MSP Mag may 151720 - Pharmacists Manitoba · Telephone: (204) 956-6680 or 1-800-677-7170 [email protected] COMMUNICATION is published six times a year. The subscription rate is $12.00

The Voice of Pharmacists in Manitoba

Publication Mail Agreement No. 40013710

Return Undeliverable Canadian Addresses To:

The Manitoba Society of Pharmacists202–90 Garry St., Winnipeg, MB R3C 4H1

Continuing Education: Therapeutic Options Focus on Pediatric Constipation

The Last Word:Script Fraud: It's A Lot Tougher, But The Desperate Keep On Trying

May/June 2007Vol. 32, No. 5

CommunicationA Publication of the Manitoba Society of Pharmacists Inc.

The Voice of Pharmacists in Manitoba

2 C O M M U N I C AT I O N M AY /J U N E 2007

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Ed Bodnarchuk, CFPFinancial Advisor

CONTACT: 1104 - 201 Portage Avenue Winnipeg MB R3B 3K6 Telephone: (204) 943-5340 Facsimile: (204) 943-5349 E-mail: [email protected]

M A N I TO B A S O C I E T Y O F P H A R M A C I S T S C O M M U N I C AT I O N 3

THIS ISSUEM AY /J U N E 2007

Up FrontDo You Ever Sit Back and Wonder 4Do you ever sit back and wonder just which direction the profession of Pharmacy is headed?

Sounding BoardManitoba Pharmacy Conference Comments 5

Feature Article2007 Bowl of Hygeia Awarded to Lori Dangerfield 6With family, friends, a successful career and an active lifestyle to manage, you might ask Lori Dangerfield where she finds the time to volunteer.

Manitoba Pharmacy Conference 2007April 13 to 15, 2007 7

Feature ArticleThe Class of 1966 Announces New Scholarship 13Class reunions are a time to reconnect, reminisce, enjoy each other's stories and boast about children, or for that matter, grandchildren.

Pharmacist Awareness Week 2007"It's Safe to Ask Your Pharmacist" 14This year's Pharmacy Awareness Week (PAW), running from March 5th to 11th, was a great success.

Feature ArticleNon-prescription Products Demystified:Oral anthistamines 15Non-prescription products are used in the self-treatment of a self-diagnosed, self-limiting condition.

Feature ArticleMSP Student Night 2007 18The Manitoba Society of Pharmacists Student Night was held on Feb. 22nd, 2007 and the students showed up ready to take part in the 3rd Annual Boss Q Challenge.

Q&A: Getting to know you Manitoba PharmacistsArpit Lotay 20

ClassifiedsPharmacist Wanted 21

The Last WordScript fraud: It's A Lot Tougher, But the Desperate Keep on Trying 22It is a paradox that, with a cascade of drugs available on the internet, some folks still try to wheedle them from dispensaries with forged or altered script.

Manitoba Society of Pharmacists

Board of DirectorsNancy Remillard, President, Professional Relations Chair

Jay Rich, Vice-President, Communication Chair

Bonnie Coombs, By-Laws Chair

Brent Havelange, Economics Chair

Mel Baxter

Michelle Glass

Elmer Kuber

Carey Lai

Tim Pattern

LiaisonsChuck Narvey, Insurance Liaison

Ron Guse, MPhA Liaison

Elmer Kuber, CPhA Liaison

Scott Ransome, Executive Director & Editor

Jill Ell, Assistant to the Executive Director, Editorial Assistant, Membership Benefits Chair

Editor/Publisher

Manitoba Society of Pharmacists90 Garry Street, Suite 202, Winnipeg, MB R3C 4H1

Telephone: (204) 956-6680 or 1-800-677-7170

[email protected] www.msp.mb.ca

COMMUNICATION is published six times a year. The subscription rate is $12.00 per issue, $77.04 per annum (including GST). The inclusion of proprietary names in this publication is for reference only. The inclusion of brand names does not imply that the brands listed are in any way preferable to those not listed. The sources of information are published articles in pharmaceutical and medical journals, private communications, etc. Incorrect quotations or interpretations are possible but not intentional. The views expressed in COMMUNICATION do not necessarily reflect the views of the Manitoba Society of Pharmacists Inc. The Society assumes no responsibility for the statements and opinions advanced by contributors in COMMUNICATION. Material from COMMUNICATION may be copied provided that the source is acknowledged. The deadline for submission of material for inclusion in COMMUNICATION is the 15th of February, April, June, August, October and December.

ISSN 0829-6197

Printed in Canada by:Leech Printing (204) 728-3037

Publication Mail Agreement No. 40013710Return Undeliverable Canadian Addresses to:

Manitoba Society of Pharmacists202–90 Garry Street

Winnipeg, MB R3C 4H1Email: [email protected]


• Bill 41 is going to bring the oppor-tunity for pharmacists to have some prescribing rights among other pro-fessional duties. A definite step for-ward…

• Pharmacists have long complained about the lack of time in the dispen-sary, and nothing has ever really been done to address this issue. If any-thing, pharmacists will be more on their own than ever before, once the technician ratio for Manitoba is abol-ished, as the cost savings of a techni-cian versus a pharmacist is already obvious to most corporations. How will we take advantage of these new found professional activities if we are still searching for the key to taking a 15 minute uninterrupted lunch after all these years? A step back…

• Everything in pharmacy is free; we have free delivery, free advice (in per-son or on the phone), free blood pres-sure monitoring, free medication and

sharps disposal, free clinic days, free medical expense printouts, and free everything else for anything I have forgotten (we’ll even knot your tie for you if you ask nice enough…true story, another time…). It’s really not that terrible that we all compete on this level, but it has unfortunately created such a patient expectation that we quiver at the thought of ever charging for any of our cognitive ser-vices. There is no other profession in the world that even remotely oper-ates this way. A step back…

· At least we still have the professional fee…or is that the dispensing fee…or maybe that is the amateur fee? There is a trend in the mighty USA that

now has select generic drugs being dispensed at a flat rate of $4. To undercut that, one chain is now giv-ing away select 2-week supplies of medications for absolutely nothing. Zero. Zilch. What message does this send to the consumer? How much can they value a service and every-thing you do if it is worth nothing? Professionals charge for their ser-vice. Amateurs do not. I think I just backed off the dance floor…

Are you happy with the direction the profession is headed? Do you read this and throw your arms up and say, “well, what can we do about it”, or do you dis-agree with me when I say we are stuck in reverse. We want to hear from you. Send your comments to the Sounding Board care of MSP to let us know where you see the profession going and what you are doing to get back to the middle of the dance floor. I’m really not a big fan of Country music, but I would rather listen to it than a funeral march…

Do You Ever Sit Back And WonderUP FRONT

JAY RICHCommunication Chair

Do you ever sit back and wonder just which direction the profession of Pharmacy is headed? Every time it seems

that we take a step forward towards a higher role on the health care ladder, we stumble back down to the ground

as the competitive business side rears its ugly head. Put on some Country music, and join me for a little two-

stepping dance:

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The Annual Manitoba Pharmacy Conference was held at the Victoria Inn on April 13th, 14th and 15th. Overall feedback from the conference has been extremely positive. Once again a pro-gram evaluation was made available at the registration desk as well as through “Communication Plus”. The Conference Planning Committee finds this informa-tion very useful and would like to encour-age conference participants to complete the evaluation.

