Since its launch in 1994 PharmWeb has developed into the premier online community of pharmacy, pharmaceutical and healthcare-related professionals with over 40,000 self-registered users. The first pharmaceutical portal on the Internet has developed into an invaluable directory of information, including a library of archives from over 100 moderated discussion forums. To browse the site either jump to a section using the pull-down menu or scroll down the home page to see what PharmWeb has to offer. PharmWeb is a registered trade mark. Full programs of major pharmacy, pharmaceutical and health-related conferences around the world plus the PharmWeb Conference Calendar. World Wide Pharmacy Colleges/Departments/Schools This is a comprehensive database of world wide pharmacy schools. The schools list is in the form of a searchable database and is regularly updated. The database includes contact names, addresses, telephone and FAX numbers, and Internet addresses where available. PharmWeb Discussion Forum The PharmWeb Discussion Forum is a collection of discussion groups and mailing lists specialising in specific aspects of medicine, pharmacy, pharmaceutical sciences and health-related issues. The discussion groups and mailing lists are designed to focus on specific areas and are moderated to ensure that discussions are within the scope of a particular discussion group. Patient Information Information on the drugs, medicines, diseases and conditions. PharmWeb Chat A real-time discussion forum for matters relating to pharmacy, pharmaceutical sciences, and health-related issues. Either drop in to see who is on-line, or arrange a meeting with colleagues on one of the 6 discussion rooms. It is even possible to have a private conversation. PharmWeb Virtual Library A repository of pharmaceutical information for educational and research purposes. Government and Regulatory Bodies Links to government and regulatory bodies around the world. PharmWeb Directory A directory of people in the health professions. Over 5,000 people are registered on the Directory. PharmWeb World Drug Alert Receive information about drugs and medicine via this mailing list. PharmWeb Yellow Web Pages Your directory to pharmaceutical information on the Internet. Includes companies, pharmacies, hospitals, plus much more. Each site is evaluated by our team of researchers before addition to the directory. Societies A directory of pharmaceutical and health-related societies around the world. Also included is a list of International Pharmaceutical Federation (FIP) member organisations (including addresses, telephone and FAX numbers). PharmWeb Appointments Job vacancies in science and the health professions, updated regularly. If you want to be the first to know about a new vacancy why not join the PharmWeb Appointments Alert? Newsgroups Links to various science and health-related newsgroups. Continuing/Further Education Links to pharmaceutical and health-related courses and teaching information. Special Interest Pages A resource of links to sites specialising in science, drugs and health-related subjects. A starting point for information other than pharmacy. PharmWeb Index An A to Z index of information held on PharmWeb. History of PharmWeb PharmWeb was the first hierarchical information resource on the Internet for pharmaceutical and health-related information. How did it all start? Pharmacy and the Internet This page contains information on pharmaceutical publications related to the Internet and considers the applications of the Internet to pharmacy. PharmWeb Internet Directory Links to some of the best sites on the Internet including search engines, news, weather, entertainment, and many other interesting sites. What's New on PharmWeb? Find out about the latest developments on PharmWeb. Access Statistics How many people use PharmWeb? Detailed access statistics for the main PharmWeb servers. How to Add/Edit Links Do you want to add or edit any link on PharmWeb, this tells you how to do it. PharmWeb and its Services What can PharmWeb do for you? A summary of the services that PharmWeb provides. Problem Solver Some of the common problems encountered using web browsers. Comments and Suggestions Let us know what you think of PharmWeb. Many developments have been the result of user feedback. PharmWeb Authors & Acknowledgements Who does all the work? Organisations on PharmWeb PharmWeb is here as a result of the support of major pharmaceutical and health-related organisations. Contact PharmWeb This page contains information on your PharmWeb contact. Please check this page before contacting us at PharmWeb to ensure that your enquiry is dealt with promptly. Contact names will change when PharmWeb staff are on vacation or out of the office. Pharmacists distribute drugs prescribed by physicians and other health practitioners and provide information to patients about medications and their use. They advise physicians and other health practitioners on the selection, dosages, interactions, and side effects of medications. Pharmacists also monitor the health and progress of patients in response to drug therapy to ensure the safe and effective use of medication. Pharmacists must understand the use, clinical effects, and composition of drugs, including their chemical, biological, and physical properties. Compounding—the actual mixing of ingredients to form powders, tablets, capsules, ointments, and solutions—is a small part of a pharmacist’s practice, because most medicines are produced by pharmaceutical companies in a standard dosage and drug delivery form. Most pharmacists work in a community setting, such as a retail drugstore, or in a health care facility, such as a hospital, nursing home, mental health institution, or neighborhood health clinic. Pharmacists in community and retail pharmacies counsel patients and answer questions about prescription drugs, including questions regarding possible side effects or interactions among various drugs. They provide information about over-the-counter drugs and make recommendations after talking with the patient. They also may give advice about the patient’s diet, exercise, or stress management or about durable medical equipment and home health care supplies. In addition, they also may complete third-party insurance forms and other paperwork. Those who own or manage community pharmacies may sell non-health-related merchandise, hire and supervise personnel, and oversee the general operation of the pharmacy. Some community pharmacists provide specialized services to help patients manage conditions such as diabetes, asthma, smoking cessation, or high blood pressure. Some community pharmacists also are trained to administer vaccinations. Pharmacists in health care facilities dispense medications and advise the medical staff on the selection and effects of drugs. They may make sterile solutions to be administered intravenously. They also assess, plan, and monitor drug programs or regimens. Pharmacists counsel hospitalized patients on the use of drugs and on their use at home when the patients are discharged. Pharmacists also may evaluate drug-use patterns and outcomes for patients in hospitals or managed care organizations. Pharmacists who work in home health care monitor drug therapy and prepare infusions—solutions that are injected into patients—and other medications for use in the home. Some pharmacists specialize in specific drug therapy areas, such as intravenous nutrition support, oncology (cancer), nuclear pharmacy (used for chemotherapy), geriatric pharmacy, and psychopharmacotherapy (the treatment of mental disorders by means of drugs). Most pharmacists keep confidential computerized records of patients’ drug therapies to prevent harmful drug interactions. Pharmacists are responsible for the accuracy of every prescription that is filled, but they often rely upon pharmacy technicians and pharmacy aides to assist them in the dispensing process. Thus, the pharmacist may delegate prescription-filling and administrative tasks and supervise their completion. Pharmacists also frequently oversee pharmacy students serving as interns in preparation for graduation and licensure. Increasingly, pharmacists are pursuing nontraditional pharmacy work. Some are involved in research for pharmaceutical manufacturers, developing new drugs and therapies and testing their effects on people. Others work in marketing or sales, providing expertise to clients on a drug’s use, effectiveness, and possible side effects. Some pharmacists work for health insurance companies, developing pharmacy benefit packages and carrying out cost-benefit analyses on certain drugs. Other pharmacists work for the government, public health care services, the armed services, and pharmacy associations. Finally, some pharmacists are employed full time or part time as college faculty, teaching classes and performing research in a wide range of areas. Working Conditions [About this section] Back to Top Pharmacists work in clean, well-lighted, and well-ventilated areas. Many pharmacists spend most of their workday on their feet. When working with sterile or dangerous pharmaceutical products, pharmacists wear gloves and masks and work with other special protective equipment. Many community and hospital pharmacies are open for extended hours or around the clock, so pharmacists may work nights, weekends, and holidays. Consultant pharmacists may travel to nursing homes or other facilities to monitor patients’ drug therapy. About 21 percent of pharmacists worked part time in 2004. Most full-time salaried pharmacists worked approximately 40 hours a week. Some, including many self-employed pharmacists, worked more than 50 hours a week. Training, Other Qualifications, and Advancement [About this section] Back to Top A license to practice pharmacy is required in all States, the District of Columbia, and all U.S. territories. To obtain a license, the prospective pharmacist must graduate from a college of pharmacy that is accredited by the Accreditation Council for Pharmacy Education (ACPE) and pass an examination. All States require the North American Pharmacist Licensure Exam (NAPLEX), which tests pharmacy skills and knowledge, and 43 states and the District of Columbia require the Multistate Pharmacy Jurisprudence Exam (MPJE), which tests pharmacy law. Both exams are administered by the National Association of Boards of Pharmacy. Pharmacists in the eight states that do not require the MJPE must pass a state-specific exam that is similar to the MJPE. In addition to the NAPLEX and MPJE, some States require additional exams unique to their State. All States except California currently grant a license without extensive reexamination to qualified pharmacists who already are licensed by another State. In Florida, reexamination is not required if a pharmacist has passed the NAPLEX and MPJE within 12 years of his or her application for a license transfer. Many pharmacists are licensed to practice in more than one State. Most States require continuing education for license renewal. Persons interested in a career as a pharmacist should check with individual State boards of pharmacy for details on examination requirements, license renewal requirements, and license transfer procedures. In 2004, 89 colleges of pharmacy were accredited to confer degrees by the Accreditation Council for Pharmacy Education. Pharmacy programs grant the degree of Doctor of Pharmacy (Pharm.D.), which requires at least 6 years of postsecondary study and the passing of a State board of pharmacy’s licensure examination. Courses offered at colleges of pharmacy are designed to teach students about all aspects of drug therapy. In addition, schools teach students how to communicate with patients and other health care providers about drug information and patient care. Students also learn professional ethics, how to develop and manage medication distribution systems, and concepts of public health. In addition to receiving classroom instruction, students in Pharm.D. programs spend about one-forth of their time learning in a variety of pharmacy practice settings under the supervision of licensed pharmacists. The Pharm.D. degree has replaced the Bachelor of Pharmacy (B.Pharm.) degree, which is no longer being awarded. The Pharm.D. is a 4-year program that requires at least 2 years of college study prior to admittance, although most applicants have completed 3 years. Entry requirements usually include courses in mathematics and natural sciences, such as chemistry, biology, and physics, as well as courses in the humanities and social sciences. Approximately two-thirds of all colleges require applicants to take the Pharmacy College Admissions Test (PCAT). In 2003, the American Association of Colleges of Pharmacy (AACP) launched the Pharmacy College Application Service, known as PharmCAS, for students who are interested in applying to schools and colleges of pharmacy. This centralized service allows applicants to use a single Web-based application and one set of transcripts to apply to multiple schools of pharmacy. A total of 43 schools participated in 2003. In the 2003–04 academic year, 67 colleges of pharmacy awarded the master-of-science degree or the Ph.D. degree. Both degrees are awarded after the completion of a Pharm.D. degree and are designed for those who want more laboratory and research experience. Many master’s and Ph.D. degree holders do research for a drug company or teach at a university. Other options for pharmacy graduates who are interested in further training include 1-year or 2-year residency programs or fellowships. Pharmacy residencies are postgraduate training programs in pharmacy practice and usually require the completion of a research study. There currently are more than 700 residency training programs nationwide. Pharmacy fellowships are highly individualized programs that are designed to prepare participants to work in a specialized area of pharmacy, such clinical practice or research laboratories. Some pharmacists who run their own pharmacy obtain a master’s degree in business administration (MBA). Others may obtain a degree in public administration or public health. Areas of graduate study include pharmaceutics