CanadaPharmacyNews.com

B.C. pharmacies put cough medicine behind counters following a rash of teen overdoses

From the Vancouver Sun:
Some B.C. pharmacies are moving cough remedies containing Dextromethorphan — known as DM or DXM — behind the counter at the request of the College of Pharmacists of B.C. following a rash of intentional overdoses by teens.

In the last two weeks alone, four teenagers in the Victoria area have landed in treatment after overdosing.

DXM, a cough suppressant and pain reliever, is easily accessible at drugstores. Youth use it to get high by exceeding the recommended dose.

According to the College of Pharmacists, the prime recreational users of DXM are 14 to 15 — although there are reports that children as young as 10 also use the drug.

Signs will be placed on pharmacy shelves where cough remedies are kept directing purchasers to the dispensary for a consultation, college spokesman Marshall Moleschi said Wednesday. ...more

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Canadian research links anti-depressants, cataracts

From the Montreal Gazette:
Some depression and anxiety drugs are associated with an increased risk of cataracts, new research shows.

According to the study in the journal Ophthalmology, British Columbia and Quebec researchers found a link between cataracts and some drugs in a class of medications called selective serotonin reuptake inhibitors.

The study used a database of more than 200,000 Quebec residents over the age of 65.

Across Canada, pharmacies last year dispensed about 24 million prescriptions for SSRIs with a dollar value of $1.1 billion.

After adjusting for other risk factors including gender, hypertension, diabetes and heart disease, the relative risk of having cataract surgery was 1.51 times greater for those taking fluvoxamine (Luvox).

For those taking venlafaxine (Effexor), the risk was 1.34 times higher and for those on paroxetine (Paxil) the risk was 1.23 times higher. ...more

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Prescription for variety

From the Montreal Gazette:
Television viewers of a certain age will remember a Western called Have Gun, Will Travel. Louise Le May is no hired gun: she's a pharmacist. But like Paladin, the star of the long-running series, she does travel for work.

Le May works as a replacement pharmacist: instead of being based in a single pharmacy, she works in pharmacies around the province: she might be in Abitibi one week, in Drummondville and Richmond the next, in a pharmacy near Joliette the week after that.

Replacement pharmacists fill in for absent pharmacists, whether they're vacationing or ill or on maternity leave, or they simply help with the general pharmacist shortage in Quebec. Often they spend just a couple of days at a time at a particular pharmacy - and never longer than a couple of weeks.

Most of the time, they're hired, through agencies, by the pharmacies or the hospitals that need them. Longueuil-based Elitis Pharma, where Le May works, has a bank of 160 pharmacists who do replacement work. About 20, including Le May, are full-time Elitis employees. The rest work part-time on behalf of the agency. It might mean 25 or 30 hours for some each week and, for others, one weekend a month. Others, in turn, choose to work flat out over several months, then take a few months off to travel. ...more

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A Rash Of Robberies

From the Calgary Herald:
After pharmacist Randy Howden was robbed at gunpoint twice last year by the same man, he had to make changes to his business.

First and foremost was a new security camera.

Then he installed signs at the front of his pharmacy and other secret security measures.

Adding security bars to the windows, though, seemed like too much.

"It's hard because you don't want to make your place look like Fort Knox and not welcoming. It's about trying to find that balance," says Howden, owner of The Medicine Shoppe on Crowfoot Crescent N.W. ...more

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Drug deal in place

From the Halifax Chronicle Herald:
Medavie Blue Cross and Shoppers Drug Mart have called a truce in their war over how and how much customers pay for drugs.

The two companies announced Saturday that they had reached a tentative deal that would end the dispute that related to payments for generic drugs.

Talks were continuing, but Medavie said in a news release from Moncton that an agreement was in place that would see their cards accepted by Shoppers Drug Mart.

And Jeff May, senior vice-president of professional affairs for Shoppers Drug Mart, said the deal ensures customers can fill their prescriptions and not have to wait to be reimbursed.

"This tentative agreement will allow these pharmacies to maintain the level of service their patients have come to expect, including the electronic processing of Medavie Blue Cross payments," May said.

Details of the tentative agreement were not released. ...more

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Sask. pharmacists to get dose of prescribing power

From CBC News:
Saskatchewan pharmacists will soon be allowed to provide services normally reserved for doctors, the province announced Wednesday.

Proposed changes to the Pharmacy Act, which could be in place by summer, would let pharmacists dispense drug refills when a doctor is on vacation and provide a limited supply of a prescribed medicine in an emergency.

