Utah Pharmacy Digest

The Utah Pharmacy Digest: Official Publication of the Utah Pharmaceutical Association. Published since 1948, the Utah Pharmacy Digest is dedicated to assisting the profession of pharmacy in better serving and protecting the public health and welfare. This involves educating pharmacists and pharmacies for public service and professional strength, and encouraging scientific and professional research ethics.

UTA I-I PI-IARMACY DIGi;OT Convention - MAR 301979 St. George May 3, 4 & 5, 1979 Make your plans NOW! tAC:.r >~I--f < H CP .... < :;o 1:> -r''O::O ')> .... " ' -< ,.. o m_. -("tl 0 MO:!t -f"1'tiTI -< 0 -.CH n C::>> -t :t: r "The Gree n House" Res tored Pioneer Home, St. George, Utah OFFICIAL PUBLICATION OF THE UTAH PHARMACEUTICAL ASSOCIATION Volume 88 March 1979 Number 3 ~armacy Automation System ~ntry AFully Operational, Computerized System Programmed to Reduce Inventory, Improve Turnover, Accelerate Cash Flow and Provide Significant Personnel Savings lor Pharmacy RETAIL PRICE STICKERS. Retail prices shown on the stickers you receive with your order are customized to your specifications. Pl-ll!:l t Pl-ll!:l 2 ~~~LF LABELS. -. A shelf label for every item purchased from Bergen Brunswig. .. ft P" 1 :II: 3 I • ELECTRONIC ORDER-ENTRY. The portable, lightweight Phase 3 Terminal. Pl-ll!:l • ~t~6'~TES~ENT ~ Allows you to review purchases, analyze profitability, and manage your business more efficiently. FLEXIBILITY II II IS THE KEY TO PHASE: Check the many, many options of PHASE. It's customized to your needs. Let Bergen Brunswig put PHASE together for you. Ill 0 ForFurther n:u;;n~~~~;~c;~~rauon 1765FREMONTDRIVE • SALTLAKECITY.UTAH84104 PHONE: ( 801) 972-4131 p- ... Opinions that may be expressed in any article in this publication are those of the individual author, or the editor as an individual and do not necessarily reflect the views or policies of the Utah Pharmaceutical Association. Subscription rate $11.00 per year, $1.00 per copy. MANAGING EDITOR Paul W. Muller, R .Ph. BUSINESS MANAGER Matilda Yacktman UTAH PHARMACEUTICAL ASSOCIATION EXECUTIVE COMMITTEE Jerry L. Graff (1979) ... Immediate Past Pres. Chesley H. Wintch (1979) ......... President LeNila Y. Homer (1980) ..... President Elect C. Edward McFall (1979) ..... Vice President William Hoge (1980) .. ........... Treasurer Paul W. Muller, R.Ph .... Executive Director Douglas T. Orchard .. Honorary Pres. (Dec'd) David K. Robinson .......... Legal Counsel BOARD OF DIRECTORS TERMS EXPIRE 1979 Don L. Anderson, Salt Lake City; Jerry L. Graff, Provo; C. Edward McFall, Salt Lake City; Chesley H. Wintch, Sandy. TERMS EXPIRE 1980 LeNila Y. Homer, Salt Lake City; Mark L. Johnson, Salem; Ross 0. Van Orden, Salt Lake City; Bill Washburn, Ogden; William Hoge, Snowbird. TERMS EXPIRE 1981 Charles Everett, Salt Lake City; Delbert A. Park, Bountiful; Jerry Parker, St. George; Arthur Lipman, Salt Lake City. ASSOCIATE DIRECTORS Dean Sedgwick, Frank Wilcock. UTAH STATE BOARD OF PHARMACY Vincent P. Tassone, President; J. Craig Jackson, Henry R. Gardner, Frederick R. Homer, Owen Wood. STUDENT APhA Russell Felt UTAH SOCIETY OF HOSPITAL PHARMACISTS Kay Matsumura UTAH VETERANS PHARMACISTS' ASSOCIATION B.A. Jacoby, President, Salt Lake City UPhA WOMEN'S AUXILIARY Mrs. Shelby Hall PUBLICATION INFORMATION The UTAH PHARMACY DIGEST, formerly, until January 1963, the U.Ph.A BULLETIN NEWS, is published monthly by the Utah Pharmaceutical Association, 1062 East 2100 South, Salt Lake City, Utah 84106. Second-class postage paid at Salt Lake City, Utah. Advertising rate card furnished on request. The UTAH PHARMACY DIGEST is dedicated to assist the profession of pharmacy to better serve and protect the public health and welfare by: (I) Educating all pharmacists and pharmacies in the state for public service and professional strength; (2) Encouraging scientific and professional research talent and ethics; (3) Supporting all Federal and State Jaws relating to the profession; and all rules, regulations, and memorandums of the Utah State Board of Pharmacy restricting the practice of pharmacy to qualified and licensed pharmacists and pharmacies. The DIGEST urges every pharmacist in Utah to join his State Association first and then join one or both of his National Pharmacy Associations. These symbols should be constant reminders of the pharmacist's professional obligation to the public. March 1979 Vol. 88, No.3 UTR~ P~RRMRCV DIGI;OT (USPS 654-220) CONTENTS President's Message ...................................... 2 Meet the Board ....... ...... ........... . ..... . .... .... ... 3 U of U College of Pharmacy ... ........ ................... 4 Diabetes: An Overview ............... ................ .. .. 6 Women's Auxiliary News ................................. 7 PAB Meeting Minutes .................................... 8 Utah State Board of Pharmacy .. ............. .. . .. ... .. ... 9 Utah Society of Hospital Pharmacists ..................... lO Chain Store Pharmacy ......... ........ . .... ...... . ..... 12 Seminar Opportunity ... ...... ............. ......... . .... 13 FTC and HEW Introduce Model DPS Law ................ 13 A Universal Cost Accounting System ...................... 14 It's Time To Renew Your Membership On The "Pharmacy Team" ............................. 14 Model Drug Product Selection Act . .................. .... 15 St. George Convention Room Registration Form .............................. 16 Magnetism and Drugs-The Force That Cures? .............. I8 Life Expectancy Increases for Americans ................... 20 R.S .V. P.- Call for Resolutions . ...... . . .................. 20 OUR ADVERTISERS Bergen-Brunswig Corporation .... ......... Second Cover McNeil Laboratories ....... .... . . .................... 5 Upjohn Pharmacy & Trade Rela.tions ................ II Halls Remedy ...... ..... ................ ..... .. .... I3 McKesson-Robbins ........ ... ...................... 17 Lone Star Life Insurance Company .. ....... . Third Cover Eli Lilly and Company ... ............ . .. .. Fourth Cover SUPPORT OUR ADVERTISERS- THEY SUPPORT US. APhA NARD President's Message Help Control the Silent Killer Chesley H. Wintch President UPhA May is scheduled for the 1979 observance of National High Blood Pressure Month, and as in the past , UPhA is urging all Regional Associations and individual pharmacists to take an active part in the observance. Hypertension afOicts 35 million Americans, according to updated estimates by the National Blood Pressure Education Program. For a person with high blood pressure the risk of dying from heart of circulatory disease is twice as great as that ofa healthy person. The risk of dying from stroke is nearly four times as great It is estimated that more than 10 million persons who have been diagnosed as hypertensives are not being satisfactorily controlled . A primary cause is lack of adherence to the therapeutic regimen. The pharmacist has a clear role in minimizing this nonadherence through patient counseling and emphasizing the importance of compliance with the doctor's instructions. Because of their accessibility to hypertensive patients, pharmacists are in a unique position to influence them. It is no exaggeration to say that a conscientious pharmacist, enforcing the doctor's therapy, can be the difference between life and death. Consider the following in your counseling: - Remind the patient of the seriousness and lifelong nature of high blood pressure. - Be sure the patient understands the conseq uences of not treating it. 2 - Explain that how he or she feels may not truly reflect the level of their blood pressure because hypertension is an asymptomatic disease. - Explain to the patient the possibility that, during the initial stages of antihypertensive therapy , he or she may temporarily feel worse--that the medication may cause symptoms in an otherwise silent disease. U Ph A, in cooperation with APhA, has obtained a copy of this year's "Month Kit" from the National High Blood Pressure Education Program and has arranged to have a copy sent to every Regional President in the State of Utah , if requested. The kit contains a wealth of ideas and suggestions about how you can take part. I urge you to make your plans now to observe National High Blood Pressure Month in May. Contact UPhA, your Regional President or the Utah Heart Association for ideas and materials to make your plans to use such things as posters, pamphlets, blood pressure screening and most of all a rededication to good patient counseling to improve