and pharmaceutical chemistry (physical and chemical properties of drugs and dosage forms), pharmacology (effects of drugs on the body), toxicology and pharmacy administration. Prospective pharmacists should have scientific aptitude, good communication skills, and a desire to help others. They also must be conscientious and pay close attention to detail, because the decisions they make affect human lives. In community pharmacies, pharmacists usually begin at the staff level. In independent pharmacies, after they gain experience and secure the necessary capital, some become owners or part owners of pharmacies. Pharmacists in chain drugstores may be promoted to pharmacy supervisor or manager at the store level, then to manager at the district or regional level, and later to an executive position within the chain’s headquarters. Hospital pharmacists may advance to supervisory or administrative positions. Pharmacists in the pharmaceutical industry may advance in marketing, sales, research, quality control, production, packaging, or other areas. Employment [About this section] Back to Top Pharmacists held about 230,000 jobs in 2004. About 61 percent work in community pharmacies that are either independently owned or part of a drugstore chain, grocery store, department store, or mass merchandiser. Most community pharmacists are salaried employees, but some are self-employed owners. About 24 percent of salaried pharmacists work in hospitals. Others work in clinics, mail-order pharmacies, pharmaceutical wholesalers, home health care agencies, or the Federal Government. Job Outlook [About this section] Back to Top Very good employment opportunities are expected for pharmacists over the 2004–14 period because the number of job openings created by employment growth and the need to replace pharmacists who leave the occupation or retire are expected to exceed the number of degrees granted in pharmacy. Enrollments in pharmacy programs are rising as more students are attracted by high salaries and good job prospects. Despite this increase in enrollments, job openings should still be more numerous than those seeking employment. Employment of pharmacists is expected to grow faster than the average for all occupations through the year 2014, because of the increasing demand for pharmaceuticals, particularly from the growing elderly population. The increasing numbers of middle-aged and elderly people—who use more prescription drugs than younger people—will continue to spur demand for pharmacists in all employment settings. Other factors likely to increase the demand for pharmacists include scientific advances that will make more drug products available, new developments in genome research and medication distribution systems, increasingly sophisticated consumers seeking more information about drugs, and coverage of prescription drugs by a greater number of health insurance plans and Medicare. Community pharmacies are taking steps to manage an increasing volume of prescriptions. Automation of drug dispensing and greater employment of pharmacy technicians and pharmacy aides will help these establishments to dispense more prescriptions. With its emphasis on cost control, managed care encourages the use of lower cost prescription drug distributors, such as mail-order firms and online pharmacies, for purchases of certain medications. Prescriptions ordered through the mail and via the Internet are filled in a central location and shipped to the patient at a lower cost. Mail-order and online pharmacies typically use automated technology to dispense medication and employ fewer pharmacists. If the utilization of mail-order pharmacies increases rapidly, job growth among pharmacists could be limited. Employment of pharmacists will not grow as fast in hospitals as in other industries, because hospitals are reducing inpatient stays, downsizing, and consolidating departments. The number of outpatient surgeries is increasing, so more patients are being discharged and purchasing their medications through retail, supermarket, or mail-order pharmacies, rather than through hospitals. An aging population means that more pharmacy services will be required in nursing homes, assisted-living facilities, and home care settings. The most rapid job growth among pharmacists is expected in these 3 settings. New opportunities are emerging for pharmacists in managed care organizations where they analyze trends and patterns in medication use, and in pharmacoeconomics—the cost and benefit analysis of different drug therapies. Opportunities also are emerging for pharmacists trained in research and disease management—the development of new methods for curing and controlling diseases. Pharmacists also are finding jobs in research and development and in sales and marketing for pharmaceutical manufacturing firms. New breakthroughs in biotechnology will increase the potential for drugs to treat diseases and expand the opportunities for pharmacists to conduct research and sell medications. In addition, pharmacists are finding employment opportunities in pharmacy informatics, which uses information technology to improve patient care. Job opportunities for pharmacists in patient care will arise as cost-conscious insurers and health systems continue to emphasize the role of pharmacists in primary and preventive health care. Health insurance companies realize that the expense of using medication to treat diseases and various health conditions often is considerably less than the costs for patients whose conditions go untreated. Pharmacists also can reduce the expenses resulting from unexpected complications due to allergic reactions or interactions among medications. Welcome to the only UK institution dedicated entirely to teaching and research in pharmacy and pharmaceutical sciences. Dynamic and internationally top rated research is integrated with excellent teaching to further knowledge and understanding of medicines - how they are made, how they act and how people use them to prevent and cure disease. Pharmacy (from the Greek ???????? = drug) is a chemical science and profession charged with ensuring the safe use of medication. Traditionally, pharmacists have compounded and dispensed medications on the orders of physicians. More recently, pharmacy has come to include other services related to patient care including clinical practice, medication review, and drug information. Some of these new pharmaceutical roles are now mandated by law in various legislatures. Pharmacists, therefore, are drug therapy experts, and the primary health professionals who optimise medication management to produce positive health-outcomes. The symbols most commonly associated with pharmacy are the mortar and pestle and the ? (recipere) character. Pharmacy organisations often employ other elements, such as the Bowl of Hygieia, conical measures, and caduceuses in their logos. Other symbols are common in different countries such as the green Greek cross in France and Great Britain, the increasingly-rare Gaper in The Netherlands, and a red stylised letter A in Germany. In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. Specifically, the legislation stipulates that the practice of prescribing must be separate from the practice of dispensing. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments. In the minority of jurisdictions (particularly in Asian countries such as China, Hong Kong, Malaysia, and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is integrated with that of the physician. In Canada it is common for a medical clinic and a pharmacy to attached and for the ownership in both enterprises to be common, but licensed separately. The reason for the majority rule is the high risk of a conflict of interest. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects. A campaign for separation has begun in many countries and has already been successful (like in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia). [edit] Community pharmacy 19th century Italian pharmacyA pharmacy (commonly the chemist in Australia, New Zealand and the UK; or drugstore in North America; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers. Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed. The dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications; there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients. All pharmacies are required to have a pharmacist on-duty at all times when open. In many jurisdictions, it is also a requirement that the owner of a pharmacy must be a registered pharmacist (R.Ph.). This latter requirement has been revoked in many jurisdictions, such that many retailers (including grocery stores and mass merchandisers) now include a pharmacy as a department of their store. [edit] Hospital pharmacy Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues. Because of the complexity of the medication use system, many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area. Hospital pharmacies can usually be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Some hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. [edit] Internet pharmacy Recently, a number of pharmacies have begun operating over the Internet. Many such pharmacies are, in some ways, similar to community pharmacies; the primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient (and private) than traveling to a community drugstore. Internet pharmacies are also recommended to some patients by their physicians if they are homebound. Some Internet pharmacies sell prescription drugs without requiring a prescription. Some customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There have also been reports of such pharmacies dispensing substandard products. In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. Although importation of prescription medication currently violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. [edit] The future of pharmacy In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists expect to be paid for their cognitive skills. This paradigm shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. In Great Britain, pharmacists (and nurses) who undertake additional training are obtaining prescribing rights. In the United States, consultant pharmacists, who traditionally operated primarily in nursing homes are now expanding into direct consultation with patients, under the banner of "senior care pharmacy." Many universities are altering their programs to increase emphasis in fields such as pharmacotherapeutics, clinical pharmacy, nuclear pharmacy, disease state management, etc. Asthma Drug Warning Causes Alarm Posting Date: 12/12/2005 Q. I saw a report on TV recently about the asthma drug Advair. The news wasn't good. I used to take Advair but am now trying free samples of Foradil from my doctor. Advair cost me almost $200 for a month's supply. I have a friend with asthma who's had good results with Advair. Is he really in danger? I've taken other drugs that have been pulled off the shelves, Vioxx and Bextra. Now I'm wondering about Advair. What's going on? A. Ever since the arthritis drugs Vioxx and Bextra were taken off the market, it seems as if the FDA has been more cautious. Several months ago an expert panel considered whether the asthma drugs Advair, Foradil and Serevent should also be withdrawn from the market. There was concern that some people taking these medications might experience hard-to-treat asthma attacks. Although the agency decided not to ban these drugs, safety concerns remain. That's why the FDA issued a warning recently stating that these medicines may increase the chance of severe asthma episodes that could result in death. The regulators want doctors to prescribe these drugs only if other medicines fail to control asthma symptoms. Do not stop taking your asthma drug until you have consulted your physician, though. He or she will want to evaluate the new warning and decide whether other medications may be more appropriate. Q. What can you suggest for chronic chapped lips? Castor oil works great, but it tastes terrible! A. Perhaps the reason castor oil works for you is that it discourages lip licking. This habit can contribute to chronic chapped lips, especially when humidity is low. We sometimes suggest a product containing lanolin, beeswax or coconut oil to moisturize the lips and discourage licking. Some products to consider include Burt's Beeswax Lip Balm, Desert Essence Lip Rescue, Lip Trip or Un-petroleum Lip Balm. For 130 years, the University of Michigan College of Pharmacy has been preparing leaders for positions in health care, business, biotechnology, higher education, law, the pharmaceutical industry, engineering, community practice, and other careers. Three such alumni leaders were honored as part of the College’s Doctor of Pharmacy (PharmD) Commencement exercises, held Saturday, June 3, at the Horace H. Rackham School of Graduate Studies in Ann Arbor, Mich. Receiving the College’s Alumni Service Award in Pharmacy was Sandra L. Chase, BSPharm’83, PharmD’84, a clinical pharmacy specialist at Spectrum Health, Grand Rapids, Mich. where she has a practice at Spectrum’s Heart Failure, Transplant, and Pulmonary Hypertension Services Clinic. Receiving the College’s Alumni Distinguished Lifetime Achievement Award were Gayle Crick Fischer, BSPharm’74, retired manager of global marketing at Eli Lilly Co., and now vice president of marketing at the Montreal, Canada-based biopharmaceutical company, Targanta; and Tsuneji Nagai, PostDoc’67, chairman of The Nagai Foundation, Tokyo, and former president of Tokyo’s Hoshi University. The Alumni Service Award in Pharmacy honors U-M College of Pharmacy alumni who have made significant contributions to the profession of pharmacy. The Alumni Distinguished Lifetime Achievement Award honors alumni who have made significant lifetime contributions in their profession or to society through practice, research, education, or public service. Both awards are made through the College’s Alumni Society Board of Governors. About the award recipients: 2006 RECIPIENT, ALUMNI SERVICE AWARD IN PHARMACY: SANDRA L. CHASE, BSPHARM’83, PHARMD’84 SANDRA CHASE is a clinical pharmacy specialist at Spectrum