"It'll cover pretty much every regular style prescription drug that, for example, they'll be able to extend if the patient runs out of their medication," Ray Joubert, the registrar of the Saskatchewan College of Pharmacists, explained at a news conference.

Pharmacists have lobbied the government for years for more leeway with prescription medicines.

"We have asthmatics coming in that need their medication," George Furneaux, a Regina pharmacist, told CBC News Wednesday. "They're late at night. They're having an asthma attack and our legal choice is not to be able to fill the prescription." ...more

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An indispensable team member

From the Montreal Gazette:
As a pharmacy student interning at the Montreal General Hospital last summer, Alexandre-Jacques Amiel often followed the doctors on their rounds in the intensive-care unit.

He listened carefully as they examined patients and made their diagnoses. One afternoon, Amiel stood at the foot of the bed of a patient suffering from endocarditis, a potentially fatal heart infection.

The doctors weren't sure which medication to prescribe as a course of treatment. The debate went back and forth. So the 22-year-old Amiel screwed up the courage and recommended the ideal antibiotic.

And they listened to him.

"The doctors were having trouble deciding what kind of treatment they were going to give, and I felt like I had a very big impact with that antibiotic," recounted Amiel, who is in his third year at the Université de Montréal's undergraduate pharmacy program. ...more

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Dispensing advice

From the Montreal Gazette:
Pharmacists these days are on the front line of health care - often the first health professionals people seek out for guidance.

"They don't want to go and sit for hours in a clinic or emergency room, so they come to us with questions," pharmacist Marc Rabbat said. "We do a sort of triage with them. We're not trained to diagnose diseases, but we're trained to look for certain symptoms."

Rabbat has been a pharmacist for 10 years. He is currently working at the Uniprix Pierre Gravel pharmacy at Plaza Pointe Claire.

Joelle Wizman has been a pharmacist for 25 years. She works at the Jean Coutu pharmacy on Monkland Avenue in Notre Dame de Grace.

"Some people don't have a family doctor, so they come to us for advice," Wizman said. "If they just have a cold, we can give them some guidance before they start to panic and then go clog the emergency rooms." ...more

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Medavie, Shoppers Drug Mart can't reach deal; card will no longer be accepted at pharmacy

This could be an interesting situation. If Shoppers is able to win this battle, I would think they would try similar tactics in other provinces.

From the Fredericton (NB) Daily Gleaner:
Most Atlantic Canadian Shoppers Drug Marts will stop accepting the Medavie Blue Cross card for prescription drug payment next week.

Shoppers and Medavie have been unable to reach an agreement on a new payment schedule. This means people with a Blue Cross drug plan who go to Shoppers for their prescriptions will have to pay the full cost up front and seek reimbursement from Blue Cross later.

Medavie spokesman Mike Randall said there may be an easier way for people who don't want to make the trip to a Blue Cross Quick Pay outlet or send their reimbursement forms through the mail.

"The easiest and simplest way would be to head to another pharmacy close to you, ask the pharmacist to transfer the prescriptions and they'll take care of the rest," Randall said, adding there are still more than 600 pharmacies in Atlantic Canada that accept the card.

"Then there will be no out-of-pocket expenses for you and you'll get seamless continuous coverage."

Medavie Blue Cross has been in discussions with pharmacies in the Atlantic region over the past few months about introducing a new payment schedule "designed to reflect ongoing changes in prescription drug landscape in Atlantic Canada, and Canada, particularly with generic drugs," said Randall. ...more

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Online medicine comes with risks

From the Montreal Gazette:
From clothing and books to groceries and dog food, it seems like you can buy just about anything online today.

But people looking to save a buck might get more trouble than they bargained for by purchasing medications and natural products online.

"If it seems too good to be true, it usually is," said Michel Caron, a pharmacist at Ordre des Pharmaciens du Quebec. "The risks of buying medications online are enormous."

Many websites claim to be selling brand name prescription drugs at discounted prices. The main problem, Caron said, is that people don't know what they're actually getting when they order medications from a website.

"There is a huge market for counterfeit drugs online," he explained. "These pills may resemble the genuine ones but many of them don't even contain medication; they're flour or sugar pills."

Some of the most popular counterfeit pills are lifestyle medications such as those for erectile dysfunction. ...more

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Pharmacies reporting slow supply of drugs

From the Swindon (UK) Advertiser:
A leading Swindon pharmacist has spoken out at a shortage of drugs which, it has been claimed, is a result of some healthcare organisations who have been selling UK drugs to Europe, where they can get a better price.