compliance. Sincerely, Chesley H. Wintch, R.Ph. President "' Meet the Board Jerry Parker - Born, raised and schooled in Salt Lake City, Jerry was a 1958graduateofSouth Highanda 1963graduate of the University of Utah College of Pharmacy. While at the U, Jerry received the Dean's Scholarship of Merit and was elected to Rho Chi in his senior year. He was active in SAPhA serving as junior class president and as class historian his senior year. After graduation he joined the Army Reserve and served six months active duty at Fort Ord, California as a pharmacy specialist. He later received a direct commission to First Lieutenant and served as pharmacy officer of the 328th General Hospital Army Reserve Unit. In 1964 he became the husband of Marilyn Redden. Jerry and Marilyn have 3 sons, Jeff, Branden and Bradley, ages 12, 6 and I year. Jerry began his pharmacy career at Professional Pharmacy in Salt Lake with Cal Robinson. He transferred to Cal's Ogden store, Robinson's Sickroom Supplies, then back to Salt Lake leaving Cal's employ to move to Heber City in 1965 . During the next 12 years Jerry became a partner in the Palace Drug, became Chief Pharmacist at Wasatch County Hospital, was employed at Hi-Mountain Drug in Kamas and was instrumental in the opening of the Village Pharmacy in Park City. Jerry's brothers, Dan and Rick, both fellow pharmacists, were two of his partners in those business ventures. It was in Heber thatJerry gained his love for small towns and his zest for civic imvolvement. While there he served his community as Secretary and President of the Wasatch Chamber of Commerce and member of and Chairman of the Heber City Planning Commission. His efforts in those positions created annual events such as the Wasatch Mountain Open Golf Tournament, the Utah High School Rodeo Championships, snowmobile races, dog sled races, a new city zoning ordinance and even a caboose on Main Street. Something a few Heber Valley natives wish he had taken south with him. In July of 1977 Jerry and Marilyn sold their interests in the Palace Drug and Village Pharmacy and moved south to where the summer sun spends the winter, which means it will be a frigid summer somewhere this year. They purchased Fenton's Pharmacy in St. George. He was elected to the U Ph A Board of Directors in 1978 and found out just how big the state of Utah is last summer while traveling to regional meetings . His civic involvement has continued here in St. George. He is an active member of Utah's most active Lion's Club and was recently appointed by the Mayor of St. George to serve as a member of the Downtown St. George Redevelopment Committee. Jerry believes in the importance of the community pharmacits role in pharmacy practice today is so strong that he chose that for the name of his store; Community Pharmacy. He also holds that only by continuing to evolve into patient-oriented practices can pharmacists achieve the role which pharmacy desires and the role which those they serve, in whatever practice, need and may soon require. He feels that continuing education is another of the necessary steps which must be taken in the pharmacists evolution. Jerry and Marilyn urge all Utah pharmacists to attend the U Ph A convention the first weekend in May in St. George. Remember, no matter how bad the weather is in St. George, it is bound to be better than anywhere else in Utah in May. Stop in Community Pharmacy and visit Nels Fenton's antique pharmacy display. But, whatever you do, don't talk shop with Jerry. You might miss the rest of the convention. 3 .-1 • '· U ofU ·. College of Pharmacy . .1.· I' ., .,' .. . .·: ~- ...·:. : '\\\;' . .) Dr. Robert C. Mason Admission Procedures Starting about fifteen years ago, pharmacy colleges across the country experienced a dramatic increase in the number of students applying for admission. Prior to that time, virtually all schools were operating at below capacity and admission standards were minimaL At the University of Utah, all applicants could be accommodated and anyone presenting a 2.0 grade point average (GPA) in preprofessional courses was admitted into the professional program. It is not too surprising that the attrition rate was high during those years, the rate approaching 50 percent for some entering classes. Within three or four years after the college moved from the third floor of the old Women's Gymnasium into the spacious quarters of a new building, enrollment had increased to the point that we had literally outgrown the building. Classrooms and laboratories which were thought to have been designed to provide ample space for the foreseeable future would not nearly accommodate that number of students. The necessity of limiting enrollment was obvious, and after considerable discussion and debate among the faculty, a compromise figure of 80 students was selected as the maximum number that would be allowed to enter the first professional year. During recent years at the University of Utah, the total number of applicants each year has exceed that figure by three to five times. The problem of selecting from a large applicant pool the 80 applicants who were the most deserving of acceptance was a new experience, and it soon became apparent from reviewing the literature on selection procedures that no foolproof solution to this problem has yet been found. Considerable research has been devoted to examining the variables that enter into selection processes and attempting to develop quantifiable admission criteria that 4 would assure the selection of applicants who would successfully complete the academic program in pharmacy. Among the many criteria that have been examined are science G PA, chemistry G PA, overall college G PA, Pharmacy College Admission Test (PCAT) scores , the quality of the institution providing the preprofessional education, residency, letters of recommendation, student statements concerning their interest, motivation, aspirations and career goals, and so on. Most of the studies indicate a degree of validity in each of these criteria in the selection process , more or less in the order in which they are listed. If only a single criterion were to be used , there is general agreement that G P A provides the best correlation. "The best predictor of future academic success is past academic performance." Until the advent of the PCAT a few years ago, G PA had been about the only basis for selection of students at this college, modified somewhat to give preference to Utah residents. However, elevation of minimum G PA levels from 2.0 to as high as 2.8 for resident students did not eliminate the problem of attrition. Although it is an unpleasant task to notify students with G PA 's in that range that they cannot be accommodated, it is even more unpleasant when students who were admitted fail to complete the program. Undoubtedly, many of those who had been denied admission could and would have succeeded . When the PCAT became a-vailable, it was immediately adopted in the hope that it would reduce somewhat the dependence upon G P A and provide additional useful information. Its use has been studied quite ·extensively, considering the short time it has been available, and most studies support it as a useful tool when used along with other criteria. Our (continued on page I 0) ... (McNEIL ) McNeil Laboratories. McNEILAB, Inc .. Fort Wash1ngton. Pa. 19034 TYLENOL w1th Codeine tablets are manufactured by McNeil Diabetes: An Overview Reprinted by Permission of the NARD Journal Diabetes mellitus is a disorder of carbohydrate, protein, and lipid metabolism classically characterized by hyperglycemia and glycosuria. The central disturbance is an abnormality in the secretion or effect of insulin, or in both. The insulin deficiency may be relative . In most instances, diabetes is genetically determined, but disorders of the pancreas, such as chronic pancreatitis and hemachromatosis, as well as endocrine disorders such as Cushing's syndrome and acromegaly, may cause diabetes. Diabetes, historical perspective and clinical concepts Although diabetes has been described in documents as ancient as the Ebers papyrus (1500 B.C.) it is also a "disease of civilization ." Clearly, its prevalence has increased as urbanization, working patterns, and diet habits have changed from primitive to civilized modes. In 1889, Yon Mering and Minkowki produced diabetes in animals by pancreatectomy, giving credence to the concept that diabetes is a hormonal deficinecy disorder. This belief was reinforced in the 1930s when Best and Banting achieved dramatic improvement in the diabetic state by the administraction of insulin. Insulin Secretion Currently, most authorities believe that insulin sec retion in diabetes may progress from nearly normal capabilities to a totally deficient state. This concept does not disregard the role of tissue resistance nor the fact that counter-insulin substances- such as growth hormone and glucagon- may exercise important pathogenic roles . Beta-cell damage resulting from viral infections in animals causes a syndrome that in many ways parallels human juvenile diabetes. The severity and frequency of diabetes after certain viral diseases are influenced by environmental factors and genetic susceptibility. Recent developments have strengthed the hypothesis that some instances of diabetes, particularly those of juvenile onset, are caused by viruses. The severity of diabetes may change in individual patients . For example, it is not unusual to diagnose "definite" diabetes in an obese person and then find a complete return to normal glucose tolerance after a weight loss . Nevertheless, genetic diabetes is generally thought of as a disease that progresses through the different stages at a variable rate (Table I). 