The comments that have been received have been summarized below.

What did you like most about the confer-ence?• Good presentations overall• Liked the venue• Liked sessions B, E2 & F• Meeting friends and classmates• Liked readable handouts and session E2• Liked stress lecture• Topics have improved• Liked visiting with old classmates• Continuing education and seeing friends• CEU's• Good relevant topics discussed • Good job• Meeting different people and seeing dif-

ferent views• Well organized• Opportunities to obtain CEU's • Meals were excellent• CEU topics - some for educational pur-

poses and other for personal develop-ment -Dr. Namaka, Dr. Tsuyuki and Sylvia Yeager

What did you like least about the confer-ence?• Rush through sessions, being late, over-

time on sessions• Too fast speakers, too small print on

handouts• Little time for issues forum, some hand-

outs unreadable • Didn't like time delay in sessions• Didn't like that they couldn't register for

half day

• Issues forum a bit too long• Venue• Hotel• Some of the printed lecture guidelines

very poor quality. Much too small let-tering, undecipherable, portion blacked out

• Nothing• Issues Forum: No time for issues - open

discussion - All others exceptional

What topics would you like to see dis-cussed at next years conference?• Suggested CE - evaluating laboratory

test results• Suggested CE - seizure disorders, pain

control• Want more on stress techniques• You're doing great, maybe a motivational

speaker• Home Health Care- products and how

to use• Info on INR's, lab tests etc.• "Bug Days" type of theme but on new

drugs• Lots of information - short and sweet• Problems encountered by everyday prac-

tice, everyday stress on pharmacists. • Repeat Evidence Based Medicine but give

more time and send out preliminary info.• Conflict management - Defusing the

angry customer or dealing with staff conflicts

• Lab tests - what are the values and what do they mean.

• Focus on Pharmacists expanded role - diagnostic tools, lab values (Dr. Laverne Vercaigne), Understanding of alternative reimbursement models (Jeff Poston)

• Bill 41 and the regulations

Do you prefer a downtown hotel or a sub-urban hotel? Did you enjoy this hotel?• Hotel was okay, prefer downtown hotel• Enjoyed hotel• Hotel - have us altogether, away from

hockey team• Like free parking• Liked suburban hotel • Sunday lunch - food not very good• Session rooms cold, and could hear

speaker in next room - distracting• No - Fort Garry would be nice or the

Fairmont

• No - Fort Garry , Delta or Fairmont• Yes - parking availability very good • Sunday luncheon satisfactory• Suburbs are fine, so is downtown • Yes, fine hotel• This hotel is okay• Liked hotel• Food was good• Conference rooms were good• Hotel rooms quality was average• Suburban hotel• This hotel was very good• Consider Brandon, this hotel is far from

my home

Did you enjoy the social events? Would you like to see more or less of them?• More social on Friday, want to mingle

more less program• Liked social events, about right• Have exhibit venue open from 11:30am

on Saturday so when AGM's end early we can go in and view booths

• Enjoyed social events• Want exhibitors venue open earlier on

Saturday at lunch• Enjoyed social events, just the right level• Yes one each day is good• Yes, good entertainment• Less, banquet could be briefer – it is a

long day• Yes• Would like to see interactive events that

would encourage pharmacists to mingle and meet other pharmacists

• Yes, same

Comments:• Maybe a conference in Brandon?!• I would like to see a conference held in

rural Manitoba at least every five years. • The print on the slides in the sessions are

very good however some were so small or blurry it was impossible to read.

If you would like to send in your comments you can still do so by downloading the program evaluation from the Conference website at www.mbpharmacyconference.com. We also invite your views on other pharmacy related topics so feel free to write, email, or fax us a letter.

The Sounding Board is here for members to speak up and speak out on issues that are of interest to pharmacy. The Sounding Board is not intended to be an expression of the opinions of the Manitoba Society of Pharmacists, but rather is meant to be a forum for opinions and thoughts. We encourage you, our members, to write in with your opinions on the topical issues of the day.

SOUNDING BOARD

With family, friends, a successful career and an active lifestyle to manage, you might ask Lori Dangerfield where she finds the time to volunteer. She has been volunteering her time and energy to her profession and community for more than 30 years now.

Dangerfield is this year’s Wyeth Consumer Healthcare Bowl of Hygeia Award recipient.

Established in 1958, this award is given to a pharmacist for outstanding community service, it is in recognition of the time and personal sacrifice devoted to the welfare of his or her respective community.

Dangerfield has been involved locally and provincially with the Brandon YMCA Board of Directors, the Brandon Economic Development Board, Volunteer for the Scott Tournament of Hearts Committee, the 1997 Canada Summer Games Medical Committee, a Director and President of the Brandon Chamber of Commerce, a member of the Provincial Exhibition, a Manitoba Cancer Treatment and Research Foundation Board Member, Preceptor for phar-macy students, member of the MPhA Professional Development Committee and member of the Brandon Curling Club. With a list of volunteer work this long, Dangerfield epitomizes the type of pharmacist the Wyeth Consumer Healthcare Bowl of Hygeia Award honours.

She has modestly accepted the honour, but admits she is thrilled to be this year’s recipient.

“I’m very excited. It is so nice to be recognized, especially by your peers, the people that you respect so much. It really is special”, says Dangerfield, “I’ve had so much fun in my career and volunteer work that it feels strange accepting the award.”

Dangerfield attributes her career in Pharmacy to a visit she had with her Aunt, who worked as a pharmacist at the St. Boniface Hospital in Winnipeg. Along with a curiosity for science, the visit sparked an interest that lasted throughout her school years to The University of Manitoba where she graduated from the Faculty of Pharmacy in 1978.

Summers were spent in the city of Brandon, where she grew up, working for affiliates of Super Thrifty Drug Mart. She started out working at the front of the store in retail and before long and after graduation she was behind the counter working as a Pharmacist. Almost 30 years have passed and Dangerfield is behind that same counter working for Home Healthcare Pharmacy, another affiliate of Super Thrifty.

Thirty years with the same pharmacy chain and in the same city allowed Dangerfield a unique opportunity to build long lasting relationships with her patients.

“It’s so nice, I’ve been able to build a rapport with people that come into the pharmacy. I know their entire families. Building rela-tionships like these is an integral part of Pharmacy.”

