Ten years after joining the faculty of the WesternU College of Pharmacy, Roger Klotz celebrated his retirement on June 29, 2017. Roger celebrated his retirement with his faculty and staff colleagues and his wife and son. The retirement party featured German food, beer and music. Roger has been a pediatric pharmacist, Director of Pharmacy, pharmacy owner, ambulatory care pharmacist, academician and always an innovator and leader. He has been active in pharmacy associations and received numerous awards. Well done, Roger!
California Specialty Pharmacy in Whittier California provides specialty medications, non sterile and sterile compounding, an infusion center and even a clinical research organization (CRO) affiliated with it. I visited with Cris Craw, PharmD, Senior Vice President and Ethan Huynh, PharmD, Vice President of Pharmacy Operations on June 1, 2017. WesternU student pharmacist Cindy Mar, PharmD Candidate 2018 and West Coast University student pharmacist Katelyn Liao, PharmD Candidate 2018 were working on optimizing the therapy of a multiple sclerosis patient during my visit.
Cindy Mar described her rotation at California Specialty Pharmacy:
"I conduct care plans, assess patient management and learn about compounding regulations. I enjoy working with Dr. Ethan Huynh along with his team to familiarize with the operation of a specialty pharmacy including billing process, prior authorizations and filling prescriptions. I was also afforded with the opportunity to call patients and understand how specialty pharmacies can help improve their quality of life through mandatory patient management."
Posted by Sam Shimomura, PharmD, FCSHP, FASHP
Dr. Benjamin Malcolm gave an excellent presentation on psychiatric pharmacy practice as part of the Noon Elective series on May 10, 2017. A couple of reflections by student pharmacists taking he course are posted below:
Reflection #1: Robert Cohen Sedgh, PharmD Candidate 2020
Dr. Benjamin Malcolm is an Assistant Professor of Pharmacy Practice and Administration at Western University of Health Sciences. He was graduated from Touro University California as a Doctor of Pharmacy. His residency were PGY1 Pharmacy Practice Resident as well as PGY2 Psychiatric Pharmacy Resident in University of California at San Diego. Psychiatric pharmacy is a field that supports the desire to care about patients and it is a credential for pharmacists who have met the eligibility criteria and who in their unique practice provide person centered care that ensure the safe, appropriate, evidence-based, and cost effective use of medications in the treatment of persons with mental illness. Other responsibilities of Psychiatric Pharmacy Practice are: Working collaboratively with interprofessional teams to optimize drug therapy; Providing direct patient care, including treatment assessment and medication management activities; Monitoring for potential adverse drug reactions and interactions; Evaluating and educating others on the medical literature; Conducting medication education groups for patients; Educating patients and families on psychiatric medications as well as psychiatric disorders and other related conditions; Engaging in patient advocacy efforts both independently and with consumer groups.
Reflection #2: Sophie Do, PharmD Candidate 2020
On Wednesday, 5/10/2017, I had an opportunity to attend a seminar lecture about Psychiatry Pharmacy, delivered by Dr Benjamin Malcon. One of the big reasons leading to drug abusive is because people have a feeling of getting rewards when taking certain drugs. Although the psychiatric disorder and mental illness are one of the big concern in the society. However, psychiatric disorder and mental illness is highly stigmatized. Sigma is a mark of disgrace with a particular circumstance, quality or person. I also learned about the burden of stigma, which is lack of understanding and empathy and social distancing and isolation and lack of seeking or obtaining care and exacerbation and perpetuation of mental illness. This lecture is interesting because I feel like I can see myself in this lecture while he was talking about encountered problems during graduate and professional school. Besides that, I learned about psychiatric pharmacist specifically such as working to optimize drug therapy, direct patient care and medication managements, monitoring for efficacy of the treatment, education patients, engaging in patient advocacy efforts, conducting research and ensuring appropriate satisfaction. This lecture also give me another option for my career choice after my graduation.
The WesternU College of Pharmacy held its 18th Annual Advanced Elective Poster Day on May 4, 2017. As part of the 16 week Advanced Elective required of all 4th year students, they complete either a project that culminates in a poster or for those in the Independent Ownership track, a business plan the they must present and defend to experienced owners and/or bankers.
Dr. James Scott, Associate Dean for Experiential Education and Professional Affairs announced the winners of the various awards at the awards ceremony following the poster session.