Health, Grand Rapids, Mich. where she has a practice at Spectrum’s Heart Failure, Transplant, and Pulmonary Hypertension Services Clinic, coordinates all cardiovascular pharmacotherapeutics for the health system, and is a member of the Women’s Heart Advantage Research Committee and the Cardiology Grand Rounds Steering Committee. She was recently selected Spectrum’s residency program preceptor of the year, and was named pharmacist of the year by the Michigan Society of Health-System Pharmacists. A member of the Michigan Pharmacists Association (MPA) executive board since 2002, Chase is the current MPA president and a member of MPA’s Public Affairs Committee. She also chairs the educational affairs committee of the Michigan Society of Health-System Pharmacists, is director-at-large of the American Society of Health-System Pharmacists section of home, ambulatory and chronic care, and is a member of the State of Michigan Cardiovascular Health Task Force. Having served multiple three-year terms on the College’s Alumni Society Board of Governors, Chase now sits on the U-M Alumni Association Board of Directors. A health and fitness instructor, she is actively involved in many American Heart Association and American Diabetes Association causes, and is a member of the Pediatric and Adult Asthma Network of West Michigan. In 2004, Chase established the Sandra L. Chase Leadership Scholarship at the College to help support Michigan PharmD students demonstrating leadership abilities and financial need. * * * 2006 RECIPIENTS, ALUMNI DISTINGUISHED LIFETIME ACHIEVEMENT AWARDS: GAYLE CRICK FISCHER, BSPHARM’74; AND TSUNEJI NAGAI, POSTDOC’67 GAYLE CRICK FISCHER joined Montreal, Quebec-based Targanta Therapeutics Inc. this year, following her February 2006 retirement from Eli Lilly Co., where she had a singular 28-plus year career. Targanta is a privately-held, venture-backed biopharmaceutical company focused on the discovery and development of new classes of antibiotic drugs for novel antibacterial targets. Fischer’s career at Lilly was distinguished by a series of successes in the areas of marketing and sales, ranging from new product planning through post-launch of numerous pharmaceutical products, including blockbuster brands. At Lilly, Fischer developed a special expertise in building and sustaining brands in infectious disease, osteoporosis, and attention-deficit/hyperactivity disorder (AD/HD). She is now vice president of marketing at Targanta where she is applying her extensive industry experience to help Targanta develop a stronger market presence. As a pharmacy student, Fischer financed her education by working in community pharmacy practice. She continued to work in community pharmacy for several years after receiving her BSPharm degree before starting her career at Lilly, initially as a pharmaceutical sales representative in Detroit, Mich. In addition to her Michigan Pharmacy degree, Fischer received a masters in management from the U-M in 1984. She is co-chair, Eastern Region, for the College’s Campaign for International Leadership and Excellence, and a long-time member of the Dean’s Advisory Committee at the College of Pharmacy. In support of Michigan PharmD students, Fischer has established two scholarships, one of which is named in honor of her parents, William T. and Norma J. Crick. TSUNEJI NAGAI is chairman of The Nagai Foundation, Tokyo. From 1971 to 1999, he was a professor at Hoshi University in Tokyo, and from 2001 to 2004 was that institution’s president. Nagai received a BS in pharmacy in 1956, an MS in pharmacy in 1958, and a PhD in pharmacy in 1961, all from the University of Tokyo. He then completed postdoctoral studies at Columbia University (1965-66) and the University of Michigan (1966-67). In 1996, he received the Doctor Honoris Causa Degree from Hacettepe University, Turkey, and in 2001, the Doctor of Science, Honoris Causa Degree from the University of London, U.K. Over his long and distinguished career, Nagai has received many awards and honors including the International Pharmaceutical Federation (FIP) Hoest-Madsen Medal (1986), the Japan National Invention Prize (1984), The Society Prize of Pharmaceutical Society of Japan (1988), The Society Prize of Society of Cyclodextrins Japan (1997), the American Association of Pharmaceutical Scientists Research Achievement Award in Drug Delivery (1999), and others. In 1999, Nagai received the Japan Imperial Prize, Medal of Purple Ribbon, one of his nation’s greatest individual honors. This honor carried with it an audience with His Imperial Majesty Akihito, the 125th Emperor of Japan. He was founder and president of the Academy of Pharmaceutical Science and Technology, Japan (1985-87), and of The Society of Cyclodextrins, Japan (1993-96); vice president of FIP (1986-94), and president of Controlled Release Society (1996-97). Today, he is president of the Federation of the Asian Pharmaceutical Association College of Pharmacy and is editor–in-chief of the International Journal of Pharmaceutics and the Journal of Controlled Release. About the University of Michigan College of Pharmacy The University of Michigan College of Pharmacy is one of America’s oldest and most admired pharmacy programs. Established in 1876 as the first U.S. pharmacy program affiliated with a state university, the College today has a total PharmD and PhD enrollment of approximately 325 students, drawn from around the nation and the world. The U-M College of Pharmacy is consistently ranked among America’s top pharmacy schools. In the most recent issue of U.S. News & World Report, the College was placed in the nation’s top five pharmacy schools, and was the only State of Michigan pharmacy program to receive a national ranking. . My husband is a walking drugstore. He suffers from depression and migraine headaches and takes Neurontin, Zoloft, Zyprexa, diazepam, Prilosec and Fiorinal. Since he retired, his memory is getting worse and he sometimes seems almost like a zombie. I worry that his pills are hurting more than helping. A. It's hardly any wonder your husband feels like a zombie. Combining a sedative like diazepam (Valium) with an anti-psychotic such as Zyprexa, a barbiturate found in Fiorinal and an anti-convulsant (Neurontin) could make almost anyone forgetful and spacey. Such a combination could also increase his risk of a fall. As people age, they become more susceptible to some drug side effects. Forgetfulness and dizziness can wreck quality of life. Please ask his doctor to review your husband's medications. We are sending you our Guide to Drugs and Older People. It lists medicines that may cause mental impairment, drugs that may be inappropriate for senior citizens and a drug safety check list. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons' People's Pharmacy, No. O-85, P. O. Box 52027, Durham, NC 27717-2027. Q. My cardiologist tells me I must take aspirin for the rest of my life to prevent a heart attack or stroke. He said to avoid ibuprofen and naproxen for pain relief. Why? A. Pain relievers like ibuprofen and naproxen may interfere with the anti-clotting action of aspirin (New England Journal of Medicine, Dec. 1, 2005). * * * In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.peoplespharmacy.com. Their newest book is The People's Pharmacy Guide to Home and Herbal Remedies (St. Martin's Press). Gary R. Matzke, Pharm.D., FCP, FCCP, was chosen ACCP President-Elect in annual elections held this spring. Dr. Matzke is Professor and Associate Dean for Clinical Research and Public Policy at the Medical College of Virginia/Virginia Commonwealth University (VCU) School of Pharmacy in Richmond, Virginia. He has previously served the College as a member of the Board of Regents (1987-1990), Research Institute Trustee (2002-2005), founding Chair of the Nephrology Practice and Research Network (PRN), and a past member or chair of numerous ACCP committees. More... As summer vacations wind down, now's the perfect time to plan a fall getaway to a well-kept secret in the midst of America's heartland—the city of St. Louis, Missouri. Join us Thursday, October 26, through Sunday, October 29, for ACCP's 2006 Annual Meeting at the America's Center Convention Center, located in historic downtown St. Louis. This vital city district is the perfect location to expand your education, network with colleagues, and explore some lively nightlife and entertainment. More... Frontiers Fund Supports Eight New Studies in 2006 This year, the ACCP Research Institute expects to again provide more than a half-million dollars in support of clinical pharmacy research and researcher development. Thanks to the generous contributions to the College's Frontiers Fund by many ACCP members, several of the PRNs, and others, this includes more than $200,000 in support of eight new Frontiers Career Development Research Awards. More... Pharmacy technicians help licensed pharmacists provide medication and other health care products to patients. Technicians usually perform routine tasks to help prepare prescribed medication for patients, such as counting tablets and labeling bottles. Technicians refer any questions regarding prescriptions, drug information, or health matters to a pharmacist. (See the statement on pharmacists elsewhere in the Handbook.) Pharmacy aides work closely with pharmacy technicians. They often are clerks or cashiers who primarily answer telephones, handle money, stock shelves, and perform other clerical duties. (See the statement on pharmacy aides elsewhere in the Handbook.) Pharmacy technicians usually perform more complex tasks than do pharmacy aides, although in some States their duties and job titles may overlap. Pharmacy technicians who work in retail or mail-order pharmacies have varying responsibilities, depending on State rules and regulations. Technicians receive written prescriptions or requests for prescription refills from patients. They also may receive prescriptions sent electronically from the doctor’s office. They must verify that the information on the prescription is complete and accurate. To prepare the prescription, technicians must retrieve, count, pour, weigh, measure, and sometimes mix the medication. Then, they prepare the prescription labels, select the type of prescription container, and affix the prescription and auxiliary labels to the container. Once the prescription is filled, technicians price and file the prescription, which must be checked by a pharmacist before it is given to the patient. Technicians may establish and maintain patient profiles, prepare insurance claim forms, and stock and take inventory of prescription and over-the-counter medications. In hospitals, nursing homes, and assisted-living facilities, technicians have added responsibilities, including reading patients’ charts and preparing and delivering the medicine to patients. Still, the pharmacist must check the order before it is delivered to the patient. The technician then copies the information about the prescribed medication onto the patient’s profile. Technicians also may assemble a 24-hour supply of medicine for every patient. They package and label each dose separately. The packages are then placed in the medicine cabinets of patients until the supervising pharmacist checks them for accuracy. The packages are then given to the patients. Welcome to the University of Florida College of Pharmacy! The faculty and staff of the College of Pharmacy truly believe that we are one of the top colleges of pharmacy in the nation. More importantly, we are not the only ones who think so. The U.S. News and World Report magazine recently ranked UF College of Pharmacy as one of the Top Colleges in the United States. The college provides students with an exceptional education because of the quality of its faculty, staff, student services, curriculum, experiential programs, and the quality of the students themselves. Graduates of the University of Florida College of Pharmacy are highly skilled pharmacy practitioners and exceptional citizens of the state and country. Over the past 10 years, we have made great strides in quality pharmacy education, providing unique learning opportunities for students and meeting the challenge of industry demands. We have implemented a new curriculum for the Pharm.D. degree and an internationally recognized non-traditional distance learning post-baccalaureate Doctor of Pharmacy degree. We are proud of our significant progress in meeting the goals and objectives of the college's mission to promote the health and welfare of the citizens of Florida and the nation. However, even though you are among the best, there is always room for improvement where the health and welfare of people are concerned. The process of improvement never ends. As the American philosopher Will Rogers said, "Even if you are on the right track, if you don't move you will get run over." Well, our college continues to be on the move! We are especially looking forward to the future with great anticipation and excitement. The college has expanded its enrollment by adding three new campuses to our Gainesville campus to meet the need of place-bound students. Students are able to join our college at sites located in Orlando, Jacksonville, and St. Petersburg. Each of these campuses accommodates approximately 50 students for each professional year. Students receive instruction in pharmacy by distance education technology and live course facilitation at the distant campus sites. Our program has achieved national recognition as “a model of quality educational practice in distance learning” by the Accreditation Council for Pharmacy Education. Look us over. We are sure that you will agree that it is an exciting time to be a Florida Gator! Oregon State University’s College of Pharmacy offers a four-year program leading to a Doctor of Pharmacy (Pharm.D.) degree. To be eligible to apply, students must complete the pre-pharmacy curriculum, which involves approximately three years of undergraduate study. Students spend the first two years on the Corvallis Campus and the third year at the Oregon Health & Science University in Portland. The fourth year is spent gaining supervised, on-the-job experience in a variety of pharmacy practice locations throughout the northwest. Students successfully completing this program are eligible to become licensed pharmacists throughout the United States. A bachelor's degree is not required for admission to the Pharm.D. program. However, students must earn a bachelor's degree prior to entering their third professional year. A path to earn a B.S. degree in general science from Oregon State University has been developed in cooperation with the College of Science. The demand for trained pharmacy professionals has exploded in recent years due to the rapid growth of the health care and pharmaceutical industries, and the growing elderly population. More prescriptions are being written than ever before, thus increasing the need for pharmacists to counsel their patients and work with physicians, nurse practitioners, and other health care providers to ensure optimal therapy. The need for pharmacists in health care services is also growing as pharmacists become more actively involved in drug therapy decision-making for patients of all ages. Welcome to the UNC School of Pharmacy, a nationally recognized leader in progressive pharmaceutical care practice, education, and research. We are in the midst of a pharmacologic revolution that will expand the role of drug therapy as the most cost-effective form of health care in the twenty-first century. The evidence is everywhere: New drugs now manage or cure previously untreatable conditions. Existing drugs are replacing hospitalization, surgery, and emergency services. On the horizon are breakthroughs in genomics, informatics, and pharmacology. And it’s all happening right here at UNC. The School of Pharmacy Center for Pharmacogenetics is pleased to announce the following promotions: Song Li, MD, PhD, has been promoted to associate professor of pharmaceutical sciences with tenure, effective June 1, 2006; Haibiao Gong, PhD, has been promoted to the rank of research assistant professor, effective July 1, 2006.