She caught the volunteering bug in high school and, fortu-nately for the community of Brandon, it stayed with her through-out University and long into her career as a Pharmacist.

“Like most people you start volunteering with small projects in high school and University and it ends up becoming part of your life”, says Dangerfield.

She experienced her most challenging years volunteering as President of the Brandon Chamber of Commerce. The years just prior to the millen-nium and the millennium itself brought celebrations and struggles.

The Chamber faced many issues brought on by the Flood of the Century in 1997. In 1999 Maple Leaf Foods announced that it would be building a $112 million hog processing plant that could potential-ly increase the City’s popu-lation by 10,000 to 50,000 people. Simplot opened a new Brandon facility in 1999, setting up a $230 million plant for liquid and granular fertil-izers and the Dutch firm Installatie Techniek Boxmeer set up a plant to manufacture livestock ventilation equipment in the same period.

The millenium also brought the departure of German troops from the Canadian Forces Base (CFB) Shilo, which lost the City of Brandon $10 million in annual business, but fortunately, the Princess Patricia's Canadian Light Infantry (PPCLI) moved from Winnipeg to Shilo one year later.

Needless to say it was a hectic time for the Brandon Chamber of Commerce. Dangerfield says it was a huge learning experience for her.

“It was a challeging time, but an enjoyable one all the same. I learned so much from working with such a diverse group of people, so dedicated and committed to the issues.”

For someone so committed to her community, career and family, Dangerfield does manage to find spare time. She enjoys curling and downhill skiing in the winter months and loves boating at Clear Lake in the summer months.

“I love to curl, I can’t say I’m good at it, but I do love it.” Having a strong support system at home and a scientific back-

ground has helped Dangerfield manage her time and priorities. “Trying to juggle three strong commitments is tough. You

really have to maintain a balance in life and thankfully I had a strong support system at home.”

According to Dangerfield, volunteering has been an enjoyable experience. She loves to be part of a team and see great ideas come to life. She has had fun, learned a great deal about herself and her community and has been able to give back.

“It’s been great to give back to the community that has given so much to you. Volunteering has become a lifelong occupation for me.”

FEATURE ARTICLE

2007 Bowl of Hygeia Awarded to Lori Dangerfield


The Changing Face of PharmacyFRIDAY, APRIL 13, 2007

MANITOBA PHARMACY CONFERENCE 2007

The Exhibitors ReceptionThe 129th Manitoba Pharmacy Conference was held at the

Victoria Inn, April 13th to 15th. The conference kicked off with the Honorable Theresa Oswald, Minister of Health giving the opening address. This was the second time in three years that the conference has been opened by the Minister of Health.

The Exhibitor’s Wine and Cheese Reception was extremely well attended this year. Highlights of the evening included a recap of 2007 Professional Development Week, an update on the new Faculty of Pharmacy building and a new scholarship introduced by the graduating Class of 1966.

The Young Leaders Awards, sponsored by the Manitoba Society of Pharmacists and the Manitoba Pharmaceutical Association were presented by Nancy Remillard, President of the Manitoba Society of Pharmacists.

The event which was hosted by the Conference Exhibitors, featured a Mexican theme complete with Quesadillas, Margueritas, Coronas and other fare to the sounds of tradition-al ballads and songs by Trio Los Romantico. The Conference Planning Committee would like to thank all the Exhibitors for their participation at this year’s conference.

Left to Right: Annie Mitchell, Heather Sheane, Bonnie Coombs, and Jim Mitchell

MSP Board Member Elmer Kuber and CPhA Executive Director Jeff Poston

Trio Los Romantico

topped off the Mexican Theme

The Young Leaders

Top Left – Arpit Lotay, Tara Hoop, Jacqui Elliott Johnson, Jonathon Fine,

Jillian Hardy, Quinton Didyk

Bottom Left – Carey Lai, Karina Cheung and Jennifer March

Conference participants were given an opportunity to see what new innovations the Exhibitors had on display.


MANITOBA PHARMACY CONFERENCE 2007The Changing Face of PharmacySATURDAY, APRIL 14, 2007

The Conference Chair Reception and Silent AuctionThe Conference Chair Reception proved to be a fun event

again this year and the Silent Auction was another success. All pro-ceeds from the auction go to the Pharmacists at Risk Committee and this year the total was $3,110. The Conference Planning Committee would like to thank all the corporate sponsors who donated items for the auction and those who placed bids.


MANITOBA PHARMACY CONFERENCE 2007

This year the entertainment at the Awards Banquet featured the Melos Folk Ensemble & the Troyanda Ukrainian Dance Ensemble. This talented group of singers and dancers (which includes Myroslaw Kurjewicz, pharmacist and Chair of the Pharmacist at Risk Committee) gave a terrific show and left the audience wanting more. We would like to thank them for their wonderful performance!

Congratulations are extended to all award winners whose achievements in the field of pharmacy and the community were recognized. The evening was truly enjoyable and the winners extremely gracious.

Annual Awards Banquet

The Changing Face of PharmacySATURDAY, APRIL 14, 2007

Honorary Conference ChairDr. Mike Namaka

The Melos Folk Ensemble The Troyanda Ukrainian Dance Ensemble

Bowl of Hygeia Award Winner Lori Dangerfield and family 2006 Pharmacist of the Year, Lois Cantin with Pat Trozzo, MPhA President



MANITOBA PHARMACY CONFERENCE 2007The Changing Face of PharmacySUNDAY, APRIL 15, 2007

The Manitoba Pharmaceutical Awards LuncheonThe Manitoba Pharmaceutical Awards Luncheon had a record number

of people in attendance. The 50 Year Gold Pins and 25 Year Silver Pins were awarded along with 2 Honorary Life Memberships. Our congratulations go out to all the award recipients on reaching these milestones in their careers.

50 Year Pin Recipients

Honorary Life Membership Recipients Ernest Stefanson and Darryl Darling

25 Year Pin Recipients

MPhA President, Pat Trozzo with Lavern Vercaigne, winner of the Bonnie Schultz Memorial Award

Manitoba Society of Pharmacists (MSP) Award of Merit Winner, Marian Kremers with MSP President, Nancy Remillard

The Changing Face of PharmacyMANITOBA PHARMACY CONFERENCE 2007

The feedback has been overwhelmingly positive, and planning for 2008 conference will get started shortly. The Conference Planning Committee would like to have your thoughts on the conference and encourages you to complete the Program Evaluation Form that is available on the confer-ence website at www.mbpharmacyconference.com.

The members of the Conference Planning Committee are listed below. Their commitment to organizing a conference all Pharmacists can enjoy is very much appreciated.

