Thursday, November 15, 2012 219 Dwinelle , 7-8:30pm

1. PILLS 4th General Meeting Thursday, November 15, 2012219 Dwinelle, 7-8:30pm Email: pills.prepharmacy@gmail.com Website: www.ocf.berkeley.edu/~pills

2. Herbal and Dietary Supplements Could Interfere With Prescription Drugs http://www.medicalnewstoday.com/articles/251953.php By Vincent Man & Yuen Ng • Natural remedies - dietary and herb supplements (HDS) • Prevent illnesses • Treat ailments • Potential interferences between HDS and Rx need more research • International Journal of Clinical Practices • Using 213 HDS entities and 509 prescribed medications, 882 HDS-drug interactions were found

3. HDS-Drug Interactions Statistics • Over 42% of HDS-drug interactions from changes in pharmacokinetics • Process by which a drug is absorbed, distributed, metabolized, & eliminated by the body • Over 26% classified as major interactions • 152 contraindications involving gastrointestinal, neurological system, & adrenal/genitourinary diseases. • Interactions from HDS that included calcium, iron, & magnesium • More research and awareness needs to be raised

4. Membership Updates • Requirements • 2 General Meetings • 1 Social • 4 Hours of Approved Volunteering • Membership Application • Fees ($17) Link to spreadsheet: https://docs.google.com/spreadsheet/ccc?key=0AroNpsCAG1wFdFRVTHVIa0FtRkFpaW0xTTJadXhKbEE#gid=0

5. Berkeley Project Recap THANK YOU FOR COMING!

6. Last Event of the Semester • TBA • Check Email for update

7. 5th Social • November 30th • Holiday Themed • Time: 7 – 8:30PM • Location: 2070 VLSB Reminder: • Need to attend at least 1 social to be an active member • This is your LAST chance!

8. Thank you guys for coming out to the Joint Cops & Robbers PhRENDs Social in October! • Be on the lookout for a November Individual Group Hangout! • Introducing the PhRENDs point system! • Any tips/suggestions for PhRENDs? Let your group PRs know!

9. Welcome to PhRENDs Point System! We have a SECRET PRIZE for the winning PhREND group at the end of Spring 2013!

10. Careers in Pharmacy Clinical, Regulatory/Policy, R&D, Management, Nursing Home, Academia, Retail

11. Clinical Pharmacist • Where they work: • Hospitals and clinics • Responsibilities: • Advises physicians and nurses • Knowledgeable about drug-drug interactions, drug allergies, history of medications, PK/PD, etc. • Oversees technicians (preparation, labeling, and deliveries) • Requirements: • PharmD degree, two year residency (can get board certified with specific specialties) • Avg salary: • $124,892

13. Pharmacy Policy • Where they work: • FDA, NIH, CDC, Pharmaceutical Companies, Managed Care Organizations, Chain Drug Stores, Academia • Responsibilities: • Evaluate effectiveness of health policy • Advise about new industry development • Develop policies to ensure best outcomes in patient care • Regulate efficiency and cost effectiveness of product development and manufacturing • Requirements: • development of skills via on-the-job experience or post-graduate education. • Average Salary: • 103,000 (FDA pharmacist) • Other: • Responsibilities vary with area of work (industry, government, academia). Positions can have responsibilities anywhere from a local to global scale.

15. Research & Development • Where they work: • Biotech companies, government institutes • Responsibilities: • Design clinical trials • Experiments in pharmaceutical development • Educational requirements: • PharmD • [optional] Post-graduate fellowships or PhD • Average salary: • $110,000 • Small but growing field

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17. Pharmacy Management • Where they work: • Retail pharmacies, hospitals, any pharmacy with a group of workers. • Responsibilities: • Manage group of pharmacists in daily tasks. Leads and directs the group. Resolves any issues and oversees pharmacy as a whole operation. • Education Requirement: • Pharm D • Average Salary: • $125,000 • Experience is the key to this profession.