The University of Colorado School of Pharmacy offers the Doctor of Pharmacy (PharmD) degree for working pharmacists in a part-time format. All didactic courses are delivered online, via the Internet. Online courses provide maximal accessibility and flexibility to working pharmacists, and provide opportunities for interaction with the faculty and with the other pharmacists in the program, and for active participation in learning. Experiential training is also very flexible. Some clerkships can be challenged for academic credit based on your experiences as a pharmacist. Others are available part time, or can be performed where you work. (See "Experiential Training" for more information.) The Nontraditional PharmD program (NTPD) is fully accredited by the Accreditation Council for Pharmacy Education (ACPE). It is designed to offer excellent, contemporary pharmacy education in a format that will fit into your professional and personal life. Each pharmacist determines his or her own course load each semester, to find their best personal balance. No campus visits are currently required. Program Outcomes: The ability to demonstrate a comprehensive knowledge of pathophysiology, pharmacotherapeutics and pharmacokinetics. The ability to observe and understand the signs and symptoms of disease as they relate to and impact drug therapy. The ability to develop an adequate data base from information extracted the patient, the patient's medical and pharmacy records, and other health care practitioners in the process of evaluating drug therapy. The ability to organize and present an assessment of the patient's health-related problems. The ability to define realistic therapeutic objectives, identify subjective and objective outcomes of drug therapy and recommend a pharmacotherapeutic plan based on patient-specific information. The ability to identify, prevent and solve drug therapy problems by recommending the use of an appropriate drug or dosage regimen. The ability to effectively assess drug efficacy and safety through the evaluation of appropriate physical and laboratory parameters. The ability to communicate effectively with patients and other health care practitioners. The ability to develop effective professional relationships with patients and other health care practitioners. The ability to select, critically evaluate and apply information from the medical and pharmacy literature. The ability to evaluate clinically relevant research. The ability to demonstrate a high level of professional maturity, commitment and ethics. Program Description: Through your computer, you will typically obtain lecture handouts and readings, view slide shows, listen to audio lectures from faculty, participate in office hours and discussion groups with faculty and classmates, submit assignments, take exams, view grades, link to the medical library, and receive and send messages. The NTPD program requires the completion of 35 semester credit hours of didactic coursework (11 courses) and 30 hours of experiential training in advanced pharmacy practice experiences (APPEs) or clerkships (six 5-week rotations), for a total of 65 semester credit hours. Students may be able to receive credit for up to four clerkships by preparing portfolios that document relevant work experience. Six Advanced Disease State Management (ADSM) courses form the core of the didactic curriculum. Each course addresses the pathophysiology, advanced pharmacotherapeutics, pharmacokinetics, and professional skill development for two to three body systems. For example, one course contains cardiovascular and renal modules. As an illustration, the programmed learning experiences within the cardiovascular section include: The pathophysiology of common cardiovascular disorders such as hypertension, myocardial infarction, congestive heart failure, and dysrhythmias; Pharmacotherapeutic management of patients with these disorders, including design of patient-specific individualized drug therapy treatment plans; Pharmacokinetics of drugs used to treat cardiovascular disorders; Basic cardiovascular physical assessment skills such as blood pressure monitoring; Problem-based case discussions of patients with cardiovascular disorders; Other appropriate clinical skills development activities. The Advanced Disease State Management (ADSM) courses are 3.5-4 credit hours each. Each ADSM course is delivered in a format which will require about four hours of "class time" online per week. Readings and other course preparation or assignments are likely to add about another 4 hours weekly for 4 credit hour courses. About one-half of ADSM class time is allocated to clinical skills development. ADSM courses may be taken in any sequence. Other course work supports the ADSM courses and develops skills that are important to the effective functioning of clinical pharmacy practitioners: The NTPD includes six 5-credit advanced pharmacy practice experiences (APPEs, or rotations). If taken on a full-time basis, each APPE is five weeks. On a part-time basis, each APPE requires 200 contact hours. Three practice areas are required: acute care medicine, ambulatory care, and drug information. All pharmacists enrolled in the NTPD program must either perform these APPEs, or successfully challenge these practice areas for credit. Each pharmacist also selects three elective APPEs. Electives may be selected from a wide variety of medicine subspecialties such as neurology, oncology, nutrition, infectious diseases, critical care, psychiatry, and pediatrics. Other elective choices include pharmaceutical care projects, community pharmacy, education, administration, industry, managed care, and clinical research. APPEs are critical in permitting the faculty to assess the pharmacist’s clinical application and integration of didactic material. However, the Postgraduate Professional Education and Clerkship Committees recognize that the time commitments of performing several traditional APPEs are not workable for most practicing pharmacists, and also present serious scheduling challenges for employers. To make the experiential components as flexible and feasible as possible, several accommodations have been implemented: The experiential component of the NTPD is shorter than that of the full time on-campus program (30 weeks maximum, compared with 44 weeks). This is possible because pharmacists enrolled in the NTPD have greater pharmacy practice experience before entering the program than most students enrolled in full time on-campus programs. You also have greater opportunity to apply your new didactic knowledge to your clinical practice while you are taking classes. Pharmacists may apply for credit by challenge of one to four APPEs, based on their professional experiences. Time limits apply. Challenges require preparation of portfolios that describe and document how you have met the expected outcomes for specific practice areas. They require a narrative, and documentation of clinical experiences, interventions, presentations, programs, etc. Tuition is not currently charged for successful APPE challenges, although a challenge fee applies. Some APPEs may be performed at the pharmacist's usual practice site with approval of the experiential programs director. Approval depends on factors such as the size of the institution, the availability of qualified preceptors, potential conflicts of interest, and many other factors. Many APPEs are available on a part-time basis. APPEs need not be taken consecutively. NTPD students may begin taking APPEs only after completing four Advanced Disease State Management classes; however, students can prepare a challenge to a clerkship at any point in the program. The drug information APPE is available through distance learning. Nontraditional clerkship models are available. Examples include "distance preceptorships" or design and implementation of a pharmaceutical care project. Every attempt will be made to arrange APPEs at sites near the pharmacist's home or usual workplace. New ACPE accreditation standards specify that required APPEs be performed within the US. Application Process: The NTPD program is open to pharmacists who have graduated from accredited colleges or schools of pharmacy in the United States or Canada, or who have passed the Foreign Pharmacy Graduate Equivalency Exam. Pharmacists must be licensed to practice pharmacy in the U.S. or Canada and be in good standing with the regulatory agency issuing the license. Admission is inclusive; there is no minimum GPA. Preference may be given to Colorado residents. The Admissions Committee reserves the right to consider exceptions to these guidelines on a case-by-case basis. Three recommendations written on standard University of Colorado School of Pharmacy recommendation forms. These are available from the same sources listed above. The reference forms should be given to people who know you and your recent pharmacy career well, and can speak to your self-motivation and professional attributes. References will usually be employers, supervisors, former faculty, preceptors, or professional colleagues. See guidelines on the application form. One-page personal statement that describes your reasons for seeking a PharmD degree and for applying to this program. Current curriculum vitae (CV) or resume that includes your pharmacy practice experiences since graduation from pharmacy school. Official transcripts from the School of Pharmacy from which you graduated and from any degree program(s) in which you have been enrolled since obtaining your BS in Pharmacy. Usually you will request these transcripts from the registrar's office of your School or College of Pharmacy. Copies will be sent directly from your school to the to the Chair of the Admissions Committee (NTPD). Please request transcripts at least 2-4 weeks before the application deadline. Non-refundable application fee of $50.00 (US dollars). Checks or money orders should be made out to the University of Colorado School of Pharmacy. Applications are accepted at any time for the Nontraditional PharmD program. However, the application must be complete at least 30 days before the beginning of a semester to be considered for admittance that semester: June 30* for admission in Fall semesters, and November 15 for admission beginning in Spring semester. Fall classes begin the last week in August, and spring classes begin in the middle of January. Pharmacists may begin the PharmD program in any spring or fall semester. Please request transcripts and letters of reference at least one month before the application deadline to ensure that your application file is complete by the application deadline! Application materials will be reviewed by the School of Pharmacy Admissions Committee. The committee reserves the right to require a telephone or in-person interview. Acceptances to the Nontraditional PharmD program will be honored for one year from the start date of the semester for which admission was requested. Pharmacists who fail to enroll in any course within that year may be required to reapply. NOTE: Applications to the NTPD program will be accepted at least through November 15, 2006, with a start date for January 2007. Extension of admissions to the NTPD program will be determined annually, based on demand. Tuition, Fees, and other Costs: Tuition per credit hour for the 2006-2007 academic year is $400 for Colorado residents and $440 for non-residents. New tuition rates are established each spring, and go into effect with summer classes. Many employers offer a tuition reimbursement benefit that can be applied to the costs of professional education programs. Tax benefits (life long learning credit) may also apply. All tuition and fees are in US dollars A one-time matriculation fee of $140 is required of any student enrolling for classes at the University of Colorado for the first time. A computer technology fee of $65 per course helps defray the costs of delivering courses online, and a $75 academic support fee is assessed each semester. There is a $75 APPE fee, which is charged for each APPE in which you enroll. The credit by challenge fee for clerkships is $450 per clerkship (however, tuition is currently waived for successful challenges). Textbook