Marnie Hilland, Director of Conferences, The Manitoba Society of Pharmacists

Shawn Bugden, Councillor, The Manitoba Pharmaceutical Association and PrISM

Kyle MacNair, Canadian Society of Hospital Pharmacists– MB Branch and PrISM

Cali Orsulak, Canadian Society of Hospital Pharmacists – MB Branch

Jill Ell, Chair, Membership Benefits, The Manitoba Society of Pharmacists

Susan Lessard-Friesen, Assistant Registrar, The Manitoba Pharmaceutical Association

Scott Ransome, Executive Director, The Manitoba Society of Pharmacists

Judy Higham, Executive Assistant, The Manitoba Pharmaceutical Association

The Conference Planning Committee wants to recognize the tremendous efforts of the Honourary Conference Chair, Dr. Mike Namaka. His commitment and professionalism were major contributors to the success of the conference.

The 2007 Manitoba Pharmacy Conference was one of the most successful in recent history.



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The Class of 1966 Announces New Scholarship

FEATURE ARTICLE

Class reunions are a time to reconnect, rem-inisce, enjoy each other’s stories and boast about children, or for that matter, grandchildren.

The University of Manitoba, Faculty of Pharmacy graduating class of 1966 celebrated their 40th class reunion one year ago. In addi-tion to catching up and sharing adventures and challenges, they decided to establish an endowment fund and create a scholarship in memoriam of two classmates who had passed away, while also wanting it to be more than that. They agreed that while they were still liv-ing and able, they wanted to show their appre-ciation for the opportunities made available through their Pharmacy degree, by initiat-ing a scholarship that would benefit future Pharmacy students as well as the profession.

At the 129th Manitoba Pharmacy Conference held April 13th to 15th, Vivian Quiring announced the new scholarship on behalf of the planning group (Linda Boyd, Marian Kremers, and Lyle Silverman) and her entire class.

“I was pleased to help make this happen because I per-sonally had benefited from awards and bursaries, as did sev-eral of my classmates”, says Quiring.

Since graduation, Quiring has practiced in community and clinic pharmacy, taught pharmacy at the University of Manitoba and Dalhousie University (Halifax) and has had several positions in the pharmaceutical industry. In 1987 she started her own business, Vivian Quiring and Associates Inc, and has been a consultant and speaker for personal and pro-fessional development across North America. She is grateful for these experiences and says her active and varied career demonstrates the versatility of a Pharmacy degree.

Not only was the class of ’66 the first class to establish a scholarship in the Faculty of Pharmacy, they also set a prec-edent at the U of M with gifts from 100% of the class! What made it more exciting was that this occurred in the midst of the new building campaign, to which 85% of the class con-tributed.

“Something wonderful happened along the way. As we contacted classmates who had not been at the reunion, almost everyone enthusiastically participated. The momen-tum became a tipping point, providing persuasion for a few more,” says Quiring.

The purpose of the announcement was not to draw atten-tion to the success of the class in establishing a scholarship, but, more importantly, to invite and challenge other graduat-ing classes to leave a legacy of their own, with a scholarship or other project.

“We did not start out with the intention of being ‘the first’ or having 100% participation. When it happened we were, of

course, very excited and proud. However, we certainly don’t want to be ‘the only’ class, and would delight in seeing the second, third, fourth and more plaques on the Awards wall.”

For those considering creating an endowment fund to provide a scholarship, Quiring says the planning group has three suggestions to make the process more efficient. The first is “Do not reinvent the wheel”; they’ve been through the process and are more than willing to share what they’ve learned along the way. (Those interested may contact her at [email protected]).

The second suggestion is “Put the gift in perspective.” Speak to classmates in person. Offer them an easy way to interpret their gift. As an example, for the average pharmacist a gift of $500.00 is the equivalent of a few days work. This puts the gift in perspective over the lifetime of a career and makes it easier for donors to see its feasibility.

The third recommendation is “Provide incentive and rec-ognition”. The plaque placed in the new pharmacy building on Bannatyne Campus will list individual names of everyone in the Class of 1966 as contributors to their Scholarship and Memorial Award.

The reasons for creating an endowment to provide schol-arships abound. Scholarships reward students for their com-mitment and hard work, they ease the financial burden that often comes with a university education, and encourage them, when able, to provide similar support to their Alma Mater.

Quiring emphasized, “The real story isn’t about the schol-arship and what we’ve done, it’s about the benefits to future students who will be helped in their career, to the Faculty and to the profession. It’s about having an attitude of gratitude and giving back while we are still able. It feels good and is extremely satisfying to be a grateful graduate.”

Vivian Quiring can be reached at “[email protected]”.

Class of 1966 Scholarship Committee members Marian Kremers, Vivian Quiring and Linda Boyd at the 2007 Manitoba Pharmacy Conference.


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PHARMACIST AWARNESS WEEK 2007

“It’s Safe to Ask Your Pharmacist”This year’s Pharmacy Awareness Week (PAW), running from

March 5th to 11tth, was a great success. The Manitoba Society of Pharmacists (MSP) joined forces with The Manitoba Institute for Patient Safety (MIPS) to help communicate their “It’s Safe to Ask” message. MIPS encouraged MSP to customize the message so that it would relate specifically to pharmacists, thus becoming, “It’s Safe to Ask Your Pharmacist”.

“It’s Safe to Ask Your Pharmacist” is based on the principle that patients and families can play an important role in ensur-ing the safety and quality of their own health care. Patients can become active, informed members of their health care team by asking the right questions.

This year’s message emphasized how critical knowledge is to quality health and improved health outcomes. A well-informed patient asks questions, tries to understand information they are given, and ensures adequate response and action by themselves, their families and their health care practitioners.

This year, over 24 pharmacies across Manitoba participated in PAW activities, ordering 2000 “It’s Safe to Ask” brochures and over 100 posters. Pharmacists took part by encouraging their patients to ask three important questions: What is my health problem? What do I need to do? Why do I need to do this? These three simple questions are a guide patients can use to start con-versations, organize their thoughts, and help keep track of infor-mation.The advertising campaign took the form of radio, print and television ads starting in October 2006. City TV aired the MSP television commercial, titled Pharmacists: Your Prescription for

Care, throughout the months of October and November as a lead up to PAW, while CTV aired it dur-ing the month of March. The TV ad reminds viewers that the role of Pharmacists expands well beyond filling prescriptions and reaches far into our communities.

Radio ads reached the air-ways everyday from March 5th to 11th on 99.9 BOB FM, 1290 CFRW, CKLQ 880 in Brandon and CFRY in Portage la Prairie and a print ad ran in the Manitoba Society of Seniors’ publication Fifty and Beyond, published by Pegasus Publications Inc. This year’s mes-sage was received by thousands of people across the Province.

PAW activities reached a high note, as the Honourable Theresa Oswald, Minister of Health recognized and proclaimed March 5 to 11th as Pharmacist Awareness Week, once again confirming the important role Pharmacists play in their communities.

The Manitoba Society of Pharmacists would like to extend their sincere thanks to all pharmacists and members of the community who participated in this year’s PAW campaign. The extraordinary efforts put forth by all those involved ensured PAW activities went off without a hitch. MSP extends a special thanks to the Manitoba Institute for Patient Safety for their support in planning this year’s theme.