As a result, the Royal Pharmaceutical Society says urgent action is needed. They claim that patients’ lives are being put at risk and UK pharmacies are facing increasing shortages of drugs used to treat cancer, high blood pressure and epilepsy.

Richard Thomas, proprietor of a small chain of five pharmacies which include Park Lane Pharmacy, Old Town Pharmacy and Toothill Pharmacy, which are part of the Hatch Ride Holdings, has become increasingly aware of the problems in sourcing some expensive drugs.

He said: “My pharmacists have been experiencing severe difficulties in obtaining certain drugs from the wholesalers. Naturally, we cannot keep each and every medicine in stock, so we rely on express ordering. ...more

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Oxycodone boom hits Manitoba

From CNews:
A few years ago people were worried crystal meth would invade Manitoba the way it did some U.S. states, which became ridden with addicts, fatal overdoses and clandestine labs.

It didn’t happen to that extent, thankfully.

But a different drug has creeped in without the hoopla and warnings, and is quickly becoming an abused drug of choice, especially for middle-class Manitobans.

The oxycodone boom is here.

Law enforcement and support workers say the continuous busts by police and rising number of addicts seeking treatment or overdosing on the highly-addictive prescription painkillers are proof, and they’re worried things will get worse if more isn’t done to educate people about the risks and signs. ...more

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Wrong Prescription Filled at Walgreens Pharmacy Costs Company $33 Million Following Death of Woman

From Drugwatch:
In 2002, a Walgreens pharmacy filled a woman’s prescription for warfarin, a medication used to prevent blood clots, at 10 times the recommended dosage, a mistake that eventually caused her death. On February 26, 2010, Walgreens was ordered to pay $33.3 million to the woman’s surviving family.

Beth Hippely took her prescription for 1 milligram tablets of warfarin (sold under brand names such as Coumadin) to a Polk Country, Florida Walgreens pharmacy, where a 19-year-old pharmacy technician filled her prescription with 10 mg tables of the medication.

Hippely took the medication for several weeks before she experienced severe headaches, a brain hemorrhage and paralysis. Prior to her death, Hippely’s only form of communication was blinking her eyes. ...more

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For-profit medical centre set to open

This has been "Where are they now?" week when it comes to some of the Canadian internet pharmacy pioneers. It's been interesting to see where they're at these days.

From the Winnipeg Free Press:
Charleswood is set to become a new front in the battle for private for-profit medical care.

The Four Rivers Medical Clinic will open a new centre at 5905 Roblin Blvd. this spring that will charge patients who are treated by nurse practitioners, registered nurses who have advanced medical training.

Internet pharmacy pioneer, downtown property developer and medical clinic operator Daren Jorgenson said he believes the time is right to charge patients a nominal fee for basic health care in place of them not being able to find a family physician.

"I think everyone understands our current health-care system is broke," Jorgenson said. "Is there any family medicine physician in Charleswood accepting new patients? No. Can I recruit 10 doctors for Charleswood? No, I can't. But what I can do is recruit some nurse practitioners and, partnered with some doctors, deliver a mixed model of fee-for-service."

The clinic is already renovated to begin operation and all Jorgenson is waiting to do is recruit some nurse practitioners. Still, it hasn't been an easy sell.

"There's some that believe that anytime you charge a patient money that somehow you're against Tommy Douglas and our universal health-care system," he said. "But then you remind them that dental care is health care and you pay for that and a pharmacist is health care and you pay for that." ...more

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Online pharmacist eludes ban

From the Winnipeg Free Press:
An Internet pharmacist who recently lost his credentials to practise in Manitoba is distributing generic drugs from an online pharmaceutical business based on an island off the coast of Venezuela.

The Free Press confirmed online pharmacy pioneer Andrew Strempler's business, PharmaCheck, started operating in a free-trade zone in Curacao in August 2006 -- the same month the U.S. Food and Drug Administration first warned consumers prescription drugs from Strempler's Manitoba-based online pharmacy, RxNorth, were unsafe.

Strempler did not respond to interview requests from the Free Press, and an employee at his Curacao office said he is currently in Panama. His company's website says PharmaCheck Canada has expanded beyond the North American market and now ships generic pharmaceutical products to Europe, Central and South America and the Caribbean.