1st Place: Mahsa Haghgooyan, Risk factors of post-transplant thrombocytopenia and association with genetic polymorphisms of platelet derived growth factor (PDGF) genes
2nd Place: Jimmy Qiu, An Evaluation of Medication Synchronization and Its Effect on Medication Adherence
3rd Place: Lena Haday, Patient Outcomes associated with Risk Factors with Clostridium Difficile Diarrhea in Hospitalized Adult Patients
Other finalists: Haig Haig & Gurpreet, Predictors of Stroke Severity with a National Institute of Health Stroke Scale (NIHSS) at 30-day, 90-day and 180-day mortality and Readmission Rates in a VA Loma Linda Medical Center (VALLMC) and Sharon Deng, Assessing and Addressing Medication Adherence Challenges Utilizing "Modified Drug Adherence Work-up (M-DRAW) tool" in a Primary Care Clinic Setting at VA Loma Linda
1st Place: Lorena Vieira-Vest/Jonathan Meas, Analyzing Medication Nonadherence and Its Predictors through CVS Health's "My Patient Care Adherence Outreach Program" in the Community Pharmacy Setting
2nd Place: Avital Kashanian, CBD Awareness among CA Pharmacists
3rd Place: Holly Nguyen, Increasing the rate of immunization in outpatient pharmacy through MTM session focused recommendation: a prospective observational study
Other Finalists: Serly Simonian, Adverse Drug Reactions Experienced by Patients over the age of 65, Taking Medication Identified to be Harmful to the Elderly According to the 2015 American Geriatric Society's Beers Criteria, and Hoang-yen Tu, Adherence to Antiretroviral Therapy among HIV infected patients at a nonprofit clinic in Oakland
Community Independent Ownership business plans:
Most Unique/Innovative: 1st Place, Diana Jeon; 2nd Place, Amirali Sepehrdad
Best Business Plan: 1st Place, Katherine Norris; 2nd Place, Aninder Singh
Best Overall: 1st Place, Katherine Norris; 2nd Place, Daniel Tieu
Please congratulate each of the winners when you see them again.
Viagra, Emsam, Warfarin… Why do we remember these names? How are drug names created? Well, first the generic name must go through review from an organization called the United States Adopted Names (USAN) Council. They compare the generic name and makes sure that the name reflects the chemical nature and will be appropriate in other languages. Later, once the company wants to create a brand name they could use a variety of companies that help research marketing strategies for the name. When those companies are asked about how they go through the process of naming a drug, they do not typically report the process. However, there are a few companies that explain how they came up with names. For examples, Warfarin was named after Wisconsin Alumni Research Foundation, a.k.a. WARF, Nystatin was named after New York State from the N.Y. State Health Department laboratory. Some were even named after people such as Emsam® was named after the developer’s children, Emily and Sam, as well as Bacitracin which was named after the girl who got an infected knee, Margaret Tracey. Overall, some drug companies go through a vigorous process of naming their drugs as other use names from stories, it makes one wonder the background of some of these drugs.
Boyle, R. (2013, April 23) FYI: How does a drug get its name? Popular Science. Retrieved on 5/2/17 from http://www.popsci.com/science/article/2013-04/fyi-how-does-drug-get-its-name
Elizabeth Lee Hazen and Rachel Fuller Brown. (2015, August 17) Chemical Heritage Foundation. Retrieved on 5/2/17 from https://www.chemheritage.org/historical-profile/elizabeth-lee-hazen-and-rachel-fuller-brown
Keltner N.L. and Steele, D. (2015) Psychiatric Nursing: Seventh Edition. Missouri, Elsevier Mosby
Meek, T. (2013, June 27) How dead cattle led to the discovery of Warfarin. Wisconsin Alumni Research Foundation. Retrieved on 5/2/17 from http://www.warf.org/news-media/news/in-the-news/how-dead-cattle-led-to-the-discovery-of-warfarin.cmsx
Scutti, Susan. (2016, November 25) ‘Creation Engineering’: The Art and Science of Naming Drugs. CNN Retrieved on 5/2/17 from http://www.cnn.com/2016/11/25/health/art-of-drug-naming/
Wick, Jenette. (2014, April 14) Bacitracin and Boo-Boos: Becoming a No-No. Pharmacy Times. Retrieved on 5/2/17 from http://www.pharmacytimes.com/publications/issue/2014/april2014/bacitracin-and-boo-boos-becoming-a-no-no
Drug Company Hearing-SNL
Posted by Leonel Garcia, PharmD Candidate 2018
Christine Acosta, PharmD, Supervising Inspector for the California State Board of Pharmacy and an alumna of the WesternU College of Pharmacy described her career path that brought her to her current position. The presentation was part of the Noon Elective series on May 3m 2017. A couple of reflections from students taking the course are posted below:
Reflection #1: Leticia Arreola, PharmD Candidate 2020