6 Treatment There is still no known cure for diabetes mellitus. However, various treatments have evloved for the control of its symptoms and metabolic abnormalities. Initially, a strong attempt should be made to control nonketotic, maturity-onset diabetes with diet alone. If this attempt fails, certain oral hypoglycemic agents or exogenous insulin should be used with diet. Exercise is also useful to decrease hyperglycemia and glycosuria. Because the patient spectrum extends from the toally asymptomatic person to one with lifethreatening diabetic ketoacidosis, treatment objectives must be highly individualized. These include relief of the symptoms of hyperglycemia and glycosuria, as well as prevention of the acute complications of ketoacidosis, hyperosmolar coma and hypoglycemia. However, the influence of therapy in preventing many of the vascular complications of diabetes is highly controversial. A program of diet, diet plus oral agents, or diet plus insulin usually can relieve the symptoms associted with hyperglycemia. By maintaining serum glucose levels below 200mg f 100 ml and limiting glycosuria to less than 20 grams per day, symptoms such as polyuria, polydipsia, dehydration, and weight loss usually can be avoided. Good Control It is very difficult to define "good control'' for all diabetic patients. In some mild, adult-onset diabetes, normalization of fasting and postprandial glucose levels can be achieved. On the other hand, some glycosuria and moderate hyperglycemia may be necessary for the brittle, insulin-requiring diabetes patient to carry on routine activities and avoid the extremes of ketosis or hypoglycemia. The important objective of therapy is to maintain glucose levels as near normal as possible thrughoutthe day without producing hypoglycemia or severely restricting the patients norma/life habits. The objective cannot be reached without a cooperative and knowledgeable patient. Each patient must be instructed and educated at the time of diagnosis and reminded at each visit to the physician. Diabetes is a lifelong disease that restricts many life styles. If a patient can make minor adjustments in therapy based on routine urine test results, anticipated problems with infection or exercise, and recognize complications quickly, life is made easier and (continued on page 12) .. Women's Auxiliary News Shelby Hall SmileBecause Somebody's Watching - Can you believe it is March already? This is a month full of happenings. New beginnings start in March. Buds begin to form in the trees, and flowers begin to break through the ground. Everything seems so fresh. On the 12th of March is the Annual Tri-Auxiliary Luncheon with the Medical Auxiliary as hosts this year. It will be held at the Lion House. The week of March 16th is Poison Prevention Week and we can't forget St. Patricks Day on the 17th. On the 26th of January, we had our dinner dance. I feel I must appoligize to you ladies for the change in our couples party. We had no idea that Tiffany's Attic would "go out of business", but we felt very fortunate in securing the Willow Creek Country Club on such short notice. The food, stuffed cornish game hen, was excellent, and the band was super, and the company was great. We appreciate all those who ventured out on such a cold evening. We all had a good time. It was also a pleasure to have President- Elect LeNita Homer and her husband Fred enjoy the evening with us. Thanks to our committee, Edna Wilcock, Cheryl Fortie, Charlotte Turner and Nona Hillyard. I would like to take this opportunity to congratulate my husband, Derek, on his promotion. For those of you that don't know, he was accepted the position of Regional Sales Manager for McKesson & Robbins. I am very proud of him and I thank him for all of his support while I have been your presi- dent. We will be relocating in California and we are really looking forward to the move. Nevertheless we will be at convention on May 3, 4& 5, and we will be looking forward to seeing You! This month I would like to introduce you to Karen Smith. Karen was born and raised in Clearfield, Utah and is a graduate of Davis High School. She met her husband, Dennis, while both of them were working at Lagoon. They were married on April 29th, 1960. Dennis graduated from the U niversity of Utah in 1963 and is presently working as Pharmacist for the Utah Valley Hospital. They have three children, Jeff 17, Debbie 14, and Derek II. Karen works at the St. Marks Hospital for two plastic surgeons. She also likes to knit, crochet, sew and ski, but like most of us she has trouble finding the time. Karen has also been active in the Auxiliary for quite a few years. She has been on the Board serving in such positions as Recording Secretary, Corresponding Secretary, Treasurer and is presently of Parlimentarian. It's good to have an active person such as Karen involved in our Auxiliary. I hope all your happenings in March are nice ones. As always, Shelby 7 PAB Meeting Minutes Pharmacy Advisory Board January 10, 1979 By Lynn Sartor announcement of constraints and reductions of Medicaid programs forthcoming. Agenda Items: I. Updated Character Recognition (OCR) Larry Kirigin took a few minutes and gave an update as to what had been done concerning the double line and single line OCR pharmacy form. The preference, by pharmacists who review the two forms, was for the single line form 37 to 3. Ed Furia brought out that REI is making a mock-up of the single line OCR pharmacy form which will be sent to printing. The target date for OCR implementation is set for sometime in April. These forms will be used in the training sessions. OHCF is going to try to co-sponsor with the University of Utah the education and training sessions on "OCR, Computer and Medicaid". There will be no costs to the pharmacists who participate in these continuing education semmares. Pat Wilde told the board that the Medicaid agency has been told they will have to reduce current duget by about 5 million dollars. The state will carry on reductions, plus submit specific recommendations on how we are going to reduce the program. 4. Lynn reviewed the PAB goals of 1977. He mentioned that the Board needs to do more work in Legislative and control utilization areas . A concern brought up by Chesley Wintch was that the PAB does not wat to be a "rubber stamp" to the Department of Social Services. The Board members, on the whole, felt like they had accomplised and were accomplishing the goals they had set in 1977. 5. 2. 3. 8 Nursing Horne Report No written or verbal comments on the proposed Nursing Home Pharmacy Rules and Regulations were handed in to Fred. An extension until February was given to have comments submitted. Budget Review Ed Furia referred to Neal's address last month. There very possibly will be an Notification Letters There has been some t!"ouble with Pharmacits not being notified of any changes on the Medicaid eligibility card. A motion was made by Monty Gully and seconded by Ed McFall to have advance notice given to Pharmacists and other Providers to help eli mate confusion when changes are made. After PAB review of the pharmacy OCR forms, the recommendations made were: - single line form - lighter brown color - NCR paper feature A motion was made by Larry to accept the form as recommended above. Also, have the Sub-committee included in the final sign-off before the OCR form goes to printing. Motion was seconded by Fred Petersen and unanimously passed. PAB Goals 6. Lynn suggested that Stewart Smith from S H PDA be invited to attend one of our meetings and give a presentation on the State Health Plann.ing Agency. It was also suggested to have Lynn Sartor report to the Board on the Health Maintenance Organization concept. 