GlaxoSmithKline and the Canadian subsidiaries of Shire and Boehringer Ingelheim had two years ago authorized Canadian generic drug maker Apotex to export to Rwanda a “fixed dose triple combination antiretroviral medicine” containing drugs over which each held patent rights in Canada.

In statements, each company reconfirmed their support for Canada’s so-called Access to Medicines Regime (CAMR) that allows the manufacture of the medicine in Canada.

Over the past year, Canada’s Apotex has sent two shipments of the generic triple-combination AIDS drug to treat for 21,000 people living with HIV in Rwanda, the only country to have so far benefited from CAMR.

The company threatened last month to abandon the project, saying it was a too “costly and complicated process.”

A shipment amounts to only one year’s supply and then “the process under CAMR would have to be completely restarted if Rwanda needs to reorder more of the same medicine or if any other developing country wanted to place an order.”

“So far, no other developing country has indicated it wishes to jump through the hoops imposed by CAMR,” Apotex said.

The company called for the CAMR rules to be simplified.

In 2004, Canada became the first industrialized country to modify its drug patent legislation to permit the export of generic drugs to developing nations in need, implementing a 2003 World Trade Organization agreement on patents.

The plot now thickens as more details become published on-line. The NAACP is praising the DA for pressing charges, in a case where the Pharmacist was white, and the attempted robber is a young black man.

“This is not a black issue. This is not a white issue. This is a justice issue,” said Anthony Douglas, state president of the Oklahoma chapter of the NAACP. “The judicial system must be allowed to run its proper course.”

Jerome Ersland, the Pharmacist, was charged after authorities examined video surveillance footage of the robbery attempt that showed two black men bursting into the pharmacy and one of them threatening employees with a pistol.

On the surveillance video, Ersland fires, hitting Antwun Parker in the head. Ersland then chases the second armed man outside before he walks back behind the counter, retrieves a second gun, returns to Parker and fires five more times.

An autopsy determined Parker was alive after being shot in the head and died from the abdominal wounds sustained by the additional shots.

Oklahoma, like many states, has a “stand your ground” law. That law says that you may use whatever force is necessary or reasonable in order to protect yourself or your property, up to and including lethal force.

So when does self-defense become Murder? How, in the heat of the moment and when your life is in danger, do you clearly decide when the threat is over?

Prosecutors said Parker was on the floor in the pharmacy, unconscious and unarmed after being shot once by the pharmacist, and then shot him five more times.

An unnamed 14-year-old boy was arrested Thursday, accused of involvement in the attempted robbery.

Ersland’s attorney says his actions came during a life-threatening crime and predicts no jury will convict him. While District Attorney David Prater said Ersland was justified in shooting Parker once in the head. But Prater said Ersland went too far when he shot Parker five more times while Parker lay unconscious.

The case will will put self-defense laws to test.  Laws that expand a citizens right to use deadly force when attacked in their homes, cars and businesses.

In my opinion, A guilty verdict in this case would put more power in the hands of those who commit violent crimes, if not encourage it.

While a “shoot first, ask questions later” mentality is dangerous, a properly trained and licensed gun owner has every right to protect himself, his property, and those in his care to any extent they can.

I see this case playing out in 2 ways, either a plea-bargain will be reached where the murder charge will be dropped to manslaughter. Or, Ersland fights the murder wrap tooth and nail, goes to trial and rolls the dice on his future.

I welcome any and all comments.

What does this mean to a rural independent pharmacy that can’t afford the payroll of two pharmacists? Would there be a question in the interview process interrogating them about their religious beliefs?

Medication errors and adverse drug reactions cost lives and dollars each year in the United States, but two new reports suggest ways hospitals and pharmacists can work to reduce these mistakes.
Medication errors are one of the most common medical errors, affecting at least 1.5 million people every year and costing the health-care system between $77 billion and $177 billion annually, researchers point out in the April 27 issue of the Archives of Internal Medicine.

