Technique Validations&lt;br&gt;
			&lt;/strong&gt;&lt;/font&gt;&lt;/font&gt;- Aseptic Hand Washing&lt;br&gt;
			- Horizontal Laminar Airflow Hood Care&lt;br&gt;
			- Vertical Laminar Airflow Hood Care&lt;br&gt;
			- Vial Manipulations&lt;br&gt;
			- Ampule Manipulations&lt;br&gt;
			- Hazardous Vial Manipulations&lt;br&gt;
			- Hazardous Ampule Manipulations&lt;br&gt;
			&amp;nbsp;&lt;br&gt;
			&lt;br&gt;
			&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Tuition Fee&lt;/font&gt;&lt;br&gt;
			&lt;/strong&gt;$648 Members&lt;br&gt;
			$698 Non-Members&amp;nbsp;&lt;/font&gt;&amp;nbsp;&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;Please note: This course is non-refundable and non-transferable.&lt;/font&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;font size=&quot;2&quot;&gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
			&lt;/font&gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;What&#39;s Included &lt;/font&gt;&lt;br&gt;
			&lt;/strong&gt;Tuition includes: &lt;em&gt;Sterile Products &lt;/em&gt;textbook by Pearson Education, official course binder, two day hands-on training institute, lunch/snacks on both training days,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div&gt;
			&lt;span &gt;&lt;span &gt;&lt;font &gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;CPE Credits&lt;br&gt;
			&lt;/font&gt;&lt;/strong&gt;40.0 Contact Hours/4.0 CEU&lt;br&gt;
			Program Type: Practice&lt;br&gt;
			UAN No: 0384-0000-11-004-H-04-T //&amp;nbsp; 0384-0000-11-004-L-04-T&lt;br&gt;
			0384-0000-11-004-H-04-P // 0384-0000-11-004-L-04-P&lt;br&gt;
			&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;span &gt;&lt;span &gt;&lt;br&gt;
			Re-Release Date: 04-18-2011&amp;nbsp;&amp;nbsp; Expiration Date: 04-18-2014&lt;/span&gt;&lt;/span&gt;
			&lt;div align=&quot;left&quot; &gt;
				&amp;nbsp;&lt;/div&gt;
			&lt;div align=&quot;left&quot; &gt;
				&lt;span &gt;&lt;span &gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;img alt=&quot;&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
	&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/498</guid>

			<pubDate>Mon, 17 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/526</link>

			<title>Chemo Certification Course on 19-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/526&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;Chemo Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130619T140000Z&quot;&gt;19-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130619T220000Z&quot;&gt;19-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;div&gt;
		&lt;strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Course Details&lt;/font&gt;&lt;/font&gt;&lt;/strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		The course requirements include:&lt;br&gt;
		&lt;/font&gt;- 10 Home Study Modules&lt;br&gt;
		- 1 Days Hands-On Training&lt;br&gt;
		- 5 Process Technique Validations
		&lt;div&gt;
			&lt;div&gt;
				&amp;nbsp;&lt;/div&gt;
			&lt;div&gt;
				&lt;br&gt;
				&lt;strong&gt;&lt;font size=&quot;2&quot;&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Prerequisite&lt;/font&gt;&lt;/font&gt;&lt;/strong&gt;&lt;/div&gt;
		&lt;/div&gt;
		&lt;div&gt;
			&lt;span &gt;&lt;span &gt;Participants must meet one or more of the following requirements:&lt;/span&gt;&lt;/span&gt;
			&lt;ul&gt;
				&lt;li&gt;
					&lt;span &gt;Successful completion or current enrollment in NPTA&#39;s IV Certification Course&lt;/span&gt;&lt;/li&gt;
				&lt;li&gt;
					&lt;span &gt;Successful completion of&amp;nbsp; an ACPE-accredited course on sterile products/aseptic technique&lt;br&gt;
					40 contact hours or more, including both didactic and hands-on training (documentation required)&lt;/span&gt;&lt;/li&gt;
				&lt;li&gt;
					&lt;span &gt;600 hours (or more) of practical experience in aseptic technique/preparing sterile products over the past twelve months. (documentation and a signed letter of attestation from the pharmacy director required)&lt;/span&gt;&lt;/li&gt;
			&lt;/ul&gt;
		&lt;/div&gt;
		&lt;div&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div&gt;
			&lt;a href=&quot;http://www.pharmacytechnician.org/chemo-certification-learning-objectives/&quot;&gt;&lt;span &gt;&amp;gt;&amp;gt;Complete Learning Objectives&lt;/span&gt;&lt;/a&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;How the Course Works&lt;br&gt;
			&lt;/strong&gt;Participants must complete ten separate modules of home-based learning, comprised of a reading assignment and comprehensive exams.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s one-day &lt;em&gt;Hazardous Drugs Training Institute&lt;/em&gt;, located at the&amp;nbsp;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot; target=&quot;_self&quot;&gt;NPTA Training Institute&lt;/a&gt; in Houston, Texas.&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;Home Study Modules&lt;br&gt;
			&lt;/strong&gt;- What are Hazardous Drugs&lt;br&gt;
			- ASHP and Other Guidelines&lt;br&gt;
			- Receipt, Storage, Labeling &amp;amp; Transport&lt;br&gt;
			- Risk Assessment, Controls &amp;amp; Medical Surveillance&lt;br&gt;
			- Biological Safety Cabinets&lt;br&gt;
			- Isolators&lt;br&gt;
			- Personal Protective Equipment&lt;br&gt;
			- Aseptic Technique&lt;br&gt;
			- Decontamination, Waste Disposal &amp;amp; Spill Control&lt;br&gt;
			- Comprehensive Final Exam&lt;br&gt;
			&lt;br&gt;
			&lt;strong&gt;Training &amp;amp; Technique Validations&lt;br&gt;
			&lt;/strong&gt;- Aseptic Hand Washing &amp;amp; Garbing&lt;br&gt;
			- Decontamination &amp;amp; Deactivation of a BSC&lt;br&gt;
			- Hazardous Liquid Vial Manipulations&lt;br&gt;
			- Hazardous Powder Vial Manipulation&lt;br&gt;
			- Hazardous Ampule Manipulations&lt;br&gt;
			&lt;br&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;strong &gt;Tuition Fee&lt;br&gt;
			&lt;/strong&gt;$498 Members&lt;br&gt;
			$598 Non-Members&amp;nbsp;&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;span &gt;Please note: This course is non-refundable and non-transferable.&lt;/span&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;span &gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/span&gt;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;br&gt;
			&lt;strong &gt;What&#39;s Included &lt;/strong&gt;&lt;strong &gt;&lt;br&gt;
			&lt;/strong&gt;Tuition includes: &lt;em&gt;Safe Handling of Hazardous Drugs &lt;/em&gt;textbook by the American Society of Health-System Pharmacists, online course content access, one day of hands-on training/validations, lunch/snacks on training day,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&amp;nbsp;&lt;/div&gt;
		&lt;div align=&quot;left&quot;&gt;
			&lt;div&gt;
				&lt;span &gt;&lt;strong &gt;CPE Credits&lt;/strong&gt;&lt;/span&gt;&lt;br&gt;
				&lt;br&gt;
				&lt;div align=&quot;left&quot;&gt;
					&amp;nbsp;&lt;/div&gt;
				&lt;div align=&quot;left&quot;&gt;
					&lt;span &gt;&lt;img alt=&quot;&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/span&gt;&lt;/div&gt;
				&lt;div&gt;
					&amp;nbsp;&lt;/div&gt;
				&lt;div&gt;
					&lt;span &gt;Contact Hours: 20&lt;br&gt;
					ACPE #s:&amp;nbsp;&lt;br&gt;
					Home /UAN#: 0384-0000-10-003-H04-T /0384-0000-10-003-H-04-P&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
					Live/UAN#:&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; 0384-0000-10-004-L04-T / 0384-0000-10-004-L-04-P&lt;br&gt;
					&lt;/span&gt;&lt;/div&gt;
				&lt;ul&gt;
					&lt;li&gt;
						&lt;span &gt;&amp;nbsp;This program is valid for continuing education until April 22, 2015, whereas the Certification you will receive from NPTA for successfully completing all components of the course does not expire, nor require renewal.&lt;/span&gt;&lt;/li&gt;
				&lt;/ul&gt;
			&lt;/div&gt;
		&lt;/div&gt;
	&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/526</guid>

			<pubDate>Wed, 19 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Events</category>

			<link>http://www.pharmacytechnician.org/en/cev/554</link>

			<title>Compounding Certification Course on 20-Jun-13 9:00 AM</title>

			<description>&lt;div class=&quot;vevent&quot;&gt;
&lt;a class=&quot;url&quot; href=&quot;http://www.pharmacytechnician.org/en/cev/554&quot;&gt;
&lt;span class=&quot;summary&quot;&gt;Compounding Certification Course&lt;/span&gt;
&lt;/a&gt;&lt;br/&gt;
&lt;span class=&quot;tdtstart&quot;&gt;Start Date:&lt;/span&gt; &lt;abbr class=&quot;dtstart&quot; title=&quot;20130620T140000Z&quot;&gt;20-Jun-13 9:00 AM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tdtend&quot;&gt;End Time:&lt;/span&gt; 
&lt;abbr class=&quot;dtend&quot; title=&quot;20130621T220000Z&quot;&gt;21-Jun-13 5:00 PM&lt;/abbr&gt;
&lt;br/&gt;
&lt;span class=&quot;tlocation&quot;&gt;Location:&lt;/span&gt; &lt;span class=&quot;location&quot;&gt;
NPTA Training Institute, 15832 W. Hardy, Suite 640, Houston, Tx 77060 &lt;/span&gt;
&lt;br/&gt;
&lt;span class=&quot;tspeaker&quot;&gt;Speaker:&lt;/span&gt; &lt;span class=&quot;speaker&quot;&gt;NPTA Faculty&lt;/span&gt;&lt;br&gt;
&lt;br/&gt;
&lt;span class=&quot;tdescription&quot;&gt;Event Details:&lt;/span&gt; &lt;div class=&quot;description&quot;&gt;&lt;div&gt;
	&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Course Details&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	The course requirements include:&lt;br&gt;
	&amp;nbsp;- 10 Home Study Modules with Exams&lt;br&gt;
	&amp;nbsp;- 2 Days Hands-On Training&lt;br&gt;
	&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;How the Course Works&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	Participants must complete eleven separate modules of home-based learning, comprised of a reading assignment and comprehensive exam.&amp;nbsp;A score of 70% or higher is required&amp;nbsp;for each exam. &amp;nbsp;After completing the home-based study modules, participants attend and complete NPTA&amp;rsquo;s&amp;nbsp;two-day &lt;em&gt;Pharmaceutical Compounding Training Institute&lt;/em&gt;, located at the &lt;a href=&quot;http://www.pharmacytechnician.org/en/cms/?1393&quot;&gt;NPTA Training Institute &lt;/a&gt;in Houston, Texas.&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Home Study Modules&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	&amp;nbsp;- Introduction to Compounding/Compounding Practices &amp;amp; Considerations&lt;br&gt;
	&amp;nbsp;- Facilities, Equipment &amp;amp; Supplies&lt;br&gt;
	&amp;nbsp;- Quality Assurance &amp;amp; Record Keeping&lt;br&gt;
	&amp;nbsp;- Capsules, Tablets &amp;amp; Powders&lt;br&gt;
	&amp;nbsp;- Lozenges, Troches, Sticks &amp;amp; Suppositories&lt;br&gt;
	&amp;nbsp;- Solutions, Suspensions &amp;amp; Emulsions&lt;br&gt;
	&amp;nbsp;- Ointments, Creams, Pastes &amp;amp; Gels&lt;br&gt;
	&amp;nbsp;- Ophthalmic, Otic &amp;amp; Nasal Preparations&lt;br&gt;
	&amp;nbsp;- Medication Flavoring&lt;br&gt;
	&amp;nbsp;- Veterinary Compounding&lt;br&gt;
	&lt;br&gt;
	&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Hands-On Training&amp;nbsp;Labs&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
	&amp;nbsp;- Capsules&lt;br&gt;
	&amp;nbsp;- Carbomer Gels&lt;br&gt;
	&amp;nbsp;-&amp;nbsp;Creams&lt;br&gt;
	&amp;nbsp;- Gelatin Troches&lt;br&gt;
	&amp;nbsp;- Lip Balms&lt;br&gt;
	&amp;nbsp;- Medicated Lollipops&lt;br&gt;
	&amp;nbsp;- PEG Troches&lt;br&gt;
	&amp;nbsp;- PLO Gels&lt;br&gt;
	&amp;nbsp;- Solutions&lt;br&gt;
	&amp;nbsp;- Suspensions&amp;nbsp;&lt;br&gt;
	&amp;nbsp;- Suppositories&lt;br&gt;
	&amp;nbsp;- Tablet Triturates&lt;br&gt;
	&amp;nbsp;- Coloring/Flavoring&lt;br&gt;
	&amp;nbsp;-&amp;nbsp;Quality Assurance Methods&lt;br&gt;
	&amp;nbsp;- Record Keeping&lt;br&gt;
	&lt;br&gt;
	&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;Tuition Fee&lt;br&gt;
	&lt;/font&gt;&lt;/strong&gt;$648 NPTA Members&lt;br&gt;
	$698 Non-Members &lt;/font&gt;&lt;/font&gt;
	&lt;div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;Please note: This course is non-refundable.&lt;/font&gt;&lt;/div&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;Rescheduling is subject to a $250 change fee and is based on availability.&lt;/font&gt;&lt;/div&gt;
	&lt;/div&gt;
	&lt;div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;What&#39;s Included&lt;/font&gt;&lt;/strong&gt;&lt;br&gt;
		Tuition includes: &lt;em&gt;Compounding &lt;/em&gt;textbook by Pearson Education, official course binder, two day hands-on training institute, lunch/snacks on both training days,&amp;nbsp;use of laboratory equipment and supplies,&amp;nbsp;statement of CE credit and an Official&amp;nbsp;Certificate of Validated Training, upon successful completion.&lt;/font&gt;&lt;/div&gt;
	&lt;div&gt;
		&amp;nbsp;&lt;/div&gt;
	&lt;div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;strong&gt;&lt;font color=&quot;#ec7e25&quot;&gt;CPE Credits&lt;br&gt;
		&lt;/font&gt;&lt;/strong&gt;40.0 Contact Hours/4.0 CEU&lt;br&gt;
		Program Type: Practice&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;
		&lt;div&gt;
			&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;UAN No. 0384-0000-11-006-H04-T //&amp;nbsp; 0384-0000-11-006-H04-T&lt;/font&gt;&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;0384-0000-11-006-H04-P //&amp;nbsp; 0384-0000-11-006-H04-P&lt;/font&gt;&lt;br&gt;
			&lt;br&gt;
			&lt;font size=&quot;2&quot;&gt;Re-release Date: 05-11-2011&amp;nbsp; Expiration Date: 05-11-2014&lt;/font&gt;&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
		&lt;font size=&quot;2&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;font size=&quot;2&quot;&gt;&lt;br&gt;
		&lt;img alt=&quot;&quot; border=&quot;0&quot; height=&quot;124&quot; src=&quot;http://www.pharmacytechnician.org/attachments/wysiwyg/37336/ACPE_web_logo1small1.JPG&quot; width=&quot;532&quot; /&gt;&lt;/font&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/font&gt;&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;/div&gt;
&lt;br/&gt;
&lt;div class=&quot;vcard&quot;&gt;
&lt;a class=&quot;fn&quot;&gt;NPTA Training Institute
&lt;/a&gt;&lt;/div&gt;

</description>

			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cev/554</guid>

			<pubDate>Thu, 20 Jun 2013 14:00:00 GMT</pubDate>

		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1487/</link>
			<title>New DSM-5 Released with Mixed Reviews</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/37336/dsm5.png&quot;  /&gt;Over the weekend the DSM-5 published by the American Psychiatric Association (APA) was released at the American Psychiatric Association&amp;rsquo;s annual meeting.&amp;nbsp; The new edition was to be released May 2012, but the issue date was halted due to delays with the first draft.&amp;nbsp; The latest edition comes with many changes and the edits are not welcomed by some healthcare providers, counselors, and psychiatrists.&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;One of the critics of the new edition is Dr. Allen Frances, an individual who headed up the team of people responsible for the 1994 DSM-IV which was used for years up until the new edition became available.&amp;nbsp; Dr. Frances, now a professor at Duke University, recently commented on the DSM-5 and his concerns about the new book.&amp;nbsp; Dr. Frances discussed the following in an article published online on May 17th in the Annals of Internal Medicine.&amp;nbsp; His concern is that patients that are seemingly normal will be diagnosed with a mental disorder where there is no need for a psychiatric diagnosis.&amp;nbsp; In addition, his other concern stems from a possible push from pharmaceutical companies giving patients the assumption that their problems can be solved with a pill.&amp;nbsp; Dr. Frances urged physicians to do the following when it comes to using the DSM-5.&amp;nbsp; &amp;ldquo;Use the DSM-5 cautiously, if at all,&amp;rdquo; said Frances.&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;Do you think the DSM-5 will help or hurt the pharmaceutical industry?&amp;nbsp; Will it really benefit patients? &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;span &gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;1.&amp;nbsp; Frances, Allen. &amp;nbsp;&amp;ldquo;The New Crisis in Confidence in Psychiatric Diagnosis.&amp;rdquo;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Annals of Internal Medicine.&amp;nbsp; Web. 17 May 2013.&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;2.&amp;nbsp; Gever, John.&amp;nbsp; &amp;ldquo;DSM-IV Boss Presses Attack on New Revision.&amp;rdquo;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; MedPage Today.&amp;nbsp;&amp;nbsp; Web. 17 May 2013.&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;3.&amp;nbsp; Jaslow, Ryan.&amp;nbsp; &amp;ldquo;Controversial Update to Psychiatry Manual, DSM-5 Arrives.&amp;rdquo;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp; CBS News.&amp;nbsp; Web.&amp;nbsp; 18 May 2013.&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;4.&amp;nbsp; Grohol, John, Psy. D.&amp;nbsp; &amp;ldquo;DSM-5 Released:&amp;nbsp; The Big Changes.&amp;rdquo;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; PsychCentral.com.&amp;nbsp; Web.&amp;nbsp; Date of Access: 19 May 2013.&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;5.&amp;nbsp; Grohol, John, Psy. D.&amp;nbsp; &amp;ldquo;DSM-5 Published, Critical Guide for Clinicians.&amp;rdquo;&amp;nbsp; &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; PsychCentral.com.&amp;nbsp; Web.&amp;nbsp; 19 May 2013.&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;22-May-13 1:00 PM
</description>
			<itunes:subtitle>New DSM-5 Released with Mixed Reviews</itunes:subtitle>
			<itunes:summary>Over the weekend the DSM-5 published by the American Psychiatric Association (APA) was released at the American Psychiatric Association's annual meeting.  The new edition was to be released May 2012, but the issue date was halted due to delays with the first draft.  The latest edition comes with many changes and the edits are not welcomed by some healthcare providers, counselors, and psychiatrists.         

One of the critics of the new edition is Dr. Allen Frances, an individual who headed up the team of people responsible for the 1994 DSM-IV which was used for years up until the new edition became available.  Dr. Frances, now a professor at Duke University, recently commented on the DSM-5 and his concerns about the new book.  Dr. Frances discussed the following in an article published online on May 17th in the Annals of Internal Medicine.  His concern is that patients that are seemingly normal will be diagnosed with a mental disorder where there is no need for a psychiatric diagnosis.  In addition, his other concern stems from a possible push from pharmaceutical companies giving patients the assumption that their problems can be solved with a pill.  Dr. Frances urged physicians to do the following when it comes to using the DSM-5.  &quot;Use the DSM-5 cautiously, if at all,&quot; said Frances.     

Do you think the DSM-5 will help or hurt the pharmaceutical industry?  Will it really benefit patients?      
 
  


            

Sources:   

1.  Frances, Allen.  &quot;The New Crisis in Confidence in Psychiatric Diagnosis.&quot;  
     Annals of Internal Medicine.  Web. 17 May 2013.  

2.  Gever, John.  &quot;DSM-IV Boss Presses Attack on New Revision.&quot;  
      MedPage Today.   Web. 17 May 2013.    

3.  Jaslow, Ryan.  &quot;Controversial Update to Psychiatry Manual, DSM-5 Arrives.&quot;  
      CBS News.  Web.  18 May 2013.        

4.  Grohol, John, Psy. D.  &quot;DSM-5 Released:  The Big Changes.&quot;  
      PsychCentral.com.  Web.  Date of Access: 19 May 2013.    

5.  Grohol, John, Psy. D.  &quot;DSM-5 Published, Critical Guide for Clinicians.&quot;          
      PsychCentral.com.  Web.  19 May 2013.    

  

  

  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1487/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Wed, 22 May 2013 18:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1485/</link>
			<title>Pharmacy Security: NJ Implements Recent Voluntary Best Practices</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/37336/stk76619cor.jpg&quot;  /&gt;Drug theft and diversion continue to be a problem in the pharmacy business despite continued efforts to deter drug loss.&amp;nbsp; In an attempt to reduce drug theft and diversion in New Jersey pharmacies the New Jersey Division of Consumer Affairs, Attorney General Jeffrey S. Chiesa, and New Jersey State Board of Pharmacy recently published a set of &amp;ldquo;Best Practices for Pharmacy Security.&amp;rdquo;&amp;nbsp; The new best practices are designed to assist pharmacists in the prevention and deterrence of the loss of dangerous controlled substances and other drugs sold by retail pharmacies.&amp;nbsp; In addition, the suggestions will hopefully help reduce pharmacy robbery, employee theft, and patient doctor shopping.&amp;nbsp; Pharmacies will hopefully see a reduction in stolen, altered, and forged prescriptions due to the new set of best practices.&amp;nbsp; The NJ &amp;ldquo;Best Practices for Pharmacy Security,&amp;rdquo; are currently voluntary, but officials hope more and more pharmacies will adopt the new suggestions for increased security.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Eric T. Kanefsky, Acting Director of the New Jersey Diversion of Consumer Affairs recently commented on the state&amp;rsquo;s best practices in a press release issued by the NJ Office of the Attorney General.&amp;nbsp; &amp;ldquo;While every pharmacy may not be able to adopt all of these security recommendations, we are encouraging them to move toward implementation of these best practices.&amp;nbsp; Incidents of theft at New Jersey pharmacies are not common, but when they do occur they often involve significant diversion of Controlled Dangerous Substances which pose a grave risk of addiction, overdose, and death,&amp;rdquo; said Kanefsky.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;To view the full list of the published &amp;ldquo;Best Practices for Pharmacy Security&amp;rdquo; pharmacy technicians may go to the New Jersey Division of Consumer Affairs and Board of Pharmacy web site or click the link below to read the list of suggested practices &lt;/span&gt;&lt;a href=&quot;http://www.njconsumeraffairs.gov/press/05012013.pdf&quot;&gt;&lt;span &gt;http://www.njconsumeraffairs.gov/press/05012013.pdf&lt;/span&gt;&lt;/a&gt;&lt;span &gt;.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; New Jersey Office of the Attorney General/Division of Consumer Affairs.&amp;nbsp; &amp;ldquo;Pharmacy &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Security Best Practices.&amp;rdquo;&amp;nbsp; Web.&amp;nbsp; 1 May 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; &amp;nbsp;&amp;nbsp;Lamm, Jeff.&amp;nbsp; &amp;ldquo;New Jersey Division of Consumer Affairs, State Board of Pharmacy, &amp;nbsp; Announce Best Practice Recommendations for Pharmacy Security.&amp;rdquo;&amp;nbsp; NJ State &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; BOP.&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 19 May 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;20-May-13 10:00 AM
</description>
			<itunes:subtitle>Pharmacy Security: NJ Implements Recent Voluntary Best Practices</itunes:subtitle>
			<itunes:summary>Drug theft and diversion continue to be a problem in the pharmacy business despite continued efforts to deter drug loss.  In an attempt to reduce drug theft and diversion in New Jersey pharmacies the New Jersey Division of Consumer Affairs, Attorney General Jeffrey S. Chiesa, and New Jersey State Board of Pharmacy recently published a set of &quot;Best Practices for Pharmacy Security.&quot;  The new best practices are designed to assist pharmacists in the prevention and deterrence of the loss of dangerous controlled substances and other drugs sold by retail pharmacies.  In addition, the suggestions will hopefully help reduce pharmacy robbery, employee theft, and patient doctor shopping.  Pharmacies will hopefully see a reduction in stolen, altered, and forged prescriptions due to the new set of best practices.  The NJ &quot;Best Practices for Pharmacy Security,&quot; are currently voluntary, but officials hope more and more pharmacies will adopt the new suggestions for increased security.  

Eric T. Kanefsky, Acting Director of the New Jersey Diversion of Consumer Affairs recently commented on the state's best practices in a press release issued by the NJ Office of the Attorney General.  &quot;While every pharmacy may not be able to adopt all of these security recommendations, we are encouraging them to move toward implementation of these best practices.  Incidents of theft at New Jersey pharmacies are not common, but when they do occur they often involve significant diversion of Controlled Dangerous Substances which pose a grave risk of addiction, overdose, and death,&quot; said Kanefsky.  

To view the full list of the published &quot;Best Practices for Pharmacy Security&quot; pharmacy technicians may go to the New Jersey Division of Consumer Affairs and Board of Pharmacy web site or click the link below to read the list of suggested practices http://www.njconsumeraffairs.gov/press/05012013.pdf.  

 
 
  


  

Sources:   

1.  New Jersey Office of the Attorney General/Division of Consumer Affairs.  &quot;Pharmacy            Security Best Practices.&quot;  Web.  1 May 2013.  

2.    Lamm, Jeff.  &quot;New Jersey Division of Consumer Affairs, State Board of Pharmacy,   Announce Best Practice Recommendations for Pharmacy Security.&quot;  NJ State           BOP.  Web.  Date of Access:  19 May 2013.  

  

  

  

  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1485/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Mon, 20 May 2013 15:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1472/</link>
			<title>FDA Issues Drug Safety Communication Concerning Pregnant Women Using Certain Migraine Prevention Medications</title>
			<description>&lt;p&gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/37336/pregnant-drugs.jpg&quot;  /&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Migraine headaches cause misery for approximately 29.5 million Americans according to the National Headache Foundation.&amp;nbsp; Migraines can be brought on for many reasons, but there are a variety of treatment options depending on a patients health needs and status.&amp;nbsp; Recently, the Food and Drug Administration (FDA) issued a drug safety release concerning the use of Valproate anti-seizure products for pregnant women in the treatment of migraines.&amp;nbsp; The FDA is warning patients and healthcare providers of the dangers in using these drugs during pregnancy and the possibility of decreased IQ scores in children that were exposed to the drugs during their mother&amp;rsquo;s pregnancy.&amp;nbsp; Pharmacy technicians should note the following information released by the FDA:&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Valproate drug labels and related products will carry a stronger warning reflecting the new FDA findings.&amp;nbsp; Valproate products include the following:&amp;nbsp; valproate sodium (Depacon), divalproex sodium, (Depakote, Depakote CP, and Depakote ER), valproic acid (Depakene and Stavzor), and their generic counterparts.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Valproate is also used in the treatment of bipolar disorder and seizures, but the drug should only be used if other alternatives are exhausted first.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Women who are pregnant or hoping to become pregnant should speak with their doctors about the risks and benefits of taking Valproate and Valproate related medications.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;The FDA is teaming up with drug manufactures to change the pregnancy category for the prevention of migraine headaches from category X to D, however, Valproate medications will stay in the D category to treat epilepsy and for manic episodes present in bipolar disorder. &lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Pharmacy Technicians can benefit from making themselves aware of the information concerning Valproate drugs and also pass on the new findings to other fellow pharmacy technicians.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;br&gt;
&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; Walsh, Sandy.&amp;nbsp; &amp;ldquo;FDA Warns Pregnant Women to Not Use Certain Migraine &amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Prevention Medicines.&amp;rdquo;&amp;nbsp; FDA News Release.&amp;nbsp; Web.&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Date of Access:&amp;nbsp; 15 May 2013.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; Neale, Todd.&amp;nbsp; &amp;ldquo;FDA:&amp;nbsp; Migraine Drugs Dangerous in Pregnancy.&amp;rdquo;&amp;nbsp; MedPage Today.&amp;nbsp; &amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 15 May 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;3.&amp;nbsp; National Headache Foundation.&amp;nbsp; &amp;ldquo;Press Kits &amp;ndash; AMPPS Fact Sheet.&amp;rdquo;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 15 May 2013.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;br&gt;
&lt;br&gt;
&lt;br&gt;
&lt;br&gt;
&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;17-May-13 10:00 AM
</description>
			<itunes:subtitle>FDA Issues Drug Safety Communication Concerning Pregnant Women Using Certain Migraine Prevention Medications</itunes:subtitle>
			<itunes:summary>Migraine headaches cause misery for approximately 29.5 million Americans according to the National Headache Foundation.  Migraines can be brought on for many reasons, but there are a variety of treatment options depending on a patients health needs and status.  Recently, the Food and Drug Administration (FDA) issued a drug safety release concerning the use of Valproate anti-seizure products for pregnant women in the treatment of migraines.  The FDA is warning patients and healthcare providers of the dangers in using these drugs during pregnancy and the possibility of decreased IQ scores in children that were exposed to the drugs during their mother's pregnancy.  Pharmacy technicians should note the following information released by the FDA:  

  


	 Valproate drug labels and related products will carry a stronger warning reflecting the new FDA findings.  Valproate products include the following:  valproate sodium (Depacon), divalproex sodium, (Depakote, Depakote CP, and Depakote ER), valproic acid (Depakene and Stavzor), and their generic counterparts. 


  


	 Valproate is also used in the treatment of bipolar disorder and seizures, but the drug should only be used if other alternatives are exhausted first. 


  


	 Women who are pregnant or hoping to become pregnant should speak with their doctors about the risks and benefits of taking Valproate and Valproate related medications. 


  

The FDA is teaming up with drug manufactures to change the pregnancy category for the prevention of migraine headaches from category X to D, however, Valproate medications will stay in the D category to treat epilepsy and for manic episodes present in bipolar disorder.  

Pharmacy Technicians can benefit from making themselves aware of the information concerning Valproate drugs and also pass on the new findings to other fellow pharmacy technicians.  
 
  


 
Sources:   

1.  Walsh, Sandy.  &quot;FDA Warns Pregnant Women to Not Use Certain Migraine     
     Prevention Medicines.&quot;  FDA News Release.  Web.  
     Date of Access:  15 May 2013. 

2.  Neale, Todd.  &quot;FDA:  Migraine Drugs Dangerous in Pregnancy.&quot;  MedPage Today.      
     Web.  Date of Access:  15 May 2013.  

3.  National Headache Foundation.  &quot;Press Kits - AMPPS Fact Sheet.&quot;  
     Web.  Date of Access:  15 May 2013. 
 
 
 
 
 
  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1472/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 17 May 2013 15:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1470/</link>
			<title>Potential Medication Errors May Result from Breast Cancer Drug Names</title>
			<description>&lt;p&gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/37336/MedErrors.jpg&quot;  /&gt;&lt;br&gt;
&lt;br&gt;
&lt;span &gt;Pharmacy technicians know the importance of avoiding medication errors.&amp;nbsp; Recently, the Food and Drug Administration (FDA) issued a drug safety communication release concerning potential medication errors resulting from name confusion with the generic name of the newly approved breast cancer drug Kadcyla (ado-trastuzumab emtansine) and Herceptin (trastuzumab).&amp;nbsp; Possible medication errors could be a possibility if the two medications were confused in automated drug systems, order-entry computer programs, or in manual counts by pharmacists.&amp;nbsp; The FDA is advising that the FDA-approved nonproprietary name for Kadcyla, ado-trastuzumab emtansine be used correctly and any omission of the &amp;ldquo;ado&amp;rdquo; prefix may cause drug errors.&amp;nbsp; Drug errors are often the cause of patient harm or death and should be avoided at all times.&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&amp;nbsp;Concern over the prefix omission &amp;ldquo;ado&amp;rdquo; was first discovered due to third-party publications, compendia references, electronic health record systems, and pharmacy prescription processing systems using the drug name incorrectly.&amp;nbsp; However, no drug errors have resulted since the approval of Kadcyla in February.&amp;nbsp; Medication errors were discovered, however, during clinical trials of the drug.&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;Drug errors can be avoided if pharmacists and pharmacy technicians are careful in their use of drug names.&amp;nbsp; Mistakes can result from improper order entry, not paying attention, similarities in drug names, name omissions, and improper pharmacy staff training.&amp;nbsp; Pharmacy technicians may wish to share this crucial and valuable information with their fellow technicians.&amp;nbsp; Taking preventative steps to avoid medication errors is imperative in patient care. &lt;/span&gt;&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;br&gt;
&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;1.&amp;nbsp; FDA release.&amp;nbsp; &amp;ldquo;Kadcyla (ado-trastuzumab emtansine):&amp;nbsp; Drug Safety Communication &amp;ndash; &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Potential Medication Errors Resulting from Name Confusion.&amp;rdquo;&amp;nbsp; FDA.&amp;nbsp; Web.&amp;nbsp;&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp; Date of Access:&amp;nbsp; 13 May 2013.&amp;nbsp;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;2.&amp;nbsp; National Alert Network (NAN) Altert.&amp;nbsp; &amp;ldquo;Confusion Regarding the Generic Name of the HER2-targeted drug Kadcyla (ado-trastuzumab emtansine).&amp;rdquo;&amp;nbsp; ISMP.&amp;nbsp; Web.&amp;nbsp; &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Date of Access:&amp;nbsp; 13 May 2013.&amp;nbsp;&lt;/span&gt;&lt;br&gt;
&lt;br&gt;
&lt;br&gt;
&amp;nbsp;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;15-May-13 10:00 AM
</description>
			<itunes:subtitle>Potential Medication Errors May Result from Breast Cancer Drug Names</itunes:subtitle>
			<itunes:summary>
 
Pharmacy technicians know the importance of avoiding medication errors.  Recently, the Food and Drug Administration (FDA) issued a drug safety communication release concerning potential medication errors resulting from name confusion with the generic name of the newly approved breast cancer drug Kadcyla (ado-trastuzumab emtansine) and Herceptin (trastuzumab).  Possible medication errors could be a possibility if the two medications were confused in automated drug systems, order-entry computer programs, or in manual counts by pharmacists.  The FDA is advising that the FDA-approved nonproprietary name for Kadcyla, ado-trastuzumab emtansine be used correctly and any omission of the &quot;ado&quot; prefix may cause drug errors.  Drug errors are often the cause of patient harm or death and should be avoided at all times.  

 Concern over the prefix omission &quot;ado&quot; was first discovered due to third-party publications, compendia references, electronic health record systems, and pharmacy prescription processing systems using the drug name incorrectly.  However, no drug errors have resulted since the approval of Kadcyla in February.  Medication errors were discovered, however, during clinical trials of the drug.  

