Parkinson’s Awareness Month

Did you know April is now Parkinson’s Awareness Month? As of March 26th this year, the senate passed a resolution to designate April as the month of awareness for this disease, which is the second most common neurodegenerative disease. This provides a new opportunity for not only raising awareness but to hopefully help those who have the disease.
In the Drake curriculum, pharmacy students do not get exposed to this disease until Principles of Drug Action III (PDA III) which takes place in the spring semester of P2 year and then the next spring semester of P3 year for Therapeutics. It would be reasonable to assume that for this reason, it may not be a topic that all pharmacy students know well, yet a designation of a whole month to raise awareness shows the importance for all pharmacy students to be aware of it.
As previously stated Parkinson’s disease is a neurodegenerative disease, one that affects the dopamine neurons in the brain. This disease causes disruptions in the ability of a person to make body movements. Currently there is no cure and treatment is aimed at controlling symptoms and slowing progression. It is partially for this reason that there was a designation of a month of awareness for this disease. In the senate resolution, the senate stated that they support the ongoing research for improved treatments and eventual cure of this disease.
As of right now since there is no cure, it is wise to be aware of the more common symptoms and features of Parkinson’s disease. A nice pneumonic, taken from the current book for therapeutics, is TRAP. T would represent tremor, which can look like a patient is rolling a pill between his/her fingers. R is for rigidity that can either be a general stiffness or a cogwheel rigidity. The cogwheel rigidity can be felt in the supported elbow of a patient’s relaxed arm as you flex and extend their forearm. A stands for akinesia, which is the absence of normal motor function resulting in impaired muscle function; the patient may also present with slowed motor function, which is known as bradykinesia. Finally P stands for postural instability. The patient may not be very stable standing due to the rigidity and akinesia and may compensate by leaning over in a tripod fashion or having to brace his/herself on objects.
There may be other signs and symptoms a patient may experience or display, but the above four mentioned are the most common to look for. By being able to recognize at least these four symptoms, it may allow you to recognize a patient suffering from Parkinson’s disease who comes to the pharmacy complaining of these symptoms. You may not be able to diagnosis, but you will be able to advise the patient to seek further care, which will hopefully allow them to have a better quality of life sooner then had they continued to be unaware of their possible condition.
For more information about the senate resolution, I encourage you to visit the National Parkinson Foundation’s website.


Sources:
• Chisholm-Burns, Marie et. al. Pharmacotherapy: Principles and Practice. New York: The McGraw-Hill Companies, Inc., 2008.
• “U.S. Senate Designates April as Parkinson’s Awareness Month.” parkinson.org. 2010. National Parkinson Foundation. 25 April 2010. .

Health Fair

On February 27th, Drake University in collaboration with Southridge Mall participated in a student-organized health fair. Twelve pharmacy organizations and 101 pharmacy students participated in the event. Each organization was responsible for at least one screening or information table by assuring there were not only supplies but people to man their booth as well. Screenings were held together in an empty store located within the mall while information tables were set-up throughout the mall. There was a total of over 400 screenings performed during the event. Below is the number of people screened for each event:
-Cholesterol: 95
-Blood Pressure: >80
-Bone density: 121
-Blood sugar: 104
-Monofilaments testing: 2
-Heart Burn Screenings: 37

This is the first year that an event like this has taken place and, in my opinion, it was a very successful endeavor. Not only were people screened and educated on their health, but it also demonstrated how well the whole college of pharmacy and health sciences was able to come together to put this together. It required input from all organizations, and without this teamwork it would not have taken place.

It is encouraging to see how well the students can come together to put on an event, since we are the future of the profession. I often hear how important it is to be a leader and have adequate leadership skills, but just as important is the ability to work together as part of a team. Pharmacy is not a solo profession and you will always have to work with others. When you see students work together to put on an event such as this one, you know that the future of the profession is a bright one.