Christine Acosta, Pharm. D. who is employed by the California Board Of Pharmacy. Her organization is responsible for providing pharmacy licenses, regulation & inspections of: pharmacies, hospital pharmacies, wholesalers, non-resident wholesalers (cardinal, mckesson) pet food animal retailer, hypodermic needle & syringe permits and outsourcers, just to name a few. As far as pharmacists working as pharmacist in charge [pic], the Board of pharmacy will investigate any patient complaints that are not regarding billing or customer service. The board will hold the pic accountable if found at fault, which may include a fine or even revoking of a license. As far as the pic’s routine responsibilities, they are required to notify the board within 15 days, to report drug theft by pharmacy licensed employee. They are also to report cures weekly and on time! She mentions that some pharmacies have it done automatically but the pic must ensure the system is doing it correctly and in a timely manner. I actually did think about working for the board of pharmacy briefly, a few years ago but as life gets busy, I quickly forgot. With Dr. Acosta coming and presenting her career path, I believe it is a worthwhile opportunity to apply to the board of pharmacy but only after working in retail and clinical as Dr. Acosta did. Having that background can really benefit the line of work she is in because she knows first-hand of how a pharmacy operates and should operate. I look forward to applying to the Board of Pharmacy after I have been a pharmacist in the retail and clinical setting as Dr. Acosta.
Reflection #2: Ida Javai Razaz, PharmD Candidate 2020
Dr. Acosta is a supervising inspector for the California Board of Pharmacy. Dr. Acosta firststarted by telling us her background and how she got to where she is today. Dr. Acosta alsotalked to us about what her role as a supervising inspector is. Dr. Acosta became a pharmacist,did research at WesternU, eventually became an inspector for the BOP and is now a supervisinginspector for the BOP. Dr. Acosta told us that the main goal of the BOP is to protect the publicfrom pharmacists and this can go as far as taking away a license from a pharmacist to endurepublic safety. Dr. Acosta mentioned some people that the BOP licenses, which includepharmacies, hospital pharmacies, clinics, wholesalers, drug rooms, probationers, andoutsources. Dr. Acosta mentioned when inspectors have to perform inspections, which includeroutine inspections, new pharmacy inspections, wholesale inspections, change of locations, andas needed inspections. Dr. Acosta also talked to us about outcomes from their investigations,which can be formal or informal. Dr. Acosta also talked about the pharmacist recovery program,which is applied to interns and pharmacists only. Issues involving the recovery program includesubstance abuse, alcohol abuse, physical impairment and mental issues. I never knew the rolesof a BOP inspector and found this talk to be very educational.
Reflection #1: Leticia Arreola, PharmD Candidate 2020
Dr. Elinore Chung is a medical liaison working for Regeneron Pharmaceuticals, a company that specializes in monoclonal antibodies for immunotherapy. She is also the Associate Director in immunology and inflammation. She graduated from University of Southern California with a Pharm D. Dr. Chung presents the process of drug development. She explains that drug discovery includes finding new targets. Once they find the target they will focus on, drug development continues with looking at the drug using animal models to identify toxicities, dosing. This takes about 1 to 3 years. Phase 1 determines PK/PD, healthy subjects are used in this setting. Phase 2 comprises of using the drug in diseased populations. This phase determines safety. Phase 3 consists of clinical trials for efficacy confirmation of the drug. After that is done, the drug manufacture applies for NDA & approval, then PDUFA, prescription drug use fee act, FDA states if approved or not or requirements for approval. Less than 12 % of drugs make it this far. Phase 4 is post marketing surveillance. For example this happened with Vioxx. It was approved for marketed use but during Phase 4, it was recalled. Dr. Mentions that to be qualified as a medical liaison, a person must hold an MD, PharmD or PhD. These medical liaisons with experts in their fields to form an advisory board for drug manufacturers. Medical liaisons are hired from phase 1 to 4 of drug development. I find this career very enticing. Although, there seems to be no patient contact, which I really enjoy. It does seem fulfilling when you think of developing a cancer or other disease medication that help people survive or improve their benefit of life.