Non-prescription products are used in the self-treatment of a self-diagnosed, self-limiting condition. These terms, as defined by Health Canada, were provided in a previous article covering oral decongestants.1 This article will review oral antihistamines available in non-prescription products.

Figure 1. Which one should I choose? Are there any differences?Which one is best for me?

What is histamine? Histamine (from histos, meaning tissue) is a biogenic

amine synthesized and stored primarily in mast cells and basophils. It plays a central role in the pathogenesis of the early-phase allergic response. Its effects include increasing bronchial epithelial cell permeability, cough, vasodilation of postcapillary venules, and bronchoconstriction. The cell types that express histamine receptors define the importance of histamine as a mediator. It appears that every cell type expresses at least one type of histamine receptor.2

Histamine receptors (H1, H2, H3, H4)The H1 receptor is widely distributed on nerve cells,

airway and vascular smooth muscle cells, hepatocytes, chondrocytes, endothelial cells, neutrophils, eosinophils, monocytes, dendritic cells (DCs), T cells, and B cells. The H1 receptor is important for modulating the body’s internal clock and a target for many clinical drugs. When histamine reacts with receptors in the brain, it results in wakefulness. Antihistamines that cross the blood brain barrier cause drowsiness because they oppose the reaction of histamine with the H1 receptors. In other areas of the body, stimulation of these receptors causes hives, bronchoconstriction, motion sickness and vasodilation. Excess activation of these receptors,

that is, an allergic response, triggers the symptoms of hayfever, urticaria and other allergic responses.

The H2 receptor is expressed on many of the same cell types as the H1 receptor including the gastric parietal cells. Histamine action at receptors on parietal

cells stimulates the release of gastric acid. H2 receptor blockers decrease the amount of stomach acid produced.

The H3 receptor is located predominantly throughout the nervous system, in particular, the central nervous system. This receptor regulates the amount of histamine produced in the body. When histamine binds to this receptor, less histamine is produced through a feedback mechanism.

The H4 receptor may play an important role as an immune modulator. This high affinity histamine receptor is highly expressed on bone marrow and peripheral hematopoietic cells, eosinophils, neutrophils, DCs, T cells, basophils, mast cells, and in spleen, lung, and thymus, as well as other tissues.3

The allergic responseAn allergy is the overreaction of the immune system

to normally harmless substances called allergens. Common allergens include, down feathers, pet dander, pollen, mites, chemicals or a variety of foods. On first exposure the allergen is taken up by the antigen presenting cell that then presents it to the T-cell. These T-cells activate the B-cells to produce IgE antibodies against the allergen. The IgE antibodies sit on the surface of the mast cell.

The mast cells have granules containing histamine, prostaglandins and other inflammatory chemical mediators. On second exposure, the antigen binds to the antibodies on the mast cells cross-linking them and resulting in the release of mediators including histamine into the surrounding tissue (Figure 2). These mediators cause the dilation of the surrounding blood vessels producing increased cell permeability. Increased permeability causes a runny nose, hives and itchy skin. Antihistamines prevent histamine from binding to the H1 receptor decreasing the body’s reaction to the allergen.

Figure 2 Release of chemical mediators from a mast cell on second exposure.

FEATURE ARTICLE

Non-prescription Products Demystified:Oral antihistamines

MEERA B. THADANIM.Sc.(Pharm.)

… continued on page 16


AntihistaminesAntihistamines are

classified as either 1st generation (sedating) or 2nd generation (non-sedating), H1 receptor antagonists.

1st generation ( s e d a t i n g ) antihistamines

The chemical structure of the first generation antihistamines contain the -CH2-CH2-N- structure of histamine and only roughly parallels the histamine structure with two aromatic rings attached through an ether (-C-O-C-) or nitrogen atom in place of the imadazole ring (Figure 3). The addition of a second aromatic ring and/or chiral centre between the aromatic rings produces a more active antagonist. This suggests that there are accessory sites to the receptor that are involved in binding the molecule. Structure-activity relationships of 1st generation antihistamines are shown in Figure 3 and the relationship summarized below:• Two aromatic rings, connected to a central carbon.• A spacer between the central carbon and the amine, usually

two to three carbons in length, may be linear, branched, ring, saturated or unsaturated

• The amine is substituted with small alkyl groups, often methyl (CH3)

• Chirality at the central carbon, can increase both the potency and selectivity for H1 receptor.

Figure 3 Histamine and the general structure of antihistamines.

All the available H1-receptor antagonists are reversible competitive inhibitors of the interaction of histamine with H1 receptors. Antihistamines antagonize the actions of histamine and relieve the symptoms of hayfever and other allergies. Many first generation antihistamines are lipophilic and cross the blood brain barrier to produce sedation. Pharmacists should counsel patients to avoid the addition of alcohol because it increases sedation. H1-receptor antagonists also bind to anticholinergic receptors causing xerostomia (dry mouth). Their lack of receptor specificity results in a less than desirable side-effect profile. Table 1 provides a list of first generation antihistamines and their recommended dosages. The dose should be individualized for the patient for their specific condition by physician and monitored by the pharmacist.

2nd generation (non-sedating) antihistaminesThe second generation antihistamines were first

developed in the 1980’s. The intitial drugs terfenadine and astemizole were removed from the market because of their potential to cause cardiac arrythmias by blocking potassium repolarization channels in the cardiac conduction system leading to QT correction prolongation and ventricular arrhythmias. Fexofenadine, the active metabolite of terfenadine, was found to retain all of the biological activity of

Table 1 Adult and pediatric and doses of first generation antihistamines5


its parent while giving fewer adverse reactions. Fexofenadine became available in 1996.

Cetirizine is a major metabolite of hydroxyzine, and a racemic selective H1 receptor antagonist. Its structural similarity to hydroxyzine can be expected to cause similar adverse reactions. In clinical trials cetirizine does show some dose dependent sedative activity. 6Cetirizine has been separated into its two optical isomers and the more active L-isomer is available in Europe and the United States.

Figure 4. Non-sedating 2nd generation antihistamines

The second generation antihistamines cetirizine and fexofenidine (Figure 4) are much more polar and theoretically should not cross the blood brain barrier to any great extent. Therefore, they are much less sedating than the first generation antihistamines. Nevertheless, the consumption of alcohol with any antihistamine should be discouraged. Second generation compounds predominantly block H1 receptors in peripheral tissues at clinical doses. Preparations are dosed once a day or twice a day. Combination products add a decongestant to the antihistamine. Table 2 provides a list of second generation antihistamines and their recommended dosages. As before the dose must be individualized for the patient and their specific condition.