I hope I am not alone in saying this, but hopefully this health fair was not just a one time deal and will happen in future years.

Jasmine Cessna
PharmD Candidate 2011
jasmine.cessna@drake.edu

Campus Conference

While being a member of IPA and APhA-ASP I have attended several state and national pharmacy events and meetings. I have gained so much insight while attending these and always feel that I need to tell everyone what I have learned. This year after attending the APhA-ASP Midyear Regional Meeting in Omaha, NE I decided I wanted to bring the student programming to campus. Hopefully by doing this I would be able to give students a small introduction to what state and national meetings offer. I know that getting more students to attend these conferences would make a huge impact for the students and Drake’s College of Pharmacy and Health Sciences.

So in order to try to get more excitement for these meetings I held a “Campus Conference”. At the APhA-ASP Midyear Regional Meeting I realized all of the speakers and round tables I attended were all topics that could be covered by our awesome faculty and students! Therefore, I asked for help from them to help plan this professional event. Topics that we covered included: Exploring Leadership, Patient Care in the Community, Navigating Post Graduate Opportunities, Delta Rx Internships, Preparing for the Future in Pharmacy, Pharmacy Policy & Advocacy Debate, and Rotations Expectations.

We had 115 students register to attend the Campus Conference. It was held in the Cline Pharmacy building on a Saturday. Now that students have attended this Campus Conference I am hoping they see that this is just a small part of the pharmacy world and hopefully this will encourage them to attend state, regional, and national Conferences to further their experiences.

Jordan Ruestman
APhA-ASP President
PharmD Candidate 2011
Jordan.Ruestman@drake.edu

A Quick Review of MRM

Drake University’s APhA-ASP Chapter attended the Midyear Regional Meeting (MRM) in Omaha, NE at the end of October. We had 17 students attend that were all excited to see what “policies” were going to be passed from our region. This was the first MRM for many of the attendees, but we were all pleasantly surprised that MRM was more than just policy debate. We were able to sit through workshops, discussions, and roundtables on how to be an effective leader, how to manage time, and how to get better chapter involvement on campus. I think it is safe to say that everyone that attended MRM will definitely be saving up for APhA Annual 2010! Also, since it was Halloween weekend there was a Friday night Halloween Social. So being the student pharmacists we are, our chapter dressed up as the periodic table of elements! We had costumes ranging from Einsteinium, Plutonium, Sodium, Chloride, and even Cesium! We all had a blast at this meeting and I think it is definitely one of those professional meetings that once you attend you are hooked! I hope that these 17 students that went can go tell other student pharmacists how it is important that our voice be heard and how fun and easy it is to get involved on a national level!

By: Jordan Ruestman and Tori Erxleben

Monofilament Testing: The Unknown Pharmacy Service

As a pharmacist, you are probably aware of the importance of daily foot care for those with diabetes. As diabetes progresses, peripheral neuropathy can occur and may lead to foot ulcers, infections, and (worst case scenario) amputation. Many pharmacists are trained in diabetic foot care and can assist patients with the following services:

-Diabetic foot exam to check for proper structure and presence of ulcers, calluses or wounds

-Diabetic shoe fitting and insole placement

-Education on proper foot care

Another service that many pharmacists are unaware of is monofilament testing. This test uses a 10-gauge nylon monofilament (looks like a small metal rod) to screen for peripheral neuropathy and proper blood flow.

How to perform the test:

Step 1: Place the monofilament tip on the patient’s hand so they are aware of what they should feel.

Step 2: Have patient remove shoes and socks and place the blindfold around their eyes.

Step 3: Gently, in a smooth motion touch the patient’s foot with the monofilament in each of the sites circled below. The touch should last for 1-2 seconds and enough pressure should be applied to make the monofilament bend. DO NOT place the monofilament on an ulcer, wound, callus or scar! Have the patient tell you each time they feel a touch. If a touch is felt, put a (+) in that circle on the diagram below. If the touch is not felt, put a (-) in that circle.