7. New Drug Ind ex The new total drug index was discussed. Ed passed out a list of the new Federal MAC drugs which will become effective tn February. Meeting adjourned at 10:00 .. Utah State Board of Pharmacy Minutes January 23, 1979 Members Present: Vincent P. Tassoni-Chairman Henry R. Gardner-Secretary Frederick Homer Owen Wood Craig Jackson Dave Reynolds: Appeared before the Board reviewing forged presectiptions for dilaudid, preIodin, biphetamines, etc. Dave said such persons are very adept at getting prescriptions. Dentists are becoming a cource for this prescription abusers who usually soak the pills and then inject the liquid. Dave commented on the methadone clinic working reasonably well. Talwin going on federal class IV status as of February 9, 1979. Discussion on meeting with Dental and Medical Boards on drug abuse. Thomas W. Suds: Appeared for Reciprocity from Michigan and was approved. He is associated with the College of Pharmacy and a staff member to the Pharmacy and Therapeutic Committee at the University Medical Center. David W. Edwards: Appeared before the Board regarding informal hearing. No further appearance will be needed. Preceptor Certificates: Sharon Briggs John S. Nield Thomas W. Suds L.S. Hamilton: Appeared for licensure for Wholesale Pharmacy and to Distribute Controlled Substances at Hamilton Drug Center, 58 South 950 West, Brigham City, Utah 84302. Licensure was approved. Gordon D. Jensen: Appeared for licensure for Kwik Stop Drugs , Inc. 346- 36th Street, Ogden, Utah for change of address of retail pharmacy. Licensure approved. Charles Beacroft: Appeared for licensure of Safeway Stores, Inc., 1756 South Main Street, Bountiful, Utah for retail pharmacy. Licensure approved subject to inspection. GuyS. Conover: Appeared for licensure of retail pharmacy; Hunter Drug being changed to Conover Pharmacy, 98 East Main, Castle Dale, Utah. Licensure approved. G. Watson Eatough: Appeared for licensure of retail pharmacy due to change of location of Kanab Drug, 72 West Center, Kanab, Utah. Licensure approved subject to inspection . Frank T. Schnitker: (Brigham Street Pharmacy) Appeared for licensure for retail pharmacy, new location at 2730 East 3300 South, Salt Lake City, located in Zions Mountain View Nursing Home. Licensure approved subject to inspection. Skaggs Drug Companies, Inc.: doing business as Skaggs Drug Center #249, 84 West Parrish Lane, Centerville, Utah; approved for licensure. Gene Etherington: Appeared before the board as per order. Gene has complied with the order. The Nabplex Exam: Given January 23 and 24 proctored by Chairman Vincent Tassoni and Morris Stout of the Department of Business Regulation. The following appeared and were approved for William H. Devereux: Intern hours approved and ready for licensure. 9 Utab Society Of Hospital Pharmacists Members and pharmacy students enjoyed a Clinical Conference presented by Sharen Kato, Pharm. D . Candidate on "Urokinase" January 18 at the University of Utah. The next conference is scheduled for March 15 at St. Mark's Hospital. The student chapter of USHP sponsored its first clinical conference on "Pharmacy Computerized Medication Monitoring". Keith Larsen, Director of Computer Service at LOS Hospital explained the current role of computers in the expanding clinical service of pharmacy. "In the explosiqn of patient data that the pharmacist and the physician is called upon to evaluate daily, computers have a costeffective place in medicine now and increasingly in the futu1c:", he told the students. USHP will sponsor a continuing education program in conjunction with the U PhA Annual Meeting in St. George, May 3, 4, and 5. The program "Oncology and the Pharmacist" will be presented Friday afternoon, May 4. Speakers include Arthur Broom, PhD, Chairman and Professor of Medicinal Chemistry; Harman Eyer, M.D., Chairman and Professor of Oncology and Hematology; Arthur Lipman, Pharm D., Chairman of the Department of Pharmacy Practice. Regional Area Panel (RAP) Sessions are scheduled for the end of March and delegates Kay Matsumura and Jim Hibbard are preparing for the Conference in Denver. Representatives from the Intermountain states will discuss techniques for membership enlargement, current developments in the supportive personnel legislation, new ideas on cost-containment and a legislative update on PPis. The United Nations has declared 1979 the U of U College of Pharmacy (continued from page 4) own experience has shown it to be useful, especially in identifying potential problems. There has been a remarkable correlation between very poor scores and attrition. Up to the present, selection criteria are necessary only for students entering the professional program. Enrollment at the preprofes~ional level has presented no problems to the college. T he only requirement for admission at the preprofessional level, either for high school grad uates without previous college work or for stude nts tra nsferring from other 10 International Year of the Child . To be observed globally, IYC is a time for all the world's countries to study the conditions in which their children live and strengthen programs which will make their lives better. A National Commission for the IYC was established in April 1978 to coordinate IYC activities in the U.S . Among the projects the Commission is planning are an immunization campaign; expanded research into children's diseases; programs to aid stigmatized, gifted and handicapped children; and several public campaigns. For information on what YOU can do to get involved in constructive, practical programs for the benefit of children write to U.S. Committee for UNICEF / IYC 331 East 38th Street, New York, NY 10016. State chapter officers will again be attending the ASH P sponsored chapter leadership seminar in May. Newly elected officers will discuss the responsibilities of the board of directors and all officers, how to set chapter objectives and advance planning, use and selection of committee members, membership motivation and communication. Sister Danille Knight is busy coordinating the actiVIties of the Nominations and Awards Committee. Ballots for the election will be in the mail soon. Members are reminded that II current 1978 and 1979 paid members are eligible to vote in this election. The 1979-1980 officers will be announced at the Annual Meeting April 20 at the Panorama Room. Kristie Smith Secretary colleges is that they meet the admission requirements of the Univer~ity of Utah. Enrollment at the preprofessional level is not limited. However, admission at the preprofessional level does not guarantee admission to the first professional year, and this fact is made clear to every preprofessional st udent. In order to be considered for admission to the first professional year, all students must have completed, or be currently enrolled in a program that will allow them to complete, all preprofessional courses prior to the beginning of the fall quarter. They are req uired to take the PCAT. They must submit an (contin ued on page 19) • • Auburn U . U. of Wisconsin RememBer Ihe sUmmer of '78? Last summer1 four young people joined The Upjohn Company as part of the NPC Pharmacy lniernship Program. They added to their educational process ... learned· about manufacturing, quality control, pharmaceutical research, and marketing/ f sales. . • We hope'we answered their questions. Certainly, we took their suggestio-ns· to heart. And when the 10 weeks w'ere ' over, we parted knowing that we'll enjoy seeing each ' ' other in the years ahead. And reminiscing about the summer of '78. ~ ....... - Upjohn ( C1978.The Upjohn Company, Kalamazoo . ' ' ! Michiga~ Chain Store Pharmacy Patient Consultation in a Chain Store Setting By Brent McKell In the past pharmacists have been reluctant to provide information to patients concerning their medication. It was felt that this was the physician's responsibility and that pharmacists should not infringe upon his territory. In today's consumer~oriented society, however, more and more responsibility is being placed upon the phar;nacy profession by the courts and our lawmakers to provide the patient