The second generation antihistamines, loratidine and desloratidine, based on the imipramine structure, are significantly different in their chemical structures compared with first generation and other second generation agents (Figure 5). Desloratidine is the major metabolite of loratadine. Both of these compounds are similar to fexofenidine in their effectiveness in treating allergy symptoms.7

Figure 5. Non-sedating 2nd generation antihistamines based on imipramine

The recommendation for the antihistamine is often from the physician for a specific diagnosis. Sedation is an important factor in suggesting a product. Most patients will prefer a non-sedation antihistamine for daytime use. In some cases a first generation antihistamine product is useful if the patient needs or wants the sedative properties to obtain relief from urticaria and to have a night of uninterrupted sleep. The consumption of alcohol with antihistamines is not recommended.

Referencs:1. Thadani, M.B., Non-prescription Products Demystified: Oral Analgesics, Communication, August/September, Communication, Manitoba Society of Pharmacists, Winnipeg, 2006.

2. Peters S.P., Schulman E.S., Schleimer R.P., et al. Dispersed human lung mast cells: pharmacologic aspects and comparison with human lung tissue frag-ments. Am Rev Respir Dis. 1982;126:1034-1039.

3. Gelfand, E.W., Role of histamine in immune regulation, American Academy of Allergy, Asthma & Immunology 61st Annual Meeting, March 18 - 22, San Antonio, Texas.2005.

4. Goodman and Gilman: the Pharmacological Basis of Therapeutics on line, accessed March and April 2007.

5. Epocrates, AHFS and eCPS on line, accessed April 2007.

6. Mann R.D., Pearce G.L., Dunn N., Shakir S., BMJ,320:1184-1187, 2000.

7. See S, Desloratadine for allergic rhinitis. American Family Physician 68 (10), 2003.

Table 2. Adult and pediatric and doses of second generation antihistamines5

The Challenge was once again held at the Quality Inn and

fortunately they were able to resurrect the ping pong table

once again so that the line up of events remained the same.

The students formed teams and they were off and running

through the events that included 3 ball pool and darts along

with Ping Pong.

The most creative team name had to be “Came Here in

a Jetta Together” consisting of third year students Cynthia

Lui, Meghann Klowak, Omolayo Famuyide and MSP Student

Liaison Alana Miller; however their creativity was not enough

to take them to the winner’s circle.

Once all the tallies were in the CP Surprisers consisting of

2nd year students Glenn Pauch, Bryan Cheung, Scott Bowles,

and Barret Procyshyn had surfaced on top of the field. There

was some speculation that the team may have been involved

in some creative scorekeeping particularly since they were

seen having their picture taken with the trophy prior to the

event starting. This was of course adamantly refuted and the

rejoicing with the trophy soon followed. This included drink-

ing out of the cup which has not happened in recent history.

The MSP team, dubbed “Three Fried Eggs” and consisting

of Board Member, Brent Havelange, Executive Director, Scott

Ransome and Chair of Membership Benefits, Jill Ell put forth a

valiant effort to capture second place.

Third place went to the third year team called “Three

White People and a Black Guy” consisting of Bobby Currie,

Colin Repchinsky, Curtis Hughes and Hilary Bohn. Fourth

place went to Robin Oliver, Lucky Sekhon, Jesslin Cecon, and

Sophon Chhin.

The most honest team of the evening proved to be 2nd

year students Margo Macrae, Crystal Kosheluk, Nicole Mauthe,

and Candice Poulsen.

Prizes were handed out by Scott Ransome and Brent

Havelange and consisted of gift certificates donated by MSP

and T-Shirts donated by the Quality Inn. The evening was

enjoyable and MSP would like to thank all the students who

came out enjoyed the refreshments, tried their luck with the

Boss Q challenge and made the night a success.

We look forward to seeing the students in the future and

wish them all the best in their future endeavors.

FEATURE ARTICLE

MSP Student Night 2007The Manitoba Society of Pharmacists Student Night was held on Feb. 22nd, 2007 and the students showed up ready to take part in the 3rd Annual Boss Q Challenge.

First place winners Barret Procyshyn, Glenn Pauch, Scott Bowles, and Bryan Cheung

First place celebrations

Third place winners Colin Repchinsky, Bobby Currie, Hilary Bohn, and Curtis Hughes

18 C O M M U N I C AT I O N M A R C H /A P R I L 2007

M A N I TO B A S O C I E T Y O F P H A R M A C I S T S C O M M U N I C AT I O N 19M A N I TO B A S O C I E T Y O F P H A R M A C I S T S C O M M U N I C AT I O N 19

FEATURE ARTICLE

Fourth place winners Sophon Chhin, Lucky Sekhon, Robin Oliver, and Jesslin Cecon

Most honest team members Margo McCrae and Crystal Kosheluk

A good time was had by all!

Scott Ransome and Brent Havelange talk strategy with Robin Oliver

The Medication Information Linefor the Elderly

(MILE)

invites you to visit us at the

University of ManitobaRoom 111 University Centre

(204) 474-6493Toll Free 1-800-432-1960(ask for MILE; ext 6493)

9:30am to 2:30pmMonday to Thursday

email: [email protected]


Do you know someone who is making a difference in the pharmacy community? We would like to highlight them in this article!

Please contact the MSP office at (204) 956-6681 or [email protected].

Q&A: GETTING TO KNOW YOUR MANITOBA PHARMACISTS

CANADA SAFEWAY has current CAREER OPPORTUNITIES for both

❑ Are you looking to work in a patient focused care setting?❑ Do you want to work for a company which provides a strong team environment?❑ Are you looking for a company that can provide you room to expand your skills and future opportunities?❑ Do you want to feel secure and work for a company that will provide you an outstanding benefits package as well as

bonus potential for your skills?

We offer a Full Compensation and Benefits Package with industry-leading components.

Our Bonus Plan allows you to participate and receive benefits as a full time Pharmacist/Pharmacy Manager every year. In addition, we believe in reimbursement for cognitive services and have developed positions in many practicing specialties including:

◆ Long Term Care Clinical Pharmacists◆ Certified Menopause Educating Pharmacists ◆ Asthma Certified Pharmacists◆ Certified Diabetes Educating Pharmacists ◆ Men’s and Women’s Health Specialty Pharmacists

Together, the Safeway family is one of the largest employers of retail pharmacists in North America, and in Canada operates pharmacies in British Columbia, Alberta, Saskatchewan, Manitoba and Ontario.

If you are a pharmacist who is licensed to practice in Canada and looking to provide patient-focused care within a strong team environment, then this opportunity may be for you.

If you would like to pursue this opportunity further, please send a cover letter and resumé by e-mail or fax to the address below:

CHRISTINE LEE, B.Sc. Pharm – Pharmacy RecruiterCANADA SAFEWAY LTD., 7280 Fraser Street, Vancouver, BC V5X 3V9Phone: (604) 301-2632 • Cell: (604) 603-1079 • Fax: (604) 322-2508 • Email: [email protected] Site: www.safewaypharmacy.ca

SAFEWAY PHARMACY

FULL TIME PHARMACISTS AND PHARMACY MANAGERSin Prince Rupert, BC; Port Alberni, BC; and Dryden, ON.