Step 4: Explain to the patient that this test does not diagnose peripheral neuropathy, but it does strongly indicate risk for development. If a (-) was marked down for any circle, advise the patient to see their physician for a more comprehensive evaluation. For all patients, emphasize the importance of continued foot care and benefits of playing an active role in their diabetes management.

Currently, pharmacists are unable to bill for an individual monofilament test; however, it can be billed as an add-on service through some programs. You could also charge a small fee for the service. Another option would be to provide it as a free service in order to help boost diabetic shoe sales.

If you currently work at a pharmacy that is interested in starting this service, you may be eligible to receive 50 free monofilaments through the U.S. Department of Health and Human Services Program called the LEAP program. LEAP stands for Lower Extremity Amputation Prevention and can be accessed at www.hrsa.gov/leap.

Source: www.hrsa.gov/leap

-By Katie McDonald

Radon Awareness

With the end of October looming closer and closer, people's thoughts often stray towards Halloween and the fun to be had. Ghouls and ghosts are often the scary things people think of at this time. Not many even consider something you can't even see that can increase your risk for lung cancer. What is this invisible risk factor? It's elemental gas radon.

Radon is the number one cause of lung cancer in people who do not smoke. It is a radioactive, colorless, odorless gas that is found naturally in the environment. It comes from the natural decay of uranium that is in the soil. In an open air environment, it can easily disperse and the small amounts found in the air is not enough to significantly increase one's chance for lung cancer. The greater concern is the amount of radon that can build up in an individual's home. According to the EPA website, it is estimated that 1 out of 15 homes in the U.S. have elevated radon levels. To be considered elevated, the radon level would need to be equal or greater than 4 pCi/L.

In order to find out what the level in one's home is, a short-term radon testing kit should be purchased. These testing kits remain in the home anywhere from two days to 90 days, depending on the kit. Once the kit has been left in-place for the indicated amount of time, the kit should be sent in to the lab that is specified according to the package. A radon specialist can also be hired to measure the radon levels in one's home as well. If the results of the short-term test reveal the levels to be 4 pCi/L or greater, a follow-up test should be done. A follow-up test consists of either a short-term or long-term (greater than 90 days) testing kit. If results are needed quickly, a second short-term test would be warranted. For a more year-round average, a long-term test should be done. Should the results continue to be elevated with either of these, the home will need to be fixed. A radon mitigator should be hired to help reduce the levels of radon in the home. For those who reside in Iowa, you can check the Iowa Department of Public Health website for certified radon testers and laboratories: http://www.idph.state.ia.us/eh/radon.asp.

This week (October 18-24,2009) was Radon Action Week and while it may be too late to take action or raise awareness, it at least has been brought to your attention. January is National Radon Action Month and might be a time to actually take some action and raise awareness. You can think of this as a time for you to become aware of it and start planning out how you can help people when January rolls around. Wintertime is the ideal testing time since it is the time when levels are highest due to the fact that homes are often all closed up, so this is all the more reason to inform people about radon and how to test for it. It can be as simple as a handout or brochure informing people about radon and testing for radon, or it could be short program open to the public to inform them about radon. The skies the limit and I encourage you all to learn more about radon so you can spread the word on the importance of testing and taking action!

Sources:
~Radon Program. Iowa Department of Public Health. 2009. Available at: http://www.idph.state.ia.us/eh/radon.asp. Accessed October 22, 2009.
~Ionizing Radiation. World Health Organization. September 2009. Available at: http://www.who.int/ionizing_radiation/env/radon/en/index1.html. Accessed October 24, 2009.
~Radon. United States Environmental Protection Agency. October 20, 2009. Available at: http://www.epa.gov/radon/whereyoulive.html. Accessed October 24, 2009


Written by: Jasmine Cessna, PharmD Candidate 2011

Influenza Type A (H1N1)

Hand sanitizers in the buildings, signs advising proper hand washing, and numerous emails have infected our life at Drake all of which pertain to the new concern for the H1N1 influenza virus. Some people feel that these precautions are overreactions to just another form of flu; other people feel these precautions are well justified. Then there are yet others who don't know enough to take a side. What is H1N1? Where did it come from? Do I need to worry about it? These are just some questions you might be wondering and I will be gladly answering so that you, the reader, will be well informed. Knowledge on the H1N1 flu will not only benefit you, but should you ever be confronted by a patient concerning it, you will know better how to answer their questions.