Drug errors can be avoided if pharmacists and pharmacy technicians are careful in their use of drug names.  Mistakes can result from improper order entry, not paying attention, similarities in drug names, name omissions, and improper pharmacy staff training.  Pharmacy technicians may wish to share this crucial and valuable information with their fellow technicians.  Taking preventative steps to avoid medication errors is imperative in patient care.  
 
  


 
  

Sources:   

1.  FDA release.  &quot;Kadcyla (ado-trastuzumab emtansine):  Drug Safety Communication -             
     Potential Medication Errors Resulting from Name Confusion.&quot;  FDA.  Web.  
 
    Date of Access:  13 May 2013.  

2.  National Alert Network (NAN) Altert.  &quot;Confusion Regarding the Generic Name of the HER2-targeted drug Kadcyla (ado-trastuzumab emtansine).&quot;  ISMP.  Web.          
 
     Date of Access:  13 May 2013.  
 
 
  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1470/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Wed, 15 May 2013 15:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1468/</link>
			<title>Celebrate National Women's Health Week!</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/37336/2013-NWHW-web-banner.jpg&quot;  /&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;The month of May is full of many health month observances and one of the many special observances is &lt;strong&gt;National Women&amp;rsquo;s Health Week&lt;/strong&gt; celebrated from &lt;strong&gt;May 12th to 18th, 2013&lt;/strong&gt;.&amp;nbsp; The 14th annual National Women&amp;rsquo;s Health Week is celebrated nationwide and is sponsored by the U.S. Department of Health and Human Service&amp;rsquo;s Office on Women&amp;rsquo;s Health.&amp;nbsp; The office reminds women during this week and throughout the year to partake in living a healthy lifestyle and staying well for optimum health.&amp;nbsp; There are five ways in which women can become proactive in helping secure a healthy lifestyle:&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;See a healthcare professional for routine checkups and preventative screenings.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Get regular exercise and stay active.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Eat a healthy and balanced diet.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Learn to avoid unhealthy behaviors.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Pay close attention to mental health, obtain adequate rest, and try to manage stress.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;Pharmacies and pharmacy technicians can help celebrate National Women&amp;rsquo;s Health Week by reminding patients and customers in the pharmacy to follow these vital tips in becoming a happy and healthy woman.&amp;nbsp; To find out more about National Women&amp;rsquo;s Health Week go to &lt;/span&gt;&lt;strong&gt;&lt;a href=&quot;http://www.womenshealth.gov/nwhw&quot;&gt;&lt;span &gt;www.womenshealth.gov/nwhw&lt;/span&gt;&lt;/a&gt;&lt;/strong&gt;&lt;span &gt;.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; &amp;ldquo;About National Women&amp;rsquo;s Health Week.&amp;rdquo;&amp;nbsp; U.S. Department of Health and Human &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Service&amp;rsquo;s Office on Women&amp;rsquo;s Health.&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 12 May 2013.&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; &amp;ldquo;National Women&amp;rsquo;s Health Week Fact Sheet.&amp;rdquo;&amp;nbsp; U.S. Department of Health and &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;br&gt;
&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Human Services Office on Women&amp;rsquo;s Health.&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 12 May &amp;nbsp;&amp;nbsp; 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;13-May-13 10:00 AM
</description>
			<itunes:subtitle>Celebrate National Women's Health Week!</itunes:subtitle>
			<itunes:summary>

  

The month of May is full of many health month observances and one of the many special observances is National Women's Health Week celebrated from May 12th to 18th, 2013.  The 14th annual National Women's Health Week is celebrated nationwide and is sponsored by the U.S. Department of Health and Human Service's Office on Women's Health.  The office reminds women during this week and throughout the year to partake in living a healthy lifestyle and staying well for optimum health.  There are five ways in which women can become proactive in helping secure a healthy lifestyle:     

  


	 See a healthcare professional for routine checkups and preventative screenings. 


  


	 Get regular exercise and stay active. 


  


	 Eat a healthy and balanced diet. 


  


	 Learn to avoid unhealthy behaviors. 


  


	 Pay close attention to mental health, obtain adequate rest, and try to manage stress. 


  

Pharmacies and pharmacy technicians can help celebrate National Women's Health Week by reminding patients and customers in the pharmacy to follow these vital tips in becoming a happy and healthy woman.  To find out more about National Women's Health Week go to www.womenshealth.gov/nwhw.  

  


  

Sources:   

1.  &quot;About National Women's Health Week.&quot;  U.S. Department of Health and Human      
     Service's Office on Women's Health.  Web.  Date of Access:  12 May 2013.   

2.  &quot;National Women's Health Week Fact Sheet.&quot;  U.S. Department of Health and            
      Human Services Office on Women's Health.  Web.  Date of Access:  12 May    2013.  

  

  

  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1468/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Mon, 13 May 2013 15:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1466/</link>
			<title>Utilizing Social Media to Find a Pharmacy Technician Job</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/44473/130318-LinkedIn-275x275.jpg&quot;  /&gt;Social Media is a tool many present and future pharmacy technicians are using to find employment in their field.&amp;nbsp; There are a few tips in which a technician can utilize to find their job of choice.&amp;nbsp; Here is a look at the top social media sites in which you may want to take a look at when seeking employment as a pharmacy technician:&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;&amp;bull; Facebook.&lt;/strong&gt;&amp;nbsp; Using Facebook to find a job is probably not the first place you may have thought of when looking for employment, but if you visit and like the pages of reputable pharmacy technician organizations like NPTA, you can then connect with other professionals in the field of pharmacy who may know of pharmacy technician job openings.&amp;nbsp; If you have a Facebook profile please clean it up to look neat and professional.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;&amp;bull; Twitter.&amp;nbsp; &lt;/strong&gt;Twitter can serve as a quick way to search for current job listings.&amp;nbsp; The links posted as part of the tweets can lead you to employment search web sites where you can browse various technician jobs.&amp;nbsp; Virtually everyone has a Twitter account and you can connect and follow other pharmacy technicians or large organizations such as the FDA or CDC for top medical news.&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;&amp;bull; LinkedIn&lt;/strong&gt;.&amp;nbsp; LinkedIn is one of the most respected sites used for networking in work and professional settings.&amp;nbsp; If you do not have a LinkedIn account consider opening one as building your profile can assist you in finding connections and also enable you to build a rapport with other individuals in the pharmacy world.&amp;nbsp; Recruiters and hiring managers can search your profile and you may make contact with someone that may lead you to your dream job in pharmacy.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Using social media responsibly to find a job can be a new learning experience and also rewarding for technicians.&amp;nbsp; Looking beyond the daily newspaper and online classified sections will help broaden your employment search in ways you may have not thought of originally.&amp;nbsp;&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; Foss, Jenny.&amp;nbsp; &amp;ldquo;What Recruiters Want to See on Your LinkedIn Profile.&amp;rdquo;&amp;nbsp; The Daily Muse.&amp;nbsp; &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 6 May 2013.&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; &amp;ldquo;Getting a Pharmacy Assistant Job Using Social Media.&amp;rdquo;&amp;nbsp; &amp;nbsp;&lt;/span&gt;&lt;a href=&quot;http://www.pharmacyassistanthq.com/&quot;&gt;&lt;span &gt;http://www.pharmacyassistanthq.com&lt;/span&gt;&lt;/a&gt;&lt;span &gt;.&amp;nbsp; Web.&amp;nbsp; Date of Access:&amp;nbsp; 6 May 2013.&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;8-May-13 8:00 AM
</description>
			<itunes:subtitle>Utilizing Social Media to Find a Pharmacy Technician Job</itunes:subtitle>
			<itunes:summary>Social Media is a tool many present and future pharmacy technicians are using to find employment in their field.  There are a few tips in which a technician can utilize to find their job of choice.  Here is a look at the top social media sites in which you may want to take a look at when seeking employment as a pharmacy technician:         

  

&amp;bull; Facebook.  Using Facebook to find a job is probably not the first place you may have thought of when looking for employment, but if you visit and like the pages of reputable pharmacy technician organizations like NPTA, you can then connect with other professionals in the field of pharmacy who may know of pharmacy technician job openings.  If you have a Facebook profile please clean it up to look neat and professional.  

  

&amp;bull; Twitter.  Twitter can serve as a quick way to search for current job listings.  The links posted as part of the tweets can lead you to employment search web sites where you can browse various technician jobs.  Virtually everyone has a Twitter account and you can connect and follow other pharmacy technicians or large organizations such as the FDA or CDC for top medical news.      

  

&amp;bull; LinkedIn.  LinkedIn is one of the most respected sites used for networking in work and professional settings.  If you do not have a LinkedIn account consider opening one as building your profile can assist you in finding connections and also enable you to build a rapport with other individuals in the pharmacy world.  Recruiters and hiring managers can search your profile and you may make contact with someone that may lead you to your dream job in pharmacy.  

  

Using social media responsibly to find a job can be a new learning experience and also rewarding for technicians.  Looking beyond the daily newspaper and online classified sections will help broaden your employment search in ways you may have not thought of originally.       


Sources:   

1.  Foss, Jenny.  &quot;What Recruiters Want to See on Your LinkedIn Profile.&quot;  The Daily Muse.       Web.  Date of Access:  6 May 2013.     

            

2.  &quot;Getting a Pharmacy Assistant Job Using Social Media.&quot;   http://www.pharmacyassistanthq.com.  Web.  Date of Access:  6 May 2013.   
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1466/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Wed, 08 May 2013 13:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1463/</link>
			<title>New Study Reminds Us That Errors Can Happen at Home</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/44473/medication-adherence-pillbox-300x175.jpg&quot;  /&gt;Pharmacy technicians know the importance of reducing and eliminating medication errors, but technicians cannot monitor drug errors in the home.&amp;nbsp; A new study observed 72 medication mistakes in homes where 92 children who have cancer were cared for from November 2007 and April 2011.&amp;nbsp; The study concluded that many children taking cancer medications were venerable to medication errors and found that between 10% and 40% of oral chemotherapy treatments were missed according to Dr. Kathleen Walsh, lead author of the study from the University Of Massachusetts School Of Medicine in Worcester.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;In one of the study&amp;rsquo;s cases, parents were sprinkling chemo medication on their ill child&amp;rsquo;s food in lieu of giving their child the chemotherapy medication as directed.&amp;nbsp; In addition, 72 medication errors were recorded along with four incidents that injured the sick children.&amp;nbsp; Forty of the mistakes were harmful and could cause injury to the patient.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Dr. Walsh recently commented on the study in an article for Reuters.&amp;nbsp; &amp;ldquo;There are a number of medications we use everyday that can be dangerous if we don&amp;rsquo;t use them properly,&amp;rdquo; said Walsh.&amp;nbsp; Doctors who observed the medication errors made by parents concluded that improved communication between families and physicians could have aided in over a third in the mistakes made by the cancer patient&amp;rsquo;s parents.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Pharmacy technicians can encourage parents to follow the advice of their children&amp;rsquo;s doctor and also stress the importance of giving medication only as directed by the prescribing doctor and pharmacist.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources: &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; Walsh, Kathleen, Dr.&amp;nbsp; &amp;ldquo;Medication Errors in the Home:&amp;nbsp; A Multisite Study of Children With Cancer.&amp;rdquo;&amp;nbsp; Pediatrics.&amp;nbsp; Web.&amp;nbsp; 29 Apr 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; Seaman, Andrew.&amp;nbsp; &amp;ldquo;Medication Errors Also Happen at Home.&amp;rdquo;&amp;nbsp; Reuters.&amp;nbsp; Web.&amp;nbsp; 3 May 2013.&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;7-May-13 8:00 AM
</description>
			<itunes:subtitle>New Study Reminds Us That Errors Can Happen at Home</itunes:subtitle>
			<itunes:summary>Pharmacy technicians know the importance of reducing and eliminating medication errors, but technicians cannot monitor drug errors in the home.  A new study observed 72 medication mistakes in homes where 92 children who have cancer were cared for from November 2007 and April 2011.  The study concluded that many children taking cancer medications were venerable to medication errors and found that between 10% and 40% of oral chemotherapy treatments were missed according to Dr. Kathleen Walsh, lead author of the study from the University Of Massachusetts School Of Medicine in Worcester.  

  

In one of the study's cases, parents were sprinkling chemo medication on their ill child's food in lieu of giving their child the chemotherapy medication as directed.  In addition, 72 medication errors were recorded along with four incidents that injured the sick children.  Forty of the mistakes were harmful and could cause injury to the patient.  

            

Dr. Walsh recently commented on the study in an article for Reuters.  &quot;There are a number of medications we use everyday that can be dangerous if we don't use them properly,&quot; said Walsh.  Doctors who observed the medication errors made by parents concluded that improved communication between families and physicians could have aided in over a third in the mistakes made by the cancer patient's parents.  

            

Pharmacy technicians can encourage parents to follow the advice of their children's doctor and also stress the importance of giving medication only as directed by the prescribing doctor and pharmacist.  


Sources:  

1.  Walsh, Kathleen, Dr.  &quot;Medication Errors in the Home:  A Multisite Study of Children With Cancer.&quot;  Pediatrics.  Web.  29 Apr 2013.  

  

2.  Seaman, Andrew.  &quot;Medication Errors Also Happen at Home.&quot;  Reuters.  Web.  3 May 2013.   
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1463/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Tue, 07 May 2013 13:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1462/</link>
			<title>May is Mental Health Month</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/44473/MHM2013HorizontalBanner.png&quot;  /&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;A patient&amp;rsquo;s mental health is just as important as their physical health and this month Mental Health America and its affiliates are celebrating &amp;lsquo;May is Mental Health Month.&amp;rsquo;&amp;nbsp; The theme this year for Mental Health Month is &amp;lsquo;Pathways to Wellness,&amp;rsquo; focusing on ways to identify avenues for Americans to obtain better physical and mental health overall.&amp;nbsp; Mental Health America suggests these four steps in helping Americans live better and healthier lives:&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p &gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; &lt;strong&gt;A healthy diet&lt;/strong&gt;.&amp;nbsp; Eating a balanced diet, reducing caffeine, and limiting alcohol intake are all positive ways in which patients can improve their physical health.&amp;nbsp; They may sound simple, but are key to living a better life.&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p &gt;&amp;nbsp;&lt;/p&gt;

&lt;p &gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; &lt;strong&gt;Regular exercise&lt;/strong&gt;.&amp;nbsp; Getting routine exercise helps elevate mood, increases energy levels, reduces stress, and helps release the body&amp;rsquo;s levels of endorphins and serotonin levels that can help patients feel better both mentally and physically.&amp;nbsp; &amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p &gt;&amp;nbsp;&lt;/p&gt;

&lt;p &gt;&lt;span &gt;&lt;span &gt;3.&amp;nbsp; &lt;strong&gt;Relaxation&lt;/strong&gt;. &amp;nbsp;Leaning to take a step back and decompress is necessary in every profession.&amp;nbsp; Taking time out of your busy schedule to just relax will help you get up and give your job all you have to give.&amp;nbsp; Remember also to take time out to laugh and enjoy life.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p &gt;&amp;nbsp;&lt;/p&gt;

&lt;p &gt;&lt;span &gt;&lt;span &gt;4.&amp;nbsp; &lt;strong&gt;Sleep&lt;/strong&gt;.&amp;nbsp; Obtaining at least 7-9 hours of sleep each night is a necessary part of keeping mental and physical health in check.&amp;nbsp; Resting the mind and body allows the system to recharge after a hard days work.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Pharmacy technicians can remind themselves and patients of these very simple steps to take in their everyday life to increase happiness, productivity, well-being, and good physical and mental health.&amp;nbsp; To learn more about Mental Health America and Mental Health Month go to &lt;/span&gt;&lt;a href=&quot;http://www.mentalhealthamerica.net/&quot;&gt;&lt;span &gt;http://www.mentalhealthamerica.net/&lt;/span&gt;&lt;/a&gt;&lt;span &gt;.&amp;nbsp; &amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; Ahmed, Erica.&amp;nbsp; &amp;ldquo;May is Mental Health Month Press Materials.&amp;rdquo;&amp;nbsp; Mental Health America.&amp;nbsp; Web.&amp;nbsp; May 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;6-May-13 8:00 AM
</description>
			<itunes:subtitle>May is Mental Health Month</itunes:subtitle>
			<itunes:summary>

A patient's mental health is just as important as their physical health and this month Mental Health America and its affiliates are celebrating 'May is Mental Health Month.'  The theme this year for Mental Health Month is 'Pathways to Wellness,' focusing on ways to identify avenues for Americans to obtain better physical and mental health overall.  Mental Health America suggests these four steps in helping Americans live better and healthier lives:     

  

1.  A healthy diet.  Eating a balanced diet, reducing caffeine, and limiting alcohol intake are all positive ways in which patients can improve their physical health.  They may sound simple, but are key to living a better life.     

  

2.  Regular exercise.  Getting routine exercise helps elevate mood, increases energy levels, reduces stress, and helps release the body's levels of endorphins and serotonin levels that can help patients feel better both mentally and physically.     

  

3.  Relaxation.  Leaning to take a step back and decompress is necessary in every profession.  Taking time out of your busy schedule to just relax will help you get up and give your job all you have to give.  Remember also to take time out to laugh and enjoy life.  

  

4.  Sleep.  Obtaining at least 7-9 hours of sleep each night is a necessary part of keeping mental and physical health in check.  Resting the mind and body allows the system to recharge after a hard days work.  

  

Pharmacy technicians can remind themselves and patients of these very simple steps to take in their everyday life to increase happiness, productivity, well-being, and good physical and mental health.  To learn more about Mental Health America and Mental Health Month go to http://www.mentalhealthamerica.net/.    


Sources:   

1.  Ahmed, Erica.  &quot;May is Mental Health Month Press Materials.&quot;  Mental Health America.  Web.  May 2013.  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1462/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Mon, 06 May 2013 13:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1461/</link>
			<title>FDA Creates New Invention to Fight Counterfeit Malaria Drugs</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/44473/malariainvention.png&quot;  /&gt;The FDA has created a new invention in the fight against sub-standard and counterfeit Malaria drugs called the Counterfeit Detector Device, version 3, or CD-3.&amp;nbsp; The battery operated handheld device will be deployed and tested in Ghana this year and a second testing program will be in an undetermined location according to the FDA.&amp;nbsp; The innovative new tool will help scientists identify fake Malaria drugs, which are often not identifiable to most people.&amp;nbsp; The CD-3 offers a quick, easy, and inexpensive manner in which to identify counterfeit meds.&amp;nbsp;&amp;nbsp;&amp;nbsp; &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;According to the FDA, Malaria is a disease which kills more than 660,000 individuals each year.&amp;nbsp; In those numbers, the most stricken with Malaria are children.&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Melinda K. Plaisier, the FDA&amp;rsquo;s acting Associate Commissioner for Regulatory Affairs recently commented on the new CD-3 invention.&amp;nbsp; &amp;ldquo;CD-3 illustrates the spirit of innovation and the commitment to public health that our scientists have.&amp;nbsp; They saw a need and invented a technology to address it.&amp;nbsp; It started off solving an immediate problem in FDA labs, and now is being leveraged to impact global health,&amp;rdquo; said Plaisier.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;The FDA will be providing the tools and training for the new gadget and the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) will provide technical help for users of the CD-3.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Do you think devices like the CD-3 will ever be used in pharmacies to identify fake medications?&amp;nbsp; Do you think the CD-3 is a good idea?&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; FDA Consumer Health Information Reports.&amp;nbsp; &amp;ldquo;FDA Invention Fights Counterfeit Malaria Drugs.&amp;rdquo;&amp;nbsp; FDA.&amp;nbsp; Web.&amp;nbsp; 2013 Apr.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;3-May-13 7:00 AM
</description>
			<itunes:subtitle>FDA Creates New Invention to Fight Counterfeit Malaria Drugs</itunes:subtitle>
			<itunes:summary>The FDA has created a new invention in the fight against sub-standard and counterfeit Malaria drugs called the Counterfeit Detector Device, version 3, or CD-3.  The battery operated handheld device will be deployed and tested in Ghana this year and a second testing program will be in an undetermined location according to the FDA.  The innovative new tool will help scientists identify fake Malaria drugs, which are often not identifiable to most people.  The CD-3 offers a quick, easy, and inexpensive manner in which to identify counterfeit meds.                

  

According to the FDA, Malaria is a disease which kills more than 660,000 individuals each year.  In those numbers, the most stricken with Malaria are children.      

Melinda K. Plaisier, the FDA's acting Associate Commissioner for Regulatory Affairs recently commented on the new CD-3 invention.  &quot;CD-3 illustrates the spirit of innovation and the commitment to public health that our scientists have.  They saw a need and invented a technology to address it.  It started off solving an immediate problem in FDA labs, and now is being leveraged to impact global health,&quot; said Plaisier.  

  

The FDA will be providing the tools and training for the new gadget and the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) will provide technical help for users of the CD-3.  

  

Do you think devices like the CD-3 will ever be used in pharmacies to identify fake medications?  Do you think the CD-3 is a good idea?  


Sources:   

1.  FDA Consumer Health Information Reports.  &quot;FDA Invention Fights Counterfeit Malaria Drugs.&quot;  FDA.  Web.  2013 Apr.  
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1461/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 03 May 2013 12:00:00 GMT</pubDate>
		</item>

		<item>

			<category>Articles</category>
			<link>http://www.pharmacytechnician.org/en/art/1457/</link>
			<title>Social Networks Affect Parents Vaccination Decisions for Kids</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/44473/Boy and vaccine syringe.jpg&quot;  /&gt;Social networks and the Internet are sometimes the deciding factor in whether patients seek treatment or not for an illness or condition for their kids.&amp;nbsp; This is also true in the decisions made by parents to vaccinate their children.&amp;nbsp; A recent study conducted by the National Science Foundation and published online in &lt;em&gt;Pediatrics&lt;/em&gt;, the Official Journal of the American Academy of Pediatrics found that parents that did not seek full vaccination for their children and this depended strongly on the advice of their close social networks of friends.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Dr. Emily Brunson, PhD, of Texas State University concluded that odds for no vaccination were 36 (95% CI 6 to 162) for parents that relied on the actions of &amp;frac14; to &amp;frac12; of their fellow friends on social networks who recommended no vaccination for their children.&amp;nbsp; Other statistics showed higher rates of no vaccination from 273 (95% Cl to 2,028) when &amp;frac12; to &amp;frac34; of their social network friends suggested against vaccination.&amp;nbsp; When 75% to 100% of social network members suggested no vaccination noncompliance rates when up even more.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;Dr. Brunson wrote in her study that &amp;ldquo;the importance of social networks strongly implies that for interventions aimed at promoting vaccine acceptance to be successful, they must take a broad approach, one that is capable of influencing not only parents, but the people parents might discuss their vaccination decisions with&amp;rdquo; said Brunson.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;As a pharmacy professional do you think parents rely too heavily on social media to make decisions concerning their children&amp;rsquo;s health and well-being?&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;hr /&gt;
&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Sources:&amp;nbsp; &lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;1.&amp;nbsp; Walsh, Nancy.&amp;nbsp; &amp;ldquo;Social Network Sways Vaccine Compliance.&amp;rdquo;&amp;nbsp; MedPage Today.&amp;nbsp; Web.&amp;nbsp; 15 Apr 2013.&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;2.&amp;nbsp; Brunson, Emily, MPH, PhD.&amp;nbsp; &amp;ldquo;The Impact of Social Networks on Parents&amp;rsquo; Vaccination Decisions.&amp;rdquo;&amp;nbsp; Abstract from &lt;em&gt;Pediatrics&lt;/em&gt;.&amp;nbsp; Web.&amp;nbsp; 15 Apr 2013.&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;
 
&lt;br&gt;&lt;br&gt;2-May-13 8:00 AM
</description>
			<itunes:subtitle>Social Networks Affect Parents Vaccination Decisions for Kids</itunes:subtitle>
			<itunes:summary>Social networks and the Internet are sometimes the deciding factor in whether patients seek treatment or not for an illness or condition for their kids.  This is also true in the decisions made by parents to vaccinate their children.  A recent study conducted by the National Science Foundation and published online in Pediatrics, the Official Journal of the American Academy of Pediatrics found that parents that did not seek full vaccination for their children and this depended strongly on the advice of their close social networks of friends.  

  

Dr. Emily Brunson, PhD, of Texas State University concluded that odds for no vaccination were 36 (95% CI 6 to 162) for parents that relied on the actions of &amp;frac14; to &amp;frac12; of their fellow friends on social networks who recommended no vaccination for their children.  Other statistics showed higher rates of no vaccination from 273 (95% Cl to 2,028) when &amp;frac12; to &amp;frac34; of their social network friends suggested against vaccination.  When 75% to 100% of social network members suggested no vaccination noncompliance rates when up even more.  

            

Dr. Brunson wrote in her study that &quot;the importance of social networks strongly implies that for interventions aimed at promoting vaccine acceptance to be successful, they must take a broad approach, one that is capable of influencing not only parents, but the people parents might discuss their vaccination decisions with&quot; said Brunson.  

            

As a pharmacy professional do you think parents rely too heavily on social media to make decisions concerning their children's health and well-being?  


Sources:   

1.  Walsh, Nancy.  &quot;Social Network Sways Vaccine Compliance.&quot;  MedPage Today.  Web.  15 Apr 2013.  

  

2.  Brunson, Emily, MPH, PhD.  &quot;The Impact of Social Networks on Parents' Vaccination Decisions.&quot;  Abstract from Pediatrics.  Web.  15 Apr 2013.           
</itunes:summary>
<itunes:explicit>no</itunes:explicit>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/art/1457/</guid>
			<author>Jennifer S. O'Reilly - noemail@pharmacytechnician.org</author>
			<pubDate>Thu, 02 May 2013 13:00:00 GMT</pubDate>
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			<category>stories</category>
			<link>http://www.pharmacytechnician.org/en/story/view.asp?7</link>
			<title>Register for our Nationwide Online Conference</title>
			<description>&lt;div&gt;
	A live, online conference that will empower you to become&lt;br&gt;
	more effective in your role as a pharmacy technician.&lt;/div&gt;
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/story/view.asp?7</guid>
			<pubDate>Thu, 16 Jun 2011 18:04:12 GMT</pubDate>
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			<link>http://www.pharmacytechnician.org/en/story/view.asp?6</link>
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	Stop by our online store for apparel, mugs,&lt;/div&gt;
&lt;div&gt;
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			<link>http://www.pharmacytechnician.org/en/story/view.asp?5</link>
			<title>Online Webinars</title>
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	Unable to join us for a live webinar? Click here for all our&lt;/div&gt;
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			<pubDate>Mon, 29 Nov 2010 16:57:00 GMT</pubDate>
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			<link>http://www.pharmacytechnician.org/en/story/view.asp?3</link>
			<title>Become A Pharmacy Technician at Home with NPTA</title>
			<description>&lt;p&gt;
	The pharmacy technician career path is quickly evolving and is in great demand across the U.S.&lt;/p&gt;
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/story/view.asp?3</guid>
			<pubDate>Tue, 23 Nov 2010 14:19:41 GMT</pubDate>
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			<category>stories</category>
			<link>http://www.pharmacytechnician.org/en/story/view.asp?2</link>
			<title>Advance Your Career</title>
			<description>&lt;p&gt;
	NPTA offers advanced certification programs for chemo, sterile products (IVs) and compounding.&lt;/p&gt;
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/story/view.asp?2</guid>
			<pubDate>Tue, 23 Nov 2010 14:17:28 GMT</pubDate>
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			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/compounding</link>
			<title>Compounding Certification</title>
			<description>http://www.pharmacytechnician.org/en/cev/479      NPTA's Compounding Certification Course has been designed to train pharmacy technicians on the topic of extemporaneous, non-sterile pharmaceutical compounding.    Extemporaneous pharmaceutical compounding is both an art and a science. Advanced career path options are available for pharmacy technicians with a comprehensive knowledge of compounding and experience with the latest equipment, techniques and methods. This program offers both!     Click Here for More Information            Target Audience   - Certified Pharmacy Technicians   - Pharmacy Technician Students   - Pharmacists    Course Details  The course requirements include:   - 10 Home Study Modules with Exams   - 2 Days Hands-On Training      How the Course Works  Participants must complete eleven separate modules of home-based learning, comprised of a reading assignment and comprehensive exam. A score of 70% or higher is required for each exam. After completing the home-based...

</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/compounding</guid>
			<pubDate>Thu, 23 May 2013 19:25:18 GMT</pubDate>
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			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/chemo</link>
			<title>Chemo Certification</title>
			<description> NPTA's Chemo Certification Course has been designed to train pharmacy professionals on the proper handling of hazardous drugs. Most health-system pharmacy settings require Chemo/Hazardous Drug Certification and/or prior experience for employment consideration. This course is designed to meet all applicable State Board of Pharmacy training requirements for Chemo Certification.        Click Here to Request More Information                   Target Audience    - Certified Pharmacy Technicians  - Pharmacy Technician Students  - Pharmacists    Course Details  The course requirements include:  - 10 Home Study Modules  - 1 Days Hands-On Training  - 5 Process Technique Validations         Prerequisite     Participants must meet one or more of the following requirements:   	 Successful completion or current enrollment in NPTA&#39;s IV Certification Course 	 Successful completion of an ACPE-accredited course on sterile products/aseptic technique  	40 contact hours or more, including both...

</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/chemo</guid>
			<pubDate>Thu, 23 May 2013 19:24:33 GMT</pubDate>
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			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/sterile</link>
			<title>IV Certification</title>
			<description>      NPTA's Sterile Product Certification Course has been designed to train pharmacy technicians and pharmacists on the topic of sterile product preparation and aseptic technique, including USP &amp;lt;797&amp;gt;.    Most health-system pharmacy settings require IV certification and/or prior experience for employment consideration. This course is designed to meet all applicable State Board of Pharmacy training requirements for IV Certified Pharmacy Technicians and Pharmacists!      Click Here to Request More Information         Click Here for 2013 Dates      Target Audience   - Pharmacists   - Certified Pharmacy Technicians   - Pharmacy Technicians   - Pharmacy Technician Students   Course Details  The course requirements include:  - 9 Home Study Modules  - 2 Days Hands-On Training  - 8 Process Technique Validations    &amp;gt;&amp;gt;Complete Learning Objectives    How the Course Works  Participants must complete nine separate modules of home-based learning, comprised of a reading assignment and...

</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/sterile</guid>
			<pubDate>Thu, 23 May 2013 19:23:53 GMT</pubDate>
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			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/weeke</link>
			<title>***Home Page - NPTA Events</title>
			<description>&lt;div&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;IV Certification&lt;span &gt;*&lt;/span&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;

&lt;p&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/497&quot;&gt;&lt;span &gt;Jun.10-11&lt;/span&gt;&lt;/a&gt;&lt;/p&gt;

&lt;p&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/498&quot;&gt;&lt;span &gt;Jun. 17-18&lt;/span&gt;&lt;/a&gt;&lt;/p&gt;

&lt;p&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/499&quot;&gt;&lt;span &gt;Jun. 24-25&lt;/span&gt;&lt;/a&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;a href=&quot;http://www.pharmacytechnician.org/sterile/&quot;&gt;&lt;span &gt;&lt;span &gt;...more dates &lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&lt;/span&gt;&lt;/p&gt;

&lt;div&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Compounding Certification&lt;span &gt;*&lt;/span&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/552&quot;&gt;&lt;span &gt;Jun. 6-7&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/553&quot;&gt;&lt;span &gt;Jun. 13-14&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/554&quot;&gt;&lt;span &gt;Jun. 20-21&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/555&quot;&gt;&lt;span &gt;Jun. 27-28&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;span &gt;&lt;a href=&quot;http://www.pharmacytechnician.org/compounding/&quot;&gt;&lt;span &gt;&lt;span &gt;...more dates &lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&lt;/span&gt;&lt;/div&gt;
&lt;/div&gt;

&lt;div&gt;&lt;br&gt;
&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Chemo Certification&lt;span &gt;*&lt;/span&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/524&quot;&gt;&lt;span &gt;Jun. 5&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/525&quot;&gt;&lt;span &gt;Jun. 12&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/526&quot;&gt;&lt;span &gt;Jun. 19&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/cev/527&quot;&gt;&lt;span &gt;Jun. 26&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&lt;br&gt;
&lt;a href=&quot;http://www.pharmacytechnician.org/chemo/&quot;&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;...more dates &lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/a&gt;&lt;/div&gt;

&lt;div&gt;&amp;nbsp;&lt;span &gt;&lt;span &gt;&amp;nbsp;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;

&lt;div&gt;&lt;strong&gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;&lt;span &gt;* &lt;/span&gt;DATES SHOWN MAY BE FULL&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/strong&gt;&lt;/div&gt;


</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/weeke</guid>
			<pubDate>Thu, 23 May 2013 19:21:53 GMT</pubDate>
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		<item>
			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/en/cms/2045/</link>
			<title>***Home Page - Current NEWS</title>
			<description>&lt;div&gt;
&lt;ul&gt;
	&lt;li&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/art/1487/&quot;&gt;New DSM-5 Released with Mixed Reviews&lt;/a&gt;&lt;/li&gt;
	&lt;li&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/art/1485/&quot;&gt;Pharmacy Security: NJ Implements Recent Voluntary Best Practices&lt;/a&gt;&lt;/li&gt;
	&lt;li&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/en/art/1472/&quot;&gt;FDA Issues Drug Safety Communication Concerning Pregnant Women Using Certain Migraine Prevention Medications&lt;/a&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;div&gt;&lt;strong&gt;From the NPTA Blog:&lt;/strong&gt;&lt;/div&gt;

&lt;ul&gt;
	&lt;li&gt;&lt;a href=&quot;http://cphtcentral.com/?p=1993&quot;&gt;Prescription to Party&lt;/a&gt;&lt;/li&gt;
	&lt;li&gt;&lt;a href=&quot;http://cphtcentral.com/?p=1979&quot;&gt;Get Ahead by Making &lt;/a&gt;&lt;br&gt;
	&lt;a href=&quot;http://cphtcentral.com/?p=1979&quot;&gt;Your Manager Proud&lt;/a&gt;&lt;/li&gt;
	&lt;li&gt;&lt;a href=&quot;http://cphtcentral.com/?p=1972&quot;&gt;Take Control of Stress in the Workplace&lt;/a&gt;&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&lt;a class=&quot;morenewslink&quot; href=&quot;/en/articles/search.asp&quot; &gt;more news...&lt;/a&gt;&lt;/p&gt;
&lt;/div&gt;


</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cms/2045/</guid>
			<pubDate>Wed, 22 May 2013 19:10:14 GMT</pubDate>
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		<item>
			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/convention</link>
			<title>Annual Meeting</title>
			<description>             QUICK LINKS  Hotel/Travel  Schedule/CE Topics  Exhibitor/Sponsorship Info  Volunteer Form             Join us this summer at the largest gathering of pharmacy technicians, educators and buyers in Las Vegas, at the Mandalay Bay!    Attending RxPO 2013 will be the perfect opportunity for you to enhance your career and benefit from the numerous sessions that are meant to expand your knowledge and sharpen your skills in the Pharmacy. You will be able to earn up to 12 hours of ACPE Accredited CE. Not only will this conference allow you to take your career to the next level, but you will have the opportunity to network with Pharmacy professionals from across the globe! You won&#39;t want to miss this conference.      For a limited time, use the discount code - blackjack when registering for an additional $21.00 savings!*      *Discount applied online only.           MEETING REGISTRATION        	 		 			  			Before April 4, 2013 			Before June 21, 2013 			After June 21, 2013 		 	...