In the first report, researchers led by Dr. Jeffrey L. Schnipper, of Brigham and Women’s Hospital and Harvard Medical School, used a computer system to keep track of the medications patients were taking when they were admitted to the hospital and the medications they were taking when they were discharged.

“It turns out that we commit about 1.5 errors per patient either for the admissions orders in the hospital or, much more commonly, in the discharge orders, which is kind of appalling,” Schnipper said. “These are errors with potential for patient harm. There are about three times as many errors without potential for patient harm.”

For the study, Schnipper’s team randomly assigned 322 patients from two hospitals to have their medications entered into a computer program at admission that was designed to reconcile those medications with the ones they were taking when they left the hospital. In addition, the researchers tried having different people take the patient’s medication history and keep track of all the medications they were taking. These included doctors, nurses and pharmacists.

Among the 162 patients in the program, there were 1.05 medication errors per patient compared with 1.44 errors among patients receiving usual care — a 28 percent reduction in errors.

Of the errors, 43 among patients in the program had the potential to cause serious harm compared with 55 among patients in the usual-care group.

The problem of medication error starts when patients are asked what drug they are taking when they come into the hospital, Schnipper said. “Patients don’t know what they are taking. You have got to carry your current accurate medication list in your wallet,” he advised.

Since the initial study, error rates have continued to drop as people got used to the system and the “culture” in each hospital changed to accommodate the program, Schnipper said. “Preliminarily, it looks like we are down to half an error per patient,” he said.

The Joint Commission on Accreditation of Healthcare Organizations has made medication reconciliation a national priority. Medication reconciliation is identifying the most accurate list of all medications a patient is taking, and using this list to give correct medications for patients anywhere within the health-care system.

Matthew Grissinger, a medication safety analyst at the Institute for Safe Medication Practices, believes the study is a good model for hospitals to follow to help reduce medication errors.

The most important feature of the system was developing a method for taking patient’s medication history on admission. “Standardizing the process of who is going to do what in regard to medication reconciliation in hospital admission and discharge is really the biggest challenge organizations have,” he said.

In a second report, a team led by Michael D. Murray, chair of the department of pharmaceutical policy and evaluative sciences at the University of North Carolina at Chapel Hill, found that among outpatients with high blood pressure, when pharmacists, doctors and patients communicate, medication errors decrease.

“By working closely with doctors and nurses, pharmacists can help people avoid problems with their medication for chronic diseases like high blood pressure and heart failure,” Murray said. “This has favorable effects on health and health-care costs.”

For the study, Murray’s group looked at the effect of having pharmacists involved in medication decisions in cutting down on medication errors and adverse drug effects among 800 patients with high blood pressure. Included among these patients were some with heart failure or other heart conditions. The researchers used a computer program to identify adverse drug reactions among the patients.

Patients assigned pharmacists intervention received instructions on using their medications. In addition, the pharmacists monitored the patients’ drugs and communicated with both the patient and the patient’s primary-care doctor to help improve adherence to medication regimens.

The researchers found that patients receiving pharmacists’ interventions had fewer medication errors and adverse drug reactions compared with the other patients. In fact, there was a 34 percent lower risk of any event, including a 35 percent lower risk of an adverse drug reaction and a 37 percent lower risk of medication error.

“There are way in which pharmacists can work collaboratively with the other members of the health-care team to improve patient safety in the outpatient setting,” Murray said.

“This study shows the importance of having a pharmacist actively involved in asking about how the patient is doing, what type of side effects is the patient having, and is the patients taking the medication,” Grissinger said. “That is as important as the initial consultation.”

Thursday’s ruling Judge Joel Novak doesn’t legalize medical marijuana in Iowa, but it requires the Iowa Board of Pharmacy to consider whether it’s properly classified as a Schedule I substance.

To be classified as Schedule I, a drug must have a high potential for abuse and no safe medical use within the U.S.

Last summer, a group, including the American Civil Liberties Union of Iowa, petitioned the pharmacy board to remove marijuana from the Schedule I classification. The board ruled against the petition last fall and the ACLU appealed.

The judge’s ruling says the board must review the classification and decide whether marijuana has an accepted medical use.