Reflection#2: Alison Augustin, PharmD Candidate 2020
On April 25, 2017 Dr. Elinore S. Chung came to speak about Drug Development and Medical affairs. There are a lot of different roles in medical affairs and is critical to Drug development. There are various different departments, such as medical education, medical research, health economics/ outcomes, etc. One of the roles, Medical science liaison, is something that I recently discovered as a career path from the AMCP Night of Managed Care. They are a field- based scientific professional and was in response to the need for scientifically trained field staff to build rapport. They are the medical face of a company and they are the only medical person that a health care provider will communicate with in the company, so an MSL must have very strong social characteristics. Some of the positives working as an MSL include intellectual challenge, the ability of working remotely, working with a lot of different colleagues, and on the job learning. In this practice, the MSL must be proactive in seeking out new and updated information. This job is still emerging, but understanding the benefits and what it offers, it is a great non-traditional career path for pharmacists.
On April 19, 2017, Dr. Jason Wong presented a lecture on "Board Certification" to the Noon elective seminar class. A couple of reflections by the students in the class are posted below:
Reflection #1: Esther Park, PharmD Candidate 2020
In this seminar, Dr. Wong talked about what board certification is, why it is important,
the requirements that are needed to sit for the exam, and the different types of board
certifications available. Each BPS pharmacist must recertify every 7 years and the passing rate is
60%, which means that 60% of the people who took the exam passed. As pharmacists, we should
consider getting certified because it gives you the credentials and gives you personal satisfaction
because you’re being recognized as a pharmacist at a specialized or higher level. In order to sit
for the exam, you have to graduate from an ACPE accredited program, need a current active
license, and need to practice for at least 3 years or you could complete a PGY1 residency. There
are many different types of board certifications available and some examples are in ambulatory
care, oncology, nutrition support, pediatric, geriatrics, and psychiatric support with each
specialization differing in exam content. There is not a lot of knowledge in terms of pediatric
treatments so pharmacists play an important role in becoming the educator of doctors, children,
and family about medications.
Reflection #2: Ramy Seng, PharmD Candidate 2020
Dr. Jason Wong’s informative lecture outlined the steps and the rewards of being board certified. As I am contemplating between applying for residency or not, I appreciate his candor and advice. Though we may not be thinking about it now, but the recent legislation that passed empowering pharmacists with provider status will create dynamic waves in the field of pharmacy. To better prepare for this oncoming change, we must pay close attention to the opportunities provided now. Though we might decide not to do residency, another alternative would be getting board certified. And it has so many fields like geriatric, nuclear, critical care, etc. The learning involved is tantamount. And as more students are graduating, the competition is getting harder, and more employers are looking for the prospective employees who are putting in the extra effort to better the profession. Dr. Wong also provided many useful links, as well as pertinent statistics to the different exams available that I will definitely check out later. This was an incredibly useful lecture.
My name is Leonel Garcia Jr. and my presentation is about Dr. Guru Betageri’s patents, my device and how to obtain a patent. Dr. Guru Betageri is the Associate Dean of College of Biomedical Colleges and is the first person in WesternU to apply for and receive a patent. He is very inspirational and I had the chance to conduct an interview with him to share some of his advice for aspiring inventors. During my IPPE II rotation, I was introduced to a Chemolock ® device, which inspired me to make a device of my own to prevent needle sticks for the extraction of liquid from capsules. Once I created the device, I introduced the idea to my work, UCI, and they were satisfied with it so much that they put a provisional patent on the idea. Patents are a key part of the U.S. Constitution as the government has an obligation to support people’s creativity. Overall, the process of coming up with an idea and protecting it with a patent is not one taught in school, so I am very happy to share my experience and hopefully inspire some aspiring inventors.
During the interview with Dr. Betageri, I asked key questions that led to his success with his multiple U.S. Patents. He credited most of success to his education as he stated, “when you construct a building, you need a strong foundation, then you build upon it.” This metaphor was a major theme throughout our discussion as he kept referring to the building as experience and that it could be built through education and reading articles. He also mentioned that he did have ideas before he came to WesternU, but it was through the support that the school gave him that would make his ideas into reality. In the interview, I mentioned that I was also an inventor with a provisional patent, but have not had an idea in a while, so I asked him how does one come up with an original idea. His process is that he first must be aware of a problem, then he could only go about solving it if the problem is within his specialty.