</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/convention</guid>
			<pubDate>Wed, 15 May 2013 21:10:46 GMT</pubDate>
		</item>
		<item>
			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/exhibitor2013/</link>
			<title></title>
			<description>             We invite you to join us at RxPO 2013 in wonderful Las Vegas to the largest gathering of CPhT&#39;s across the globe! You don&#39;t want to miss this opportunity to connect face-to-face with Pharmacy professionals and showcase your products &amp; services. This is a unique opportunity to visit with a diverse audience that includes Certified Pharmacy Technicians, Managers, Educators, Buyers and so many more!          Meeting Location   The meeting and expo will be held at Mandalay Bay Hotel in Las Vegas.    3950 Las Vegas Blvd. South  Las Vegas, NV 89119    Exhibit Hall Schedule  Tuesday, July 9, 2013         12:00pm - 1:30pm  Wednesday, July 10, 2013     12:00pm - 1:30pm       Exhibit Set up  Monday, July 8, 2013      Exhibit Teardown  Wednesday, July 10, 2013         Booth Application &amp; Payment  To reserve your space, please fill out the Exhibitor/Sponsor Application and return to Harrell Jones at hjones@asyntria.com or by fax at 888-247-8706. Click here to download the...

</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/exhibitor2013/</guid>
			<pubDate>Mon, 13 May 2013 19:42:23 GMT</pubDate>
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		<item>
			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/advertise</link>
			<title>Advertise - Media Kit</title>
			<description>&lt;p&gt;&lt;span &gt;&lt;span &gt;From increasing market share to building professional relationships and impacting one of the most influential referral categories, the National Pharmacy Technician Association is the ideal marketing platform for reaching pharmacy professionals.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;Please &lt;a href=&quot;http://www.pharmacytechnician.org/attachments/files/1510/2013 Media Kit.pdf&quot;&gt;click here&lt;/a&gt; for view our updated Media Kit for 2013.&lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

&lt;p&gt;&lt;span &gt;&lt;span &gt;&lt;strong&gt;For more information, or for a custom proposal, please &lt;a href=&quot;mailto:laura@pharmacytechnician.org?subject=Media%20Kit%20-%20Request&quot;&gt;click here&lt;/a&gt; or call 832-426-2675&lt;/strong&gt;&lt;/span&gt;&lt;/span&gt;.&lt;br&gt;
&lt;br&gt;
&lt;br&gt;
&lt;a href=&quot;http://www.pharmacytechnician.org/attachments/files/1510/2013 Media Kit.pdf&quot;&gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/37336/Media_Kit_Cover.png&quot;  /&gt;&lt;/a&gt;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;


</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/advertise</guid>
			<pubDate>Mon, 13 May 2013 15:08:04 GMT</pubDate>
		</item>
		<item>
			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/en/cms/1693/</link>
			<title>Membership intro</title>
			<description>&lt;p&gt;&lt;a href=&quot;http://www.pharmacytechnician.org/attachments/files/1505/2013NPTA_MemApp.pdf&quot; target=&quot;_blank&quot;&gt;Download this application to pay by check&lt;img alt=&quot;&quot; src=&quot;../users/images/icons/filetypes/pdf.gif&quot;  /&gt; Members Application&lt;/a&gt;&lt;/p&gt;


</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/cms/1693/</guid>
			<pubDate>Fri, 03 May 2013 15:34:04 GMT</pubDate>
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		<item>
			<category>Content Managers</category>
			<link>http://www.pharmacytechnician.org/TT2012</link>
			<title>2013 Schedule</title>
			<description>&lt;div&gt;&lt;img alt=&quot;&quot; src=&quot;/attachments/wysiwyg/44473/pg4(1).jpg&quot;  /&gt;&lt;/div&gt;

&lt;div&gt;&amp;nbsp;&lt;/div&gt;

&lt;div&gt;
&lt;hr /&gt;&lt;br&gt;
&lt;span &gt;&lt;strong&gt;&lt;span &gt;*Please note that Today&#39;s Technician Magazine is mailed via Pre-Sort Standard U.S. Mail out of Texas. &lt;/span&gt;&lt;br&gt;
&lt;span &gt;The delivery date is determined by your local postmaster. Standard delivery dates are 2-4 weeks from the estimated mail date.&lt;/span&gt;&lt;/strong&gt;&lt;/span&gt;&lt;/div&gt;


</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/TT2012</guid>
			<pubDate>Fri, 03 May 2013 15:32:07 GMT</pubDate>
		</item>
		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?27</link>
			<title>RxPO 2007</title>
			<description>Objectives: &lt;p&gt;Attendee feedback and comments only&amp;nbsp;allows NPTA and RxPO to better serve your needs at future events.&lt;/p&gt;
&lt;br&gt;&lt;br&gt;Release Date: 16-Oct-07 1:00 PM&lt;br&gt;Expiration Date: 14-Jan-08 1:00 PM&lt;br&gt;&lt;p&gt;Share your thoughts with us on RxPO 2007.&lt;/p&gt;
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?27</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Tue, 16 Oct 2007 18:00:00 GMT</pubDate>
</item>

		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?20</link>
			<title>Peer Training/Education</title>
			<description>Objectives: What is the one thing you feel your coworkers need training in to make the pharmacy service better?
&lt;br&gt;&lt;br&gt;Release Date: 5-Jul-07 9:00 PM&lt;br&gt;Expiration Date: 3-Oct-07 9:00 PM&lt;br&gt;Please complete the following survey by answering questions and then include your name, city and state. Select responses will be published in an upcoming issue of Today's Technician magazine.
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?20</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 06 Jul 2007 02:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?21</link>
			<title>Peer Training/Education</title>
			<description>Objectives: &lt;br&gt;&lt;br&gt;Release Date: 5-Jul-07 9:00 PM&lt;br&gt;Expiration Date: 3-Oct-07 9:00 PM&lt;br&gt;Please complete the following survey by answering questions and then include your name, city and state. Select responses will be published in an upcoming issue of Today's Technician magazine. 
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?21</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 06 Jul 2007 02:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?23</link>
			<title>Law Interest</title>
			<description>Objectives: Plese complete the following survey by answering the questions then include your name, city and state. Select responses will be published in an upcoming issue of Today's Technician magazine.
&lt;br&gt;&lt;br&gt;Release Date: 5-Jul-07 9:00 PM&lt;br&gt;Expiration Date: 3-Oct-07 9:00 PM&lt;br&gt;</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?23</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 06 Jul 2007 02:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?22</link>
			<title>Topics Request</title>
			<description>Objectives: &lt;br&gt;&lt;br&gt;Release Date: 5-Jul-07 9:00 PM&lt;br&gt;Expiration Date: 3-Oct-07 9:00 PM&lt;br&gt;Please complete the following survey by answering the questions and then include your name, city and state. Select responses will be published in an upcoming issue of Today's Technician magazine.
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?22</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 06 Jul 2007 02:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?19</link>
			<title>Consumer Survey</title>
			<description>Objectives: The goal of this survey is to obtain feedback from&amp;nbsp;consumers on NPTA's recommendations for improving patient safety through standardized regulations for pharmacy technicians. 
&lt;br&gt;&lt;br&gt;Release Date: 6-May-07 10:00 AM&lt;br&gt;Expiration Date: 31-Dec-07 10:00 AM&lt;br&gt;Please complete the entire survey.
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?19</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Sun, 06 May 2007 15:00:00 GMT</pubDate>
</item>

		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?18</link>
			<title>Pharmacy Professional Survey</title>
			<description>Objectives: The goal of this survey is to obtain feedback from pharmacy professionals on NPTA's recommendations for improving patient safety through standardized regulations for pharmacy technicians.
&lt;br&gt;&lt;br&gt;Release Date: 2-May-07 11:00 AM&lt;br&gt;Expiration Date: 31-Dec-07 11:00 AM&lt;br&gt;Please complete the entire survey.
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?18</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Wed, 02 May 2007 16:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?17</link>
			<title>CPhT to CPhT 8.1/8.2</title>
			<description>Objectives: &lt;p&gt;Select responses of this survey will be published in &lt;u&gt;CPhT to CPhT - Practical Advice for Pharmacy Technicians&lt;/u&gt; in Volume 8 Issues 1 and 2 of &lt;b&gt;&lt;i&gt;Today's Technician Magazine&lt;/i&gt;&lt;/b&gt;.&lt;/p&gt;
&lt;br&gt;&lt;br&gt;Release Date: 3-Apr-07 2:00 PM&lt;br&gt;Expiration Date: 2-Jul-07 2:00 PM&lt;br&gt;&lt;div&gt;1. Number and answer each question in the space provided.&lt;/div&gt;
&lt;div&gt;&lt;span style=&quot;COLOR: red&quot;&gt;2. Please include your name, city and state to be considered for publication.&lt;/span&gt;&lt;/div&gt;
&lt;div&gt;&amp;nbsp;&lt;/div&gt;
&lt;div&gt;&amp;nbsp;&lt;/div&gt;
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?17</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Tue, 03 Apr 2007 19:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?16</link>
			<title>CPhT to CPhT Vol 8 Issue 1</title>
			<description>Objectives: &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; 
&lt;br&gt;&lt;br&gt;Release Date: 23-Mar-07 1:00 PM&lt;br&gt;Expiration Date: 21-Jun-07 1:00 PM&lt;br&gt;Please complete the following survey by answering all four questions and then include your name, city and state. Select responses will be published in an upcoming issue of Today's Technician magazine.
</description>
			<guid isPermaLink="false">http://www.pharmacytechnician.org/en/sur/?16</guid>
			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Fri, 23 Mar 2007 18:00:00 GMT</pubDate>
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		<item>
			<category>Survey</category>
			<link>http://www.pharmacytechnician.org/en/sur/?15</link>
			<title>CPhT 2 CPhT V7.4</title>
			<description>Objectives: &lt;br&gt;&lt;br&gt;Release Date: 2-Dec-06 3:00 PM&lt;br&gt;Expiration Date: 2-Mar-07 3:00 PM&lt;br&gt;&lt;p&gt;Provide your answer along with your first name, first initial of your last name, city and state....in each answer box to ensure that you are properly cited, if published in Today's Technician magazine.&lt;/p&gt;
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			<author>noemail@pharmacytechnician.org</author>
			<pubDate>Sat, 02 Dec 2006 21:00:00 GMT</pubDate>
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<title>Multiple Sclerosis: Searching for Answers</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=373</link>
<description><![CDATA[Instructor: Sandra Andrews, CPhT<br><br>

2.5 million, 1.2 million, 2,844 deaths are staggering numbers no matter what they relate to, but even more daunting when you consider how they relate to the disease state known as multiple sclerosis (MS). 2.5 million people worldwide are diagnosed with MS each year, 1.2 million people in the United States. 2,844 deaths each year are from MS related symptoms. Multiple sclerosis is a chronic disease state that is often restricting to those who experience its symptoms. The central nervous system (CNS), which encompasses the brain, spinal cord, and optic nerves, is the principal system affected by MS. Thoughts, movements, sight, and sensations are all controlled through the central nervous system, so it is no wonder this disease can have such a profound effect on those who are impacted by it.   Once thought to be an autoimmune disease, scientists now argue that multiple sclerosis is actually an immune-mediated disease. Simplistically, an immune-mediated disease is an overreaction of the body's immune system, while overreaction and an autoimmune disease is a subgroup of immune mediated diseases. While science continues to debate whether MS should be labeled generally as an immune-mediated disease or more specifically as an autoimmune disease, the National Multiple Sclerosis Society maintains that MS is an immune-mediated disease.   So, what is multiple sclerosis and more importantly how does it affect the lives of those with it? What are its symptoms? Is there a cure? How is MS diagnosed? What drugs are available to treat the disease? Do the drugs treat the disease or just the symptoms? Finally, what role does pharmacy play in the containment and treatment of the disease? These are all questions we need to explore, which need to be answered.   As previously mentioned, multiple sclerosis, per definition from the National Multiple Sclerosis Society, is an immune mediated disease. Immune-mediated diseases attack the body's central nervous system and therefore alter spinal cord, brain, and optic nerve responses. The central nervous system is responsible for processing sensory information that allows our bodies to move about and complete the tasks associated with daily life. The brain and the spinal cord, the two main organs of the central nervous system, work in tandem with one another to perform the jobs most of us take for granted, for example, walking.       The brain is made up of three key areas, the forebrain, the midbrain, and the hindbrain. The forebrain is responsible for functions related to language and understanding. Located within the region of the forebrain are the thalamus, hypothalamus, cerebrum (the largest section of the brain), and the cerebral cortex. The cerebral cortex is the central processing center for the brain, much like a motherboard for a computer.   The midbrain, which is the bridge between the forebrain and the hindbrain, works to ensure auditory and visual functions are properly working in the brain. The midbrain and the hindbrain function together to form the brainstem, which with the cerebrum connects the brain to the spinal cord. The spinal cord then assists the brain in the neurological responses needed to engage the body in walking (for example).   Finally, the hindbrain extends from the spinal cord and allows for the synchronization of movement and the balancing of equilibrium. Also housed within the hindbrain is the medulla oblongata. The medulla oblongata controls the autonomic functions of the body, such as digestion, breathing and heart rate. Without the medulla oblongata, the brain and the spinal cord could not share the responses that allow us to perform the daily functions of living, many of which we often do not think about.   It is clear, then, that the brain and spinal cord's involvement in our daily lives is monumental; so when these systems are compromised, the results can be devastating. Multiple sclerosis throws barriers in the path of those just trying to lead a normal life. Loss of coordination, blurred vision, tremors, extreme fatigue, slurred speech, numbness in the fingers and toes, inability to concentrate or hampered memory and, in extreme cases, blindness and even paralysis are just a few of the symptoms patients diagnosed with multiple sclerosis experience everyday.   The etiology of multiple sclerosis has managed to evade science, but through the study of immunology, epidemiology and genetics, scientists have been able to gather clues that shed a bit more light on why MS affects some people, not others. Understanding the origins of the disease is key to understanding how to control its symptoms and, one day, possibly even finding a cure.   Immunology, the study of the body's immune system, seems to have given the most insight to the causes of MS. As previously mentioned, there has been some debate within the health profession and science as to how to categorize the disease. Because the National Multiple Sclerosis Society states that MS is an immune-mediated disease we will also describe it that way.   The theory surrounding immunology as a central cause of multiple sclerosis involves the myelin (protective sheathing) that surrounds and insulates the nerves of the central nervous system. It is thought that the myelin becomes damaged or compromised allowing the immune system to attack the CNS. Once damaged, it can no longer protect the nerves of the central nervous system, resulting in loss of function in patients.   Further damage happens when scar tissue is formed where the myelin is attacked by the immune system. This scarring causes electrical impulse interruptions within the CNS, leading to symptoms associated with multiple sclerosis. Axons, fibrous nerves that myelin protects, along with neurons, become damaged, forming lesions along the central nervous system. These lesions interrupt nervous signals between the brain and body, causing symptoms such as tremors, bladder problems, numbness and slurred speech.   Epidemiology as defined by the World Health Organization is the study of the distribution and determinants of health-related states of events and the applications of this study to control diseases and other health problems. In other words, it describes how the environment around us is related to a specific disease state. In this case, scientists have used epidemiology to develop hypotheses to understand the causes of multiple sclerosis as they relate to our environment.   Epidemiologists take into consideration factors such as age, sex, ethnic background and migration patterns when trying to determine the underlying causes of a disease state. While scientists cannot definitively state what causes MS, there is evidence that proves a greater incidence of multiple sclerosis in countries with moderately cool climates whether in the northern or southern hemisphere. Further investigation has lead science to link this phenomenon to the migration patterns of Middle Eastern Europeans. North America has by far the highest number of multiple sclerosis cases; only the areas of Eastern Europe and Australia come close to the number of cases seen in North America.   In conjunction with the migration patterns of our ancestors, researchers believe the depletion of sunlight and vitamin D, which our bodies produce naturally through the exposure to sunlight, are responsible for the higher occurrence of multiple sclerosis. This falls inline with a greater incidence of multiple sclerosis taking place north of the equator considering those who live closer to the equator are exposed to more sunlight and thus produce more vitamin D naturally.   While multiple sclerosis occurs in all ethnic groups, African Americans, Asians and Hispanics or Latinos have seen the smallest incidence. Caucasians, in particular Caucasian women, are the most likely to be diagnosed with MS. In fact, women are two to three times more likely than men to be diagnosed with multiple sclerosis. It is because of this dynamic that researchers have started investigating the role hormones play in the development of multiple sclerosis. Even though the number of cases of MS in women is almost three times greater than in men, multiple sclerosis in men appears to progress faster and become more aggressive as the disease spreads.   Genetics, which can be a primary factor in many disease states, has also been explored as a cause of multiple sclerosis. According to the National Multiple Sclerosis Society, the average person has a one in 750 chance of being diagnosed with multiple sclerosis. Sadly, the chance increases to one in 40 when a first degree relative, such as a parent or sibling, is diagnosed with the disease. Even more enlightening is the one in four chance seen by persons who share the same genes, such as an identical twin. Although genetics may be responsible for a small percentage of those diagnosed with multiple sclerosis, there are still too many variable factors to conclude that genetics is the sole determinant for being diagnosed with multiple sclerosis.      Finally there have been some studies conducted that suggest infections of the CNS, which lead to an immune reaction in the area, instigate a trigger and result in MS. Scientists have not been able to isolate the culprit responsible for the infection, but Epstein-Barr, chlamydia, pneumonia, measles, canine distemper, and human herpes virus 6 remain candidates for the trigger. Of all the bacteria and viral infections mentioned, Epstein-Barr has shown the most promise for establishing a connection between multiple sclerosis and viral infections.   It wasn't until the 19th century that MS was recognized as a disease state and it wasn't until the late 1960s that scientists understood the connection between the central nervous system's protective myelin and the deterioration that leads to a diagnosis of multiple sclerosis. It was also during the late '60s that researchers established the first guidelines for initiating a diagnosis of multiple sclerosis. Keeping these guidelines in mind, what establishes a diagnosis of MS? What factors must be seen in a patient's health exam in order to identify multiple sclerosis as solid diagnosis?   According to the National Multiple Sclerosis Society, the following criteria should be met before a patient can be definitively diagnosed with multiple sclerosis.    Find evidence of damage in at least two separate areas of the central nervous system, which includes, the brain, spinal cord and optic nerve    Find evidence that the damages occurred at least one month apart    Rule out all other diagnoses    Make use of diagnostic tools, including:   o MMR (magnetic resonance imaging)   o VEP (visual evoked potential)   o Cerebro spinal fluid (CSF) analysis   Without the use of these diagnostic tools, multiple sclerosis can become difficult to definitively identify. The patient's medical history also becomes key to a substantiated diagnosis for multiple sclerosis. Patients who track MS attacks or who can provide their physician with a detailed history of their symptoms give the physician an advantage when diagnosing multiple sclerosis.   There are two recognized levels of multiple sclerosis and knowing each level helps the patient to understand their disease state, including what they need to know in order to control the disease and the attacks that ensue. The two primary levels of MS are progressive multiple sclerosis and relapsing multiple sclerosis. Within each of these two categories are additional subcategories, which we will discuss further.   People who have been diagnosed with progressive multiple sclerosis fall under one of three disease courses: primary progressive, secondary progressive or progressive relapsing. A steady stream of neurological degeneration marks the first course of primary progressive MS, giving the patient little, if any, time for remission from the disease. The patient may have recognized highs and lows, but will never really obtain remission from the disease's progression.   Secondary progressive typically comes after a course of the most diagnosed form of multiple sclerosis, relapsing-remitting MS. Secondary progressive MS deteriorates the patient's physical state at steady pace. Patients who are diagnosed with secondary progressive MS may or may not have remission from the disease, but like primary progressive MS, the disease continues to progress. The key difference between primary and secondary progressive MS is that secondary progressive MS is secondary to relapsing-remitting MS and not a primary course of MS.   The final course of progressive MS is progressive-relapsing MS and is the least common of the progressive courses of MS. As with the primary progressive and secondary progressive MS, progressive relapsing MS is marked by the continual advancement of the disease. However, unlike primary and secondary progressive MS the patient may have occasional relapses, which may not give the patient a time of recovery. Still, the disease continues to develop, a hallmark of the level of MS categorized as progressive.   The next level of multiple sclerosis is relapsing MS, which is marked by bouts of remission and progression. Within this level of multiple sclerosis are three separate courses, relapsing-remitting, secondary-progressive, and progressive relapsing MS.   The National Multiple Sclerosis Society estimates that up to 85% of all people who are diagnosed with multiple sclerosis fall under the category of relapsing-remitting multiple sclerosis. Relapsing-remitting MS has clearly defined lines of attacks and progressions, followed immediately by long periods of remission. During the patient's period of remission, the disease sees no progression.   The next course of relapsing MS is secondary-progressive MS. Secondary-progressive MS usually follows a bout with relapsing-remitting MS and is marked by a continued progression of worsening disease state. The disease state may have occasional remissions, but will continue to be recognized by an indicated stream of progression. It is for this reason secondary-progressive MS is considered to be both progressive and relapsing.   The final course of relapsing MS is progressive-relapsing MS. Progressive-relapsing MS is the least common of the relapsing courses of MS. Progressive-relapsing MS progresses from the beginning of the disease and continues throughout the course of the disease. Patients may or may not find relief from the disease through remission; however, the disease continues to progress, depleting the patient's physical state and overall health.   Clearly multiple sclerosis is a disease of progression. The patient often sees periods of remission, where attacks from the disease are non-existent and the patient's disease course seems to improve. Still, a patient may have a course of the disease where they see no exacerbation of the disease, but the disease continues to advance, offering them highs and lows of the disease but no real relief.   How is MS treated? There is no current cure for multiple sclerosis, although researchers are closer to understanding the disease. Most of the pharmaceutical treatments currently available for MS simply alleviate the symptoms, offering the patient temporary relief. When it comes to the treatment of multiple sclerosis, the drugs that treat the disease state can be broken down into three different categories: modifying disease course, treating exacerbations and managing the disease symptoms.   The first category of drugs, those that modify the disease course, reduces the progression and the activity of the disease. Patients who have been diagnosed with relapsing forms of multiple sclerosis, including secondary progressive relapsing MS, see the most relief from this form of treatment.   Interferon is the first category of drug modifying therapies and exists as either beta-1a or beta-1b. Biological miscellaneous is the second category in this class and currently Copaxone is the only brand available in the U.S. Interferon beta-1a has been proven to reduce the relapse of multiple sclerosis by 18-38%. Interferon beta-1a is commercially available under the names Avonex and Rebif.   Avonex, which is produced by Biogen Idec, is a once-a-week treatment offered to the patient through the convenience of an injectable pen. While Avonex has been proven to provide relapse relief for the multiple sclerosis patient, it does have considerable side effects. Some of these side effects include seizures, infection, low or decreasing red and white blood cell counts, as well as decreased platelet counts and heart problems, including heart failure. Another common side effect of Avenox is flu-like symptoms such as fever, muscle aches, chills and fatigue.   Rebif, produced by Pfizer, works along the same premise as Avenox and also comes as a once-a-week dose in a self-administered syringe. As with Avenox, the patient with MS sees relief from relapse, but not without the risk of some potentially alarming side effects such as thyroid issues, heart problems, decreasing blood counts and potential for decreased liver function. Both Avenox and Rebif offer patient support lines on the manufacturer websites. Patient support for Avenox can be found at http://www.avenox.com and for Rebif patient support can be found at http://www.rebif.com.   Interferon beta-1b is the second group of interferon medications used to modify the disease state of multiple sclerosis. Betaseron and Extavia are two interferon beta-1b products commercially produced to modify the disease state of multiple sclerosis. Betaseron, which is produced by Bayer Health Care, works much the same way as Avenox and Rebif, helping to reduce the number of relapses a patient may have by modifying the disease.   Interferon is a protein produced naturally by the body. When the production of interferon is disrupted in the body, it leaves a gap open in the immune system and in the case of multiple sclerosis, a vulnerability to demyelination. As we have learned, when the myelin is decreased, there is greater risk of damage to the nerves it protects. When the nerves become damaged, then the symptoms of MS become apparent.   Betaseron and its counterpart, Extavia, produced by Norvartis, help to modify the patient's disease state and in turn reduce the number of relapses a patient may have. Both Betaseron and Extavia are produced as self-medicating, subcutaneous kits. Betaseron and Extavia are interferon beta-1b products and differ only from interferon beta 1a products by the slight difference in their amino acid structures.   The manufactures of Betaseron and Extavia have set up patient-friendly help centers at each one of the drug websites, http://www.betaseron and http://www.extavia.com. Patients who have further questions or concerns about these drugs are encouraged to visit the site and follow up by a conversation with their neurologist and pharmacist concurrently.   As with interferon beta-1a, interferon beta-1b also comes with a risk of potentially harmful side effects such as depletion of liver function, potential for increased depression, possible heart problems, including heart failure, as well as seizure, flu-like symptoms and injection site issues. Currently, research is not strong enough to argue for an interferon beta-1a product over an interferon beta-1b product. Such decisions should be made solely by the patient and their neurologist.   Copaxone, or as it is known generically, glatiramer acetate, is also a disease-modifying drug, but falls under the category of biological miscellaneous. Copaxone, which is the only biological miscellaneous product approved in the United States, is produced by Teva Pharmaceuticals. The medication works along the same lines as the interferon groups, modifying the disease and in turn producing a decrease in disease relapse.   The one significant difference between Copaxone and the interferon-based drugs is that the patient must inject Copaxone daily subcutaneously. For a patient who is already burdened by the symptoms of MS, this may very well be one more issue they are not willing to do.   Copaxone has been on the market in the U.S. since 1996 and while it has offered the patients who use it relief, it does not come without warnings.   Side effects when using Copaxone are primarily related to the daily need for patient-produced injection, specifically warnings against overuse of injection sites and the potential for infection. However, more serious side effects can occur include shortness of breath, heart palpitations, anxiety, skin rashes and dizziness. If patients recognize any of these symptoms after taking Copaxone they should seek medical attention immediately. Most reactions will occur within 15 minutes of injection, but any reactions that occur at a later time should not be dismissed.   Gilenya (sphingosine 1-phosphate receptor modulator) and Novantrone Antiplatic (agent/anthracenedione) are the next class, which modify MS. This class of drugs is generally reserved for patients with advanced stages of MS or those who have not responded to other treatment. Gilenya works by preventing nave immune cells from leaving the lymph nodes and circulating to other tissues in the body, such as the brain. As such, it prevents their action against myelin in the CNS. Careful consideration should be taken before beginning treatment with drugs in these two categories.   Finally, there is the category that includes Tysabri (natalizumab), a monoclonal antibody selective adhesion molecule inhibitor. Tysabri is the only brand available in the U.S. and is usually a last course of action drug. This medication works by blocking integrin receptors, which prevents T cells of the immune system from entering the brain. Only patients who have not responded to any other treatment should begin this therapy. Stringent monitoring of therapy is essential.   From drugs that modify the disease, we move to drugs that manage the symptoms of the disease. This specific set of drugs offers the patient temporary relief from the symptoms of their disease. Corticosteroids such as prednisone, methylprednisolone, dexamethasone and adrenocorticotropic hormone (ACTH) offer the patient the most relief from the inflammatory symptoms associated with multiple sclerosis. But once again, patients should be cautioned about the potential for harmful side effects and should be monitored carefully by their neurologist. Medication management should be a joint effort by the patient's physician(s) and pharmacist. Efforts made in such a manner reduce the potential of harm to the patient.   Corticosteroids like prednisone and dexamethasone are effective for such symptoms as inflammation, but should be prescribed only as needed and not for over-extended periods of time. Overuse of corticosteroids may cause swelling, thinning of the skin and bones, endocrine and metabolic issues, allergic reactions of the skin and possible cardiovascular issues.   When treating multiple sclerosis, three main categories of drugs exists: ones that modify the disease such as interferon-1a and 1b; drugs that treat the exacerbations or flair-ups of the disease, like corticosteroids for inflammation; and finally those drugs that manage the symptoms of the disease. This final category of drugs may be largest group of drugs available for treatment, due to the wide array of symptoms possible in a patient who has been diagnosed with MS.   Some of the drugs approved by the FDA to treat the specific symptoms associated with multiple sclerosis include:      Managing the symptoms of multiple sclerosis may sometimes be the most challenging aspect, for the benefit of one drug may increase the side effects of another, making it necessary for the patient to medicate yet again for another symptom. Often times it is the side effects that need the most management.   It is no secret that over the last decade pharmacy has taken progressive steps toward a greater role in patient medication management. Federal laws such as the 1990 OBRA patient counseling laws and current pending federal regulation under the Affordable Care Act have forced the pharmacist into center spotlight as a primary manager for patient medication management (MTM). The significance and importance of a pharmacist/physician regulated patient MTM is all too evident in the overall well being of a patient diagnosed with MS.   So what role does this leave for the pharmacy technician? As pharmacists continue to move towards more direct care roles, pharmacy technicians take on more traditional roles once filled by the pharmacist. Of course, a pharmacy technician should never move beyond the legal or structured elements of their position, but being aware of disease states and the drugs that treat them, particularly side effects and potential warnings, might very well keep a patient from harm.   Take the following example:   Jamie works at Parks Drug as a pharmacy technician. She has been a certified pharmacy technician for over five years and prides herself on staying informed of the latest changes in pharmacy law and disease states and the advancements made to treat those diseases. Jamie is also cautious to never go beyond her job duties, knowing the pharmacist is the only person who is legally capable of answering drug medication questions.   One day when Jamie is working at the front counter of the pharmacy, Mrs. Banks walks into the pharmacy. Jamie does not recognize her as a regular customer and ask if she might be able to help her. Mrs. Banks tells Jamie her name, then continues by telling her that she has just moved to town and was given Parks Drug as reference. Mrs. Banks has two new prescriptions from her physician that need to be filled and three prescriptions from her old pharmacy that need to be transferred.   Immediately Jamie begins by starting a new patient profile for Mrs. Banks. Jamie, upon gathering Mrs. Banks' information sees that one of the health issues she has listed is multiple sclerosis. Reviewing the patient's list of prescriptions to be transferred she notices a prescription for Avonex, prednisone, Effexor, and Symmetrel, as well as Ditropan. Because the new prescriptions Mrs. Banks has given Jamie are for Betaseron and Ditropan XL, Jamie notices a potential problem.   Jamie politely excuses herself and then speaks to the pharmacist on duty about her concerns with Mrs. Banks' prescriptions. Knowing that Mrs. Banks has listed multiple sclerosis as a health issue and that Avonex and Betaseron are both approved treatments for the relapse of multiple sclerosis, Jamie is concerned Mrs. Banks might be receiving duplicate treatments. She also informs the pharmacist Mrs. Banks has been prescribed Ditropan and Ditropan XL.   The pharmacist notes Jamie's concerns about Mrs. Banks' medications, thanks Jamie, and goes to speak with Mrs. Banks. Mrs. Banks, who did not realize she could have potentially duplicated medication therapies, thanks the pharmacist and Jamie for being so proactive in her care.   In this instance, because Jamie sought to maintain her skills as a certified pharmacy technician through educational resources, the risk of harm to a patient was eliminated. Jamie's recognition of MS treatments and the drug categories they fall into helped her see a risk potential. Not only did Jamie help the patient, but also certified her skills as a pharmacy professional.   Multiple sclerosis is a disease state that can be debilitating to the patient as well as the ones who love and care for them. Treatments such as interferon beta-1a and interferon beta-1b work to modify the disease state, while corticosteroids like prednisone and methylprednisolone help to manage the symptoms of multiple sclerosis. Drugs like Ditropan, a drug commonly prescribed for bladder control, and Effexor, often prescribed for depression, work to control the symptoms of multiple sclerosis. Still the need to develop better treatment plans continues to grow; one of the most significant developments taking place at Northwestern University.   Recently, Northwestern University Feinberg School of Medicine has had great success with a drug therapy currently known as MW151. In phase 1 human clinical trials, it was the first drug therapy which decreased brain inflammation and the first MS drug to target CNS functions. MW151 prevents the overproduction of pro-inflammatory cytokines. Initially developed for Parkinson's disease, MW151 may prove to serve a dual purpose.   Special populations such as pregnant women and children have their own specific set of concerns when it comes to the treatment of multiple sclerosis. Women who are pregnant and have been diagnosed with MS seem to have relief from MS symptoms during their second and third trimesters. Researchers believe this is do to the increased level of natural steroids and immune activity. Pregnant women who experience relapse post partum have had success with therapies that include intravenous steroids and IVIG.   During pregnancy, Tysabri and interferon are contraindicated and have been known to cause fetal harm. The situation is not much better for glatiramer Copaxone, which cannot rule out fetal harm. Corticosteroids may be used, but only under strict supervision by a physician. Before therapy with corticosteroids begins, the physician should consult with the specialty pharmacist and determine whether the benefits of the drug outweigh the potential of risk. Corticosteroids have been linked to cleft palate when administered during the first trimester and patients beginning them should be clearly warned of this possibility.   Other concerns for women who have MS and are pregnant include lower birth weights for children and a higher incidence of Cesarean sections. Patients should be consulted in order to understand all therapies available as well as the safety of those therapies. Coordination of therapy between the patient's neurologist and obstetrician as well as the benefit of the pharmacy specialty services is essential for the safety of the patient and the fetus.   Children are also susceptible to MS's reach, but there are some who are at a greater risk. Children who live in the northeastern U.S. are at the greatest risk and Caucasian children have a higher incidence than any other ethnic group and, of course, girls more than boys. Researchers attribute these risks to a possible genetic link, especially when a parent or sibling has been diagnosed with MS. Decreased vitamin D and geographic areas where sunlight is often not as prevalent as well as children whose parents smoke are risk factors for being diagnosed with MS.   Some of the symptoms that adults experience may be the same in children. CNS involvement is generally at the center of these symptoms. Cognitive functions and walking abnormalities are just a few of the concerns associated with MS in children. Treatment may become a challenge as well. Most MS therapies are not FDA-approved for pediatric use and the side effects associated with the treatments may not be worth the benefits. Most of a treatment's value will be depend upon the child&#39;s ability to tolerate the treatment.   Gilenya may show the most promise for modification of the disease, but the studies have only been proven for children over the age of 16, which still leaves another demographic that needs reliable treatment. Corticosteroids like prednisone can relieve issues of inflammation, but close monitoring by the child's pediatrician is suggested. The invitation of specialty pharmacy services may also be advantageous.   Treatment with methylprednisolone is not recommended, but if therapies are enacted they should be closely monitored and should not be taken under lengthy periods of time. Dexamethasone, like prednisone, is indication-specific and as with other corticosteroids needs close monitoring.   As pharmacy continues to evolve so must the pharmacy technician. Understanding disease states like multiple sclerosis and the treatments required to control the disease advance the career of the pharmacy technician as well as perpetuate the well-being of the patient.   References:   Avenox, http://www.avenox.org, January 2013, accessed 12 February 2013   Betaseron, http://www.betaseron.org, January 12,2013 accessed 13 February 2013   Copaxone, http://www.copaxone.com, January 2013, accessed 12 February 2013   MedWatch Safety Alerts, May 2012: MS Drug Investigation Continues The Food and Drug Administration. 2012 http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm307217.htm#5   Accessed 26 July 2012   MedWatch: The FDA Safety Information and Adverse Event Reporting Program The Food and Drug Administration. 2012. http://www.fda.gov/Safety/MedWatch/default.htm Accessed 21 July 2012   Multiple Sclerosis Association of America, http://www.mymsaa.org ,January 31 2013, accessed 13 February 2013   Multiple Sclerosis Foundation, http://www.msfocus.org , January 2013, accessed 13 February 2013   Multiple Sclerosis, http://www.multiplesclerosis.com , January 31,2013, accessed 14 February 2013   National Multiple Sclerosis Society, http://www.nationalmssociety.org ,January 2013, accessed 14 February 2013   New Drug Could Treat Alzheimer's, Multiple Sclerosis and Brian Injury Science Daily. July 2012. http://www.sciencedaily.com/releases/2012/7/2012147/1302.htm Accessed 26 July 2012    Pharmacist Prescribing Better Care U.S. Department of Health and Human Services Health Resource and Services Administration. April 2009. http://www.hrsa.gov. Accessed 22 July 2012.   Pharmacist's Role in Meeting National Patient Safety Goals Health Care Associated Infection and Prevention. Volume 44:pp: 404-411.May 2009.   Polman, C Reingold, S.Banwell, B. Clanet, M. Cohen, Massimo J., F.Kazuo, F.Havardarvo, E. Hutchinson, M. Kappos, L. Lublin, F. Montilban, O'Conner, P.Wolheilm-Sandburg, M Thompson, A. Waubant, E. Weinshker, B.and Wolinsky, J.  Diagnostic Criteria for Multiple Sclerosis: 2010 Revision to McDonald Criteria. Annals of Neurology. February 2011. Volume 69:pp292-302.   Preventing Medication Errors pp: 26-32. To Err is Human: Building a Safer Health System. November 1999. Institutes of Medicine. http://nap.edu/catalog/11623.html. Accessed 21 July 2012.   What is Paresthesia? National Institute of Neurological Disorders and Strokes. May 2010. http://www.ninds.nih.gov/disorders/paresthesia/paresthesia.htm Accessed 26 July   Author Bio:   Sandy Andrews lives in Chambersburg, Pennsylvania with her husband of 17 years, Rob and her two teenage sons, Joshua and Caleb. She will be completing her BA in English from Arizona State University in July and will be moving on to complete her Masters Degree in English from Northern Arizona University. Sandy has over 20 years of experience as a Certified Pharmacy Technician, primarily in institutional pharmacy. Recently, Sandy has had a career change and is writing educational material for pharmacists and pharmacy technicians. Sandy is hoping to continue the growth of this new career choice.   Idea in Brief:   Multiple sclerosis is a progressive neurodegenerative disease that results in compromised function of the central nervous system. While there is no cure for the disease, science continues to make strides toward a better understanding of MS. This program will interpret some of the mysteries associated with multiple sclerosis as well as give greater insight to the treatments used to control the disease.   Idea in Practice:   As the role of the pharmacy technician continues to evolve, understanding disease states, such as multiple sclerosis, becomes a required part of the pharmacy technician's skill set. Treatments associated with the management of multiple sclerosis will also continue to develop. It is necessary for the pharmacy profession to be informed of available treatments in order to better serve the patient. Pharmacy technicians are essential to the practice of medication management. Patients who are afflicted with multiple sclerosis will require the skills of a qualified pharmacy team and central to this team will be the certified pharmacy technician.  <br>
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<dc:date>2013-03-15T13:00:00Z</dc:date>
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<title>Avoiding the Pitfalls of Communication in the Workplace</title>
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<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=371</link>
<description><![CDATA[Instructor: Crystal Collins, CPhT &#0038; Laura De La Rosa<br><br>