The H1N1 virus, a new influenza virus, was originally referred to as the swine flu because many of the genes in the new virus were similar to an influenza virus that was normally found in pigs. It wasn't until further study that they discovered it differed greatly from the viruses found in North American pigs. It actually consists of genes from Asian and European swine influenzas, birds and humans. For this reason, the term “swine flu” should be avoided. It also is a common misconception that people will get it from pork products. Should a patient ever express this concern, make sure to reassure them that the virus has not been found to be transmissible to people from eating properly prepared pork products; eating pork will not cause them to get the H1N1 virus.

The H1N1 flu virus is passed from person to person through the same way the seasonal flu virus is spread, through coughing and sneezing of an infected person or by touching an object the contains the flu virus and then touching one's nose or mouth. For this reason, it is highly important to practice good hygiene and proper hand washing. It is highly contagious and it is strongly advised that people who suspect that they have the virus to stay home to avoid infecting other people. The World Health Organization (WHO) has declared an H1N1 pandemic and has issued guidance documents that can be found on its website (http://www.who.int/csr/disease/swineflu/en/index.html).

How do you know if you might have it? You would display some of the following symptoms: fever, chills, cough, sore throat, runny/stuffy nose, body aches, headache, and fatigue. The illness can vary from mild to severe and you should seek medical attention as necessary. Many people recover with no need for medical attention, but there are some high risk groups. These groups include people over 65 years of age, children younger than five years old, pregnant women, immunocompromised individuals and people of any age with certain chronic medical conditions (such as diabetes or heart disease). It is these groups of people who have the greatest risk of having serious flu-related complications. An adult should seek immediate medical attention should they experience the following: difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, or if flu-like symptoms improve but then return with fever and worsening cough.

Finally you or your patients may be wondering about the vaccine for the H1N1 influenza virus. It is a separate vaccine from the usual seasonal influenza vaccine that comes out each year. The vaccine for the seasonal vaccine will not cover you for the H1N1 vaccine just as the H1N1 vaccine will not protect you from the seasonal influenza. The CDC recommends the following groups of people get the vaccine: pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems. Should a person decide to get both vaccines they can be immunized at the same time. If someone is debating whether or not to get the vaccine, talk with them to find out the reasons why they would and would not get the vaccine and help answer any questions or concerns they may have.

If you have any more questions or concerns regarding the H1N1 influenza virus, I urge you to check out the CDC website for more information. Also if you are curious about the activity of the influenza, the CDC also has a FluView which gives a weekly synopsis of the activity of the flu virus. It can be found at the following website: http://www.cdc.gov/flu/weekly/.

Sources:
-2009 H1N1 Flu (Swine Flu). Centers for Disease Control and Prevention. September 18, 2009. Available at: http://www.cdc.gov/H1N1FLU/. Accessed September 19, 2009.
-Joint FAO/WHO/OIE Statement on influenza A (H1N1) and the safety of pork. World Health Organization. May 7, 2009. Available at: http://www.who.int/mediacentre/news/statements/2009/h1n1_20090430/en/index.html. Accessed September 19, 2009.
-Pandemic (H1N1) 2009. World Health Organization. 2009. Available at: http://www.who.int/csr/disease/swineflu/en/index.html. Accessed September 19, 2009.


Written by Jasmine Cessna
PharmD Candidate 2011