requirements are determined by individual instructors, but are limited, since much of the required instructional materials will be provided online. Textbooks may be ordered online through the University of Colorado Health Sciences Bookstore. Computer Equipment Needed: To take full advantage of the interactivity of the NTPD courses, the following setup is required: IBM compatible PC strongly recommended with pentium® processor (90MHz minimum), most but not all components of the delivery system will perform with Macintosh with PowerPC processor (604 PowerPC minimum) Windows 2000 or XP or MacOS 9.1or later 28.8 kbps modem (56K recommended). High speed Internet access such as "cable modems" or "DSL lines" are recommended to improve the speed and function of online course delivery, but are not required An Internet connection and Internet service provider (ISP) An e-mail account Speakers and a sound card (Soundblaster® or equivalent) Web browser such as Microsoft’s Internet Explorer R (preferred) or Netscape CommunicatorR, the newest version of either. (download free, see below). Internet Explorer 6 or Netscape 7 are recommended browsers for PC Netscape 7 or Internet Explorer 5.2.2 are recommended browsers for Mac OS-X RealPlayerR for audio and video, newest version (download free, see below) Microsoft OfficeR 97 or newer (or Microsoft OfficeR 98 for Macintosh), Standard Version or better (available at excellent discounts through the HSC bookstore to enrolled students) Printer Please visit the following website for more detailed information on required technical features,http://strata.ecollege.com/index.learn?action=technical_info. - (Click into the Technical Info. Tab). Also, the website offers downloads for the newest browser versions, free of charge. It is also recommended that you have a second phone line installed in your home for dedicated use with your computer, or use a high speed internet service such as cable or DSL. This will decrease the inconvenience for other members of your household when you are online and will reduce the time it takes to download files. Frequently Asked Questions about the Nontraditional PharmD Program You may ask additional questions by sending them to NTPharmD@UCHSC.edu Thank you, and we hope to hear from you soon! Carol Balmer, PharmD, BCOP Assistant Dean, Postgraduate Professional Education EC PHARMACY UPDATE EC pharmacy access legislation, SB 849, was introduced in the 2005 legislative session (bills can only be introduced every other year). Amendments were made to SB 849 to add a physician assistant as an authorizer and to address record-keeping and rule-making.EC pharmacy access legislation, SB 849 For the past several years the Board of Pharmacy and the Oregon State Pharmacists Association (OSPA) have been involved in efforts to simplify the restrictions on collaborative protocols and thereby permit pharmacists to initiate EC. Similar legislation, SB 677, was proposed in the 2003 session but died. Health advocates had a major role in attempting to move this legislation and the Board of Pharmacy and Pharmacists Association were less visibly involved. In April 1999 the Oregon Board of Pharmacy and the Oregon Medical Association explored the concept of a pilot project where pharmacies would initiate EC. However, the Oregon Pharmacy Act did not provide the appropriate framework to support this type of project, and the concept died. During the 2001 legislative session, OSPA proposed broad enabling legislation similar to Washington State that would allow pharmacists under protocol to initiate drug therapy including EC. This legislation was opposed by the Oregon Medical Association, Kaiser Permanente and the Oregon Association of Hospitals and Health Systems. In November 2002, representatives from the Oregon Office of Family Health, the Oregon Health and Science University, and Columbia University School of Public Health presented at the American Public Health Association’s 130th Annual Meeting on Improving Access to Emergency Contraception using Oregon PRAMS (Pregnancy Risk Assessment Monitoring System) data. They highlighted that one barrier to increased use of EC in Oregon has been that very few retail pharmacists were stocking EC. They concluded, “Many women would benefit if mores states passed laws allowing pharmacist counseling, referral, and prescription of emergency contraception.” EC awareness training aimed at health care professionals occurred in the Portland metropolitan area. The State Department of Human Services also contracted with Population Services International to train providers throughout the state including 36 agencies and 128 clinics. Planned Parenthood of the Columbia/Williamette (PPCW) in Portland, OR, offers women a way to access EC through the PPCW website. A nurse practitioner contacts the patient by phone to review the information submitted and answer questions. Since the program’s launch in 2002, almost 600 women have received an EC prescription. Additional papers from the Oregon Department of Human Services, Office of Family Health, on the need for advance prescriptions, knowledge of EC and pregnancy intendedness, and EC in emergency departments have been or will be published. Jeanne Atkins Manager, Women's and Reproductive Health Services, Office of Family Health PROTOCOL ENVIRONMENT Possible Environment: Revision to Existing Authority Required This state permits collaborative practice agreements or a similar agreement between physicians and pharmacists. However, some modification of existing statutes and/or regulations is required to allow pharmacists to initiate EC for the general community. Pharmacist initiation of EC would require: Modifying the requirement for patient-specific protocols Modifying the requirement that only prescribers may initiate drug therapy PHARMACY PRACTICE ACT Pharmacy Practice Act Regulatory and Statutory Authority Note: The text presented below has been prepared by the American Pharmacists Association for the Pharmacy Access Partnership and reflects legislation or regulation promulgated as of June 15, 2003. Pharmacists with special training, working in any practice setting, may engage in patient-specific protocol agreements with physicians or other prescribers. No external Board review is required. Collaborative drug therapy management must be initiated by prescription order for each individual patient by the participating practitioner. Training requirements for the pharmacist are stated in the protocol, which is valid for two years. Therapeutic substitution is not allowed. The scope of practice is defined within the protocol and must include – a detailed description of the collaborative role the pharmacist shall play; specific drugs the pharmacist may base drug therapy management decisions on; and a description of the mechanism for communication and circumstances under which the pharmacist will initiate communication with the practitioner, including the need for new prescription orders and reports of patients’ therapeutic responses or adverse effects. Pharmacists who complete other required training may administer immunizations, by any route of delivery, to those 18years and older. Pharmacists must follow written protocols approved by the Oregon Health Division for administration of vaccines and the treatment of severe adverse events, keep detailed records, and provide information to the Board. Statutory authority: Or. Rev. Stat. § 689.005, § 689.015, § 689.645 Regulatory authority: Or. Admin. R. 855-041-0400, 855-041-0500, 855-006-0010 (1) “Administer” means the direct application of a drug or device whether by injection, inhalation, ingestion, or any other means, to the body of a patient or research subject by (a) A practitioner or the authorized agent thereof; or (b) The patient or research subject at the direction of the practitioner. 689.015 “Practice of pharmacy” defined. The “practice of pharmacy” means the interpretation and evaluation of prescription orders; the compounding, dispensing, labeling of drugs and devices (except labeling by a manufacturer, packer or distributor of nonprescription drugs and commercially packaged legend drugs and devices); the administering of vaccines and immunizations pursuant to ORS 689.645; the administering of drugs and devices to the extent permitted under ORS 689.655; the participation in drug selection and drug utilization reviews; the proper and safe storage of drugs and devices and the maintenance of proper records therefor; the responsibility for advising, where necessary or where regulated, of therapeutic values, content, hazards and use of drugs and devices; the monitoring of therapeutic response or adverse effect to drug therapy; and the offering or performing of those acts, services, operations or transactions necessary in the conduct, operation, management and control of pharmacy. [1979 c.777 §4; 1999 c.350 §3 ivision 41 - Operation Of Pharmacies (Retail And Institutional Drug Outlets) Consulting Pharmacists And Operation Of Drug Rooms The Oregon Administrative Rules contain OARs filed through July 15, 2002 Collaborative Drug Therapy Management (1) A pharmacist shall engage in collaborative drug therapy management only under a written protocol that includes; (a) The identification, either by name or by description, of the participating pharmacist(s); (b) The identification, by name, of the participating practitioner(s); (c) The name of the principal pharmacist and practitioner who are responsible for development, training, administration, and quality assurance of the arrangement; (d) A detailed description of the collaborative role the pharmacist(s) shall play, including but not limited to: (A) Written protocol for specific drugs pursuant to which the pharmacist will base drug therapy management decisions for an individual patient. (B) Circumstances which will cause the pharmacist to initiate communication with the practitioner, including but not limited to the need for new prescription orders and reports of patients' therapeutic responses or adverse effects. (C) Training requirement for pharmacist participation and ongoing assessment of competency, if necessary. (D) Quality assurance and periodic review by a panel of the participating pharmacist(s) and practitioner(s). (e) Authorization by the practitioner(s) for the pharmacist(s) to participate in collaborative drug therapy. (f) A provision for the collaborative drug therapy arrangement to be reviewed and updated, or discontinued at least every two years; and (g) A description of the mechanism for the pharmacist(s) to communicate to the practitioner(s) and for documentation of the implementation of the collaborative drug therapy. (2) Collaborative drug therapy management is valid only when initiated upon the prescription order of a participating practitioner for each individual patient. (3) Nothing in this rule shall be construed to allow therapeutic substitution. (4) The collaborative drug therapy protocol must be kept on file in the pharmacy and made available to the Board of Pharmacy and to the Board of Medical Examiners upon request. The state comparison information above was adapted from a study conducted by the American Pharmacists Association and commissioned by the Pharmacy Access Partnership. About Us • EC & Pharmacies • State Profiles • Legislation • Resources • Get Involved • Home • Site Map © 2006 Pharmacy Access Partnership Hosting Donated by eZigma, Inc. Edited by Professor Christine Bond from the Department of General Practice and Primary Care, University of Aberdeen, UK, the International Journal of Pharmacy Practice (IJPP) publishes reviews and original research on all aspects of the use of medicines and the practice of pharmacy. Published quarterly the IJPP has a respected international editorial board and publishes work from academics and practitioners worldwide. Topics covered by the IJPP include: Primary and secondary care Health economics, health policy and medicines usage Medicines information Pharmaceutical services provision Pharmacy education and practice Medicines utilisation Health improvement Pharmaceutical public health Research methods The first of two review articles by Watson et al. in IJPP June, discusses the use of simulated patients (i.e. mystery shoppers) – those who are trained to test pharmacists or pharmacy staff in specific scenarios – as a ‘methodological tool’ for pharmacy practice research. The authors aimed to provide a definitive review and identify the important characteristics that should be considered for inclusion in any study that uses this method. The review retrieved relevant studies from electronic databases (MEDLINE, EMBASE, CINAHL), as well as additional studies that were found in the references of retrieved articles, and a notice was also published in the Pharmaceutical Journal. Criteria was defined with articles being included in the review if ‘primary reports of trials conducted in the community pharmacy and drug store settings’. The review was restricted to publications from 1976 to May 2005; whilst articles were excluded if computer-, telephone, or laboratory-based simulations. It is also noted that the review’s purpose ‘was to assess the research method used in primary studies, rather than the results of the individual studies per se’. Of the 46 studies included in the review, these included nine randomised controlled trials (RCTs), three controlled clinical trials (CCTs) and 30 cross-sectional studies. The review details the randomisation, blinding and follow-up used in the studies; and how validity in the studies was achieved. Several studies used formal scenarios for the simulated patients in order to achieve some standardisation in the visits, and it was noted that simulated patients may require ‘face validity’ in order that pharmacy staff did not become suspicious and alter their behaviour. The purpose of the studies was also detailed; as was the characteristics and training of the simulated patients. Watson et al. note that their results demonstrate a growth in the use of simulated patient methodology during the past 30 years, stating that ‘this can be a rigorous and robust method of measuring practice’. However, the review was limited by variable