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<dc:date>2013-02-27T14:00:00Z</dc:date>
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<title>The Affordable Care Act</title>
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<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=370</link>
<description><![CDATA[Instructor: Sandra Andrews, CPhT<br><br>

   Obamacare, the Obama Health Care Plan, Health Care Reform Bill, Patient Protection and Affordable Care Act (PPACA) or simply the Affordable Care Act (ACA): no matter which name is most familiar to you or what your personal opinion is concerning this often controversial bill, one thing is certain, this piece of legislation will touch each and every American. Most would agree there is a need for health care reform in the United States; however, agreeing on how to go about completing the needed changes has presented more of a challenge.      From the very mention of a nationalized health care plan, there was a call to challenge what some have suggested is socialized medicine and others have felt was a move in the right direction for all US citizens. Once again, this falls under the veil of personal opinion, but perhaps some of the most important questions we should be asking are; how will this change the tide of health care and how will the changes affect health care professionals? These are questions that require thorough investigation and meaningful thought.      According to the US Bureau of Labor Statistics, in 2010 there were 274,900 licensed pharmacists working in the United States and that number is predicted to rise to 344,600 by the year 2020. Pharmacy technicians surpass the number of pharmacists by almost 20% with 334,400 technicians working in this country in 2010. Like the projections for pharmacists, the number of pharmacy technicians is expected to grow with statisticians predicting approximately 443,000 technicians by 2020. No matter how you interpret the numbers, by 2020 the number of pharmacists and pharmacy technicians will be over 750,000 strong, too large a number not to have a significant effect on the surge of health care changes we are now about to experience.      In order to best understand the dynamics of the Affordable Care Act it is probably best to understand how the bill came about, what the bill entails and when the changes will be fully in place.      President Barack Obama will most likely be remembered in history for several reasons, but perhaps his most considerable achievement is -passing- the Affordable Care Act. On March 23, 2010, President Obama signed ACA into law, holding to a significant piece of his campaign platform. Passage of the bill did not come without a fight, nor did it end when President Obama signed it into law.      The challenge of implementing a national health care plan in the United States has not gone unnoticed. Generations of presidents and presidential candidates have run their campaigns on the promise of health care for the masses. In 1912, Theodore Roosevelt, who decided to make another run for the White House under the Bull Moose Party, touted a National Health Insurance as part of his campaign promises. In 1935 our nation was in the center of the Great Depression and President Franklin Roosevelt pushed for national health insurance, but had to abandon his aspirations in exchange for the Social Security Act. In 1945, President Harry S. Truman urged Congress to pass a National Insurance Program for anyone who was willing to pay a voluntary fee, but the American Medical Association felt this was a move towards socialized medicine and shut down Truman's intentions. In 1965, President Lyndon B. Johnson proudly signed an amendment to the 1935 Social Security Act, which created the Medicare and Medicaid programs. These two programs have experienced several changes throughout the years, but still retain a prominent place in the history of health care in the United States.      The Nixon administration also sought to develop a national health care plan, requiring employers to cover their employees and allowing federal subsidies for those who bought private insurance, but the Watergate Scandal marred the administration and the initiative died almost immediately. An economic recession in 1976 forced President Carter to end his charge for a national health plan. In 1988 President Ronald Reagan signed into action the legislative rule, which required employers to offer the continuance of health insurance for up 18 months to employees who had left their positions. COBRA, the Consolidated Omnibus Reconciliation Act, required the employee to absorb the cost of the insurance, but allowed the employee a bridge from their prior employer's insurance benefits to their new employer's benefits.      Further attempts to form a national health care plan did not develop until 1993, when President Bill Clinton appointed the First Lady, Hillary Rodham Clinton, as the chair responsible for formulating a universal health care plan. The plan, which not only required businesses to cover their workers, but also mandated health insurance for all citizens, hit hard opposition from Republicans and Democrats, as well as setting off a storm of criticism from the medical community. The plan eventually died on the Senate floor. However, in 1997, President Clinton was able to sign into law the workings of a State-Federal program that would be the vehicle for insuring a large number of moderate-income families with children, whose adjusted gross income made them ineligible for Medicaid. The Children's Health Insurance Program (CHIP) helped to insure millions of children who would have otherwise, fallen between the cracks.      While President George W. Bush's administration did not advocate a national health care plan, he did champion the expansion of Medicare benefits by adding prescription drug coverage, one of the last significant changes made to Medicare. This, of course, leads to 2009 and the Obama administration, when President Obama and a Democratic-controlled Congress worked together to shape what is now known as the Affordable Care Act into law. The plan was met with opposition within hours of being signed into law.      On the day that President Obama signed ACA, 26 States: Alabama, Alaska, Arizona, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming, filed a lawsuit in federal court. Spearheaded by Florida, the states' lawsuit contended that the Affordable Care Act's mandate for individual health insurance and the expansion of Medicaid was unconstitutional in regards to the right of the individual citizens of the United States. The National Federation of Independent Business (NFIB) and other separate plaintiffs, who did not have health insurance, also filed suit. The courts elected to hear the cases together as one case, rather than two separate lawsuits.      The Supreme Court would hear the history-making case and would need to make a decision on the constitutionality of the individual mandate and the expansion of Medicaid, two of the principal conditions of the bill. Settled with a monumental task, the Supreme Court would first need to decide if they indeed had authority to make a decision on the case. All nine justices decided overwhelmingly that they indeed did have jurisdiction over the case and the lawsuit moved forward, allowing both sides to present their arguments.      The first element of the lawsuit revolved around the bill's individual mandate. This part of the legislation requires all individuals to have health care insurance or face the penalty of a fee administered as a shared responsibility payment. The United States Internal Revenue Service (IRS) would be accountable for assessing and collecting the penalty as reported on federal tax returns. The penalty, which is to begin in 2014, would initially be either $95.00 or one percent of income, whichever number is greater. In 2015 it increases to $325.00 or two percent of income and in 2016, $695.00 or 2.5 percent of income. After 2016, the penalty amount would be appraised to fall into conjunction with the cost-of-living. There are, however, those who are not subject to the individual mandate or the shared responsibility payment.      Persons who are not subject to the individual mandate of ACA:   Undocumented immigrants   Religious objectors   Those who are serving jail time      Persons who are not subject to the shared responsibility payment:   Those who pay insurance premiums, which are more than eight percent of their adjusted household income   Any person who is a member of an American Indian tribe   Those who apply for a financial hardship waiver   Any person who was without insurance for less than three months of the year   Any person whose income falls below the federal tax filing threshold      The second challenge of the lawsuit, which would be known as National Federation of Independent Business v. Sebelius, was the expansion of the Medicaid program. Medicaid, which receives funds from both federal and state governments, is not a mandatory program, but most states do participate. Under the Affordable Care Act, states who participate in Medicaid would be obligated to increase coverage to include anyone who was 65 and under and whose income fell at or below the Federal Poverty Line (FLP), $14,856 per year for a single person and $30,657 per year for a family of four. While some state Medicaid programs already exceed ACA guidelines, the majority do not, covering only families with dependent children. Parents of children who participate in Medicaid are also covered, but at an income level that does not meet the new levels provided by the ACA expansion to Medicaid. In order to help states cover the cost of the Medicaid expansion, the federal government has promised to cover 100% of the state's associated cost. From 2014 through 2016 federal aid to state run Medicaid programs will remain at 100%, after 2016 the aid will slowly start to decline until it reaches 90% in 2020, where it will remain until further determination.            On June 28, 2012, the United States Supreme Court delivered a decision on National Federation of Independent Business v. Sebelius. On a narrow vote of 5-to-4, the Supreme Court ruled that the United States Congress had the right to levy tax and that the penalties associated with violation of the individual mandate could constitutionally be considered taxes, since they fell under the responsibility of the Internal Revenue Service. There was somewhat of a smaller separation between the Supreme Court justices on the ruling regarding the expansion of Medicaid.      So how does all of this affect us as pharmacy professionals? Actually, there are quite a few points of the Affordable Care Act which require substantial contribution from the pharmacy profession. The American Pharmacists Association (APhA) recognizes the involvement of pharmacy in the following areas:   Medication Therapy Management (MTM)   The Independence at Home Demonstration Project   Accountable Care Organizations (ACOs)   Electronic Health Record (EHR) incentives and e-prescribing      MTM utilizes pharmacy services to develop a medication plan that is not only therapeutic, but also optimizes treatment in a way that offers the patient the best outcome. Several national pharmacy organizations such as the American Pharmacists Association, American Society of Health System Pharmacists, American Society of Consultant Pharmacists and American College of Clinical Pharmacy already advocate for the use of MTM. ACA charges the Secretary of Health and Human Services with awarding grants to chosen entities who meet the requirements necessary to perform MTM.      MTM is an invaluable tool that requires the specific skills of a pharmacist. The Affordable Care Act mandates that MTM services must include the following:      Initial evaluation of the patient and the patient's disease state(s)   Assessment of the patient's medication plan as prescribed by the patient's physician, then producing a medication therapy plan based on this analysis   Making adjustments or suggestions to the medication therapy plan through a cooperative effort made between the patient, the patient's physician and the pharmacist   Once the medication therapy plan has been initiated, monitoring of the patient's response to therapy in order to appropriately evaluate the patient's response and benefit of medication therapy   Documentation of all information regarding the patient's medication therapy management   Providing patients and caregivers with easy-to-understand information concerning their medication therapy, as well as any training which may be necessary for administering the medication      Providing patients and caregivers with information concerning additional MTM services that are applicable to the practice of pharmacy and are underwritten by other federal programs             While the use of MTM is a service, which may have benefit for any patient who must use prescription medications to treat a disease state, the Affordable Care Act directs MTM services to those patients who are taking at least four prescriptions, taking medications considered to be high risk and have been diagnosed with at least two chronic diseases or are at a higher risk for problems with their medication therapy. Entities who are awarded grants for MTM through the Department of Health and Human Services must provide an analysis of the program's worth and in turn the Secretary of Health and Human Services will present the required reports to Congress.      Another aspect of the Affordable Care Act that may require the involvement of pharmacy services is the Independence at Home Demonstration, a project under the Centers for Medicare and Medicaid Innovation. The Independence at Home Demonstration, currently in the testing phase, is a direct result of ACA.      The premise of the Independence at Home Demonstration is to provide Medicare patients who have numerous, chronic disease states, home-based primary care in order to improve the patient's overall medical outcome and, in turn, ease the costs associated with that care. The Centers for Medicare and Medicaid Services (CMS) will then award physicians and nurse practitioners, the primary facilitators of the program, with incentive payments when they meet quality standards and decrease Medicare's cost.      Home-based care, which is a large part of this service, allows the practitioner more assessment time with the patient in the patient's home, ultimately providing the patient with a more appropriate plan of care and a better quality of life. It is also assumed this will reduce the cost of health care, considering the patient would normally incur costs associated with an institutional or clinic setting.      Primary care practice teams chosen by CMS will provide care to the intended patient for a period of three years. During this time the primary care team will report to CMS, tracking the quality of care the patient is receiving as well as measuring the benefit afforded to the patient from this type of care plan. Practices who wish to participate in the Independence at Home Demonstration will need to meet the following criteria:      Are led by physicians or nurse practitioners   Are organized for the purpose of providing physician services   Have experience providing home-based primary care to patients with multiple chronic conditions   Serve at least 200 eligible beneficiaries   The primary care team may include physician assistants, pharmacists, social workers and other staff      There are also specified criteria for the patient who may need to participate in the Home Independence Demonstration:      Have two or more chronic conditions   Have coverage from original, fee-for-service Medicare   Need assistance with two or more functional dependencies (walking, feeding, etc.)   Have had a non-elective hospital admission within the last 12 months   Have received acute or subacute rehabilitation services in the last 12 months      While it may still need to be determined to what extent pharmacy will play in the primary care team, it is certain that consultation and collaboration of pharmacy services will be key to the development of the patient's plan of care. Home deliveries of patient medications as well as thorough evaluations of patient medication therapy management are just a few of the services which can be offered by pharmacy through the Independence at Home Demonstration.      As of April 2012, there were 15-individual practices that participated in the Independence Home Demonstration and as of August 2012 there were three consortia, a combination of several individual practices that participated in the program. As the Obama health care plan develops and the Independence Home Demonstration proves itself as a benefit, additional individual and consortia practices will be needed, which in turn will call for the need of extended pharmacy services.      MTM and the Independence Home Demonstration will call for the collaboration of the pharmacist and the pharmacy technician. Pharmacists will be called upon for more advanced clinical duties and the pharmacy technician will be needed to complete tasks such as inventory management and filling of medication orders. Of course, the final check will always go to the pharmacist; regardless of how evolved the technician's tasks become.      The Affordable Care Act is a collection of medical and legal jargon almost 1000 pages long. It can often be long on words and short on understanding. This is perhaps, one of the reasons it has been met with resistance. Accountable Care Organizations (ACO) is an avenue of the Affordable Care Act that has not only caused controversy, but confusion as well.      An ACO is a system of physicians and health care institutions that agree to provide medical services, as a cooperative effort, for a minimum of 5,000 Medicare participants for a period of no less than three years. The idea behind ACOs is to bring together services, such as specialists, home health care services, pharmacy services and rehabilitation services. The thought is to create one connected continuance of care, providing the patient with integrated care and cutting cost to an already financially stressed Medicare system.      While care of the patient should always be central to any health care service, HHS estimates ACOs could save the Medicare system up to 960 million dollars in just the first three years. ACOs save Medicare money by making providers and their service partners equally responsible for the health of the patient. Not only will cooperating partners be able to share patient information without effort, but joint accountability will decrease the incidence of unnecessary testing and procedures.      Medicare operates on a fee-for-service basis, meaning physicians, health care institutions, and other service providers are paid based on the service or procedures they perform. The more services that are performed, the more fees are paid to the provider. This, along with the increase of Medicare beneficiaries, drives the costs associated with the Medicare system. ACOs, which are also paid as a fee-for-service model, offer a twist from the traditional Medicare fee-for service, by giving incentives and bonuses to providers who, not only meet the required benchmarks, but also help to cut Medicare costs by focusing on preventive care as well as overseeing the health of those with chronic diseases.      A pharmacy's involvement in ACOs will again involve consultation and medication management services. Pharmacy technicians who work for organizations that participate in an ACO may be called upon to complete medication reconciliation, or perhaps in order to provide more extensive pharmacist services, be part of Tech-Check-Tech implementation. The extensiveness of pharmacy's involvement will depend upon the expansion of the program as well as state and federal regulations, but ultimately gives proof to the fact that ACA touches all facets of the health profession.      Electronic health records (EHRs) and e-prescribing is the final pharmacy-based potential that has received attention. EHRs and e-prescribing are not new ideas; in fact, some institutions have had EHRs in place for several years. Electronic health records are just another indicator of the medical profession moving forward into the electronic age. Rather than have endless mounds of paper, EHRs allow the physician to not only see the patient's medical history much more completely, but also allow other health professionals, such as the pharmacist, to have expedited access to information that may be essential when formulating plans of care.      The Affordable Care Act calls for mandatory use of electronic health records as well as e-prescribing. In the last several years there has been a push towards the use of these records. In 2009, approximately 16% of all hospitals and 17% of all physicians' offices implemented the use of electronic medical records (EMRs). In 2012 those numbers doubled, with 35% of all hospitals and 34% of all physician's offices employing the use of EMRs. ACOs, which we spoke about in previous paragraphs, will rely heavily on the use of EMRs in order to provide its professionals with a seamless system for accessing and validating patient medical information.      E-prescribing, which actually works alongside EHRs, will also be an enforceable piece of technology under the Affordable Care Act. Electronic prescribing is just as it sounds: prescribing patient orders electronically through a computer system. The prescriber will initiate the medication order or prescription from their computer where it will then be transmitted to the pharmacy, either one associated with the institution or a mail order pharmacy. The pharmacist will be able to access the patient's records, including such information as the patient's allergies, current and past medication therapies and documentation concerning the progression of the patient's disease state(s).      A final piece of legislation that we should mention, which does and will continue to have a great deal of impact on the practice of pharmacy is the Medicare Modernization Act of 2003. The Medicare Modernization Act (MMA), which actually went into effect in 2006, was the first piece of legislation that founded an outpatient prescription plan for Medicare patients. Medicare Part D, which as of September 2012, has over 32 million beneficiaries, is a completely voluntary process for most recipients. Those who fall out of the voluntary status are considered to be low-income recipients or who have dual eligibility, meaning they are covered under Medicare and Medicaid. Typically, these recipients are automatically enrolled in a prescription drug plan (PDP), unless they elect to choose their own PDP.      There are two basic types of Medicare prescription coverage, Medicare prescription drug plans (PDPs) and Medicare Advantage plans, such as a health maintenance organization (HMO) or a preferred provider organization (PPO). In order to participate in a Medicare Advantage Plan (MA-PD) the recipient must also take part in Medicare Parts A and B. PDPs simply add drug coverage onto the original plan.      Customarily, Medicare prescription plans have what is known as a donut hole, or a gap in coverage. This simply means there is a limit on what the drug plan will cover for the patient's medications. This gap in coverage is normally temporary and only lasts until the patient and their drug plan have spent a specified amount of drug cost. In 2012 patients who reached the coverage gap paid 50% of the cost associated with brand name drugs and 86% of the cost associated with generic drugs. In 2013 the gap decreases to 47.5% for brand name drugs and 79% for generic drugs.      Under ACA, the coverage gap will continue to gradually decrease each calendar year, until it reaches 25% for both brand and generic drugs in 2020. ACA also seeks to keep monthly Medicare prescription plan premiums at a leveled price. In 2012 the average premium for a Medicare prescription plan costs the recipient $30.00 each month. In 2013 premiums are predicted to hold steady at $30.00 a month, due in part to the ACA's effort to decrease Medicare costs. In fact, in July 2012, Medicare and CMS reported that since the Affordable Care Act was put into law, 5.2 million Medicare recipients saved over three billion dollars on prescription drug costs.      For example: In 2013, Medicare Part D pays 21% of Mr. Rooney's prescription as long as it is a generic and he has not reached the coverage gap. He goes to his regular pharmacy to have his lisinopril filled. When Mr. Rooney goes into the pharmacy the next day, the pharmacy technician rings up his prescription. If there is a $2.00 dispensing fee and the prescription costs $20.00, then the cost would be $22.00, but Mr. Rooney participates in Medicare Part D and only pays 79% of the cost associated with generic drugs. The pharmacy technician tells Mr. Rooney his prescription will cost $17.80: $15.80 is the amount Medicare does not cover and the $2.00 dispensing fee.      Mr. Rooney, who has gotten the same prescription for several months, notices the prescription cost him less than it did when he had it filled in December. He asks the pharmacy technician to check the pricing to make sure she did not make a mistake. The pharmacy technician explains to Mr. Rooney that after the first of the year Medicare would be paying for more of his generic prescriptions. In 2013 Medicare will pay 21% of the cost associated with generic drugs. However, the pharmacy technician goes on to explain to Mr. Rooney that he will have to pay more for his brand name drugs, since the discount is at 47.5%. Mr. Rooney seems satisfied with this explanation and leaves the pharmacy with a more thorough understanding of his Medicare gap coverage.      The pharmacy technician, who was keen enough to see that Mr. Rooney did not understand his Medicare prescription plan, helped eliminate the need for the pharmacist to be interrupted to speak with Mr. Rooney. This example shows how important a role the pharmacy technician plays and will continue to play in the practice of pharmacy. The technician made sure she was up-to-date on information she knew would affect her patients; in this case, it was understanding the Medicare Part D donut hole.      Whether or not the Affordable Care Act will achieve all its intended purpose still remains to be seen. One certainty is contained in the changes the health care profession will undoubtedly face in order to accommodate the legislation. The practice of pharmacy will need to adjust accordingly, moving the pharmacist into a more progressive clinical consultation role and mandating roles for the pharmacy technician that allow the pharmacist to take on these necessary tasks.      Pharmacy technicians should familiarize themselves with the language of ACA, in particular those changes dealing with medication management and Medicare Part D. A pharmacy technician who is able to comprehend the particulars of the Affordable Care Act is not only able to take on a larger role as a pharmacy team member, but also address misunderstandings, which might normally require the pharmacist's attention. Still, the pharmacy technician must always remember to stay within the legal definitions of their profession.      Understanding the language of the Affordable Care Act can be overwhelming and often confusing. However, http://www.healthcare.gov/law/index.html is a user friendly website provided by the federal government, which may help to educate and answer any questions. Another website, http://www.healthcareandyou.org, is not sponsored by the federal government, but is useful in answering some generalized questions concerning ACA. Pharmacy technicians who need to have a greater understanding of Medicare Part D and the coverage gap can find more information at: http://www.medicare.gov or http://www.hhs.gov.      Change, as many have said, is inevitable; being able to adapt with the change often decides the success of those associated with it. With change comes evaluation and implementation of the laws that govern and protect us. As the role of the pharmacy technician continues to evolve, the need to understand these laws will become increasingly essential. A pharmacy technician who realizes the importance of laws and actively seeks to understand them builds credibility for themselves and the pharmacy profession.      References:   A Guide to the Supreme Court's Affordable Care Decision, The Henry J. Kaiser Family Foundation, 7-2012, http://www.kff.org/healthreform/8332/cfm      Accountable Care Organizations: Improving Care Coordination for People with Medicare, HealthCare.gov, 3-12-12, http://www/healthcare.gov/news/factsheets/2011/03/accountablecare03312011a.html      Coster, J. Khani, J. Health Care Reform's Impact on Community Pharmacy, National Community Pharmacist Association, 4-10-12, http://www.ncpanet.org      Gentiviso, C. Health Care Reform 2012: A History of US Efforts. Huffington Post, 6-23-12, http://huffingtonpost.com/2012/6/23/Health-Care-Reform-2012-History   Health Care Reform- Implementation of the Affordable Care Act American Pharmacist Association, 8-12-12, http://www/pharmacist.com/health-care-reform-implementation-affordable-care-act      Health Care Reform-The Affordable Care Act American Pharmacist Association, 8-16-12, http://www.pharmacist.com/health-care-reform-affordable-care-act      Medicare and You: The Official U.S.Government Medicare Handbook 2013United States Department of Health and Human Services, 9-2012, pp.81-133      Medicare Prescription Drug Benefit-An Updated Fact Sheet, Q1Medicare.com, 2012, http://www.q1medicare.com/PartD-the-2013-Medicare-Part-D-Outlook,php      Medicare Prescription Premiums to Remain Steady for Third Straight Year, Department of Health and Human Services, 8-6-12, http://www.hhs.gov/news/press/2012press/08/20120806.html      Neyarapally, G. Affordable Care Act: Improving Public Health Through Pharmacists, The Network for Public Health Law, 7-26-12, http://www.networkforphl.org      The Medicare Prescription Drug Benefit- An Updated Fact Sheet, The Henry J. Kaiser Family Foundation, October 2012, http://www.kff.org/medicare/7044cm-Oct2012      Vivian, J. Affordable Care Act (Mostly) Upheld, U.S. Pharmacist, 8-21-12, http://www.uspharmacist.com, Vol. 37(8): 73-74      Author Bio:   Sandy Andrews lives in Chambersburg, Pennsylvania with her husband of 17 years, Rob and her two teenage sons, Joshua and Caleb. She will be completing her BA in English from Arizona State University in July and will be moving on to complete her Masters Degree in English from Northern Arizona University. Sandy has over 20 years of experience as a Certified Pharmacy Technician, primarily in institutional pharmacy. Recently, Sandy has had a career change and is writing educational material for pharmacists and pharmacy technicians. Sandy is hoping to continue the growth of this new career choice.      Idea in Brief:   The Affordable Care Act is a piece of legislation that has been plagued with controversy from its inception. The continuation of this legislation will lie in the hands of the next administration as well as representatives elected by the people. The language of the Affordable Care Act is long and may be confusing, but without a doubt this legislation will bring changes to the practice of pharmacy. This program will decode some of the confusion that surrounds the Affordable Care Act and give a clearer understanding of how the practice of pharmacy will be affected.      Idea in Practice:   As the Affordable Care Act is implemented in phases, changes to the practice of pharmacy will begin to occur. The pharmacist, whose time will be needed for more clinical tasks, will need to rely more heavily on the pharmacy technician. There are four programs under the Affordable Care Act that the American Pharmacists Association recognizes require direct pharmacy involvement. Pharmacy technicians should obtain an understanding of these programs in order to substantiate their role, not only as an essential member of the pharmacy team, but also as a key player in the continuation of safe and effective patient care as defined by the Affordable Care Act.  <br>
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<dc:subject>Course</dc:subject>
<dc:date>2012-12-24T14:00:00Z</dc:date>
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<item>
<title>Pharmacological Treatment of Alcoholism and Other Chemical Dependencies</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=369</link>
<description><![CDATA[Instructor: Dominic P. Decker, MS, CPhT<br><br>