with information concerning the safe and effective use of his medication. Our problem in a high vo lume pharmacy is how to provide the essential information the patient requires in a format easy to compre hend in the limited time we have to provide a patient consultation. In our pharmacy we have approached this problem with two separate systems. First, we use a simple system of drug consultation stickers; labels containing some of the more common warnings are attached to the appropriate prescription vial. This system has many drawbacks, one of them being that the pharmacist is severely limited as to the amount of space he may use to provide the necessary information. The warnings themselves are often vague and inprecise. The second method is a sophisticated computerized system which provides each patient with a detailed patient consultation with each prescription. This consultation can be tailored to each specific drug product and can provide precise, Diabetes: An Overview (continued from page 6) more pleasant for him. Attaining an appropriate ·psychologic adjustment should be the primary goal of the educa tiona! program, for both the family and the patient. This is an area in which the knowledgeable pharmacists can be very supportive. Diet The basic nutritional requirements of a diabetic patient are the same as those of a nondiabetic person. There is no need to buy special foods or cook differently for the diabetic member of the family. Yet the regimentation of food intake is the cornerstone of diabetic therapy. Timing of food intake, the caloric value of food ingested, and the proportions and quality of carbohydrate, fat , and protein are important aspects of the diet. 12 accurate information regarding the individual drug product. With this system each patient is assured of receiving the necessary information with every prescription dispense. This also aids the pharmacist in providing important warnings which might have otherwise been omitted . Together these systems provide an easy, precise method of transferring information to the consumer, but they are by no means the total answer to the problem of providing a thorough patient consultation. We cannot simply shuffle a stack of papers, stickers and manufacturers' patient package inserts across the counter with the prescription and expect the patient to be adequately informed about his medication. We should take a moment to explain the information and allow the patient to ask questions pertaining to his medication. Often, when there is no discussion of the warnings, the patient never reads or is unable to comprehend the written instructions pertaining to his medication. How many times have you been asked a question by a patient on a refill prescription, only to find that the answer was taped to the side of his prescription bottle all along? Pharmacy is an exciting profession and with the rapidly advancing technological innovations it is bound to be more exciting and challenging in the future. One thing cannot be replaced by technology, and that is the pharmacist's rapport with his patients . Adherence to diet is especially important for the patient who requires insulin. Food must be ingested in quantities and at intervals that are planned to avoid marked hyper- or hypoglycemia. Factors such as fiber content in the diet can also play a role in controlling postprandial hyperglycemia. In the diabetic patient who does not need insulin, the basic diet is one that would probably be ideal for most people- total calories adequate to achieve and maintain ideal body weight, restriction of simple sugars, and a decrease in the total animal or saturated fat intake. Oral hyperglycemic agents Many agents have been investigated for hypoglycemic activity, but only two types of compounds (continued on page 18) Seminar Opportunities! -.... · Sponsored by the Governor's Task Force on Venereal Disease. Subject: Sexually Transmitted Diseases Place: Hotel Utah Motor Lodge April 21, 1979 Date & Time: (Registration Time 8:00 am) Keynote Speaker: The Honorable Scott M. Matheson 8:45- 9:00 am C.E. Credit Given: 5 hours approved C.E. Fee: $10.00 Contact: Mr. Ed McFall at 966-4269 Registration will be limited - Suggest Pre-Registration. Contraceptives; Pharmacists' Role April 8, 1979 Registration 8:00 a.m. - Skaggs Hall College of Pharmacy Contact Albert Olson 581-6304 FTC and HEW Introduce Model DPS Law Two U.S. government agencies have gone on record in favor of a state model drug product selection law which embodies principles which APhA has been supporting since 1970. In a joint press conference on January 10, Health, Education and Welfare Secretary Joseph Califano and Federal Trade Commission Chairman Michael Pertschuk introduced a model drug product selection law which was developed by the Federal Trade Commission (FTC) in conjunction with the Food and Drug Administration. This drug product selection law is designed to serve as a model to states modifying or enacting such legislation. Option for pharmacist Under the model law, the pharmacist has the option of selecting lower-cost therapeutically equivalent drug products for patients in lieu of the prescribed brand name product. The patient would receive notification, and if the patient chooses to accept the equivalent source of the drug product, the law would not require the pharmacist to pass on all of the cost savings to the patient. A physician would have the option of writing the words "medically necessary" to indicate that the pharmacist should dispense only the prescribed brand or the generic produced by the manufacturer indicated. A positive formulary listing therapeutically equivalent drug products would be used by pharmacists in selecting drug sources. This formulary would be based on a list of therapeutic equivalents just proposed by the Food and Drug Administration. "The pharmacist, because of his or her specialized training, is the most logical person to search out the lower-cost generic equivalents," Pertschuk said. He added that the pharmacist must have an "economic incentive to sea rch out and stock" less expensive drugs. "Under state laws which require mandatory pass-em of all cost savings," said Pertschuk, "no matter how appealing on their face, the pharmacist coannot profit by so much as a penny for costs incured in searching for, stocking and dispensing" lower cost drugs. "Mandatory pass-ons provide an economic disincentive and should not be part of a drug product selection law," he said "For this reason, the model law would permit the pharmacist to retain a portion of the cost savings." Pertschuk said he feels that the marketplace itself would work to insure that pharmacists pass on to patients a healthy portion of cost savings from drug product selection. FDA's list At the same press conference, Califano announced that the Food and Drug Administration has compiled, for the first time, a list of 5,000 prescription drug products that it has approved a~ safe and effective. In issuing this list the FDA proposes to designate about 2,000 drug products as therapeutically equivalent. The majority of the rest are single-source drugs. In addition, Califano announced that he directed the Administrator of the Health Care Financing Administration "to set- by the end of the yearmaximum cost limits for all of the therapeutically equivalent drugs on the FDA list which meet the Maximum Allowable Cost (MAC) program's requirements." *The full text of the model act appears on page 15 of this issue. Over a Century of Satisfied Users Aids in treatment of simple sore throat and other minor mouth and throat irritations. • HALL's REMEDY P. 0 . Box 6231 Sa lt Lake City, Utah 84106 ORDER YOUR SUPPLY NOW CALL YOUR WHOLESALER 13 --~ "How can you do without it?" A Universal Cost Accounting System The Uniform Cost Accounting system is slowly but surely becoming recognized as essential if a pharmacist expects to do more than just get by financially. Dr. Bruce Siecker, director of APhA 's Pharmacy Management Institute, is overseeing the final preparation of a pharmacist's manual for implementing the Uniform Cost Accounting System for pharmacy, commonly called UCAS. "We've spent several years trying to solve a problem that has plagued pharmacists forever," said Siecker. "How do you determine your cost of dispensing?" The result of those efforts is a comprehensive manual that takes the pharmacist step by step through the process of implementing UCAS in his own pharmacy. The manual is expected to be released this month . "The purpose of UCAS