“On March 23, 2009, a federal court issued an order directing the FDA, within 30 days, to permit the Plan B drug sponsor to make Plan B available to women 17 and older without a prescription. The government will not appeal this decision. In accordance with the court’s order, and consistent with the scientific findings made in 2005 by the Center for Drug Evaluation and Research, FDA notified the manufacturer of Plan B informing the company that it may, upon submission and approval of an appropriate application, market Plan B without a prescription to women 17 years of age and older.”

The product won’t become available to women of that age until the manufacturer of Plan B submits and receives approval for a labeling change

The deaths of the ponies, witnessed in full view by spectators Sunday in a dramatic scene where horses collapsed one after another, have shaken the prestigious polo tournament at the marquee International Polo Club Palm Beach in Wellington, Florida.

An internal investigation by Franck’s Pharmacy in Ocala, Florida, “concluded that the strength of an ingredient in the medication was incorrect. We will cooperate fully with the authorities as they continue their investigations,” the company said in a statement issued Thursday afternoon.

“We extend our most sincere condolences to the horses’ owners, the Lechuza Polo team and the members of the United States Polo Association. We share their grief and sadness,” the pharmacy’s chief operations officer, Jennifer Beckett, said in the statement.

A memorial ceremony for the horses is scheduled for Thursday at the U.S. Open Polo Championship, where officials hope to resume play after matches were postponed by rain Wednesday. The memorial service will include a brief speech and a wreath-laying on the field.

The pharmacy said it prepared medication for the horses on orders from a veterinarian.

Liz Compton, a spokeswoman for the state Department of Agriculture and Consumer Services, told CNN that the agency is awaiting toxicology results from the animals and could not comment on the pharmacy’s disclosure.

“Obviously, we are going to follow any and every potential lead to get to the bottom of this,” she said.

The horses were trained by Lechuza Polo, a Venezuela-based team. Its captain, Juan Martin Nero, told an Argentine newspaper earlier this week that he had “no doubts” vitamins administered to the animals were at fault.
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“There were five horses that did not get the vitamin, and those were the only ones that survived,” Nero said.

The horses collapsed one after another in front of spectators at the International Polo Club Palm Beach in Wellington, Florida, while being prepared for a tournament Sunday. Most were dead within an hour. Post-mortem examinations done by a University of Florida laboratory found significant hemorrhaging in several horses, but the findings did not single out a specific cause

House Resolution 326, sponsored by Rep. Michael McMahon (D-NY), recognizes “the growing trend of crimes against retail pharmacies and the need for pharmacists in all practice settings to take steps to improve pharmacy safety and security.”

The move was welcomed by Bruce T. Roberts, RPh., executive vice president and CEO of the National Community Pharmacists Association (NCPA). “On the anniversary of our Protect Your Pharmacy Now! program, Congress bolsters our effort with their endorsement and designation of Protect Your Pharmacy Week,” he said. “This growing trend will only be met by vigilance and determination in the pharmacy community. Thank you to Congressman McMahon for keeping America’s patients’ safety at the forefront.”

In 2008, NCPA, Purdue Pharma L.P., FBI LEEDA (Law Enforcement Executive Development Association), and the Community Pharmacy Foundation created the “Protect Your Pharmacy Now!” initiative to combat pharmacy crime by improving pharmacy safety and security.

They also created “Protect Your Pharmacy Week” in a further effort to encourage pharmacists to protect themselves, staff, and patients against pharmacy crime, including prescription drug theft. The new bill urges pharmacists in all practice settings to take steps to protect staff and patients from pharmacy crime.

“Community pharmacists can not only benefit from this initiative by helping law enforcement apprehend pharmacy robbers, but community pharmacists can also gain access to important information on robbery trends and patterns that will help reduce their vulnerability to theft,” according to the bill.

During Protect Your Pharmacy Week, NCPA will begin a national campaign for independent community pharmacy retail owners, offering resources and information necessary to improve pharmacy safety and security.

HR 326 has been referred to the House Committee on Energy and Commerce for consideration.