   Introduction   An article headline in a recent issue of The New York Times read, Dr. Griffith Edwards, Addiction Specialist, Dies at 83. To see a similar newspaper story prior to the latter third of the 20th century would have been nearly unthinkable, as addiction is a relatively new field of scientific study. In fact, the article is an obituary for the man who is largely credited with establishing addiction medicine. His accomplishments included defining alcohol and drug dependence and treating substance abuse, among many others. Benedict Carey, the article's author, reports, Dr. Edwards reshaped thinking about heavy drinkers and their problems, about the psychology of drug use and its treatment, and about the policy implications for governments and health agencies seeking to reduce abuse. He continues, He was among the first doctors to perform careful studies of skid row drinkers and of talk therapies for addictive drinking - these at a time, in the 1960s, when habitual drunkenness was considered a moral failing and virtually the only treatment was to dry out.      As Dr. Edwards discovered in the course of his work, treatment modalities of alcoholism and other chemical dependencies vary by individual. Today, cognitive behavioral therapy can be used in conjunction with pharmacological interventions with varying degrees of success. Pharmacological treatment will be the primary focus of this continuing education feature. The pharmacy technician plays a vital role in ensuring the safe and efficient distribution of prescription medications. With increased knowledge of those medications indicated for the treatment of addiction, the technician will be poised to assist the pharmacist in providing optimal care to patients with this condition.      Scope   While much has changed since the 1960s, substance abuse and dependence present an ongoing problem in the United States, affecting a growing number of people from all segments of society. According to research conducted over the last two decades and cited in Clinical Work with Substance-Abusing Clients, edited by Shulamith Lala Ashenberg Straussner, it is estimated that 11 million adults are dependent on alcohol, while an additional 7 million are addicted to it. Furthermore, 14 million adults admitted to using illicit drugs in the year 2000. Data indicate that 2.8 million of those individuals were drug dependent and 1.5 million were drug abusers.      Additional studies provide more insight into the scope of this problem. In 2003, a total of 22 million people, or nearly 10% of the total population of the US, were substance abusing or dependent. Straussner writes, The abuse of alcohol and other drugs affects individuals, families, communities, and society as a whole. Substance abuse causes more deaths, illnesses, accidents, and disabilities than any other preventable health problem today. And, in equally distressing statistics, it is estimated that the federal drug control budget allocates only 18% of its resources toward treatment, while 60% goes to prosecution for drug-related crimes.      Language   The language of addiction, relapse, and recovery is often complex. It is for this reason that we start with definitions used by those working in the field of addiction medicine. The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association and soon to be released in its fifth edition, defines mental disorders in the context of diagnostic criteria. Among these disorders are substance abuse and dependence. According to the current edition of the DSM, substance abuse is a maladaptive pattern of substance use leading to clinically significant impairment or distress. Straussner elaborates that one or more of the following will be experienced within a 12-month period:      The continued use of psychoactive substances despite experiencing social, occupational, psychological or physical problems   Inability to fulfill major role obligations at work, school or home   Recurrent use in situations in which use is physically hazardous, such as driving while intoxicated   Recurrent legal problems related to the use of a substance      In contrast to abuse, substance dependence is defined as experiencing at least three of the following seven symptoms in a 12-month time frame:      Tolerance, as defined by either a need for increased amounts of a substance to achieve a desired effect or diminished effect with use of the same quantity of substances   Withdrawal, as characterized by specific withdrawal syndromes defined for each substance, or using a substance in order to relieve or avoid withdrawal symptoms   Taking the substance in larger amounts or over a longer period than was intended   A persistent desire or unsuccessful efforts to reduce or control use   A great deal of time spent obtaining, using and recovering from substance abuse   Important social, occupational or recreational activities are given up or reduced because of the substance use   The substance continues to be used despite knowledge of resulting serious physical or psychological problems      Just as substance abuse and dependence are categorized, so are stages of treatment and recovery. The DSM specifies that individuals who formerly abused substances can be identified as in remission after use has ceased for at least one month. The stages of remission include: early full remission (substance-free for 1-12 months), early partial remission (intermittent, but infrequent use of substance within the first 12 months of recovery), sustained full remission (substance-free for more than 12 months), and sustained partial remission (substance use resumes after 12 months free of symptoms). Many individuals who have previously been abusing or dependent on a substance will always identify themselves in a stage of remission, regardless of how long it has been since their last date of use. This pattern suggests that alcoholism and other chemical dependencies present as ongoing challenges, requiring social support systems to maintain sobriety.      Assessment   Assessment of chemical abuse and dependency requires that health care providers be informed about how it manifests in the lives of their patients. Screening tools have been developed to facilitate this assessment process, two of which will be discussed here. As part of a routine office visit, a patient will be asked about the use of drugs and alcohol. Providers must approach these potentially sensitive topics in a non-judgmental way, as a patient who withholds this information from his or her health care provider risks continuing destructive behavior. Straussner writes, The clinician needs to remember that once individuals start abusing substances such as alcohol, opiates or cocaine, they often become addicted to them. They cannot just stop using the drug or drugs through willpower alone. She continues, They should not be condemned or made to feel guilty for their dependence on a chemical any more than a client would be condemned for having an uncontrolled medical condition.      The CAGE screening tool has been developed specifically to assess for alcoholism. It can be used in a variety of health care settings due to its simplicity. Each letter of the test name represents a question to be asked:  C:Have you ever felt that you should Cut down on drinking?  A: Have people Annoyed you by criticizing your drinking?  G: Have you ever felt bad or Guilty about your drinking?  E: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?(Eye opener)      As is indicated by the National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health, The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.      The Drug Abuse Screening Test, or DAST, was developed to parallel the Michigan Alcoholism Screening Test. It utilizes a 28-point questionnaire that asks about the use of prescription or over-the-counter medications in excess of the directions and the non-medical use of other drugs. Respondents are asked to think about the past 12 months, then respond yes or no to a variety of questions, including:      Have you used drugs other than those required for medical reasons?   Have you abused prescription drugs?   Are you always able to stop using drugs when you want to?   Do you ever feel bad about your drug abuse?      Each yes response is scored as a 1, except for three items on the questionnaire, in which a no response is scored as a 1. Data collected from this assessment reveal that a score of 6 or higher indicates the strong possibility of substance abuse or dependence, while a score of 12 or higher is definitive and requires further assessment, intervention and treatment.       Etiology   The phenomenon of substance abuse and dependence in this country and worldwide raises several questions about the etiology of the disorder. Why do some people become addicted, while others do not? Are certain individuals more likely to become addicted to a substance because of their race, ethnicity, gender or socioeconomic status? Do genetics play a role in families with multigenerational substance abuse? Is there a connection between substance use and mental health disorders? Research has shown patterns and trends among those who use drugs and alcohol. Despite this, Straussner notes that data collected reveal no single etiological factor that accounts for why some people become dependent on a substance and others do not.      We again turn to research conducted within the past two decades for insight into proposed disease models. Perhaps most notable among these studies is that addiction can result from biochemical, genetic, familial, psychological, environmental and sociocultural factors, either individually or in combination. Recent findings in the area of environmental and sociocultural factors suggest that more substance use today can be linked to the increasing availability of drugs, social acceptance and idealization of drug use and the prospect of selling drugs for financial gain. A 2001 study showed that young adults who used marijuana were more likely to try other, more harmful drugs. But, of course, these findings tell only part of the story. More research in this field is necessary.            Treatment   As discussed earlier, a number of addiction treatment modalities exist. With the above theories of addiction in mind, Straussner suggests that it may be best to view substance abuse as a multivariate syndrome, in which multiple patterns of dysfunctional substance abuse occur in various types of people with multiple prognoses requiring a variety of interventions. Among these interventions is pharmacological treatment. Table 1 includes a summary of seven medications currently used for the treatment of alcohol, opioid and nicotine addiction. Three of these medications, representing each category of addiction, will be discussed in further detail.   Antabuse (disulfiram) oral tablets are indicated for the treatment of alcohol addiction. As an alcohol agonist, disulfiram inhibits the oxidation of acetaldehyde. Metabolism of alcohol in the absence of disulfiram would degrade this product. When disulfiram is administered and alcohol ingested, acetaldehyde builds up in the body, producing a number of unpleasant side effects. These can include nausea, vomiting, headache, dizziness, flushing, sweating, thirst and weakness. The reaction is proportional to the amount of alcohol ingested and the dose of disulfiram, but it is important to note that reactions with the above side effects can happen even with small amounts of alcohol and last from 30-60 minutes to several hours. While the medication does not reduce the rate of alcohol metabolism, it can remain active in the body for 1-2 weeks after the last dose.      Because of the potential for severe reactions, patients and family members should be thoroughly counseled about the effects of the medication. The medication is not to be administered to a patient who is actively intoxicated. A patient should abstain from alcohol for a minimum of 12 hours prior to taking a dose of disulfiram.      Disulfiram is available in 250mg and 500mg tablets. Initial dosing is 500mg once daily for two weeks, typically in the morning. For those who experience drowsiness or fatigue while on the medication, the dosing schedule can be adjusted to bedtime. After the initial dosing period, a maintenance dose of 250mg daily is recommended. In all cases, dosing should not exceed 500mg daily.      Concomitant administration of disulfiram and phenytoin can result in severe side effects. The latter drug is used in the treatment of seizure disorders. Disulfiram may inhibit the metabolism of phenytoin and thus decrease its elimination rate, resulting in increased serum phenytoin levels. In patients on both medications, phenytoin levels will have to be carefully and routinely monitored by the prescriber.      Disulfiram prescribing information states that the medication should be used until the patient's alcoholism has been deemed in remission and under control. Pharmacological treatment can take a number of months, or even years, and will likely be coupled with cognitive behavioral approaches.      Dolophine hydrochloride (methadone) oral tablets are indicated for the treatment of opioid addiction. Specifically, the medication is used for the treatment of moderate-to-severe pain that is not responsive to non-narcotic analgesics, detoxification treatment of opioid addiction or maintenance treatment of opioid addiction. Opioids are defined as heroin or other morphine-like drugs, including Duragesic (fentanyl), OxyContin (oxycodone), Dilaudid (hydromorphone) and Opana (oxymorphone). Methadone, as a mu-agonist, is a synthetic opioid analgesic that mimics the effects of morphine. Treatment of opioid addiction with methadone is coupled with additional social and medical services, as will be further explored.      The historical use of methadone is of particular interest because of ongoing controversy surrounding it today. Two decades after its development as a long-acting analgesic, methadone began to be used for opioid addiction in the 1960s. It was during this time that the first methadone maintenance treatment program was opened at Beth Israel Hospital in New York City. Evidence of methadone administration as a solution for the growing opiate abuse problem was established, and maintenance programs became publicly funded in 1967. It is estimated that 179,000 people receive methadone treatment in licensed facilities in this country today.      In a chapter of Straussner's book entitled The Treatment of Opiate Addiction, authors Ellen Grace Friedman and Robin Wilson outline the therapeutic uses of methadone, including the three mentioned above, that is, the treatment of pain, detoxification and maintenance. They write, The most common use of methadone, however, is as a long-term treatment, referred to as methadone maintenance. In this model, patients remain in treatment indefinitely and receive ongoing counseling, medical assistance and vocational services. Tapering from methadone is voluntary and neither encouraged nor discouraged. As cited by the authors, advantages of methadone maintenance programs include: oral administration, eliminating use of needles; cost-effective treatment; regular clinic visits and frequent interactions with health care professionals; and drug-related crime reduction. Disadvantages include: methadone is addictive (like heroin and other morphine-like drugs); use of methadone in pregnancy results in children being born addicted and requiring detoxification; and not promoting drug abstinence.       Methadone is a Schedule II controlled substance and available in 5mg and 10mg tablets. Distribution of methadone for the treatment of opioid addiction is limited to programs that have been certified by the Substance Abuse and Mental Health Services Administration, a division of the U.S. Department of Health and Human Services. In initiating methadone treatment, the health care professional will consider several factors to determine the correct dose of medication. These include the opioid the patient had been taking previously, the degree of opioid tolerance, and the age, general condition and medical status of the patient. A typical initial dose is 30mg/day, while maintenance doses range from 80 to 120mg/day.      Side effects include lightheadedness, dizziness, sedation, nausea, vomiting and sweating. Methadone interacts with cytochrome P450 inducers, such as carbamazepine, phenytoin and phenobarbital, and may be less effective when administered with these drugs. It also interacts with cytochrome P450 inhibitors, such as ketoconazole and erythromycin, and may be more effective when concomitantly administered.      Chantix (varenicline) oral tablets are indicated as an aid in smoking cessation. The medication is a nicotinic receptor partial agonist. As such, it selectively binds to neuronal nicotinic acetylcholine receptors, preventing nicotine from binding to these receptors itself. In greater detail, the prescribing information states, Varenicline blocks the ability of nicotine to activate 42 receptors and thus to stimulate the central nervous mesolimbic dopamine system, believed to be the neuronal mechanism underlying reinforcement and reward experienced upon smoking. Smokers who use varenicline will experience decreased, and therefore less rewarding, effects of nicotine ingestion.      Varenicline carries with it a warning about serious neuropsychiatric side effects. Post-marketing reports have indicated increased instances of depression, psychosis, paranoia and anxiety, among others, in those being treated with the medication. Reports also indicate the potential for suicidal ideation, suicide attempt and completed suicide. While mood depression may be a symptom of nicotine withdrawal, depression and suicidal ideation have rarely been reported in those undergoing a smoking cessation program without medication. As the prescribing information states, These events have occurred in patients with and without pre-existing psychiatric disease; some patients have experienced worsening of their psychiatric illnesses. All patients being treated with Chantix should be observed for neuropsychiatric symptoms or worsening of pre-existing psychiatric illness. Those who experience any of these symptoms should stop taking varenicline and contact their health care provider.      The medication is available in 0.5mg and 1mg tablets. In the first week of use, it is dosed at 0.5mg once daily on days 1-3 and 0.5mg twice daily on days 4-7. In continuing weeks, dosing is 1mg twice daily for a total of 12 weeks. To increase the likelihood of sustained abstinence, the patient may repeat the 1mg twice daily dosing for an additional 12 weeks. Varenicline should be started one week before the date to stop smoking. Or, the medication can be started and smoking stopped between days 8-35. It should be taken after eating with a full glass of water after eating.      Side effects of treatment with varenicline include nausea, vomiting, constipation and abnormal dreams. While no meaningful pharmacokinetic drug interactions have been recorded, the concomitant use of varenicline with nicotine replacement therapy products (e.g. gum, lozenges and patches) has been shown to increase the incidence of nausea, vomiting, headache, dizziness, and fatigue among other symptoms.      Conclusion   As noted earlier, substance abuse and dependence is a multivariate syndrome, that is, its etiology, symptoms and treatment vary according to the individual. With this in mind, health care providers must be responsive to the unique needs of each patient with this condition. The provision of care should be approached in a non-judgmental way. For many, addiction is out of the scope of their control. Social and medical treatment programs have been developed in response to this reality. The one type of treatment presented - pharmacological intervention - has proven to be successful when the patient has additional social supports. Thorough patient counseling is necessary for medications that have been developed for the treatment of addictive disorders, including the three discussed here. With knowledge of these medications, pharmacy technicians can identify patients in need of counseling and direct them to the pharmacist, thus ensuring the safe and efficient distribution of prescription medications.   References   Antabuse Prescribing Information (2012). http://www.drugs.com/pro/antabuse.html.      CAGE Screening Test. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/arh28-2/78-79.htm      Carey, B. (2012, September 25). Dr. Griffith Edwards, Addiction Specialist, Dies at 83. The New York Times, p. A25.      Chantix Prescribing Information (2011). http://labeling.pfizer.com/ShowLabeling.aspx?id=557.      Dolophine Prescribing Information (2006). http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM142842.pdf.      Drug Abuse Screening Test. http://www.drtepp.com/pdf/substance_abuse.pdf.      Friedman, E.G. &#0038; Wilson, R. (2004). The treatment of opiate addiction. In S. Straussner (Ed.), Clinical work with substance-abusing clients(187-208). New York: Guilford Press.      Potenza, M., Mehmet, S., Carroll, K., &#0038; Rounsaville, B. (2011). Neuroscience of behavioral and pharmacological treatments for addictions. Neuron, 64(4), 695-712.      Straussner, S. L. A. (Ed.). (2004). Clinical work with substance-abusing clients (2nd ed.). New York: Guilford Press.      Author Biography   Dominic P. Decker is a first year medical student at the University of Minnesota in Minneapolis. He holds a Master of Science degree in Narrative Medicine from Columbia University. He has seven years of experience working as a certified pharmacy technician in community pharmacy settings and has authored numerous articles for Today's Technician with a special interest in the interstices between communication, pharmacy, and medical practice.      Idea in Brief   While much has changed since the 1960s, substance abuse and dependence present an ongoing problem in the United States, affecting a growing number of people from all segments of society. Treatment modalities of alcoholism and other chemical dependencies vary by individual. Today, cognitive behavioral therapy can be used in conjunction with pharmacological interventions with varying degrees of success. Pharmacological treatment of addictive disorders will be the primary focus of this continuing education feature.      Idea in Practice   The pharmacy technician plays a vital role in ensuring the safe and efficient distribution of prescription medications. With increased knowledge of those medications indicated for the treatment of addiction, the technician will be poised to assist the pharmacist in providing optimal care to patients with this condition.     <br>
]]></description>
<dc:subject>Course</dc:subject>
<dc:date>2012-11-03T13:00:00Z</dc:date>
</item>

<item>
<title>The ABC''S of Heart Disease</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=368</link>
<description><![CDATA[Instructor: CoraLynn B. Trewet, MS, PharmD, BCPS, CDE Clinical Professor, University of Iowa College of Pharmacy<br><br>

  	Introduction   	Heart disease is the cause for one of every three deaths in the United States. Every 25 seconds someone experiences a coronary event and every minute someone will die from a coronary event. This translates to the staggering number of people in the United States that have cardiovascular disease, one in every three people. The total cost for cardiovascular disease each year is more than 400 billion dollars. Women, specifically, have different risks and issues to consider in heart disease. Women are more likely to survive a coronary event and have a greater risk for stroke than men. In the most recent statistics from the American Heart Association, more than 50% of white women and approximately 75% of black and Hispanic women are overweight or obese and at high risk for cardiovascular disease. More than 50% of women age 20 and older have elevated cholesterol, another risk factor for cardiovascular disease.1   	  	   	Recently, a national initiative has started aimed at decreasing heart attacks and strokes. The Million Hearts campaign is an initiative by the Centers of Disease Control and Prevention (CDC), Department of Health and Human Services (HSS) and Centers for Medicare and Medicaid Services (CMS) with the goal to prevent one million heart attacks and strokes by the year 2017. There are five aims of the Million Hearts campaign: 1) improving access to effective care; 2) improving the quality of care for the ABCS; 3) focusing clinical attention on the prevention of heart attack and stroke; 4) motivating the public to lead a heart-healthy lifestyle; and 5) improving the prescription and adherence to appropriate medications for the ABCS.2   	  	   	Pharmacies and pharmacy personnel are the most visible, available and trusted health professionals caring for patients with cardiovascular disease. Many pharmacies have services that offer blood pressure readings and cholesterol screenings. Other pharmacies provide smoking cessation programs for patients. Pharmacists can play an essential role in the prevention of coronary events and the optimization of drug therapy for cardiovascular disease. Pharmacists have been shown to improve medication use in patients with cardiovascular disease and decrease risk of adverse drug events and medication errors. Pharmacy technicians are part of the team of people who help patients receive the very best care to optimize medication outcomes for cardiovascular disease.     	  	   	A is for Appropriate Aspirin Therapy   	What is it?   	Aspirin is a medication in the category of salicylates. Aspirin can be used for pain or headaches, or it can be used as an antiplatelet to help thin the blood to prevent cardiovascular disease, such as a stroke or heart attack. A dose of 325mg or more is used for pain, while a lower dose such as 81mg is used for prevention of cardiovascular events. For the purpose of this article, the use of aspirin in preventing a cardiovascular event, as opposed to using it for pain, will be the main focus. Cardiovascular events such as a heart attack or stroke occur because of a blood clot. A blood clot is formed when there is injury to a blood vessel. Platelets in the blood then become sticky and adhere to each other at the site of injury and, with the help of the body's clotting system, form a blood clot. Aspirin prevents the blood from clotting by inhibiting the platelets from sticking together, therefore reducing the risk of a cardiovascular event by preventing clots. As with any medication, there are risks when taking aspirin. Aspirin is an antiplatelet that will thin the blood and can increase the chance of bleeding anywhere in the body.3 If a patient is taking aspirin, they should be counseled by their pharmacist on the warning signs of a bleed or allergic reaction.   	  	   	Prevention   	Aspirin has a place in both primary and secondary prevention of cardiovascular disease. Primary prevention is preventing a first cardiovascular event from happening in someone at risk for such an event. Secondary prevention is preventing another cardiovascular event in someone who has already experienced such an event and is at risk for another event. Studies have shown the use of aspirin in primary prevention should be based on the individual's characteristics and risk factors and also on the clinical judgment of the provider. The patient's coronary heart disease risk must first be assessed before they are prescribed aspirin for primary prevention. Risk factors for cardiovascular disease are listed in Table 1. Some of these risk factors can be altered by the patient (modifiable) while some cannot and are non-modifiable).4 Health care providers can assess a patient's cardiovascular disease risk by using calculators such as the Framingham Risk Score. This calculator weighs each of the patient's risk factors and demographics by points and then calculates their total risk in percentage for the next ten years of their life.5 This specific calculator weighs the following risk factors: age, cholesterol, blood pressure, presence of diabetes, and smoking status.5   	  	   	Table 1: Risk Factors for Cardiovascular Disease4   	  	   	Current Guidelines   	The United States Preventive Services Task Force (USPSTF), American Heart Association (AHA), American College of Chest Physicians (ACCP), and the American Society of Health System Pharmacists (ASHP) have developed recommendations for the use of aspirin for primary prevention of cardiovascular disease based on evidence through current studies.6-9 Recommendations are listed in Table 2. These organizations recommend the use of aspirin in these specific patient populations only if the benefit of preventing a cardiovascular event outweighs the risk of bleeding.6-9   	  	   	The USPSTF recommends the use of low dose, daily aspirin as primary prevention for men to prevent a heart attack and for women to prevent a stroke because evidence shows that men are significantly more likely to experience a heart attack as a result of coronary heart disease and women are more likely to experience a stroke.6   	  	   	According to AHA, ACCP, and the ASHP, any person with a 10-year Framingham risk for coronary heart disease of over 10% should be on low dose aspirin for primary prevention.7-9 The American Diabetes Association (ADA) also recommends low dose aspirin for primary prevention if the patient had diabetes and a 10-year Framingham risk score for coronary heart disease over 10%.3 The ADA also recommends low dose aspirin use for primary prevention in diabetic men over the age of 50 and women over the age of 60 with at least one major cardiovascular risk factor. These major cardiovascular risk factors include: high blood pressure, high cholesterol, family history of cardiovascular disease, and albumin in the urine.3   	  	   	Table 2: Recommendations for Use of Asprin6-9   	  	   	If a person has already experienced a cardiovascular event, such as a heart attack or stroke, they will most likely be prescribed an anticoagulant, or blood thinner, to prevent a second event from happening. Examples of medications used besides aspirin to help prevent a second event are warfarin, clopidogrel, or dipyridamole. The dose of aspirin prescribed for secondary prevention depends on what type of cardiovascular event the patient experienced, but a dose of 75-100 mg is the typical dose prescribed if someone has already experienced a cardiovascular event.3 Some disease states may require higher doses such as 325 mg. Overall, aspirin is used to prevent the blood from sticking together and forming clots that can cause cardiovascular events, and it has a place in therapy for primary and secondary prevention of such events.   	  	   	B is for Blood Pressure Control   	What is it?   	Maintaining a healthy blood pressure is important in preventing cardiovascular diseases, including stroke and heart attack. For example, patients with high blood pressure, or hypertension, have a 30.5% chance of having a heart attack or stroke.2 One in three Americans has high blood pressure with half of these people not having their condition controlled.2 The prevalence of high blood pressure increases with age. For example, around half of Americans age 60-69 and around 75% of Americans over the age of 70 have high blood pressure. As their blood pressure increases, so does the chance of developing cardiovascular disease, such as heart attack, stroke, heart failure, and kidney disease.11   	  	   	Blood pressure is measured as systolic over diastolic (SBP/DBP). Systolic blood pressure measures the force of blood out of the heart as it contracts. Diastolic blood pressure measures the force of blood as the heart rests between contractions. Patients cannot tell if they have high blood pressure because there are usually are no signs or symptoms. Therefore, it is important to have blood pressure measurements taken at least every two years if the patient's blood pressure was found to be normal or once yearly for patients at risk for hypertension.11 Diagnosis of hypertension is made based on a patient's blood pressure measurement from a health care provider.    	  	   	Current Guidelines   	The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, or the JNC 7, is a resource many health care providers use to help aid in the diagnosis, treatment, and prevention of high blood pressure. The JNC 7 has classified blood pressure into stages, shown in Table 3. The goal blood pressure of a healthy adult is less than or equal to 120/80. If a patient has a history of high blood pressure, the goal blood pressure is 140/90. However, the goal blood pressure of a person with either diabetes or chronic kidney disease is 130/80 because they are at an increased risk of cardiovascular disease.11   	  	   	Table 3: JNC 7 Classification of High Blood Pressure11   	  	   	Prevention   	If a patient does not already have high blood pressure, and is at risk for developing high blood pressure, there are many preventative lifestyle methods one could take to decrease the risk. For example, many factors that contribute to the risk of developing high blood pressure can be changed or modified by a patient's lifestyle. The factors that contribute to the development of high blood pressure are listed in Table 4 along with recommendations on how to prevent those factors from increasing blood pressure according to the JNC 7.11   	  	   	Table 4: Contributing Factors to High Blood Pressure and Recommended Lifestyle Modifications11   	   	Current Medications for Treatment   	  	   	Many people with high blood pressure that cannot be controlled by lifestyle modifications alone need medication for treatment. Multiple medications exist that can help lower blood pressure. The number of blood pressure medications a patient should be on is determined by the stage of hypertension they are in. Stage 2 hypertension patients start with up to two different medications to help control their blood pressure.11 The choice of medication depends on the patient's other medications, chronic conditions, and allergies. Once a patient is started on a blood pressure medication, they need to follow up with their doctor in four weeks to have a blood pressure measurement taken to see if they need an increased dose or if they need to add another medication to their regimen.11 Table 5 lists the classes of medications that can be used for blood pressure along with an examples from each class that is commonly prescribed for this purpose. Not only are there individual drugs for certain classes of medications, there are also combination blood pressure medications to benefit the patient. With combination medications, patients will have to take less medication and this becomes less of a burden on them.   	  	   	Table 5: Common Medications Used for Hypertension   	   	  	   	C is for Cholesterol   	What is it?   	Cholesterol is a natural part of the human body. Levels of cholesterol are affected by a variety of risk factors such as age, gender and family history (Table 1). Higher levels of cholesterol can run in families. Older individuals tend to have higher cholesterol as well. It has been observed that women tend to have lower levels of cholesterol when they are younger, but usually catch up to men later in life. These risk factors are not under our control. However, patients are in control of other risk factors such as diet, body weight, and the amount of physical exercise. One can reduce the amount of cholesterol in a diet by avoiding foods high in fat, saturated fat specifically, and cholesterol. By increasing the amount of physical activity a person performs, it is possible to lower body weight and bad cholesterol, as well as increase good cholesterol and feelings of well-being.12,13   	  	   	A body can either make cholesterol from scratch or can obtain cholesterol from the diet. There are multiple types of cholesterol. 'Bad' cholesterol is also known as low-density lipoprotein, or LDL. When the body has too much LDL in the bloodstream, cholesterol slowly builds up on the inner walls of blood vessels. After a long period of time, the build-up of LDL causes the bloodstream to narrow and decreases the amount of oxygen flowing to the heart, which may cause a heart attack.12 'Good' cholesterol is called high-density lipoprotein, or HDL. Higher levels of HDL have been shown to be protective against heart attacks. Lower levels of HDL have also been associated with higher risk of heart attack. Experts think that HDL helps the body remove LDL build-up and take cholesterol back to the liver, where it is eliminated from the body.12 Triglycerides are a type of fat made by the body. Elevated levels of triglycerides are often found in patients with heart disease, diabetes, and commonly are elevated when a patient's total cholesterol level is high. This elevation can be due to a variety of factors like obesity, excessive alcohol intake, smoking, a diet high in carbohydrates, and physical inactivity.12   	  	   	Ideally, when health care providers and patients try to control cholesterol they aim to lower the amount of bad (LDL) cholesterol in the blood while at the same time increasing the amount of good (HDL) cholesterol. This is achieved by controlling diet, body weight, and by using drugs to help achieve the cholesterol goals. Each person's cholesterol goal depends on a variety of factors. These would include their current cholesterol levels and any other diseases a person has as well. The ATP III Guidelines has offered ideal cholesterol goal values for patients and clinicians to strive for during the course of treatment (Values are listed in Table 6).14   	  	   	Table 6: Current Classifications for High Cholesterol14   	   	  	   	Current Guidelines   	The National Cholesterol Education Panel (NCEP) recommends a diet of less than seven percent of total daily calories from saturated fat and less than a total of 200 milligrams of dietary cholesterol daily.14 This diet can be further improved with the addition of fiber (10 - 25 grams per day) from either natural or synthetic sources or by the addition of plant stanols and sterols (2 grams per day). Plant stanols and sterols are found in wheat products, beans, and are often added to yogurts and select margarine spreads.15   	  	   	The 2008 Physical Activity Guidelines for Americans suggests that all patients try to perform at least some physical activity every day, as even the bare minimum activity is better than performing none. In order to truly receive health benefits from exercise, patients should aim to either perform 120 minutes of moderate-level activity or 75 minutes of vigorous-level activity spread out over one week.16 It is also suggested to find an activity that the patient finds enjoyable, as they will be more likely to stick with their exercise regimen.   	  	   	Treatment goals for cholesterol are set based on a patient's risk factors and disease state(s). A summary of the target levels for therapy is presented in Table 7. Patients with more risk factors, who have coronary heart disease, or have a disease equal to coronary heart disease in severity, will have lower cholesterol goals. Once a target goal has been identified, patients can begin using lifestyle changes and drug therapy to work towards reducing cholesterol levels.14   	  	   	Table 7: Current Recommendations for Cholesterol Goals15   	   	  	   	Medications for Treatment   	There is also a multitude of medication options for patients still needing help in lowering their bad cholesterol and raising their good cholesterol. These drugs often require a prescription from their physician and help from a pharmacist. Patients with questions about their medications should be referred to their pharmacist. The NCEP also offers recommendations on appropriate drugs to use in patients.17   	  	   	HMG-CoA reductase inhibitors, also known as statins, help prevent the body from making cholesterol (Table 8). Statins remain the most effective medication available to lower the amounts of bad cholesterol. The choice of statin primarily depends on a patient's levels of cholesterol but can also be affected by price, poor kidney or liver function, and whether a patient experiences any adverse effects from one statin over another. Statins are usually well tolerated by patients. Patients may report feelings of muscle weakness or aches, and these patients should be referred to the pharmacist.17   	  	   	Table 8: Common Statins Used to Lower Cholesterol   	   	  	   	Niacin is a drug that is effective at helping lower levels of LDL and triglycerides, but is also very effective at raising levels of HDL. Niacin at smaller doses can be purchased over-the-counter. Most patients will require prescription strength niacin. Occasionally, patients will experience flushing with niacin. Because of this common side effect, many formulations of niacin are available. Patients struggling with side effects should talk to their pharmacist to develop strategies to tolerate the medication better.17   	  	   	Fibrates, like gemfibrozil and fenofibrate, work primarily by lowering triglycerides. These drugs have several drug interactions, but minimal side effects. Omega-3 fatty acids, or fish oils, are commonly seen in the treatment of cholesterol. Fish oil helps by significantly lowering the levels of triglycerides in the blood. Many patients find that fish oil tends to produce a lot of belching and fishy breath. Patients asking about fish oil should be referred to a pharmacist to help determine the correct dose to take.17   	  	   	S is for Smoking   	What is it?   	It has been well documented that smoking leads directly to many health complications and deaths annually. Smoking tobacco has been shown to increase the risk of blood clots leading to strokes, lowers HDL (good cholesterol), and increases risk of peripheral artery disease and heart disease. Smoking has also been linked to causing multiple types of cancer, like lung, throat, and mouth cancer.18,19   	  	   	People who are breathing the air around others who smoke (termed second-hand smoke) also have higher risks of stroke and heart disease. Studies have predicted that second-hand smokers have approximately a 25-30% increased risk of heart disease over individuals who are not exposed to second-hand smoke. Children of smokers tend to have more respiratory tract infections than children of non-smokers.18,19   	  	   	Despite knowing risks, people continue to smoke. A study published in the journal, Addictive Behaviors, found that roughly half of individuals ages 14-21 years old who smoke less than once a month display signs of nicotine addiction. About 30% of those individuals also displayed the same addiction characteristic after just one cigarette. The results of this study show the high risk of addiction to nicotine in cigarettes.20   	  	   	Many individuals find that it is very difficult to quit smoking. Even with social support and the use of smoking cessation aids, the path to quitting is difficult. When somebody uses nicotine, the brain is exposed to more chemicals than normal. These chemicals provide feelings of pleasure and increased energy associated with nicotine use. Eventually though, the brain becomes less responsive to nicotine and requires much more nicotine to feel the same effects. This is called tolerance.21   	  	   	Unfortunately, tolerance to a drug can lead to dependence on a drug. Dependence is a state where lack of a drug in the body causes unwanted and generally unpleasant effects. For example, when a person who normally smokes tobacco is placed into a situation where smoking is forbidden (i.e. workplace) they may become irritable and agitated. The combination of tolerance and dependence makes it very difficult for people to stop smoking. It is highly suggested that individuals interested in smoking cessation talk to their physician or pharmacist about assistance programs.21   	  	   	Current Guidelines   	At the core of the issue, every major guideline for maintaining patients' health and preventing heart disease emphasizes the need to stop smoking. The benefits from smoking cessation are also realized immediately. Within a half hour, a patient's blood pressure will drop to the level it was prior to any tobacco use. Before the month is over, a patient will notice that it is easier to breathe as their lung function improves. Roughly one year later, a patient's risk of heart disease is cut in half. By years five to fifteen, the stroke risk is cut in half. After ten years, a quitter's risk of cancer is greatly decreased.18   	  	   	Medications for Treatment   	There is a plethora of pharmacologic options for patients looking for assistance with smoking cessation. Nicotine gums, lozenges and patches provide relief from nicotine withdrawal and are available over-the-counter at most pharmacies. There are also a few prescription drugs, like Zyban (buproprion) and Chantix (varenicline), which help patients deal with the physiological cravings associated with nicotine. Each product has its own advantages and disadvantages for patients. There are many considerations such as patient preference and triggers that need to be taken into account as pharmacists help patients select the best smoking cessation product.   	  	   	Nicotine gum is used with the chew-chew-park method. After chewing a few times, the piece of gum should be placed in between the gum and cheeks and left there for a little under a minute. If done correctly, a person should begin to feel a slight tingling around the site of the gum. The gum should not be swallowed after use. The gum gives a patient nicotine for approximately thirty minutes before the piece is exhausted. The maximum amount of gum a patient should use per day is 24 pieces. Side effects of using nicotine gum include upset stomach, tired mouth, oral irritation, and unpleasant taste. Nicotine lozenges are also another option for patients seeking nicotine replacement. The lozenge works similarly to candied lozenges. One simply needs to swish the lozenge around the mouth and let it dissolve in order to receive the nicotine dose. Patients should not use more than 20 lozenges per day. Side effects associated with the lozenges include a greater amount of stomach upset compared to nicotine gums, oral irritation, headache, heartburn, nausea and flatulence.17,22   	  	   	Nicotine patches work by delivering a set amount of nicotine across the skin over a long period of time each day. Notable side effects from nicotine patch use include nausea, dizziness, diarrhea, sweating, headache and vivid dreams. Local skin irritation is also a possibility with patients who have sensitive skin. Nicotine inhalers deliver nicotine through a device that resembles a cigarette. It is optimal for patients who also find that the hand to mouth act of smoking itself is pleasurable. Side effects associated with inhaled nicotine include oral irritation, cough and occasional nasal congestion. Nicotine nasal sprays work much like nasal sprays used for seasonal allergies. Patients simply spray the dose into each nostril. The nasal spray provides the fastest relief of withdrawal symptoms of all the nicotine replacement products. Patients may report a peppery nasal irritation, coughing, sneezing, or watery eyes while using the nicotine spray.17,22   	  	   	Bupropion is a commonly prescribed prescription drug for mood disorders. However, it can also be used to help patients cease smoking because it alters the chemical pathways in the brain. This helps patients slowly reduce their addictive habits, nicotine cravings and withdrawal symptoms. The most common side effects reported include sleeping problems and dry mouth. The FDA has given bupropion a black box warning due to post-marketing surveillance studies. These studies have found that patients taking bupropion may be at an increased risk of agitation, hostility, depression or suicidal ideation.17,22   	  	   	Varenicline is the newest agent available to assist with smoking cessation. The drug works in the brain in ways similar to nicotine; however, it does not cause the same harmful effects as tobacco products. The most common side effects reported with varenicline include headache, insomnia, nausea, and vivid dreams. Varenicline also has a black box warning from the FDA for agitation, hostility, depression and suicidal ideation.17,22   	  	   	Role for Technicians   	There is a significant role for pharmacy in helping reduce cardiovascular disease and prevent one million heart attacks and strokes in the next five years. The team of pharmacists and pharmacy technicians can promote healthy living and risk reduction strategies. As outlined in Table 4, innovative programs at pharmacies can promote weight loss, healthy eating and increased physical activity. Technicians can assist pharmacists in development of drug utilization review mechanisms which identify appropriate patients for aspirin use. Blood pressure machines are commonly located in pharmacies and can be promoted by technicians for patients taking medications for blood pressure. Many pharmacies have cholesterol screening programs to identify patients with high cholesterol. The technician can play a significant role in the development and implementation of these and other screening programs. Smoking cessation products should be placed in prominent locations in the pharmacy. Technicians can assist patients in promotion of these products and referral to pharmacists as patients work to quit smoking. The success of preventing heart attacks and strokes will require a team approach. Pharmacy technicians can play an important role in helping patients to reduce heart disease.    	  	   	References   	1. Executive Summary: Heart Disease and Stroke Statistics--2012 Update : A Report From The American Heart Association. Circulation 2012;125:188-197.   	  	   	2. Million Hearts. Centers for Disease Control and Prevention. 29 May 2012 .   	  	   	3. Lexi-Comp. Aspirin. 23 May 2012 .   	  	   	4. Coronary Heart Disease Risk Factors. National Heart Lung and Blood Institute. 24 May 2012 .   	  	   	5. Framingham Heart Study. 24 May 2012 .   	  	   	6. Aspirin for the Prevention of Cardiovascular Disease. December 2009. U.S. Preventive Services Task Force. 23 May 2012. http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm&#62;.   	  	   	7. Mosca L, et al. Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women - 2011 Update. JACC 2011; 57: 1401-1423.   	  	   	8. Cairns, JA, Therous P, Lewis HD Jr. et al. Antithrombotic agents in coronary artery disease. Chest. 2001; 119 (1 suppl): 228S-52S.   	  	   	9. Saseen JJ. ASHP therapeutic statement on the daily use of aspirin for preventing cardiovascular events. Am J Health-Syst Pharm. 2005; 62:1398-405.   	  	   	10. Standards of medical care in diabetes. Diabetes Care 2012;28 (suppl 1: S11-S63.   	  	   	11. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA. 2003;289.   	  	   	12. Good vs. Bad Cholesterol. Mar 2012 American Heart Association. 30 May 2012. http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/Good-vs-Bad-Cholesterol_UCM_305561_Article.jsp&#62;.   	  	   	13. Heart Attack: MedlinePlus. May 2012. U.S. National Library of Medicine. 28 May 2012 .   	  	   	14. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). ATP 3 Cholesterol Guidelines, NHLBI. Circulation 2002;106:3143.   	  	   	15. Concord Hospital. Plant Stanols and Sterols. Sept 2006. Concord Hospital, University of New Hampshire. 28 May 2012. .   	  	   	16. Physical Activity Guidelines. 2008. U.S. Department of Health and Human Services. 28 May 2012. .   	  	   	17. Antilipemic Agents, Smoking Cessation. Lexi-Comp. Lexi-Comp, Inc. Web. 30 May 2012. .   	  	   	18. How Cigarettes Damage Your Body. Mar 2012. American Heart Association. 29 May 2012 .   	  	   	19. Quit Smoking. 2012. American Heart Association. 31 May 2012 .   	20. Scragg R, Wellman RJ,Laugesen M, DiFranza JR. Diminished Autonomy over Tobacco Can Appear with the First Cigarettes. Addictive Behaviors 2008;33.5:689-98.   	  	   	21. Drug Facts: Understanding Drug Abuse and Addiction Understanding Drug Abuse and Addiction. Understanding Drug Abuse and Addiction. Mar 2011. National Institute of Drug Abuse. 31 May 2012. .   	  	   	22. Medicines To Help You Quit Smoking. Mar 2011. American Heart Association. 31 May 2012 .   	  	   	Author Bio:   	CoraLynn B. Trewet is an Associate Clinical Professor of Family Medicine for The University of Iowa where she coordinates the endocrine therapeutics course and serves as the Director of Continuing Education. Dr. Trewet is a Board Certified Pharmacy Therapy Specialist (BCPS), a Certified Diabetes Educator (CDE) and is certified as a Wellcoach Health Coach. Dr. Trewet currently serves on the NHLBI Coordinating Committee of the National Program to Reduce Cardiovascular Risk (NPRCR), where she is involved with the development and dissemination of the upcoming hypertension, cholesterol and obesity guidelines.    	  	   	Idea In Brief:   	The Million Hearts campaign is an initiative with the goal to prevent one million heart attacks and strokes by the year 2017. A main focus of the Million Hearts initiative is based around ABCS of cardiovascular disease which stand for aspirin use, blood pressure control, cholesterol management and smoking cessation. This activity will highlight current guidelines and treatments in these four areas of cardiovascular disease.    	  	   	Idea In Practice:   	More patients come into the pharmacy with cardiovascular disease than any other disease state. A new initiative, The Million Hearts Campaign, is based around ABCS of cardiovascular disease which stand for aspirin use, blood pressure control, cholesterol management and smoking cessation. These four areas are specific areas pharmacy technicians can focus their efforts to help improve patient care and decrease heart disease.  <br>
]]></description>
<dc:subject>Course</dc:subject>
<dc:date>2012-08-23T13:00:00Z</dc:date>
</item>