is to separate prescription costs from all others in a systematic way," he said. ~ I t's a consistent, comprehensive way to measure costs." Determining costs of dispensing without UCAS is a laborious task, as anyone who has participated in the Touche-Ross fee study can testify. Some pharmacists spent more than eight hours fi ll ing out forms, and it took months for the results to go through bureaucratic channels before they were released. Seicker says UCAS "will overcome the deficiencies in other existing compilations. Traditionally, to find out costs of dispensing, surveyors just asked pharmacists what their costs were, and the pharmacist gave a rough estimate. The problem with this intuitive approach is that no one can prove it. Yet easily 85 percent of all pha rmacists determine their costs of dispensing intuitively. M edicaid can't prove it either, but they hold the purse strings. "The problem with fee surveys is that they try to measure costs one way, when different methods are used in different pharmacies. Moreover, in the end you know the state average, but not your own costs. "But UCAS," Siecker said, "gives the pharmacist an active role in knowing his costs. It represents a system so the pharacist knows what his cost of dispensing really is." UCAS does more than just identify dispensing costs, however. "It gives the pharmacist good information on cost so that the pharmacist can decide prices in all departments ," Siecker said, "and it shows him the results of his pricing. Once you know this, you can determine which areas need to be tightened up. lt'sone thing to make profits. I don't see how you can run a pharmacy without knowing this. A manager's abi lity to manage well is directly related to the information he has to work with. If you're Oying blind, you don't know what is causing you problems. "The end result of UCAS is a neat summary, and you've got documentation for government agencies when they want data on fees. The loose-leaf manual contains 35 chapters. "Everything is cross-referenced," Siecker said. "It's a sharplooking piece with some good artwork; we think pharmacists will like it." Siecket has planned the first special UCAS workshop for the upcoming APhA annual meeting this April in Anaheim . "I cannot overstate the valuable contributions pharmacists have made in helping develop UCAS," Siecker said. APhA will keep pharmacists posted on the progress of the user manual and other UCAS projects, he added . "UCAS doesn't make decisions," Siecker cautions. "The pharmacist looks at the summary and then he makes his own decisions - and he makes them based on valid, documented information. "It's more than an accounting system . It's a means to write an economic history of a pharmacy for use a s a management tool. It can accommodate any pncmg system." ... .... _- It's Time To Renew Your Membership On The "Pharmacy Team" Every member not only adds strength to the Association, but a lso helps bring success to the team. In regard to membership, "the state association must speak with a strong united voice - a voice that will speak for independent community pharmacits, employers and employees, pharmacists, as we ll as all other practitioners within our profession . We can no longer afford to let any segment go it alone, for no one is an island unto himself." Exercise your professional decision and join the winning team APhA, U PhA and your local association . Pharmacist members stimulate the Association into action and the Association. in turn, coordinates these 14 efforts while stimulating others into action . Using the organization as a coordinator, the Association provides a focus for mutual efforts and achievements . This teamwork - stimu lation / coordinat ion - is seen m every Association activity . There is strength m coordinated numbers. Dues statements are mailed early so that members may utilize such professional dues as a tax deduction. By renewing your membership early, you will be saving your Association money (which can better be spent on membership services), eliminating the cost of repeated billings. Make The Team ... Renew Your Dues Today! .. _ .. HEW/FTC Model Drug Product Selection Act Section I. (DEFINITION.) (a) "Established name" has the meaning given in Se~­ tion 502(e)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 352(e)(3)) • (b) "Equivalent drug product" means~ dr~g pro?uct with the same established name, active mgred1ent, strength, quantity and dosage form as the drug product identified in the prescription, and listed as therapeutically equivalent in the current (name of state) drug formulary. (c) "Prescriber" means a person licensed by the state of prescribe drug products. Section 2. (DRUG PRODUCT SELECTION.) (a) Unless instructed otherwise by the person rece!v!ng the drug pursuant to the prescription, a pharmacist filling a prescription for a drug product prescribed by its trade or brand name may select an equivalent drug product listed in the current (name of state) drug formulary. (b) The pharmacist shall not se lect an equivalent drug product if the prescriber handwrites "medically necessary" or words of the same meaning on the written prescription or, when ordering a prescription ora ll y, t~e prescriber specifies that the prescribed drug product IS medially necessary. The designation of medical ne~es_s1ty shall not be preprinted or stamped on the prescnpt1on. This subsection does not preclude a reminder of the procedure required to prohibit se lection of an equivalent drug product from being preprinted on the prescnpt1on. I # include the trade or brand name, if any, or the name of the manufacturer, packer or distributor of the drug product dispensed.· Section 5. (DRUG FORMULARY.) (a) The (state health department, board of pharmacy or drug formulary commission) shall establish and maintain by regulation a (name of state) drug formulary of equiva lent drug products. This formulary shall list all drug products the Commissioner of Food and Drugs, United States Food and Drug Administration, has approved as safe and effective, and has determined_ to be therapeutically equivalent. The formulary shall hst all drug products that were not subject to premarketing approval for safety and effectiveness under the Federal Food, Drug, and Cosmetic Act, that are manufactured by firms meeting the requirements of that Act, are subject to pharmacopoeial standards adequate to assure product quality, and have been determined by the Commissioner of Food and Drugs to meet any other requirements necessary to assure therapeutic equivalence. The formulary may li st additional drug products that are determined_ by the (department, board or commission) to meet requirements adequate to assure product quality and therapeutic equivalence. (b) The (department, board or commission) shall provide for revision of the formulary as necessary but not less than annually. (c) The pharmacist shall not se lect an equivalent drug product unless its price to the purchaser is less than the price of the prescribed drug product. (c) The (department, board or commission) shall provide for distribution of the formulary and revisions to all pharmacies and prescribers licensed in this state and to other app ropriate individuals. (d) The pharmacist, or the pharmacist's agent .. assistant or employee shall inform the person rece1vmg the drug pursuant to the prescription of the selection of a lower-cost equivalent drug product and of the person's right to refuse the product se lected. (d) The (department, board or commission) sha ll assess the need and if appropriate provideforpubliceducation regarding the provisions of this act and from time to time shall monitor the effects of the act. Section 3. (PRESCRIPTION LABEL.) Unless the prescriber instructs otherwise, the label for every drug product dispensed shall include the product's trade or brand name, if any, or its established name and the name of the manufacturer, packer or distributor, using abbreviations if necessary. Section 4. (PRESCRIPTION RECORD.) The pharmacy file copy of every prescription shall Section 6. (PHARMACIST LIABILJTY.) (Optional) A pharmacist who selects an equivalent drug pursuant to this act assumes no greater liability for selecting the dispensed drug product than would be incurred in filling a prescription for a drug product prescribed by its established name. Section 7. (ENFORCEMENT.) Section 8. (EFFECTIVE DATE.) 15 Room Registration Form for Utah Pharmaceutical Association PLEASE NOTE: We have reserved a block of rooms for your