My invention is named the Capsule Holder for Safe and Efficient Liquid Medication Extraction in Pharmacy Setting posted on the UCI website. This idea is for a medication called nimodipine which is for the treatment of subarachnoid hemorrhagic stroke, SAH. SAH accounts for 10% of the 800,000 people in the United States that have a stroke per year. Nimodipine has only two forms available in the U.S. as liquid filled capsules and liquid, but the liquid is far more expensive than the capsules. However, since most stroke patients do not have the ability to swallow, drugs are usually given intravenously or through a nasogastric tube. Therefore, capsules must have the liquid extracted from it and placed in an oral syringe. By using the device that I have created, hospitals can save up to $1,800 per patient and prevent possible needle sticks. After creating my device, I met with the UCI Invention Transfer Group and they liked my idea so much that they decided to put a provisional patent on it. This inspired me to make more prototypes and research the patenting process.
Patents are built on the idea from the first article of the U.S. Constitution which states that the U.S. shall protect original ideas made by its citizens. The first step in protecting an idea is to research if there is already a patent on the product which could be done by utilizing patents.google.com. Afterwards, a provisional patent may be a good first route as it is not evaluated by the United States Patent and Trademark Office while holding a filing date for the inventor’s idea. Then the inventor could file for a utility patent which will protect the idea for about 20 years if granted. Once the fees are paid for, the patent grant comes with references to prior patents, the inventor’s name, specification and claims along with a gold seal and red ribbon. Overall, by interviewing Dr. Betageri and explaining the patenting process using my experience as an example, I hope that I will be able to inspire more people to explore their ideas and pursue their patents.
Posted by Leonel Garcia, PharmD Candidate 2018
Dr. Nghia Pham and her two rotation students, Vinnie Nguyen (Midwestern) and Maggie Wong (WesternU) gave an excellent presentation on "Hospice Pharmacy: End of Life Care" on April 12, 2017 as part of the Noon Elective Seminar series. A couple of student reflections are posted below:
Reflection #1: Fadi Hasso, PharmD Candidate 2020
Dr. Nghia Pham spoke about hospice care and what that sector of pharmacy entails. The hospice movement was started by Dame Cicely Saunders. Hospice is now a Medicare part A benefit. Patients are assigned into hospice care if they have less than 6 months to live and may live at home, assisted living facility, etc. Average length of service is 71 days and approximately 1.6 million patients. Only 30 percent is related to cancer. Hospice, is common for many other conditions, especially now that people live longer due to medical advances. Pharmacist do not usually deal directly with patients, rather having a close relationship to doctors and nurses. At this point in life, medications are not used to cure rather to relieve symptoms such as pain, nausea, vomiting, metal instabilities, and delirium. Death is a challenging process to witness. Usually patients become sleepy, lethargic, obtunded, semi-comatose, comatose, then die. Others have a more difficult death which involves confusion, tremulous, hallucinations, mumbling delirium, myoclonic jerks, seizures, prior to death. The last 3 to 6 months are troublesome with many difficulties carrying normal life functions like breathing, eating, drinking, and withdrawing from society. Working in hospice takes a great deal of maturity. One must understand that it’s a privilege to care for someone during their last days of life.
Reflection #2: A Ra Hwang, PharmD Candidate 2020
Dr. Nghia Pham from Home Care-Rx gave a lecture on “Hospice Pharmacy: End of life care.” She spoke about working with hospices and her role as a pharmacist in Costa Mesa. Taking care of the dying began in the middle ages but in America it has only been 40 years. It is part A Medicare benefit. Palliative care comes before hospice and is for symptom control. It is paid for by the patients insurance and not the government. Hospice begins when a physician certifies patient has 6 months to live. Hospice patients can live anywhere from home to nursing facilities. Earlier hospice was related with cancer when there were no chemotherapy treatments and only radiation. I currently work at a closed door pharmacy and work with long term care, assisted living facilities, and hospices. I thought it was interesting to see that they give packets of medications for actively dying patients to aid with the process. Our pharmacy does not do that but it was interesting to see that. It seems that this pharmacy also compounds medications specially for patients into suppositories. I really liked that she talked about how it is a privilege to take care of patients.