<item>
<title>COPD; Working to Breathe: A Growing Epidemic</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=367</link>
<description><![CDATA[Instructor: Sandra Andrews, CPhT<br><br>

  	  		Breathing, I would venture to say, is something we rarely think about, yet all of us must do it to survive. As a matter of fact, it is estimated that we breathe 12-18 times a minute. Our heart will beat 100,000 times a day. Our lungs will take in roughly 11,000 liters of oxygen each day. These are amazing feats completed by our bodies; yet we are rarely aware of these processes as they take place. Now, imagine if this cycle wasn't flawless. What if walking down a hallway left you breathless? What if part of your daily routine included using a portable oxygen tank? What if the sound of your breath was a wheeze? This is a glimpse of what your life would be like with COPD. 	  		  		 	  		Chronic obstructive pulmonary disease (COPD) is the third largest cause of death in the United States. According to the American Lung Association, 13.1 million adults in the U.S. were diagnosed with COPD as of 2008. What may be even more alarming is the evidence that shows that nearly 24 million Americans have some form of chronic lung disease. It is this statistic that suggests COPD is underdiagnosed. 	  		  		 	  		So what is COPD? How does it affect those who have it? What treatments are available and how will this disease be treated in the future? Most importantly, how can this disease be prevented? In order to answer these questions we must first understand the cycle that allows us to breath. 	  		  		 	  		Breathing is the process our body uses to move air in and out of our lungs. It is an unconscious effort; one which is essential for delivering oxygen and removing carbon dioxide throughout the body. When we breathe in or inhale, the air flows to the back of the throat and makes its way down the trachea and into the bronchial tubes. Once in the bronchial tubes it passes on into the lungs and then disperses further into smaller passages known as bronchioles. After air makes its way past the bronchioles, it stops in tiny air sacs known as alveoli. Alveoli help the air pass through to the blood where the exchange of oxygen and the removal of carbon dioxide begins. 	  		  		 	  		In a person diagnosed with COPD, this respiratory cycle is exceptionally hampered. COPD is a progressive disease which slowly limits breathing capacity. Shortness of breath, wheezing and a chronic cough followed by a substantial amount of mucus are just a few of the symptoms a doctor might use to diagnose COPD. As stated previously, the disease grows steadily worse as time passes. It may begin with breathing heavily after taking the stairs, known as shortness of breath on exertion. Left untreated, the disease may warrant admission to the hospital for aggressive treatment. 	  		  		 	  		What causes COPD? COPD occurs when the lungs are chronically exposed to irritants which are caustic to the lungs and airway. The primary cause of COPD in the U.S. is cigarette smoke, but cigar and pipe smoke can also be damaging. Although tobacco smoke is the central cause of COPD others include environmental dust, chemical fumes, pollution from the air and secondhand smoke. Although it is uncommon, COPD can also be caused by genetics. Researchers have found that patients with low levels of a liver protein known as AAT (or alpha-1 antitrypsin) have a greater chance of being diagnosed with COPD. This chance worsens if the patient is a smoker or is exposed to secondhand smoke. Even though genetics can be a cause of COPD, it should be noted that this research is still in its infancy. 	  		Gaining a greater understanding of how COPD impacts the respiratory system has given the pharmaceutical industry a leg up in creating treatments to try and tame the disease. As certified pharmacy technicians, it is only to the benefit of our patients that we understand the treatments used to cope with COPD. 	  		  		 	  		The first category of drugs that treats COPD is bronchodilators. Bronchodilators are used to help a person affected with COPD or various other lung diseases breathe easier. Most bronchodilators are inhaled, giving the patient more immediate relief. Inhaled bronchodilators spray a mist of medication that makes its way directly into the lungs, opening up the bronchial tubes and providing much needed relief. It should be noted that while most bronchodilators are used in the form of an inhaler, they may also be used in pill form or as a subcutaneous injection. It is also important to remember bronchodilators ease the symptoms of COPD, but do not reverse the effects of the disease. 	  		  		 	  		Bronchodilators are the first line of defense in diminishing the effects of COPD and providing the patient with relief. They can be broken down into two categories: short-acting and long-acting. These categories do as their names suggest. Short-acting bronchodilators provide immediate relief and should only be used for exacerbation of COPD symptoms. Long-acting bronchodilators help with the persistent symptoms of COPD and are normally given on a scheduled basis. 	  		  		 	  		Short-acting bronchodilators have two classifications: anticholinergics and beta2-agonists. Anticholinergics work by blocking nerve reflexes that cause constriction of airways. Beta2-agonists work in much the same way by causing smooth muscle relaxation which, in turn, causes the bronchial pathways to dilate and offer the patient expedited relief. These classes of bronchodilators are often referred to as rescue inhalers for their specified use in immediate relief. 	  		  		 	  		Atrovent or ipratropium as it is know generically is a short-acting, anticholinergic inhaler often prescribed for patients with COPD. Ipratropium works by blocking acetylcholine receptors causing smooth muscle relaxation and decreasing constriction of the lungs and airways. Ipratropium is available as a metered dose inhaler (MDI) or as a liquid for use in a nebulizer.  	  		  		 	  		Short-acting, beta2-agonist inhalers outnumber short-acting, anticholinergic inhalers. The former include albuterol or Ventolin/Proventil as it is known commercially and levalbuterol or Xopenex in the brand name. Alupent (metaproterenol), Maxair (pirbuterol), and terbutaline should also be recognized as short-acting, beta2-agonists. 	  		  		 	  		Short-acting bronchodilators, such as those mentioned above, are not to be used on a prophylactic basis. Just as their name indicates, short-acting bronchodilators are used for immediate relief of exacerbated symptoms. These medications should be used as directed, under the guidance of a physician and pharmacist. Using a short-acting bronchodilator more frequently than suggested can lead to a tolerance build-up for the drug. If tolerance for the drug is established, the drug may become ineffective when the patient needs it the most. When you are struggling to breathe, relief becomes more than just a time sensitive issue: it becomes an issue of life or death. 	  		So are there bronchodilators available for preventive use? The answer is yes, and they are known as long-acting bronchodilators. Long-acting bronchodilators are used on a daily basis to control the symptoms of COPD. While the symptoms of COPD (chronic cough, wheezing and hard or labored breathing) cannot be eliminated, they can be managed by the prescribed, daily use of long-acting bronchodilators. 	  		  		 	  		Long-acting bronchodilators are also broken down into anticholinergic and beta2-agonists. Spiriva (tiotropium bromide) is a commonly used long-acting anticholinergic bronchodilator prescribed for patients diagnosed with COPD. Spiriva works to ease the symptoms of the disease by relaxing the muscles around the airways, making breathing less labored and providing the patient with relief. However, should the patient have an exacerbation of their COPD, a situation which calls for immediate rescue, then a short-acting bronchodilator such as albuterol would be necessary. 	  		  		 	  		As with short-acting beta2-agonists, long-acting beta2-agonists outnumber long-acting anticholinergic bronchodilators. Foradil (formoterol) and Serevent (salmeterol) are commonly used to treat patients with COPD. Another option for treatment is combination inhalers, which include a long-acting beta2-agonist and an inhaled corticosteroid. Corticosteroids are a synthetic imitation of cortisol, a hormone produced naturally by the adrenal gland. Corticosteroids help reduce swelling. A reduction in the tissue that surrounds the airways means the patient with COPD breathes more easily. Advair (salmeterol/fluticasone), Symbicort (formoterol/budesonide), and Dulera (formoterol/mometasone) are just a few of the combination, long-acting, beta2-agonist bronchodilators available on the market today. 	  		  		 	  		While short- and long-acting bronchodilators provide relief and maintenance, they do not come without side effects. Nervousness, anxiety, muscle tremors and increased or irregular heart palpitations are all possible side effects of bronchodilators. Patients who experience any of these side effects should contact their physician. It should never be advised that a patient discontinue the use of bronchodilators without consulting their physician first. Recognizing these side effects and routing the patient's concerns through the proper channels is the first step in effective patient care and counseling. The safe and effective use of medication is an essential part of pharmacy practice and must be a key component in patient care. Medication safety should be not limited to pharmacists; patients often replay concerns to the pharmacy technician first. 	  		  		 	  		What can be done to prevent COPD? The answer to this question is relatively simple. Smoking plays the largest part in the future of COPD. The American Lung Association states that 85 to 90 percent of deaths due to COPD are related to smoking. Smokers are 12 to 13 times more likely to die from COPD, than non-smokers. In 2010, it was estimated the cost of COPD in the U.S. totaled over 49 billion dollars. 76% of those affected by COPD say the disease limits almost every physical aspect of their lives, from household chores to sleeping. 	  		  		 	  		Can COPD be prevented? The primary preventive measure is to avoid or stop smoking. Make your home smoke free. People who live with a smoker or are regularly exposed to secondhand smoke are also at a higher risk for COPD. Many states have laws governing smoking in public places. Smoking is also known to be responsible for some forms of heart disease and lung cancer. 	  		  		 	  		While smoking remains the primary cause of COPD, it is important to remember breathing clean air in our homes and at work will help decrease the risk of COPD. Chemical fumes, dust and other caustic materials have been proven to compound the chance of COPD. Preventive measures should be taken when working with any type of chemical or caustic materials. Working in a well ventilated area, using a facial mask, and limiting the amount of material you work with are just a few ways you can help decrease your risk of COPD. 	  		  		 	  		If you suspect you may have COPD or you know someone who has COPD the first step is to stop smoking if you are a smoker. The next step is to see your physician. 	  		  		 	  		If you have further questions or concerns about COPD, the American Lung Association offers an extensive amount of information. Other reliable sites for information include the Centers for Disease Control and Prevention and the National Institutes of Health. Those sites are listed in the references. Your physician or pharmacist can also provide information on diagnosing and treating COPD. 	  		  		 	  		As certified pharmacy technicians, it is our responsibility to provide patients with support in attaining reliable medical information. Knowing the side effects of COPD treatments and then routing these questions and concerns through the right channels can provide patients with the resources they need. The effects of COPD can be treated, but not cured. Symptomatic treatment of the disease is key to successful management of it, and spreading the word about COPD will help decrease the number of diagnosed with it in years to come. 	  		  		 	  		Case Study: COPD, Patient Safety, and Bronchodilators 	  		Sue is a 49-year-old mother of three who presented to the emergency department last week with the following symptoms: shortness of breath, tightness in her chest, and chronic cough which she says leaves her with a lot of mucus. After some basic questions concerning her medical history, the physician discovers Sue has been a smoker for most of her adult life; two packs a day since she was 18. Sue's parents smoked and so this habit seemed like a normal step into adulthood. The doctor asks Sue how long she has noticed the cough. Sue replies that she can't remember not having some cough, but in the last 6-8 months it seems to have gotten worse. As the doctor is examining Sue he notices an audible wheeze. Sue cannot recall when the wheezing began. Based upon her physical exam and the history Sue has given him, the doctor feels she may have chronic bronchitis brought on by an exacerbation of chronic obstructive pulmonary disease, or COPD. He recommends that Sue be admitted to the hospital for further treatment. 	  		  		 	  		The doctor orders a chest x-ray and EKG. He also orders a nebulizer treatment using the short-acting bronchodilator albuterol (Ventolin or Proventil). Oxygen via nasal cannula is ordered for Sue and a pulse oximeter is placed on her finger to monitor oxygen saturation. He orders an IV corticosteroid, methylprednisolone (Solu-Medrol) 1-2mg/kg every 6-12 hours. He also orders a five day course of double strength sulfamethoxazole/trimethoprim (BactrimDS) with instructions to take one tablet by mouth twice daily for treatment of chronic bronchitis. The doctor also suggest Sue begin a smoking cessation program. Sue is hesitant; after all, she has been smoking since she was 18 and it would seem next to impossible to quit. The doctor states that quitting smoking will not only decrease her cough, but could also stop the effects of COPD from getting worse. Sue is still hesitant, but agrees to try and the doctor orders a course of a transdermal nicotine patch (NicoDerm CQ). 	  		  		 	  		After three days in the hospital, Sue's doctor feels she is doing well enough to discharge her. Giving her specific instructions on each medication, he discharges her with the following prescriptions: albuterol inhaler, a short-acting bronchodilator; tiotropium bromide (Spiriva), a long acting bronchodilator; a 14-day course of an oral corticosteroid, prednisone, and five-day course of double strength sulfamethoxazole/trimethoprim (Bactrim DS). In addition to her prescriptions, she is to continue on the step-down course of NicoDerm CQ. The doctor asks if she has any questions, and Sue replies that she does not. Before the doctor leaves, he reminds Sue that the albuterol inhaler is only to be used in emergent situations where she feels she is having difficulty breathing and the Spiriva is to be used once a day, everyday. Sue acknowledges that she understands and the doctor leaves. 	  		  		 	  		Sue leaves the hospital and asks her husband to stop at the local pharmacy so she can get her prescriptions filled. When Sue and her husband walk into the pharmacy there are people lined up to the pharmacy counter. Though she feels the pharmacy is too busy, Sue and her husband decide to stay. When they finally reach the pharmacy counter they are greeted by a certified pharmacy technician. Carly, the CPhT, is a new technician who received her certification six months earlier. By now Carly has gotten used to being busy and she takes the prescriptions Sue hands her. Carly looks over the prescriptions to make sure she has all the necessary information. What is your date of birth? she asks Sue. Sue answers and Carly continues by verifying Sue's address, the doctor, allergies and finally, the prescription plan. Carly gives the prescriptions to the pharmacist. 	  		  		 	  		After a 20-minute wait, Sue's prescriptions are ready. By this time the pharmacy has gotten even busier and Carly is ringing up her prescriptions. Sue reads over the prescription labels; Albuterol, Spiriva, prednisone, and SMZ/TPM DS. Sue does not recall her doctor prescribing the last drug and the directions for the prednisone are confusing. Sue also cannot remember which inhaler the doctor told her to use for emergencies only. Carly tries to hurry through Sue's transaction, because her line is getting longer, people are getting impatient, and her pharmacist is falling further behind. 	  		  		 	 		What is SMZ/TMP DS? I don't recall my doctor prescribing this? Sue questions. 	 		  		 	 		It's just a shortened generic name for Bactrim DS. Carly is starting to feel the agitation of the people waiting behind Sue. The lady behind Sue gives Carly an irritating glare. 	 		  		 	 		Alright, but what about this medication? Sue points to the prednisone. I really do not understand these directions. You know, they seem very confusing. 	 		  		 	  		Carly is ready to move on to the next customer. She knows Sue should really speak with the pharmacist for patient counseling, but he is up to his neck in prescriptions and the crowd is getting even more restless, not to mention it is almost 5:00pm and the day before Thanksgiving and the pharmacy closes at 6:00pm. 	  		  		 	 		Didn't your doctor explain it to you before you where discharged? 	 		  		 	 		Yes, but I can't really remember what he said. Sue is becoming upset. She really just wants to understand her prescriptions and go home. She is growing tired and this technician seems to have no idea what she is talking about. 	 		  		 	 		Well the pharmacist is really very busy right now. If you want to speak with him, then you are going to have to wait. 	 		  		 	 		How long will my wait be? asks Sue. 	 		  		 	 		I don't know, maybe twenty minutes, Carly caught another glare from the customer behind Sue. 	 		  		 	 		But I want to go home. I was just discharged from the hospital today and I' am very tired. 	 		  		 	 		I'm sorry, but I really can't promise you it will be any faster. 	  		  		 	  		Although Sue is frustrated and really doesn't understand how to use her medication, she decides to go home. Tomorrow is Thanksgiving so she won't be able to get in touch with her doctor, but she can manage one more day. Sue takes her prescriptions and leaves. 	  		  		 	  		Two days later, Carly is working the pharmacy counter again when Sue comes in. As soon as Sue comes up to the pharmacy counter, Carly notices she has shaking in both hands. 	  		  		 	 		Can I help you?  Carly also notices Sue seems to be breathing with some difficulty. 	  		  		 	  		Sue puts her prescriptions on the counter and begins to explain her situation. I had these prescriptions filled here a few days ago and I think something is wrong. 	  		  		 	 		What do you mean? Carly asks. 	 		  		 	 		Well, ever since I started taking these medications my heart feels like it is racing out of my chest and my hands seem to shake all the time now. I took these same medications while I was in the hospital and didn't have any of these problems. Also, I still don't understand how to I am supposed to take the prednisone. 	  		  		 	  		Carly gets Sue's name and looks up her profile in the pharmacy computer. She sees Sue has no allergies and that the medications she most recently had filled were the albuterol inhaler, Spiriva inhaler, SMZ/TMP DS and prednisone. 	  		  		 	 		Are you having any other symptoms? 	 		  		 	 		Yes, I feel nauseated and I have a headache. I really didn't feel this way until I started on the medication. 	  		  		 	 		Are you taking any other medication, either medication prescribed by your doctor or over-the-counter? 	 		No, except I am using NicoDerm CQ patches to help me stop smoking. Although, I don't think they are working, because I still feel like smoking. 	  		  		 	  		Carly writes down all the information which Sue has given to her, then approaches the pharmacist-on-duty with the situation. The pharmacist carefully goes over the information, and then comes to the counter to speak with Sue. 	  		  		 	  		Once the pharmacist begins speaking with Sue she realizes that Sue has been using her inhalers incorrectly. Upon further conversation, the pharmacist finds Sue has not been taking the prednisone as the doctor intended. The pharmacist counsels Sue on her medication, making sure she thoroughly understands how to use it before she leaves the pharmacy. She stresses the importance of the albuterol for immediate relief, explaining it is for emergent use. Should Sue not receive relief after using the albuterol inhaler, then she should return to the emergency department. The pharmacist goes on to highlight the therapeutic reasons behind her daily use of Spiriva, while also showing her the proper technique for using it. She also makes sure Sue understands that diligent use of her Spiriva will help make the symptoms of her COPD less pronounced. Finally, the pharmacist goes over the step down dosing for Sue's prednisone. She highlights that it is important for Sue to take the prednisone as directed and not to suddenly stop taking the medication. The pharmacist also warns Sue of some of the side effects of prednisone such as, stomach irritation, increased appetite and fluid retention. The pharmacist asks Sue if she has any further questions. 	  		         	 		Yes, I am also using NicoDerm CQ patches to help stop smoking and I really do not think they are working. 	  		         	  		The pharmacist first asks Sue how she has been using the transdermal patch. Sue explains that she first makes sure her arm is dry and clean. She then puts the patch on the area and changes it after 24 hours. The pharmacist asks if she is still smoking and Sue replies, yes. The pharmacist warns Sue that she is not to smoke while using NicoDerm CQ or any other nicotine patch as it can lead to a build up of nicotine in the body and possibly a nicotine overdose. 	  		         	  		Sue seems satisfied with the information the pharmacist has provided. The pharmacist suggests Sue follow up with her doctor if problem persist. Sue thanks the pharmacist and leaves the pharmacy more confident about her medications. 	  		  		 	  		Follow Up Discussion 	  		What could Carly have done which might have helped Sue avoid confusion and misuse of her medications? 	  		  		 	  		This seems like a question with a fairly easy answer. In the best case scenario Carly should have gotten the pharmacist to counsel Sue on her medications. Although it was busy and the pharmacist was falling behind, some of Sue's questions could have been answered during a brief consultation with the pharmacist. Patient safety should always be the first priority for the certified pharmacy technician. Sue recognized something was wrong with her medications and came back to the pharmacy. Some patients do not recognize issues, trusting that everything is correct. Sue's situation had an ending which was positive, but it does not always workout this way. 	  		What were some of the factors which distracted Carly from Sue's situation? 	  		  		 	  		There where several factors in play here, but none of which were large enough to compromise patient safety. Glaring customers, long lines, getting close to closing time and a pharmacist piled up with prescriptions all distracted Carly from Sue's situation. 	  		  		 	  		While no one likes to stand in line or deal with customers who have lost their patience, chances are if that customer had questions or concerns about their medication they would want answers as well. Even though tempers can run high, patient safety should always be the primary concern for the CPhT. Not only are you putting the patient at risk, but possibly the license of your pharmacist as well. 	  		  		 	  		Since the pharmacist was busy, should Carly have tried to counsel Sue by herself? 	  		         	  		The answer her is a resounding no. While Carly should recognize Sue is unsure of her medication she should never counsel a patient. Counseling is the job of a licensed professional and the reason the pharmacist is there. Again, being too busy is not a reason to skimp on patient safety. 	  		  		 	  		On Sue's second trip into the pharmacy, Carly recognized the situation and called for a pharmacist, but first gathered all the information the pharmacist would need to answer Sue's questions. Carly also recognized some of the side effects which can be associated with improper use of short-acting bronchodilators such as albuterol. After carefully reading over Sue's medications Carly noted these were medications used primarily in patients with COPD. Once Sue also told Carly she was using NicoDerm CQ to quit smoking, Carly knew Sue's condition was most likely associated with COPD. Completing her pharmacy technician training just six months earlier, she remembered her instructor going over some of the same side effects Sue was having. 	  		  		 	  		Recognizing disease states can be essential for the CPhT. In most cases it can help avoid situations such as Sue's and lead to a better outcome for the customer. 	  		  		 	  		How can Carly improve her skills as a certified pharmacy technician?  	  		  		 	  		As certified pharmacy technicians we are always learning and growing. Carly recognized initially that Sue should have spoken with the pharmacist, but delayed counseling by telling Sue the pharmacist was too busy. Carly now knows she should have taken the time to retrieve the pharmacist so he or she could counsel Sue on her medications. Again, patient safety should never be excused. 	  		  		 	  		While Carly does not have the skill level needed to counsel patients her desire to learn more helped her recognize the side effects Sue was having. Learning about disease states such as COPD and the medications associated with them will make us more informed CPhTs, which in turn will help us recognize which situations need the most attention. 	  		  		 	  		Finally, Carly knew to ask the right questions. The second time Sue came into the pharmacy, Carly was sure to get a list of Sue's medications and ask if she was taking other medications, either prescribed or over-the-counter. Once Carly was able to find out this information she was able to have a much clearer picture of Sue's situation.             	  		  		 	  		The Bottom Line 	  		While no one intentionally seeks to do harm, Carly's preoccupation with distractions in the pharmacy could have cost Sue another trip to the emergency department or, worse yet, another hospital stay. If Carly had acted on her instincts as a CPhT that Sue needed counseling by the pharmacist, the situation might have been much different. Patient safety should never be sacrificed no matter how busy we are. Oftentimes CPhTs are the first point of contact for patients. Patient safety is not only the pharmacist's responsibility: as the first contacts for patients, CPhTs should be recognized as integral to ensuring patient safety. 	  		  		 	  		While a CPhT should never assume the role of the pharmacist, being informed about the medications and the diseases they control is essential in becoming a better technician. 	  		  		 	  		Carly recognized the medications Sue was prescribed were commonly used in patient with COPD. Furthermore, on Sue's second trip to the pharmacy Carly visually recognized the symptoms she was having. Had these symptoms of shortness of breath and tremors been more pronounced, Carly should have immediately retrieved the pharmacist, who would make a decision on whether to call 911 for transport to the nearest hospital. Carly remembered short-acting bronchodilators, such as albuterol should only be used in emergent situations and an overdose can lead to tremors, headache and heart palpitations. Carly's assumptions of Sue's COPD diagnosis were further verified by Sue's use of NicoDerm CQ for smoking cessation. Knowledge such as this can be invaluable in having a positive outcome for the patient. 	  		  		 	  		Continuing to gain knowledge as CPhTs will not only make for a better outcome in patient care and safety, but also lead to more fulfillment as CPhTs. Knowing how to best use the knowledge we gain is the key to our success. Ensuring that we obey state and federal laws is one of the ways that we can become more effective pharmacy technicians. 	  		  		 	  		  		 	  		Author Bio 	  		Sandra Andrews has been a CPhT for 20 years. She is currently completing her degree with Arizona State University. She is currently working on a reference book for pharmacy technicians which deals with neurological diseases and the drugs that treat them. 	  		  		 	  		  		 	  		References 	  		1. American Lung Association, www.lung.org 	  		2. Centers for Disease Control and Prevention, www.cdc.gov/copd 	  		3. National Institutes of Health, www.nhlbi.nih.gov/health/public/lung/copd 	  		4. Cleveland Clinic, www.myclevelandclinic.org/disorders/copd 	  		5. WebMD, COPD medications, www.webmd.com/lung/copd 	  		6. Health.com, Drugs Used to Treat COPD. www.health.com/conditon/article 	  		7. Science-facts, Human facts, www.science-facts.com 	  		8. http://www.fpnotebook.com/lung/COPD/CpdManagement 	  		9. http:// www.primeinc.org/casestudies/pharmacist 	  		10. http:// www.nicodermcg.com 	  		  		 	  		  		 	  		Idea in Brief 	  		Chronic Obstructive Pulmonary Disease, COPD, is the 3rd leading cause of death in the United States. According to the American Lung Association the primary risk factor for COPD is smoking. As the diagnosis of COPD continues to grow so do the cost. In 2010 it was estimated COPD cost the United States an estimated 49 billion dollars. 29.5 billion was related to direct health care cost. Treatment of COPD does not cure the disease, but rather eases the symptoms associated with the disease. A combination of short-acting bronchodilators and long-acting bronchodilators are some of the key treatment recommendations. However, the best preventative measure in COPD is not to never smoke and if you do smoke take every measure to stop. 	  		  		 	  		Idea in Practice 	  		As pharmacy technicians it important to recognize disease states and as the incidence of COPD continues to grow in the Unites States knowing the medication treatments associated with COPD is invaluable. It is important for the pharmacy technician to recognize the difference between short-acting and long-acting bronchodilators. Short acting bronchodilators should be used in rescue situations. A through treatment for COPD will often include a combination of short-acting and long-acting bronchodilators. Management of these inhalers is essential to the patient and any questions concerning these medications should be handled as a cooperative effort between the technician and pharmacist. Patient safety should always be the first concern of the certified pharmacy technician. While the CPhT may not own the knowledge necessary for patient counseling, recognizing when a patient needs counseling with the pharmacist plays major role in patient care, safety and satisfaction. 	  		   <br>
]]></description>
<dc:subject>Course</dc:subject>
<dc:date>2012-06-21T13:00:00Z</dc:date>
</item>

<item>
<title>The Transmission of HIV in the Healthcare Setting</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=366</link>
<description><![CDATA[Instructor: Vanessa Mrazek,MBA,CPhT<br><br>

