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Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP

Recent Posts

Celebrating National Pharmacist Day

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Jan 12, 2018 7:07:20 AM

 

National Pharmacist Day is recognized by several national and state pharmacy organizations. It honors and recognizes the important role that pharmacists play in healthcare.

Pharmacists’ role in healthcare has evolved over centuries and significantly changed over the past 30 years. Before WW II, pharmacists compounded most medications that they dispensed pursuant to a physician’s prescription or order. After WW II, pharmacists performed the more familiar and traditional “lick and stick” pharmacy – counting tablets and capsules or measuring liquids, putting them in properly labeled prescription bottles, and counseling the patients about the use and storage.

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Flu Season is Here Again!

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Nov 3, 2017 8:33:44 AM

It is flu season again and time to immunize. Unfortunately the flu vaccine is not like other vaccines, such as the MMR or dTAP, because a new vaccine has to be developed on an annual basis because the virus constantly mutates. According to the Center for Disease Control and Prevention (CDC), quadrivalent and trivalent influenza vaccines will be available for the 2017-2018 season. Inactive influenza vaccines (IIVs) will be available in trivalent (IIV3) and quadrivalent (IIV4) formulations. Recombinant influenza vaccine (RIV) will also be available in trivalent (RIV3) and quadivalent (RIV4) formulations. Live attenuated vaccine (LAIV4), also known as FluMist®, is not recommended this year due to concerns of effectiveness; however, there are no recommended preferences between the different injectable products. This season the vaccine viruses include an A/Michigan/45/2015 (H1N1)pdm09-like virus, an A/HongKong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (Victoria lineage). Additionally the quadrivalent influenza vaccines contain aa B/Phuket/3073/2013-like virus.[i]  Despite popular belief in the general population, no one can get the flu from an inactivated influenza vaccine. The vaccine only covers the respiratory-type of influenza, not the “stomach flu”.

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Celebrating Pharmacists’ and Pharmacy Technicians’ Long Journey

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Oct 20, 2017 6:46:24 AM

The art of pharmacy has been practiced for centuries and it is truly one of the oldest professions. According to the University of the Pacific Academy of Student Pharmacists, pharmacy and the treatment with drugs goes back to about 2600 B.C. in Babylonia and it has evolved into one of the most trusted and respected professions. The doctors and healers used to compound medicines for their patients, but starting in the late 1600s, apothecarists (the old term for pharmacists) started to compound medicines and created a variety of different medicines and tonics touted to cure different ailments. Most medicines were actually compounded by pharmacists until World War II when more drug manufacturers were started.

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October is Breast Cancer Awareness Month

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Oct 13, 2017 11:00:00 AM
Most people have been affected personally or know someone who has or have had breast cancer: family, friends, co-workers, and/or acquaintances. It is the second leading cause of death in women (after lung cancer). According to the American Cancer Society (ACS), about 1 in 8 women (12%) will develop breast cancer in her lifetime. In 2017, ACS estimates that 252,710 women will be diagnosed with invasive breast cancer and 40,610 or about 20% will die from it. October is Breast Cancer Awareness Month and a good time to learn some facts about this disease, risk factors, signs and symptoms, and what pharmacists can do for patients before and after diagnosis and treatment.

Only 5% to 10% of breast cancers are genetically linked or “runs in the family”. Most cancers are “sporadic” meaning there is no genetic connection to developing the disease. Some risk factors can be reduced or avoided with changes in lifestyle and habits: sedentary, poor diet, obesity, frequent alcohol consumption, and hormone replacement therapy. The following risk factors cannot be avoided or changed:

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Incorporating CAPA into the Quality Assurance Program

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Sep 7, 2017 6:00:02 AM

The USP standards generally outline characteristics of a quality assurance program, but really do not specifically go into detail or requirements for a program. The pharmacist has the professional discretion to create a quality assurance program for his or her practice site. According to the USP<797>1, characteristics of a QA program include the following:

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The Need for Office Use Compounding

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Aug 4, 2017 11:12:21 AM

Physicians who perform certain procedures or minor surgical procedures are currently in a crisis and patients are having difficulty getting the treatment or care that they need. The ACA, commonly known as “Obama Care” cannot take the fall for this one. Since the Drug Quality and Security Act (DQSA) was implemented, the FDA has taken the stance that “for office use” compounding should not and cannot be done by 503A pharmacies. Even though several state boards of pharmacy allow pharmacies to compound for office use, pharmacy owners are choosing not to do it anymore because of the risk of being inspected by the FDA. The FDA is attempting to prevent sterile medications from being compounded by pharmacies that may not be following standards leading to the preparation and dispensing of contaminated preparations. The action by the FDA may be having the opposite effect than the Agency is intending to have.

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A Lesson from the Food Preparation Industry

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on May 18, 2017 6:10:18 AM

All pharmacists, as rotation students, have a wide variety experiences and often see both good and bad habits. Pharmacy technicians in formal training programs also have similar experiences while doing their rotation activities. During these rotations, how many students have ever seen a licensed pharmacist or technician actually scrub up, don gloves, hair covers, and masks to prepare a non-sterile compound in a traditional retail pharmacy? Everyone is aware, unless they have been living in total isolation, of good hand hygiene and garbing practices for preparing sterile or hazardous preparations; however, there is very little focus about doing it for non-sterile compounding too. The USP<795> does state in the section of Responsibilities of the Compounder under General Principles of Compounding that “Personnel engaged in compounding maintain good hand hygiene and wear clean clothing appropriate to the type of compounding performed (e.g. hair bonnets, coats, gowns, gloves, facemasks, shoes, aprons, or other items) as needed for the protection of personnel from chemical exposures and for prevention of drug contamination”. Since non-sterile compounding often involves working with syrups and oral vehicles that could support bacterial or fungal growth, it makes sense that precautions should be taken in the non-sterile compounding environment too.

Let’s take a brief look at the food preparation industry. There have been reported news stories of restaurant employees not using gloves or washing their hands after using the restroom and causing an
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What Can Be Done to Protect the Staff Now from Hazardous Substances

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Apr 24, 2017 7:53:25 AM

The USP<800> chapter doesn’t officially go into effect until July 2018. The physical requirements of the chapter is definitely going to have a financial impact on pharmacies, clinics, health-systems, and other healthcare facilities to build a proper negative-pressure room, sterile or non-sterile. Although this chapter is very burdensome for everyone, it was well-intentioned. USP<800> was published to provide practice and quality standards for handling hazardous substances “to promote patient safety, worker safety, and environmental protection.”

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Deactivation, Decontamination, Cleaning, and Disinfection

Posted by Linda F. McElhiney,PharmD, RPh, FIACP, FACA, FASHP on Apr 6, 2017 6:06:18 AM

Does your staff know the difference between deactivation, decontamination, cleaning, and disinfection and are they properly trained to do it? Lack of training and knowledge in section 15 of the USP<800> on Deactivating, Decontaminating, Cleaning, and Disinfecting (DDCD) can unnecessarily cause contamination with hazardous substances of the environment and equipment and exposure to staff members and possibly patients. Even though the USP<800> does not officially go into effect until July 2018, learning how to deactivate, decontaminate, clean, and disinfect is a simple procedure that can be implemented immediately without “breaking the bank” to protect the environment and equipment, as well as healthcare workers and patients.

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Spectrum Pharmacy Products, a division of Spectrum Chemical, is a global supplier of high quality chemicals, pharmacy supplies and equipment.

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