reporting such as studies from developing countries making it difficult to classify the setting; while others did not state if staff were pharmacists or not. Future studies using simulated patients should present sufficient data and information to allow assessment. The review also discusses quality, validity and ethics. The authors summarised their findings by noting that simulated patient methodology is an internationally applicable tool with which to derive outcome measures in pharmacy practice research. Models and frameworks for implementing cognitive services in community pharmacy Roberts et al. carried out a literature search which contained discussion of models or frameworks for the implementation of cognitive pharmaceutical services (CPS) in pharmacy practice. It is noted that community pharmacy practice has been documented along a ‘continuum’ from manufacturing, compounding and distribution to pharmaceutical care and CPS. There have been very few studies which have evaluated the implementation process for pharmaceutical care or CPS, and the authors’ objective was to review the literature on practice change models so that approaches for implementing CPS could be investigated. Only a small number of papers met the criteria for inclusion. However, many of the papers were either conceptual, descriptive or non-empirical and so did not have methods sections. Thus, the authors divided the papers into two categories, conceptual and empirical. Within both categories the papers could be separated into two broad areas: models relating to specific services; general models which focused on implementation or change management process. The papers in these categories were discussed in further detail. Roberts et al. conclude that emphasis is still placed on the skills, knowledge and attitudes of individual pharmacists, assuming that improving those areas will ‘automatically result in successful change’. Many models identified overlooked the importance of the organisational process, and whilst some included elements such as business plans and external support, the authors feel that ‘it is of concern that the majority of models in which business and financial aspects were included remain conceptual in nature’, and in practice were not utilised. Furthermore, organisational models for implementing CPS that existed had not been tested thoroughly. Many studies used small groups of pharmacists; whilst most studies contained participants who had actively chosen to be involved. It is accepted that ‘the characteristics of innovators are different from those of later adopters’ and can affect the generalisability of findings. Roberts et al. find it clear that improving the generalisability and applicability of the models requires larger samples to be used in future research. Individual factors are important but the authors highlight that the implementation process is complex and involves both internal and external factors. Literature from other healthcare settings have been faster to adopt key concepts in organisational change management, and cognitive services ‘should no longer be presented in the absence of a clear framework’ for implementation. A documentation system to support pharmaceutical care of day-case oncology patients between hospital and community pharmacists Fisher et al. discuss ensuring that appropriate pharmaceutical care continues with increasing numbers of day-case cancer patients. The increase in patients being treated with oral chemotherapy at day-case chemotherapy clinics has increased and clinical monitoring is needed in primary care in order to minimise the risks associated with the medicines used. Detailed information about monitoring requirements needs to be conveyed from the day-case clinic to the patient’s GP and community pharmacist, and both need to be aware of the ‘therapeutic plan for the patient, the management of potential toxicities and possible drug interactions’. Methods involved a postal survey sent to pharmacists in cancer centres/units in the UK; pharmaceutical care issues (PCIs) from 90 day-case patients at the Edinburgh Cancer Centre were recorded in order to obtain a profile of pharmaceutical needs and PCIs were categorised; six community pharmacists from the NHS Lothian, who provide pharmaceutical care to palliative care and elderly patients, participated in interviews to agree the PCIs which should be transferred and followed up in the community; and a patient medication profile (PMP) document was designed and tested in a ‘purposive sample’ of 20 consecutive patients (10 had received intravenous and 10 had received oral chemotherapy). This study confirmed a need for continuity of pharmaceutical care between hospital and community pharmacists, and that no established systems currently exist. For example, only one study from a literature search was found that evaluated a medication system for oncology patients. The authors discuss one limitation that no community pharmacists were involved when identifying PCIs. The PMP should be assessed, ideally, at a national level so as to identify the PCIs that would be raised in a larger group of oncology patients and ‘determine the opinions of more community pharmacists’. It was concluded that further development work is needed in order to identify patients’ needs and to establish a system addressing community pharmacists’ needs and expectations. Thus helping to strengthen dialogue between oncology specialists and primary care users. 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Best tramadol Directory Looking for tramadol? We have sorted out the best websites about tramadol available on the web! Find the best sites about tramadol and tramadol related topics at giantexplorer.com! http://www.giantexplorer.com/result/"tramadol"&source... 6. Buy Tramadol (Ultram) Online Get all of your medications like Tramadol (Ultram) from these great online pharmacies. http://www.the-info-planet.com/tramadol.htm 7. The Best tramadol Directory on the Web Looking for tramadol? Webdirectory about tramadol, and related topics. Only top tramadol websites listed. Great comparisons, great deals http://www.giantexplorer.com/result/"tramadol"&source... Secure Online Access Order Prescription Refills Check Order Status Set-up Refill Reminders Learn About Generics and Their Benefits Visit Your Message Center Edit Online Profile Access Drug Information, Including Interactions and Possible Side Effects View and Print Needed Forms Access and Print Prescription Expenditure Summaries Learn About Diseases and Other Health Conditions Drug Recall and Product Alert Information Access Health Newsletters Pharmacy discount sales are increasingly becoming popular. For people with average income, paying hefty prices for medication poses tremendous financial pressure. With pharmacy discount programs common people now have the option to pay less for OTC and Prescription drugs. Studies indicate that a common American is now ready to go to a Canadian or Mexican online pharmacy if they have a pharmacy discount offer running! If you are tired of paying huge medication bills, it is time to opt for pharmacy discount offers. A search on the net would help you to locate the discount pharmacies. Online pharmacy discount offers help you save money if you buy your medications online. To avail yourself of an attractive pharmacy discount sale you need to search for the online discount pharmacies. An online pharmacy discount offer can save up to 75% of your medications bills. And not only that, there are reputable pharmacies online that offer free shipping, doorstep delivery, attractive refill packages and many other sweet deals you would love to grab as a consumer. Many big online pharmacy stores offer pharmacy discount cards or special refill discounts for regular customers. They want to 'reward' their regular clients with special discounts. You can save money if you purchase medications from such stores. Online pharmacies are becoming increasingly popular worldwide. Availability of free shipping, discount prices, and 24/7 customer services are some of the main factors that propel the buyers to an online pharmacy. Discount is the most important factor that tempting the US medications buyers go online as Due to the absence of proper pricing regulation in the United States, American consumers pay much higher prices for drugs than consumers of Italy, France, Germany and Great Britain. As a result U.S. consumers are becoming more and more inclined to purchasing their medication and health related requirements from online discount pharmacies, which are present not only in United States but also overseas. It is obviously an individual's choice to purchase drugs from online discount pharmacies, but at the same time one should be cautious enough. When someone shops from online discount pharmacies he or she should consider certain parameters pertaining to the same. Like, which company might offer the best possible prices on the medication one is interested or who offers the best overall cost on medication etc. It is nice to get free overnight delivery of drugs but it should not be considered at the cost of "discount". Also other factors like quality, reliability and customer service should also be considered while choosing online discount pharmacies. It is also important for a customer to check the following other parameters while choosing an online discount pharmacy. * Do the pharmacy provide evidence either that they are a licensed pharmacy themselves or work as a middleman facilitating delivery of medicines and health products via a licensed pharmacy. * Do they state a privacy policy? Or should one expect an innumerable Spam mails once a customer discloses his or her personal information to them. * Do they provide actual prescriptions and online medical consultation? * Do the company mention about a real physical address or a toll free number for client servicing? Best online pharmacies have certain characteristics. Online pharmacies have evolved strongly with the increasing popularity of e-commerce. Best online pharmacies should have a wide range of medicines, and all of them should be available to a customer in 24x7 quantum. A customer can order health and medication related products at a time, which suits his or her own convenience and that too from the comfort of his or her home. Best online pharmacies facilitate doorstep delivery of medicines. A competent logistics company is employed to deliver the same at a location, which a customer desires. Also Best online pharmacies do not compromise with security issue of a customer. Even the credit card payments (a wide range of credit cards are normally accepted by best online pharmacies) that they receive from the customers are processed by a safe and secure transaction server. Online pharmacies, if they want to be the very best in the market should adhere to the following parameters: * Prices-It should be on the lower side. * There should not be any kind of hidden costs. * Product quality---Nothing less than superior * It should be highly reliable. Reliabity in terms builds up trusts an d facilitates to get on going customers. * Speed of delivery---Absolutely should be within the turn around time. * Faster processing of orders. * There should methods and practices in place pertaining to customer service and subsequent follow up * Integrity and security of site. There should not be any cyber fraud. * Discrete billing and delivery * The establishment should be highly committed to Anti SPAM activity. Have you ever heard about a Compounding pharmacy? Like how it works, how much unique it is, how it is different from other pharmacies etc. If the answer is negative then you should definitely read this article. The intention to write this article is to give the readers a general idea about Compounding pharmacy. A Compounding pharmacy is one, which normally prepares all forms of natural hormones as per the requirement or specification made by a patient's doctor. They in fact make special combinations of bio-identical (natural) hormones to meet the specific medical needs of a patient as per doctor's prescription. Also if a patient or his physician desires to get the required medical information packet then a compounding pharmacy also takes care of the same. A Compounding pharmacy takes care of almost all types of medication requirement including the following: * Hormone replacement * Nutritional support * Longevity therapy * Pain management * Injectables * Cognitive medicines * Chelation therapy The medication requirements are always given by the patient's physician There is a probability that people might raise their eyebrows when someone talks about a Mexican pharmacy. There are certain steps which one should follow while purchasing drugs from a Mexican pharmacy. Ideally one should first call his or her U.S. doctor to ask permission to purchase Mexican medicines. If the answer is an emphatic "NO!" then it is important to reconsider the effort. For example, some of the heart rhythm drugs are so sensitive that different brand names of the same chemical substance in the same dosage might react differently in the same person. On the other hand, if the ailment is not extremely sensitive such as drugs required for curing arthritis, antibiotics or asthma inhalants, one can join the 'Aware Consumer' bandwagon and go ahead for purchasing drugs from a Mexican pharmacy. There are certain other steps that one should follow while purchasing drugs from a Mexican pharmacy. If a patient decides to buy prescription drugs in Mexico then it is advisable that he or she should ask his U.S. based pharmacist to provide him or her with a small brochure called 'package insert' that which is normally attached to all bottles of U.S. wholesale medicines. This insert has exactly the same data and information that's listed in a huge reference book called Physician's Desk Reference (or PDR). The package insert contains an enormous amount of information about the medicine, its generic name, dosage formulations etc. When the same (i.e. PDR) is handed to a counter person in a Mexican pharmacy, they can cross reference the names and dosages, and provide a sample for the patient's approval. The