  	  		Nearly three decades since its discovery, Human Immunodeficiency Virus (HIV) continues to affect massive amounts of people worldwide.1 HIV is characterized by progressive immune system impairment through the destruction of T-cells. This impairment makes the patient more susceptible to infection.4 Because of a compromised immune system, it is quite common for people infected with HIV to encounter other illnesses. Common illnesses they may experience include herpes simplex, herpes zoster, tuberculosis, non-Hodgkin's lymphoma, oral thrush, vaginal thrush, dementia, meningitis, Kaposi's sarcoma, progressive multifocal leukoencephalopathy, and wasting syndrome.4 The length and course of both the disease and the treatment can vary from patient to patient; however, the result is always death.4 	  		  	  		HIV can be transmitted several ways including through contact with infected blood or blood products, sharing contaminated needles, contact between infected body fluids and mucous membranes, and across the placental barrier. HIV is found in many body fluids and tissues including blood, semen, vaginal and cervical secretions, cerebrospinal fluids, synovial fluid, pleural fluid, pericardial fluid, and amniotic fluid.4 HIV antibodies have been found in saliva, urine, tears, and feces; however, there is not any evidence that HIV can be spread by means of these fluids.4 	  		  	  		As of December 2004, the number of people living with HIV or AIDS worldwide was 39.4 million. As of 2005, the Center for Disease Control reported that about one million of those people live in the United States and twenty-five percent of those one million people are not aware they have HIV.6 	  		  	  		In 1985, the Center for Disease Control developed a set of universal precautions in response to the continued transmission of HIV.1 Universal precautions are recommended for use with every patient, regardless of their HIV status. Healthcare employees, including pharmacy staff, are encouraged to use precautions in all situations that risk exposure to blood, body fluids, and secretions. The universal precautions published by the Center for Disease Control include proper hand hygiene and safe injection practices. They also recommend any equipment or materials that were used by the patient, and are likely to have been contaminated with infectious body fluids, must be handled in a manner to prevent the possible transmission of HIV.1 The Center for Disease Control recommends the use of personal protective equipment to reduce the possibility of transmission as another standard precaution. Personal protective equipment (PPE) can include the use of gloves, gowns, mouth, nose, and eye protection to protect mucous membranes.9Standard universal precautions have helped to play an important role in reducing the likelihood of a healthcare employee being exposed to HIV. 	  		  	  		Universal precautions that define safe injection practices include, but are not limited to, using aseptic technique to avoid contamination of sterile injection equipment and using a separate syringe to administer different medications, even if the needle or cannula on the syringe is changed.9 It is important to use fluid infusion and administration sets like intravenous bags, tubing and connectors, for one patient only and dispose of them after use. The Center for Disease Control also recommends using single dose vials whenever possible to avoid multiple sticks.9 	  		  	  		In order to ensure the consistent use of universal precautions, healthcare administrators need to make preventing the transmission of infectious agents a priority for their organization.1 Administrators should provide support, including keeping an adequate supply of equipment on hand and maintaining enough employees per shift. These employees need education and training on the prevention of the transmission of HIV during their job orientation.1 Continuing education related to the prevention of the transmission of infectious disease should be a yearly requirement in order for employees to remain up to date on current procedures. It is also recommended that administration develops a system to ensure that all employees complete continuing education modules.1 Workplacepolicies for healthcare employees who have regular contact with possible HIV transmission situations need to be in place and employees need to be properly trained on the correct ways to administer first aid and the use of protective equipment without risking exposure, as well as what compensation may be available if the occupational exposure leads to transmission.1 	  		  	  		When handling possibly infected spills, you should always wear disposable gloves and wipe up the spill using disposable paper towels or rags. The contaminated area should then be cleaned using a solution comprised of &#188; quart of water mixed with one tablespoon of bleach. The area may then air dry. You should then place all soiled materials in a closed, leak proof container and place in the trash. After removing your gloves, follow proper hand hygiene procedures.1 	 		  	  		Case Study #1 	  		  			You are employed as a pharmacy technician at a nearby hospital. You are making your rounds delivering floor stock to the nurse's stations when you witness a patient trip over their IV line and fall. You rush over to help them up and notice they have pulled out their IV and their nose is bleeding. What should you do? 	 	  		  	  		First aid and spill kits should be kept in an easily accessible area and ought to be equipped to handle possible exposure to blood and/or body fluids. The kits need to be stocked with disposable gloves, antiseptic or disinfectant, a bottle of bleach, disposable paper towels, and sterile gauze for covering wounds, medical tape, adhesive bandages, and a leak proof biohazard bag for disposal of solid materials.1 Many healthcare employees are concerned about exposure to HIV and having a properly stocked first aid and spill kit nearby can help ease these concerns. Any wounds or open areas exposed to blood or body fluids need to be washed thoroughly with soap and water, and any exposed mucous membranes need to be repeatedly flushed.1 Anyone exposed to HIV needs to be evaluated for potential transmission of HIV. After giving informed consent, a healthcare employee can begin baseline infection testing. All reports concerning the exposure are to be completed in a way that is non-judgmental to the healthcare employee or patient.1 	  		  	  		Education about the prevention of HIV exposure is the most effective way to reduce the transmission of HIV. In order to be effective in preventing the transmission of HIV, healthcare employees need to be properly trained on universal precautions and supplied with the proper materials and equipment.1 Unfortunately, occupational exposure to HIV is very common. Many accidental transmissions occur due to healthcare employees failure to follow universal precautions concerning the safe handling and disposal of needles and sharps.1 	  		  	  		Since the Center for Disease Control's publication of universal precautions, the occurrence of needle stick injuries has decreased; however, they continue to occur.7 Studies from 1996 show a reported one million needle stick injuries occurred in the workplace that year and they have slowly decreased with a reported 386, 000 needle stick injuries occurring in 2000. The decline in the number of needle stick injuries has been attributed to the publication of universal precautions by the Center for Disease Control and the implementation of these precautions by healthcare facilities and their employees.7 	  		  	  		In the healthcare setting, employees have reportedly become infected with HIV after being stuck with needles containing HIV infected blood or infected blood was able to enter an open cut or mucous membrane like the eyes or the inside of the nose.1 The Center for Disease Control recommends testing of possibly affected persons one month after exposure as the body may not have produced antibodies any sooner than that. Reports have shown that for some people it has taken up to fourteen months after exposure for their test to come back positive although the average positive test occurs three to seven weeks after exposure.5 The Center for Disease Control recommends that treatment for exposure to HIV begins within two hours of the exposure, or at least within seventy-two hours, as the treatment has been shown to be ineffective if it occurs after three days from the time of exposure.5 	  		  	  		The Center for Disease Control conducted studies in 2004 and discovered that suture needles, scalpels, IV catheter stylets, butterfly needles, hypodermic needles, and phlebotomy needles account for a majority of accidental needle stick injuries. Hollow bore needles pose the greatest risk for accidental transmission due to their ability to house patient blood.7 This same study showed that situations that lead to these occurrences of accidental needle sticks included manipulating the needle within the patient, being distracted while disposing of a needle, having a collision with another healthcare employee or sharps container, during the clean-up process of soiled materials, while attempting to access a patient's IV line, or while recapping a needle after use in a patient.7 Needle stick injuries can be eliminated through consistent review and education of possible situations that may cause an accident.7 	  		  	  		The Center for Disease Control reports that the occurrence of transmission of HIV due to workplace exposure to HIV is about one in 300, although there are factors that increase the risk of transmission to one in twenty. These factors include having blood visible on the needle, having a needle that was used to access an artery or vein, or if the needle was used on a patient, who was newly infected.7 Other reports by the Center for Disease Control show that healthcare employees do not report an average of forty percent of needle stick injuries due to fear of repercussions by management.7 The risk of acquiring HIV following an occupational exposure to infected blood or body fluids is actually very low. The main concern and focus of healthcare employees need to be how we can maximize patient health and safety while protecting employees when it comes to HIV.1 Any healthcare employee who believes they may have been exposed to an HIV infection must follow proper policies and procedures. 	  		Stigma and discrimination surrounding people with HIV have lead many infected people to become secretive and feel ashamed about their disease. A non-supportive workplace can cause other healthcare employees to veer away from proper patient care in order to avoid possible exposure and contamination.1 Inadequate staffing and poor working conditions have also been shown to lead to increased accidental exposures to HIV. Healthcare employees have reported that they have a tendency to rush more and pay less attention when attempting to perform the work of several employees.1 	  		  	  		Healthcare employees who have been exposed to HIV should be given a short-term antiretroviral treatment to help reduce the transmission of the infection. This antiretroviral treatment needs to be provided as part of a standard post exposure kit that is given to healthcare employees.5 According to the Center for Disease Control, studies performed in 2001 showed that zidovudine or AZT demonstrated a reduction in accidental transmission by eighty percent when used a post-exposure medication. The Center for Disease Control report that newer antiretrovirals are even more effective when used as post-exposure treatments due to their ability to work better when used for treating infected patients.7 	  		  	  		The classification of medications used to treat HIV is Antiretroviral. Antiretrovirals are used to control the reproduction of the virus and slow the progression of the HIV related disease. They do not stop the disease from being transmitted to another person. Highly Active Antiretroviral Therapy (HAART) is often the recommended treatment. HAART combines a minimum of three medications in a daily course of therapy for treatment.2 HIV has been shown to become resistant to antiretroviral medications that are administered individually so it is important for patients to be dosed using an antiretroviral cocktail. To date there is no cure for HIV; however, there are many drugs available to help prolong life. Not all treatments are the same; the correct medication cocktail can vary from person to person.2 	  		  	  		Non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, protease inhibitors, fusion inhibitors, and integrase inhibitors are the five classes of approved antiretroviral medications. Non-nucleoside reverse transcriptase inhibitors bind to and disable reverse transcriptase. Reverse transcriptase is the protein that HIV uses to reproduce and duplicate itself. Nucleoside reverse transcriptase inhibitors are faulty versions of the building blocks that HIV requires in order to duplicate. Consumption of nucleoside reverse transcriptase inhibitors results in the halting of reproduction of HIV. Protease inhibitors disable protease, the protein that HIV uses during duplication. Fusion inhibitors help to block HIV from invading healthy cells in the body and Integrase inhibitors inhibit the combining of HIV's DNA with human DNA. Many HIV cocktails will also include anti-infective medications, used to treat opportunistic infections, and antineoplastic medications, used to treat associated cancers.4 Successful complementary treatments for the side effects of HIV and the necessary medications include acupuncture, massage therapy, aromatherapy, and reflexology.6 	  		  	  		As of 2011, three medications for the treatment of HIV are in the development stage. Tibotec Pharmaceutics is working on developing a non-nucleoside reverse transcriptase inhibitor called rilpivirine. Gilead Sciences is developing an integrase inhibitor called elvitegravir and GlaxoSmithKline is working on a different integrase inhibitor called dolutegravir.2 	  		  	  		  			The following table lists five classes of antiretroviral drugs, their actions, and the names of medications: 		  			 		  			  	 	  		According to studies published in October 2011 by Aids Alert in Atlanta Georgia, the current recommended cocktail for initial HIV treatment includes efavirenz, rilpivirine, or nevirapine. Out of these three medications, efavirenz is preferred due to its better potency and tolerability with patients even though rilpivirine is a new medication fresh to the market.6 These same studies listed several prescription and herbal medications that are contra-indicated while on this class of medication. Some of the medications are rifamycin, proton pump inhibitors, St. John's wort, carbamazepine, phenobarbital, phenytoin, rifampin, and rifabutin, clarithromycin, and dexamethasone that is dosed more than once; St. John's wort is an herb that is contraindicated. They found antacids and h2 antagonists do not interfere with Antiretrovirals if they are administered four hours after the administration of the antiretroviral.6 	  		  	  		Although HAART has substantially decreased morbidity and mortality rates associated with HIV, the given therapy is not without its limitations. Numerous side effects, potential drug interactions, and substantial costs all affect the adherence of the patient. Polypharmacy is common among HIV patients and causes an increased occurrence of non-adherence among patients. The average HIV patient takes 4.5 antiretroviral agents along with numerous medications to help with side effects and any other illnesses they have contracted due to a decreased immune system.6 	  		  	  		Studies performed by the Cornell Medical School show that HAART is highly effective for HIV therapy; however, improvements are still needed. The amount of HAART therapies administered has greatly increased from 1996 to 2011, however, due to significant toxicity excessive costs, and patient non-adherence, a better treatment is still necessary.6 	  		Most patients are prescribed a combination of medications immediately in order to maximize the benefits of the medications working together, and to stop the progression of the disease as soon as possible. The Center for Disease Control recommends that patients have their viral load, or HIV DNA, checked every three months and physicians adjust their medications accordingly.4 	  		  	  		Multiple studies have shown that a minimum of 95% medication adherence is necessary to maintain optimal control and slow the progression of the spread of HIV through a person's body.6 Several published studies show that non-adherence can be due to several factors including drug or alcohol abuse, depression, financial situation, family support, and old age.6 HIV control is best obtained when patients have the added support of their healthcare providers. Building a trusting relationship between doctor, pharmacy, and patient is crucial to medication adherence and controlling the spread of the virus.6 	  		  	  		Specialty pharmacists who have been trained on HIV; the ways it affects the body and the medications used to treat the progression and its symptoms, are very useful in educating patients concerning the different medications available, possible side effects they may encounter, and ways to cope with those side effects. Pharmacists are also a useful tool for patients who need assistance finding funding for their medications or talking to an insurance company.6 	  		  	  		HIV and its transmission is an issue that every healthcare employee needs to be aware of regardless of their job title. The transmission of HIV in the healthcare field has decreased tremendously since the publication of the Center for Disease Control's universal precautions. In order to continue the downward curve of accidental transmissions we need to all be aware of how we can contribute to the decline. 	  		  		 	  		Case Study #2  		 	  		You are working the drop-off counter at the pharmacy. A patient brings you three prescriptions. You verify the patient's information and take the prescriptions for processing. As you are checking the shelves to see if you have the medications in stock you sneeze and rub your eyes. You then stop to blow your nose because of the sneeze. Both your eyes and your nose are made up of mucous membranes. When you return to the patient to alert them you have the medications in stock you notice there is a sticky substance that looks like blood on the back of one of the prescriptions. What are your rights as a healthcare employee who was just exposed to a possible HIV transmission? 	 		References 	  		  		 	 		1. Campbell, sue. Management of HIV/aids Transmission in Health Care. Nursing Standard (2004): 33-35. 	 		2. HAART Highly Effective, but Better Therapies Still Needed. Infectious Disease News 1 March 2011. 	 		3. Kagan, I., K Ovadia and T. Kaneti. Perceived Knowledge of Blood-borne Pathogens and Avoidance of Contact With Infected Patients. Journal of Nursing Scholarship (2009): 13-19. 	 		4. Lipincott, Williams, and Watkins. Professional Guide to Diseases. Philidelphia: Elsevir, 2009. 	 		5. Sharifi-Azad, J., and D. Rizzolo. Postexposure Prophylaxis for HIV: Pivotal Intervention for Those at Risk. JAAPA (2011): 22-25. 	 		6. What&#39;s New in HIV Treatment? Aids Alert 1 December 2011. 	 		7. Wilburn, S. Needlestick and Sharps Injury Prevention. Online Journal of Issues in Nursing (2004). 	 		8. Wilson E Sadoh, Adeniran O Fawole, Ayebo E Sadoh, Ayo O Oladimeji, and Oladapo S Sotiloye. Practice of Universal Precautions Among Healthcare Employees. Journal of National Medical Association (2006): 722-726. 	 		9. www.CenterforDiseaseControl.gov. N.d. 12 March 2012. 	 		  	  		Author Bio  		 	  		Vanessa Mrazek is the Director of Pharmacy Technology at Fortis College in Westerville, Ohio. She has been involved in various pharmacy settings for the last ten years. She received her bachelor's degree in Healthcare Management and her master's degree in Strategic Leadership from Franklin University in Columbus, Ohio. She currently lives in Delaware, Ohio with her husband and two month old. 	 		  	  		Sample Response for Case Study #1 	  		After giving consent, you have the right to HIV antibody testing and prophylactic treatment. You also have the right to continue your current position of employment without judgment or bias from other employees. You have the right to defend your reason for accidental transmission to the administrators without bias and you have the right to ask about any compensation that may be available due to an occupational exposure. 	  		  	  		Sample Response for Case Study #2 	  		After making sure the patient is okay, find a nearby first aid and spill kit. After placing gloves on your hands, hand the patient gauze to place against their nose to stop the bleeding. Use paper towels to wipe up any blood on the floor and use the bleach solution to clean the contaminated area. Place all materials in a biohazard bag and dispose of it properly. 	  		  		 	  		Idea in Brief 	  		Pharmacy Technicians play an important role in the prevention of the accidental transmission of HIV. Pharmacy Technicians must be aware of the ways HIV can be transmitted, the universal precautions set forth by the Center for Disease Control to prevent accidental transmission, and the medications that are currently available for the treatment of HIV. This article allows the pharmacy technician to become more knowledgeable about what part they can have in reducing the amount of accidental transmissions that occur yearly. 	  		  	  		  			Idea in Practice 		  			After completion of this continuing education module, pharmacy technicians will have a better understanding of the Center for Disease Control recommendations and precautions concerning accidental HIV transmission as it relates to healthcare employees. 	  <br>
]]></description>
<dc:subject>Course</dc:subject>
<dc:date>2012-04-26T13:00:00Z</dc:date>
</item>

<item>
<title>A year in Review:New Drug Application Approvals in 2011</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=365</link>
<description><![CDATA[Instructor: Dominic P. Decker<br><br>

  	  		Background The year 2011 was prolific for drug research, development, and output. As of December 31, the FDA had approved 102 new drug applications (NDAs), 30 of which were for new molecular entities. The medications presented here are a sampling of these approvals, with a range of indications and uses and from different drug classifications. Among these drug classifications, or chemical types, are new molecular entities (NMEs); new ester, new salt, or other noncovalent derivatives; new formulations; new combinations; new manufacturers; new indications; drugs already marketed, but without an approved NDA; and over-the-counter (OTC) switch.  	  		  	  		According to Matthew Herper in his article The Truth About 2011's New Drug Approvals, found in the July 18 issue of Forbes magazine, As many new drugs were approved in the first half of this year as in all of last. The year 2011 was, indeed, prolific for drug research, development, and output. The medications presented in this article were approved by the U.S. Food and Drug Administration (FDA) between January 1 and December 31, 2011, and cover the areas of endocrinology, gastroenterology, rheumatology, pulmonology, infectious diseases, psychiatry, and oncology, among others. It is important to note that the FDA reports drug approvals according to its fiscal year, October 1, 2010 through September 30, 2011, and so numerical data obtained from other sources may be incongruous with the information here. 	  		  		 	  		As of December 31, the FDA had approved 102 new drug applications (NDAs) in the year 2011. The medications presented here are a sampling of these approvals, with a range of indications and uses and from different drug classifications (Table 1). Among these drug classifications, or chemical types, are new molecular entities (NMEs); new ester, new salt, or other noncovalent derivatives; new formulations; new combinations; new manufacturers; new indications; drugs already marketed, but without an approved NDA; and over-the-counter (OTC) switch. The key to the table at the end of the article assigns a number to each chemical type and pairs it with the medications listed. While some classifications are obvious, others may be unfamiliar and should be elaborated on further. 	  		  		 	  		In approving new drug applications, the FDA distinguishes between duplicate therapies, or those medications that compete in the marketplace with the same kind of products already approved, and new molecular entities, which are new and innovative chemical structures never used before in clinical practice that offer new hope for patients suffering from the condition these products are intended to treat. Of the 102 new drug applications approved last calendar year, 30 of those were for new molecular entities. Three of these medications - Dificid, Arcapta Neohaler, and Viibyrd - are featured in this article. To reinforce Herper's statement in his article in Forbes magazine, the FDA states in its FY 2011 Innovative Drug Approvals report, In Fiscal Year 2011 FDA approved 35 innovative drugs that offered important advances in treatment for hepatitis C, late-stage prostate cancer, lupus, drug resistant skin infections, pneumonia, and other serious and life-threatening diseases. This is among the highest number of approvals in the past decade, surpassed only by 2009 (37). 	  		  		 	  		Although the medications presented here may not yet be commercially available, it is necessary for the pharmacist and pharmacy technician to understand how each of these drugs works in the treatment of the diseases and disorders for which they were developed in order to be prepared for their upcoming arrival on pharmacy shelves. 	  		  		 	  		Juvisync(sitagliptin and simvastatin) oral tablets are indicated for the treatment of diabetes mellitus (DM) type 2. The medication improves both glycemic control and cholesterol levels in patients with diabetes and hyperlipidemia when used in conjunction with diet and exercise. It is a combination of two drugs: sitagliptin, (Januvia) and simvastatin (Zocor). Sitagliptin inhibits DPP-4, an enzyme that rapidly inactivates incretin hormones. As a result, concentrations of active intact incretin hormones are increased and physiologic regulation of glucose homeostasis improved. Simvastatin is a prodrug, meaning that it is administered in an inactive or less active state and is metabolized into an active state in the body. After administration, simvastatin is hydrolyzed to simvastatin acid, which inhibits HMG-CoA reductase, an enzyme involved in the biosynthetic pathway for cholesterol. Simvastatin thus reduces low-density lipoprotein (LDL or bad cholesterol) and raises high-density lipoprotein (HDL or good cholesterol). 	  		  		 	  		Juvisync is not indicated for the treatment of DM type 1 and its use has not been studied in children under the age of 18. It is contraindicated with itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, and telithromycin (collectively termed strong CYP3A4 inhibitors) and gemfibrozil, cyclosporine, and danazol. The medication is initially dosed at 100mg/40mg per day taken as a single dose in the evening. The tablets should not be split, crushed, or chewed before swallowing. Lipid levels should be analyzed four weeks after beginning the medication and dosage changes made as necessary. Common side effects include upper respiratory infection, headache, nausea, and abdominal pain. 	  		  		 	  		Juvisync is manufactured by Merck of Whitehouse Station, N.J., and was approved in October 2011. It is available in three strengths: 100mg/10mg, 100mg/20mg, and 100mg/40mg. The tablets are pink-beige (100mg/10mg and 100mg/20mg strengths) or orange-beige (100mg/40mg strength), biconvex modified capsule shaped, and film-coated, coded with the Merck logo. The medication is packaged in bottles of 30, 90, or 1000 tablets and should be stored at room temperature in a dry place with the cap tightly closed. 	  		  		 	  		Dificid(fidaxomicin) oral tablets are indicated for the treatment of Clostridium difficile-associated diarrhea. Clostridium difficile, or informally C. diff, is a gram-positive bacterium that inhabits the intestinal tract and causes severe diarrhea. Growth of the bacteria typically occurs in patients who have taken antibiotics that disrupt the balance of gut flora, but can also occur in patients who have been exposed to the bacteria during hospitalization or admission to a care facility such as a nursing home. A stool culture is obtained to test for the presence of C. difficile before a formal diagnosis is made. Fidaxomicin is a macrolide antibacterial drug that works against C. difficile by inhibiting RNA synthesis by RNA polymerases. 	  		  		 	  		Dificid should not be used to treat systemic infections. As the prescribing information states, To reduce the development of drug resistant bacteria and maintain the effectiveness of Dificid and other antibacterial drugs, Dificid should be used only to treat infections that are proven or strongly suspected to be caused by Clostridium difficile. There are no contraindications to the use of this drug. The medication is dosed at 200mg twice daily for 10 days with or without food. Common side effects include nausea, vomiting, and abdominal pain. 	  		  		 	  		Approved in May 2011, Dificid is manufactured by Optimer Pharmaceuticals of San Diego, Calif. It is available in 200mg tablets, packaged in bottles of 20 or 60, and also as a 10-tablet aluminum blister card. The tablets are white to off-white, film-coated, and oblong, with FDX on one side and 200 on the other. They should be stored at room temperature. 	  		  		 	  		Duexis(ibuprofen and famotidine) oral tablets are indicated for the relief of rheumatoid arthritis and osteoarthritis and the reduction of risk for developing upper gastrointestinal ulcers. The medication is a combination of ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), and famotidine (Pepcid), a medication that treats gastric ulcers and gastroesophageal reflux disease, or GERD. The drug is formulated in such a way that the famotidine component reduces stomach acidity during the peak time of risk for ulceration while the ibuprofen component relieves pain. Ibuprofen is an analgesic and antipyretic (fever-reducing) medication whose mechanism of action as an NSAID is not completely understood, but thought to be related to the inhibition of prostaglandin synthetase, an enzyme involved in sensitization during pain response. Famotidine is a competitive inhibitor of histamine H2-receptors and, as such, reduces gastric secretion and stomach acidity. 	  		  		 	  		Duexis should not be used in patients with a known sensitivity to ibuprofen or famotidine, nor should it be used by patients in the perioperative period of coronary artery bypass graft (CABG) surgery or pregnant women beyond 30-weeks gestation. The drug interacts with warfarin-type anticoagulants and aspirin, as taking these medications with ibuprofen increase the risk of adverse reactions such as gastrointestinal bleeding. It also interacts with ACE-inhibitors, diuretics, and lithium. The recommended daily dose of Duexis is 800mg/26.6mg three times daily. The tablets should be swallowed whole, not chewed, divided, or crushed. Common side effects include diarrhea, constipation, upper abdominal pain, and headache. 	  		  		 	  		Duexis, approved in April 2011, is manufactured by Horizon Pharma of Northbrook, Ill. The drug is available in one strength, 800mg/26.6mg, and comes in a bottle of 90 tablets that should be stored at room temperature. The tablets are light blue, oval, and biconvex with HZT on one side. 	  		  		 	  		Arcapta(indacaterol maleate) inhalation powder is indicated for the treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. Indacaterol maleate is a long-acting beta2-adrenergic agonist (LABA) and acts locally as a bronchodilator. LABA drugs stimulate intracellular adenyl cyclase, an enzyme involved in the conversion of adenosine triphosphate (ATP) to cyclic monophosphate (AMP), thereby causing relaxation of bronchial smooth muscle. 	  		  		 	  		Like all LABA drugs, Arcapta is contraindicated in patients with asthma who are not on long-term asthma control medications. The medication is not indicated for the treatment of asthma, nor is it indicated for acute deteriorations of COPD. When used concurrently with other LABA drugs, indacaterol can produce cardiovascular effects in some patients, such as increases in pulse rate and blood pressure. Because of increased risk for adverse cardiac events, LABA drugs should be used with extreme caution in patients taking monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, or other medications known to prolong the QTc interval as measured on electrocardiogram tracings due to increased risk of ventricular arrhythmias. Indacaterol and beta-blockers also interact, as beta-blockers block the therapeutic effects of beta-agonists and should only be administered in emergent situations. The recommended dose is a 75mcg capsule inhaled via the Arcapta Neohaler once daily at the same time each day. It should not be used more than once in a 24-hour period. Common side effects include cough, oropharyngeal pain (sore throat), nasopharyngitis (common cold), headache, and nausea. 	  		  		 	  		Arcapta is manufactured by Novartis of Stein, Switzerland, and was approved in July 2011. It is available in one strength, 75mcg, and packaged as capsules in aluminum blister cards with a Neohaler inhaler and an FDA-approved medication guide. Capsules should be removed from the aluminum only immediately before use and a new Neohaler inhaler should be obtained with each prescription refill. The physician and pharmacist should be careful to counsel the patient on the appropriate use of the inhaler. The blister cards come in a box of 30 (five blister cards containing six capsules each) and should be stored at room temperature, protected from light and moisture. 	  		  		 	  		Complera(emtricitabine/rilpivirine/tenofovir disoproxil fumarate) oral tablets are indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) in treatment-nave adults. According to AVERT, an international HIV/AIDS advocacy group based in the UK: There are two types of HIV: HIV-1 and HIV-2. Both types are transmitted by sexual contact, through blood, and from mother to child, and they appear to cause clinically indistinguishable AIDS. However, it seems that HIV-2 is less easily transmitted, and the period between initial infection and illness is longer in the case of HIV-2. Worldwide, the predominant virus is HIV-1, and generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere. The medication is a combination of two nucleoside analog HIV-1 reverse transcriptase inhibitors (emtricitabine [Emtriva] and tenofovir disoproxil fumarate [Viread]) and a non-nucleoside reverse transcriptase inhibitor (rilpivirine [Edurant]). As an antiretroviral drug, emtricitabine/rilpivirine/tenofovir disoproxil fumarate inhibits HIV-1 reverse transcriptase and thus slows the replication of the virus in the body. 	  		  		 	  		Complera is a complete regimen for HIV treatment and thus should not be used with other antiretroviral drugs for the treatment of HIV-1 infection. The prescribing information notes, There were no drug-drug interaction trials conducted with the fixed-dose combination tablet. Drug interaction studies were conducted with emtricitabine, rilpivirine, or tenofovir DF, the components of Complera. Drug interactions include rilpivirine and drugs that induce or inhibit CYP3A4. Rilpivirine also interacts with antacids that increase gastric pH (from acidic to basic conditions), such as aluminum, magnesium hydroxide, and calcium carbonate, as these may cause significant decreases in rilpivirine plasma concentrations and could potentially result in resistance to rilpivirine. Antacids should only be administered at least two hours before or four hours after Complera. The recommended dose of the medication is one tablet (containing 200mg of emtricitabine, 25mg of rilpivirine, and 300mg of tenofovir disoproxil fumarate) taken once daily with a meal. Common side effects include insomnia, headache, fatigue, nausea, and diarrhea. 	  		  		 	  		Approved in August 2011, Complera is manufactured by Gilead Sciences of Foster City, Calif. The drug is available in one strength, a combination of 200mg of emtricitabine, 25mg of rilpivirine, and 300mg of tenofovir disoproxil fumarate, and packaged in bottles of 30 tablets that should be stored at room temperature. The tablets are purplish-pink, capsule-shaped, and film-coated, with GSI on one side. 	  		  		 	  		Viibryd(vilazodone hydrochloride) oral tablets are indicated for the treatment of major depressive disorder. Vilazodone is a selective serotonin reuptake inhibitor (SSRI) and a 5HT1A receptor partial agonist. The prescribing information states, The mechanism of the antidepressant effect of vilazodone is not fully understood but is thought to be related to its enhancement of serotonergic activity in the CNS through selective inhibition of serotonin reuptake. Vilazodone is also a partial agonist at serotonergic 5-HT1A receptors; however, the net result of this action on serotonergic transmission and its role in vilazodone's antidepressant effect are unknown. Despite this, the efficacy of vilazodone was established in two eight-week, double-blind, placebo-controlled studies in adults with major depressive disorder as measured by the Montgomery-Asberg Depression Rating Scale (MADRS). 	  		  		 	  		Viibryd carries with it a black box warning regarding the increased risk of suicidal thinking and behavior in children, adolescents, and young adults (ages 18-24) taking antidepressants for major depressive disorder and other psychiatric disorders. Studies have not shown an increase in the risk of suicidality with the use of antidepressants in adults beyond age 24. Viibryd is not approved for use in patients under the age of 18. It must not be administered concomitantly with MAOIs as serious, sometimes fatal drug interactions can occur. MAOI use should be ceased at least 14 days prior to starting Viibryd. Individuals being treated with antidepressants should be monitored closely by a mental health professional, who can assess the efficacy of the prescribed dose and medication. The recommended daily dose of Viibryd is 40mg once daily with food. The medication should be gradually titrated to the 40mg dose, starting with 10mg once daily for seven days, followed by 20mg once daily for seven days, then 40mg once daily thereafter. Common side effects include diarrhea, nausea, vomiting, and insomnia. 	  		  		 	  		Viibryd, approved in January 2011, is manufactured by Forest Laboratories of St. Louis, Mo. It is available in 10mg, 20mg, and 40mg strengths. The medication is packaged in 30-count bottles or, alternatively, in a patient starter kit as a blister card containing 30 tablets (7-10mg, 7-20mg, and 16-40mg). The tablets are oval in shape and pink (10mg), orange (20mg), or blue (40mg) in color and should be stored at room temperature. 	  		  		 	  		Lazanda(fentanyl) nasal spray is indicated for the management of breakthrough pain in patients with cancer who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. The prescribing information defines opioid tolerant individuals as those patients who are taking at least: 60mg of oral morphine/day, 25mcg of transdermal fentanyl/hour, 30mg oral oxycodone/day, 8mg oral hydromorphone/day, 25mg oral oxymorphone/day, or an equianalgesic dose of another opioid for a week or longer. Administration of Lazanda is contraindicated in patients who are not already opioid-tolerant, as respiratory depression and death can result. The medication is to be used for breakthrough pain only and is not appropriate for use in acute or postoperative pain. Fentanyl, a Schedule II controlled substance, is a pure opioid agonist that primarily acts as an analgesic. Lazanda is supplied only through the Lazanda REMS program, which requires health care providers, patients, pharmacies, and distributors to enroll in the program in order to prescribe, receive, dispense, and distribute the medication, respectively. 	  		  		 	  		The nasal spray should not be used as a substitute for other fentanyl products, as a fatal overdose may occur. Bottles of the medication contain fentanyl in a dose that can be fatal to a child, so care should be taken when storing and disposing these bottles. As with Complera, Lazanda adversely interacts with drugs that induce or inhibit CYP3A4. Concomitant use with CYP3A4 inhibitors (such as itraconazole, ketoconazole, clarithromycin, and erythromycin) can cause potentially dangerous increases in fentanyl plasma concentrations, while use with CYP3A4 inducers (such as barbiturates, carbamazepine, phenobarbital, or phenytoin) can cause decreases in fentanyl plasma concentrations. The initial dose of Lazanda for all patients is 100mcg as a single spray into one nostril. This dose may be titrated up from 100mcg to 200mcg, 400mcg, or a maxium of 800mcg depending on the patient's analgesic needs. No more than four doses should be taken in a 24-hour period. Common side effects during the titration phase include nausea, vomiting, and dizziness. During the maintenance phase, these side effects include vomiting, nausea, fever, and constipation. 	  		  		 	  		Lazanda is manufactured by Archimedes Pharma of Bedminster, N.J., and was approved in June 2011. It is available in two strengths: 100mcg (yellow label) and 400mcg (violet label). The medication is supplied in a clear glass bottle with an attached metered-dose nasal spray pump that delivers a total of eight sprays after priming. The pump has a visual spray counter and comes in a child-resistant container and should be stored at room temperature. To dispose of any leftover medication, the patient should empty the remaining sprays into a disposable pouch according to the instructions provided on the FDA-approved medication guide. 	  		  		 	  		The seven drugs presented within this article are representative of the new medications receiving FDA-approval in the year 2011 in the areas of endocrinology, gastroenterology, rheumatology, pulmonology, infectious diseases, psychiatry, and oncology. The Center for Drug Evaluation and Research (CDER) of the FDA maintains updated online resources regarding newly approved drugs. As with all medication regimens, the strength, dosage, and administration should be under the direct supervision of a physician with the support of the pharmacist and pharmacy technician. Together with the physician, pharmacist, and patient, the pharmacy technician plays an essential role in the successful administration of medications. With an increased understanding of newly approved drugs in the year 2011, the pharmacy technician will be better able to support the patient to ensure that therapy is consistent and effective. 	  		  		 	  		Conclusion 	  		Together with the physician, pharmacist, and patient, the pharmacy technician plays an essential role in the successful administration of medications. With an increased understanding of newly approved drugs in the year 2011, the pharmacy technician will be better able to support the patient to ensure that therapy is consistent and effective. 	  		  		 	  		References 	  		1. AVERT. HIV Types, Subtypes, Groups and Strains. 25 Jan. 2012. 	  		  		 	  		2. Arcapta Prescribing Information. July 2011. Novartis Pharmaceuticals Corporation. 25 Jan. 2012. . 	  		  		 	  		3. CenterWatch. FDA-Approved Drugs 2011. 25 Jan. 2012. 	  		  		 	  		4. Complera Prescribing Information. Aug. 2011. Gilead Sciences. 25 Jan. 2012. . 	  		  		 	  		5. Dificid Prescribing Information. May 2011. Optimer Pharmaceuticals, Inc. 25 Jan. 2012. . 	  		  		 	  		6. Duexis Prescribing Information. April 2011. Horizon Pharma USA, Inc. 25 Jan. 2012. . 	  		  		 	  		7. Herper, Matthew. The Truth About 2011's New Drug Approvals. Forbes Magazine. 18 Jul. 2011. . 	  		  		 	  		8. Lazanda Prescribing Information. June 2011. Archimedes Pharma US, Inc. 25 Jan. 2012. . 	  		  		 	  		9. Juvisync Prescribing Information. Oct. 2011. Merck &#0038; Co., Inc. 25 Jan. 2012. . 	  		  		 	  		10. U.S. Food and Drug Administration. CYP3A Inhibitor List. 25 Jan. 2012. . 	  		  		 	  		11. U.S. Food and Drug Administration. FY 2011 Innovative Drug Approvals Report. 25 Jan. 2012. . 	  		  		 	  		12. Viibryd Prescribing Information. Jan. 2011. Forest Laboratories, Inc. 25 Jan. 2012. . 	  		  		 	  		Author Biography 	  		Dominic P. Decker is completing a Master of Science degree in Narrative Medicine at Columbia University and will be a first year medical student next year at The George Washington University School of Medicine and Health Sciences. He has six years of experience working as a certified pharmacy technician in community pharmacy settings and has authored numerous articles for Today's Technician with a special interest in the interstices between communication, pharmacy, and medical practice. 	  		  		 	  		Idea in Brief 	  		The year 2011 was prolific for drug research, development, and output. As of December 31, the FDA had approved 102 new drug applications (NDAs), 30 of which were for new molecular entities. The medications presented here are a sampling of these approvals, including seven new drugs in the areas of endocrinology, gastroenterology, rheumatology, pulmonology, infectious diseases, psychiatry, and oncology. 	  		  		 	  		Idea in Practice 	  		Together with the physician, pharmacist, and patient, the pharmacy technician plays an essential role in the successful administration of medications. With an increased understanding of newly approved drugs in the year 2011, the pharmacy technician will be better able to support the patient to ensure that therapy is consistent and effective. 	  		  		 	  		Table 1: FDA New Drug Approvals for 2011 	  		This report lists all applications approved for the first time during the year 2011. It includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. 	  		  		 	  		Source: FDA http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Reports.ReportsMenu 	  		  		 	  		 	  		  	  		 	  		  	  		 	  		  	  		 	  		 	  		  <br>
]]></description>
<dc:subject>Course</dc:subject>
<dc:date>2012-02-21T14:00:00Z</dc:date>
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<item>
<title>Medication Errors Update- How Can the Pharmacy Technician Help</title>
<category>Courses</category>
<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=364</link>
<description><![CDATA[Instructor: Joseph Tinervia, CPhT, MBA<br><br>