organization at the FOOR SEASONS MOTOR INN & CONVENTION CENTER in St. George, Utah. Your room reservation should be made directly with the FOUR SEASONS MOTOR INN. Special room rates for you are as follows: TYPE OF ROOM RATE One Queen Bed $24.00 One King Bed 26.00 Two Queen Beds 26.00 ~ -! Above rates are for two persons (deduct $4.00 if single) and are for rooms with THERMASOL In-Room Steam Bath. Direct correspondence to: ' l FOUR SEASONS MOTOR INN 747 E. St. George Blvd. St. George UT 84770 Telephone: [phone] (Toll free in Utah) 1-801-673-4804 (Out of state) CU T H ERE CU T H ER E ROOM RESERVATIONS FOR: Utah Pharmaceutical Association Please reserve accommodates for: May 3, 4, 5 NAME------------------------------ Organization----------------------------Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ City _ _ _ _ _ _ _ _ _ _ _ _ _ __ For the nights of May 3 4 5 (circle) State _ _ _ _ _ _ _ _ _ Zip _ _ __ Room Type Rate This reservation form will constitute a confirmed reservation. Reservations must .be cancelled before 6 p.m. of the first night's reservation to avoid being billed for that night. Please send $20.00 with this form to guarantee your room. We wil reserve the type of accommodation requested above. If we are sold out of that type of room, do you want us to reserve you a room in the next price bracket? Yes _ __ No _ __ 16 ·~ McKesson has vvhat you need to keep ahead of your cotnpetition. - - Today's pharmacy is undergoing rapid change. To remain competitive, you need the most advanced professional services you can get. And McKesson has them. prescription management, third party processing, patient profiling and more in one easy-to-use system. Convalescent aids. To expand the scope of your professional Computer management services. services, there's the SunMark® line Because the computer offers of convalescent health care products ... everything you need- from significant advantages to pharmacy wheelchairs to canes and crutchesmanagement, McKesson now pro· vides five different computer-based to establish a total home health care department in your pharmacy. programs: Economost-the most Pharmaceuticals/OTC's. For complete inventory management/ today's health-conscious Americans, order entry system available; McKesson provides a line of Econofiche- up-to-the-minute pharmacy information at your fingertips; vitamins, OTC products and pharaccounts receivable services through maceuticals offering quality, availability, broad item selection DRS; Touchtone®telephone orderand competitive prices. ing with Econotone; and our new Sundries. For special needs, the Econoscript program, which offers S/ DS Sundries Drop Shipment program offers a wide variety of promotional and staple sundries on a drop-ship prepaid basis. Pharmacy design. Your expanding role in the community may have led you to question the adequacy of your present facilities. Our Pharmacy Design Department provides a full range of services including store design, layout and location analysis. Services like these can give you the competitive edge you need. Ask your McKesson representative for details on how they can help. .~~ McKESSON ., -r ~. f?§ROBBINS DRUG COMPANY a Foremost-McKesson company Magnetism and Drugs The Force that Cures? Could sitting under a large magnet really be part of a drug therapy? It could be if a recent ly developed drug delivery system fu lfills its initial promise . This novel delivery system for water-soluble drugs consits of extremely small protein she res that contain magentic particles and an anticancer agent, doxorubicin. After the material is inject, the spheres can be moved to the desired site in the body by an externally applied magnetic fie ld . The use of these spheres resulted in 100 times as much drug administration. The preparation and characterization of this novel drug deli\-~ry system by Kenneth Widder, George Flouret, and Andrew Senyei, Northwestern University Medical School, are reported in the January 1979 issue of the Journal of Pharmaceutical Sciences, published by the American Pharmaceutical Association . Since this new type of delivery of chemotherapeutic agents allows for maximum concentration of an agent at the desired body site, much smaller doses than are now used would be effective. The use of smaller doses has the additional advantage of decreased toxicity. This type of delivery system using a carrier for the active drug ·may also be va luable in decreasing unwanted distribution of drug throughout the body and in eradicating localized disease conditions. Diabetes: An Overview ing stage. In sulin therapy is necessary in some stable diabetic patients who are subjected to stresses such as infection, pregnancy, a nd surgery. (continued from page 12) have been used in the United States- the sullonylureas and the biguanides. These oral agents have been useful for the management of hyperglycemia in maturity-onset diabetes since they were first used in the 1950s. The biguanides, however, were withdrawn from the market about a year ago, and the sulfonylureas should not be used with patients who require insulin, have hepatic or renal disease, are pregnant, or whose hyperglycemia can be controlled with diet alone. Although the precise mechanism of act ion of the sulfonylureas is unknown, they do stimulate endogenous insulin secretion . It is necessary that some insulin secretory capabilities be present for these agents to be effect ive. Pharmacology The oral hypoglycemic drugs are well absorbed from the intestinal tract. The potency, and, therefore, the dose and dosage frequency of the sulonylureas are largely functions of the metabolism and excretion of these compounds. Toxicity The annual reported incidence of adverse reactions to the hypoglycemic agents in the United Kingdom is about one reaction per 15,000 patients. Blood dyscrasias, skin reactions, cholestaticjaundices, hyperthroidism, and gastrointestinal symptoms have been reported. Toxic reactions are generally mild. Insulin Diabetic patients who have absolute insulin deficiency must be treated with exogenous insulin. Generally, persons who require insulin tend to be younger than age 30, lean, prone to develop ketoacidosis, and markedly hyperglycemic even in the fastIS Insulin Preparations Many insulin preparations are available. They differ primarily in the onset of action and duration of effects. Amorphous insulin was the first preparation avai lab le for clini cal use. Later, purified insulin crystals - such as crystalline zinc insulin, which has a rapid onset of action and can be injected subcutaneously or intravenously were produced and used in regular insulin. Preparations other than regular insulin have the effect of prolonging the hypoglycemic action. When insulin is mixed with a solution containing protamine and zinc, absorption from body fluids is less rapid and duration of action is longer. Each ml of protamine zin c insulin (PZ I) contains 40, 80, or 100 USP units of in sulin together with approximately 1.25 mg of protamine and about 0.2 mg of zinc per 100 units of insulin. An ideal ratio of protamine and regular insulin was formulated so that duration of action could be approximate ly 24 hours. This product is called PH (neutral protamine Hagedorn). Likewise, the addition of higher concentrations of zinc and changes in the buffer solution resulted in the lente family of insulins. Strength of insulin In the past, most physicians have used U-40 insulin to treat those patients who require less than 40 units perday and U-80 insulin for those requiring more. One-milliliter syringes marked with both U-40 and U-80 scales have been used common ly and have been the cause of many dosage errors. Therefore, 100 units per milliliter insulin and the U-100 scale one-milli lit er syringe were introduced commercia lly in 1973. U-100 (continued on page 19) U of U College of Pharmacy (continued from page 10) .,... application for admission to the professional program in which they include a statement regarding their reasons for wanting to pursue a career in pharmacy and their professional aspirations. They must also have three letters of recommendation submitted from individuals familiar with their intellectual abilities, work performace, communication skills, personality and maturity. The Admission's Committee reserves the right to request an applicant to appear for a personal interview. Requiring an interview with all applicants was considered but presented too many problems, both to the applicants and to the committee. However, any applicant requesting