Name: ARPIT LOTAY

Place/Year of Graduation: University of Manitoba, BSc. Pharm. Class of 2006

Years in Practice: 8 months

Currently Working: I am a full time pharmacist at the Drugstore Pharmacy, Real Canadian Superstore. I am currently working in two different locations. It is quite interesting as I enjoy the variation in patients, prescription flow and the people I work with. Some of my duties include dispensing, compounding, counseling on diabetes and heart health. I have also hosted various clinics that run in the store on a monthly basis to increase awareness on certain medical conditions and cur-rent issues in medicine. It has been exciting for me as a recent graduate to be able to incorporate everything I’ve learned in my training years into my practice.

Accomplishments in pharmacy: I have received several schol-arships and awards as part of my education but it doesn’t com-pare to what I’ve accomplished in my practice so far. A true accomplishment for me is when I’m able to go the extra mile for my patients so I can serve them better with the help of my practice. It is the appreciation and the gratitude that I receive from helping others that is truly rewarding.

Family:Mom: Pushpinder (‘Vicki’), Dad: Surinder and Sister: Anu

Hobbies: Reading, writing and painting

Community activities: I donate my free time by volunteering at the Sikh Temple and fundraising for its development.

Favorite thing about Manitoba: My favorite thing about Manitoba is the people; can’t find a nicer, ‘friendlier’ town anywhere else.

Most relaxing vacation choice: Somewhere in Europe, Italy or Greece.

Pet peeves: Superficiality, arrogance and liars.

Favorite fictional character and why: Right now, I am a fan of the Harry Potter series. He is strong-minded and adventurous. He is not a perfect person and always meets his challenges head on.

What could you do without forever? Sorrow

Pharmacy is the most important part of our business at ShoppersDrug Mart®/Pharmaprix®, and we want you to be a part of it! As Canada's leading pharmacy, we have tremendous careeropportunities. We offer competitive salaries and benefits and, if youhave an entrepreneurial spirit, the chance to become a PharmacistOwner. You will also have access to rewarding professional practiceopportunities, career development, and leading-edge technology.Achieve your full potential while providing top patient care.

We are currently looking for Licensed Pharmacists for the following store locations:

• Winnipeg, Manitoba • Thunder Bay, Ontario• Kenora, Ontario • Calgary, Alberta

• Red Deer, Alberta • Campbell River, B.C.• Osoyoos, B.C.

Shoppers Drug Mart has opportunities for pharmacistsand pharmacists/owners across Canada! Visit our website

for more information.

www.shoppersdrugmar t .caFor the experience of a lifetime, please contact, in strict confidence:

Kari Ferguson, Recruitment CoordinatorPhone: (403) 410-4800

e-mail: [email protected]

FULL TIME PHARMACIST REQUIRED: Mitchell’s Drug Store, Roblin, MB. Competitive wage, housing package, license fees paid, benefits package. No evenings, Sundays or Holidays. Please contact Whitney or Jim at 204-937-4424 (days) or 937-2796 (evenings), or by email to [email protected].

PHARMACIST WANTED for Glenboro Pharmacy in Glenboro, the gateway to Spruce Woods Provincial Park. Living accommodations are available. No weekends, holidays or evenings. Competitive salary offered along with chance of partnership. Please call Connie at home at 204-535-2593 or at work at 204-535-2577 or John at home at 204-723-2351 or fax to 204-723-2351.

RELIEF PHARMACIST REQUIRED for independent pharmacy. Daily hours are 10:00 am to 6:00 pm. No evenings or holidays. Contact Donna at 295-8045 or email resume to [email protected].

PART TIME TECHNICIAN required for independent pharmacy 2:00 pm to 6:00 pm daily. No evenings or weekends. Contact Donna at 295-8045 or email resume to [email protected].

FULL TIME PHARMACIST required for Shoppers Drug Mart, 43 Marion St., Winnipeg. You will also have access to rewarding professional practice opportunities, career development and leading-edge technology. Achieve your full potential while providing top patient care. This store has a great team with great shifts. We specialize in compliance, diabetic services, and the prescription needs of the elderly. As a member Canada's leading pharmacy chain, we have tremendous career opportunities as well. We offer competitive salaries and benefits and, if you have an entrepreneurial spirit, the chance to become a Pharmacist Owner. You will also have access to rewarding professional practice opportunities, career development and leading-edge technology. Achieve your full potential while providing top patient care. Please contact Dale Crawford by phone at (204) 235-1919 ext. 10 by fax at (204) 233-1973 or by e-mail at [email protected]

Full colour advertisement rates range from 1/8 page to full page. Save more with multiple issue ad placement. MSP members are entitled to place one free classified ad per membership year. Contact MSP for classified rates for non-MSP members and business (corporate) classified ads (priced according to size).


All rates are subject to GST. Space is limited. Call MSP today at (204) 956-6680 for the full current 2007 ad rate schedule. As a service to members, MSP maintains a list of employment opportunities. This list is updated every week and is available by fax or on our website at www.msp.mb.ca.

CLASSIF IEDS

Shoppers Drug Mart in Chilliwack, BC is looking for a qualified full time pharmacist starting in July of 2007.We are a new store that opened in October, 2006 and are located in the beautiful Fraser Valley in a vibrant and growing community. We are one hour from Vancouver and are surrounded by mountains. There are plenty of outdoor activities to do as well have a brand new WHL team.For more information please contact Don Martens at 604-824-1036. Resumes with cover letters can be emailed, faxed or mailed to:

Shoppers Drug Mart #225145800 Promontory RoadChilliwack, BC V2R [email protected]: 604-824-1037

mailto:[email protected]

THE LAST WORD

It is a paradox that, with a cascade of drugs avail-able on the internet, some folks still try to wheedle them from dispensaries with forged or altered script. In spite of the procedural safeguards built into the Manitoba Prescribing Practices Program (M3P) which now, in spite of the reference to a triple form, uses a duplicate form, forgery remains a problem. As we shall see, DPIN has not stopped some patients from trying to deceive pharmacists with dubi-ous prescriptions.

Kim Bright, a pharmacist at the Super Thrifty Pharmacy in Brandon, recalls an incident of a woman who came in with a vial labeled by her dispensary. “She had pasted ‘Tylenol 3’ over the real label and expected a refill. Naturally, that did not work. But every day, people come in for codeine compounds. You question them and they say that their prescription was lost or stolen.”

Other patients want benzodiazepines. “They have script for it, but they say that they are going out of town and will be away and want a fill right away before they leave.”

Desperation breeds invention. Ms. Bright recalls custom-ers who have come in with fake casts. “They will ask for a ten-sor bandage and maybe a sling and then some codeine.”