  	  	   	Introduction   	The topic of medication errors has been at the forefront of discussions throughout the medical industry for as long as can be remembered. The Institute of Medicine (IOM) has directed much attention to medication errors in the hopes that basic education can help reduce increasing error rates. The 1848 Code of Ethics of the Philadelphia College of Pharmacy identified four specific reasons for errors, such as illegible handwriting on prescriptions, from which many errors to occur.1 These still exist some 163 years later. The four reasons were;   	  	   	1. Poor handwriting of prescribing physicians.   	  	   	2. Improper and mistaken use of medical and pharmaceutical abbreviations and selection of wrong drugs with various synonyms.   	  	   	3. Poor conditions of the environment making it easy to lose concentration while dispensing and selecting the medications correctly.   	  	   	4. Poor training of pharmacy staff and lack of follow through by the pharmacist in the dispensing process.   	  	   	The subject of medication errors has received more national attention recently than any other time. Thanks to attention drawn to the subject by the public, government, and health care providers, the goal is to reduce the potentials of medication errors drastically with proper education and training. Pharmacists have a long history of conducting research on medication errors, starting 40 years ago (1971) with a study that demonstrated errors are a much bigger problem than anyone realized. Barker and McConnell compared the effectiveness of incident reports and voluntary reports to direct observation of nurses as error detection methods.2   	  	   	Thirty-six errors were documented by incident reports during the year studied. By comparison, two weeks worth of data collected by direct observation when extrapolated over the same one year period indicated that 51,200 errors may have occurred (including 600 wrong time errors). This figure is 1,422 times the number identified by incident reports. Other studies have confirmed the difference between the two methods.2, 3, 4, 5, 6, 7 Medication administration errors were used by researchers studying the quality of the output of drug distribution systems back in the 1960s when the unit dose drug distribution system was being developed.8 Such errors are recognized as an important indicator of quality of drug therapy from the patient's perspective. Research on the effect of automated drug dispensing devices on errors has been performed,9 showing that errors have not been eliminated by technology.   	  	   	The history of the definitions and terminology used when discussing medication errors is important to be aware of when evaluating the literature. Errors of omission and errors of commission were used in one study.10 Drug misadventure is a broad label applied to adverse drug reactions, prescribing errors, and medication errors.11, 12 Adverse drug events are defined as an injury from a drug-related intervention, which can include prescribing errors, dispensing errors and medication administration errors; this term has been used in the medical literature in particular.13   	  	   	The National Coordinating Council for Medication Error and Prevention (NCCMEP) defines a medication error as any preventable event that may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems including: prescribing, order communication, product labeling, packaging and nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use.14   	  	   	The research-based definition of a medication administration error is any deviation from the prescriber's written order, or as entered into a computer system by the prescriber.8  Medication errors are typically viewed as being related to drug administration while dispensing errors refer to mistakes made by staff in the pharmacy when distributing medications to nursing units or directly to patients in an ambulatory, or outpatient, pharmacy setting. Medication error has been defined to include errors in the process of ordering or delivering a medication,14 whereas errors by the ordering prescriber have typically been labeled prescribing errors. Error category definitions that have been tested in research studies are described here. Categories may not be mutually exclusive; therefore, the reader is cautioned that rates for different error types can't always be simply added to obtain an overall error rate. An unordered or unauthorized drug error is defined as administration of a dose of medication that was never ordered for that patient. Some researchers refer to this type of error as a wrong drug error. An extra dose error is counted if a dose is given in excess of the total number of times ordered by the physician, such as a dose given on the basis of an expired order, after a drug has been discontinued, or after a drug has been put on hold. If a patient fails to receive a dose of medication that was ordered, an omission error is noted if no attempt was made to administer the dose. Reasons for the omission should be sought, such as doses withheld according to policy, (e.g., nothing by mouth before surgery). A wrong dose error occurs when any dose is given that contains the wrong number of preformed dosage units (such as tablets) or was, in the judgment of the observer, more than 17% greater or less than the correct dosage. Some researchers use a narrower definition of wrong dose errors for injectable doses that are measured by the nurse - any dose that is more than 10% different from the correct dosage administration would be in error.1, 15, 16, 17, 18 Wrong dose errors are counted for ointments, topical solutions, and similar medications only when the dose was quantitatively specified by the physician (e.g., in inches of ointment).2 Wrong route errors are typically defined as those situations where a medication is administered to the patient using a different route than was ordered, an example of which would be the oral administration of a drug ordered for intramuscular use. Also included in this category are doses given in the wrong site, such as the left eye instead of the right eye. Wrong time errors are typically defined as the administration of a dose more than 30 minutes (or 60 minutes depending on the site) before or after the scheduled administration time, unless there is an acceptable reason for this time difference. Acceptable reasons include situations where the physician has ordered that the patient not consume anything by mouth (NPO), or when the patient is off the floor at a diagnostic test or in surgery. The hospital's standardized dose administration schedule should be used to determine the time at which a regularly scheduled dose should be given. The schedule programmed into the pharmacy's computer system can be used to define correct administration times, but input from the nurse and patient preference should be accommodated. A wrong dosage form error involves the administration of a dose form different from that ordered by the physician, provided the physician specified or implied a particular form. If an extended release tablet is crushed, a wrong dosage form error is counted, it is likely that the timing of the release of the drug has been destroyed. A number of techniques have been used to study medication errors. The following are twelve examples of error detection methods that have been used in research:   	  	   	1. Direct observation 19   	  	   	2. Chart review 20, 21   	  	   	3. Incident reports involving medication errors 22   	  	   	4. Stimulated self-report using interview 15, 16   	  	   	5. Attending medical rounds to listen for clues that an error has occurred 23   	  	   	6. Doses returned to pharmacy 24   	  	   	7. Urine testing as evidence of omitted drugs and unauthorized drug administration 25   	  	   	8. Examination of death certificates 26   	  	   	9. Attend nurse change of shift report 27   	  	   	10. Medication administration record (MAR) comparison to physician orders 28   	  	   	11. Computerized analysis to identify patients receiving target or tracer drugs that may be used to treat a medication error   	  	   	12. Comparison of drugs removed from an automated drug dispensing device for a patient to physician orders 29   	  	   	The Institute of Medicine (IOM) has also focused on the identification of a common medication error of illegible handwriting. It firmly believes that with the use of e-prescribing (eRx) a great number of errors can be eliminated. Addressing the issue of handwriting from a federal perspective, legislation known as the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes new and separate incentive program for eligible professionals who are electronic prescribers. The Electronic Prescribing (eRx) Incentive Program went into effect on January 1, 2009. Electronic prescribers could earn a 2% incentive payment during 2010. Paying physicians to prescribe electronically on their Medicare Part B claims may encourage them to also prescribe and transmit non-Medicare prescriptions electronically, which should overall reduce a great number of potential medication errors due to handwriting mistakes.39 E-prescribing participation is now on a voluntary basis, but with a penalty in 2012 for prescribers who do not e-prescribe for Medicare and Medicaid patients.   	  	   	The IOM also found that errors can occur through use of abbreviations and believes that most abbreviations should be avoided. Certain abbreviations are misinterpreted today as easily as they were 150 years ago. The Institute for Safe Medication Practices (ISMP) has identified many easily misinterpreted abbreviations which are directly linked to patient harm. These can be viewed on the ISMP website www.ismp.org, which will be discussed further in this article.40   	  	   	Another agency, the Food and Drug Administration (FDA) receives medication error reports on marketed human drugs (including prescription drugs, generic drugs, and over-the-counter drugs) and non-vaccine biological products and devices. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing, order communication, product labeling, packaging, and nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use.   	  	   	In 1992, the FDA began monitoring medication error reports that are forwarded to FDA from the United States Pharmacopeia (USP) and ISMP. The Agency also reviews MedWatch reports for possible medication errors. Currently, medication errors are reported to the FDA as manufacturer reports (adverse drug events resulting in serious injury and for which a medication error may be a component), direct contact reports (MedWatch), or reports from USP or ISMP. The Division of Medication Errors and Technical Support includes a medication error prevention program staffed with pharmacists and support personnel. Among their many duties, program staff review medication error reports sent to the USP Medication Errors Reporting Program (MERP) and MedWatch, evaluate causality, and analyze the data to provide feedback to others at FDA.   	  	   	Campaign to Eliminate Use of Error-Prone Abbreviations   	The FDA and ISMP have launched national education campaigns to eliminate the use of ambiguous medical abbreviations that are frequently misinterpreted and lead to mistakes that result in patient harm. The campaign seeks to promote safe practices among those who communicate medical information. As part of the campaign, FDA recommends that health care professionals consider ISMP's List of Error-Prone Abbreviations, Symbols, and Dose Designations http://www.ismp.org/tools/errorproneabbreviations.pdf and the confusing drug similarities listing http://www.ismp.org/Tools/confuseddrugnames.pdf whenever medical information is communicated. In addition, FDA and ISMP have provided a toolkit of resource materials available at ISMP and FDA website locations to avoid the look-alike, sounds-alike (LASA) drug names by using tall man (mixed case) letters to help draw attention to the dissimilarities in their names. Several studies have shown that highlighting sections of drug names using tall man letters can help distinguish similar drug names, making them less prone to mix-ups. High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error.40 Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly more devastating to patients. Strategies for avoiding errors include improving access to information about these drugs, limiting access to high-alert medications, using auxiliary labels and automated alerts, standardizing the ordering, storage, preparation, and administration of these products, and employing redundancies such as automated or independent double checks when necessary. (Note: manual independent double-checks are not always the optimal error-reduction strategies and may not be practical for all of the medications on the list). The ISMP, FDA, Joint Commission and other safety-conscious pharmaceutical organizations have promoted the use of tall man letters as one means of reducing confusion between similar drug names. http://www.ismp.org/Tools/tallmanletters.pdf The ISMP also has published a High Alert Medications http://www.ismp.org/Tools/highalertmedications.pdf. This listing is a very valued piece of reference literature that can be used to alert pharmacy staff that errors can be made quite easily with these medications. The above three listings can become part of any pharmacy routine in identifying possible medication errors or potential problems.39   	  	   	The American Hospital Association lists the following as some common types of medication errors: 42   	  	   	 incomplete patient information (not knowing about patients&#39; allergies, other medicines they are taking, previous diagnoses, and lab results)   	  	   	 unavailable drug information (such as lack of up-to-date warnings)   	  	   	 miscommunication of drug orders, which can involve poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviation.   	  	   	 lack of appropriate labeling as a drug is prepared and repackaged into smaller units.   	  	   	 environmental factors, such as lighting, heat, noise, and interruptions, which can distract pharmacy staff and health care professionals from their dispensing and administering tasks.49   	  	   	Medication Error Test Results   	Data were collected in the 50 pharmacies that agreed to participate over a 10-month period between July 2000 and April 2001.43 Corporate executives from one chain pharmacy declined to participate. Among the chains that accepted, 12 individual pharmacies declined participation in the study. Sixty independent or health-system pharmacies declined the invitation to participate as one of the 30 observation sites available for these types of pharmacies. An additional 30 randomly selected independent and health-system pharmacies were excluded because they were no longer in operation or did not have a prescription filling operation (for example, a hospital might not have had an outpatient pharmacy).   	  	   	Of the observed prescriptions, 52% (2,335) were filled in 26 chain pharmacies, 31% (1,370) were filled in 15 independent pharmacies, and 17% (776) were filled in nine health-system pharmacies. Observers were not able to interpret one prescription of the 1,962 new prescriptions evaluated (0.05%). This prescription was excluded from the study, making the total new prescriptions equal to 1,961. This is comparable with a previously identified uninterpretable rate in a hospital and nursing home study of 0.2%.13   	  	   	Accuracy Rates and Error Types   	The overall dispensing accuracy rate was 98.3% (77 errors among 4,481 prescriptions; range, 87.2%-100%; 95% confidence interval, &#177; 0.4%). Accuracy rates for all 50 pharmacies are displayed in Table 1, a summary of accuracy rates by pharmacy type and prescription type. There was no significant difference in accuracy rates between the pharmacy types (F 2,47 = 0.259, P = .773). Uncategorized prescriptions were not identified as new or refill by the observer. This information was either not determinable during the observation or not collected by the observer (due to the fast pace of some operations, for example). The accuracy rates for uncategorized prescriptions were 99.6% (840 correct out of 843 prescriptions). Accuracy rates for all pharmacies combined in each of the six cities are displayed in Table 2 (no significant differences detected; F (5,44) = 0.801, P = .555). The dispensing accuracy rate for new prescriptions was 96.8%, or 63 of 1,961 (all characteristics of the filled prescription were checked).   	  	   	Potential Sources of Error   	During the study, 74 process deviations were recorded. Examples of the deviations are shown in Table 5 . Note that all process deviations were corrected and may or may not have resulted in negative outcomes or errors. One instance involved a pharmacist who, working alone because the technician scheduled for that work period was ill, retrieved rofecoxib (Vioxx -- Merck) and tamoxifen, counted rofecoxib, was interrupted by a telephone call, returned to the counter and saw the label for the rofecoxib on top, and counted another vial of rofecoxib. The first rofecoxib vial was labeled with the rofecoxib label, while the second was labeled with the tamoxifen label. The pharmacist caught the error during inspection by opening each vial and comparing the contents to what the label said should be in the vial.   	  	   	Error-Prevention Techniques and Technology Loopholes   	A list of 20 error prevention techniques used in one or more of the participating pharmacies is provided below. Observers recorded information about some of the methods indicating that the systems were not always effective. For example, the prescription check-off system -- in which seven label characteristics are compared with the original prescription -- failed to catch a wrong label instruction (label read three times daily instead of four times daily). A loophole in a bar code checking system was described by an observer at one of these sites as follows: When a clerk scanned the receipt&#39;s bar code at the cash register in preparation to dispense a prescription, an error message told the clerk that a pharmacist had not yet verified the prescription; the clerk took the bag and receipt to the pharmacist verification area, scanned the bar code on the receipt and then entered the National Drug Code number for the drug from the receipt (instead of the drug stock bottle used to fill the prescription), thus bypassing the safety system.   	  	   	 Work procedures enhancing organization, simplification   	  	   	 Work on one patient&#39;s prescriptions at a time, and keep the prescriptions in a bin to separate from other patients&#39; prescriptions   	  	   	 Return drug stock bottles to shelves immediately after filling the prescription to avoid overcrowding on work counter   	  	   	 Use a bin system for drug stock bottle up above filling counter: one bin for drug stock bottles to be filled, second bin for those in process, then put in third bin after filling   	  	   	 Circle number of tablets in a bottle if different from 100 to avoid dispensing incorrect quantity   	  	   	 Manage interruptions -- tell patient, I&#39;ll be right with you -- and then finish work before helping patient   	  	   	 Put drug stock bottle on counter upside down after filling to prevent mix-ups   	  	   	 Inspection processes   	  	   	 Smell check for oral liquid products and some oral solid tablets   	  	   	 Counseling: show and tell, review filled prescription with patient   	  	   	 Bar code double-check of drug product using the NDC on the drug stock bottle compared with label (should avoid entering drug in computer using drug stock bottle; select from list instead to realize benefit of bar code checking system)   	  	   	 Write middle NDC numbers on back of prescription, then compare with NDC printed on label   	  	   	 Circle middle NDC numbers on labels   	  	   	 Seven-check system: compare seven items on new prescriptions with what is printed on vial label -- patient name, drug name, strength, instructions, quantity, number of refills, prescriber name -- and check off each item after checking   	  	   	 Have magnifying glass available to inspect tablet/capsule identification codes that are very small (e.g., lorazepam tablets)   	  	   	 Double-check drug product by reviewing tablet/capsule identification code and comparing  with drug in stock bottle or with computer system photograph   	Table 1. Accuracy Rates by Pharmacy and Prescription Type   	   	 Try to have two different staff members check prescription   	  	   	 Use yellow or pink highlighting of drug name, drug strength, and patient name on pre-printed prescription vial labels   	  	   	 Facility design, work environment   	  	   	 Additional lighting over filling and inspection areas   	  	   	 Anti-fatigue floor mats, chairs available   	  	   	 Modification of drug container   	  	   	 Magic marker highlighting on drug bottle labels or caps to indicate unusual strengths or brand-name equivalents   	  	   	 Memory aid   	  	   	 Take label to shelf to get drug -- this serves as a memory and efficiency aid.   	  	   	Observer Evaluation   	Was there an effect of the observer on the pharmacy staff? A test for related measures found no significant difference between the error rates for prescriptions filled (or refilled) on the observation day and will call prescriptions filled before the study day (t = 0.252, df = 27, P = .803) when no observer was present. Fourteen errors were detected on 1,299 will call prescriptions checked at 28 study pharmacies by 2 observers. Content errors (drug and strength) were compared for the two groups of prescriptions (wrong label information and wrong label instruction errors were excluded from this analysis because the accuracy of the label was not evaluated for will call prescriptions).43   	  	   	The ability of observers to collect adequate data was also evaluated. Observers missed or did not record adequate data to evaluate the accuracy of 5 of 5,790 (0.1%) filled prescriptions reviewed. This is in addition to the one prescription that was deemed non-interpretable.   	  	   	There was no significant difference among the accuracy rates detected by the three pharmacist researchers (F 2,47 = 1.108, P = .339). One pharmacist observed in 42 pharmacies, while the other two pharmacists completed observations in 4 pharmacies each.   	  	   	Discussion   	Four errors occur each day in pharmacies filling 250 prescriptions per day. This finding is comparable with results of some previous observational studies that used comparable error definitions,4-6 but lower than others that identified error rates of 6% and 10%.3,7 We believe that the two pharmacies involved in the 6% and 10% error rate studies may have had higher error rates because they were conducting research as a result of suspected error problems.   	  	   	The finding that there was not a significant difference in accuracy rates between cities may indicate that our results are representative of a national dispensing accuracy rate and can be generalized to pharmacies willing to participate in such studies.   	  	   	Wrong label information and instructions were the most common types of errors. Importantly, this indicates that errors in the computer order entry process used to create the label occur most frequently. These types of errors must not be ignored by pharmacists who might tend to focus on the less frequent, but often more dangerous, wrong drug errors (the target of bar code checking).   	  	   	The inspection is the weakest part of the prescription fulfillment process. Efforts to improve accuracy should focus on helping pharmacists perform inspections more accurately. The ability to keep the original prescription (or an electronic representation of it) with the product and label throughout the filling process is important; one study used the original prescription during the counseling and double-check processes and found that this helped detect errors.45 Lighting levels of 146 foot candles,4 elimination or minimization of interruptions and distractions,46 and addressing noise issues47 can also help improve pharmacists&#39; inspection accuracy.   	Table 2. Accuracy Rate by City  	   	  	   	  	   	  	   	Implications for Practice   	The typical pharmacist fills about 13,000 prescriptions annually according to Consumer Reports.48 Assuming a 40-hour work week with time off for vacations and holidays and 220 workdays during which those 13,000 prescriptions are filled, pharmacists have a workload of about 60 prescriptions per day. Hypothetically, if those 60 prescriptions are all new, the error rate detected in this study for new prescriptions (3.2%) suggests that, every day, the typical pharmacist fills two new prescriptions incorrectly, in one or more ways. These two daily errors most often involve giving the wrong instructions for use but may also include dispensing the wrong drug, wrong strength, or wrong quantity (such that the patient may run out of medication or have extra doses).   	  	   	To the patient, this means that the chances of receiving an incorrectly filled new prescription are about 1 in 30. The chances are 1 in 1,000 that a patient will receive a prescription with a potentially clinically important error. Grasha estimate[s] that for every 1 million prescriptions filled, only about 30 will contain a clinically significant mistake that goes unnoticed by the pharmacist or patient (1 in 33,000 ratio). 48 However, the method of error detection used by Grasha in his research, which was cited in Consumer Reports, was not clear. The errors detected in our study using direct observation indicate that 1,115 potentially important errors occur in every 1 million prescriptions, producing an estimate of 3.3 million potentially important errors among the 3 billion prescriptions filled annually in the United States.10   	Table 3. Examples of Errors Detected for Selected Error Types  	   	  	   	  	   	Clinically important errors were defined as those having the potential to lead to patient harm or discomfort. True clinical importance on a case-by-case basis has never been studied because it is so difficult to evaluate -- follow-up by a medical team would be needed for each ambulatory patient for the initial fill and all refills of each prescription or medication order. A central problem is that safe therapy for one patient may be dangerous for another, depending upon the patient&#39;s illness and physical condition. We believe that all prescriptions -- and, therefore, all problems -- should be considered to be clinically important because the medications were important enough for the physician to order and for the pharmacy to charge the patient (even placebos, though none were observed in the present study). However, researchers in hospitals have attempted to go further and distinguish a potentially more dangerous class of error based on the pharmacologic category of the medication involved.21, 38 For such purposes, we provide information about errors involving all of these more dangerous drugs so that readers can make their own judgments about the errors detected in this study (see Table 4). The scope of the errors problem includes economically adverse consequences such as extended hospital stays, additional treatments, and malpractice suits. The mean cost of medication-related problems (medication errors and adverse drug reactions) at a university hospital ranged from $95 for extra laboratory tests, to $2,640 for intensive care. The estimated total cost of medication-related problems reported at the hospital during 1994 was $1.5 million. A report of insurance claims related to medication errors by the Physician Insurers Association of America identified an average indemnity payment of $99,721 per claim between 1985 and 1992.   	Table 4. Errors Judged to be Potentially Clinically Important  	   	  	   	  	   	Limitations   	Pharmacists who agreed to have their pharmacies participate in this study may have been more likely to do so because they believed they did not have an error problem -- the results may, therefore, overestimate the national accuracy rate. The accuracy of labels was not verified for refill and will call prescriptions, and our results for those types of prescriptions likely overestimate the true dispensing accuracy rate.   	  	   	The effect of the observer on the observed is always a concern in studies of this type. However, evidence comparing study day prescription accuracy with accuracy of prescriptions filled before the observer&#39;s arrival suggests that the observers did not affect the accuracy rates. (Note that this comparison did not include the third observer, but because the accuracy rates detected by the observers did not differ significantly, lack of effect of the third observer is suggested.)   	Table 5. Examples of Process Deviation  	   	  	   	  	   	Conclusion   	Dispensing errors are a problem on a national level, at a rate of 4 errors per day in a pharmacy filling 250 prescriptions daily. The rate of errors on new prescriptions (3.2%) is less than the only comparable standard of 5% set by the federal government for the nursing home industry.11 Based on these findings, an estimated 51.5 million errors occur during the filling of 3 billion prescriptions each year. This figure includes 3.3 million errors of potential clinical importance.   	  	   	Dispensing Error Category Definitions   	1. Wrong drug: A medication that is different from what the prescriber wrote on the prescription order or, for refill prescriptions, what is printed on the prescription label.   	  	   	2. Wrong strength: A dosage unit containing an amount of medication that is different from what the prescriber specified is dispensed without an adjustment to the dosing instructions to the patient.   	  	   	3. Wrong dosage form (correct drug): The form of the medication used to fill the prescription is different from what the prescriber wrote on the prescription order. Examples of this type of error include filling a prescription with an enteric-coated tablet when it was not ordered as such and using a sustained-release product when one was not ordered.   	  	   	4. Wrong quantity: The number of dosage units or the volume of a product was different from what the prescriber ordered. Unless the observer could see a difference in the number of solid oral dosage forms without counting on a tray, we assumed that the correct quantity was used. Liquid measures were included if it was possible to observe the volume dispensed. If the quantity or volume of liquid could not be determined, the prescription was classified as no error if there were not errors in any other categories.   	  	   	5. Wrong prescription label information (excluding instructions): Defined to include one or more of the following deviations from any one of the federal or state requirements for label contents, whichever was more strict:49   	  	   	Name and address of dispenser (pharmacy)   	Serial number of prescription   	Date of prescription or date of filling   	Name of prescriber   	Name of patient, if stated in the prescription order   	Drug name   	Drug strength (if more than one strength was available)   	Quantity dispensed   	Expiration date   	Manufacturer or distributor   	  	   	  	   	Dispensing Error Category Definitions   	1. Wrong label instructions: The directions on the prescription label deviated in one or more ways from what was prescribed, except for changes made based on good pharmaceutical practice. (Note that auxiliary label information included on the package by the pharmacist that was not required by the physician was not evaluated in this study.) For example, if for 14 days was added at the end of the directions for an antibiotic that was prescribed to be taken for a complete course of therapy, an error was not counted. However, if the physician wrote for 14 days on the prescription order and this was omitted from the label instructions, a wrong label instruction error was counted.   	  	   	2. Omission: Failing to dispense a prescribed medication.   	  	   	3. Wrong time: A medication was packaged in blister pack locations that were different from what was conveyed on the prescription (e.g., a medication was placed in the bubble for bedtime doses instead of the one for dinner doses).   	  	   	4. Deteriorated drug: A medication that had passed its expiration date was used to fill a prescription or a prescription was filled with a medication that was stored in a location not in accordance with the manufacturer&#39;s recommendations (e.g., outside a refrigerator).   	  	   	Recommendations for Error Prevention in the Future   	Based on a long history of research, pharmacy medication system automation features that are desirable for prevention of medication administration errors are available.49 The recommended system characteristics are as follows:   	  	   	1. Comprehensiveness: Control over the medication distribution system should start with entry of the order into the computer and continue through administration to the patient.   	  	   	2.Focus: error-prone dosage forms should be accommodated by the system, such as injections, oral liquids, and specially prepared doses for pediatric patients.   	  	   	3. Dispenses unit doses: Medications delivered to the nurse should not require further manipulation or preparation by the nurse.   	  	   	4. Signals at dosing times: In order to minimize omission errors and wrong time errors, the device should remind the nurse when a dose is due.   	  	   	5. Labels machine printed and affixed: The medication delivered should contain written labeling information that is machine-printed and affixed to the container.   	  	   	6. Machine identification: It should be possible to identify the dose, patient, and person administering the dose prior to administration (e.g., with bar codes or radio frequency tags).   	  	   	7. Access controlled: Medications should only be accessible at the right place at the right time based on the patient's medication profile, and only to approved personnel as verified by the machine.   	  	   	8. Captures dose administration: Documentation of medication administration time and location should take place at the point of administration.   	  	   	9. Drug use information provided: Any information that the nurse should be aware of in order to facilitate correct administration of the drug should be provided at the point of administration.   	  	   	10. Controls not easily compromised: Any compromises or overrides of the system should be associated with a visible and/or audible alarm. Documentation of the override should occur simultaneously and automatically.   	  	   	Summary   	History has a tendency to repeat itself. If pharmacists and administrators build on what's been learned in error research when implementing new medication systems, perhaps the (patient's) pain from repeating known mistakes and problems can be minimized. Patients expect safe, error-free medication distribution by pharmacists. However, pharmacists involved with medication distribution occasionally misfill or mislabel a prescription. Systems can be created to decrease the risk of errors and injuries to a patient. Pharmacy technicians must be aware and alert to the possibilities of errors and continue to take steps to identify errors and correct them before they reach the patient.   	  	   	References   	1 Smith DB, Ellis C. Troth SF. A code of ethics adopted by the Philadelphia College of Pharmacy. Am J Pharm. 1848; 20:148-151.   	  	   	2 Barker KN, McConnell WE. The problems of detecting medication errors in hospitals. American Journal Hospital Pharmacist. 1962; 19:360_69.   	  	   	3 Barker KN, Kimbrough WW, Heller WM. A study of medication errors in a hospital. Fayetteville: University of Arkansas; 1966.   	  	   	4 Shannon RC, De Muth JE. Comparison of medication-error detection methods in the long term care facility. Consultant Pharm. 1987; 2(Mar/Apr):148-151.   	  	   	5 Barker KN, Harris JA, Webster DB et al. Consultant evaluation of a hospital medication system: Analysis of the existing system. American Journal Hospital Pharmacist. 1984; 41:2009-16.   	  	   	6 Cullen DJ, Bates DW, Small SD et al. The incident reporting system does not detect adverse drug events: A problem for quality improvement. Journal Comm Quality Improvements. 1995 (Oct); 21:541-548.   	  	   	7 Borel JM, Rascati KL. Effects of an automated, nursing unit-based drug-dispensing device on medication errors. American Journal Health-Systems Pharmacist. 1995;52:1875-9.   	  	   	8 van Leeuwen DH. Are medication error rates useful as comparative measures of organizational performance? Joint Commission on Quality Improvement. 1994   	(April); 20:192-199.   	  	   	9 Flynn EA, Barker KN. Medication error research. In: Cohen MR, ed., Medication Errors: Causes and Prevention. Washington, DC: American Pharmaceutical Association. 1999.   	  	   	10 Barker KN, Felkey BG, Flynn EA, Carper JL. White paper on automation in pharmacy. Consulting Pharmacist. 1998 (Mar); 13:256-293.   	  	   	11 Allan EL, Barker KN. Fundamentals of medication error research. American Journal Hospital Pharmacist. 1990;47:555-71.   	  	   	12 Manasse HR Jr. Medication use in an imperfect world: drug misadventuring as an issue of public policy, part 1. American Journal Hospital Pharmacist. 1989; 46:929-44.   	  	   	13 Manasse HR Jr. Medication use in an imperfect world: drug misadventuring as an issue of public policy, part 2. American Journal Hospital Pharmacist. 1989; 46:1141-52.   	  	   	14 Fink J, ed. Pharmacy Law Digest 1985. St. Louis, Mo: Facts and Comparisons; 1985.   	  	   	15 Bates DW, Cullen DJ, Laird N et al. Incidence of adverse drug events and potential adverse drug events: Implications for prevention. JAMA. 1995 (Jul 5); 274:29-34.   	  	   	16 Cullen DJ, Bates DW, Small SD et al. The incident reporting system does not detect adverse drug events: A problem   	  	   	17 Bates DW, Cullen DJ, Laird N et al. Incidence of adverse drug events and potential adverse drug events: Implications for prevention. JAMA. 1995 (Jul 5); 274:29-34.   	  	   	18 Cullen DJ, Bates DW, Small SD et al. The incident reporting system does not detect adverse drug events: A problem for quality improvement. Jt Comm J Qual Improv. 1995 (Oct); 21:541-548.   	  	   	19 Barkers KN, Kimbrough WW, Heller WM. A study of medication errors in a hospital. Fayetville: University of Arkansas; 1966.   	  	   	20 Schnell BR. A study of unit_dose drug distribution in four Canadian hospitals. Can J Hosp Pharm. 1976; 29:85_90.   	21 Barker KN, Heller WM, Brennan JJ et al. The development of a centralized unit dose dispensing system. Part six: the pilot study _ medication errors and drug losses.  Am J Hosp Pharm. 1964; 21:609_25.   	  	   	22 Jozefczyk KG, Schneider PJ, Pathak DS. Medication errors in a pharmacy-coordinated drug administration program. American J Hosp Pharm. 1986; 43:2464-67.   	  	   	23 Barker KN. Data collection techniques: observation. Am J Hosp Pharm. 1980; 37: 1235-43   	  	   	24 Bates DW, Boyle D, Vander Vliet M, et al. Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995:10; 199_205.   	  	   	25 Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events: implications for prevention. JAMA. 1995: 274; 29_34.   	  	   	26 Cohen MR, ed., Medication Errors: Causes and Prevention. Washington, DC: American Pharmaceutical Association. 1999.   	  	   	27 Andrews LB, Stocking C, Krizek T, et al. An alternative strategy for studying adverse events in medical care. Lancet. 1997:349(9048); 309_13.   	  	   	28 Gifts, MG. Mavko, LE. Vanderpool, WH. Evaluating returned doses as an approach to improving medication use. ASHP Midyear Clinical Meeting. 31(Dec): Pages_446E. 1996.   	  	   	29 Ballinger BR, Simpson E, Stewart MJ. An evaluation of a drug administration system in a psychiatric hospital. Br J Psychiatry. 1974; 125:202_7.   	  	   	30 Phillips DP, Christenfeld N, Glynn LM. Increase in US medication_error deaths between 1983_1993. Lancet. 1998; 351:643-644.   	  	   	31 Baker HM. Rules outside the rules for administration of medication: A study in New South Wales, Australia. Image: Journal of Nursing Scholarship. 1997; 29(2): 155-158.   	  	   	32 Barker KN, Allan EL. Research on drug-use-system errors. Proceedings, Conference on Understanding and Preventing Drug Misadventures, Chantilly, VA, October 21-23, 1994. Am J Health-Syst Pharm. 1995; 52:400-3.   	  	   	33 Barker KN, Pearson RE, Hepler CD et al. Effect of an automated bedside dispensing machine on medication errors. Am J Hosp Pharm. 1984; 41:1352-8.   	  	   	34 Douglas JB, Wheeler DS. Evaluation of trained pharmacy technicians in identifying dispensing errors. ASHP Midyear Clinical Meeting. 1994(Dec); 29:P-244(E).   	  	   	35 Woller TW, Stuart J, Vrabel R et al. Checking of unit dose cassettes by pharmacy technicians at three Minnesota hospitals. Am J Hosp Pharm. 1991; 48:1952-6.   	  	   	36 Becker MD, Johnson MH, Longe RL. Errors remaining in unit dose carts after checking by pharmacists versus pharmacy technicians. Am J Hosp Pharm. 1978;35:432-34.   	  	   	37 Mayo CE, Kitchens RG, Reese RL et al. Distribution accuracy of a decentralized unit dose system. Am J Hosp Pharm. 1975;32:1124-26.   	  	   	38 Taylor J, Gaucher M. Medication selection errors made by pharmacy technicians in filling unit dose orders. Can J Hosp Pharm. 1986; 39(Feb):9-12.   	  	   	39 Hassall TH, Daniels CE. Evaluation of three types of control chart methods in unit dose error monitoring. Am J Hosp Pharm. 1983; 40:970-5.   	  	   	40 U.S. Department of Health and Human Services. Centers for Medicare and Medicaid Services. Electronic Prescribing (eRx) Incentive Program. http://www.cms.gov/ERXincentive/. Accessed January 20, 2011.   	41 Institute for Safe Medication Practices (ISMP). ISMP's list of error-prone abbreviations, symbols, and dose designations. ISMP Medication Safety Alert! Washington DC: ISMP; 2001:6.   	  	   	42 Hoffman RP, Bartt KH, Berlin L et al. Multidisciplinary quality assessment of a unit dose drug distribution system. Hosp Pharm. 1984; 19(Mar):167-169,173-174.   	  	   	43 Chi J. Tech-check-tech, as sanctioned practice, gaining in states. Hosp Pharm Rep. 1994(Aug); 8:14, 17.   	  	   	44 Ness JE, Sullivan SD, Stergachis A. Accuracy of technicians and pharmacists in identifying dispensing errors. Am J Hosp Pharm. 1994; 51:354-7.   	  	   	45 Pang F, Grant JA. Missing medications associated with centralized unit dose dispensing. Am J Hosp Pharm. 1975; 32:1121-23.   	  	   	46 Physician Insurers Association of America. Medication Error Study. June, 1993. p. 3.   	  	   	47 Barker KN, Harris JA, Webster DB et al. Consultant evaluation of a hospital medication system: Analysis of the existing system. Am J Hosp Pharm. 1984; 41:2009-16.   	  	   	48 Barker KN. Ensuring safety in the use of automated medication dispensing systems. Am J Health-Syst Pharm. 1995; 52:2445-7   	  	   	49 Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human: Building a Safer Health System. Washington DC: National Academy Press; 1999.   	  	   	50 Buchanan TL, Barker KN, Gibson JT, et al. Illumination and errors in dispensing. Am J Hosp Pharm. 1991; 48:2137-45.   	  	   	51 The ABCs of drugstores. Consumer Reports. October 1999; 64:39-44.   	  	   	52 Flynn EA, Barker KN, Gibson JT, et al. Relationships between ambient sounds and the accuracy of pharmacists&#39; prescription-filling performance. Hum Factors. 1996; 38:614-22.   	  	   	About the Author    	Joseph A. Tinervia is a certified pharmacy technician that has written previous CE articles in Today's Technician magazine on various topics. He is the pharmacy technician instructor at the Tulsa Job Corps Center for the pharmacy technician program. He has also been part of the Adjunct Faculty at Tulsa Community College in their pharmacy technician program. Joe has recently completed both certifications for online instruction and development of blackboard online computer coursework for the potential to develop coursework and exam review courses for Tulsa and the surrounding areas. Joe has a Bachelor of Science in Business Administration (emphasis in marketing and psychology) from the University of Missouri at St. Louis and an MBA (emphasis in management) from Webster University in St. Louis, Missouri.   	  	   	Idea in Brief:   	This article is a comprehensive look at the different types of medication errors and how they are categorized. Why these errors happen, implications these errors can have as well as techniques for error-prevention are also discussed. A detail of a study done with 50 participating pharmacies is also presented for consideration.   	  	   	Idea in Practice   	Pharmacy technicians and students need to understand the responsibility they have in their position as a tech and always strive to improve. Staying alert and vigilant on the job to help prevent medication errors is paramount. Having a foundation of knowing the information in this article will help in preventing errors from occurring in the first place. <br>
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<dc:date>2011-11-30T14:00:00Z</dc:date>
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<title>Understanding the Business of Pharmacy</title>
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<link>http://www.pharmacytechnician.org/en/courses/view.asp?courseid=362</link>
<description><![CDATA[Instructor: Wendy Meigs, RPh<br><br>

  	 	 		Understanding the Business of Pharmacy 10-20-11 from RxPO 2011 on Vimeo.   <br>
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<dc:subject>Course</dc:subject>
<dc:date>2011-10-16T13:00:00Z</dc:date>
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