The news that Strempler is still in business outside Manitoba comes as a shock to local regulators, who recently wrapped up a three-year probe into allegations his Minnedosa-based Internet pharmacy sold counterfeit prescription drugs to Americans. Strempler agreed to strike his name from the provincial pharmacist registry and pay $7,500 as part of a deal to stay the charges against him at a discipline hearing last October. Experts say it's the most severe penalty that can be handed to a pharmacist and prevents Strempler from renewing his licence to practise in Manitoba. ...more

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Generation B - Independent Drugstores Seek Own Rx for Survival

From the New York Times:
Drugstore chains measure success in market share — Walgreens, CVS and Rite Aid, the three largest, fill one-third of all prescriptions in the United States. But small family-owned stores, like Tepper Pharmacy on East Lancaster Avenue here, build a business a customer at a time, sometimes at the darkest hour.

Barbara Renninger, 52, became a Tepper customer for life during a 1996 snowstorm. Her son had pneumonia, roads were impassable, stores in this Philadelphia suburb were closing early, and she needed a prescription filled. “Tepper said, ‘We’ll stay open until you can get here,’ � she recalled. “I walked. The pharmacist was standing at the door waiting for me to lock up. You never forget something like that.�

Last Dec. 24, as the store was closing for the holiday, Naomi Bolts’s family called. Ms. Bolts, 79, was being discharged from the hospital at 4:30 Christmas Eve after open-heart surgery and needed 15 prescriptions filled. “I don’t know who did it, but I’m sure that nice young Joe Niagara was involved,� Ms. Bolts said last week. Mr. Niagara, 47, the manager, who started working 30 years ago as a delivery boy for the current owner’s father, stayed two extra hours, helping the pharmacist fill the order.

When Pauline Hirsch’s grandson became sick in the middle of the night, she reached the owner, Steven Tepper — who has a 24-hour answering service — and he came in to fill the prescription. “I shop here five days a week,� said Ms. Hirsch, 74. “I want them to stay in business.� ...more

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Lawsuit launched over common Parkinson’s drug

From the National Post:
An Ontario judge has approved to a class-action lawsuit by Parkinson’s patients who say a commonly used drug turned them into “relentless� gambling addicts, causing some to lose hundreds of thousands of dollars.

The decision to certify the unusual class action is the first such ruling in Canada among several cases that have been launched over “dopamine-agonist� drugs, designed to counter stiffness, shaking and other symptoms of the nervous-system disease.

A growing number of studies have linked the medicine to excessive gambling, sex addiction and other compulsive behaviour in a minority of Parkinson’s sufferers.

The certification judgement by Justice George Strathy of the Ontario Superior Court deals with Permax, which was taken off the market in 2007 because of other, heart-related side effects. About three dozen Parkinson’s patients have already signed up with the class-action, said Darcy Merkur, one of the lawyers handling the lawsuit. ...more

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E-prescriptions more reliable than handwritten ones

From CNET News:
Here's one for the important-but-obvious files.

New research at Weill Cornell Medical College in New York finds that medical professionals writing prescriptions by hand are seven times more likely to make errors than those using electronic systems.

Researchers looked at prescriptions written by health care providers at 12 community practices in the Hudson Valley region of New York. They compared the number and severity of the found errors between 15 providers who wrote prescriptions by hand and 15 who used a commercial system that provides dosing recommendations and checks for drug allergies, duplicates, and combination effects.

The researchers inspected 3,684 paper-based prescriptions at the start of the study and 3,848 paper-based and electronic prescriptions written one year later. After one year, the percentage of errors for providers using the electronic system dropped from 42.5 to 6.6. For those writing prescriptions by hand, the percentage of errors held almost steady, increasing slightly from 37.3 percent to 38.4 percent. ...more

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Hilo pharmacist’s life or death struggle with armed robber

From Big Island Video News (Hawaii):
It was a day like any other at Tom Moyer’s Windward Pharmacy at the Puainako Town Center in Hilo on Tuesday, until he found himself in a life or death struggle with an armed robber who was demanding drugs and wielding a loaded 30.06 bolt-action rifle.

As Moyer recounts in this video, the lengthy (and terrifying) grapple over the rifle led to suspect Paul Santoro - a 28 year old Puna man - being disarmed, and later arrested at the pharmacy for his actions.

Pharmacist Tom Moyer's life or death struggleThe 57 year old Moyer had some help from his pharmacy employees. Hawaii County Police say two of the pharmacy employees were injured during the incident. A female employee sustained an injury to the back of her head when she was allegedly struck by the suspect. The male pharmacist sustained lacerations to his hands. Both refused treatment. ...more

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Anti-seizure drug promotion faces legal fire

I can't recall ever seeing Neurontin being used for a seizure disorder. It's one of the few drugs I can think of that is almost exclusively used off-label.