It doesn’t work, Ms. Bright says. Sometimes sheer brazenness does succeed. Alfred Au,

pharmacist at the Leclerc Pharmacy at the St. Boniface Clinic in Winnipeg recalls the time several years ago that a patient came in with script for narcotic. “We are trained to call the doctor and I did. It was night, but I tried anyway. In fact, the call was answered and the reply was that the script was okay. Later I found out that there were two guys in on the fraud. One was the patient that I saw and the other was a guy who had broken into the doctor’s office and was waiting for my call. I think there were probably a lot of other calls that night!”

Not every effort to get a drug on the M3P list is quite so bold. Some of the pranks play on the confirmation procedure that drug abusers expect. Au recalls the time that a kid with script for Ritalin presented it for a fill. It was a proper prescrip-tion, but the patient had bad news written all over him. “So I checked with the receptionist at our clinic and she said that the kid’s guardian was with him. So that was okay, but then I learned that both the kid and his guardian were in the same group home. They were working a scam together.”

Script forgery and related subterfuge is a growing prob-lem, according to data from the Manitoba Pharmaceutical Association as reported to the Canadian Community Epidemiology Network on Drug Use 2006 Report. According to data for the years 2002 to 2005, the number of forged pre-scriptions filled rose from 3 at the beginning of the period to 11 in 2003, 5 in 2004 and then 34 for 2005. In the same period, the number of forged prescriptions presented but not filled

moved from 12 in 2002 to 8 in 2003, 11 in 2004 and 73 in 2005. It would appear that while the volume of forged prescriptions presented is up, detection has improved. “The increase in reported cases comes from our efforts to raise awareness of the requirement to report drug diversion, of which forgery is a part. That increased awareness shows up in the increased rate of detection,” says Ron Guse, Registrar of the Manitoba Pharmaceutical Association.

DPIN, established in 1994, allows pharmacists to check a patient’shistory of drug fills and to deter-mine if the patient is obtaining drugs from other pharmacies in Manitoba. However, the system breaks down if patients have script purportedly issued by a prescriber in another province, says Andrew Holowaty, a staff pharmacist at the Point Douglas Pharmacy in Winnipeg.

“Recently, we have had a rash of people who come in with out of province script,” Holowaty explains. “So we check with the prescribers and often find that they do not know the patients. What’s more, the script often looks false. It may be in too nice of handwriting. The script will call for ‘one tab daily’ rather then 1 t.i.d. The quantities may be huge – 300 at a time. And they want to bill it to a third party.”

Phony script peddlers know the dispensary routine well, Holowaty adds. “They expect we’ll check on the script, so they come in between 7 p.m. and 10 p.m. when we can’t get in touch with the doctor. So we just tell them that we will get in touch with the prescriber and that they should come back in the morning.”

The M3P list of reportable narcotics and controlled drugs includes codeine in Tylenol 4. But Tylenol 3, a top choice for abusers, is the one narcotic that does not require the form used for morphine and other hard narcotics,” says Christian Onyebuchi, pharmacist at the Lakeview Pharmacy in Winnipegosis. “But we have to be careful,” he adds. “We had one patient who came in with script on a pad stolen from a local doctor. The handwriting was close, but the amounts were large. I asked the prescriber, who said he had not writ-ten it. I called the police and they arrested the girl who had brought the script.” The solution to the problem of deception, says Onyebuchi, is “be vigilant.”

That vigilance appears to be called for when the most abused drugs show up on script. According to Warren Hicks, pharmacist at The Pas Super Thrifty Drug Mart, in addition to Tylenol 3, they include benzodiazepines, and oxycodone. The first two are widely prescribed, the third, often called “hillbilly heroin,” is not, he says.

Catching bad script is not hard in a small town, Hicks says. “We know the prescribers and we know the other pharmacies in town. That limits multiple doctoring and polypharmacy. So what we get are usually simple frauds – people who write their own scripts, and the more difficult situation of people from

Script fraud: It’s a Lot Tougher, But the Desperate Keep on Trying

ANDREW ALLENTUCK


Saskatchewan who do not have a DPIN number.”Myron Kurjewicz, proprietor of Brothers Pharmacy in

Winnipeg, has seen it all. Head of the Pharmacists at Risk pro-gram, he notes that the excuses are endless. Top on the list are: ‘I forgot it on the bus,” “my uncle stole it,” and “a water pipe burst under the sink and ruined the pills.” In his view, there is another and very serious kind of prescription fraud or drug misuse. It’s by the pharmacist in the dispensary.

“A pharmacist may create script for a fictitious patient,” Kurjewicz says. “Or there may be real script for a patient and the pharmacist will just add a drug to the list. Sometimes it’s just a few tablets that disappear and don’t really amount to much in an audit. But if the pharmacist is addicted, a few tab-lets won’t be enough. Then the problems grow.”

Kurjewicz takes script fraud seriously. “I will not fill or deal with people who have altered or fiddled with a prescrip-tion. They are affecting my life. It is not a game.”

Yet the genesis of script fraud cannot be written off as mere drug dependence by a user or greed by someone who wants to resell drugs, he says. “A person may be coerced by a partner to obtain drugs. The person who is in front of me may be a victim too.”


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Helvetica, Helvetica Bold,Helvetica Black, Helvetica Light,Helvetica 77 Bold Condensed,Helvetica 67 Medium Condensed

Client is responsible for checking all copy before project prints. Colour separators, pre-press service bureaus and/or printers are responsible for verifying all technical/mechanical specifications, including but not limited to tolerances, registration, accuracy of measurements and construction details before film and plates/cylinders are generated. Any changes to accommodate print requirements must be submitted to client for approval. Perennial makes every reasonable effort to ensure all artwork is error-free; however, we cannot be held responsible for any errors present once client provides final sign-off.

• This is a digital colour mechanical, no traps have been made. Trapping to be applied by separator.• This proof/PDF is for colour break and content only and may not accurately reflect final printed inks.• Do not open this file with software and version other than that specified.

printed at 100%

9833LMO_DSP_ManCommAd_17Apr.ai9833LMO DrugStore Pharma_Manitoba Adobe Illustrator CS2, Macintosh

• Placed images in this artwork are FINAL Hi-Res, to be used for colour separations and printing.• This mechanical artwork has been prepared size as - 100%

Substrate(No Ink)

Trim(Do Not Print)

Cyan

Yellow

Magenta

Black

LoblawsDSP Manitoba Ad9833LMO-OR9833LMO-ORDSP Manitoba Ad8.25" x 10.875"Digital Imaging4Not suppliedn/aNot supplied

Documents

MSP Mag may 151720 - Pharmacists Manitoba · Telephone: (204) 956-6680 or 1-800-677-7170 [email protected] COMMUNICATION is published six times a year. The subscription rate is $12.00