19. Long-term Care Pharmacist • Where they work: • Nursing homes, group homes, correctional facilities, alcohol/drug rehabilitation centers, with long-term care pharmacy chains like Omnicare and PharMerica • Responsibilities: • Compounds and dispenses prescribed drugs • Pain management counseling • Therapeutic drug monitoring • Educational requirement: • PharmD • Avg salary: • $107,2201 • Most recent national study in 2003 showed average number of medications used per nursing facility resident was 8.1 routine + 3.2 PRN2

21. Pharmacy Academia • Where they work: • Pharmacy schools and laboratories/clinics • Responsibilities: • Educate the pharmacist workforce • Conduct research (e.g.: evaluating scientific data, patient compliance, etc.) • Educational requirement: • Graduate degree (e.g.: PharmD, PhD, etc.), residency, teaching licensure • Avg salary: • $117,038 • Diversity in types of pharmacy faculty: Pharmaceutical sciences; pharmacy practice faculty/clinical sciences; social, economic, behavioral and administrative faculty

23. Retail Pharmacy • Where they work: CVS, Walgreens, Walmart, Safeway, Target, Costco • Responsibilities: • Traditional: dispense medication, patient consultation • Expanded: vaccination, Medication Therapy Management(MTM) • Educational requirement: PharmD., (residency if necessary for your speciality) • Avg salary: ~$132,000 (according to indeed.com) • Fun Fact: • Before, pharmacists only needed a B.A. or B.S. • The most prescribed drug in the U.S. is Vicodin (128.1 million in 2009)

24. Retail Pharmacy Setting

25. Ambulatory Care Pharmacy Umang Patel and Kelly Valine

26. Role of an Ambulatory Care Pharmacist • Interact with patients in an outpatient clinic setting for the management of chronic conditions under protocol • Responsible for adjusting medication doses counseling patients on side effects of medications and the importance of medication adherence, and making therapy recommendations to prescribing physicians.

27. Patient MJ MJ is a 68 year old male referred to you by Dr. Smith to manage high blood pressure. Past Medical History Hypertension Diabetes Cholesterol Allergies Penicillin – rash Medications Lisinopril 20mg 1 tablet daily Hydrochlorothiazide 25mg 1 tablet daily Simvastatin 40mg 1 tablet daily Metformin 500mg 1 tablet 2 times per day Vitals BP 175/92 HR 72 (4/5/12) BP 160/90 HR 69 (2/12/12) BP 150/85 HR 85 (1/6/12) Labs Scr 1.8 (kidney function) ALT 24 (liver function) WHAT IS YOUR PLAN?

28. What do you need to know? MJ is a 68 year old male referred to you by Dr. Smith to manage high blood pressure. Past Medical History Hypertension Diabetes Cholesterol Allergies Penicillin – rash Medications Lisinopril 20mg 1 tablet daily Hydrochlorothiazide 25mg 1 tablet daily Simvastatin 40mg 1 tablet daily Metformin 500mg 1 tablet 2 times per day Vitals BP 175/92 HR 72 (4/5/12) BP 160/90 HR 69 (2/12/12) BP 150/85 HR 85 (1/6/12) Labs Scr 1.8 (kidney function) ALT 24 (liver function) ASSESSMENT / PLAN: • BP goal is < 130/80 • Combine lisinopril and hydrochlorothiazide into 1 pill called prinzide • Start atenolol 25mg 1 tablet daily. Monitor heart rate • Start aspirin 81mg 1 tablet daily for heart protection • Continue all other medications • Recheck BP in 4 weeks What is MJ’s blood pressure goal?Does he exercise? How often? Eat excessive salty foods? What blood pressure medications to avoid with penicillin allergy? What are these medications and for what conditions? Any interactions? Duplicates? Safe for elderly? Adherent to therapy? Experiencing side effects? Follow recommended treatment guidelines? Cost savings opportunities? Reduce quantity of medications? What do these lab results mean? Are medications safe given this labs?

29. What settings do Ambulatory Care Pharmacists Work? • Internal medicine • Oncology • Nephrology • Gastrointestinal • Endocrine • HIV • Chronic Pain • Hospice • Much more…

30. Why choose Ambulatory Care? • Manage chronic conditions and educate patients • Build great working relationships with physicians, nurses, medical assistants • Develop expertise in a specialized area

31. The road to Ambulatory Care Pharmacy School (3-4yrs) AND Residency (1 year)

32. Questions?

33. PILLS 5th General Meeting: Pharmacy Opportunities Tuesday, November 27, 2012110 Barrows, 7-8:30pm Email: pills.prepharmacy@gmail.com Website: www.ocf.berkeley.edu/~pills