From CBC News:
A lawsuit over the anti-seizure drug Neurontin began in the United States on Monday, with patients, insurance companies and unions accusing the drug manufacturer of aggressively marketing it as pain medication, an unapproved use.

Neurontin, also known by its generic name gabapentin, is approved for use in Canada and the United States to help control epileptic seizures.

Doctors in both countries prescribe gabapentin to control pain. Canadian doctors wrote two million prescriptions for the drug or its generic versions in 2009.

In 2004, Pfizer subsidiary Warner-Lambert settled a lawsuit filed by federal and state drug programs over the marketing of gabapentin, admitting it fraudulently promoted the drug. Pfizer paid $430 million US in penalties and fines, including $152 million to reimburse the drug programs, which had covered the drugs. ...more

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AMA backs pharmacist/doctors shops

From the Gladstone (Australia) Observer:
The Australian Medical Association (AMA) believes a one-stop pharmacist/doctors shop would allow each health professional to work to their full potential in a well-supported environment.

They said the arrangement fits within the GP Primary Care Centres proposal that is outlined in the AMA’s Priority Investment Plan for Australia’s Health System.

AMA Capricorn Area Representative Dr Kim Bulwinkel said the provision of health care wasn’t really a one-person patch.

“The right thing to do is to provide the right care for the patient, and there are significant concerns with pharmacists dealing with medications as they are not trained as doctors,� he said.
...more

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U.N. narcotics board warns of prescription drug abuse

From Reuters:
Abuse of prescription drugs is growing rapidly around the world, with more people abusing legal narcotics than heroin, cocaine and ecstasy combined, the United Nations global drugs watchdog said on Wednesday.

The International Narcotics Control Board (INCB) also pointed to a rise in the use of so-called "date rape drugs," as sexual abusers try to get around more rigorous controls with substances not banned by international drugs laws.

The INCB said several high-profile celebrity deaths, such as pop star Michael Jackson last year, had focused attention on prescription drug abuse.

In the United States, abuse of prescription drugs "is now the second most important drug abuse issue after cannabis," it said, with 6.2 million people hooked on them in 2008. ...more.

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HIV drug combination carries heart risk

From CBC News:
People taking a combination of two anti-HIV drugs may face potential heart risks, U.S. regulators say.

Invirase and Norvir are antiviral medications given together to treat HIV infection. Norvir is given at a low dose to boost the level of Invirase in the body.

The U.S. Food and Drug Administration said Tuesday that preliminary data suggests taking Invirase and Norvir together may affect electrical activity in the heart.

Both drugs are approved for use in Canada.

The FDA advised patients currently taking Invirase that they should not stop taking the drug, but to discuss any questions or concerns they have about Invirase with their doctors. CBC News - Health - HIV drug combination carries heart risk

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Internet pharmacist accused of selling phoney drugs loses credentials

From the Calgary Herald:
One of Canada's Internet pharmacy pioneers has lost his credentials to practise in Manitoba after a three-year probe into allegations he sold counterfeit prescription drugs to Americans.

Andrew Strempler, founder of the Minnedosa, Man.-based Mediplan Prescription Plus Pharmacy, agreed to strike his name from the provincial pharmacist registry at a discipline hearing last October. The outcome of the fall hearing has only recently been posted on their website.

Experts say it's the most severe penalty that can be handed to a pharmacist, and prevents Strempler from renewing his licence to practise in Manitoba.

The fallout comes nearly four years after the U.S. Food and Drug Administration first warned consumers that drugs from Strempler's Manitoba-based firm were unsafe.

In August 2006, the FDA said preliminary lab tests of intercepted shipments found counterfeits of widely prescribed drugs such as Lipitor and Celebrex. ...more

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Natural Remedy Makers In 'Crisis'

From the National Post:
Makers of natural-health products say they are bracing for widespread layoffs and millions of dollars in losses after Canada's pharmacy regulators issued a surprise directive recently urging druggists to stop selling unlicensed natural remedies.

The order affects thousands of herbal treatments, multi-vitamins and other products, most of them waiting for approval from Health Canada under a backlogged, five-year-old program to regulate natural-health goods.

The National Association of Pharmacy Regulatory Authorities (NAPRA) says pharmacists cannot be assured the products are safe until they are granted a government licence, and should not sell them in those circumstances.

"Pharmacists are obliged to hold the health and safety of the public or patient as their first and foremost consideration," said the association's recently issued position statement.

Representatives of the natural health industry, however, have reacted angrily to the directive issued last month, predicting it will have little impact on patient safety, while triggering an economic "crisis" for their members. ...more

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