counter person is experienced in identifying generic names and equivalences. That`s the highest level of expertise that one can expect out of them. It is advisable that a customer consults his or her U.S. based physician if he or she has the slightest doubt about the product. Also, it is important for the customer not to rely on the advice of the person behind the counter. Unlike their U.S. counterparts, they have no medical training! They are absolute salesman. As because Prescription drugs are regulated in the United States they are so powerful. They can be pose to be a peril if used improperly or paired with an incorrect, conflicting drug. Nowadays in the field of pharmacy business the buzzword or the latest bandwagon is "on line pharmacy". Evolution of Internet and websites is the primary reason for this hype. Earlier when someone used to talk about a pharmacy then it used to remind us of a retail establishment where people are flocking with prescriptions to purchase drugs. Now times have changed so did the concept of pharmacy. When everything is available with the help of e-commerce then why should pharmaceutical business lag behind? Pharmacy however is not like other businesses whereby it has some social commitments too. Because at the end of the day it is question of dealing with a "human life". A business house has to abide by certain line of working if it wants to float an on line pharmacy. An on line pharmacy has to give paramount importance to the following factors if it wants to be become a key and ethical player in the market. * Prices----It should be on the lower side (May be a discount pharmacy) * A strict no no to hidden costs * Superior product quality * It should be highly reliable * Speed of delivery---exceptional (Otherwise it will have no place for itself in the competition) * Order processing--- exceptional * Unmatched customer service standards. * Integrity and security of business. There should not be any cyber fraud. * Discrete billing and delivery * A clear commitment to Anti SPAM activity The following factors however should be taken into consideration while choosing an online pharmacy. Like, * Is it a licensed pharmacy themselves? Or do they work as a middleman just facilitating delivery of medicines and health products to the clients by liaising with a licensed pharmacy. * Do they state a privacy policy? Or should a customer expect a innumerable number of Spam mails once he or she discloses his or her personal information to them. * Do they provide actual prescriptions and online medical consultation? * Is there any mention about company's real physical address or a toll free number for client servicing? Best online pharmacies have certain characteristics. Online pharmacies have evolved strongly with the increasing popularity of e-commerce. Best online pharmacies should have a wide range of medicines, and all of them should be available to a customer in 24x7 quantum. A customer can order health and medication related products at a time, which suits his or her own convenience and that too from the comfort of his or her home. Best online pharmacies facilitate doorstep delivery of medicines. A competent logistics company is employed to deliver the same at a location, which a customer desires. Also Best online pharmacies do not compromise with security issue of a customer. Even the credit card payments (a wide range of credit cards are normally accepted by best online pharmacies) that they receive from the customers are processed by a safe and secure transaction server. Online pharmacies, if they want to be the very best in the market should adhere to the following parameters: * Prices-It should be on the lower side. * There should not be any kind of hidden costs. * Product quality---Nothing less than superior * It should be highly reliable. Reliabity in terms builds up trusts an d facilitates to get on going customers. * Speed of delivery---Absolutely should be within the turn around time. * Faster processing of orders. * There should methods and practices in place pertaining to customer service and subsequent follow up * Integrity and security of site. There should not be any cyber fraud. * Discrete billing and delivery * The establishment should be highly committed to Anti SPAM activity. Best Online pharmacies are normally classified into two categories namely "Brand Name Pharmacies" and "Generic Name Pharmacies". Some of the important brand name pharmacies are Viamedic, IntegraRX, USOnlineRx, NewPharm, Direct Pharmacy, Brand Pills, and European Pharmacy etc. Some of the important generic name pharmacies are Budget Medicines, Rx Mex, GenericPharmacy, RxPillsMD, Quality Generics, AllPills net, XLPharmacy etc. Internet and Mailorder Pharmacy Accreditation Commission or IMPAC™ defines quality and consumer safety or patient safety in its quality standards for prescription drugs purchased through a mailorder pharmacy or internet pharmacy; verifies these standards through an accreditation or certification process at the location of an international pharmacy including Canadian pharmacies, United States pharmacies and others; provides a seal of accreditation to an approved pharmacy which differentiates that pharmacy from a rogue pharmacy or a pharmacy that might dispense counterfeit medications through importation. BBB The BBBOnLine Reliability seal tells customers that our company: Makes a commitment to high levels of ethical business practices and customer satisfaction. Has been in business for more than a year. Has a satisfactory record with the Better Business Bureau. Commits to work with its customers and the Better Business Bureau to resolve disputes that might arise. CIPA The Canadian International Pharmacy Association (CIPA) created in November, 2002, is an organization who represents the Canadian International Pharmacy Industry. Our presence is to represent and support the ethical and professional practice of International Pharmacy, and to ensure the highest standards of practice are carried out by its members. CIPA promotes the growth and viability of the Canadian pharmacies that provide international services, as well as to provide a unified voice to address the challenges facing the industry at large. PharmacyChecker.com PharmacyChecker.com LLC ("PC") collects, evaluates, and reports credentials, prices, and customer feedback regarding pharmacies that operate online and through mail-order and fax (generally referred to as “online pharmacies”). CanadaDrugs.comTM is presently licensed in the province of Manitoba by the Manitoba Pharmaceutical Association. License Number 32195 CanadaDrugs.comTM is located at: 24 Terracon Place, Winnipeg, Manitoba, Canada, R2J 4G7 Copyright © 2001-2006 CanadaDrugs.comTM. "Canada Drugs" and "CanadaDrugs.com" are registered trademarks of CanadaDrugs.comTM Partnership. All rights reserved. FDA's general position: The FDA, due to the current state of their regulations, has taken the position that virtually all shipments of prescription drugs imported from a Canadian pharmacy by a U.S. consumer will violate the law. Canadian Pharmacies Looking to buy drugs at discounted prices? Find yourself Canadian pharmacies. Canadian pharmacies sell the generic drugs at cheaper prices than the US stores. Before further divulgement it should be kept in mind that buying drugs from Canadian pharmacies violates FDA law. However, a consumer can buy a small amount of FDA approved drugs for PERSONAL use only if the drug is not available in the US. Why choose Canadian pharmacies? The main reason is to save money. Buying medications is an expensive affair in the US. Studies show that more Americans now prefer Canadian pharmacies as they get same quality, effective medications in a cheaper price. Ideal Canadian pharmacies would offer the buyers with discounted prescription drugs, free shipping, overnight deliveries etc. But how would you know that you are buying from legitimate Canadian pharmacies? If you prefer to buy medications from Canadian pharmacies, make sure it has a valid provincial license. Check if they have any accreditation. The website should include detailed information on their fact file. Examine the commitments of your chosen Canadian pharmacy before you buy. Do they have a clearly written terms-of-sale? Where is there brick-and-mortar store located? Do they have a return policy? Also check the strength of customer care service. Are there toll free numbers? This information would help you to determine the credibility of your Canadian pharmacies. Remember! You are buying lifesaving drugs and ignorance from you part might prove to be dangerous for your health.

SOMA's interdisciplinary team approach brings a unique perspective to each project combining real world, academic and regulatory experience. For more in-depth information regarding our staff members contact SOMA. Areas of Expertise of SOMA Staff &Associates • Occupational Medicine • Industrial Hygiene/Exposure Modeling • Occupational Health Nursing • Information Science • Neurology/Neuropsychology/Psychiatry • Pulmonology Animal Toxicology • Risk Assessment • Dermatology • Allergy/lmmunology • Epidemiology/Biostatistics • Pathology • Oncology • Radiology • Gastroenterology • Cardiology • Endocrinology • Orthopedics Buy Soma online Learn more about usage, cautions, and possible side effects. Prescription Soma Tablets Chemical Name: CARISOPRODOL (kar-eye-soe-PROE-dole) Common uses of prescription Soma containing Carisoprodol Carisoprodol is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. Soma drugs / carisoprodol may also be used for purposes other than those listed in this medication guide. return to top Before using Prescription Soma Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. USE OF SOMA DRUGS is not recommended if you are also taking cyclobenzaprine or medicine for depression or other emotional or mood disorders. If you are taking any of these medicines, be sure your doctor knows. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking bupropion, narcotic analgesics, carbamazepine, or have a history of seizures. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine. Use caution when driving, operating machinery, or performing other hazardous activities. soma / carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking soma / carisoprodol. Also, in combination with aspirin, alcohol can be very damaging to your stomach. Watch for bloody, black, or tarry stools or blood in your vomit. This could mean damage to your stomach. Never take more of this medication than is prescribed for you. If your pain is not being adequately treated, talk to your doctor. return to top Directions Follow the directions for using this medicine provided by your doctor. STORE THIS MEDICINE at room temperature, away from heat and light. IF YOU MISS A DOSE OF THIS MEDICINE, take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of soma / carisoprodol. Keep your doses at least 4 hours apart from one another.take it as soon as possible. Do NOT take 2 doses at once. return to top Cautions DO NOT EXCEED THE RECOMMENDED DOSE OR TAKE THIS MEDICINE for longer than prescribed. IF YOU EXPERIENCE difficulty breathing or tightness of chest; swelling of eyelids, face, or lips; or develop a rash or hives, tell your doctor immediately. Do not take any more of this medicine unless your doctor tells you to do so. AVOID ALCOHOL while you are using this medicine. This medicine will add to the effects of alcohol and other depressants. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. Caution should be used in the elderly since they may be more sensitive to the effects of this drug. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. THIS MEDICINE IS EXCRETED IN BREAST MILK. DO NOT BREAST-FEED while taking this medicine. Do not take soma / carisoprodol if you have acute intermittent porphyria. Codeine is habit forming and should only be used under close supervision if you have an alcohol or drug addiction. Before taking this medication, tell your doctor if you have: kidney disease liver disease an ulcer in your stomach or intestines a bleeding or blood-clotting disorder urinary retention an enlarged prostate hypothyroidism a head injury addison's disease You may not be able to take soma / carisoprodol, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above. It is not known whether soma / carisoprodol will harm an unborn baby. Do not take soma / carisoprodol without first talking to your doctor if you are pregnant. It is also not known whether soma / carisoprodol passes into breast milk. Do not take soma / carisoprodol without first talking to your doctor if you are breast-feeding a baby. Soma / carisoprodol is not approved for use in children younger than 12 years of age. return to top Possible side effects If you experience any of the following serious side effects, stop taking soma / carisoprodol and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); paralysis (loss of feeling) or extreme weakness vision loss agitation or tremor red, black, or bloody stools blood in your vomit other, less serious side effects may be more likely to occur Continue to take soma / carisoprodol and talk to your doctor if you experience: drowsiness or dizziness headache depression blurred vision or small pupils insomnia; hiccups faint ringing in the ears nausea, vomiting, or constipation Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. return to top Drug interactions Many drugs can increase the effects of soma / carisoprodol and lead to heavy sedation. Before taking this medication, tell your doctor if you are taking any of the following medicines: antihistamines such as brompheniramine (Dimetane, Bromfed, others) chlorpheniramine (Chlor-Trimeton Teldrin, others) azatadine (Optimine) clemastine (Tavist) narcotics (pain killers) such as meperidine (Demerol) morphine (MS Contin, MSIR, others) propoxyphene (Darvon, Darvocet) hydrocodone (Lorcet, Vicodin) oxycodone (Percocet, Percodan) fentanyl (Duragesic) codeine (Fiorinal, Fioricet, Tylenol #3, others) sedatives such as phenobarbital (Solfoton, Luminal), amobarbital (Amytal) secobarbital (Seconal) phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin) mesoridazine (Serentil) perphenazine (Trilafon) prochlorperazine (Compazine) thioridazine (Mellaril), and trifluoperazine (Stelazine) antidepressants such as doxepin (Sinequan) imipramine (Tofranil) nortriptyline (Pamelor) fluoxetine (Prozac) paroxetine (Paxil) sertraline (Zoloft) phenelzine (Nardil) tranylcypromine (Parnate) Other over-the-counter and prescription drugs may increase the effects of aspirin and cause dangerous side effects: oral anticoagulants such as warfarin (Coumadin) nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Rufen, others) ketoprofen (Orudis, Oruvail) naproxen (Anaprox, Naprosyn, Aleve) other commonly used NSAIDs, including diclofenac (Voltaren, Cataflam), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin) other salicylates (forms of aspirin) such as salsalate (Disalcid), choline salicylate, and magnesium salicylate bismuth subsalicylate in drugs such as Pepto-Bismol; and calcium supplements and antacids. other drugs that should not be combined with aspirin and carisoprodol include steroids such as prednisone (Deltasone) oral antidiabetic drugs such as glipizide (Glucotrol) and glyburide (Micronase, Diabeta) alcohol lithium (Lithobid, Eskalith, others) cyclosporine (Sandimmune) Drugs other than those listed here may also interact with soma / carisoprodol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. return to top If you take too much If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include cold and clammy skin, low body temperature, slowed breathing, slowed heartbeat, drowsiness, dizziness, lightheadedness, seizures, deep sleep, and loss of consciousness. Seek emergency medical attention. Symptoms of an aspirin soma / carisoprodol overdose include: headache ringing in the ears dim vision small pupils nausea vomiting diarrhea sweating increased thirst low blood pressure (weakness, fainting, confusion) decreased breathing unconsciousness. return to top Additional information DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out. Soma This page contains drug information on Soma. The information provided includes the following: what is Soma the possible side effects of Soma what happens if you miss a dose of Soma what happens if you overdose with Soma the most important information about Soma how to use Soma other drugs that may affect Soma what to avoid while using Soma Generic Name: carisoprodol (kar eye soe PROE dole) Brand Names: Soma, Vanadom What is the most important information I should know about carisoprodol? • Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking carisoprodol. What is carisoprodol? • Carisoprodol is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. • Carisoprodol is used, along with rest and physical therapy, to treat injuries and other painful muscular conditions. • Carisoprodol may also be used for purposes other than those listed in this medication guide. Who should not take carisoprodol? • Do not take carisoprodol if you have acute intermittent porphyria. • Before taking carisoprodol, tell your doctor if you have kidney or liver disease. You may need a lower dose or special monitoring during your therapy. • It is not known whether carisoprodol will harm an unborn baby. Do not take carisoprodol without first talking to your doctor if you are pregnant. • It is also not known whether carisoprodol passes into breast milk. Do not take carisoprodol without first talking to your doctor if you are breast-feeding a baby. • Carisoprodol is not approved for use in children younger than 12 years of age. How should I take carisoprodol? • Take carisoprodol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each dose with a full glass of water. • The maximum amount of carisoprodol you should take in one day is 1,400 mg (4 tablets). • Store carisoprodol at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication. Try to keep your doses at least 4 hours apart. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a carisoprodol overdose include low blood pressure (weakness, fainting, confusion), decreased breathing, and unconsciousness. What should I avoid while taking carisoprodol? • Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking carisoprodol. What are the possible side effects of carisoprodol? • If you experience any of the following serious side effects, stop taking carisoprodol and seek emergency medical attention: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); · paralysis (loss of feeling) or extreme weakness; · vision loss; or · agitation or tremor. • Other, less serious side effects may be more likely to occur. Continue to take carisoprodol and talk to your doctor if you experience · drowsiness or dizziness; · headache; · depression; · blurred vision; · insomnia; or · hiccups. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect carisoprodol? • Many drugs can increase the effects of carisoprodol, which can lead to heavy sedation. Before taking this medication, tell your doctor if you are taking any of the following medicines: · antihistamines such as brompheniramine (Dimetane, Bromfed, others), chlorpheniramine (Chlor-Trimeton, Teldrin, others), azatadine (Optimine), clemastine (Tavist), and many others; · narcotics (pain killers) such as meperidine (Demerol), morphine (MS Contin, MSIR, others), propoxyphene (Darvon, Darvocet), hydrocodone (Lorcet, Vicodin), oxycodone (Percocet, Percodan), fentanyl (Duragesic), and codeine (Fiorinal, Fioricet, Tylenol #3, others); · sedatives such as phenobarbital (Solfoton, Luminal), amobarbital (Amytal), and secobarbital (Seconal); · phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), and trifluoperazine (Stelazine); or · antidepressants such as doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), phenelzine (Nardil), and tranylcypromine (Parnate). • Drugs other than those listed here may also interact with carisoprodol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. Where can I get more information? • Your pharmacist has more information about carisoprodol written for health professionals that you may read. Soma is a medication that acts as a muscle relaxant, usually for the purpose of helping patients deal with the pain associated with injury. On our site, generic Soma (known as Carisoprodol) is made available to consumers for the lowest prices online. The reason so many people decide to purchase their Soma online from our website is the service that we offer, and our low prices. That, combined with the convenience of online ordering, and not needing a prior prescription make ordering your Soma online from us an easy decision for you to make. If you are in the process of recovering from an injury, and need Carisoprodol to help during the recovery period, you can buy it online here and have it in your hands in as little as one or two business days. Keep in mind that Soma is not intended to directly heal the injury you have suffered. Rather, it works to temporarily suppress the pain so that you can more comfortably go on with your normal daily activities. Although, it is usually regarded as best to rest an injury such as that as much as possible. A good amount of rest, supervised physical therapy, and your daily dosages of Soma will often form a good plan for getting through and past a muscular injury. Soma is taken orally. A single pill is ingested, three times a day. It is recommended that you take it with food, or with milk, to minimize the likelihood that you will suffer an upset stomach as a result of taking the medication. When taking Carisoprodol, you should be very careful if you intend to ingest alcohol or alcoholic beverages. This medication may very well intensify the effects of the alcohol you ingest. In addition, you should refrain from operating dangerous machinery or from operating an automobile until you have an understanding of how having this medication in your system will effect your ability to perform the mental or physical tasks necessary for those activities. As always, keep this and all other medications (prescription, as well as over the counter) stored safely out of the reach of children. Soma, or its generic form called Carisoprodol is a muscle relaxant which works by blocking nerve impulses that are sent to your brain. Many poeple use Soma to treat injuries and other painful muscular conditions. It has the best results when taken in combination with rest, physical therapy and other measures. Although people find it benificial to use for other purposes, it is mainly meant to treat pain and stiffness of muscle injuries including the following: strains sprains and muscle spasms Take Soma exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.Take each dose with a full glass of water.The maximum amount of Soma you should take in one day is 1,400 mg (4 tablets).Store Soma at room temperature away from moisture and heat.Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication. Try to keep your doses at least 4 hours apart. Carisoprodol belongs to the category of drugs known as muscle relaxants. These drugs directly react on the Central Nervous System to reduce pain. Soma is known to produce very few side effects which is why doctors prefer prescribing soma instead of other muscle-relaxants. The side effects from Soma are known to emerge as soon as you start taking the medication. In the starting days you may encounter problems like headache, body ache and other troubles. But once your body adapts to the medication, these side effects usually go away. You should continue using Soma even after you see few side effects during the early stages. However if any of the problem remains for longer than expected period you should contact your doctor immediately. It may happen sometime that drug may affect some patients adversely. The following is a list of side effects that may occur in the beginning stages of using Soma: SOMA' (carisoprodol) Tablets, USP is available as 350 mg round, white tablets. Chemically, carisoprodol is N-isopropyl-2- methyl-2-propyl-1,3-propanediol dicarbamate. Carisoprodol is a white, crystalline powder, having a mild, characteristic odor and a bitter taste. It is very slightly soluble in water; freely soluble in alcohol, in chloroform, and in acetone; its solubility is practically independent of pH. Carisoprodol is present as a racemic mixture. The molecular formula is C 12 H 24 N 2 O 4 , with a molecular weight of 260.33. The structural formula is: Carisoprodol produces muscle relaxation in animals by blocking interneuronal activity in the descending reticular formation and spinal cord. The onset of action is rapid and effects last four to six hours. INDICATIONS Carisoprodol is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The mode of action of this drug has not been clearly identified, but may be related to its sedative properties. Carisoprodol does not directly relax tense skeletal muscles in man. CONTRAINDICATIONS Acute intermittent porphyria as well as allergic or idiosyncratic reactions to carisoprodol or related compounds. WARNINGS Idiosyncratic Reactions --On very rare occasions, the first dose of carisoprodol has been followed by idiosyncratic symptoms appearing within minutes or hours. Symptoms reported include: extreme weakness, transient quadriplegia, dizziness, ataxia, temporary loss of vision, diplopia, mydriasis, dysarthria, agitation, euphoria, confusion, and disorientation. Symptoms usually subside over the course of the next several hours. Supportive and symptomatic therapy, including hospitalization, may be necessary. Usage in Pregnancy and Lactation --Safe usage of this drug in pregnancy or lactation has not been established. Therefore, use of this drug in pregnancy, in nursing mothers, or in women of childbearing potential requires that the potential benefits of the drug be weighed against the potential hazards to mother and child. Carisoprodol is present in breast milk of lactating mothers at concentrations two to four times that of maternal plasma. This factor should be taken into account when use of the drug is contemplated in breast-feeding patients. Usage in Children --Because of limited clinical experience, `SOMA' is not recommended for use in patients under 12 years of age. Potentially Hazardous Tasks --Patients should be warned that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. Additive Effects --Since the effects of carisoprodol and alcohol or carisoprodol and other CNS depressants or psychotropic drugs may be additive, appropriate caution should be exercised with patients who take more than one of these agents simultaneously. Drug Dependence --In dogs, no withdrawal symptoms occurred after abrupt cessation of carisoprodol from dosages as high as 1 gm/kg/day. In a study in man, abrupt cessation of 100 mg/kg/day (about five times the recommended daily adult dosage) was followed in some subjects by mild withdrawal symptoms such as abdominal cramps, insomnia, chilliness, headache, and nausea. Delirium and convulsions did not occur. In clinical use, psychological dependence and abuse have been rare, and there have been no reports of significant abstinence signs. Nevertheless, the drug should be used with caution in addiction-prone individuals. PRECAUTIONS Carisoprodol is metabolized in the liver and excreted by the kidney; to avoid its excess accumulation, caution should be exercised in administration to patients with compromised liver or kidney function. ADVERSE REACTIONS Central Nervous System --Drowsiness and other CNS effects may require dosage reduction. Also observed: dizziness, vertigo, ataxia, tremor, agitation, irritability, headache, depressive reactions, syncope, and insomnia. (See also Idiosyncratic Reactions under "Warnings." ) Allergic or Idiosyncratic --Allergic or idiosyncratic reactions occasionally develop. They are usually seen within the period of the first to fourth dose in patients having had no previous contact with the drug. Skin rash, erythema multiforme, pruritus, eosinophilia, and fixed drug eruption with cross reaction to meprobamate have been reported with carisoprodol. Severe reactions have been manifested by asthmatic episodes, fever, weakness, dizziness, angioneurotic edema, smarting eyes, hypotension, and anaphylactoid shock. (See also Idiosyncratic Reacti