a personal interview will be accommodated. An attempt at a more quantitative application of admission criteria will be applied to the selection of the next entering class. Weighing factors based on relative reliability of criteria as indicated in various research publications will be applied to preprofessio nal core GPA, chemistry GPA, overall GPA, PCAT scores measuring scientific background, and PCAT scores measuring communication skills. A Diabetes: An Overview (continued from page 18) insulin is marketed as regular Semilente, Lente, NPH, Ultralente, and protamine zinc. The "purity" of U-100 insulin has been improved from 92 to 99 per cent. Substitution of U-100 insulin for both U-40 and U-80 insulins should reduce dosage mistakes, and the increase in purity may reduce both injection-site dermal reactions and generation of insulin antibodies. Complications of insulin therapy Exogenous insulin replacement is not as physiologic a process as was originally conceived. In contrast to physiologically regulated , endogenous secretion of insulin into the portal vein, exogenous insulin is given subcutaneously in one large do se. It is then absorbed continuously throughout the day, and food must be ingested at certain intervals and in specific amounts to avoid hypoglycemia or hyperglycemia . Because the injected insulin is a foreign protein obtained from animals, it consistenly causes production of antibodies to insulin in man. Fortunately , production of anti bodies sufficient to interfere with treatment is rare. However, some patients develop insulin resistance because of the insulin-binding antibodies. This condition sometimes improves with the substitution of pork insulin , which is less antigenic than is beef insulin . * * * This synopsis is intended only to review a small portion of the clinical concepts of diabetes mellitus . A more comprehensive discussion is available in tentative scale for quantifying the applicants stat ements of interest, motivation and professiona l goals ha s been developed and a weighing factor assigned to thi s. Certain priorities have been established, with first priorit y being given to Utah residents, followed by non-residents taking preprofessional work in Utah colleges, and finally other non-resid e nt applicants. From these various criteria and their respective weights, a composite value will be obtained which will, hopefully, provide a ranking of applicants that will rely less heavil y than in the past upon GPA figures and allow other pertinent factors a more important role in the selection process. The professional curriulum has recently been modified to provide instruction and experience in the development of communicative skills and the understanding of sociological aspects of patient care. Insight into an applicant's interest and aptitude in these areas cannot be obtained from the preprofessional G PA. It is hoped that the additional factors will provid e this insight. The deve lopment of knowledge and experti se in the communicative and soc iological areas will contribute to the preparation of our graduates from the present and future practice of the professio n. current standard textbooks. Because diabetes mellitus is an example of a common metabolic disorder that is encountered in patients who also have other di seases, it continues to stimulate investigation by sc ientists, pediatricians, surgeons, ophthalmologists, neurologists, and especially internist s. Advancements in the understanding of one disease often accelerate knowledge in others. Because of the variable complications or manifestations of diabetes, a basic understanding of the disease is imperative for all professionals regardless of their field of interest. Good diabetic management is a very complex and difficult task which necessitates both education and health professionals and patients in the technique s involved and close cooperation in patient management. Most important is a commitment to the view that better control, when achievable, is beneficial. Table 1. Characteristcs of Stages of Diabetes Stage Response to PBS Glucose Tolerance Response Test Symptoms I Prediabetes Normal Normal None Other Characteristics May ha ve thickened capillary basement membrane M ay temporarily deYelop Rare abnormal GTr response (Reactive with pregnancy. inHypoglycemia) fections . cortisone II Latent Chemical Diabetes Normal Normal Ill Chemical Diabetes Usually Normal Abnormal Occasional Delayed in>ulin respon>e usually seen IV 0\crt Diabetes Abnormal Abnormal U>ual As fasting hyperglycemia increases. the insulin response adequate become~ in- 19 Life Expectancy Increases for Americans By Marvin Rogoff, CLU Regional Sales Director Lone Star Life Insurance Co. A sudden and dramatic increase in life expectancy has developed during the past few years. From 1950 through 1970 the average American added 1.2 years to his previous life span. In only five years, 1971-76 life expectancy grew at almost twice the pace of the prior twenty years; adding one year. These figures are reavealed from a study completed by Martin E. Segal Company, a New York consulting and actuarial firm specializing in employee benefits. It was further revealed that the trend included both males and females and all races. Whereas the 1950-70 era study showed the moderate increase in life expectancy was due to a decline in mortality at younger ages, the more recent study reveals a different story. The 1971-76 period shows a strong rise in the remaining years for middle and older age groups. Based on the study if you are a 45 year old white male you have gained one year and can anticipate on an average, 28.7 remaining years . A female at the same age tacked on 1.3 years for a total of 34.9 additional years. A non white male was up 1.5 years to 26.1 years . An age 70 white male had his life expectancy increase from 10.5 to 10.9 years and from 13.4 to 14.4 R.S.V.P. Call for Resolutions Members of the Utah Pharmaceutical Association are invited to participate in planning association policy and direction. Exercise your membership privilege by submitting resolutions to be considered at the 1979 Convention, May 3, 4 & 5, in St. George . Start thinking now about the issues in which you believe UPhA should be involved. Submit resolutions in writing to UPhA Resolutions Committee, 1062 East 2100 South, Salt Lake City, Utah 84106. NOTE-Space has been allocated at the 1979 Convention for exhibitors (May 3, 4, 5 Four Seasons Convention Center). A number of the booths have already been reserved, but space is still available. You may know of companies or individuals who would be interested in exhibiting that the UPhA office has not contacted. Would you let us know, and we'll follow through by sending them information and an order form? We want to bring as many to the Utah Convention for you as we can. Members should be aware toot hat you can rent exhibit space if you have an exhibit. Let us know if you would like more information. Call 801-484-9141 . 20 years for female . Caution is urged not to accept these figures as a proven and reliable trend since they obtained over a relatively short period of time. In addition, accurate statistics required large numbers in addition to a lengthy period of time to iron out any "lumps" or "depressions" in the figures. In, however, these increases in life expectancy hold true we will be faced with further national problems. The increased life expectancy will bring additional pressures on pension or retirement funds to assure such plans can meet the time demand on those living longer. Provision for health care is another problem faced by a nation with an aging population . Also, can our country utilize the abilities of the aged by keeping them economically productive for addi tiona! years or providing fulfilling retirements for those years? Also are we faced with the compounding of the problem with early retirements becoming commonplace? It appears that an increasing percentage of the American population is moving into "geriatric era" and this should bring about interesting demands on our American socio-economic life style. University of Utah College of Pharmacy Alumnae & Friends Breakfast Time and Place: Saturday, May 5, 1979 7:30 to 9:00 a.m. Four Seasons Convention Center St. George , Utah Program: Breakfast meeting with informal remarks by Dean Harold Wolfe and Student APhA Representative, fallowed by a question and answer period . Everyone in attendance at Convention is in vited (with a special in vitation extended to the wives)